Political speech on health care, quite a bit of it, doesn't match up well with reality on the ground.
Some of the most critical votes in Congress when time comes, presumably some weeks hence, to vote on health care, will be those of the more skeptical Democrats. One of the Democrats most reluctant to accept the various health plans pushed in recent weeks through committees has been Idaho's Walt Minnick.
He's made a number of statements on health care; one (arriving in email) that seemed to need clarification was this: "Third, no 'socialized medicine.' The health care system of insurance must be private – not run by the government." In Minnick's use of the term (exact definitions can vary by person), what does socialized medicine mean? His press secretary responded:
He is firmly opposed to a public option. We of course have Medicare and Medicaid, and while people who use those services like having the benefits of some healthcare, most people very clearly do not like the process associated with those programs. So that partially informs his thinking.
The other key thing to understand is the reasoning by most proponents of a public option. The proposed plan and its proponents on Capitol Hill very much want a single-payer, single-provider system of health insurance – that is a poorly kept secret in Washington, D.C. They view the public option as a way to not just compete with insurance companies, but drive them out of business. The public option would so effectively kill competition in the marketplace, that the proponents would likely be successful in that endeavor.
For Walt, competition is at the heart of this part of the healthcare discussion. A public company would not have to pay taxes, it could bond without restriction, it could go into debt without being beholden to banks or shareholders and would not have to worry about losses. It could just add those losses to the national debt. Most importantly, it would not have any real incentive to drive down costs, because it would quickly become the dominant, overwhelming force in the marketplace. It would be the largest insurance company in the country, run by the federal government and subsidized by taxpayers at enormous cost. That is socialized medicine.
Walt said something interesting the other day as an off-the-cuff way to oversimplify and explain this. Let’s say you sell bikes. And the bike industry is an absolute mess due to poor standards, a lack of accountability, out-of-control costs which are due to a wide variety of complex factors, and wide spectrum of regulations differing from state to state, etc. The government decides it is critical that the industry be reformed so the cost of bikes stops spiraling out of control. Is the way forward for the government to start its own bike company?
Fairly clear as explanation of philosophy. Now, an explanation of how the matter looks as a matter of governing philosophy, from here:
We have laws, generally accepted across the philosophical spectrum, that prohibit someone from walking into your house (or your convenience store), pointing a gun at your head and demanding "your money or your life."
That is what our health care system is doing to us, right now, and on an immense scale. It is extortion at the least, robbery at the most. Governmental activism is needed to stop it.
That may sound harsh or extreme. It isn't. That way of looking at American health care today could be backed up by any number of statistics or studies, but, as Minnick drew on his experience to inform his take on health care, let me draw on some personal events that occurred about 13 months ago. Individual experiences differ widely, of course, but here's some of what informs my thinking on this: (more…)