Monday, November 25, 2013

Rush Limbaugh, Liberal Trailblazer

An economist from UMass-Amherst (that storied home of austerity debunking) posits that the latest right wing conspiracy theory may be having the serendipitous effect of giving Single Payer health care a much-needed shot of adrenaline.

Writes Nancy Folbre in today's New York Times Economix blog:
Rush Limbaugh’s take on the disastrous rollout of the Affordable Care Act could, ironically, warm the hearts of those at the other end of the political spectrum. He contends that President Obama knew all along that the Affordable Care Act would crash and burn, but pushed it through so that the conflagration would clear the way for single-payer health insurance.
I sincerely doubt that any mythical Obamian eleven-dimensional chess tactics played into the backroom deals he forged with Big Pharma and Big Insurance, sweeping the public option right off the table. But if the latest right wing paranoia is having a positive effect, who am I to deny the prez his undeserved credit should the ACA prove to be naught but a noxious designer gateway drug to true Single Payer nirvana?

In his column today, Paul Krugman points to the relative success of the Obamacare rollout in California, home of Governor Moonbeam and a solid Democratic legislature. Krugman contends that this bodes well for the eventual success of the kludge nationally. But my response is more along the lines of Dr. Folbre's thinking:
If the botched rollout of the ACA proves anything, it's that public-private partnerships are deals made in free-market hell. Corporations whose motives are profits over people have shown that they can't be trusted with either our wallets or our well-being. Let the problems with a law that is essentially a mass giveaway to predatory private insurance be the death knell of neoliberalism.
But let us also rejoice that John Boehner is now the proud owner of an ACA policy himself. Kinda puts the kibosh on their whole government-is-the-problem canard, doesn't it? Even a few GOP governors appear to be tiring of their roles as Scrooges for refusing to cover their most vulnerable citizens under expanded Medicaid. The political reality is that even sadists have their limits when their own jobs are at stake.
And speaking of success stories -- what about Vermont? Having just announced plans to cover 100% of its citizens under true single payer by 2017, this is the real state to emulate. People will be green with envy when they look at the Green Mountain State and notice the plummeting medical costs and great service and democracy in action.
A website is the least of it. Because even had it worked perfectly from Day One, some 30 million people were still going to be left out of any coverage at all. And that is unacceptable.
 Medicare for All would save $592 billion in the first year alone, as well as millions of lives. So what are we waiting for? Single payer, here we come!
And, to clarify once again, the "Medicare for All" bill now mouldering in the House is not the same thing as Medicare As Usual without the age discrimination. It does away entirely with the whole for-profit wasteful way in which American health care is currently delivered. Unlike current Medicare, there are no co-pays and no premiums. Everything except elective cosmetic surgery will be covered.

Vermont, meanwhile, is leading the way in un-Americanism with the notion that health care is a right and not a privilege. Already, 91% of the state's population has health insurance, and none of its hospitals operates for profit. A true sense of community, and the idea that government's task is doing the greatest good for the greatest number.... multiply it by 50, and we might get ourselves a functioning democracy if we're not real careful.


Zee said...

Sadly, I doubt that the cratering of ObamaCare will in any way usher in an American single-payer system.

Rather, I think that it will reinforce in the minds of the public that government really can't do anything well, and we will return to the status quo ante for quite some time to come.

Certainly, it's a long way to
the midterm elections, but I don't see Democratic prospects as being very good for 2014, which is what would be required to transform ObamaCare to single-payer any time soon.

The Black Swan said...

Gotta love those public/private partnerships. I was in Chicago last weekend and got to experience firsthand the wonderful new Ventra system!

btw, my captcha was: ttrientr
very subliminal...

Pearl said...

Although Vermont can be a role model for how to give its people good quality health coverage, it is a rather unique state. Its current population is only 626,146 with a small land mass and is the lowest in population next to Wyoming.

Vermont is the least religious state in the US with only 19% claiming
to be 'very religious. Vermont has become a trailblazer for gay rights. In April 2009, Vermont became the fourth state to legalize gay marriage. It was the first state to legalize gay marriage by a legislature's vote. The House and Senate voted to override Governor Jim Douglas' veto. Prior to this vote,
Vermont was the first state to legalize same-sex civil unions.

It has a fairly liberal history with Democratic dominance from 1962–
currently. In 2007, with three-quarters of the state opposing the Iraq War, the state nevertheless had the highest rate of deaths there in the nation. This was due to volunteers and participation by the Vermont National Guard.

All in all, not representative of the rest of the country. Therefore, before being able to institute proper health care in the United States, the forces that are preventing it in the nation as a whole would have to change drastically with Vermont's successful program being highly criticized and dismissed by the private sectors in control.

We have a long way to go, and before praising California, we had better wait and see how that works out which could help or hinder further changes for the better. Regardless, as Karen has pointed out so well, as long as the private health care organizations are in control, the costs alone cannot be sustained. We need a political revolution in order to accomplish a system as we have in
Canada which is supported by all the parties and population. The changes in Canada were opposed at first but once in place were solidly supported and that is what will have to happen in the U.S., which is a formidable

Valerie Long Tweedie said...

Although I am a big fan of a single payer system, the pragmatic Valerie says there needs to be some kind of co-pay that is reasonable - some kind of contribution on the part of he people consuming the services. Otherwise, too many people will run to a doctor for a cold, a flu, a graze - which will ultimately clog up the system. Like it or not, having to pay $25 a visit to the doctor IS enough to slow people down. I know this isn't going to be a popular position with my liberal compatriots but I need to speak what I see as an economic truth. We should pay something for our medical care. What is unfair and unreasonable is to have to pay $800 a month per adult in a household like we would have had to pay to add my husband to my insurance. There was no way we could absorb that kind of hit.

