Health Care Funding

Introduction

I believe I have the solution to the US health care crisis. The catch is American are too irrationally attached to ideologies to implement it. Yet the solutions are simple and will completely solve the problem.

Americans have been fed so much BS about health care that they are mightily confused about something that should be simple. The most important facts for Americans to know are:

Denying people the basics of life, food, water, shelter and health care is for all practical purposes attempting to impose the death penalty without trial. I think we should at least attempt to avoid doing it wherever practical.

The Problem

1. American health care works fine for Bill Gates. He gets the best health care money can buy.
2. The costs are spiraling 4% per year faster than inflation. The middle class and people on fixed incomes who buy medical insurance are getting squeezed.
3. The working poor cannot afford health insurance and have to go without medical care of any kind. It is a national disgrace that 46 million citizens of the richest country is the world receive the same health care as those in a Darfur refugee camp — namely none. According to a Harvard study, far more Americans die every month, month after month, from lack of health insurance than died on 2001-09-11. Yet Michael Steele, head of the Republican party, assures Americans there is no need to take any action.
4. It works reasonably well for those whose health care is paid for by the state with Medicare (the indigent) and Medicaid (the elderly and disabled).

The function of insurance companies is to make a profit. They do this by accepting premiums then refusing to pay out or refusing to continue coverage when people get sick. The paperwork doctors and hospitals must submit is mind boggling. It is the main reason American health care is so much more expensive than in other countries. It is complicated by the fact every insurance company wants it done a different way. The insurance companies give large amounts of money to politicians to make sure the patients have no legal recourse. Bill is still done largely with multipart paper forms without the efficiencies of computerisation.

Ideology

Americans are so patriotic they refuse to notice they are paying 3.5 times anyone else does for health care while they enjoy the worst health in the developed world, with the worst infant mortality, even when Kathleen Sebelius, Secretary of the Department of Health and Human Services, tells them the facts. They have an almost religious attachment to being ripped off. It is a Good Thing™ Americans long ago adopted indoor plumbing or they would also be claiming outhouses were superior to flush toilets.

Conservative politicians imagine they can save money by slashing public health care programs. Yes, such cuts get the expenditures off the government books and the taxpayer may save $1000 in public insurance fees, but he then has to buy those services from the private sector for $2000. The taxpayer is a net $1000 worse off, while the politician takes a bow for his brilliance.

Americans so strongly prefer to be screwed over by corporations than the government, they are willing to pay 3.5 times as much for health care as people in other developed countries. This is irrational. If the government screws you over, that money has at least some chance of being spent for your benefit. When a corporation screws you over, there is none. You would think someone who values money above all else would select his health care from whomever ripped him off least, no matter who they were. This is strikingly emotional thinking for Republicans.

Americans cross themselves at the thought of socialised public health care, but they cling tenaciously to the notion of socialised roads. They insist roads be paid for out of general revenue, unlike other nations that fund them with gas taxes or usage fees. They want those who cannot afford cars to subsidise those that can. This is socialism, American style, where the poor subsidise the rich.

Nobody ever gives a reason why the notion taking care of people panics them so much. It is a Pavlovian response trained into Americans by the corporations so they can take unfair advantage of them.

Christianity

Americans loudly proclaim to subscribe to Christianity, but when it comes to being your brother’s keeper they run the other way. Americans, if they were at the well, would have gleefully stoned the woman to death, despite Jesus’s efforts to protect her.

Americans have an informal scheme for ranking the value of a life. You get points for having more years of expected remaining life. You get points for having education. You get massive numbers of points for having money. You lose points for having health problems, a disability, dark skin or a drug addiction. So the value of the life of an elderly disabled homeless person is negative. This is why Republicans are so violently opposed to universal health care. They don’t want to waste resources on lives that they consider worthless. To the Republican, it is even more important to ensure unworthies don’t get health care than it is to ensure they get it for themselves.

Dueling Stances

There is so much B.S being slung in the American health care debate, trying to turn it into a freedom issue. There are essentially two points of view:

1. Whether people can afford it or not, they deserve health care. You can’t just toss sick or injured people out onto the street to die. We have to look out for one another! Food, water, shelter and medical care are basic human rights. Why should the right to life end at birth?
2. The ideal health care system is one that serves only the elite. Care for the important people should not be watered down by letting the little people in. The healthy and wealthy should not have to subsidise the health care of the sick and indigent. If people cannot pay, they deserve to die. Greed is good!

