What You Learn When You Listen

The debate over universal healthcare rages on.

My last column on this matter raised considerable debate both in response to the OregonCatalyst posting and my newsletter distribution list. More importantly, you can hardly go anywhere today that the conversation, at some point, doesn’t lead to a discussion of the concept of universal healthcare. So much is being said and so few are listening that I thought it might be time to close my mouth and open my ears. It is always amazing what you will learn when you stop talking and start listening.

While the views and arguments of my friends are interesting and I enjoy the give and take of a good debate, I tend to listen to those who actually know what they are talking about. And when it comes to healthcare I tend to listen to those involved actually involved in the field — doctors, nurses, healthcare administrators — and I tend to disregard those who aren’t— politicians, labor unions leaders, and trial lawyers.

And so here are the views and questions emanating from some of those to whom I have listened.

One of my good friends has been involved in healthcare administration his entire professional life — nearly thirty years. He has participated at every level from plant management to executive and is recognized by his peers as one of the most knowledgeable people in the field. His first comment was, “I cannot discuss this without getting emotional.” He then went on to relate his major concerns:

ï‚· Regardless of what the politicians say, this is socialized medicine. The provisions that mandate a “public option” and allow you to maintain your current health insurance only until you change insurers (new job, new insurer, retirement, etc.) at which time you must accept the “government option” is simply a migration strategy to a “single payer plan” and that is code for socialized medicine. (Both President Obama during the presidential campaign and Rep. Barney Frank in a recent interview acknowledged this migration strategy and affirmed that the end plan was for a single payer plan.)
ï‚· There are well over a hundred amendments pending to the various alternative plans. Nobody knows precisely what is in the plans currently and nobody will know the effect of all of the amendments when they vote on it. These amendments deal with everything from euthanasia to mandatory participation in abortions regardless of moral objections.
ï‚· The cost estimates already provided by the Congressional Budget Office indicate that there will be no savings under any of the pending proposals and that is because none of the proposals adequately address cost containment.
ï‚· Every government plan in America has exceeded, not by a little but by a lot, the estimates of its costs. Government then attempts to manage the cost by reducing coverage and payments to healthcare providers.
ï‚· The fact that Congress has exempted themselves and the public employee unions should indicate that the end product would be inferior to what is currently available to eighty percent of the population.

A doctor responded to my last column with a number of criticisms — most suggesting that I was using inflammatory language in categorizing the proposals as socialized medicine and suggesting that these plans emanate from far left wing of Democrat Party.

The doctor did strike a telling note when he suggested that access to emergency room services is not an adequate substitute for general healthcare. He is right and the point I was attempting to make (that the real problem is much smaller and less costly than these plans address) can be better said.

The experts say that there are approximately 47 million people in America who do not have health insurance — not access to healthcare, but health insurance. Included in the number are those illegally in the United States (nearly 20 million strong), those who are temporarily without health insurance because they have lost their jobs or in the process of changing jobs, those who decline health insurance because they are young and healthy and do not wish to pay the high costs, and those who have made a conscious decision to “pay as you go” in lieu of health insurance.

According to the United State Census Bureau approximately 40% of those household without health insurance make in excess of $50,000 per year. These are households that can afford health insurance but choose not to pay for it. Those who choose not to pay covers the last three categories of those referenced above.

Assuming that there are one and one-half persons in each such household, reduces the number of people not covered by health insurance to about 19 million. I am being generous in assuming that half of those illegally in this country are covered by health insurance. Even at that generous assumption that reduces the total number of uninsured to about 9 million. The current population of the United States is 300 million people and, therefore, those who do not have access to health insurance (9 million) represent less than three percent. And yet we propose a solution that covers not the three percent in need but the one hundred percent who neither want nor need socialized medicine.

In the end, however, the doctor acknowledged that he opposed the current plans because they are “foolhardy and costly” — precisely the right reasons.

Another doctor appeared at one of the public forums in McMinnville to ask a simple question. How can the government discuss limiting multiple diagnostic tests if the same government refuses to do anything to limit malpractice litigation? The point is that doctors often run multiple, and sometimes unnecessary, diagnostic tests and procedures simply because they fear lawsuits if they do not.

But all of these cogent points are lost in the din of political posturing. The Democrats are stage managing the so-called “healthcare forums” by stacking the audiences through the backdoor with their friends in the labor unions — principally the public employee unions. They don’t want to hear the questions or comments because their minds are already made up and they want to rush to a vote before anybody else points out the obvious, embarrassing provisions — just like they did with the “no pork stimulus plan” which contains billions of “pork” to Democrat constituencies, including ACORN. And the Republicans are so busy trying to score political sound bites for the next election that they are not making the reasoned arguments that will prevail with voters.

In the end, everybody is talking and nobody is listening. And lost in all of this is the import of this dramatic change in the provision of healthcare — a change that once begun — like all other social programs — will never retreat and will only grow. There will be no going back even when America’s healthcare system degenerates into a third world status like Canada, France and other countries who embraced socialized medicine as the big answer to a little problem.