Wednesday, July 29, 2009

POLITICS- Dennis Prager Has 10 Questions About Health Care

Dennis Prager has written an article that asks 10 questions about the health care debate and postulates that no one can answer them. I haven’t said anything about health care because I’ve been waiting to see not if the Democrats were going to screw it up but how the Democrats were going to screw it up. If you think the Dems are any less beholden to money they get from the Insurance industry than the Reps are then you think the Dems weren’t equally responsible for the banking meltdown or the Iraq war. I’ve got news for you, both parties are working for the same people and those people aren’t the American public at large. That’s why Dems keep talking about needing a Bi-Partisan plan even though they have enough votes to do it unilaterally. They need some cover for the crap they are going to build into the bill to protect the insurance industry!

But Prager is just a moron. So here are the answers to his idiotic questions.

1. President Barack Obama repeatedly tells us that one reason national health care is needed is that we can no longer afford to pay for Medicare and Medicaid. But if Medicare and Medicaid are fiscally insolvent and gradually bankrupting our society, why is a government takeover of medical care for the rest of society a good idea?

Since this question (and the other nine for that matter) isn’t a question but a group of questions I’ll take each one in turn. (I used to listen to Prager’s radio show in Denver so his inability to count isn’t surprising to me.) First of all, it isn’t a “government takeover”, it’s an alternative to having a quarter of the country without health insurance. And it’s a way of having some control over costs that we are all paying anyway.

> What large-scale government program has not eventually spiraled out of control, let alone stayed within its projected budget?

This is a good point and why I’m not completely without sympathy for the Tea Party Revolutionaries and anyone else who thinks government isn’t the first, best answer to most problems. Unfortunately, we only have two choices: (1) deal with the problem or (2) ignore the problem. We’ve been ignoring the problem and that has escalated costs anyway. Unless you are happy that if you aren’t rich in our society then eventually you are going to get a major illness and when you do it’s going to take away everything you’ve been able to acquire during the course of your life then you realize we have to do something.

> Why should anyone believe that nationalizing health care would create the first major government program to "pay for itself," let alone get smaller rather than larger over time?

Because insurance companies are profitable. Saying that you don’t think the government can do it is not the same as saying that it can’t be done. Insurance companies do it.

> Why not simply see how the Democrats can reform Medicare and Medicaid before nationalizing much of the rest of health care?

Medicade and Medicare are in trouble because the population is aging. Having a universal health care system would actually help these systems by including the younger wage earning population. It’s called “dispersed risk” and it’s the reason insurance was invented in the first place.

2. President Obama reiterated this past week that "no insurance company will be allowed to deny you coverage because of a pre-existing medical condition." This is an oft-repeated goal of the president's and the Democrats' health care plan. But if any individual can buy health insurance at any time, why would anyone buy health insurance while healthy?

Because they were required to. Like they are required to buy car insurance.

> Why would I not simply wait until I got sick or injured to buy the insurance?

See above answer.

> If auto insurance were purchasable once one got into an accident, why would anyone purchase auto insurance before an accident?

Because they are required to. Why is this so hard? If you want to drive a car, you have to have insurance. If you want to live in a country where health insurance is considered a right, you have to buy health insurance. It’s no different than wanting the roads paved or the military to protect us from invaders. We all pay for the things we decide are necessary for the common welfare. It’s the purpose of government in a democracy.

> Will the Democrats next demand that life insurance companies sell life insurance to the terminally ill?

Straw man. Nobody is talking about life insurance.

> The whole point of insurance is that the healthy buy it and thereby provide the funds to pay for the sick. Demanding that insurance companies provide insurance to everyone at any time spells the end of the concept of insurance. And if the answer is that the government will now make it illegal not to buy insurance, how will that be enforced? How will the government check on 300 million people?

Uh, the way they do with taxes? And you notice that here he does realize what ‘dispersed risk’ is even though he pretended not to earlier.

3. Why do supporters of nationalized medicine so often substitute the word "care" for the word "insurance?"[?]

I don’t know why either. What we are talking about is a government run health insurance plan, not government run health care. I’m sure the Republicans would have called it something more attractive.

>[I]t is patently untrue that millions of Americans do not receive health care. Millions of Americans do not have health insurance but virtually every American (and non-American on American soil) receives health care.

And that’s the whole problem. These people are being cared for and we are all paying for it. The only difference is that we have no control over that. And the result of having no control is that most of that care is being delivered in Emergency Rooms. If you don’t have health care you don’t go to your local doctor- he’s going to tell you to fuck off. You go to the Emergency Room where they HAVE to take you. The result is that when you show up in an ER you sit in the waiting room bleeding while the treatment room you should be in is filled with the child of some welfare mother who waited until her child had been throwing up for three days before seeking treatment. Giving people who rely on ER’s for standard treatment an option, and making them use that option is the only way to keep the system working.

> No one denies that in order to come close to staying within its budget health care will be rationed. But what is the moral justification of having the state decide what medical care to ration?

Because the state has to be responsible to the whole citizenry while the insurance companies only have to be responsible to their stockholders. Do you think care isn’t rationed now? Are you familiar with the word “triage”? This claim is simply more rhetoric without understanding. Something I’ve found Prager to be full of. (As well as the other thing he’s full of.)

