Medicare

Healthcare Reality

Reading time – 3:44; Viewing time – 5:17  .  .  .

The most recent policy issue – in contrast to the daily dump of Trumpian crazy – was healthcare. That issue deserves one last piece of clarity.

Conservatives believe that small government is best. They like minimum taxes, which obviously means that in their view the government cannot take on the 17% of our economy that is healthcare, because taxes would have to increase to pay for that. That’s a key reason they rail against Medicare and Medicaid, claiming that the government has no business being in that business. Some say that the issue should be handled by the states, while others think the citizenry, we rugged individualists, should be responsible for ourselves and that government should just butt out. These notions are offered in earnest, but let’s get serious about the actual facts, not magical thinking (see How America Lost Its Mind). Let’s take a look at Medicaid.

Medicine has changed dramatically over the past 100 years. We have amazing pharmaceuticals and they come with astronomical prices. We can replace joints and modify genes, all at very high cost. Medicine is finely specialized and the medical people in those highly specialized fields spend ungodly amounts of money for the schooling required and, in consequence, it’s expensive to use their services. Medical tools like MRIs and robots that do surgery are crazy expensive, but if you need what they do in order to save your life or restore you to health, there has to be a way to pay for that.

The point is that when Doc Smith came to the house with his black bag, it was possible to pay his bill with a couple of chickens. But Doc Smith doesn’t work that way today and the price of everything is orders of magnitude higher now. So if all you have are a couple of chickens, unless you get help from somewhere, you’ll have to go without healthcare.

In the absence of Medicaid, that means that poor people never visit the doctor until things are dire. Then they go to the emergency room, where they can’t be turned away even though they can’t pay for their care. By the time they get there, symptoms are far worse than had they earlier been under the care of a primary physician. They require even more extensive and more expensive medical care, all delivered in the very costliest manner, in the ER; worse, the patient may be too ravaged by disease to be saved.

What that means is that leaving people nothing but the ER for their medical care produces less than the best outcomes and has the highest cost. Because hospitals have to admit ER patients who can’t pay for their care, the cost of their care is passed along to the rest of us through inflated charges when we use the system, like the $40 Band-Aid. And what that means is that one way or another you and I have, are and will pay for the healthcare for poor people.

Medicaid was created so that poor people could get better, earlier medical care at lower cost and not have to rely solely on the ER. Limiting or removing that support will make the cost to taxpayers that much higher and cause unnecessary suffering and even early death for poor people.

So, forget the idea that getting government out of healthcare is fiscally sensible. The libertarians, conservatives and neo-cons are simply wrong – factually wrong about who covers the costs.

Click for the commercial

Yes, we have higher taxes on you and me to do that. The alternative is a dramatically higher cost you and I will pay when we go to the hospital. It’s a little like that old Fram oil filter commercial. You can pay your mechanic a little bit now to install a new oil filter, or you can pay him big time later when  your engine breaks down. Translated to healthcare, you can pay for healthcare for our poor through taxes or by grossly inflated hospital and doctor charges when you need care. Pick one.

And another thing  .  .  .

On his way out the door of the White House in January, 2001, President Clinton issued a pardon to Marc Rich, the financier and hedge fund manager who had fled to Switzerland to avoid prosecution for tax fraud. Using his wife’s name, Rich donated $1 million, distributed among Hillary’s campaign for the Senate, the Democratic Party and the Clinton Library. Righties and lefties alike cried foul, as this had the profound and unmistakeable stink of Rich having bought a pardon.

Now that President Trump has issued a pardon to the justice flaunting, law breaking, immigrant hating Joe Arpaio, one of the first public officials to endorse Trump for President, I’m looking for that same blend of howlers from the law and order types. Where are those tough-on-crime voices now that a severe rightie is the perp and the President is a Republican? I want to hear the Congressional tough guys and the Fox News propeller heads and the radio talkers crying, “Foul!” As of this writing, it’s been eerily quiet.

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Ed. note: There is much in America that needs fixing and we are on a path to continually fail to make things better. It is my goal to make a difference – perhaps to be a catalyst for things to get better. That is the reason for these posts. To accomplish the goal requires reaching many thousands of people and a robust dialogue.

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Copyright 2017 by Jack Altschuler
Reproduction and sharing are encouraged, providing proper attribution is given.

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