No, Thank You

Nice (and by that, I mean idiotic) commentary in the FT this morning by Clive Crook, who writes their Friday science wrap-up and usually does a bang-up job, but who should be banned from writing editorials because---ahem---he's an idiot. 

{...}In my view, there are worse things than Medicare for all – and the present system might be one of them. Medicare for all would give the US truly universal coverage and better control of costs. It would preserve choice of doctor and hospital, and private insurance for supplementary services could co-exist for those who wanted it. The demise of employer-provided plans would make labour more mobile and relieve workers of the worry that losing their job means losing their health insurance.

One obvious objection is that Medicare for all would politicise US healthcare to a degree that the country has not known. Controlling costs by denying expensive treatments and squeezing suppliers’ incomes is something Medicare for all could try to do, but this is a formula for perpetual political conflict – and if it were ineffective, taxpayers would pay the cost.

A less obvious objection is that a healthy private insurance market is worth preserving. The seething hatred many Democrats – and many other Americans of no fixed ideology – feel for private health insurers ignores the value they bring – and the extra value they could add if their incentives were better designed and their customers had the information they needed to make intelligent choices.

If competition is a good thing, competition among insurance providers is a good thing too. Yes, abolishing it reduces one kind of lump-sum administrative overhead, which is all some Democrats seem to care about. But it also abolishes pressures for innovation and other kinds of cost reduction. In other industries, competition pays for itself in spite of the apparent waste of marketing and other forms of duplicated effort. Healthcare is different – but not that different. At the very least, one should pause before shutting competition down.

Shutting it down is not the purpose of the public plan, say its Democratic supporters: the public plan is just one more choice. This is disingenuous. If the public plan had to compete on truly level terms with private plans, how would it be able “to keep them honest”? If it is going to exert the pressure it is intended to and really make a difference, it will have to flex its political muscle, its ability to attract subsidy and its superior buying power: “accept this lower reimbursement or no Medicare patients for you”. A public plan cannot be just another competitor: it is anti-competitive, and meant to be.

As I say, the present system is so bad that Medicare for all might be an improvement. I think the US would do even better to build its reform around competition among intelligently regulated private insurers. But if Medicare for all is what this president and Congress really want, they should come clean, and be out there making the case.

How many flips can this guy make in, what, six paragraphs?  Medicare isn't hot. It doesn't provide competition, but who's to say anyone wants to get rid of competition in the first place.  After all, Medicare does have its points...and it might actually be better than what's out there now. And, if that's what Obama really wants he should just be honest about it.

What the hell? 

First of all, it annoys me when Brits chime in on this issue.  Ahem.  YOUR HEALTH CARE SYSTEM SUCKS ROCKS!  You people have absolutely NO right to tell anyone---and that includes the pigeon first-aid stand in Trafalgar Square, where flying-rat care is their business---how to run theirs.  Period.  End of story.  Shut zee hell up. 

Second, the existing system is NOT bad.  It actually works.  Does it work perfectly?  No, it does not. But what does work perfectly?  Nothing is perfect, after all, because everything is run by humans, who are not perfect.  This is just the way things are.  Is there room for improvement?  Yes, there is.  But not with the government---the fucker-up of all things great and small---running it. 

One simple example to prove my point: I don't see wealthy people from all over the world flying to Great Britain---or any other country with socialized medicine, for that matter---for medical care.  Never mind the cutting edge stuff that happens in the bigger cities, at the bigger hospitals in our country.  Just head on down to Rochester and the Mayo Clinic and see what foreigners with money will pay to have a baby or partake in cancer treatment that's hardly cutting edge, but isn't available in their own country.  Take a peek at the plush surroundings they have built to entice these foreign purchasers of their services to realize we really DO have the best health care system in the world. Everyone who can afford it comes here.  That right there says we have the best health care system in the world, jack.  Switching everyone over to Medicaid simply because some people don't have health insurance will not keep us at the top of the list, ya dig?  These people are smart: they place a high value on life and they realize health care is something that should cost money, that there should be some competition to providing it, and that the free market is the way to go.  

For anyone who thinks that American health care sucks simply because there are forty-five million people without health insurance, I would request, no I demand, that you do the freakin' math: according to census estimates we have a population in the United States of THREE HUNDRED MILLION PEOPLE. The math is relatively simple. 45m/300m=.15.   That's FIFTEEN PERCENT, people.  How often do you hear that figure in the media, eh?  Or quoted by government officials who want to get across how dire this supposed problem is?  Not much, eh? Well, it's simple arithmetic, and you should pay heed, because, quite frankly, your life may very well depend upon it if you don't.  We're going to throw out a perfectly good health care system because of fifteen percent of the population, who, by the way, aren't doing anything illegal by not purchasing health insurance. There may be varying reasons why they haven't purchased health insurance, and I'm not saying it's all because of choice, but it's their choice.  They could find a work around if they really wanted to.  I did. 

C'mon people.  This is ridiculous. Furthermore, that we would reduce our standard of care (And that's what WILL happen if this plan gets passed into law, because rationing care will be the only way we will be able to afford this plan.  Anyone who says differently is a liar.  Or a politician.  Or both.) because fifteen percent of the population don't have health insurance, which is, by anyone's standards hardly a majority, is ludicrous. 

I've said it before and I will say it again: socialized medicine is least-common-denominator health care.  Your life in such a system has a finite value attached to it, and that value will be lower in a socialized system than it would be in a privatized system.  That's the plain, honest truth.  It IS the equivalent of a state-run eugenics program. 

If you would prefer not to die because you would prefer not to receive the lowest-common-denominator treatment when you become ill, it might behoove you to take a peek at the legislation currently on offer, and realize it could, conceivably, kill you at some point in the future, and call your legislators and tell them to reject this crap.  

No, the system is not perfect.  But unlike Clive Crook, I don't think expanding Medicare is the way to go.  Just because it's---supposedly--- better than what's already on offer.  What's already on offer is pretty damn good.  Appreciate what you already have, rather than bitching about what you don't, because what you will get in response is positively deadly. 

And, damn expensive to boot.  If you think your health insurance premium is bad now, wait until this gets passed.