health and healthcare

Bob’s musings about how deeply we might have been had have been making me twitchy. I decided to see what Jacob Hacker’s been saying, in hopes that it might prove curative of my increasing paranoia. It has.

Sept 4th, 2009  interview with Hacker:

What do you make of the fixation on the public option, both from the left and the right?

I think it’s understandable that the public option has attracted a lot of attention from both sides. But I think it has also taken on an importance that has exceeded its intrinsic value. Both sides of the debate see health care reform and the way in which it’s done as symbolic of how government should deal with economic insecurity in the United States.

For those who are supportive of the public option, the fact that a reform proposal that doesn’t include it would be requiring individuals to obtain health insurance from the same private insurers that have gotten us into this present mess is deeply troubling. On the other side, the public option somehow symbolizes the specter that is entirely mythical that expanding coverage to all Americans is tantamount to government takeover.

It’s important, as we consider what options for the public plan are being proposed, that we understand what it’s meant to do. It’s not meant to become the sole insurer for most Americans, but instead to provide a critical counterweight to private insurance in markets where private insurance plans are increasingly consolidated.

So you have not given up hope on the public plan?

Not at all, not at all. I don’t think we should give up hope on health care reform, and I don’t think we should give up hope on having a strong public plan.

Ultimately, I have a great deal of faith the cause is just and the argument is correct. We have had many, many debates over health care that have resulted in failure, and it is not at all easy to be optimistic. But I still feel there is a real chance of victory.


And another, Sept 9th, 2009:

On page two he articulates the thought process I was assuming was behind Obama’s apparent “selling out” on the necessity of the public plan option…

To me, the real question — if the discussion is about whether there should be a public plan — is what would take its place? So far I’ve seen no proposals that have a real viable alternative to having this public plan competing with private insurance. That public plan provides both savings in the legislation, helps make it easier to expand coverage and provides a guarantee of a much greater degree of certainty that there will be long-term efforts to control costs and improve the quality of care.


I feel better. At the same time, I’m wondering if, since The Party Of No is going to keep on just saying no to any and everything no matter what…maybe we should just say “screw the public option” and support HR 676?

I mean, this really is doable, politics be damned. I’m pretty sure we could actually get a lot of openminded consevatives on board if we presented what’s the most logical course of action. Really, this is what we should have been doing all along.

Look at out healthcare expenditures compared to other nations.

healthcare 2

Source (chart 11-7)

Everyone else is able to cover their ENTIRE POPULATION on what we pay for Medicare and Medicaid ALONE.  Something is seriously wrong here. I mean, WTF???  We should be able to figure out what’s we’re doing wrong and switch to single payer without even raising taxes! Then, we wouldn’t even be “nationalizing” more of the economy or anything. (that stuff that makes conservatives think we’re really communists or whatever.)




In honor of vibinc‘s new title/header/thingie which is:

EDUCATE YOURSELF – The more informed you are the less fear you will have
I bring you a word of the day:



Autodidacticism (also autodidactism) is self-education or self-directed learning. An autodidact is a mostly self-taught person, as opposed to learning in a school setting or from a tutor.

A person may become an autodidact at nearly any point in his or her life. While some may have been educated in a conventional manner in a particular field, they may choose to educate themselves in other, often unrelated areas.

Self-teaching and self-directed learning are not necessarily lonely processes. Some autodidacts spend a great deal of time in libraries or on educative websites. Many, according to their plan for learning, avail themselves of instruction from family members, friends, or other associates, although strictly speaking this might not be considered autodidactic, unless the emphasis is placed on collecting specific information as opposed to being guided in a general course of study by a teacher figure.

The term “self-taught” is something of a journalistic trope these days, and is often used to signify “non-traditionally educated”, which is entirely different, as the flow of information and its focus is usually governed by the teacher or educational source and not the student.

Inquiry into autodidacticism has implications for learning theory, educational research, educational philosophy, and educational psychology.


I am of the opinion that many people who presently believe in various myths, superstitions, false ideologies, etc.  are far from hopeless. I believe that the internet will bring about a lot of consensus among the people of Earth. People now, for the first time ever, have an amazing degree of access to information. And the truth tends to shine.

I think the day will come when most people agree about most things, because they can’t be debunked. It will take generations, unfortunately, but it’s coming.

It is the nature of our species to want to understand. Just like few now contest the spherical nature of the Earth, the reality of human behavior in different social scenarios will eventually be beyond controversy. The reality, whatever it is (and as a progressive, I have my deep suspicions about what’s up) will just shine as fact.

I believe with every fiber of my being that the era of the Demon Haunted World is coming to a close. What we’re seeing now with healthcare reform, etc, is a death pang. A temper tantrum from the mythology-true-believers.

In the end, the truth always shines. It’s why Russia collapsed. 

At the end of the day, truth always wins. Humans are driven by nature to think critically and laterally. All they need is an (at least) mostly corruption-free fact base to derive facts from. So I don’t think it a coincidence that in 2008, Americans joined the rest of the developed world in proclaiming healthcare a basic human right. The masses are able, for the first time ever, to actually talk to and compare notes with citizens of other nations. And the truth, as it tends to do, shines.


On September 4th at 10 PM Memphis has the dubious honor of being visited by the Misinformation Express.

Looking into who these people are, you can see on the “about” part of their website:

Vice Chairman, Our Country Deserves Better PAC
Who’s he?

