Framed

Fantasy

Shorter John McCain: big publically-run nonprofit healthcare is bad; big privately-run for-profit healthcare is good:

"I've made it very clear that what I want is for families to make decisions about their health care, not government, and that's the fundamental difference between myself and Sen. Obama and Sen. Clinton," McCain told reporters in Miami, Florida, referring to the two remaining Democratic presidential candidates, Sens. Hillary Clinton and Barack Obama.

"They want the government to make the decisions, I want the families to make decisions," he said.

Well, bullshit.  Under our current system--and under McCain's tepid plan for health care reform--"families" do NOT get to make health care decisions.  Decisions are made for them by health insurance companies financially self-interested in minimizing payouts and maximizing premiums.  Decisions are not being made by "families," they're being made by health care industry bureaucrats who are rewarded with bonuses and promotions not on the basis of how healthy their policyholders are but on the basis of how little money they authorize their employers to pay out.

Of course, McCain gets Tricare, the excellent government-run health plan for military retirees.  Tricare doesn't make any decisions about healthcare; it trusts people to make those decisions, and Tricare pays the bills without fuss, paperwork or delay.

McCain's fantasy of "families" sitting around the kitchen table and rationally choosing which doctors, which procedures, which tests, and which specialists they will avail themselves of is part and parcel of the laissez-faire delusion that individual consumers and giant health insurance companies are bargainers of equal power in a vast marketplace.  In fact, most people take whatever health insurance their employer offers and grit their teeth.

Sales Job

(h/t to Amanda Marcotte)

No Profiles in Health Care Courage

This post over at MyDD about Taiwan's single-payer health care system shows why I am disappointed in both Hillary Clinton's and Barack Obama's health care plans.

Both of them merely expand the customer base of the private, for-profit health insurance industry by requiring people to buy their products.

I would think that health insurance executives must be all but delirious about the prospect a Democratic win in '08.  Clinton and Obama are working hard to require the millions of uninsured Americans to become customers of theirs. 

I know, I know--politics is the art of the possible.  I suppose C & O  figure that the insurance industry lobby would never, ever let Congress pass a law that would take the profit out of health insurance.  It's disappointing, though, that neither Democrat will even try--because it seems to be working out pretty well in Taiwan:

In the decade since it was launched, the National Health Insurance (NHI) has contributed to a modest reduction in the gap in life expectancy between the rich and poor sections of society, public health researchers found in a recent study....

He [sic] found that those in the more marginalized sections of society had benefitted more from the creation of the NHI than those in more privileged groups in terms of increases in life expectancy....In the decade prior to the launch of the NHI, the life expectancy gap between the rich and the poor was steadily widening.

What I find especially ironic about the success of a program like this in Taiwan is that the government there was founded on staunch anti-socialist principles.  Apparently, though, Taiwanese politicians realized that "socialized health care" isn't so scary after all.   If  the heirs of Chiang Kai Shek can figure this out, you'd think that people as smart as Clinton and Obama could too.

Upending

I used to hear it said that the anti-abortion crowd is made up of people who believe that life begins at conception and ends at birth.  This quip was often deployed to describe the paradox of politicians who claim to be "pro-life," "pro-child" or "pro-family" and who then vote against programs designed to help children and their families obtain medical care, escape from poverty, and educate themselves.

So imagine my surprise when I read this headline:

Conservative Catholic Group Runs Ads Targeting Anti-SCHIP Lawmakers as 'Not Pro-Life'

In October, Catholics United, “a non-profit, non-partisan organization dedicated to promoting the message of justice and the common good found at the heart of the Catholic Social Tradition,” launched an ad campaign targeting “pro-life Christian” politicians who voted against expanding the State Children’s Health Insurance Program (SCHIP).

The ads criticized the members of Congress for saying they’re “pro-life,” but then voting “against health care for poor children.” “That’s not pro-life. That’s not pro-family,” concluded the ads.

