Yes, I know, the two are not mutually exclusive, but I still think it’s a good title. The latest bit of evil idiocy? More fanning of fears about health care reform. Don’t misunderstand, there’s plenty of potential pitfalls to health care reform, but Rush is an idiot. He calls it “Five Freedoms You’ll Lose Under Obamacare”. Let’s see what he’s talking about.
I’ll let you in on his absurdist intro just for the fun of it:
One of the best points that anybody could make in describing the uniqueness and greatness of this country, do you realize that the history of the world is tyranny? The history of the world is dictatorship. The history of the world is dungeons and torture chambers. That’s why this country is so unique.
“Guantanamo isn’t a dungeon because:”
A) It isn’t underground
B) Cheney says it’s really a “Freedom Field”
C) Only bad people are imprisoned
OK, moving on to health care. Rush says of we Americans, “who’s going to vote for torture, who’s going to vote for tyranny, who’s going to vote for dictatorship? But we did. We did. And you see it slowly encroaching. ” He’s not talking about the Bush administration’s suspension of habeus corpus or any such real tyranny. He’s talking about the Obama administration—just in case you weren’t sure.
Anyway, his list of Five Freedoms is really his riff on a CNN piece, so while the FF’s are not unique to him, his analysis certainly is.
Freedom 1: Freedom to choose what’s in your plan.
The federal government will impose a minimum list of benefits that each plan is required to offer. … Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.” Many states require these “standard benefits packages” and they’re a major cause for the rise in health care costs along with tort reform.
Of course, that has nothing whatever to do with an individual freedom. Most Americans have no “freedom” to choose what their health plan covers. Most Americans get their health care from their employer or the federal government (Medicare). An employer does not typically give you a choice other than perhaps between an HMO and a fee-for-service plan. This is different from “choosing what’s in your plan”. Companies offer plans, you choose the plan. Hair transplants are not a commonly covered entity. But there are services that people wish they had but do not, such as coverage for female oral contraceptive pills. Typically, states may impose coverages based on what patients and providers demand. One person’s hair transplant is another’s dialysis. This is a much more complicated topic than The Great Oversimplifier would have you believe. It’s really about rationing.
Freedom 2: Freedom to be rewarded for healthy living, or pay your real costs. That doesn’t sound like a freedom at all, but like a benefit. Currently, many health plans offer rewards (such as reduced premiums) to people who quit smoking, check their blood pressure, etc. This is becoming the norm. But what Rush is really upset about is risk-pooling. Insurance works by taking a large number of people, having them all pay into the system, and using that money to pay for the needs of the members. Inevitably, some members will use more services, some less. Insurance doesn’t work unless the pool contains lots of healthy people. To allow healthy people to pay significantly less defeats the purpose of insurance.
Freedom 3: Freedom to choose high-deductible coverage. What’s that, like freedom to get involuntarily sodomized? High-deductible plans may help drive people to more economically-driven health behaviors, but what it really does is discourage people from seeking preventative and proactive care. (I’m also not sure whether or not any plan that gets passed will forbid this; it may be true, it may not be.) Patients are not economic rational actors. When you’re sick, you are irrational. High-deductible plans are idiotic.
Freedom 4: Freedom to keep your existing plan. I don’t know how many Americans care whether or not a health care reform bill will preserve this “freedom”. Most Americans just want decent coverage, regardless of who provides it. And what does this freedom mean? Let’s say a small business, under the new plan, is given a choice between providing coverage to employees or paying an additional tax and letting them go with a public or other private option. That’s a market-driven decision. That’s capitalism. If private insurers can’t keep their overhead down and compete, then that’s the way it is.
Freedom 5: Freedom to choose your doctors. This is perhaps the most ridiculous “freedom”. First of all, if you’re not insured, you can’t choose any doctor. And do you know what plan has the most “freedom of choice”? That’s right, it’s the government plan, Medicare. Any provider can choose to participate in Medicare, and most do. The most restrictive choices are by HMOs provided by employers as part of their “lower tier” insurance (see Freedom 3).
People don’t understand health care, and this makes them easy targets for ideologues. Let’s face it: Rush Limbaugh, Glenn Beck, Barack Obama—none of these folks is going to have a problem getting care. The rest of us have a horse in this race, and it’s time to start paying close attention to the facts.