Wednesday, May 6, 2009

Gentlemen, Start Your Rebuttals!

There's a very illuminating article on Politico, from a big-time Republican consultant on how to defeat healthcare reform. He talks a lot about the language conservatives need to use to thwart our reform efforts.

Here are the phrases he thinks are winners for Republicans, followed by my rebuttals:

THEM: “One-size-does-NOT-fit-all.”

US: "Exactly. That's why we need options: private insurance or a public plan. American's deserve to have a choice."

**

THEM: “Would you rather … ‘Pay the costs you pay today for the quality of care you currently receive,’ OR ‘Pay less for your care, but potentially have to wait weeks for tests and months for treatments you need.’”

US: "We're in luck, we don't have to make that choice. By giving all Americans access to healthcare, we will lower costs by preventing the most serious illnesses. The money saved will be used to make sure that no one waits weeks or months for tests or treatments. And lower healthcare costs mean lower premiums for everyone, in both the public plan and private insurance."

**

THEM: “It could lead to the government rationing care, making people stand in line and denying treatment like they do in other countries with national healthcare.”

US: "Do you know someone without health insurance? Since that's 1 in 6 Americans, you almost definitely do. And those people --- your neighbors, your friends --- are on a very long waiting list: forever. Even people who have insurance in the U.S. are on waiting lists. I know a woman who is in constant knee pain, but her insurance plan only uses certain surgeons, so she has to wait until a spot opens up. It's been months of chronic pain, and she's still waiting."

**

THEM: “President Obama wants to put the Washington bureaucrats in charge of healthcare. I want to put the medical professionals in charge, and I want patients as an equal partner.”

US: "President Obama wants to keep healthcare private, but give Americans choices. In his recent press conference, Obama said "I have two wars to run. I have an economy to fix. I have enough on my plate." He has no interest in putting Washington in charge of healthcare. He supports a public plan because it's the only way to give quality, affordable healthcare to everyone in America. A public health insurance option is exactly that: an option. Doctors and hospitals will stay private, and decisions will always be made between doctor and patient."

**

THEM: “In countries with government run healthcare, politicians make YOUR healthcare decisions. THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”

US: "Creating a public health insurance option is not 'government run healthcare'. A public plan just adds an option for people who can't get health insurance through their employer. Private insurance exists exactly like before. If you like your current health plan, you can keep it. Politicians don't make healthcare decisions now, and they won't after the public plan is created."

**

THEM: “A balanced, common sense approach that provides assistance to those who truly need it and keeps healthcare patient-centered rather than government-centered for everyone.”

US: "Yes, by all means let's have a balanced approach. Let's not get rid of the insurance companies, but let's have an alternative to them. They can compete with each other on a level playing field, and everyone in America will have more choices. That sounds like patient-centered common sense to me."

**

THEM: “More access to more treatments and more doctors…with less interference from insurance companies and Washington politicians and special interests.”

US: "Republicans are trying to block reform by promising you anything you want as soon as you want it: more treatments, more doctors, more everything. But someone has to be responsible for controlling costs and making sure our premiums are not sky high. We are in favor of responsible reform, where every proven treatment is available to every American that needs it. Be suspicious when politicians start promising you the moon so they can block any kind of reform."

Thursday, April 30, 2009

Let Me Get All Up In Your Healthcare Plan

Best pick-up line in a video ever: "my co-pays are quite modest"

Tried to embed it but no go. Check it out here

Monday, April 27, 2009

Always Look on the Bright Side of Death

What's the Venn diagram containing both Monty Python fans and healthcare reform advocates?



At least one.

Is Healthcare a Right...Yet?

A recent CNBC segment posed the question of whether healthcare is a right. They brought on commentators to argue in favor and against, one from the Cato Institute and one from the National Physicians Alliance. (you can see the clip at curethis.org).

The host started by posing the question to the conservative commentator, Michael Cannon. “I think it should be a right,” he replied. “And therefore I think physicians should work for nothing.” Sarcasm notwithstanding, his point was clear: healthcare cannot be a right because it involves payment. The exchange of goods and services for money equals capitalism, which puts healthcare squarely in the category of commodity.

Mr. Cannon backed up his point by contrasting healthcare with other things we commonly think of as human rights, like freedom of speech and religion. No one has to be paid in order to let us speak freely and worship freely, he implied, which is why they are rights and healthcare is not.

This argument is persuasive. We like to think that a human right is something you are born with, not something that has to be given. The very phrase ‘freedom of speech’ suggests its simplicity: just let people speak! It’s not that hard! Healthcare, on the other hand, is not accomplished by standing aside and letting citizens exercise their freedoms. For healthcare to be your human right, something has to actively be done to you.

But is it true that freedom of speech requires no involvement by the government? Let’s imagine taking a trip to place where there is very little government, for example Somalia. You might have the basic human right to freedom of speech there, but it’s not worth much. If you stand on a milk crate (assuming you can find one) and give a speech that others find disagreeable, those people may choose to gag you, stuff you in the trunk of a car, drive you 20 miles out of town, and perhaps kill you. The government has done nothing to take away your freedom of speech, but they haven’t done anything to protect it either.

