Health Care; Just Another Chapter in the Class Wars?

[Still Sensible]

Listening to all the blovating on all sides of the issue, it seems to me the biggest hurdle for supporters of single payer or public option is simply that the republicans have convinced many Americans over the last three decades that have-nots are un-American and a threat to them. The conservatives (laissez faire capitalists, corporatists, etc.) have been so successful that a lot of people have a knee-jerk reaction to seeing ANY government assistance to anybody. They shocked the public with anecdotal stories of abuse--and there has always been some--so that the anecdotal became the common perception.

This pervasive perception plays quite well alongside the Reaganesque storyline about self determination, pulling yourself up by your bootstraps and the like. The mythical glorification of individuality (unless of course the individual is female, gay or minority, but that's another thread).

It is the same point of view--of picturing ne'er do wells and welfare queens--that led to all the changes to "welfare as we know it." It is a part (along with blatant racism) of how republicans demagogue the immigration issue. And we are going to see it play out again on health care as it has on many issues.

Today there was a story where a reputable poll said people supported a single payer approach by 49% to 47%. The support for a viable public option in the same poll was in the 60s. But we are starting to see the arsenal on the other side with headlines like "health care may cost $1 trillion." They will subtly or not-so-subtly start rallying the opposition around the idea that it is patently unfair for hard working Americans to pay for the health care of those that cannot afford it. They will vilify the poor once again--as they have on issue after issue.

Why is even the plan put forth by Senator Kennedy--the lion whose life has been devoted more than any other thing to this issue--being shown to come up 36 million people short of universal coverage?

Because it is about the cost. It is about the fear that democrats have of this Class War issue. It is because on issue after issue in the last 30 years, democrats and other champions of the middle class and the underclass have been beaten over and over again by republicans singin' that song. Elections have been lost at every level because the republicans have so poisoned the public with their class war kool-aid and their distorted ideal of America.

They have been so successful that for decades this bullshit has overtaken fairness and empathy. "Why should I have to pay for deadbeats?" or "I work hard for mine, let them get their own" have become the acceptable reactions to public plans in the aftermath of the republican greed campaign.

I believe we are now at the best opportunity in my lifetime to beat that point of view back. Unfortunately, the current economy--with so many of those hard working people that have in the past bought into it now facing life from the other side--is a big reason why. I think the hardest part will be convincing the politicians that it is indeed possible at this time.

[Oregone]

1. Its also becoming the latest means to get re-elected

Its sometimes seems they are more interested in touting the ideals of Health Care rather than delivering it

Health Care needs to evolve beyond talk about dollars and cents though, and more to talk about principle. Are we seeking the cheapest, most efficient solution (which may come out of rationing care to anyone over 38 years old) or rather the best (more affordable for all, covering all). People need to also start asking about principles in this question, because numbers only take you so far (though they are a great starting point).

"The observable economic facts belong to that phase and even such laws as we can derive from them are not applicable to other phases. Since the real purpose of socialism is precisely to overcome and advance beyond the predatory phase of human development, economic science in its present state can throw little light on the socialist society of the future." - Albert Einstein

[valerief]

2. Health care is to the left as abortion is to the right. nt

[county worker]

3. Here is part of the problem.

I think this gets missed a lot here. Many people are happy with the health coverage they have. They feel that they will lose some part of it if a public plan is in place.

My guess is that supporters of a public plan do not care about that. Basically a one size fits all is what is wanted and that is just what a public plan is.

So as I say both sides in the issue do not care that the other side's is important to them. As was pointed out in the OP those happy with their health care do not care about those who want a single payer and those who want a single payer do not care about those who are happy with their health care.

[Still Sensible]

4. You make a good point, and

unfortunately those that are happy with their health care are more likely receptive to the republican point of view.

What I find incredible right now is that the business community isn't getting behind at least public option. Heck, if it was there and if it cost 15-25% less than private insurance, why wouldn't any business sign its people up immediately? Is it just that business people have been so brainwashed (despite the incredibly efficient and cost-containing Medicare example) by the republican idea that private is always better than public? That baffles me... especially small business.

[county worker]

5. I think that if there was a public option, a business , especially small business would not offer

health care as a benefit unless forced to. If they are not forced to offer the benefit it will save them money and put more people in the public option.

The other problem with the public option is that it will pay doctors less. Now doctors are opting out of Medicare. They will have to be forced to see public option patients and get paid less for it.

There is a lot here that is not resolved by putting a public option in place of for profit health care. There are a lot of players in the game and the uninsured are not holding very good cards.

