Saturday, August 01, 2009

The Problem With Reform Isn’t Common Sense

by John Wilson

There are some aspects of the health-care reform debate that are informative, add value and contribute a unique perspective that is needed in the ongoing discussion. And then there is this: on Friday Peggy Noonan wrote an illogical rant about the reasons public support is shrinking for the bills emanating from the House.

On one hand, there are the Blue Dog Democrats who are “fiscally conservative” and would rather not see the deficit increase in any new plan that is proferred. And any efforts to cajole the Blue Dogs is viewed as “arm twisting,” or “forcing them to go against their principles.” That’s hogwash.

Democrats have a resounding majority in both halls of Congress. In addition, the reasons they earned that majority is due to the promises they made and are now fulfilling. When did the fulfillment of a campaign promise (which got you elected in the first place) become a hypocritical act looked down upon by the electorate and general public?

In a forthcoming article in Club Relaford I mention the “arm twisting” that the Bush administration engaged in during time in the majority in Congress. It included, but surely wasn’t limited to, “threatened severe retribution for fellow Republicans who balk at casting a desired party vote, hitting them in two important goals: reelection and status in the Congress,” according to political science researchers and professors William and Carol Weissert.

Now some readers are inclined to ask two pertinent questions: Since two wrongs don’t make something right, is it a good idea to follow the Republican way? Also, when Obama ran on a platform of “change” and a “new kind of politics,” didn’t he essentially rebuke those kinds of actions?

Both of those are good questions. But they are based on a faulty premise which could only lead to a non sequitor. Fact is, it is fanciful at best to believe politicians vote only in their constituents’ best interests or that they even should. For instance, what if a district that I represent is strongly opposed to a program or resolution that has overwhelming support nationally and is the correct course to take?

A member of Congress’ allegiance is not only to constituents that put them there but also to the nation as a whole. Their votes have far reaching implications and oversight lies essentially with only the Supreme Court. Sure presidents have veto power, but how often do they use it? Not often at all. Bush 43 vetoed 12 times in 8 years.

Now back to Peggy Noonan and her thoughts on the lack of public support for health-care reform. She exclaims that “common sense” is the reason support is lacking. Questions abound in the public’s mind such as:

Can I afford it right now? “No, I’m already getting clobbered.” Will it make the marketplace freer and better? “Probably not.” Is our health care system in crisis? “Yeah, it has been for years.” Is it the most pressing crisis right now? “No, the economy is.” Will a health-care bill improve the economy? “I doubt it.”

What stands out about these questions is (1) How really “free market” is the health-care marketplace now? and; (2) To what extent is the health care problem in this country either causing or helping to extend the economic maelstrom we are seeing?

Numerous studies show increased monopolization in the health-care market. This one by Health Care for America Now! shows 94% concentration of the health care market in states. It has led to a “more than 90 percent [rise in premiums] between 2000 and 2007, while the profits of the 10 largest insurers increased 428 percent over the same period,” according to Ezra Klein, in an excellent piece he wrote Sunday.

As far as the extent to which health care costs are causing further economic strain, look at the number of those who no longer have insurance - an additional nearly 5 million people since Sept. ‘08 are uninsured. So how are these people paying for the prescriptions? Better yet, when they must seek care where are they turning to and how are they financing it? Increasingly, foreclosures and bankruptcies are the only way out.

Noonan also says:

“The first has to do with the doctors throughout the country who give patients a break, who quietly underbill someone they know is in trouble, or don’t charge for their services. Also the emergency rooms that provide excellent service for the uninsured in medical crisis. People don’t talk about this much because they’re afraid if they do they’ll lose it, that some government genius will come along and make it illegal for a doctor not to charge or a hospital to fudge around, with mercy, in its billing. People are afraid of losing the parts of the system that sometimes work-the unquantifiable parts, the human parts.”

But those same doctors she mentions do those things because the system has no solution for those that they help. Dr. Benjamin, recently appointed as Surgeon General, knows this too well. For years she has given out free medical care and underbilled clients. But for how long can that be a reality? Even on the corporate side companies such as Costco have long provided insurance for all their employees, and not just the full-time staff. Can they afford to continue doing so? No, not without reform.

Let’s face it the doctors that Noonan mentions are a rare breed and getting rarer. Not because their heart isn’t in it but because the current system is working against them.

Lastly, Noonan exhorts this charm:

“It is a new opportunity for new class professionals (an old phrase that should make a comeback) to shame others, which appears to be one of their hobbies. (It may even be one of their addictions. Let’s stage an intervention.) Every time I hear Kathleen Sebelius talk about “transitioning” from “treating disease” to “preventing disease,” I start thinking of how they’ll use this as an excuse to judge, shame and intrude.”

So basically we are back to the “elitists” in D.C. telling Americans what to do. Give me a break. Every time a Democrat has a plan or method of reform Republicans trumpet “Elitism!” Ironically, the judging, shaming and intruding must be an equal opportunity method of legislating. Right now in Ohio Representative John Adams (R) is sponsoring a bill that would force a woman to have the consent of her unborn baby’s father before an abortion would be deemed legal. But there’s no shaming or intruding in that.

This is ‘94 redux folks. If reform doesn’t happen now, when will it?

Bio - John is a senior at Virginia Commonwealth University pursuing a double major in sociology and women’s studies. He blogs at and is a contributor

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