Wednesday, April 17, 2013

Standing Up for Medicare

Don’t Be Fooled by the “Reformers”

             In the ongoing ruckus over “entitlements,” saving Social Security is one thing, but what about Medicare? It’s got more baggage, a program Lyndon Johnson shoved through Congress in the 1960s, thinking we could have a Great Society and an expanding war at the same time without going broke. He was wrong. In pursuing both, we achieved neither.
            And now that our wars, having gone global, cost much more but are kept more hidden from public scrutiny, we’re left discussing whether we can afford Lyndon Johnson’s Great Society any longer. Medicare is the primary target for “reform,” though one wonders why so little is mentioned about Medicaid. If you weaken Medicare, don’t you drive many people straight into Medicaid?
            In any case, Medicare, with all its flaws, has been a life-saver for me. My retirement plan was never to retire. I figured I was healthy enough, enjoyed my patchwork of part-time jobs, and, no matter what happened, I could always write.
            But the world changed as I and the nation suffered simultaneous heart failure. It hit me when it hit most people, in 2007-2008, when the real estate market buckled, then collapsed, and I went into the hospital with persistent chest pains. When I came out the old economy was gone.
            I found new life during the Great Recession, but my old habits were in tatters. For one thing, one of my primary jobs disappeared in the economic carnage, so I had a lot more free time but also a lot less money. Fortunately, I had Medicare.
            But now the politicians want to “reform” Medicare. This is a red flag. In Washington, as we saw with welfare, reform does not mean improve so it works better. It means tear down, limit, withhold. Not that Medicare doesn’t need improvement. But, fundamentally, it gives me and millions of others access to basic health care and emergency help, too, if we need it. When reform means tear down and redistribute public funds to private, profit-driven companies, I see a bad scene coming. It may not hurt me too much, but it’s likely to hurt those younger than me a whole lot.
            The aggravating thing is, Medicare works pretty well. If there’s a problem with it, it’s not government. It’s greed, infecting the for-profit health care system we Americans cling to. Opponents of Medicare want our payroll-tax money—and more—for themselves. Our health care is secondary to the pressure on the medical industry to profit a large number of investors in insurance and pharmaceutical companies, hospitals, medical suppliers, and the list could go on. But when the patient and the doctor—that primary relationship—are not central to health care, how can we expect the quality of that care to be anything but “fast medicine,” as my ex-primary doctor called it before he quit his practice?
            Too little, when you need it most. Too late, when it might have done you the most good. Diagnosis and treatment, hit or miss. If the doctors finally get it right, which, admittedly, they often do, you pay for their misses. That’s the American health-care system for most people.
            So real reform would begin with defining the purpose behind health care in the first place. Is it for private profit? Or is it for public health? And what about individual choice in the matter?
            These are decisions for the government to make, and the government is beholden to the people. So it’s a decision each one of us must make and notify our government with our voices and with our vote.
            As things stand now, a complacent government is so easy to rip off that many are tempted to get in on the scam. Meanwhile, insurance companies are cleaning up on Obamacare, with more to come down the road when the demons of competition are unleashed in full. Obviously our health care system, even under Obamacare, is fundamentally flawed. It rewards the cheaters, under-serves the deserving, and moves a steady flow of cash to investors.
            I support single-payer health insurance or Medicare for All (MFA). Even President Obama admitted (once) that single-payer is the least costly alternative to all other plans put forward, including his own, because it doesn’t need to profit from services rendered.
            But could the financial system take the shock of MFA? There would be chaos on Wall Street and panic throughout the industry if health care shifted to the government.
            Yet, from all I’ve read, the cost of health care would come down, and, with everyone covered, the health of the general population would likely improve. 
            Why isn’t that at least part of the discussion about reform? 
            Many Americans flinch at the idea of socialism, but neither capitalism nor socialism is necessarily democracy, whose idea is more far-reaching than either. Therefore a wise democracy will sometimes be socialistic, sometimes capitalistic, and sometimes, in the brilliance of its freedoms, create the unexpected, something entirely new.
            Unless someone comes up with that entirely new something, Medicare is the best insurance for the money on the market, and MFA would be the most efficient, least expensive health-care plan for the entire country. The only problem is a lot of folks invested in the present system, who expect continuing, growing returns on their money, oppose changes that could threaten profits, even if earned at the expense of the sick, the poor, and the elderly.
            It could be a long debate—between the profitability of a burgeoning industry and a culture’s quality of life and health. History does not favor the latter, but routinely idealists have moved history.
 
(For related articles on this subject, see Thinking Dog Archives for "Health Care: The Tipping Point," published on June 18, 2009, and "Is Health Care a Civil Right?" published on Sept. 3, 2009.)

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