I think there is a revolt brewing among some of the people who followed their "pro-life" Christian leaders for years.  As I wrote the other day, in reaction to Pat Robertson's endorsement of Giuliani for President, I think that many of the Christian right's footsoldiers

are in for a rude awakening to the wonderful world of cognitive dissonance when their preachers tell them to vote for a guy whose beliefs and conduct are as antithetical to their belief system as Giuliani is.  These are real people who are going to be hurt, puzzled and angry that they've been played for saps.  I feel bad for them; many of them are not shallow and insincere, and they're world view is going to be completely upended in the coming months.

The SCHIP  radio ads are a part of that upending.  So is the increased attention some in the evangelical community are paying to global warming and other ecological concerns.  Many of those footsoldiers--not the Robertsons or the Falwells or the Donohues or the Dobsons, but the people who have been quietly nodding in agreement with those fulminators--are not power-hungry hypocrites.  They're ordinary people, decent folks for the most part, people of sincere Christian faith.  But the contradiction neatly encapsulated in the life-begins-at-conception-and-ends-at-birth jibe is now just too plain to ignore.

Pete

Congressman Pete Stark (D- CA) today:

“You don't have money to fund the war or children,'' he said. "But you're going to spend it to blow up innocent people if we can get enough kids to grow old enough for you to send to Iraq to get their heads blown off for the president's amusement."

Go Pete!  And don't you dare apologize. About time someone used plain language to describe the Republican agenda.

Ploy

I commented recently on the alarming success that the right wing has enjoyed in channeling class and culture resentment into anti-immigrant resentment.  Now Amanda Marcotte has expressed a similar idea, albeit more succinctly and elegantly than I did:

This passage [by the NRO's Mark Hemingway] could be best summed up as: “Hey, asshole, what gave you the right to think that you should be allowed a decent living just because you work hard for a living? Here, hate on some other people who work for a living instead of focusing on the real culprits, people like me who want to defund your schools and retirement and give it all to Wall Street.”

What makes me a sad panda is how often that cheap ploy works on so many people. Don’t look at how the rich are getting richer while you’re getting poorer! Look, some Mexicans got some government cheese—hate them instead!

Marcotte shows how this ploy is repeated in different contexts--specifically in the debate over the S-CHIP program.  Hemingway argues that people who take jobs that don't carry health insurance shouldn't complain (or seek assistance from society) if they decide to have kids and those kids get really sick.  As Marcotte points out:

The pro-punishment bent of Hemingway’s article—with its unsavory implication that this baby should have died to punish the parents for feeling like they had a right to elitist privileges like sex and marriage—really gets to the heart of how a worldview that can be against the right to abortion (and other birth control methods) can somehow also be against child-bearing, at least from people of a certain class. It’s the same logic as the angry comments below about how the poor are getting away with murder because we let them have TVs now—simple, simplistic, hare-brained elitism. A worldview that posits that the main benefit of wealth is having much, much more than your neighbor. It’s not enough to have more than enough anymore; it loses its sweetness if your neighbors are getting by and not entirely miserable. That BMW drives that much better if your neighbor couldn’t afford to keep her baby alive. That McMansion seems so much more spacious if you know that the poor can’t even enjoy the momentary pleasure of fucking because they don’t have a choice to have a baby or not to have one.

It’s a worldview I don’t understand. The night air is sweeter if everyone is enjoying it in my eyes. That color TV is so fun everyone should have one. My sex life isn’t diminished if someone else gets to enjoy their own on their own terms. . . .   It’s almost hard to believe other people are so mean-spirited, but the undeniable evidence of essays like this and the damn “let them eat cake” crap below forces me to see that what I don’t want to believe really is so.

To which I would add that the worldview she identifies seems to apply to marriage as well as sex.  My marriage is not desanctified (is that even a word?) by giving homosexual couples the right to wed.

