For me, the most interesting parallel between the national debates over how to stop heating the planet and how to reform health care insurance is the response both have generated in my own brain.
For years now, the failure of a sizable portion of the American public to accept the need to sharply reduce the primary causes of anthropogenic global warming has elicited frustration and, at times, fury. Similar emotions jump across my synapses in the face of daily news reports of the paranoid reaction of what is probably the same demographic slice of the country to proposals for government-run health insurance.
The irrational, anti-intellectual, conspiracy-mongering response of climate change denialists and pseudoskeptics have long puzzled me. I just don't understand why so many people would choose to reject the expertise of those who have devoted their professional lives to the study of a subject that doesn't lend itself to armchair quarterbacking. Much has been written about the lack of respect for science in certain American circles in the past couple of years (Unscientific America by Chris Mooney and Sheril Kirshenbaum, The Assault on Reason by Al Gore, The Age of American Unreason by Susan Jacoby) and there's a long list of explanations. None of which do I find satisfying.
But the opposition to public health insurance makes even less sense to me. I've found my Canadian-raised self explaining to true blue Americans why a single-payer public system ends up costing a country less and produces superior results (longer lifespans, healthier citizens, fewer dead newborn and mothers, etc.). For some reason they just can't accept that private health insurance will always cost more because you have to add a profit margin to the bottom line.
"Why are you so attached to paying more and getting less?" I ask. You can almost see the logic circuits frying. I am reminded of the scene in the original Star Trek where Kirk and his crew shut down the evil androids by feeding them logically impossible statements (The episode is called "I, Mudd.")
It's not brain surgery. It's not rocket science. It's not even high-school math. It's axiomatic. And yet there are plenty of people in Congress who insist that any reform legislation that includes a public insurance option is a non-starter. There are also those who insist any legislation that doesn't include a public insurance option is dead in the water, but the numbers at this juncture, and hints from the Obama administration, suggest that we could end up with a bill that includes only non-profit cooperatives rather than what used to be the core of the plan: government-supplied insurance.
Some might argue that if all we get is a bill that makes it illegal for private insurers to deny insurance for pre-existing conditions and caps out-of-pocket expenses at a reasonable level, then we should be happy and move on. This is America 2009, after all, and radical change isn't as popular as it was 230 years ago. What such an argument ignores, or course, is that a public option represents an enormous compromise from the only genuinely sustainable system: single-payer, universal, government-supplied health insurance. Not to get even a public option isn't compromise; it's capitulation.
Which brings us back to the climate campaign, which has also made massive compromises to get something before Congress.
ACES, or Waxman-Markey, is the result of the same modern-America pathological fear of meddling with the status quo. It includes the core idea of capping fossil-fuel emissions but waters it down by allowing emitters to avoid any real emissions reductions for a dozen years or more through the use of offsets -- offsets that will prove exceedingly difficult to guarantee or verify. It's such a colossal compromise from a scientific point of view that one wonders why industry is mobilizing elaborate and dishonest astroturf campaigns against it.
I try to stay optimistic by telling myself that just passing a theoretical cap-and-trade bill would represent enormous progress (otherwise, industry won't be working so hard against it, right?) and we can always go back in a year or two and close the loopholes. Which may or may not be naive and/or wishful thinking. But it turns out that even theoretical climate change mitigation is too much for some senators. As a result, we may be about to capitulate on that one, too.
Health insurance reform, by comparison, is actually less urgent. Sure, millions are uninsured and people are dying because insurance companies are spending fortunes on the salaries of employees whose sole job it is to find legal ways to deny coverage to deathly sick subscribers. But unlike climate change, there is no ticking clock, no irrevocable and devastating tipping points lying somewhere in the future of health care. (Well, there is the fact that rising heath care costs will eventually bankrupt the nation, but compared with the physical realities involved in climate change, they are relatively simple challenges.)
So why do the dwindling prospects for substantial, economic and ethical health insurance make me even angrier?
