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I'm dubious about opinion pieces which paint an entire part of the political spectrum with one brush, which The Republican Party Is Turning Into A Cult, over at the Huffington Post, arguably does. But it's worth skipping over those exasperated opening paragraphs to the meat of the matter:

"The US is the only major industrialized country that does not provide regular healthcare to all its citizens. Instead, they are required to provide for themselves -- and just under 50 million people can't afford the insurance. As a result, 18,000 US citizens die every year needlessly, because they can't access the care they require. That's equivalent to six 9/11s, every year, year on year. Yet the Republicans have accused the Democrats who are trying to stop all this death by extending healthcare of being "killers" -- and they have successfully managed to put them on the defensive.

The Republicans want to defend the existing system, not least because they are given massive sums of money by the private medical firms who benefit from the deadly status quo. But they can't do so honestly: some 70 percent of Americans say it is "immoral" to retain a medical system that doesn't cover all citizens. So they have to invent lies to make any life-saving extension of healthcare sound depraved."

(Emphases mine.)

(Bet you wish you hadn't got me interested in this stuff now! Sorry, guys...)

ETA: That 18,000 figure is solid - it's from the Institute of Medicine. And, as the comments folks are leaving here are making clear to me, that's just part of the picture - even if you can afford some insurance, you're still likely to be looking at huge medical bills. No wonder (and that Huff Post op-ed should have acknowledged this) there's a consensus in US politics that this is wrong and needs fixing.)

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Even those of us lucky enough to have health insurance don't have it so great. I pay $300 a month for a policy that has a $3,000 deductible. Once that's met, the insurance company will pay half my expenses until I meet another $2,500 deductible. After that, I'm not sure what happens, because legends say no one has ever made it that far.

(Before the $3,000 deductible is met, the insurance company pays for nothing- preventative care, prescriptions, nada.)

*nods* I think for the many millions who are actually uninsured, there are similarly large numbers of *under*insured - those who are on policies with weird deductibles, or with restrictive lists of "in-network" medicos, or what have you. Problem is, I wonder how many people currently opposing the public option *don't know* they're underinsured because they've had the good fortune not to need to claim on it?

Until that 70% who say it's immoral to retain the current system gets fired up and stays fired up, the system isn't going to change. There is too much money changing hands between politicians and the medical industry. It's too profitable to write off 18,000 citizens who, let's face it, are probably too poor to matter in our wealth-obsessed culture. The worst of the disruptions are coming from paid protesters, and I'll give you one guess who's bankrolling them.

As a chronically ill American, I will never be eligible for private insurance. My health plan, as it stands, is to hope I don't ever need a treatment I can't administer myself. I cut my finger badly a few months ago, and since I couldn't see bone, we decided not to go to the emergency room. Communities hold raffles here for poor kids to get life saving surgeries they'll otherwise be denied. I consider myself a peaceful person, but the next time I hear a Republican whine about how they don't see why their tax dollars should pay for someone else's health care...

One positive I see in all this is that I don't think the old system will last. We tried health reform in the early 90s and it failed, but a few things have changed since then. First, the insurance companies have gotten even worse so more Americans are mad about it. Second, the Internet has put more Americans in contact with 'ferners' than ever. Americans are looking out and seeing that we aren't the envy of the civilized world. We're seeing that other countries are getting it right and that they... feel sorry for us? Ouch. Kind of makes the old lies harder to maintain.

I think the Americans who want change just have to get louder about it. In theory, being on the side of basic human decency should be enough, and yet...

Ahem! Sorry to spam your LJ. This is a topic in which I'm rather invested.

Americans are looking out and seeing that we aren't the envy of the civilized world.

That's a good point - I wonder if that's the thinking behind the lies about Britain's NHS.

It's the same old lies as before. It's just that now the lies are spreading across the world within seconds and British people are able to weigh in on what's being said. Of course, for the isolationist wing-nuts who are just want to 'win' at all cost, their words won't hold any weight whatsoever. But for the people who honestly want to know what's going on, those voices are so important. Fifteen years ago they wouldn't be heard in numbers large enough to matter. Now, it's a different world, and thank goodness for that.

