This week, I became confused. I'm 58 and uninsured. I thought the only thing that could save me was the public option. I've been uninsured since 2001. Haven't had a pap smear, a mammogram, or any other important test since then. I've never had a colonoscopy. I can't afford any of these things, and couldn't do anything about it even if they found something wrong. I'm a 24/7 unpaid family caregiver for my 91-year old father with advanced Parkinson's disease. Dad has some assets, so I'm not eligible for MediCal. We can't spend the assets. I'm stuck.
So I, along with most others here, was insisting that without a public option, Obama's plan couldn't be reform. I thought we had to have even a weak public option that could grow over time. We had to get that camel's nose under the tent. I was under the impression that most of the other advanced nations in the world, the ones with universal healthcare that works, were socialized.
Well knock me over with a feather; they're not. Read on to learn what they really are.
I became confused this week when I saw Jonathan Alter get into a shouting match with Ed Schultz on Ed's show. Alter is a cancer survivor and the author of The Defining Moment about FDR's first 100 days. I read it; it's a good book. He's generally a good guy. He said (shouted) several times to Ed that he's for the public option, and for single payer. But he said it isn't nearly the most important thing in Obama's health care reform. He said liberals who wanted to trash the whole thing were "fools" (his word, not mine). He said that by far the most important thing in Obama's reform is stopping the discrimination against sick people.
Sick people. Those people that nyceve and Slinkerwink have been writing about for months. Those people the "murder-by-spreadsheet" insurance conglomerates throw out into the street and/or drive into bankruptcy. Those people who need health care the most, but can't get it. The ones who suffer and die. The ones who easily could be me, if I'm unlucky.
Jonathan Alter confused me, but he didn't convince me at first. I believed, and I still believe, as Alter believes, that the public option is the best way to go if we can't get single payer. Yet, Alter's point was that we're "fools" to trash the whole plan if we can't get a public option. Me, I was for socialism or bust.
But this op-ed, "Five Myths About Health Care in the Rest of the World" by T.R. Reid in the (admittedly usually awful) Washington Post, convinced me that Alter is right. Why? Because out of all those other wonderful universal coverage systems run by all those other wonderful countries who believe in keeping their citizens alive and healthy, many of them do not have socialized systems. They use private insurance. The difference between them and us is that their private companies are not allowed to make a profit on sick people. Instead, their insurers are merely delivery systems to pay for their citizens' health care.
These five myths are required reading mostly for those opposed to reform, but we could learn from a couple of them too.
Myths, according to Reid:
- It's all socialized medicine out there.
- Overseas, care is rationed through limited choices or long lines.
- Foreign health-care systems are inefficient, bloated bureaucracies.
- Cost controls stifle innovation.
- Health insurance has to be cruel.
Lest you believe this guy is an apologist for insurance companies, I'll quote two of his last four paragraphs:
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
and
Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero.
Germany: zero.
(emphasis mine)
Back to the beginning of Reid's op-ed:
. . . Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
He spends his three-page op-ed describing many of these other systems. He doesn't mention Obama's reforms, but reading this piece makes it painfully clear that socialized public plans are not the only way to do this job well. This is necessary reading.
Britain is socialized. Canada is socialized, but less so. Japan is not. Germany is not. Switzerland is not. The Netherlands is not. France (France???) is not. Japan, Germany, Switzerland, The Netherlands, and, yes, France all use private insurance systems. They are heavily regulated, rather as ours will be, although our new regulations won't go as far.
Nevertheless, American insurance companies won't be allowed to refuse to cover people because of pre-existing conditions. There will be no lifetime cap on payments. There will be limits on deductibles (probably nowhere near as good as the foreign plans). They will not be allowed to throw people out. They will not be allowed to turn people down.
All of those things will be illegal under Obama's reform. All of those things that, as Alter says, "discriminate against sick people." All of the things that nyceve and Slinkerwink have been screaming about.
It all will be illegal.
If we're forced to buy private insurance (as I greatly hope we will not be), at least it won't be junk insurance. It will be real. It will get us covered, and it will get us health care, because it will be illegal to do anything else.
I still want a public plan. I still think we'll get one. I don't trust American companies to keep the bargain. I expect that they'll find ways around the regulations eventually, probably by buying congresscritters and senators to repeal the regulations just as the banksters did, although I think public pressure will hold it steady for quite a long time and will improve it. Also, unlike the other countries, our insurers will still be allowed to make profits.
But for now, for awhile, it will stop people from suffering and dying. Isn't that what nyceve and Slinkerwink and the rest of us have been asking for? Screaming for? It might even get me covered so I can have those tests on a regular basis, and do something about it if there's anything wrong.
And many here are willing to throw that away because we might not get everything we want? Because it isn't "progressive" enough? Because it isn't socialist? Because of ideology? If so, we're no better than the Republicans.
Read the op-ed.