Americans pay 3.5 times much (and for inferior care) as people in other developed nations do, nations that cover everyone. Americans can’t afford to continue avoiding public health care on childish, delusional, ideological and emotional grounds.

Republican Motivation

Republicans suffer from terminal wishful thinking. In particular, they imagine their bodies will go on and on in perfect health, never growing old or decrepit. Thus they imagine health care insurance to look after them when they eventually do get sick is not only unnecessary, it is an affront to their freedom. They crave the Philippine system where the hospital literally tosses you out onto the street the day you can no longer pay the bills. The hospital doesn’t care if expulsion is your death warrant. Republicans may think they want that, until, of course, they need medical care and their private insurance company decides they are not profitable enough to insure or too costly to pay out. This happens to everyone eventually. The only people who can feel secure under such a system have at least five million dollars socked away to deal with their own health problems and their significant other’s. Republicans are under the delusion, that real soon now, they will be that rich. That’s also why they lobby for the interests of those much richer than they are.

Republicans wring their hands at the cost of public health care. Of course, it is expensive, but private care with 3.5 times even more costly. What matters is how much cheaper it is than private health care. It replaces private health care. It is not an additional expense.

There are three motives for Republicans to strenuously oppose universal health care:

1. They are Ayn Randians. They believe the sick, weak or poor should die. Some even oppose completely private insurance. This view lasts only until they become seriously ill themselves.
2. They strongly resent any of their money going to prolong the life of another. In their view, compassionate care of one another is weakness. Selfishness is the ultimate virtue, an attitude they unwittingly borrowed from Hitler.
3. Republican politicians take large contributions from private insurance companies to espouse such views. It is not just politicians who take under the table money. There are also astroturf rent-a-crowds.

The medicare debate in the USA is quite simple. The Democrats want to make sure seniors get health care, even if it means topping up the fund from general revenue. The Republicans want to get rid of medicare altogether. They want to abscond with the funds seniors have contributed over the years for their care. If the seniors don’t have money to provide their own private medical care, they should go without, even if it means dying. That is the same as an insurance company accepting premiums over the years then refusing to pay out. It is a breach of contract.

Who has the most generous publicly-funded health care in the world? US senators and congressmen who fight tooth and nail to ensure no one else gets anything anywhere near as good.

Trust

After watching the insurance companies and big pharma corrupt politicians, fund astroturf organisations and spread the most outrageous lies, I can’t imagine why any American would entrust them with their health care. After seeing the blatant corruption of senators and congressmen, I can see why people would not trust the U.S. government to have anything to do with health care. At least the people have to power the vote out badly misbehaving politicians. They have no power at all over the CEOs (Chief Executive Officers).

Capitalism

Everyone knows and applauds that corporations have only one concern — profitability. Why then are people so surprised when corporations lie and take serious risks with the customers’ health? Surely people know that lying is usually more profitable than telling the truth. Surely they know that risking customers’ lives costs less taking precaution.

Capitalism requires competition. When you don’t have it, the government must regulate the monopolies to prevent them from gouging and cheating the public. The health insurance companies have effectively eliminated competition by mergers and acquisitions. According to the American Medical Association, in 94% of America there is no longer a competitive market. The insurance companies have bribed American politicians to prevent them from introducing either regulation or competition from a public option. The insurance companies have a sweet deal, keeping $2 for every $1 they pass on to the doctors and are willing to tell any lie, bribe, threaten, anything to keep things as they are. What is so astounding is the way they have bamboozled so many Americans into helping them fight the competition needed for capitalism to function.

Supreme Court

Opponents of public health care in the USA have taken the case to the supreme court claiming a law requiring people to buy health insurance is unconstitutional. I think this is nonsense. There are unchallenged laws requiring you to buy car insurance, life jackets, fire extinguishers, smoke alarms, air bags, seat belts, snow shovels, lawn mowers, leaf rakes, child support and even clothes (nudity is illegal). Right wingers periodically try to pass laws forcing people to buy firearms. Whether the payment is a fee or a tax makes no difference to the consumer. The end result, either way, is money being taken involuntarily from the consumer’s pocket.

If the working poor wander about with out health care, they spread communicable diseases, especially TB (Tuberculosis) and HIV (Human Immuno-deficiency Virus) to those that have it. It is in everyone’s best interest to get everyone treated.

Cutting Costs

Republicans claim the only way to deal with spiraling health costs is to cast the poor and elderly to the wolves. This is nonsense. There many proven ways to cut the costs to 30% of what health care is costing now. Further, I offer a number of other ways.