When I moved from Vancouver, B.C. to Saluda, N.C., four and half years ago, saying goodbye to the Canadian health insurance system in favor of expensive and unreliable private insurance was among the most difficult things I had to do. Rarely does a day go by when I'm not reminded of the dangers I, a freelancer who has to cover my own insurance costs, face from financial ruin if I become genuinely sick. My wife and I agree that in the event of a serious health threat, we'll probably have to return to Canada, as much as we love our remarkable and beautiful small-town home in North Carolina's mountains.
So when Obama rode to victory on a campaign that included genuine health insurance reform, it was hard not to feel like the tide was turning and everything would be OK, or least less absurd. I guess I just haven't had time to get used to being disappointed with the lack of progress on health insurance reform. For that I'll need something similar to what 20 years of banging my head against the wall of climate change denialism can do.
- Log in to post comments
NO CO-OP'S! A Little History Lesson
Young People. America needs your help.
More than two thirds of the American people want a single payer health care system. And if they cant have a single payer system 76% of all Americans want a strong government-run public option on day one (85% of democrats, 71% of independents, and 60% republicans). Basically everyone.
Our last great economic catastrophe was called the Great Depression. Then as now it was caused by a reckless, and corrupt Republican administration and republican congress. FDR a Democrat, was then elected to save the nation and the American people from the unbridled GREED and profiteering, of the unregulated predatory self-interest of the banking industry and Wallstreet. Just like now.
FDR proposed a Government-run health insurance plan to go with Social Security. To assure all Americans high quality, easily accessible, affordable, National Healthcare security. Regardless of where you lived, worked, or your ability to pay. But the AMA riled against it. Using all manor of scare tactics, like Calling it SOCIALIZED MEDICINE!! :-0
So FDR established thousands of co-op's around the country in rural America. And all of them failed. The biggest of these co-op organizations would become the grandfather of the predatory monster that all of you know today as the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT health insurance industry. And the DISGRACEFUL GREED DRIVEN PRIVATE FOR PROFIT healthcare industry.
This former co-op would grow so powerful that it would corrupt every aspect of healthcare delivery in America. Even corrupting the Government of the United States.
This former co-op's name is BLUE CROSS/BLUE SHIELD.
Do you see now why even the suggestion of co-op's is ridiculous. It makes me so ANGRY! Co-op's are not a substitute for a government-run public option.
They are trying to pull the wool over our eye's again. Senator Conrad, if you don't have the votes now, GET THEM! Or turn them over to us. WE WILL! DEAL WITH THEM. Why do you think we gave your party Control of the House, Control of the Senate, Control of the Whitehouse. The only option on the table that has any chance of fixing our healthcare crisis is a STRONG GOVERNMENT-RUN PUBLIC OPTION.
An insurance mandate and subsidies without a strong government-run public option choice available on day one would be worse than the healthcare catastrophe we have now. The insurance, and healthcare industry have been very successful at exploiting the good hearts of the American people. But Congress and the president must not let that happen this time. House Progressives and members of the Tri-caucus must continue to hold firm on their demand for a strong Government-run public option.
A healthcare reform bill with mandates and subsidies but without a STRONG government-run public option choice on day one, would be much worse than NO healthcare reform at all. So you must be strong and KILL IT! if you have too. And let the chips fall where they may. You can do insurance reform without mandates, subsidies, or taxpayer expense.
Actually, no tax payer funds should be use to subsidize any private for profit insurance plans. Tax payer funds should only be used to subsidize the public plans. Healthcare reform should be 100% for the American people. Not another taxpayer bailout of the private for profit insurance industry, disguised as healthcare reform for the people.