Right now my husband and I pay (in Australia) $150 a month for our family to have supplemental health insurance and between $40 and $65 a doctor visit. Prescriptions are $33 whether it is an expensive chemo-therapy drug or a generic anti-biotic. These are reasonable costs that most households can absorb.

Noodge said...

@ VLT: I agree those costs are reasonable and that most households can afford them. But we have a system now with costs that most households can afford. The problem isn't "most households," and it never has been. The problem is the large minority of households that can't afford health care at all.

Let me ask: When you make the decision whether to see a doctor for some malady, do you decide to go based on the $40? Of course not. But what about the people for whom that $40 is a lot of money?

For a minimum wage worker in the US, a $25 co-pay represents about 10% of a week's after-tax income. I understand your concern, and you're right; you're getting a little grief from a liberal over it. ;-) But this goes beyond practical considerations for me. I see this issue as being a moral/philosophical one.

Our government was created for the purpose of securing our rights to life and liberty and to promote the general welfare. Being able to receive medical care is an essential element of the right to life. Telling people to pay for the privilege of exercising their rights is anathema to me.

James F Traynor said...

Yeah, Noodge, that's what the Declaration of Independence said, but, unfortunately, that's not what they did, beginning with the Constitution, which was carefully crafted to benefit the plantation South and the budding mercantile North. The Shays' and Whiskey rebellions were early examples of the true intent of the 'founding fathers'.

Fred Drumlevitch said...

@VLT (and @all):

I agree that at least in the U.S., people are often too quick to run to the doctor, and one could indeed argue for a co-pay as deterrent to prevent unwarranted use of the system. However, as Noodge points out, the impact --- and therefore, deterrence --- of a co-pay can vary widely, inconsequential for those who are well-off but an excessive deterrent for those of limited means. (I also sympathize with the moral/philosophical argument that he makes about health care being a fundamental right --- and which therefore should be fee-less --- but won't get into that now).

My suggestion: Perhaps medical co-pays could be structured similarly to traffic fines in Finland, where the penalty is proportional to one's income (as well as the severity of the offense).

Obviously, medical co-pays shouldn't be quite that costly, after all, with regard to medical care, the goal is neither punishment nor an attempt at high deterrence. But it would be much more egalitarian to make co-pays proportional to income.

Zee said...

As I have tried to explain before, I don't see health care as a “right.” It's a service provided by people to other people: no provider, no right. But it's a service that we should offer to all citizens if we—as a wealthy, nominally advanced society—have the resources to do so.

But be that as it may, I'm inclined to agree with Valerie. Something that is seen as being “free” will be abused, to the detriment of the providers and those who actually foot the bill. I think that Fred has found a straightforward solution to the “moral dilemma” that Noodge has raised: Require a co-pay proportional to income in order to place some restraint on “perpetual patients.”

CitizenX said...

Zee, (and Karen)

Pardon me for barging in, but Zee is the only NM citizen I know. What the heck is up with your police force? First the internal exams and now mace to the vagina? What's the buzz out there?

Zee said...


Several New Mexico law enforcement agencies are under close scrutiny at the moment for alleged improprieties, to the alarm of those of us who value our civil rights—even sorta-Conservatives like me who try to give the cops the benefit of the doubt when circumstances are not entirely clear.

First, the Albuquerque Police Department is under investigation by the Department of Justice for alleged civil rights violations in the wake of several years' worth of questionable police killings:

Next, cops in southern New Mexico have clearly exceeded their authority with unwarranted, excessive and thoroughly undignified “body cavity searches” that—apart from having been entirely illegal to do—came up “empty,” if you will:

Just a few days ago, New Mexico State Police ran amok when a woman whom they had pulled over for a routine traffic stop unwisely decided to flee—a couple of times—with a car full of children.

The “vaginal macing” of an inmate in the Bernallilo County Detention Center (BCDC) by a corrections officer (CO) was news to me—I had to Google the story—but nothing coming out of BCDC would surprise me these days, where COs have been charged with having sex with female prisoners, a female CO became pregnant by a prisoner, multiple COs have been accused of smuggling drugs in for prisoners, there have been numerous charges of rapes by COs, and COs have been charged with forcing prisoners to fight for the entertainment of the guards.

As to “what gives?”, as I said, I think even Conservatives like me are becoming quite alarmed at the conduct of our various police forces throughout the state, and we are grateful that the ACLU and the local media have been covering these stories.

To what do I attribute the increasingly brutal and corrupt behavior of some of our police? Well, I just don't entirely know. I have a certain amount of interaction with APD owing to my participation in a neighborhood association: they all seem highly professional, restrained and, yes, even empathetic, as I have related to Sardonickistas regarding the help they have offered, and watchful eye that they have kept, on a dear friend of ours who has a total, psychotic break with reality.

I would like to explain it away as merely a few bad apples spoiling the barrel, but I am concerned that there may be more to it than that. If I were to blame anything, I would say it relates to an increasing arrogance on the part of those in authority in our country—right up to and including the Prez—that they have the right—maybe even the responsibility—to do whatever it takes to impose their version of the law on everybody else.

And the increasing amount of firepower that they have at their disposal at a moment's notice doesn't help, either.

CitizenX said...

Zee, many thanks for your input.