Like Marcotte, I don't want to believe that conservatives are inherently bad.  The issue of health care for children, however, is essentially the issue of what we as a society owe to the people in it.  That does indeed get down to some pretty basic political questions.  Are we one people?  What is our obligation to our fellow people?  What are life's most important choices?  All of these questions can be answered neatly and consistently by the philosophies of libertarianism and totally free market capitalism.  Move off those easy answers, though, and there's a lot of uncomfortable line-drawing to do, a lot of messy choices to make.  I guess I think that some conservatives are too much in love with intellectual consistency and too much afraid of ambiguity.  People adopt the let-them-eat-cake philosophy not because they're inherently mean, but because they're intellectually lazy.

Low Forties

Blondesense Liz highlights a recent survey that shows that the U.S. ranks 41 among nations in instances of maternal deaths.  As she points out,

"For a country so darn obsessed with being "pro-life" and hell bent on shoving family values down our throats, you would think that we'd fare much better in maternal death (dying during or just after pregnancy) statistics among industrialized countries. But we suck."

What struck me about this number is now close it is to the rank of the U.S. for longevity--which, as I noted two months ago, is 42.  And by and large, the same countries--those with socialized health care systems--came out ahead of the U.S. of A.  So while the results of one of these studies might be dismissed as an anomaly, when they're read together we see how absurd Bush's claim that the United States has "the best health care system in the world" really is.  We're nowhere near the best; we're stuck in the low forties.

Exactly

As loopy as Bush's recent comments were about how everyone in America can get all the health care they need down at the local ER, he is actually on to something.  As Steven Benen points out:

If you’re sick, there are public hospitals that will treat you in an emergency room. Of course, it’s extremely expensive to treat ill patients in this way and it would be far cheaper to pay for preventative care so that people don’t have to wait for a medical emergency to go to the hospital.

Under the Bush administration model, a sick person with no insurance goes to the emergency room for treatment. Does he get a bill once he’s taken care of? Probably, but it doesn’t matter because he can’t afford to pay it.

If the patient can’t pay the bill and hospital can’t treat sick patients for free, who pays the medical bill? Everyone else.

Yes, everyone pays, everyone gets treatment. Bush and his team support the most inefficient system of socialized medicine ever devised.

Yes, exactly. To "inefficient" I would add "maddening, complex, frustrating and degrading," but the point is that we could be doing a much better job keeping people healthy for a lot less money.

I'm surprised more candidates don't hammer home this point.  Maybe it's because the right has engineered a Pavlovian response to the phrase "socialized medicine" that has many people thinking of wearing drab clothes while waiting in line for hours in some dirty 1970's East European clinic.

The correct response to that, though, is to point out that we have socialized a number of vital services in this country.  We have socialized education, socialized mail delivery, socialized air traffic control, socialized book distribution (i.e., libraries), socialized public safety (i.e., police and firefighters), and so on--why shouldn't we do the same with health care?

Rank

Yee-ha!  We're Number 42!!!  How will those politicians who thump their chests about how we have the best health care in the world explain that the citizens of 41 other countries have longer life expectancies than we do?

253 days . . .

. . . until the New Hampshire primary.  Actually, not.  I got behind after last weekend.

But anyway, rumor has it that Michael Moore has challenged Fred Thompson to a debate in his usual, inimitable way.  No verification of this is available on Moore's website--much less Thompson's--but here is what Drudge (shudder) is reporting:

May 15, 2007

Senator Fred Thompson
American Enterprise Institute
110 Seventeenth Street, N.W.
Washington, DC 20036

Dear Senator Thompson,

Given that it has been publicly reported in The Weekly Standard, a leading neo-conservative publication, that you support Fidel Castro and the Cuban regime by being a purveyor of fine Cuban exports despite the trade embargo, I was surprised to see your recent op ed in a more traditional conservative outlet, The National Review, regarding my trip to Cuba (I suspect you choose The National Review in an effort to pander to an outlet that had criticized you for your opposition to medical malpractice legislation).

