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Healthcare swan song


Fri, Jul 17th, 2009
Posted in Commentary

It's pretty frustrating to be interested in health care reform and live in Southeastern Minnesota. Minnesota has been one of the most progressive states in giving its citizens health care safety nets. I feel like I'm preaching to the choir while the rest of the country is a congregation of sinners. More, Mayo Clinic has been and is outstanding in treating everyone that truly needs treatment and making financial arrangements, including free treatment as needed.

Chris McCoy, the doctor that put the American Medical Association president's knickers in a knot when he gave his reasons for resigning from the AMA, probably fits in pretty well with most Mayo docs. The Texan head of the organization shot himself in the foot with his quick draw snarky remark about McCoy quitting his "job." At least at this house hold.

As I predicted earlier, the opponents of health care reform and promoters of the status quo have dragged out all of the old arguments used against Medicare. I expect to see Harry and Louise reincarnations any time now. They can't use the old Harry and Louise because they now have Medicare and there is no way they would give it up now.

Obama seems to have a long ways to go to explain that his idea of reform does not mean limiting patients' right to choose their own doctor, require giving up insurance coverage or a doctor that you are satisfied with, or the rationing of care. The opponents are sticking to Frank Luntz's cynical memo talking points. One is reminded of the use of harsh interrogation or enhanced interrogation and like terms used by the same people instead of the proper term, torture. Sad to say, the press has picked up all this and parroted it back to the public.

I don't know that it is going to work this time. An NBC/Wall Street Journal (a conservative paper) poll in June 2009 showed 76% of respondents thought a public option plan was very (41%) or quite (31%) important for reform. A CNN poll reported July first by Paul Steinhauser indicated only 51% approved of the Obama plan. Go figure.

Obama is telling us, if you're happy with what you have, you can keep it. If you are not, you can have other choices. What's not to like?

A lot of folks are hearing and listening to the fear mongering of the opponents telling them of dire consequences if we do actual health care payment reform. They're hearing:

1. This is all a step down the slippery slope of socialized medicine (Medicare, of course, all ready caused "socialized" medicine. Please, if you believe Medicare is socialized medicine get a good dictionary and look up socialism.).

2. Socialized medicine then will bring long lines and rationing.

3. Long lines and rationing will bring control from an unelected Washington bureaucrat that will get between you and your doctor.

4. Control by the Washington bureaucrat will bring control over which doctor you can see and which hospital you must go to.

5. The result will be the U.S. will become a third world country.

I heard all of this before in the early 60's. The people who believe this didn't experience this demagoguery or didn't learn from it.

What really makes my navel raw is the response of some democrats who, apparently, think only of their own bailiwick and not the nation as a whole. This is especially true for the Senators. All of the congressmen and women in both houses are elected to run the nation's affairs, not just those of their congressional districts or states. I thought that was established in the 1860's when northern states banded together to cement the idea we were all in this together. Except for Texas where the governor hinted at a new secession (and we called our wrestler governor goofy).

Now we have Senator Feinstein who, when lobbied by proponents of a public option who pointed out the NBC/WSJ poll of 76% in favor of the option, publicly thumbed her nose. She, with apparent arrogant egoism, states she pays no attention to these kinds of findings. She is going to make her own assessment and decide what's best for the country without weighing citizen input. Polls can be wrong and the public can change, but weighing the preponderance of public opinion seems reasonable to me.

I'll make another prediction. All indications are that unemployment will continue to go up even as the economy improves and rights itself. The Kaiser Family Foundation estimates for each 1% increase in unemployment 1 million people lose their health insurance. Cobra (the law that requires employer "provided" insurance be made available for individual purchase at l05% of the group cost) is too expensive for 50+% of the newly unemployed. That means since the last figure of 47 million uninsured we can add another 3 million and counting. Many of these people will find for the first time what it means to be uninsured in America. Their friends, neighbors, and other family members will vicariously share in the experience.

If this recession, started in 2007, continues for another 2 years we will see a large increase in the general public and some of the stakeholders interested in a health care safety net for everyone.

Doctors (many of whom now recognize the need, possibly a majority do) and hospitals will be doing more and more "charity" work and shifting the cost to others. This will increase the cost of insurance and co payments hugely. Insurance companies and politicians still feel the "moral hazard" of co payments reduces costs. This despite the studies that show it just delays or lengthens the fuse of disease until it blows up into a truly expensive treatment problem. The increased cost to industry and business of health insurance will speed the shifting of premium cost to workers and increase their co-pay. Then all of these groups will wish for Medicare for all, even the docs who now can't see where their best interests lie.

I'm going to take a break now from the health care scene. It is too wearing. As the previous publisher requested, I'll try to address some other facets of the elderly who now have Medicare and for the moment are well taken care of. Even elderly conservatives (except for the super rich) are thankful for Social Security and Medicare. A happier topic for the moment. Aren't you glad Bush was unable to get us to put our social security funds into the stock market?

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