29 January 2007

Injustice's apologists

There's a column at the Guardian's comment is free section about the U.S. healthcare system. The author, Sasha Abramsky, mixed up a few quibbling points. Bill Clinton, for instance, didn't try to institute a "single-payer" system. Bill and Hillary kept the private insurers in an amazingly complicated loop. Abramsky also writes, "While leaving the delivery of healthcare in private hands," Massachusetts and Schwarzenegger's California proposal "aim to subsidise the purchase of insurance for those too poor to pay."

To me, that implies that other reform proposals, in particular single-payer proposals, would not leave the delivery of healthcare in private hands.

That's wrong. All the single-payer advocates I'm aware of want healthcare delivery to remain in private hands — as it is everywhere except Great Britain. It's the financing that should be publicly administered — as it is everywhere in the industrialized world except the United States.

Doctors and hospitals would still compete.

My friend whose doctor is in sole practice would still choose him (and she'd still wait, I assume, for an extra day because she got Strep on his day off) and I'd still choose Kaiser.

The difference is that our taxes would pay for it instead of our premiums. The difference would be that instead of up to a third being taken off the top for administrative expenses, it would be about 3 percent.

The main problem with Abramsky's column was with the commenter who regurgitated the same nonsense Denver talk show host Mike Rosen wrote up a couple weeks ago in "No Crisis of the Uninsured" for the Rocky Mountain News.

For these two (and who knows how many others living in the right-wing echo chamber of weapons of mass destruction, no global warming, the "gay agenda," Bush's competence and other myths of the new millenium), the peer-reviewed and generally accepted count for the uninsured (about 47 million), based mainly on Census figures, aren't good enough. Back in 2003, the GAO decided that they would count differently, and that the uninsured were actually "only" 30 million. Some research assistant wrote this up for the Heritage Foundation in 2004. Expect the right-wing to glom onto this.

Did anyone refute this back then? Rosen's explanation was pretty eye-watering.
The ploy is to pretend that a rotating aggregate or a snapshot is the same thing as a permanent population. Fifty-nine million is the aggregate number of those who at some time during the year, even if only for a day, were without health insurance. This is a meaningless statistic.
Forty-six million is the snapshot figure, the average number who have no insurance on a given day.

I've seen that explained far differently, although I don't have sources at hand.

Reassuringly, Rosen writes that the average family that loses its insurance during the year will become insured again within five and a half months.

So! Not to worry! Just put off that diabetes, that heart attack, that appendicitis.

What a way to run a country.

Watch out for these numbers. They're not likely to convince many, but they're being tested for their ability to cloud the water. We should have evidence on hand to refute them.

Rosen begins his piece by writing:
If your goal is to lay a political foundation for socialized medicine in this country, what better way to do it than to create the public impression that we have a vast army of people - even better: children - who are permanently unable to obtain health insurance.

And if your goal is to perpetuate an unjust system, what better way to do it than to twist numbers to convince enough people that there is no problem?

This line worked better 10 years ago, when there was less of a problem because healthcare costs were half of what they are now.

This tactic isn't likely to work today. Americans aren't worried about healthcare because of propaganda. They're worried because they've been personally hurt by the system, or know someone who has been. Physicians haven't been won over in large numbers because progressives have twisted the facts. They've come over because they've anguished over not being able to do the right thing for their patients, trapped in a system rigged for profit, not care.

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