In your May 2, 2007 National Review article, "Paradise Island," you specifically raised concerns about whether my trip to Cuba with 9/11 heroes, who have suffered serious health problems as a result of their exposure to toxic substances at Ground Zero that have gone untreated was somehow going to support Castro and the Cuban government:

"It always leaves me shaking my head when I read about some big-time actor or director going to Cuba and gushing all over Castro." [http://article.nationalreview.com/?q=OWNhNzA2YmY3NTNjZjZhNjE1NmZjMDFkOTdjN2Q4ZmE=]

Putting aside the fact that you, like the Bush Administration, seem far more concerned about the trip to Cuba than the health care of these 9/11 heroes, I was struck by the fact that your concerns (including comments about CastroÕs reported financial worth) apparently do not extend to your own conduct, as reported in The Weekly Standard's April 23, 2007 story, "From the Courthouse to the White House Fred Thompson auditions for the leading role" (emphasis added):

"Thompson's work space looks just like what the home office of a successful politician or CEO should look like -- though a little messier: a large desk, dark wood, leather furniture, lots of books and magazines and newspapers, a flat-screen TV, and box upon box of cigars -- Montecristos from Havana." [http://weeklystandard.com/Utilities/printer_preview.asp?idArticle=13528&R=1136E33842]
In light of your comments regarding Cuba and Castro, do you think the "box upon box of cigars -- Montecristos from Havana" that you have in your office have contributed to CastroÕs reported wealth?

While I will leave it up to the conservatives to debate your hypocrisy and the Treasury Department to determine whether the "box upon box of cigars" violates the trade embargo, I hereby challenge you to a health care debate.

Survey after survey has indicated that health care is one of the top issues to the American voters. Today, more than 46 million people lack health are coverage, including 9 million children. We pay significantly more than any other country in the world -- and get less back. Americans life expectancy is lower than other Ground Zero 9/11 workers live in a society where the Bush Administration has shown more concern about their travel than about their health.

Our debate would provide you an opportunity to appeal to the right wing of the Republican Party by continuing to attack me; it would give me a chance to discuss health care and tell you exactly what happened in Cuba, given your apparent inters; and it would provide the American people an opportunity to see just how serious Hollywood can be, with a purported conservative and an avowed progressive Hollywood personality on stage.

Over the course of the debate, we could specifically address the following issues:

(1) Your work as a lobbyist in light of the fact that the health care and insurance industries have maintained the current health care system through their effective control of the political establishment.

(2) The fact that you raised hundred of thousands of dollars in campaign contributions from the health care and insurance industries.

(3) Discuss the fact, highlighted in yet another conservative outlet The New York Sun, that you inexplicably wanted to cut funding for AIDS research. [http://www.nysunpolitics.com/blog/2007/05/thompsons-1994-issue-positions.html]

(4) Your relationship with the Frist family and by extension HCA, one of the nation's largest for-profit hospital chains. It has been reported that former Senate Majority Leader Bill Frist (who was renowned for his over-the-television-screen Schiavo diagnosis) is serving as one of your confidantes on your potential presidential campaign. The Frist family has historically controlled HCA, which paid a record $1.7 billion in civil and criminal fines, including a $631 million penalty for Medicaid fraud -- in other words, ripping off the taxpayers.

(5) Discussing whether Arthur Branch, as the District Attorney of Manhattan, supports a woman's right to choose, gun safety reforms, gay marriage, the trans fat ban and anti-smoking laws (which would impact Cuban cigars, including your Montecristos).

Like American Idol, we could even have the country vote to determine which one of us wins the debate. Though in the spirit of full disclosure, I feel obligated to forewarn you that I was the winner of the 1971-72 Detroit Free Press Debate Award for the state of Michigan.

The winner of our health care debate could even light a Victory cigar with one of your Montecristos (though we may want to consider shipping them to the safe house where I have put a master copy of SiCKO in the event that the Bush Administration tries to seize the film).

Sincerely,


Michael Moore

I'd pony up for pay-per-view to see that.