...But could you, for once in your miserable hate-filled and fear-driven lives, try arguing a position based on facts and using something bearing at least a casual resemblance to logic?
This health care thing is beyond crazy. I'm not wild about what President Obama is trying to get through Congress--not because I think it goes too far, but rather because I'm quite sure that it doesn't go far enough--like so many other things the president has tried in his first few months in office. But to hear the Republicans talking about it, any change to our manifestly broken and equally manifestly shitty health care system would be a disaster at least an order of magnitude greater than Armageddon. What's more, they're cackling to themselves with barely concealed glee, thinking that this is the president's Waterloo.
This debate may turn out to be a Waterloo moment for somebody. But I doubt it will be President Obama. But before I get to that, let's deconstruct a few things that people really ought to know about this health care thing. First and foremost, our system is not the greatest and bestest one on earth. How do I know that? Well, we could start with the fact that some 50 million people in this country (which prides itself on being the wealthiest in the world, although that is almost certainly not true either) don't even have health insurance, much less access to actual health care. Or we could notice that 28,000 children under the age of one year die in the United States, meaning that our infant mortality rate is higher than Cuba's, among 28 other countries. Or consider that the average life expectancy at birth in the U.S. is roughly 78 years--forty-fifth among 191 nations, and little more than a decade better than the worldwide average of roughly 66 years. Bosnia and Herzegovina does better than we do, as does Puerto Rico, Jordan, Macao, and virtually every country in western Europe except for Denmark, Ireland, and Portugal.
Another bugaboo the Republicans are trying to make hay out of is the spectre of "the government" controlling your access to doctors, controlling your choices, and making medical decisions instead of you. Oooooh, scary! Except, how is that different in any relevant way from the situation most of us are in right now, where our choices, our access to doctors, and our ability to make medical decisions for ourselves are all dependent upon, more or less, blind luck? For those of us lucky enough to have health insurance, it almost always comes with a whole host of restrictions--can only see in-network providers, procedures can't cost more than some set amount, this and that and the other thing aren't covered, and so on and so forth. This fiction that we're all free as birds to choose whatever doctors we want and to get whatever treatments we want is exactly that--fiction. Maybe if you're a member of Congress or fabulously wealthy--but for the average working stiff, not so much. You go where your insurer tells you you can go, and you take what your insurer tells you you can take, and you'll like it. (And chances are pretty good that your insurer will tell you something different next year--at the same time as it tells you that your premiums have just increased by 50%.)
The president is not proposing "socialized medicine"--or anything even close to it. I wish he were proposing something of the kind--because then I'd be considerably more vocal in my support for his health care agenda. I said it during the primaries when he announced this plan, and I'll say it again now: health insurance isn't the same thing as health care. I don't give a shit if people have health insurance. I insist that people have health care. And, frankly, the only system I can see that makes any kind of sense at all is a government-run single-payer model, similar to what you'll find in most of the developed world (including, as the Republicans are eager to point out, places like Canada and the United Kingdom).
Why does single-payer make sense? If for no other reason than something the Republicans are usually in favor of, to wit, economies of scale. When you buy flipping great wodges of something, you usually get quite a price break because you're buying so much. When you're buying prescription drugs for most of the people in America, you should be able to get them at pennies per dose--at least as long as the lobbyists for Big Pharma don't manage to stick a rider on this bill like the one they got inserted into the Medicare reform bill a few years ago--the one that precluded the federal government from doing what Big Pharma certainly does with the companies that supply them with raw materials--negotiate a reduced price on a high-volume contract.
Let me illustrate with some specifics. The State of Illinois sets fringe benefit costs for all of its employees every year. Since I work in grants administration, I have access to those numbers (which are part of the public record, so I'm not revealing any state secrets or violating confidentiality by disclosing this information). For an employee with a spouse (or a domestic partner) and a couple of dependents who wants something like a standard Blue Cross/Blue Shield plan, the state has to pay out roughly $21,000 per year, per employee. The university where I work employs around five thousand people who are eligible for benefits. Let's assume their average insurance cost per employee works out to something like $16,000 per year, since not all employees have dependents, and not all employees choose the most expensive insurance option available. Multiply $16,000 by 5,000 and you get $80 million. Eighty million dollars a year, just for employee health insurance--and that doesn't even take into account things like what the employees themselves contribute toward their benefits, or things like worker's compensation, and other forms of health care costs. If I remember correctly, that $80 million represents about a quarter of the annual operating budget for the university.
Now multiply that by all the businesses in the country. It's a standard assumption that salaries and fringe benefits are going to account for around 75% of the cost of operating any business. According to the Bureau of Economic Analysis, the U.S.'s gross domestic product last year was on the order of $14 trillion in current dollars. One-quarter of that amount is still $3.5 trillion. That's roughly twice the Congressional Budget Office estimate of what one of the reform proposals currently floating around Capitol Hill would cost over its first decade. That $3.5 trillion, however, represents costs that businesses are already paying for employee health care premiums--each and every year. Hell, at $150 billion per year, Obama's plan would be cheap at twice the price--and still a huge savings (as in an order of magnitude) over current costs. Imagine what those businesses could do if they could use that 25% of their annual operating expenses as working capital. I think we could put a few more people to work, for starters--and maybe even manage to pay most of them a living wage and give them benefits.
Now, of course, there are rounding errors in my numbers, and factors that I didn't take into account. Still, they are likely to be trivial in comparison to the size of the numbers we're talking about. The basic point is that virtually anything we do to change the fucked-up mess that is the American health care system will represent an improvement. All the Republicans in the world can't change that fact--but that fact won't stop them from trying to make you think that they know what they're talking about.
Don't fall for the lies of the Party of No. And keep the pressure on the president not only to get his health care agenda passed, but to work for the next step in the process, which is actual health care for everyone in America--not just health insurance.
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