Wednesday, September 9, 2009

Daschle, Baucus, and the Wellpoint healthcare joke

Why did we bother
Should have stayed away
Death of a Party

There’s only one goal in health care reform that counts: to get the cheapest healthcare coverage to the greatest number of people. If Government taking over the healthcare system would do that, I’d be all for government taking over the healthcare system. But in fact nobody in the OECD has that kind of system. Which makes sense. As always, economic performance is best when it is mixed. Thus, all OECD countries have the kinds of public/private mixes that optimize what the private sector can do – competing with each other to either lower costs or offer higher quality – and what the public sector can do – guaranteeing basic care for all and operating as a horizon against which all parts of the healthcare industry have to adjust their costs.

This, by the way, includes the U.S. The U.S. just does it extremely badly.

The figures are simple and scandalous. Anne, the analyst who comments at Economist’s View (a brilliant woman), provided a nice link to the OECD breakdown of health care costs as percentage of the GDP and per person. OECD are the European developed economies, plus Mexico. The U.S. is, of course, a joke:

“Total health spending accounted for 8.4% of GDP in the United Kingdom in 2007, compared with an average of 8.9% across OECD countries. The United States is, by far, the country that spends the most on health as a share of its economy, with 16% of its GDP allocated to health in 2007. France and Switzerlandfollowed with 11.0% and 10.8% of their GDP spent on health, respectively. Several EU countries –Germany, Belgium and Austria – and Canada also devote more than 10% of their GDP to health.”

Which means: the U.S. spends 7290 per person, and Canada, 3895.

Now, the U.S. could do this kind of thing perhaps in the 90s, the last decade in history in which the U.S. economy would dominate in the world. It can’t do it now.

Now, a sign that a country is in real trouble is when the policy solutions it seeks aren’t solutions at all. Rather, one side seeks only to aggravate the other side. During the years of Bush, the Great Fly, many whacky and visibly unsuccessful policies, as for instance a Global War on Terrorism that didn’t seem to hurt a hair on Osama bin Laden’s head, was defended because it made liberals mad. This isn’t a strategy that works, outside of highschool cliques. The real world has one characteristic that you can count on: it is real. If your politics is fashioned around attitude, then basically, you’ve lost touch with reality. But reality has not lost touch with you, and will crash into you and hurt you with supreme and utter indifference to your pain and suffering and death. In fact, that is going to happen. And that’s the way things work, baby.

So, given these facts, what are the Dems in Congress worried about? Not giving an unfair advantage to any government supported health plan.

I’ll write that again, so that we can all smell the Daschle cologne on it, that mixture of politico sweat, pure greed, stupidity, and the assurance that once you are tossed on your ass by the voters, you’ll bounce into the back of some lobbyist limousine: they are concerned that the insurance companies might suffer from, well, having to become efficient.

Luckily for the insurance companies, they wrote the Baucus plan. Which, incredibly, seems to be the plan that the Senate Dems are now thinking about rallying round. It is not simply that there is no public option that could cross states, allow for much cheaper coverage, take advantage (o heavens) of government subsidies (like, you know, the ones that are given to banks), and bring the cost of healthcare insurance down to a Canadian level. No, when the Dems jump into the pit of corruption,, they do it like kamakazi pilots.

The plan was written, literally, by Baucus’s chief aid, Liz Fowler. The person who writes Empty Wheel at FDL has been all over the fact that chief aid, Liz Fowler, was recently the VP of WellPoint.

Now, back in the day, I remember liberals howling about Bush’s energy commission, chaired by Cheney, making itself a wholly owned subsidiary of Exxon. Now, big voices in the liberal blog community, like Matt Yglesisas, are simply exasperated that anyone would find a taint or stain in Liz Fowler coming up with a plan that is a … good compromise. A first step! And what does this first step entail? Well, luckily, it doesn’t entail cutting into the profits of insurance companies. Thank God! Rather, it entails robbing you in a truly bold and insane way. I haven’t checked these figures from Empty Wheel, but if true, they are astonishing:

“A bunch of outlets have now released Bad Max's framework on health care.
Here are some ways to think of Max Tax:
Maximum amount a family of four making $67,000 would have to pay for health care, per year:$20,610 (31% of income)
Total amount that family of four would pay in fine if they did not get health care insurance: $3,800
Total amount a corporation with more than 50 employees would pay in fine if it did not offer health insurance: $400 per employee
Total amount a corporation can pay for health care plans without paying 35% tax: $8000 individual, $21,000 family.”


Let’s be clear. The U.S. is the richest nation on earth, but it has devised the most dysfunctional healthcare system on earth. American companies simply can’t remain competitive given the way healthcare costs have been hooked to compensation packages to which they contribute for workers. This system is about to fall apart.
The system has lead to gross and pointless disparities in healthcare, which, as is recognized by the rest of the world, is a public good. And this is actually recognized by the U.S. – one of the things that raise prices in the U.S. is government “interference” in the healthcare market. One has to remember: people who think that the government ‘interferes’ in an economy are living in cloud cuckoo land. The same people who are hollering, today, at the government takeover of medicine, were voting, yesterday, for the largest expansion of Medicare in history, Bush’s pill bill. Beyond the ideological fog, the real cause here is to shift money from whatever sources it can be extracted to the wealthiest sector of the population. MacDonald’s sells hamburgers. The GOP protects the rich. The Dems are like a MacDonald’s that has gone upscale. They want to protect the rich, just like the GOP, but they also want to create great vegetarian fare for working people, plus let’s not forget pate and political correctness for you educated women in the suburbs, y’all! A MacDonald’s that operated like that would soon be serving its last cheeseburger.
Healthcare reform is and should be about making the government kick the medical industry’s ass, so that the cost comes out of that industry. Obama set the worst possible precedent for this business when he compromised with BigPharma about negotiating for prices on drugs. Let’s say it loud: that’s nuts. It is nuts to run a welfare system for the world’s richest corporations. When judging the efficiency of governments, you have to relate the efficiency to the national scope of their operation. In those terms, there is no buggetty buggetty magical reason governments should be less efficient than private enterprise. But just as inkind dealing in private businesses leads to inefficiency and robbery of the customer, so, too, government, when it falls into the hands of corrupt oligarchs who use it as a milk cow to become ever wealthier, becomes a sad spectacle of impotence and bad service.

1 comment:

traxus4420 said...

great post, thanks -- this is classic:

"Beyond the ideological fog, the real cause here is to shift money from whatever sources it can be extracted to the wealthiest sector of the population. MacDonald’s sells hamburgers. The GOP protects the rich. The Dems are like a MacDonald’s that has gone upscale. They want to protect the rich, just like the GOP, but they also want to create great vegetarian fare for working people, plus let’s not forget pate and political correctness for you educated women in the suburbs, y’all!"

i didn't know about the liz fowler conflict of interest. i guess it's right in line with everything else.