Sick and Wrong

Matt Taibbi is wrong on several points, but I enjoyed his take on the situation:

Sick and Wrong

I like this:

Just as we have a medical system that is not really designed to care for the sick, we have a government that is not equipped to fix actual crises. What our government is good at is something else entirely: effecting the appearance of action, while leaving the actual reform behind in a diabolical labyrinth of ingenious legislative maneuvers.

However, he is wrong when he says that we have an “urgent national emergency” and when he says that a single-payer system is used by “every single developed country outside the United States (with the partial exceptions of Holland and Switzerland, which offer limited and highly regulated private-insurance options).” I don’t think Taibbi knows anything about Singapore or Germany, for example.

What Taibbi probably meant to say was that every developed country has some kind of system to provide health care to every citizen, whether it is through a single-payer system, a government-run insurance plan, a government subsidy for private insurance, or government-run health care facilities. The United States, on the other hand, rations health care according to the intrinsic value of each individual, which is calculated by dividing their financial net worth by the number of incurable diseases they have.

Taibbi also thinks that doctors have to fill out claim forms for “each and every one” of the “more than 1,300 private insurers in this country.” Well, they are all “private” only in the sense that they aren’t centrally controlled by the federal government; and no doctor deals with all 1,300 of them, since most states are dominated by two or three.

Basically, Taibbi is blinded by his adherence to a single-payer system. It is true that a centralized administration can lead to cost savings in any industry, due to the elasticity of clerical productivity versus demand for it. However, it does not necessarily lead to cost savings, especially if it ends up being contracted out. If the US ever offered a less restrictive public insurance plan than Medicare or Medicaid, it would probably contract out all the administrative work to private insurers anyway. Sorry, buddy, but the dream of Soviet-style American communism really is dead.

Here are other places where I think Taibbi does well, though, since they show off his political astuteness:

The president and the Democrats decided not to press for the only plan that makes sense for everyone, in order to preserve an industry that is not only cruel and stupid and dysfunctional, but through its rank inefficiency has necessitated the very reforms now being debated. Even though the Democrats enjoy a political monopoly and could have started from a very strong bargaining position, they chose instead to concede at least half the battle before it even began….

In many ways, the lily-livered method that Obama chose to push health care into being is a crystal-clear example of how the Democratic Party likes to act — showering a real problem with a blizzard of ineffectual decisions and verbose nonsense, then stepping aside at the last minute to reveal the true plan that all along was being forged off-camera in the furnace of moneyed interests and insider inertia. While the White House publicly eschewed any concrete “guiding principles,” the People Who Mattered, it appeared, had already long ago settled on theirs. Those principles seem to have been: no single-payer system, no meaningful public option, no meaningful employer mandates and a very meaningful mandate for individual consumers. In other words, the only major reform with teeth would be the one forcing everyone to buy some form of private insurance, no matter how crappy, or suffer a tax penalty. If the public option is the sine qua non for progressives, then the “individual mandate” is the counterpart must-have requirement for the insurance industry….

By blowing off single-payer and cutting the heart out of the public option, the Obama administration robbed itself of its biggest argument — that health care reform is going to save a lot of money. That has left the Democrats vulnerable to charges that the plan is going to blow a mile-wide hole in the budget, one we’ll be paying debt service on through the year 3000. It also left them scrambling to find other ways to pay for the plan, making it almost inevitable that they would step in political shit with seniors everywhere by trying surreptitiously to whittle down Medicare. As a result, the Democrats have become so oversensitive to charges of fiscal irresponsibility that they’re taking their frustrations out on people who don’t deserve it. Witness Nancy Pelosi’s bizarre freakout over the Congressional Budget Office. When the CBO questioned Obama’s projected cost savings, Pelosi blasted them for “always giving you the worst-case scenario” — which, of course, is exactly what the budget office is supposed to do. When you start asking your accountant to look on the bright side, you know you’re not dealing from a position of strength….

To recap, here’s what ended up happening with health care. First, they gave away single-payer before a single gavel had fallen, apparently as a bargaining chip to the very insurers mostly responsible for creating the crisis in the first place. Then they watered down the public option so as to make it almost meaningless, while simultaneously beefing up the individual mandate, which would force millions of people now uninsured to buy a product that is no longer certain to be either cheaper or more likely to prevent them from going bankrupt. The bill won’t make drugs cheaper, and it might make paperwork for doctors even more unwieldy and complex than it is now. In fact, the various reform measures suck so badly that PhRMA, the notorious mouthpiece for the pharmaceutical industry which last year spent more than $20 million lobbying against health care reform, is now gratefully spending more than seven times that much on a marketing campaign to help the president get what he wants….

The much-ballyhooed right-wing scare campaign, with its teabagger holdovers ridiculously disrupting town-hall meetings with their belligerent protests and their stoneheaded memes (the sign raised at a town hall held by Rep. Rick Larson of Washington — keep the guvmint out of my medicare — is destined to become a classic of conservative propaganda), has proved to be almost totally irrelevant to the entire enterprise. Aside from lowering even further the general level of civility (teabaggers urged Sen. Chris Dodd to off himself with painkillers; Rep. Brad Miller had his life threatened), the Limbaugh minions have accomplished nothing at all, except to look like morons for protesting as creeping socialism a reform effort designed specifically to change as little as possible and to preserve at all costs our malfunctioning system of private health care.

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Instigate some pointless rambling

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