Healthcare Rant

First off I’ll leave the links up top, because this is probably going to get long.

Thers of Whiskey Fire responds to a Crooked Timber post, The Heavy Burden of Level-Headedness which responds to a Christopher Caldwell criticism of Michael Moore and the movie SiCKO.

Then R. Neal at Facing South reports in SiCKO: What now? Answer: HR676?, of the efforts of John Conyers to expand Medicare coverage to everyone in HR 676 that he introduced in the 109^th Congress.

Thers is wrong in assuming that people know about the American healthcare system. What they know is the system that directly affects them and those they love. There is no American healthcare system.

Medicare and the military Tricare are the only systems that work in the same way all over the U.S. There is a different system in every state for Medicaid, and every other program varies widely not simply from state to state, but often within a state, i.e. different coverage in rural areas than urban areas.

This lack of standards or standardization is the source of a great deal of waste in the system and drives the costs up unnecessarily.

Some think that individuals should be given healthcare vouchers. That will make matters worse, not better. It will drive up insurance company profits and healthcare costs without providing real improvement. Costs and benefits need to be negotiated, and the individual has no power in relation to a corporation. If negotiations are to succeed they must be between economic equals.

Conyers has a good start in thinking about using Medicare as the basis, but the Federal government needs to clean up its mess first. Everyone currently receiving Federally financed medical care should be in the same system and receive the same coverage. The money spent on all of these separate systems needs to be pooled, and so should the administration.

The Federal healthcare administration [or whatever it’s called] should be negotiating for pricing. I’m not saying that Congress should be mandating anything, the prices should be negotiated. Negotiating the cost of drugs under Medicare Part D and having a single program with known benefits should significantly reduce the cost of the current corporate welfare system [AKA No Big Pharma Lobbyist Left Behind].

After the Federal system is unified, then more people can be brought in. State and local governments can’t be forced to use the new system, any more than they can be forced to join Social Security, but they should be able to.

Actual healthcare providers should continue to function as they do now. They shouldn’t be required to accept the Federal system. If they want to remain apart, there is no reason to force them to join. I can’t imagine they will find very many people who will opt out of a Federal system, but if a doctor or hospital thinks they can make a living without accepting patients under the Federal system, it’s their choice.

As for insurance companies, if they had been providing reasonable service at a reasonable price, people wouldn’t be looking at a national system. They flunked capitalism in return for short-term profits. The fact that they have been shedding customers at an ever accelerating pace for some time now, just demonstrates their failure to understand their market as they concentrated on the stock market. There’s a lot of that going on in corporate America.

For those who believe that the market should decide – it has decided. The customers want a single payer system because “private enterprise” has failed to provide them with a product they can afford. Anyone who doubts that should talk to the corporate leaders who back a national system because they are being gouged by insurance companies.

[Minor edit for readability.]