God Bless You
Jacksmith â Working Class
Twitter search #welovetheNHS #NHS Check it out
(http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healt…)
(http://www.youtube.com/watch?v=IbWw23XwO5o) CYBER WARRIORS!! - TAKE THIS VIRAL
those in power, regardless of their religion, are ALL social darwinists and thus, will NEVER support a single-payer health insurance plan for all americans. rich and/or powerful americans are determined to propound their erroneous view that the poor and uninsured are poor and uninsured because of one or more character flaws (laziness, for example), that they LIKE to be poor and destitute in a land filled with extreme waste and therefore, they should be PUNISHED FOREVER for not being part of mainstream society: the sooner these worthless humans die, the better life will be for those who are living the proper american dream. not providing health insurance simply speeds that very desirable process along.
The reason some people can't accept that is that they believe a government-run system will cost even more. Sure, a gov't-run system doesn't include profits, but gov't-run systems are likely to be full of inefficiencies and political waste. At least, that's the argument I often hear.
And, I can understand why the argument gets traction. After all, in many markets it's generally true that competition between private firms leads to lower costs and more efficient production and distribution than a gov't-run system could.
I think the challenge is to clearly show why health care is not such a system. Simply pointing out that private insurer's require profits isn't enough.
For me, one of the most persuasive arguments is that every western nation with gov't sponsored health care spends less than the US, with overall healthcare outcomes that are certainly not worse, and arguably better. Of course, citing such stats often elicits claims that different nations account for healthcare spending, lifespan, child mortality, etc., in different ways, and that the US is really much better than those supposedly biased numbers suggest.
Maybe there's even be some truth to that, but as often as I see such claims by those who favor our current system, I've yet to see decent data to back them up.
(P.S. The comment preview function seems to be on the fritz.)
The insurance racket's 'recission' practice is outright criminal fraud, committed across state lines and through the US mail. When it comes time to pay a claim, they claim the poor sucker wasn't really insured after all.
Bernie Madoff got 150 years for cheating the greedy super-rich out of billions.
The insurance racket has been cheating the desperate out of trillions. This fraud should be attacked under the RICO statutes by the FBI. The investors' assets should be seized and they and the insurance executives should be sentenced commensurately to at least 10,000 years each.
I've got to quibble with the statement that getting a grip on greenhouse gas emissions is more urgent than good healthcare reform. In the US, inefficiency in healthcare (excess costs) are hobbling the economy and seriously limiting our options and will to do something about climate change. Real healthcare reform would have an effect in the relatively short term, freeing up resources and political energy.
The profits argument against private health-insurance is simple, but not really all that important explaining why it sucks so badly. "Profit motive" does a better job since it captures why not actually providing coverage is such a common thing these days.
More fundamentally, a market based approach focusing on consumers 'choosing' is just stupid for healtcare. Not only is it immoral (providing access based on the ability to pay), but it also won't work economically speaking... even in theory. The consumers of healthcare are most often not free to 'shop', and when they, they don't have nearly enough information to make a rational choice. Even if they had perfect info and a real choice, what is the utility function for your (or your loved one's) life? How much money would you be willing to pay for a treatment with a 95% chance of success vs one with a 90% chance?
That's the real kicker for me. Even over here in the UK, there's a lot of talk these days of "improving patient choice". Given two options, who the hell wants to chose the worse one when it comes to healthcare?
Some things just aren't markets.
I just keep telling myself no legislation is final. Passing ACES through the Senate would have the following effects:
1. Immediately begin affecting investment decisions.
2. Cause some people to start making money from it, from 1 initially and through selling credits later. These people would have a vested interest in lobbying congress to make the legislation stronger so carbon prices go up.
3. Show the world in advance of Copenhagen that we are willing to do something, perhaps spur others to take some action.
4. Establish an insufficient cap on carbon, and establish a perfectly viable framework through which a tighter cab could be implemented.
5. Improve efficiency standards for appliances and automobiles. We tend to underestimate the importance of this because we went through college econ classes where they taught us how consumers will compute the cost of these appliances plus the discounted future cost of use under reasonable assumptions about future costs of electricity and gasoline and decide if the cost is worth the benefit. Of course, it works nothing like this and in the past these sorts of standards have improved energy efficiency and consumers have benefitted.