[Still Sensible]

7. I suppose it depends on how it's marketed, but

generally employers don't offer insurance because they are required to. They offer it because if they didn't good employees would go work for a company that does. That said, if there was a real public pool, and if the public option indeed was able to provide real competition to the private insurers, I see no reason why any business wouldn't look at the cost saving and consider it.

That said, the "pays doctors less" situation is a troubling one. In my mind, doctors generally are not the problem (although some are hyper rich, etc.) so much as the outrageous cost of medications, the over-use of testing resources at high cost, the unbelievable level of charges for hospital stays, procedures and services, and the incredible administrative burden on the system today. I would certainly want to know if doctors in other countries (Canada & France for example since they have mixed systems where public coverage is supplemented by private) are upset over poor compensation or is that an American doctor's phenomenon.

[Oregone]

6. Then why would 49% of people, with no real campaign, prefer a single government plan?

I mean really...where is the data that most people are happy with their own care? They are probably happy until they have to pay a fortune to use it.

http://www.kff.org/kaiserpolls/upload/7892.pdf

[Still Sensible]

8. I do believe the canard "a lot of people are happy

with the plan they've got" has been in the republican arsenal since the debate in the 90s. In fact the Harry and Louise campaign was sort of a bastardization of the idea "...why they're gonna replace our real good health care with guvmint bureaucrats decidin'" and such crap.

That canard has been so effective over the years that the basic starting point in what Obama's plan (and Clinton's plan she was pushing last year) is that "if you like the insurance you have you get to keep it."

[county worker]

10. It isn't a canard! Just because a repub says something does not make it untruthful!

Man we really have a problem with ideas here and perceptions here. If there were not a lot of people happy with their coverage everyone would be asking for a change! They aren't!

On edit, you said it yourself. They scared people into believing the would get less care or something. How could you scare people if they did not feel they had something to lose?

[Still Sensible]

12. Well since places like France or Canada do it and

have what many objective measures rank as better outcomes than our country with their public plan and supplemental private insurance, when we have arguably as much medical talent and resources... then yes I'd say it is a canard. And the Harry and Louise scare tactic obviously worked. It is no less a scare tactic than the ones republicans used after 9/11 to justify their agenda. It's just this scare tactic is designed to scare people for the protection of the health insurance industry, the pharmaceutical industry and entrenched hospital conglomerates.

But if you want to keep your insurance, great. Apparently a number of people do. But that Kaiser poll was very telling. It was the first time I have seen a poll where those wanting a single payer plan out-polled those that don't.

[county worker]

13. First, because Canada and France do it does not mean that much here.

If the scare tactic worked how did it work if people liking their health care is a canard? You can't have it both ways. If they were scared they had something to protect. If it is a canard there would be nobody to scare because they would not have anything to protect.

I think at times we are as ideological as the right is. It doesn't make any sense to talk ideas because our minds are made up that single payer is the right answer to the problem. Just as on the right it isn't because it isn't free market. Both sides have it wrong IMHO.

[eilen]

14. You know, I'd like to see how many really do love their current insurance

and break it down --which already have government plans (medicare, medicaid, military, federal, state and county workers), how often they actually use their plan (people who are in general good health and have only accessed benefits for check ups and the occasional sick office day/ED visit). It seems that once you actually require your insurance company to pony up the benefits they offer, that is where the dissatisfaction rises as the company declines benefits as not being "medically necessary." etc.

I've seen many patients, once diagnosed with cancer have all kinds of difficulties with their insurance. Then there is the paradox of how do you keep your job when you are very ill so that you can continue to be insured. How do you pay for insurance when you can't work? How satisfied with their coverage are those people?

What about the people who are hurt on the job, and it is a chronic injury that requires multiple surgeries?

The rhetoric seems to be focused on those with white collar jobs and is very classist. I wonder if we don't need over 10% unemployment in order to pass single payor health coverage because who can get employer-based health insurance when that avenue is closed?

[county worker]

9. I don't know the percentage of those happy with their own care.

I know they have more financial power then those who are uninsured.

I have good coverage. I don't pay for it. I have high deductible and a health savings account. I put money in the health savings account and so does my employer. I do not have to cover dependents. I am in good health.

A public plan would not help me one bit. But I am not against a public plan. I just would like to keep what I have and not have to go to a public plan.

That said, if it takes a single payer to get health coverage for all I would be willing to give up what I have and go to the single payer. I will have to pay more in taxes I would expect. I am not a me first type of person. I would like to see the dual system that Dr Dean talks about.

[Cleita]

11. I think we need to call it something else, like government

secured health insurance. That way no one can mistake it for the government giving you health care as the insurance industry would like you to believe.