We often ignore the role of infrastructure, such as our police force and civil and criminal court system, in allowing rights like freedom of speech and religion to flourish. The U.S. legal system is a highly complex bureaucracy, and it plays an important role in keeping the right to free speech alive.

The same principles apply in healthcare. We have a complex bureaucracy in place — doctors, nurses, hospitals — to protect our right to health. There’s no difference, in principle, between free speech and healthcare, so why is one an unquestioned human right while the other is relegated to a commodity?

In fact, no matter what human right you can name, there is an infrastructure in place to protect and defend it. And the professionals who manage that infrastructure need to get paid. So it’s foolish logic to argue that since doctors are paid a salary, healthcare cannot be a right.

Now, an opponent of the idea that healthcare is a right could argue that sure, the legal system keeps freedom of speech alive. But it also does other things. We would need cops and judges around to deal with violent crime, even if society had no right to free speech. So the added cost to society from having freedom of speech is pretty minimal.

But the same argument could be made for healthcare. The medical industry has to exist regardless of whether healthcare is a right or not. Once again we can see that healthcare and freedom of speech are identical.

Still, let’s be generous. Let’s say we do accept the distinction that Mr. Cannon was trying to make when he drew a bright line between healthcare and freedom of speech. I think what he was trying to get at was that there are two types of rights. And actually, he’s correct. Philosophers and ethicists commonly refer to them as “positive” rights and “negative” rights.

In the U.S., we are very comfortable with the latter category. Negative rights are when a person has the right not to have something done to him. For example, the right not to be tortured, not be persecuted for your religion, and not to be thrown in jail for disagreeing with the government.

Healthcare falls into the category of positive rights, for obvious reasons. (i realize, by the way, that i’m not using the strict philosophical definition of these terms. If you really care about the subtleties, check out this.) We Americans, when polled on this subject, have always been uncomfortable with positive rights. Positive rights seem to imply whininess, laziness, petulantly asking others for help.

But positive rights are actually a strong part of our tradition. Universal public education was introduced in the U.S. in the late 1800s, and today it is as American as apple pie. Ask any fourth-grader if she has a right to go to high school, and you’ll get a quizzical look because the answer is so obvious. We still fight about ways to improve education in the U.S., but no one has seriously proposed abolishing the public school system. Why? Because we understand what an incredible boon to our country it has been to have a well-educated workforce.

So we’ve established that healthcare, from the standpoint of principles, is no different than other accepted human rights. And from a practical standpoint, we see that Americans already support rights that are very similar to healthcare, like education.

So it seems to me that healthcare is a right. Other people, of course, can disagree. What they can’t do is pretend that there are objective, empiric differences between healthcare and other accepted human rights.

Should we pay primary care docs more?

Read and think about it, quiz later.

Tuesday, April 14, 2009

The Latest in Cancer Treatment

IV drugs administered in the doctor's office are covered. But the same medicines in pill form are not.

I hardly need to comment on this. So I won't.

This Fight Will Get Dirty

In case you thought the private insurance industry was going to sit back and let healthcare reform happen....well, check out this article in a local Massachusetts paper:


"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence.

Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune.

...

The letters were, in fact, composed and sent by the Boston office of [Dewey Square], a national political consulting firm, attempting to create the appearance of a "grass-roots" movement for Medicare Advantage.

America's Health Insurance Plans, an industry trade group, hired Dewey Square to defend the Medicare Advantage program.


It gets worse:

The Eagle-Tribune received a call from a man who turned out to be an intern at the Boston office of the Dewey Square Group, a national political marketing and consulting firm.
The man, who identified himself as Noah, wanted to know if Gloria Gosselin's letter had been published. Asked what interest he had in the letter, Noah replied that he was Gosselin's grandson.

Gosselin does not have a grandson named Noah working in Boston. Her only grandson is a student at Central Catholic.


Got it? The fight will be dirty. AHIP knows that to block healthcare reform, they will have to get rough. And they're not going to sit back and let the groundswell of support for healthcare reform wash over them.

Conservative estimates are that AHIP has $100 million set aside to fight against healthcare reform. And they seem to have every intention of playing dirty with it.

So this is it. We've been warned. Consider this a shot across our bow. It's going to be a serious, heavy-duty fight.

And if we fail to reform the system because we don't fight back hard enough.... well, i was going to say we have no one to blame but ourselves. But we can always blame the big bad insurance industry. We can fail, and then we can comfort ourselves that they had more money, and they played dirty.

But I'd rather not comfort myself. I'd rather win. And we can. We have the truth on our side, and better arguments, and oh yeah, history is on our side too, both in the U.S. and around the world. Those are far more powerful than a willingness to play dirty.

Smears can always be defeated by the truth. But someone has to speak that truth. Unfortunately, the truth never speaks for itself.