05 December 2005

Medical care

Kevin Drum is puzzled. Medicare for the elderly and medicaid for the poor seem to work pretty well.
Here are the percentages of Americans who say they are "fairly or very satisfied" with their own health system:
  • Poor: 45%
  • Elderly: 61%
  • Everyone else: 34%
Americans in general are highly dissatisfied with their healthcare system --- the one that's supposedly the "best healthcare in the world" --- and yet they've been conned into thinking that a national healthcare system would be even worse. This is despite the fact that people in America who are enrolled in a national healthcare system (most of whom have previous experience with private employer programs) like it better than the working stiffs who have private coverage.
Meanwhile, Ezra Klein reflects on the propaganda triumph thus puzzle represents.
We've so fully demonized government-run health care that we won't even believe it can work when it already is. The totality of propaganda's triumph over not just the facts, but our subjective interpretation of the facts (i.e, how satisfied we are with our health care) is truly stunning.
Having done some recent work for foks in the insurance biz, I have to say that I'm convinced that the government could not possibly screw things up any worse than the current system. I doubt even the Bush administration could find a way to do it.


Anonymous said...

Y'know, I believe in national healthcare only because something, anything has to be better than our current stupid system.

But... I do think that it's very likely that national health coverage would turn into an even worse system than the one we have now. We would have to learn how to ration based upon likelyhood of survival, and not have hard decisions made for us by financial ability.

With national healthcare, we will end up spending millions of dollars on "saving" 21 week old babies (called "million dollar babies", because they'll probably need repeated surgeries throughout their lives), then we'll gripe and moan at the expense. We will expend drastic efforts to give cancer patients another week of pain, then finally state that national healthcare is just too expensive.

National healthcare will work only when Americans give up their stupid concepts of "miracles" and face the cold, hard truth:

No, your 21 week old baby is too young. I'm sorry. We're not doing anything. It will die.

No, your mother has end-stage kidney disease. I'm sorry. We won't do a full code.

No, you're eighty five. I'm sorry. We won't put you on dialysis. The waiting list of people younger than you is just too long.

Are we, as a society, ready to face these facts? I doubt it. We'll want to stay in the make-believe land of private insurance, which we may HATE, but it's where we can pretend that there is no rationing, the drug companies aren't big jerks, and everybody gets the care that they need.

--- Willow (who should really be studying for finals right now)

Anonymous said...

A point that often gets missed in these debates is that with a properly run national healthcare system, there would actually be more resources available to everyone; and we would not have to ration. Having worked for a major HMO (that does work, unlike a lot that don't), and having met some of the heads of the major private health insurance companies in this country; I can tell you that there are big players out there with a mission in their hearts. It is not fiduciary, it is quality healthcare for everyone. Their participation at a public level, along with the incredible cost-saving that a single system would engender, could make quality healthcare in this country available to everyone without the problems that we see either in the Canadian system or that of the UK. We already have so many resources in place, that are not being used to the fullest capacity, that it would not take that much more to create a far more perfect system then any of us can imagine. By eliminating the extraordinary waste of dollars used just to generate billings, and advertising, the surplus would more then take care of any needed additional resources. It would also change the dynamics between us and the greedy drug folks. We should not have to make hard decisions based on financial ability, and that is what often happens with even the best private insurance. We have the right to take this power away from the 'black-tie dinner attendees' and put it in the hands of the people that are looking out for our interests.

Indri's Mom

Anonymous said...

I do agree that single system healthcare would save a staggering amount of money by eliminating billing alone, but with technological life-prolonging advances and our aging population, I'm not convinced that rationing wouldn't be necessary. We've created new (and expensive) problems just by prolonging life further than we ever have before (MODS, for example).

And, I like the point that a single-healthcare force would have much more power over the drug companies. Perhaps we could set up a price-limited system like Canada's, provided that the drug company lobbies don't have TOO powerful a hold over Congress.

--Willow (who REALLY needs to get back to studying for finals.)

Blue Cross of California said...

Great blog I hope we can work to build a better health care system. Health insurance is a major aspect to many.

Jonathan Korman said...

I can only hope that a single payer medical system would not resort to comment spam.