Ways to lower the spiraling American health care costs include:

• The obvious place to trim is in the last year of life when 50% of all health care dollars are spent.

• Don’t force ail Mary, expensive, painful or low benefit procedures on the elderly, that can only hope to extend life by a few months.
• If an expensive procedure offers only a few months extra life, the patient should have to pay out of pocket.
• No more Hail Mary, painful, expensive procedures that can only hope to extend life by a few months.
• Doctors and hospitals deal with a single payer with fully computerised billing to reduce administration and paperwork no matter who ultimately pays. This is different from a true single payer as in Canada. This is just a way to simply bookkeeping.
• Pay doctors a flat yearly fee to keep patients well rather than paying them for every expensive and unnecessary test they order.
• Revise the tort system to punish only malfeasance, not simple mistakes. This will reduce malpractice insurance.
• Many levels of care so that people can live as independently as possible as long as possible.
• Legalise  physician-assisted suicide with safeguards to prevent pressuring either way.
• Research into nursing care technology — machines to keep the bed comfortable and clean, help patients into the bath or to their feet, help patients dress and undress, deliver medications on time…
• A true public one payer system streamlined, standard and computerised. Then you don’t have to pay multi-million dollar salaries to CEOs, on dividend cheques to stockholders. Bulk buys of drugs at a discount (currently banned as pork for the pharmaceutical companies).
• Set up a crown corporation, similar to Canada’s Petrocan, than keeps the other health care companies honest by competing fairly. It’s primary function is to bust up monopolies by competition.

Excuses

Republicans claim American cannot afford healthcare for all its citizens. How peculiar! America claims to be the richest country on earth, but they cannot afford this? Every other developed nation manages to afford it. Further, other countries spend 30% of the money that Americans do. Further, even for the gold-plated prices Americans pay, they rank #42, two ranks below impoverished Cuba. So what are the Republicans really up to:

• Helping the health industry make more money for doing less work to pay back the industry that bribes them both legally and illegally.
• Pissing on the poor.
• Refusing to save money on military spending or fund government programs by taxing corporations as billionaires. Most big corporations pay negative taxes. The beneficiaries of the status quo bribe the Republicans both legally and illegally to keep thing the way they are.

Public vs Private Health Care

In a public health care system, there is giant pot of money, collected by the government or a government agent from insurance fees and taxes. Experts try to figure out how to allocate it to get the most bang per buck, i.e. the most lives saved, most life extension, most quality of life, most health etc. Treatment depends the patient’s medical condition and the total size of the government pot but not the patient’s bank account. Republicans think this is terrible thing. How dare the government treat everyone equally! Republicans would rather die than live under such a system. Canadians, Britons and the French could not bare the anxiety of living any other way.

In a private health care system, resources e.g. doctors, drugs, hospital beds, operating rooms, are lavished on the wealthy. Everyone else gets substandard or no care, with atrocious outcomes. The USA ranks overall #43 in IMR, two rungs below Cuba. The course of treatment chosen for any particular medical condition depends mainly on the patient’s bank account. Republicans think this is a very Good Thing™. Canadians, Britons and the French think it is good approximation of hell.

Which policy is in your best interest? If you are wealthy enough to pay your medical expenses out of pocket without strain, obviously, the private system will suit you better. If you are not, the threat of being unable to afford skyrocketing private insurance premiums, or the insurance company dumping you because you are no longer profitable (i.e seriously ill), or the insurance company refusing to reimburse you for the excuse of the week means a public scheme will better serve you. Most people are not wealthy enough to enjoy the benefits of decent private care.

American politicians enjoy a third class of care, similar to deluxe private care, but the taxpayer picks up all the bills. The people who provide the heavy duty support for politicians’ campaigns are necessarily rich. So American politicians do what benefits a relatively small percentage of voters, the wealthiest slice.

Selling Public Health Care

Public health care is a difficult political sell. There was a doctor strike and threats of violence when it was first introduced in Canada in Saskatchewan. Now it is as part of the national identity of Canada as apple pie is for America. Even the doctors defend it. The story is similar in Britain with its National Health. Opponents managed to confuse people they would end up paying more for health care, when in actuality universal medical care costs 1/3 of what Americans pay for private care. Granted, taxes and government fees go up, but you no longer have to pay for much more expensive private medical care. The government spends more, but the taxpayer spends less.

