[The end of the “American Politics” blog series is in sight. I’m still working over the topic of ‘socialized medicine,’ which will take up three more blogs, and then I will move to a new topic.]
If you listen to conservative talk shows, you hear a deep disdain for the idea that medical care be controlled by the government. In an attempt to respond, I’ve tried to identify the different phobias that conservatives have, and I’ve come up with a list of five, organized into questions. I think that there are good responses to each of these conservative worries, and since this list of five questions is comprehensive as far as I can tell, I believe that an adequate response to each of these five concerns will show the fear of ‘socialized medicine’ to be unfounded. They are:
1) Isn’t competition between rival hospitals and health care providers necessary for the most effective medical care? (discussed in American Politics, Part VIII;
2) Won’t people become lazy if they get free health care, as is usually the case in a socialistic society? (discussed in American Politics, Part IX)
3) Doesn’t everyone need a personalized health plan? (discussed this week)
4) Won’t health providers lose their motivation to provide quality health care if everything is government sponsored? (to be discussed next week)
5) Hasn’t the government already shown its ineptitude in managing Medicare and medical care for the Armed Services? (to be discussed in two weeks).
But for now, we are treating the conservative worry that everyone needs to have a unique health care plan; just one ‘blanket plan’ will not do. When Bush restructured Medicare in his first term, he put this philosophy into practice by dramatically expanding the number of plan options that seniors had. I don’t have numbers on hand, but I seem to remember that the expansion went from something like four plan options to something like 80. His public defense was simple and straightforward. He said that the reason the system needed an overhaul was because different seniors needed different medicines and thus different plans. This would eventually (somehow – how?) lower the cost of drugs for everyone.
Well, the re-structured plan (like just about everything Mr. 28% Popularity has done) was unpopular. Seniors complained that there were so many options that they had no idea what plan was best for them. “Just go to the internet,” the Administration told the confused seniors. Unfortunately, not only do old people not know how to ‘surf’ the web, but they think a monitor is someone who stands in the hallway to make sure you don’t run or chew gum on school property. And even when they turned to their children for help, the younger generation was just as confused in some cases.
I have since developed an enormous amount of sympathy for this problem. When I was choosing between health plans before we had our second son, I really worked hard to figure out which of the two university plans would cost us less out of pocket. I settled on one, but once we had our child, I found out that the plan I didn’t choose would have saved us about $6,000 out-of-pocket. Why the difference? I have no earthly idea. The premiums were about the same, so why was the level of coverage so different?
There were many hidden technicalities. For example, under the plan that I choose, “circumcision” was listed as an optional procedure for a congenital condition, and thus was not paid for. Is an uncircumsized penis congenital? Yes, I suppose it is something about half of us are born with. But if Kerry would have won in 2004, he would have given everyone a chance to buy into the same insurance package as the Senators have. I would have done that, because I guaran-freaking-tee you that when a Senator has a boy, their insurance pays for the circumcision. I would also be willing to guess that Senator-insurance pays for more than one day in the hospital for those female Senators who arrive at the hospital slightly before midnight (Not a joke – if we would have checked in 10 minutes later, we somehow would have saved $3000).
My point is that there are two things that happen when a system gets complicated: 1) vulnerable people get taken advantage of (as I was when I was not able to properly understand the confusing (because intentionally deceptive) wording in the 30-page brochure for the medical plan I chose), and 2) wealthy people are able to manipulate the system more easily, since a complicated system always has loopholes, and money can always navigate loopholes. There is absolutely nothing good that can come from giving seniors 80+ options for health plans. When everyone has the same health plan, regulated by the federal government, there will be no Plan 36JB7 that pays for circumcisions, while Plan 36JB5 doesn’t. In the case of health insurance, simpler is better. I would be happy to pay the higher premiums of the Senator-insurance-plan just for some peace of mind. I feel like I’m playing Russian Roulette every time I or one of my children visit the hospital. It makes me mad to know that at some time there was a meeting where the insurance company said, "How can we word this in such a way as to make the customer think that we will pay for procedure X when we actually won't?" There will be far less of this kind of deception if everyone had the same policy,
