Tuesday, April 29, 2008

Talking health care blues

Ross Kaminsky's last post on health care was a perfect storm of demagoguery and misinformation. Today he treats us to a reprise with another post that is light on substance and heavy on the smoke and mirrors.

First he attempts to parse out the number of uninsured in this country. He points out that some people who don't have insurance could seemingly afford it bases on their annual income - this may or may not be, a persons income level doesn't really tell us much about their financial situation. He plows through demographic numbers before widdling the "47 million uninsured" down to a core of 10 million that are "chronically uninsured" and proclaims,

In short, the 47 million number that supporters of socialized medicine throw around is partly an outright lie and partly an intentional exaggeration to bolster their claims that we need a massive health care big brother, when the real problem (and I admit that uncompensated care is a real problem) could be solved by much more targeted and less oppressive solutions.

It's neither of those things. It's an entirely accurate statement substantiated by the very numbers that Kaminsky is dissecting that at any given time 47 million Americans are without health insurance. Whether one is just between jobs or is one of the chronically uninsured is not a relevant issue when you get sick and end up in the hospital. A guy who is seriously injured in an accident who is uninsured because he is between jobs costs just as much to treat as a guy who is chronically uninsured and is injured in an accident.

Kaminsky's deconstruction of the numbers is just a distraction from the issue. The uninsured cost our system significantly. When someone who is uninsured utilizes an emergency room instead of a primary care physician or is hospitalized with a disease or injury those costs are passed on to you, me and Ross Kaminsky. We pay for the uninsured to receive care through higher and higher health care costs and higher and higher health insurance premiums. Why someone is uninsured is entirely beside the point. If we want to reign in our out of control health care costs we need to get people insured so they can make use of primary care physicians and not emergency rooms and so when the unpredictable and unimaginable does occur the bills can be paid. Tied in knots by ideology Kaminsky and other conservatives cannot see the economic damage that having tens of millions of uninsured Americans causes the rest of us.

Kamisnky's piece devolves into a critique of the United States' oft-cited very high infant mortality rate. Kamisnky dismisses the numbers as "misleading." Well that's interesting, Kaminsky had a different opinion of such statistics when they superficially seemed to support his position last week. It seems to me that if one is interested in an actual debate on the issues there would be an internal consistency to their arguments.

Next Kamisky proclaims,
I maintain my position that our system is indeed far superior to Canada or Great Britain, two places often talked about as comparisons when Democrats bring up the idea of creating government-run health care.

So much to unpack here,

1. Kaminsky may feel our system is superior to Canada or Great Britain but it's not. Studies that look at the overall health care system consistently rank the American system far behind other western democracies.

2. Let's also remember that we spend 15% of our GDP on health care and twice as much per patient as any of those countries. In short, we pay more for significantly less.

3. Great Britain and Canada are rarely if ever cited by proponents of health care reform. Rather they are the favorite bogeymen of conservatives desperately trying to defend a broken system. There are better systems throughout the world than Canada or Great Britain and we should take the best from countries like Germany, France and Australia and import them here.

4. The tired old trope of "Government run health care" rears it's ugly head again. I smacked this down last time but let me repeat myself, no one is advocating such a system. Democrats would like to employ the government as a purchaser of private health care.

The whole post is just a desperate attempt at distraction. There's no discussion of the actual issues or the actual proposals just lots of blog-by-numbers demagoguery.

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