Got health care?

Now that the Republicans have regained the House, health care is back front-and-center in the political spotlight. As an apoplectic opponent of the nanny state and all things politically correct, I take a contrary view on this singular issue. Consider: the cost of a night in the hospital in the U.S. is six times that in Europe. We spend more than twice as much per person on health care as the other rich nations of the world; fully one-sixth of every dollar generated by our economy. So, with one-sixth of the population with no health care coverage, and day-long emergency-room waits (the latter largely a direct consequence of the former): no, FoxNews et al, we don't have the best health care in the world. What we do have is arguably the very worst health care delivery system in the industrialized world.

Health care reform as a political imperative, specifically a single-payer system, has found a home in the Democratic Party.  To the Republican Party it is anathema, considered an evil on the order of paganism or communism. Hence the partisan struggle that erupted over it with the Obama administration’s initiative.

The Republicans' strategy was simple and effective: in Congress, oppose every facet and proposal to force cumbersome and costly compromises to the evolving legislation while attacking universal health care coverage in principle 24/7 in the media. The goal was to produce a final bill that would be so onerous, generating new opposition piecemeal with each new compromise, that it would simply be unworkable and eventually go down to defeat, falling down just shy of the finish line.

This simple but brilliant plan almost worked—everything succeeded but the final step: the bill actually passed.  Let me get this straight: the problem was that the cost of health care had grown to such absurd proportions that it was bankrupting individuals and businesses, hurting our ability to compete in the global marketplace (can you say “General Motors”?), not to mention the ever-growing cost of Medicaid and Medicare to the federal government. And so the final solution is not to implement anything that will actually reduce costs, but rather, simply require all Americans to buy health insurance— and to add insult to injury, inflict new costs to business! Yes, this is the worst of all worlds. Collectively and individually, we are now worse off than before “Obama-care” became law. Thank you, Republicans.

A typical health care premium costs between one and two mortgage payments. So, in the first instance, it is absurd and insulting to believe working-class Americans can afford this. Secondly, in the midst of the greatest financial/economic crisis since the Great Depression, the legislation places enormous new burdens on businesses small and large, guaranteeing a severe braking force on any potential economic growth needed to turn the corner and avoid going over the economic cliff (i.e., the so-called “double-dip”).

In the 2008 primaries, while the Republicans were elbowing each other out of the way to proclaim the authenticity of their denial of evolution, the Democrats were competing in an equally stupid manner. One after the other, each candidate asserted their allegiance to the notion that under their administration mental health would be treated no different than conventional health care. Wonderful. Hence, bipolar disorder, the scourge of our time, is to be considered a “disease” no different than diabetes. Common sense begs to differ.

How no Republican candidate failed to seize on this, if for no other reason than to distinguish themselves from their opponents, is beyond me. Instead, they all parroted the party-line  conservative talking points. Forgive me, but as a working-class American, my chief fear about health care is not that “a government bureaucrat gets between me and my doctor”—but that (a) I don’t have a doctor because I have no insurance, or (b) I don’t lose my home because I accidentally break my leg and the cost of surgery and several days in the hospital is counted in the tens of thousands of dollars.

And with respect to all those Canadians streaming across the border to take advantage of our superior medical care, please consider the following scenario. If Americans without any health care coverage or who can’t afford their growing deductibles and various out-of-pocket expenses were permitted to travel to Canada to take advantage of its supposedly terrible medical care, how would their numbers compare with the dissatisfied (and presumably inordinately wealthy) Canadians?  If it was me and the choice was (a) tough it out for several weeks until it’s my turn for the inferior medical procedure, or (b) lose my home to pay for it here where we have the “best system of health care in the world,” it’s a no-brainer.

And finally, to the complaint that socialized medicine would require rationing, I say, bring it on.  Of course rationing will be required!. But intelligent rationing—something that politicians from neither party have addressed. So, to help get the discussion started on intelligent rationing, here, off the top of my head, are some suggestions:

Alzheimer’s: yes;                Anorexia Nervosa: no.

Cancer: yes;                      contraception: not on my dime.

Gout: yes;                          General Anxiety Disorder: maybe next year.

AIDS: yes;                        ADHD: where’s daddy?

Bronchitis: yes;                  Botox: sorry, Nancy.

Appendicitis: yes;               abortion: not on your life.

Gallstones: yes;                  gender re-assignment surgery: go fuck yourself.

Dental work: yes;               breast implants: get over yourself.

Diabetes: yes;                    Depression: get a job.

Arthritis: yes;                     Alcoholism:  Have you made your decision for Christ?

Knee replacement: yes;      Nutrition: sorry, can’t afford it right now; do your own due diligence.

Osteoporosis: yes.             Obesity: try eating less?

Atrial Fibrillation: yes;        Asperger’s Syndrome:  get a life.

Testicular cancer: yes;       Tourette’s syndrome: fuck you.

Hospice: yes;                    “Death panels”:  no, Sarah.

The obscene cost of health care bankrupts Americans and businesses alike—and it is bankrupting the nation as a whole. A problem this big can't be fixed by tweaking the existing private insurance system with "market reforms," or tort reform—it is way too late for that. The only solution is the one employed by every other civilized nation in the world: a single-payer system.