I've made progress in discussions with family just by being able to give a layperson's second-hand account of, say, Australia's system, because I've got an Australian friend, and we talk about this stuff. Without the Internet to facilitate those discussions, it would be harder to make a case. There have been some interesting posts around LJ (I'll link them if I can find the again) where Americans have talked about their health care experiences in counterpoint to non-Americans discussing their experiences. The differences are very illuminating.

Yes. There's a definite subset of Americans who would like to see the Canadian and UK systems go down in flames, mainly as a validation.

Big Pharma and the insurance companies would like to see all the public systems crash and burn because it would mean they'd be able to jack up prices worldwide and make even more obscene profits.

there's a consensus in US politics that this is wrong and needs fixing.

Correction: there's a consensus among the US citizenry that this is wrong and needs fixing. If that consensus extended to the political level, we'd have something done by now.

Sorry - should've linked to this again:

http://www.nytimes.com/2009/08/01/health/policy/01health.html?_r=1

"Lawmakers of both parties agree on the need to rein in private insurance companies by banning underwriting practices that have prevented millions of Americans from obtaining affordable insurance. Insurers would, for example, have to accept all applicants and could not charge higher premiums because of a person’s medical history or current illness. All insurers would have to offer a minimum package of benefits, to be defined by the federal government, and nearly all Americans would be required to have insurance... Lawmakers also agree on the need to provide federal subsidies to help make insurance affordable for people with modest incomes. For poor people, Medicaid eligibility would be expanded."

And the argument against doing that, of course, is that you're limiting all the cost-cutting tools that insurance companies use to make money.

Which is why I advocate taking profit out of the equation whenever possible, at least for basic services.

The needless deaths are just part of the problem, as you say. The US health care system generally gets worse outcomes on almost every measure for a higher percentage of GDP than every other OECD country. There are huge numbers of people with chronic problems that receive very limited care - often chronic problems that keep them out of work so they can't get better health care, problems that under state health care would receive significant ongoing care. There are the issues about various self-employed people (especially creatives) who have a second job for no reason other than health care. There are people who can't change employer easily due to health care issues. Distortions of the economic system due companies carrying health care costs as a large percentage of labor costs (this is what made the US steel industry uncompetitive, for example). It doesn't even keep costs down for insurers - US health care has a culture of over-servicing and defensively testing in order to both defend themselves against litigation, and retain control over the process vs insurers who are always trying to reduce treatment levels.

The US commercial sector basically forced the US onto its current system decades ago in order to reduce worker mobility and make labor more dependent on employers. That turned out to be a bad idea for business, and a disaster for the country, as well as being basically immoral in its intent. Now no one benefits except basically insurers.

It is a disaster. The Republicans have decided to defend the existing system, and I think it is likely to be a disaster for them. Now they are probably committed to the wrong course -- if Obamas health care plan gets through, it is likely to be hugely popular by the end of a likely Obama second term, and as the party who opposed it, they will have given the Democrats a weapon to keep hammering them with.

The trouble is, the Democrats are incredibly adept at shooting themselves in the nuts -- although there's some growing resentment at the Rethugs within the greater majority of the Democratic group (and even amongst some of the Blue Dogs like Rep. Gabrielle Giffords, who's the target of both sides now -- the teabaggers are riding her like a prize pony here in Tucson; Giffords' sympathies are straying away from the right as a result), which could mean some nigh-unto explosive action on this issue, rather than the folding that's been going on.

Part of the problem right now, though, is that Obama's tram pretty much blew any hope of controlling Big Pharma's greed by essentially agreeing that there'll be no price controls. Smarrrrt move.

Overall, then...a plague on both their houses.

the Democrats are incredibly adept at shooting themselves in the nuts

My mind (being the jumble of junk that it is) immediately recalled the Bloom County about hunting the elusive Liberal:

and even amongst some of the Blue Dogs like Rep. Gabrielle Giffords, who's the target of both sides now -- the teabaggers are riding her like a prize pony here in Tucson

I have to confess to you that I found that completely incomprehensible!

IIRC from "The West Wing", a blue dog is a Democrat who generally votes Republican to stay in power.

Yup. (Seems to be quite a common term in the US political blogiverse.)

"Teabaggers" are the conservative anti-tax (at the fringe: most are anti-tax-hike) activists who want to re-enact the "Boston Tea Party" by sending teabags to their elected representatives. They're tagging along with the "deathers" (those convinced that Obama's healthcare proposal will lead to "healthcare rationing" and "death panels") because they see the public option as another excuse for the administration to take away more of their hard-earned money and use it for the benefit of society's "trash" (poor white, black, immigrant).