Towards the end of the rally, Williams invoked a long-discredited smear against Obama that seems designed to play on fears of his “otherness”: that he’s not really a U.S. citizen. “We all know that Barack Obama is not qualified to be president of the United States, beyond being above the age of 35 and probably an American citizen,” said Williams, emphasizing the word “probably.” He laughed and then repeated: “Probably. Even money.”

A birther.
Williams’ tendency to make sensational — and sometimes offensive and misleading — comments is well documented. On his blog, Williams refers to Obama as “Barack bin al Hussein Osama O’Bomber,” a “domestic insurgent” and the “Jihadian Candidate.”
And according to his wiki quote page:
“The Left’s experiment in training Americans to be passive and expect the government to do absolutely everything for them has been overwhelmingly successful in creating an infantile mindset, with the result being that in New Orleans and entire segment of the population, mostly black – the Left’s guinea pigs in this endeavor — apparently no longer have the requisite brains and common sense to get out of the way of a Category 5 hurricane.”
On Hurricane Katrina (9 September 2005 CNN HN)
Outlandish conspiracy theories spiced with a heaping dose of racism for good measure. This is what the right has been reduced to.
Christ on a cracker.
If it’s possible to be gobsmacked by stupidity then I am exactly that.



Mr Taylor has made it very clear that he is opposed to the Obama administration’s plan to reform healthcare, because it costs too much.

He wants to see the inefficiencies in the existing system reformed first.

Mr Taylor is what is called a blue dog Democrat – one of an influential group of conservative leaning democrats in Congress who are deeply concerned by government spending and the spiralling national debt.

“Now everyone in this room is aware that I’m not going to vote for the healthcare plan,” says the congressman, to loud applause.



At the Bethel free health care clinic, set up in the aftermath of Hurricane Katrina, which devastated Mississippi’s Gulf Coast, people without health insurance are treated by volunteers.

The centre is funded by donations.

In the clinic I spoke to Vicky MacArthur, who has come because she needs medication to keep her blood pressure down.

She lost her health insurance when she became unemployed.

I asked Ms MacArthur what she made of the government’s plan to help Americans like her.

“There’s no way the government is going to provide a service like this,” she told me.

“This clinic is run by people who care. I can just picture people standing in lines, you don’t get to pick who your doctor is.

“It just sounds like communism, that you just have to do what they say to do if you’re sick.”


Amazing. Only in the South, huh?

I wonder how insane this must look to the rest of the developed world…people committing health care kamikaze in the name of rugged individualism. I wonder if there even could be a uninsured ‘tipping point’ with these people? Even if 75% of their community was uninsured, would they still hold fast? I almost think they might. Ideology is some potent stuff.

Over the past few days, I’ve been having a conversation with Dr Rich over at the covertrationing blog. Now, Dr Rich is a libertarian, so suffice to say, we have vastly different perspectives. But he tends to be right a lot, too.

I highly recommend everyone read this post of his, because he’s right about a lot of it. He’s not spouting paranoid nonsense there about how soon, we’re all going to be “fair game” if some get their way. There really is a dominant theory on healthcare “cost control” that proclaims that the ultimate answer is to force doctors, to force patients, to act differently.

I realise this sounds nuts. I do. But it’s true. I can go into detail and prove it if anyone wants, but for now, I’ll just ask you to believe me on this. In defense of healthcare reform, it’s worth noting that insurance companies do all these bad things, too, already. So the problem of “lifestyle policing” is not unique to the healthcare reform debate.

Except…(now we get to the discussion between Dr Rich and myself) :

Let’s suppose you’re someone with a health problem that responds best to a treatment that is not the one recommended by the guidelines physicians are “supposed” to follow. (these guidelines are often really “rules” doctors are forced to follow, and enforced by mechanisms such as “pay for performance” measures.) And let’s suppose you do find a doc that understands your situation, but he’s one of those “retainer docs” and doesn’t take any sort of insurance. (a lot of good doctors have actually switched to this model, disgusted by insurance companies trying to dictate to them how they should practice medicine.) You have to pay him $100 an office visit  to see him, but most besides the mega-poor would be able to come up with a little extra cash to see a doc like this if they found themselves wanting or needing to.

The problem is that HR3200 is incredibly vague. It’s just a skeleton framework for reform; something that will be built upon at a later date into an actual functioning structure, and there is a chance (however remote some might think it is) that someone might later try to use some vague something it says to effectively “ban” private physicians who don’t accept insurance.

And that, if it happened, would be bad. Really, really bad.

In my discussion with him in the comments here, Dr Rich states that he thinks it’s plausible enough to where he opposes HR3200 for this reason. I (Jupe) told him I don’t think even the liberalest of the liberals would want to see a prohibition on “pay out of pocket” medicine. “Even we damn liberals” would freak out over that, right? I mean, even in the UK there’s a small, but thriving private industry operating alongside the NHS. If the NHS doesn’t offer a service, and someone wants to buy it with their own money, they’re perfectly free to.

Would American liberals allow the government to deny people that right here? Tell me I’m right, and that pretty much everyone in the US would go ballistic (for good reason) if some creepy control freaks tried to ban private medicine.

Memorize this:

According to the Supreme Court of the United States:

Herdrich argues that Carle’s incentive scheme of annually paying physician owners the profit resulting from their own decisions rationing care distinguishes its plan from HMOs generally, so that reviewing Carle’s decision under a fiduciary standard would not open the door to claims against other HMOs. However, inducement to ration care is the very point of any HMO scheme, and rationing necessarily raises some risks while reducing others.


“Inducement to ration care is the very point of any HMO scheme. “

One more time…

“Inducement to ration care is the very point of any HMO scheme.”