Friday, August 28, 2009

Just Cold Makin' Stuff Up

We apparently live in an age where any outlandish lie about Obama and the Democrats can gain media traction. Here's one now! So I decided to come up with some outlandish lies about Republicans just to see if I could get them to catch on. Keep in mind, these are all lies written by a treacherous liberal. You shouldn't believe them...but you will! So here's a peek at the upcoming Republican policy platform:

The GOP will take your children away and force them to live in a moon colony. How will you feel when you see your kids flying away on a moon rocket? I bet you'll feel bad.

The GOP will force old people to work on cactus plantations in the desert southwest. Something about that just doesn't sit right with me.

You know that favorite TV show of yours? The Republicans want to cancel it.

The Republican health plan requires all Americans to take Dr. Sanjay Gupta as their personal physician. Sorry, that doesn't sound like the land of freedom to me.

The GOP will require all domestic pets to be added to a communal soup pot.

Every morning the Republican leadership gathers and prays - for you to die!!

An old man and his grandson were walking along a dirt road, fishing poles resting against their shoulders, the early morning quiet but for their laughter. Just then Republican Senator Chuck Grassley stepped out of the bushes and snapped their fishing poles in half with a derisive sneer. Then he threw the shredded remnants of a health reform bill in their faces. That just seems way beyond the pale.

The GOP will require each family to have at least one child named "Mega-Dittos." That child will, of course, be sent to the moon.

Wednesday, August 19, 2009

Some Insurance Basics

Despite the detailed and heated health care debate, I haven't read much discussion of what insurance is and why we have it. It's worth discussing briefly, as it gets at some of the fundamental need for reform.

Insurance in theory is a pretty great idea. When you pay your periodic fire insurance bill, you're basically paying for a portion of all the fire damage that occurred during that time period, in the understanding that if you ever suffer fire damage then you too will be covered. That's a really rough sketch of the idea, but it's basically about looking after each other and your own self-interest.

This works fine, in theory, until the people controlling the inflow and outflow of money realize that they're sitting on a huge pot of money that can be played with and invested, and that their profits can be maximized by increasing the in-payments, restricting any out-payments and denying coverage to anyone who looks risky. Suddenly they've gone from being a simple conduit between participants in the insurance program to being a self-interested, profit-maximizing entity.

Now, here's the thing: it's possible to have a perfectly good functioning insurance system without having a bloated middleman skimming billions of dollars for profit and denying coverage to millions of people. This morning I followed an Atrios link to this post by John Cole:

Hell, I can’t, for the life of me, figure out what value the insurance companies add at all. Seems like all they do is skim money off the top, add layers of paperwork, and then screw people when they get a serious illness.

This is precisely the function of private insurers, and there's no need for it. You could have a non-profit co-op or a public option for providing insurance. I've never heard a single good reason why it's better to have a huge, bureaucratic, profit-driven corporation that looks after only its own bottom line and sabotages the purpose of insurance in the first place.

Public Option and the Mandate

This is a good point: an individual mandate really doesn't make sense without the public option.

Zombie Death Panel

Depressing stat of the day: 45% of Americans believe the death panel lies emanating from Palin & Co. There's a quote often attributed to Twain: "A lie can travel halfway round the world while the truth is putting on its shoes."

Friday, August 14, 2009

Some Health Care Talking Points (I)

I've noticed that many opponents of health care reform seem to deeply misunderstand what is actually being proposed, so figured it might do both proponents and opponents some good to lay out in simple terms exactly what reformers would like to see.

First of all, no one would force you to give up your health insurance. Much of the anger out there seems to be based on a fear of not having that freedom of choice. If you like your current policy, you can keep it. You can buy all the private insurance you want - knock yourself out! What is being proposed is that people who cannot afford or cannot attain private insurance, e.g. because of exorbitant costs, a pre-existing condition, a fixed income, or whatever other reason, would have recourse to a public option. That is, they could purchase an insurance policy from the government. The government's role is that of an "insurer of last resort." The government isn't going to be running the healthcare industry, they are simply going to be offering insurance to those who need it, much like extended Medicare (a very popular *government* scheme).