4. According to Dr. David Gratzer, health care specialist at the Manhattan Institute, "While 20 years ago pharmaceuticals were largely developed in Europe, European price controls made drug development an American enterprise. Fifteen of the 20 top-selling drugs worldwide this year were birthed in the United States." Given how many lives -- in America and throughout the world – American pharmaceutical companies save, and given how expensive it is to develop any new drug, will the price controls on drugs envisaged in the Democrats' bill improve or impair Americans' health?

This is the same argument the republicans use to prevent taxing the rich. If you tax the people with all the money they won’t invest it. BULLSHIT! In fact, this is bullshit squared. First of all, European drug companies were suddenly working in an environment where they didn’t have to develop new drugs to get paid, they could just import drugs from America and get paid for them. By making the European drug companies compete on a level playing field with American companies you not only spur development on both sides of the Atlantic, you stop Americans from having to bear the brunt of all the R&D for the whole world. When the rest of the world stops being able to profit from American research subsidies perhaps they will get back into the business of developing drugs and treatments.

5. Do you really believe that private insurance could survive a "public option"?

Ah! Finally we get to the heart of it. This isn’t about what’s best for America or Americans or even the world. This is all about protecting the insurance companies obscene profits.

6. Or is this really a cover for the ideal of single-payer medical care?

Huh? Personally I’m a proponent of going back to the system we had before the end of the second world war. If medicine wants to compete in the free marketplace, then let them get paid the same way everybody else does. I don’t have plumber insurance, or furniture insurance, or television insurance. When I want one of those things I pay for them. Likewise, fifty years ago if you wanted to see a doctor you paid him out of pocket. It kept costs in check. It established a meritocracy (truly great doctors could command a premium payment). And it was a free market. Is that what the conservatives want? Hell no.

> How could a private insurance company survive a "public option" given that private companies have to show a profit and government agencies do not have to – and given that a private enterprise must raise its own money to be solvent and a government option has access to others' money -- i.e., taxes?

Duh. The whole debate is about whether there should be a middle-man in healthcare who decides who lives and dies and whether they should have any accountability to the average citizen or just to making money off the deal. Leave it to Prager to miss the whole point. If insurance companies can’t compete then tough. They shouldn’t have gamed the system until they broke it.

7. Why will hospitals, doctors, and pharmaceutical companies do nearly as superb a job as they now do if their reimbursement from the government will be severely cut?

Because half of more money than you should have is better than none? Because if they wanted to be whores for money they would have been political pundits, not doctors? Because caring for the sick has always been a calling while being a propagandist for your rich masters was always a job for wanton whores?

Dennis, everybody ain’t like you. Some of us have a conscience. There have always been doctors, even when getting rich wasn’t part of the equation.

> Haven't the laws of human behavior and common sense been repealed here in arguing that while doctors, hospitals and drug companies will make significantly less money they will continue to provide the same level of uniquely excellent care?

Again, everybody isn’t like you. Some of us think that there is more to alleving human suffering than making a fat paycheck.

8. Given how many needless procedures are ordered to avoid medical lawsuits and how much money doctors spend on medical malpractice insurance, shouldn't any meaningful "reform" of health care provide some remedy for frivolous malpractice lawsuits?

My answer to this has been the same since I was in college twenty years ago in Florida, when doctors were getting out of the profession because their malpractice premiums were skyrocketing. Fifty percent of the malpractice claims at that time were against four percent of the doctors in the state! Which is easier? Getting rid of the four percent who were making all the mistakes or driving all the good doctors out of the system?

Frivolous lawsuits? Often the only way we have to weed out bad doctors is through the civil courts. You want to take away the last check and balance in a health care system run by doctors who wont censure their own even when there is compelling evidence that they are incompetent?

9. Given how weak the U.S. economy is, given how weak the U.S. dollar is, and given how much in debt the U.S. is in, why would anyone seek to have the U.S. spend another trillion dollars?

Given how we’ve gone into debt to fund a worthless war and to fund a bailout for Goldman Sachs and the other richest people in the country, how can we insure the plebeians? Agro-business subsidies? Sure! Corporate welfare? You betcha! Why is it that the Republicans always draw the line only when some regular citizens might get some good from it?

> Even if all the other questions here had legitimate answers, wouldn't the state of the U.S. economy alone argue against national health care at this time?

Again, WE ARE ALREADY PAYING FOR THE UNINSURED! Do you think when someone uninsured gets treatment that the Health Fairy pays for it? Your health care costs and insurance payments go up to pay for the treatment! The only difference is whether you want to pay a 1-2 percent surcharge for Medicare’s overhead or a 20-30 percent surcharge for the insurance industry’s overhead.

10. Contrary to the assertion of President Obama -- "we spend much more on health care than any other nation but aren't any healthier for it" -- we are healthier. We wait far less time for procedures and surgeries. Our life expectancy with virtually any major disease is longer. And if you do not count deaths from violent crime and automobile accidents, we also have the longest life expectancy. Do you think a government takeover of American medicine will enable this medical excellence to continue?

Sorry, this is just more Prager bullshit. We pay more than almost every other industrialized nation as a percent of GDP, we don’t have the longest life expectancy, and we don’t have the most access to treatment. Don’t trust me- look it us for yourself!

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