Saturday, August 15, 2009

Medicare is Government Health Care

Medicare is a single-payer, government health care program. This simple fact, if known, would likely cool the jets of most of the angry anti-health care reform shouters at town hall meetings.

Many of the shouters are obviously on Medicare, but they don't seem to know that they are in a single-payer government health care system. At one of the town halls there was a sign saying "Keep the government out of my Medicare!" At another, the congresswoman asked for a show of hands: "Who's on Medicare?" Half the audience raises their hand. "Who's happy with it?" most hands stay up. "Who wants government health care?" most of the hands go down. "Do you know that Medicare is a government program?" Booing -- they don't believe it! They are dead wrong. We need to repeat one simple fact -- Medicare is government health care -- over and over and over and over until it penetrates their consciousness. This will take time.

A couple years ago I had a knock-down-drag-out argument with three of my conservative neighbors trying to convince them that members of the U.S. Navy were government employees. It didn't matter that their commander is the U.S. President. It didn't matter that weapons are bought and paychecks are cut from federal tax dollars by the U.S. Treasury. It didn't matter that the "U.S." in U.S. Navy stands for the United States Government. I couldn't convince them. In their minds government employees are lazy incompetents, but members of the military are brave, hyper-competent defenders of freedom -- how could they also be government employees? But they are.

If you don't have the critical facts right, you will come to the wrong conclusions and make poor decisions. The fact is that a huge number of Americans are on single-payer government health care programs. Those over 65 and the disabled are on Medicare. The poor are on Medicaid. These are both private-provider-government-payment, but many Americans are on government-owned healthcare: namely, the military are taken care of by doctors on a government salary and veterans can get care at government owned clinics and hospitals. For the most part, Americans in single-payer government health programs get pretty good care.

Why not the rest of us?

Monday, August 3, 2009

Health Care Falsehood

A recent Wall Street Journal article claimed that "comparative effectiveness research," an important part of keeping medical costs down, is code for letting old folks die rather than treating them. In addition, many on the conservative right are claiming that government health care will result in seniors being left to die rather than receive treatment.

These are both false.

First, "comparative effectiveness research" simply means comparing the effectiveness of two or more treatments for the same condition. The drug companies hate this, and for good reason. It's quite possible that independent research along these lines will discover that the drug they just spent a half billion dollars developing is no more effective than aspirin. To get FDA approval a drug needs to be reasonably safe and more effective than a sugar pill. No test comparing effectiveness with existing treatments is required. While the drug companies save a lot of lives and relieve a lot of suffering, if cheap treatments are better than expensive treatments they'll just have to deal with it.

Claiming that government health care is meant to kill seniors is truly bizarre. Why? Because seniors are already on government health care: it's called medicare. Medicare gives us a clue as to why the attack on health care reform is so vociferous: medicare has a 3% administrative overhead; meaning that about 97% of medicare costs are for doctors, nurses, drugs, hospitals and so on and only 3% goes to paper pushers. The private insurance companies have a roughly 25% administrative overhead.

That 22% difference in overhead means that someone, somewhere is getting roughly $220 billion dollars a year (1) not for treating patients, but for unnecessary administrating. Nobody gives up that kind of money without a fight, and the insurance companies are currently spending $1.3 million per day to stop health care reform, or at least slow it down. Sure the present system costs a fortune and doesn't deliver very good results, but some folks are making boatloads of money.

Not only are the anti-reform lobbyists doing the usual stuff, but one started the 'deather' rumor that a reformed health care system would kill seniors. They have also organized masses of hecklers at congressional town halls to shout down proponents of sensible reform. This is serious money and those receiving all these wasted dollars seem to be willing to do anything to keep it going into their pockets.

Those receiving that $220 billion a year recently won a great victory -- they delayed reform for a month while Congress goes on recess. That means at least $18 billion more in their pocket, more if they can delay a few more months. The whole $220 billion a year if they can stop it.

Don't forget who's paying those billions of dollars of unnecessary overhead: you are. Let your representatives in Congress know that the current health care system is the most expensive in the world, helps drive one million Americans a year into bankruptcy, plays a roll in 18,000 deaths a year of people who can't afford treatment, and -- worst of all -- doesn't deliver a healthy America.

NOTES

(1) This is a rough figure. Assuming $2 trillion total medical costs, 50% paid by the government, 22% of the private part works out to $220 billion.