Second, there would be an individual mandate saying that people have to have health insurance. This seems to be another source of anger out there, with protesters suggesting that it's wrong to force insurance on people. In fact, it's not unusual and not unprecedented - we already do this with auto insurance. If you drive a car, you are required to have a minimum of liability insurance in case you are in an accident. Similarly, people would be required to have health insurance to avoid cases where an uninsured person gets sick and ends up in the emergency room where taxpayers are liable to pick up the tab.

The third idea is that insurance companies would be prohibited from charging different premiums, or denying coverage, based on your medical history or perceived risk. This is sometimes called "community rating." This relates to the first point above in that it would lower the access bar for many people to acquire a private policy. It would also greatly lower administrative costs of insurers because they have huge bloated bureaucracies dedicated to weeding out and denying risky applicants. This last point is important - people assume that a government plan would be bureaucratic and unwieldy compared with private plans, but it's quite the opposite.

Those are the keys ideas, believe it or not: a public option, an individual mandate, and community rating. Simple as that. No death panels, no internment camps. Hopefully you'll find these notes useful in talking to people about health reform. I'll post some more points and arguments soon.


Here's one reason to be optimistic that health reform will be passed. The American Medical Association and the pharmaceutical industry have thrown their mighty weight behind the cause. Every attempt at health reform in the post-war period has been stymied by the opposition of the AMA, so this is huge if they truly are on side. This has obviously made people nervous about what exactly is being compromised on to curry their favor, and with good reason. But I agree with Paul Begala that a solid foundation of reform is the critical thing right now. Some compromises will be necessary. I disagree with Begala in that I think a public option and individual mandate are the bare minimum to begin with, but we can't expect the ideal set of reforms to all come in one fell swoop.

Reducing Costs

This NYT opinion piece has some relatively simple suggestions for reducing health care costs. One example: in a nation of 300 million people, there are 32 million CAT scans each year. That's nuts - not only illustrating unnecessary procedures, but potentially harmful ones.

The Treatment

Jonathan Cohn, the guy who was on Colbert the other night, has a good health care blog if you feel like getting all wonky.

Wednesday, August 12, 2009

Krugman's Take

For a comprehensive take, I really recommend reading Conscience of a Liberal, but these two pieces give a very concise overview of the ideas behind health reform and the reasons that a purely market-based approach won't work.

Improving the Health Care Debate

I'm a big fan of eccentric America. You meet a bewildering variety of folks with outlandish views on everything from aliens and black helicopters to the brainwashing power of chlorinated water. It makes for good pub conversation. Having said that, I'm not sure it's a good sign that these are the people currently leading the health reform debate. In a week when you would've assumed that the administration would be receiving some plaudits for the death of the Pakistani Taliban leader or the release of two American journalists from North Korea, pundits and bloggers have been engaged in the very serious discussion of whether Obama plans to round up and execute old people.

It's difficult to try to explain the nature of this national conversation to a non-American. "Wait, Americans don't actually believe that Obama is going to execute old people, do they?" I'm at a bit of a loss trying to answer that question. I know America well enough that I'm sure there is a percentage of people who sincerely do believe that. This seems to have started with Palin's comment that her family would be forced to stand in front of Obama's death panel. You might've expected that this sensational lie would've been denounced by more of her colleagues, but instead the head of the party, Michael Steele, endorsed Palin's claim, as did the lead Republican on the health reform negotations, Chuck Grassley. I'm not convinced they really believe the claim, but top Republicans seem happy to propogate this lie to their political advantage. But assuming Grassley has actually read the legislation he is helping to negotiate, he knows it's BS.

In short, there is a ton of misinformation out there right now, from the outrageous (Obama is planning to round up citizens in internment camps) to more subtle fear-based defenses of the health care status quo. I'd just like to suggest that those of you who support health care reform talk to your friends and family about the issue, because if we don't then the people in tin-foil hats will be the ones deciding whether you get guaranteed coverage. It's critical, especially within the next four weeks of the August recess, to counter the lies and information in a blunt but civil manner. In the next days I'll post some of my own pro-reform thoughts here.

Monday, August 10, 2009


An anti-health-reform protester gets in a scuffle at a town hall event, and is now soliciting donations for his medical costs because...he's uninsured. Wow.