An Unhealthy Debate

Lies, Damned Lies, Yet No Statistics

I keep trying to start a blog post that aims to refute all the lies, idiocy and misinformation that the right-wing (Grassley, Boehner), ignorant ("Keep the government's hands off my Medicare!"), and downright evil (Palin, Beck, etc. etc. etc.) are putting out there about health insurance reform and health coverage. But every time, I end up realizing it would be full-time job that should have started over a month ago. And then, today, I read two column that help put a lot of the bad information out there into perspective.

The first was Steven Pearlstein's look back at the 20th century and how the right-wing loses its mind every time a liberal (even a nominal liberal) gets into power. It froths at the mouth. It takes two opposing thoughts ("socialism! fascist!") and says they're the same thing. It basically makes stuff up, and the more bizarre the better. That's what gets attention, at least.

The second was Paul Krugman's column about the "Swiss menace." In it, he lays it out more clearly than anyone has yet so far. (This is why he wins Nobel Prizes, and I start blog posts only to abandon them in a sputtering mess of exasperated fury.) The summary of his summary is this:

• Every wealthy country other than the United States guarantees essential care to all its citizens.


• In Britain -- with a system much maligned here, but much appreciated by Britons -- the government runs hospitals and employs doctors. The shorthand for this kind of healthcare is that it is "nationalized" healthcare; even "socialized medicine." Such a thing is totally alien to what we believe here in the United States, and is nowhere in the plans being put forth by the Obama administration, with this one caveat: Obama intends to maintain and improve the Veterans Health Administration, which is another example of "socialized medicine." So not so alien a system after all, I guess.


• In Canada and France, the government doesn't own the hospitals or employ the doctors, but it pays the bills. This is a "single-payer" system. This makes health insurance a public service, but keeps medical care a private industry. Of course, such a thing is also completely alien to the U.S. and even suggesting a single-payer system is an assault on American freedoms. Until you reach the age of 65. Because Medicare is, of course, a single-payer system and receives higher favorability ratings from its "customers" than private insurance companies, on average, do,


• Finally, there's the system they have in Switzerland. This is where everyone, by law, must have an insurance policy, but the government subsidizes people who can't afford it on their own. They buy those policies from private insurers, who aren't allowed to discriminate based on medical history or pre-existing conditions. Again, not so alien to the U.S. after all, according to Krugman. This is the system currently in place in Massachusetts.

To be clear: the "public option" that, until the last couple of days, was the stated goal of the Obama administration and the Democratic leadership in Congress (and hopefully will be again), exists between the Medicare model and the Massachusetts model. Rather than the government being the sole payer of medical bills, the government would provide an insurance option for people who can't afford or don't want to buy private insurance -- though they and their employers would still be able buy private insurance if that was what they wanted.

This is the extent of the "socialism," the "fascism," and the "un-Americanism" behind the public option, and public health insurance and public healthcare in general. That's it. And yet, all that lying and distortion now looks like it will keep the Blue Dog Democrats from supporting a public option.

I just called my congressman's office (Charlie Rangel, definitely not a "Blue Dog") to urge him to vote against any final healthcare proposal that doesn't include a public option. Because America's healthcare system is the most expensive in the world, but ranks 37th in terms of its effectiveness (World Health Organization). Not coincidentally, U.S. citizens receive less government support for their health than any of the other industrialized countries ahead of us. Perhaps more on this later.