With point 2, that can come back to bite you, see corn ethanol, so certainly we should be wary of offsets. But for me it really comes down to point 3. This isn't going to be solved in one attempt because it won't be solved by one country. Nobody wants to pick up the tab while all their manufacturers move to a less strict country. But taking incremental action will make other countries willing to take incremental action, and that makes it easier to take further action.
Even the Victor/Wara study acknowledged that many of the CDM offsets were real, and ACES has a number of improvements on the CDM mechanism. I don't think you have the backing for the statement that no real reductions in emissions will occur due to offsets.
And offsets/cap and trade are only part of the bill, while other parts are also important, such us promoting green tech and renewable power portfolio standards.
Equation !
$1.042trillion (cost of reform) + $245bn (cost to reflect annual pay raise of docs) = $1.287bn (actual cost of reform).
$583bn ( the revenue package) + $80bn (doughnut hole) + $155bn (savings from docs) + $167bn (ending subsidies for insurers) + $277bn (ending medical fraud, a minimum of 3%) = $1.257bn + the reduced tax on the wealthiest = why not ? (except for magic pill, an outcome-based payment reform & IT effects and so forth)
In relation with medical fraud, please visit http://www.npr.org/templates/story/story.php?storyId=111967435, you will be stunned ! Thankfully, in May 2009, the Obama administration announced a new task force made up of officials from the Department of Justice and the Department of Health and Human Services to work on health care fraud.
Thank You !
I guess we should have expected this sort of treasonous tomfoolery from the blog author, who, bless his heart, is from Soviet Canukistan. But what about those of you commenting here who are born and raised true blue Americans? Don't you know that every time you attack the Free Market, Joseph Stalin wins? You're weakening our defenses against the Reds, and if you don't stop soon, one day you'll wake up to find their missiles arcing over the Earth to bring Doom And Destruction to us all!
P.S. : Please see about getting preview fixed.
I need some help.
I am not a scientist, and have only been interested in this issue for a few years. I'm fine to point people in the right direction for broad concepts. But I don't even know any calculus yet.
I have a commenter who knows a heck of a lot about Steve McIntyre and the Hockey Stick controversy. He's got a complicated chain of logic and citations which supposedly show that every 1000-year temperature graph ever used by the IPCC is flawed, when the flaws are taken out (specifically bristlecone pine data) the conclusion falls apart, and this has been suppressed by the IPCC which proves they have an agenda.
I've been holding up okay until now. But now I really need someone who knows their climate science well - either to help me out or to (preferrably) take over. I'm not the right person to be taking part in this debate. I'm not a scientist.
The thread starts here - http://climatesight.org/2009/08/13/by-your-own-logic/comment-page-1/#co… - and really gets into the specifics around here - http://climatesight.org/2009/08/13/by-your-own-logic/comment-page-1/#co….
Any takers?
Kate: there are plenty of places to find good debunking of the notion that the hockey stick is flawed. Try Real Climate:
http://www.realclimate.org/index.php/archives/2004/12/myths-vs-fact-reg…
And my colleague at A Few Things Ill Considered:
http://scienceblogs.com/illconsidered/2006/03/hockey-stick-is-broken.php
The simplest answer, however, is that regardless of the merits of the analysis that generated the original hockey stick graph, it has been independently confirmed a dozen ways to Sunday. There simply is no argument left among climatologists, just stubborn statisticians like McKitrick. -- jh
really agree with this comment
I guess we should have expected this sort of treasonous tomfoolery from the blog author, who, bless his heart, is from Soviet Canukistan. But what about those of you commenting here who are born and raised true blue Americans? Don't you know that every time you attack the Free Market, Joseph Stalin wins? You're weakening our defenses against the Reds, and if you don't stop soon, one day you'll wake up to find their missiles arcing over the Earth to bring Doom And Destruction to us all!
P.S. : Please see about getting preview fixed.