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First of all, I think it’s very sad that the fevered outburst of Senator Joe Wilson is getting more news coverage than the content of the speech he was bursting out about. And many liberals are basking in their outrage that a man would yell at the president during one of his royal courts, and loving all of the fury and disdain being heaped upon the Senator. Really? Obama’s a human being, and a politician, and deserves to be called on his shit. If he doesn’t lie, he certainly talks out of both sides of his mouth enough that you can’t pin down his claim well enough to determine it’s truth or untruth.
Of course, Joe Wilson was also full of shit, and IS being called on it. But funny that when you bomb civilians in Afghanistan and Pakistan, or give trillions of taxpayer dollars to wealthy investment bankers, it’s no big deal. But when you yell rudely during a speech, you clearly owe the nation an apology.
It also pissed me off when I listened to the NPR talking heads on the radio prior to Obama’s speech. They were talking about what Obama had to say in his speech to win political points, or bring up his poll numbers, or win public support for health care reform. I was thinking, “hey! Why not talk about what he has to do so that my working poor friends don’t get sick and die?”
While health care insurance reform is certainly an important issue, there are many other important issues about American health that aren’t getting much mainstream news coverage. The incredibly unhealthy American industrial diet, the way that healthy foods are often out of reach (economically or geographically) of poorer folks, the uber-busy American work/commute-day that gives them little time to cook or exercise, air pollution, water pollution, and more. None of these issues are currently on the table, just the idea of making some moderate alterations to health insurance regulations.
Which is important, of course. The best figures I can find say that about 22,000 adults die each year solely because they don’t have health insurance (the figure’s a little squiggly, it only covers people 25-64. What about children or the elderly?). That’s 7 9/11’s a year. The deaths of three thousand by horrible terror attacks, we have enough passion to invade two countries (three, if you count the ongoing attacks on parts of Pakistan), give sweeping new powers to the goverment, and scorch large portions of the Constitution. 22,000 dead from corporate business-as-usual, well, that’s not enough to get the blood pumping. Because it’s all part of the plan, as the Joker might say.
The simplest health insurance reform I’ve heard is to expand Medicare. Lower the entry age, let people buy into it, something like that. Americans love them some Medicare, I imagine this idea would be very popular, and not require gymnastic contortions to pull a workable legislative plan together.
One more interesting point, is that for all the fear that the Obama plan is “government-run health care” (it isn’t), a number of recent studies and surveys say that the best health care in the United States today is the Veterans Health Administration (VHA, or VA). This is hard to believe, given the VA’s popular reputation, especially the Walter Reed scandal, but it appears to be true. Of course, this apparently high quality health care institution is government-run health care. Not single-payer national health insurance, like the UK or Canada or Medicare, but actual government doctors, government hospitals, etc. I’m not saying that America needs an all-government health institution for all Americans, just throwing this out there.
And finally, the train wreck of our national health care also shows how bankrupt American democracy really is. In a recent speech, Noam Chomsky pointed out how Americans have favored some sort of national health care program for five or six decades, but it’s always called “politically impossible” by politicians and the press. And it is only now coming to the fore, he claims, is because some big American businesses are starting to favor it: if the government pays for people’s health insurance, the companies don’t have to spend the money to buy it for their employees (it’s a wonder that more businesses haven’t been on this bandwagon for years). But there’s our democracy: large majority of the voters, no change; some players in the business world, Congress takes action.
Okay, let’s start looking at the new plan that Obama outlined in his big speech.
The first part sounded promising: laws to prohibit insurance companies from dropping customers when they get sick, from limiting coverage, and from using pre-existing conditions as an excuse not to take on new clients in the first place. The devil will be completely in the details on this part. If the loopholes are big enough, or the enforcement lax, these provisions will be meaningless.
The second part sounded shady-to-appalling. First of all, all Americans will be forced to have health insurance. If you’ve got it now, cool. If you don’t, you’ll be forced to buy it. His reasoning is valid, that no insurance company would willingly accept the prohibitions mentioned above, without having a larger base of healthy client premiums to add to the pot. But fuck them. Seriously, I give 0% of a shit about insurance company CEOs and their shareholders and their diamond-encrusted polo ponies. Fuck them and what they want. Any justice-minded politician at all would be looking at ways to break the backbone of the insurance companies’ power, not how to help them maintain or prosper.
Then Obama mentioned some confusing “health insurance exchange”, which would somehow make insurance affordable for people who currently can’t afford it. Um… okay? I don’t understand what this is, and have not seen any revelatory analysis that explains what the fuck these exchanges are, how they will work, or how the free market– which so regularly allows capitalistic vultures to pick everyone’s bones clean– is going to accomplish this. His argument is that insurance companies will be competing with each other for all these new customers, and therefore the rates will become cheap and affordable. Honestly, these days companies compete not through price and quality, but through advertising, so I don’t see this as likely.
If you still can’t afford this new, cheap insurance, you’ll get tax credits that will make up the difference. This also kinda sucks. If you can’t afford it, you might not be able to afford paying for it, and then getting that money back in a tax return twelve months from now. I’d prefer some sort of subsidies right away for these folks.
Then, Obama somehow talks about how great it would be to have a public option (as part of the health exchange), yet seems to also say that it’s not mandatory for his new plan to have a public option. This would be presumably some sort of Medicaid-like program, but again, no details, not even enough to tell if this will even exist. This is the only saving grace of his “exchange” idea. If there is a public option, it might actually be a cheap alternative for people. Otherwise, I imagine many of the nation’s poor wil be forced to buy insurance with cheap premiums, little coverage, and exorbitant deductibles if they ever try to actually use their coverage.
The only other good news about this is that there will be some sort of “hardship waiver” for people who still can’t afford health insurance, even after all of the wonderful half-ass measures above. Again, devil in the details, it will depend on what the government defines as “hardship” and how difficult they make it to get one of these waivers.
But never mind that, Obama said that it would take four years to set this up in the first place.
The rest of the plan is about methods to cut cost, which is ridiculous since we’re a) keeping the same corrupt, inefficient, for-profit insurance companies at the head of this thing and b) making it illegal to negotiate with corrupt, inefficient, for-profit drug companies to get medicine at more reasonable prices.
How does the Obama plan match with any of the bills that Congress has actually compiled to vote on? I have no idea. Seems like the whole plan’s moot if no legislator actually puts these elements into a bill.
In conclusion, I typed a lot just now.