Better Than Nothing?

So, I have a problem with the current proposals for health care reform on the table. And this problem, to put it bluntly, is that these proposals suck giant donkey testicles. I’m not going to pussyfoot around here: I’m totally opposed, and I’m totally pissed. For once, I find myself in agreement with the right, except for entirely different reasons.

I’ve been going back and forth on this issue with Tristan. I think that the plan sucks because it doesn’t go far enough, and that it could potentially be highly damaging in addition to totally useless. He argues (to paraphrase hours of conversation) that something is better than nothing. Reform is needed, the popular argument goes, and thus any reform is better than no reform.

But I don’t actually agree with this stance. And I think that this argument is dangerous, because it’s being used to push people into supporting this plan. It’s the same problem I had during the Presidential primaries: being forced to choose between a bunch of candidates I did not like was not actually being presented with a choice. And I don’t understand why American politicians continue pretending that they are presenting actual, valid, diverse choices, because they aren’t.

So, here’s the thing. The health care system is not working. I’m not going to argue with that. But the solution, in my mind, is not to try to repair it from within the framework of the existing system. The solution is to totally dismantle the system. We don’t want to fight the status quo, we want to erase it. In real estate terms, the health care system is a teardown. Do we want to spend a bunch of money and energy trying to prop it up and fix it? No. We want to hire a demolition company to destroy this sucker and clear the ground so we can build a new one. Or ask the fire department if they’d like to burn it down for practice, if we’re feeling like turning demolition into a public service.

Any reform is like, well, trying to patch a leaky boat with cheesecloth. The system is so complex, so loaded with bureaucracy, so insane, and the lobby is so powerful, that “reform” will have basically no effect. Especially because there’s a really simple solution: national single-payer healthcare.

I’m not just saying this because I’m a raging socialist. A national single-payer plan is more cost efficient than any other system. It’s better medicine. It guarantees access. It just makes sense, from multiple perspectives, and it’s pretty easy to implement. Logically, it’s the best and really the only solution, yet it’s basically not being discussed, because everyone is so terrified of the health insurance lobby. Single-payer advocates weren’t even invited to the table when it came to discussing plans.

I don’t want a “public option.” A “public option” will be effectively useless. I’m willing to bet that any “public option” would not cover me, and if I was forced to buy private health insurance under mandates, it would bankrupt me, because I’d be paying stratospheric premiums and paying for all of the health care that my insurance wouldn’t cover. I would be faced with paying penalty fines or buying a crappy plan I couldn’t afford. Furthermore, a “public option” will effectively damage any potential chance at a national single-payer system, because it is going to fail and therefore it will be used to beat advocates for healthcare reform over the head forever.

Talking with RMJ about this, RMJ said that if we went to¬† national single-payer, we would lose jobs, because people in the insurance industry would no longer have jobs. I argued that this wasn’t actually the case, for a number of reasons; private insurance companies would still exist and people would have the opportunity to buy additional coverage from them if they wanted, for starters, and a national single-payer system would actually create jobs, because we would need administrators and staffers to manage it.

Furthermore, I think that the “what about the workers” argument is a red herring used to prop up capitalist inequality. I’m a utilitarian. I go for the greatest good for the greatest number, and the greatest good in the long term. I think that things like job loss and bank failures are acceptable, if they lead to improvements in the future. I think that using “the workers” to prop up and maintain a broken system is despicable, especially when people are tricking those same workers into believing lies and rightwing propaganda.

These proposals are not, in fact, better than nothing. They are worse than nothing, because if nothing was done, people might actually revolt, overcome the power of the insurance lobby, and do something. Instead, these plans are going to be used to lull people into complacency, while allowing the rich to get richer. Oh, and while ensuring that people like me will continue to be deprived of access to health care.

6 Replies to “Better Than Nothing?”

  1. I am so definitely about single payer. There would be some things that would have to be dealt with to make it fair and acceptable but long term it would be so much better than our current system that people would look back and go “were we nuts?”

    OTOH, health reform is a great thing to get people arguing about. What is proposed will not much change the status quo but the arguing gets people minds off other things such as everlasting war, a deepening economic depression, etc.

  2. As I’m not American, not sure what you mean by single payer system. (In fact, I’ve given up trying to follow this debate – because, as someone who has grown up in a socialist democracy (Australia) alot of the debate seems steeped in the notion that if people can’t afford healthcare, that is their problem, and I’m not going to pay for it!! – Which, I find abhorrent, and which, my Dallas habituating family have expressed in no uncertain terms.) I have to wonder why you think a public system won’t work? We have a public system (though it may have inadequacies) that does work, despite its problems. And, it doesn’t bankrupt us, either.

  3. Ok, so, I’m going to define some things, but brace yourself, this gets long. I’m sorry, I really have not been thinking about international readers at all when talking about health care issues, thanks for alerting me to the fact that the content on a lot of my posts about health care has probably made no sense at all.

