Thursday, August 20, 2009

My two cents on what is passing for the healthcare debate

It really isn't even worth that much. My contribution, that is.

What I want to know is, why is it when thousands and thousands of people march in protests against going to war do we still go to war, but when hundreds and hundreds of people yell about health care we back off. Does it have something to do with being yelled at personally? Surely professional politicians are used to being yelled at. Surely they know that for every one person who yells, there are probably many more who aren't making a fuss, who are either for or against or unclear on the legislation.

I wonder if it has something to do with this being something that is close instead of far, affecting me instead of them. I remember a couple of years ago when the youth group from Christ Church offered a diocesan resolution that encouraged every parish to change one--ONE--lightbulb to an energy-efficient fluorescent. There was more debate over that resolution than about immigration reform. Why? I suspect it was because this was a resolution that actually asked the people in the room to change (in this case a lightbulb), to do something. Most of these other resolutions didn't require anything of us and passed with barely a squeak. Suddenly, when the people in the room were being asked to take action, oh the outcry over what this would cost, is it really better for the environment, the mercury in the lightbulbs...I couldn't believe it.

Don't get me wrong: the majority of the people in the room were supportive, and it passed with no problem. But it brought home to me how much easier it is for anyone--I don't care where you are on the political spectrum--to support a program or a cause or a policy when it makes no nevermind for you.

What boggles my mind though is when people who will be helped by health care reform are arguing against it. And I really wish some of our folks in Washington were willing to be grownups about it and not simply give in to people who are having tantrums.

My lack of contribution to this topic is now complete.


Art Deco said...

Just out of curiousity, who will be helped by health care reform, by what sort of reforms, and with what sort of downstream second-order consequences? How does 'reform' result from the 1,000 pages of proposed amendments to the United States Code that Rep. Conyers (D-Michigan) had admitted he cannot be bothered to read? If you are not in the tank for the Democratic Congressional Caucus, how can you be confident that Henry Waxman is not sneaking time bombs into those 1,000 pages of text (with consequences rather more distressing than Mr. Dodd's AIG bonuses)?

Laura Toepfer said...

My goodness! When I tagged this "things I know nothing about" and "a willful display of ignorance" I wasn't kidding, you know.

My post wasn't so much about the best way to do health care reform as it was wondering

a) Why the thought of changing a system that so clearly leaves so many people uninsured, ailing, or bankrupt can get people bringing guns to political town halls? Automatic weapons, for Pete's sake!

and b) why Democrats seem so willing to cave to what seems a small group of noisy and CLEARLY ill-informed people? When a good chunk of people who "don't want government in healthcare" admit they receive Medicare, then we have a real communication problem. (eg:

The questions you raise ARE the question that need to be raised at town halls. But not with guns. Screaming and refusing to listen are not what I would call a civil debate. If what I saw were reasoned arguments, I would have written something else.

I'm flattered that you would think my blog worth the trouble of your comment. I know there are plenty of sources where you can find the answers to your questions.

Molly said...

What baffles me is how we can be expected to find solutions to our problems if, when a serious solution is offered, it is met with weapons and Hitler photos rather than reasoned debate.

Is the system broken? You bet. How do I know? I've worked with the executives of a very large health insurance company on the issues in their claims department.

Is the Democratic plan the best plan ever? I doubt it. Is it a genuine effort to make needed changes? I believe it is. And I have yet to hear of an intelligent, detailed alternative.

As a Republican-in-exile, hoping someday to return to the party once it becomes sane again, I grow ever more tired of screaming "NO" and name calling as the party's contribution to our national debate on critical issues.

One doesn't have to be "in the tank" for the DNCC to think that a genuine policy initiative has more going for it than the old politics of paranoia.

Art Deco said...

I think there was a meeting in Phoenix where picketers milled about outside with weapons (to make some sort of 2d amendment point, I think). Not that important.

As for people 'screaming', there are folk in positions of authority who are very practiced at deflecting people. They do not if they can help it utter a candid word. Civil discussion with such people is a non-starter. Whether the public officials in question are this type I cannot say; you are familiar with the type because this type is abnormally common among the clergy. Lawyers may be able to mess with their heads enough in a civil manner to get them to say something forthright, but ordinary people are left with the Morton Downey method: get them upset and off-balance and then they tell you what they really think.

I am not sure how many papers have been submitted to journals on medical bankruptcy. In the one I have seen referred to in fora such as these (and which I have read), the subfraction of their sample the authors classified as 'medically bankrupt' had $18,000 in unpaid medical bills out of $180,000 of total liabilities.

About 15% of the population is uninsured, a figure which has been stable for a generation. Some portion of these are eligible for Medicaid but have not enrolled and some portion are illegal aliens.

You complain about how uninformed people are. The thing is, only about a quarter of the population pays much attention to public affairs. Public discussion is bound to be messy for this reason alone. Another problem is that the legislation itself is hopeless. It is quite impossible for anyone to be well-informed. Even schematic representations of the institutional infrastructure and options created by the legislation are hopelessly rococo. You can expect people to listen to the President and Henry Waxman and just give them what they want; that expectation would be unreasonable, even if these two men were all that trustworthy.

I should note in this context that Singapore has had (by many accounts) a fairly successful run with a system which conjoined public insurance (over a high deductaible) with medical savings accounts funded through payroll deductions. Economy in the delivery of medical care is achieved in part by interactions between physicians and patients for whom costs are transparent (as they were in this country prior to 1942). Why do you suppose the president did not propose that?

Laura Toepfer said...

Art Deco,

I respect that you hold a different opinion and that from the sources you have seen you come to different conclusions from the ones I have drawn from the sources I know.

I'm writing this only to say that, again, I'm amazed and flattered you would bother to comment on my little blog. This is not a forum where I'm going to spend a lot of time on comments other than acknowledging their presence and sticking to the initial entry I write. What you are writing about has gone--not far afield, but away from the original intent of what I thought was a rather innocuous posting.

Thank you again, and I hope you can find a place where you can engage fully in this meaty debate.