The best part of that is they called *themselves* teabaggers b/c part of their protest involved mailing out teabags in protest etc. Never mind the slang meaning of the term (you can, erm, look it up), even AFTER being told what it meant o.O

Political theater. You just can't make this shit up.

o.O

Hey, we didn't need a diagram! XD

Thank you.

I must admit, most of what I know of US politics and government comes from "The West Wing", so I have a fairly slanted view!

That said, any administration which gives a tax break to the highest earners has got something very wrong. (I currently work a little over one day out of five for the UK government, and would love to work my way up to the next tax bracket, which would take it closer to two days in five!)

... what's their position on "Children of Earth"?

A 'Blue Dog' is generally a Southern Democrat, who tends to straddle the fence on a lot of issues and leans heavily on the ideas of fiscal conservatism. Ironically, the last 8 years of absolute fiscal irreponsibility was totally acceptable to the GOP and said Blue Dogs until all of a sudden power changed hands in November.

The Republican stance on government is generally, "Government can't do anything competently! Just elect us, and we'll show you exactly why!" :P

I have a huge freaking Teabagger rally happening in my county on September 5th. I understand about 10,000 people are expected to be in attendance. Meanwhile, my little group of Democrats will be holding a press conference across the road from their rally point and trying to counter the ~~stupid~~misinformation with doctors and other speakers for the local press.

Wish us luck. I think we're going to need it.

GIVE 'EM HELL

Well, we're kind of hoping *not* to have hell. Hell would be bad, given what some of the rather less desirable elements have been up to lately. :P

Case in point: my wife, who hasn't worked for three years because of severe chronic depression and back problems, those specifically being degeneration in the lumbar spine. Last MRI, two years ago (when she was able to get into a system with a sliding scale) showed three herniated discs. She gets another MRI on Tuesday thanks to the fact that in the last annual open enrollment, I've gone to a high-deductible insurance plan where my employer pays my premium (and that's increasingly rare - except for the insurance companies themselves, I think my employer is one of only a handful in Chattanooga, TN to do that) and places the difference ($115) between the HDIP and old-fashioned PPO into a Health Savings Account. I can at least use that money on her. Cost of the MRI - $510, payable over 3 months (thankfully, as that total sum is 20% of my monthly take-home pay - the remaining $55 per month for this we can manage). Cost to carry her on my work insurance - about $600 a month, which the employer does *not* cover.

My own back continues to suffer, because that HDIP doesn't pay squat until I've paid $1200 out of pocket on me. Can't afford that. The idea is for the HSA funds to cover my deductible, which it would - except for the fact I have to worry about her. She's in much worse shape than I am. (We're both eligible for and have handicap tags on our cars.)

Bloody fucking hell. The more I learn about this shit, the more appalled I get, and I was pretty appalled in the first place.

Glad I could help appall you. I think...

I mean, honestly, I hear and see people over here ranting and railing about how they don't want our medical system to turn into socialized medicine, like the UK or Canada or Australia, and my only reply is, "Gee, I know people in the UK and Canada and Australia, and they *love* their health care system and wonder why we put up with ours."

Only in America... *sigh* I'd be happy for us to emigrate, if only for the better health care we'd get. (And frankly, no, that's not the only reason.)

Just incidentally, I'm one of those people who got bankrupted by health costs while insured. Happened as a result of the severe pneumonia I had years ago, which put me in Burbank Hospital for a week. The condition essentially put me out of work for quite some time (and on disability), and the insurance deductible was $5,000 -- the actual total for the stay was closer to $30,000.

This also left me with a pre-existing condition, as it brought back my asthma full tilt. That got expensive too.

Yep. Far and away the best people at killing Americans are - other Americans.

Somewhat ironic given the recent current terrorist paranoia.

Oh there is so much wrong with the system that that's the tip of the iceberg *at the tip*!

Throw in the fact that all members of congress have access to what amounts to a socialized all expenses paid health care (not insurance) plan at the same time they are voting on this crap, and you'll see why this drives some of us just insane.

Which, of course, "we the people" pay for with our taxes...

