Dear America,
As I watched the "Health Care Summit" with a combination of consternation and despair, I recognized the reality that we have all already acknowledged: there is a fundamental difference between Republican and Democratic priorities. The disparity cannot be reconciled and thus we, as a nation of voters, bear the responsibility to break the deadlock in Washington over health care, among other things.
During the health care conclave, the issues continued to be as obfuscated by rhetoric as they were before and I fear that the American people are as confused by the misdirection tactics of the Republican Party and the complexity of both the problem and the Democratic proposal for solving it as they ever were. I took three pages of notes while I watched, and then I stopped because it was abundantly clear that nothing is going to change as far as the national debate is concerned. So let me start with the last thing I have to say.
Because there is a deficiency in every alternative, the only way to take care of you, the American People, is with a public plan-- not insurance reform-- a public plan. It is the only way to prevent the greed of a few from dominating the process of treating the sick. Among the pharmaceutical and health insurance industries, and the medical profession itself, the quest for wealth is the overarching principle, and that will never change unless medicine is no longer less-than-universally available. The competition that both the Republicans and the Democrats tout as the great leveler only levels those in need. It does not level those who have with those who have not, and that is the problem.
As long as people go into medicine to get rich and others sell insurance so that they can get rich, the ones who will pay what I call "the vig," that is the element of the cost above what is reasonable that goes into the pockets of those in control of the process, are the consumers of the services rendered because they have no choice. That is alright for the providers of luxury cars, fast food and art work. But when we are dealing with an essential service, with a thing that everyone needs, and that some need desperately even when they do not have the wherewithal, we cannot leave dispersal of that service to a market based on the pursuit of wealth. On that point, I fear no contradiction-- at least none that is not contrived and fallacious.
Unfortunately, what I saw and heard at the summit was the perseveration of the partisan sniping that has stalemated the process of legislating health care reform. Here are some specifics. According to the Congressional Budget Office, the CBO, tort reform, that is limiting malpractice law suit damages, could save $54 billion in ten years: that is $5.4 billion per year. A Republican brought up that point saying that it was a substantial step toward bringing down the cost of health care reform. But the Republican complaint is that the current health care proposals will cost about $1.3 trillion over that period. Hence, the savings from tort reform, which the pro-wealth Republican establishment has been harping on for decades, amounts to less than .1%, that's right, less than one tenth of a percent of the total cost of health care reform-- hardly a substantial difference, but a major point for the Republican Party. I admit that I am a lawyer myself, but whether the law needs reform or not, and I concede that it does, in this context legal reform is nothing more than a political straw man. Perhaps we can discuss that issue another time, but it is insignificant for health care.
A Democratic congresswoman named Louise Slaughter, on the other hand, spoke concisely and directly about the inability of people to get health insurance and the heavy price they pay for it. She said, in effect, that the issue is whether we care more about people or money. A Democratic senator said that every day, 8,000 Americans die because they cannot afford health care. A Democratic congresswoman told the story of a young boy from her district who told her that his mother was a manager in a fast food restaurant, and they were doing okay. But she lost her job, and then she died because she had no health insurance to cover care for an illness for which there is treatment and a cure.
As to the Republicans, I never heard any of them say anything about a constituent who had suffered because of lack of insurance. I heard them say plenty however about what small business needs. I heard them complain that insurance premiums will go up an average of ten to twelve percent because of the insurance exchanges that the Democrats propose (an idea that it seems was a Republican solution before it was a Democratic one that the Republicans now criticize). But with typical Republican casuistry, they omit the fact that the reason for the prospective increases in premiums is that the Democratic proposal would require the provision of meaningful coverage rather than permitting the low grade coverage that insurers now offer to cover very little at excessive cost.
But whether the Republican position is based on prevarication or not, even what the Democrats propose is flawed, beyond redemption as far as I am concerned. The fundamental problem is that there are so many who are not poor enough to get health care for free, but not rich enough not to have to worry about it. Thus, the economy, the capitalist system, the most detestable form of economic Darwinism, determines who among them get what they need because it is their priorities that prevent them from buying coverage, not the absolute lack of resources. They have food, clothing and shelter; they have cars and pay tuition; but they are unable to pay for all of those things and to also pay $1,000 per month for health insurance. Thus, the Democrats insisting that they do so is in effect prescribing their priorities for them, or fining them in the alternative. But I say, if the goal is for everyone to have access to healthcare, why not just give it to them and cut out the middle man, in this case, the insurance industry and the entrepreneurial medical practitioner.
By taxing the entire populace according to its ability to pay and creating a public system, everyone is guaranteed the care he or she needs. No one dies for want of the ability to pay, or because the needs of the family outweigh the risk of going uninsured. And all we have to do is cut the pursuit of outlandish riches out of the process. Mind you, I did not say all riches, just outlandish riches gained from perquisites given in exchange for prescribing drugs, and profit from prescribing MRI's on a machines owned by the prescribers, and the vig from what amounts to a private form of taxation for the benefit of its owners and officers: the insurance industry.
So, we have come full circle. It is once again up to us, the voters as it was in November of 2008. We can subscribe to the Republican notion that if you leave the free market to work, it will serve us all. Never mind what it has done to us in the past, especially recently. If the Republicans are right, with health care it will work, even though it hasn't so far. Or, we can subscribe to the Democratic notion that the government should impose on everyone the obligations that it thinks are good for them-- not just that they should not kill or rob each other, not just that they should not take drugs or drive their cars at unreasonable speeds, but that they should buy health insurance from which someone else profits and forego college tuition for the kids. Or, we can eliminate the philosophical, ethical and moral flaws in both systems proposed by the major political parties and insist that they give us what, in the end, we all want. We can tell them, Democrat and Republican alike, to give us what we need or we will get someone who will. It's time for you to raise your voice, America. Not just you loud mouths who think you are at a tea party when in reality you are just spouting more ill-conceived ideas masquerading as populism. All of you who live with the lack of a civilized and moral method of allocating a critical resource-- medical care-- do us all a favor. Vote, but do it loudly.
Your friend,
Mike
Copyright © 2010 by Michael Wolf.
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