March 16, 2010

Facebook Is For Ranting

I've heard many people, particularly folks older than myself, dis social media. They think it's some sort of game, the ultimate time waster. I don't know how anyone who watched Obama sweep the 2008 election (no matter which way they voted) can think that. Some of the best conversations I have are on Facebook, often with my fellow opinionators from the paper. The groups I belong to, pages I follow, and what I choose to be a 'fan' of are all very selective and usually issues based. (Okay, being a fan of LEGOS and squirrels may be a little silly, but hey, I'm allowed.)

That being said, I couldn't prevent myself from the following rant when friends of a friend commented about health care reform. If the damn 'costs to much' argument wasn't likely to get me stirred up, the wanton patronizing of college age adults managed it.

"Zach is tired of seeing these 'Stop Obamacare in Wisconsin' ads put up by Mark Neumann, former Congressman and current Republican gubernatorial candidate in Wisconsin. His ads are yet another example of the Republican healthcare plan: Die quickly." Two people liked this.

Andrew commented "How much is Obama's plan going to cost us, the tax payer? If it is not a good plan, why should the congress approve it?"

Zach commented "It is a good plan. And it will save you money. Premiums in the individual market: down 7-10%. Large group market: down 3%. That's with conservative estimates of cost controls like the excise tax on expensive insurance plans, bundling of Medicare payments, the phasing out of fee-for-service, etc. Moreover, the deficit is decreased by over 100 ... See morebillion dollars over the next ten years, and by over 600 billion dollars in the next twenty years. To solve America's deficit problem is to attack healthcare, the number one problem with our long-term deficit.

"Beyond that, the plan covers 31 million people, who won't walk into emergency rooms and receive free care passed on to the taxpayer--another savings. It cuts waste in Medicare: specifically reductions in overpayments to hospitals and private insurers (Medicare Part C), and examination of many mispriced Medicare procedures (imaging is one example).

"It prevents insurers from excluding on pre-existing conditions, or recissions on care. It prevents insurers from jacking rates up without due cause (like in California earlier this year) verified by the exchanges, a marketplace where people can buy health insurance in a similar manner to, say, car insurance, where you can compare quotes and services offered. In short, it's a good plan.

"Now, is it the best it could be? No, it could have much more cost control, but Congress doesn't have the stomach. It could have a public option, but the same rule applies. But it's a reshaping of a health care system that spends nearly double what other First World countries do."

Cherri commented "You sound well informed Zach...but have you ever had to handle insurance claims or manage your own health care? Health care definitely needs fixing but there has to be a compromise in there somewhere...I think starting with regulating/standardizing the costs of common procedures is a good place to start."

Then Monica (that's me) had to jump in with: "I have had to handle my own claims and manage my own health care. In 2004 I got a job with the university I am attending - not a student worker position an honest to God job with benefits in everything. Then when I saw the amount being taken out of my paycheck every month for health insurance, I got a second job, and eventually a third. (It cost more and provided less than the plan I'd had at the bank.) And when open enrollment came around again, I dropped the damned employer health insurance and got on the student plan for half the price (just to me, let alone what my employer had been paying). That being said, to a broke college student that $900 deductible (of the first plan) was just as insurmountable as no insurance at all. I skipped routine checkups, ignored doctor's advice, didn't fill prescriptions.

"The bottom line is - not having health insurance kills people. I was good friends with a 32 year old man who dropped dead of a heart attack. He hadn't been in for a physical in a decade. Why? No health insurance. He left a widow and kids behind. Emergency room care isn't good enough. There's no such thing as an emergency routine mammogram or cholesterol test.

"Zach is right about the costs. I've read the reports. But even if it cost twice as much, I'm not going to say my pocket book (or the whole damn nation's, in terms of the deficit) is more important than a person's life. We passed the military spending bills to fund the war on that very premise, to buy body armor and safer vehicles because money isn't worth our soldier lives. Why should it be worth our citizens? Because they're poor? Pah!

"Imagine the last time you went to the doctor about something, even something little and routine (you hope). Now imagine making that choice if you didn't have insurance, $100 dollars in the bank and still had to buy groceries for two weeks. Would you want Obamacare then?"

I didn't even get around to the fact that the Democrats have spent the last year trying to compromise the hell out of this bill. It's hard to compromise with a colleague who only knows one word. You can guess it.

Nor did I to mention cost controls or tort reform, which went the way of the dinosaurs early in the process. I don't know what they're all so afraid of. Nebraska has for a long time had limits on lawsuits and medical malpractice awards beyond incurred costs. There's a cap on pain and suffering that prevents multi-million dollar awards (beyond covering actual damages, even should those damages include lifelong care). As a result, insurance and health care in Nebraska is still reasonable (which is to say only mildly outrageous) compared to the rest of the country. Now if we could combine that with what Massachusetts has, and seems determined not to share, I think we could really get somewhere.

The longer this drags on, the more and more I think Republicans are just selfish, compassion-less, greedy, fearful, ignorant, lying, back-stabbing assholes who honestly don't care if poor people die (they might prefer it that way since poor people vote Democratic), and that's not a very productive way to think about one's fellow human beings. Not to mention, less than true. I know some very thoughtful, compassionate Republicans and conservatives. And my sympathy for the plight of the insurance companies has dwindled to the point where I wouldn't believe a thing they say. How can I make an informed opinion about what this bill will do to them when I can't tell the difference between wolf and truth? Plus I'm pissed off at the media for always framing the health care debate in a political argument. "What will this do for the Obama presidency? How will the Dems make out in November if they do/don't pass this?" Who the hell cares? I want to know if Sally down the street is going to be alive next year because she was able to get health insurance to cover the biopsy of that troublesome mole that may or may not be malignant melanoma before it spreads to her internal organs.

Am I the only one who has the unfulfillable urge to give the nation a collective smack upside the head?


John said...

Conservatives say things like: stay in school, get a job, work hard, and buy your own insurance. Don't expect the other taxpayers to bail you out.

Monica said...

46.3 million people (Census Bureau) were without health insurance in 2008.

In 2008, 39.8 million people lived at or below the poverty level. 54.5% of these people worked full time year round. 74% of people living below the poverty level have a high school diploma. 21% have at least some college.

The currently proposed legislation (Senate, House, and Obama's versions) all recognize people making up to 4 times the poverty level still need help buying health insurance because it's so damned expensive. They would also expand the availability of Medicaid to people under 65 earning below 133% (Senate & Obama) and 150% (House) of poverty. In other words, people making less than 150% of the poverty level can't afford to spend anything on health insurance because they're busy trying to feed their families and people making up to 4 times the poverty level still need help. And most of these people stayed in school and do work!

The number of people with private health insurance went down between 2007 and 2008, from 202 to 201 million. 88% had employee insurance and the rest had to buy their own. Meanwhile people on government insurance (Medicare, Medicaid, and the military/VA) went up from 76.8 in 2003 to 79.1 in 2004 to 83.0 in 2007 to 87.4 million people in 2008.

So, how's this "stay in school, get a job, work hard, and buy your own insurance" plan working out then? How do we expect it to keep working?

John said...

It works pretty well. 85% of Americans are "satisfied with their current health coverage." The system we currently have of private insurance, Medicare, and Medicaid has worked satifactorily for a long time. This is why a major overhaul of the system is unappealing to a majority of Americans.
That said, there are millions of Americans who want and need coverage but can't afford it. I can't believe that it takes a 1200 page bill, the Cornhusker Kickback, the Louisiana Purchase, and the Gatorade Amendment to improve the current system. Congress is entirely populated by liars, thieves and total bastards.