Disadvantages of Public Health Care

• Doctors get paid less, so there are relatively fewer of them. This means they have less time to spend with each patient and the waiting times are longer, most notoriously for non-life threatening conditions like hip-transplants or back surgery.
• Unless there are at least token user fees, patients tend to overuse doctors. They waste the doctor’s time when all they really needed was a visit from a Sunshine boy/girl.
• Countries with public health care highly subsidise the training of new doctors to attract recruits. Then the young doctors leave for a country where the pay is much higher, one that has private health care.
• The bleeding heart media influence public policy to cover obscenely expensive drugs and procedures with low efficacy. This tends to waste far too much of the budget on Hail Mary procedures. Depending on your point of view, this could be considered an advantage.
• Everyone is treated equally. No matter how rich you are, you cannot use your wealth to obtain special priority, care or comforts, other than by seeking private treatment, perhaps out-of-country and paying for them out-of-pocket. There is no Cadillac care option for the wealthy. The Mayo Clinic does offer it.
• If your country has universal health care, Americans will jeer at you as a freedom-hating communist/socialist. They champion the right to be denied health care. I suppose that privilege could be looked on as a branch of the right to die movement. I far prefer the freedom from financial worries over health care. Barring the collapse of Canada, my health needs will be taken care of, no matter what.

Advantages of Public Health Care

• It is 1/3 the cost.
• You cannot be refused for pre-existing medical conditions.
• You cannot be denied the same level of health care everyone else gets for any reason.
• You never have to pay out of pocket, even if the government thinks the procedure was unwarranted. At worst, the doctor does not get paid.
• The health outcomes for the country as a whole are much better.
• People who, in a private system, could not have afforded medical care, or who would choose not to buy it, no longer wander about sick, spreading diseases, harming the health of even wealthy people who come in contact with them.
• You can vote to replace the people who set policy for the system. Thus they have a vested interest in keeping costs down. In a private system, the motive is profit, which normally means keeping prices as high as possible and dumping unprofitable (i.e. sick) patients and finding some excuse not to provide or pay for the promised care.
• Everyone is treated equally. Rich people are served the same ghastly hospital food that you are. They, thus, have a vested interest in using their political influence to maintain overall quality.
• Since the goal is to keep everyone healthy rather than make money, there is more emphasis on immunisation, prevention, education, sanitation… which help the general health of the population.
• Because of bulk buying, pharmaceutical companies provide drugs at much lower cost than in private health care countries.

Personal Bottom Line

I lived in the USA for 6 months. Most of my friends were employed, but did not have health insurance. They never sought medical attention for anything. I was grossed out by what they would tolerate. This drags down the health of the entire nation. People without health care spread serious communicable diseases such as HIV and TB (Terabytes).

I got a murderous toothache. The American dentist insisted on $500 up front before he would do anything about the pain. He never completed the promised work and refused to give me a refund.

Another time a boulder came flying through the windscreen, causing a glass shard to stick in my friend’s eye. She was rich with fully paid up health care. We went to emergency in Portland. Before they would even look at the shard, the hospital insisted on spending a hour filling out paper forms in triplicate. The equivalent in Canada is flashing your MSP (Medical Services Plan) card in front of a scanner. My American friend, a hospital administrator, explained that all US hospitals had room upon room of clerks manually handling billing.

Every other encounter in my life with the US health care system similarly left me despising it passionately. Americans have no idea how abused they are. It is as if they had battered-wife syndrome and lie to themselves their husband is the best imaginable. The national philosophy seems to be Screw others to whatever extent you can get away with it. People accept this abuse from the health care providers as normal American behaviour.

In contrast I have had only two negative experiences with the Canadian health system, and that was with Christian fundamentalist doctors who took exception to me being gay. Most of the time when I have had any extended health care, in Canada, I went back afterwards with a gift of chocolate hedgehogs to thank the staff for taking such good care of me. Canadian health care is far from the nightmare Republicans claim it is.

DVD referral for Sicko

	recommend DVD⇒Sicko
		DVD
	by	Michael Moore
	birth	1954-04-23 age:64
	asin	B000UNYJXQ
	upc	796019807500
	isbn	00796019807500
Mainly shows how well other developed countries do with their public health care systems. He left out many of the benefits because he thought Americans would not believe him. Americans are so isolated and so arrogant it never occurs to them that other countries could have already discovered the solutions to problems bedevilling America.
Online stores carrying Sicko amazon.de amazon.co.uk amazon.es amazon.ca amazon.fr amazon.com amazon.it powells.com junglee.com Barnes & Noble other stores
Greyed out stores probably do not have the item in stock

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