Another Nutshell

This is what it has come to. The campaign of disinformation has truly done its work. Rep. Robert Inglis (R - SC) was reportedy told by a constituent: "Keep your government hands off my Medicare!" Dear Lord. A Republican congressman in a Republican state is forced to try, unsuccessfully, to convince his constituent that Medicare is a government program. Ah, the irony. Republicans have done such a good job convincing their public that government programs are bad, people don't even realize that the Medicare they seem to like so much is a government program.

Of course, just because the Republicans are wrong, this does not mean the Democrats are right. No, the Democrats are wrong too, just not for the reasons the Republicans give. Myself, I lost any hope for healthcare reform when President Obama met with the stakeholders to map out his plan. How nice. Too bad the biggest stakeholders are insurance and pharmaceutical companies: folks who are getting filthy rich off the current system and like things just fine as is.

Perhaps we should sit down with the foxes to see if they might self-regulate the number of hens they eat. I'm sure that would streamline the system. Think of all the money we'd save on dog food and shotgun shells.

Let's see if a prickly but honest Porcupine can clarify matters a bit, shall we?

First of all, we don't have a healthcare system in the US; we have a healthcare market. The problem is, healthcare is not really a commodity in the usual sense. If I need my appendix out, I can't very well shop around and compare estimates, can I ? Furthermore, the purchase isn't exactly optional. Buy or die, is what it amounts to. I think we might all agree this is different from choosing between Ford, Toyota, or taking the bus?

Secondly, what is the biggest source of waste and inefficiency in our current system? Insurance companies. They contribute nothing while siphoning off money at every level. Think about it: patients hate them, doctors hate them, hospitals hate them, even employers hate them. Am I leaving anyone out? How do insurance companies make money? By taking in more in premiums than they pay out in claims. If we're talking about health care, they have a clear incentive to give you as little as possible while charging as much as possible. That's how they make their money.

Pause briefly to consider just how much money this is.

Of course, this drives up the price of everything. Doctors and hospitals charge more to compensate for the discounts they give the insurers. For those of us with decent insurance, doesn't it seem like you're asked to come in for an awful lot of "follow-up" appointments? Yup, you're still breathing. Heart still beating. Feeling ok? Yes? Great. See you in 3 months. (Ka-ching!) Is this how the doctors work the system? Quick easy money? Makes you wonder.

What of the concerns we hear about: health care rationing? Wake up, people. We have that now. Don't believe me? Your claim has been denied. Believe me now? How about this: I'm sorry, that's a preexisting condition. And let's not forget the millions of Americans whose health care "ration" is zero.

"Death panels?" We have that now. Still don't believe me? That treatment is experimental. Your plan doesn't cover that. See what I mean?

While the drug companies deserve their own ration of quills, let's not forget their interest here: high drug prices. No pesky negotiating for them, although they do this with almost every other industrialized country. But don't they need the money for research? Guess what? Most research is done at the NIH, paid for by us. The drug companies just buy in at the end. They make nice ads though. Ask your doctor if Damitol is right for you.

Why should we have universal health care in America? Aside from the fact that every other industrialized nation has some form of it, it's good for society to have relatively healthy citizens. Right now, it's practically illegal to get sick in America. Worried about the flu? Well, it would be nice if sick people didn't go to work and spread it because they can't afford to stay home. I think that might help, too. Here's another common scenario we could do without:

1. Get sick
2. Can't work
3. Lose job
4. Lose insurance
5. Lose it all

Only in America, folks. Now, maybe single-payer would, in fact, be difficult to implement here. That could be, I don't know. I'm just a Porcupine. That doesn't mean I have no suggestions, though. I think two simple changes could do quite a bit.

1. Require health insurance to be non-profit
2. Require each plan offered to be sold at one price to all customers

That's it. First, we remove the profit motive. Then, we stop insurance companies cherry-picking and selling plans only to young healthy people. That's the only reason the insurance industry didn't oppose Medicare and Medicaid. It let them get rid of people who actually need expensive healthcare. And boosted their profits enormously, I might add.

Pause again briefly to consider how much money this is.

The biggest inefficiency we have right now is all the money we spend keeping rich people rich. If we could cut back on that, I bet we could find a way to provide health care for all. That's it in a nutshell. Now, wasn't it the truth I told ye?

Very Truly Yours,

Porcupine