    The first thing to be understood is that the debate in the United States, right now, is not about health care. Oh, you think it is, and they want you to think it is, but really, it’s about health insurance. The government, right now, is focusing solely on how to get Americans to buy health insurance, rather than thinking about how to provide health care to Americans. This is one of the consequences of living in a capitalism society which is effectively run by corporations.

    In the US, the term “single payer” is used to refer to a health care system in which everything is covered by the government; the government is the “single payer” which provides all coverage, either by paying for it or directly providing it through government-owned facilities, government-paid health care providers, etc. (People also use terms like “socialized medicine” to refer to such a system.) Basically, what we are calling single payer is probably what you have in Australia? I don’t know much about the Australian health care system, so I may be wrong; please feel free to educate me on how your system actually works. I am pretty sure that it would be safe to say that single payer=what you call a public system. “Public option” and “public plan” are actually types of insurance for which people pay, which would be provided (or possibly subsidized) through the government. In other words, “public option”Ͱ”public system.”

    The “public option” which is getting thrown around in the news a lot is basically an extension of an existing government plan (there are several health plans run by the government here: Medicare, Medicaid, military/VA care, and the health plans open to members of Congress and government employees, some of which run state by state, some of which run nationally…gee, I can see how the debate would be confusing) which would be opened to some people, but not everyone, and for which people would be expected to pay. It is by no means a public system.

    Do folks overseas think that when the government talks about a “public option,” they mean a single payer plan? Yikes. I guess using “public” in their rhetoric is working out better than they realize, since an alarming number of Americans also think that “public option” or “public plan” also means “single payer.” (And, as you have noted, are reacting violently against the very idea of providing health care to anyone, let alone everyone, which is one of the reasons why nationalized single payer would be so hard to push through. The other reason, of course, is that it would threaten the profits of the insurance companies and the health care industry, which is why they have lobbied against it so effectively that advocates for nationalized single payer have not even been invited to participate in round table talks about possible plans for reform.)

    So, what I am asking for (and what many intelligent people are asking for) is a nationalized single payer plan, which means that we want the federal government to provide complete health care to all citizens. (As opposed to a state by state plan which might have irregular coverage and be run inefficiently.) I do not want the “public option” because it focuses on health insurance, rather than the provision of health care, it does not cover everyone, and citizens would have to pay for it. The “public option” being discussed in the media here is just another type of health insurance which many Americans couldn’t afford, and my argument is that maintaining our current system with one more insurance option will not fix America’s health care issues, like lack of access to care, skyrocketing costs, etc.

    Now, I recognize that a nationalized single payer plan would cost the taxpayers money; probably taxes would go up (although they don’t really need to, we have the funds to run such a system if we totally dismantle the existing system and rebuild it, because the current government-run/government-paid plans are hugely inefficient, and if streamlined into a single system which also included all Americans, they could be run more cheaply) and there would probably be some copays, which I am also ok with. I’m also ok with people buying private insurance for supplementary care, which is, I understand, what some people do in Britain (and possibly Australia?). In other words, I want a plan where the government owns and runs hospitals, clinics, etc, and people can get care there, but I’m also ok with there being private clinics/hospitals/etc which people can pay to go to, if they want to. And I’m ok with people buying insurance to cover things which will not be covered by the government. The government’s coverage, I think, should be based on evidence based medicine, with the government actually studying things to determine how coverage can be offered more efficiently, and not paying for things which it believes is not effective. I know that this is done in Canada, and I think it’s a good standard of care.

    This long and meandering explanation is really making me think that I should do a primer post outlining some of the terms we use and the problems with our system; is that something you and other international readers might be interested in?

  4. Mel – that is the best explanation of this fiasco (which is what I really do think it is) I have read.
    And you are right, what Americans are referring to as ‘single payer,’ is what Australians refer to as the public health system. (Which many people, especially foreigners, also refer to as socialised medicine)
    As with Britain, we have the option to purchase private health insurance – which provides you with a level of hospital cover, and a whole bunch of extras. One of the biggest motivating factors for this is the dental extras. We hardly have a public dental system worth speaking of, (in fact, dental decay is our biggest preventable disease), thus private health insurance.
    Personally, I would be interested in a write up explaining the basics of the current healthcare debate… sans death panel hysteria. (Although, admit, seeing photo’s of the crazies coming out of the woodworks has provided a level of amusement, when I have the benefit of distance. Then amusement falls to bewilderment.)

  5. Also, thought that you might be interested in how the finances work out.

    Essentially, there is a Medicare (which is what we call our public health system) Levy that you have to do when you do your tax. However, it changes depending on how much you earn. When I was at uni, I never had to pay a Medicare levy. Really, at the end of the day, it isn’t that much either. (Comparatively.. we are the highest taxed western country, I believe. Not that it really bothers me at the end of the day. I can go to a public hospital, if I had kids send them to a public school and know that they can get into a top uni if they have the marks – I did… and regularly catch a reliable and safe public transport system. So – those taxes go a long way, I think.)

    Additionally, as you have pointed out above, public health systems employ bucket loads of people. At least, here they do.

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