The healthcare issue is also a feminist one, in a lot of regards: many women are on the health plan of their spouses. Divorced women are about twice as likely to lack health insurance as married women - a 1998 Ohio Dept. of Health study found only 8.1% of married women were uninsured, as compared to 18.5% of divorced or separated women. 26.2% of never-married women were not insured, compared to 16.9% of widows.

The link between employment and health insurance, and its obvious bias towards the nuclear family model forces many women to remain in abusive and violent marriages, ironically for the sake of their health. Abused women flee with very little money because their controlling spouse or boyfriend has held the purse strings, and are isolated from community or social contacts, therefore lacking opportunities to gain employment. Add in the mental and physical effects of abuse, which contribute to them being less employable.

Women on welfare report shockingly high rates of past domestic violence. The MA Governor's Commission of Domestic Violence conducted a study in 1997 and found that 1/3 of the the participants in the state's Transitional Aid to Families with Dependent Children program had been abused by a current or former partner during the preceding year. and almost 2/3rds had been abused at some point in their lives. Welfare gives women just two months to find employment after receipt of assistance, which often leads to them going back to their abuser.

I have to say this, 'cos it's true. While I learned a few things, the discussion at over at

jblum was almost entirely made out of hot air. Here, I'm being deluged with evidence - facts, figures, personal stories.

That doesn't mean it's impossible to object to the proposed reforms, or details of the proposed reforms, on the basis of evidence, but horribly, I have the impression that bullshit isn't just the weapon of choice, it's a very effective one. But then, after a decade of Howard, I have no excuse for being surprised by that.

Alas, after many decades of the GOP *and* the Democrats over here, I'm not at all surprised by that.

There is a distinct and very manipulative method some in the Right have used, politicians included, to fan outrage amongst their base. It's a tool that's been effective for some time, and really appeals to the more thuggish elements. It's building to quite frightening levels in some places, and of course, nobody will accept responsibility for inciting the violent discourse that happens as a result, and even fewer still among them are uttering a word that their constituents might want to dial it back a notch; their silence is their ongoing consent. It's pretty fucking shameful.

Hell, I've even seen people *die* because of the high cost of health care. Actually, a father and son double act. Both were self-employed. Dad had no insurance, and even when he started feeling under the weather in a regular way, he would look at monthly bills and decide that going to the doctor would have to wait so things like food could be paid for instead.

When he finally went in (to the emergency room), his cancer was Stage 4. Oops.

A couple years later his son, also self-employed (and no insurance) was *trying* to look after his health, but all he could afford was going to the free charity clinic about 2 hours' round-trip drive away (this was before gas prices spiked). He and his wife, the first time he went there, reported that it was a creepy experience; they'd expected to be encountering the lower edge of society at this place (i.e., winos, meth cases, etc.), but those attending were middle class, driving OK cars, etc. . . . it was just that medical care was *so* expensive, even middle class folks without outside insurance were being driven to places like this.

Son's diagnosis was diabetes, which was oddly resistant to treatment, but the clinic was too harried and underfunded to really conduct a full battery of tests . . . until it turned out to be pancreatic cancer, not diabetes, and going metastatic by the time it was noticed (if it had been noticed earlier, there might have been treatment options). Oops.

So, within about 3 years' time, this one poor woman lost her husband and her son both, to cancers that could have been caught and significantly slowed with earlier screening.

That's *my* experience with the US health system and its current "death panels." >:(

Sorry, tl:dr, but every time this comes up, I think of two good men who shouldn't have died as soon as they did. Tends to make me type a lot . . .

For me, there's no "tl;dr" or "spam" when it comes to these personal stories. I'd rather read a dozen screenfuls of concrete evidence than even one screenful of ideological declarations.

I'm starting to realise how lucky I've been when I've visited the US over the last decade: I've bought travel insurance here in Australia for a few hundred dollars, with a deductible of... wait for it... about a hundred bucks.

I've had my personal dealings with the American health care system this year. Too long to go into here. It sucks.

And let us not forget stories of people who find themselves with chronic conditions, are lucky enough to have insurance through their employer, but when the insurance company jacks the premium on the employer, the patient finds themself unemployed. This happens at a couple of employers in a row and soon the person is not only uninsurable, they're unemployable. I've seen it happen.

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