Health Care Reform and Debate That Never Happened

by: Dark Wraith

The Baltimore Sun has a writer who publishes "Jay Hancock's Blog," and Mr. Hancock's entry for November 6, 2009, is entitled, "Profiles in wimpiness," briefly citing several leading voices calling for approval of pending health care reform legislation.

Mr. Hancock first quotes Paul Krugman, a fellow whom I have harshly criticized, both in writing and on my Internet talk radio show. Even the most meritorious of ideas will have its share of oafs littering the parade route, and Dr. Krugman's unconscionable intellectual prostitution for countries that massively undervalue their currencies against the U.S. dollar qualifies for the blue ribbon parade award for the Float That Should Be Shot, notwithstanding his Nobel Prize in economics this year (a prize previously granted to the very epitome of oafishness on the speaking tour parade, the late Right-wing extremist and howlingly lackluster "intellectual," Milton Friedman).

One comment, written by someone using the pseudonym "MrRational," on Mr. Hancock's article struck me:

I still remain opposed to the entire scheme.

Corporate and Government are two sides of the same nannyism coin. Neither can be expected to solve anything for us.

But to the degree that either is allowed a brief or responsibility...
make it a narrowly focused one.

there are three basic levels/categories of care:
1) the 80% that constitutes everyone's day to day uses which should be paid for out of pocket (by most of us) on a fee for service basis to the provider we choose. (and yes, people with some conditions can expect to pay more for that basic care than people who don't have those conditions.)

2) the 10 % that will occasionally crop up beyond those routine year to year expenses that we can mitigate the budget impact of by having some back stop insurance (or an HSA) which we also pay for on our own and most will use very similarly to how we use our homeowner or auto insurance.

3) The 10% that NO ONE can reasonably expect to afford or in most instance to even insure against privately. These catastrophic and traumatic bankrupting expenses are the perfect category for and reasonable limit to a government plan with a tax supported 100% actuarial base.

If we are willing to be truly honest we can add a fourth category:
4) Stop pretending that anyone gets out alive by refusing to flog and abuse our elderly loved ones and call it medicine.

We can make it more complicated but there is no reason to.

I have not had much success in recent years with getting my comments I write published at reputable Websites. The Leftist site truthout.org — persistently begging for donations while doing little more than republishing other sites' content — will not post any comment I write, The Huffington Post only rarely lets one of my comments through, and the same goes for CNN.com; hence, I no longer bother visiting these sites much. Long-time readers here at Big Brass Blog know very well that my style of writing does not include the use of profanity or unrealistically hyperbolic literary imagery unless in the service of occasional satire.

Okay, I did use an obscenity, a profanity, and several vulgarities in writing about Paris Hilton's early release from incarceration; in my own weak defense, however, once in a blue moon, the mockery of uniform rule of law that is the American justice system bunches my boxers. As a broad principle, however, I write what could be published just about anywhere children would not be a target audience.

Still, I get censored. My short-lived gig writing for OpEdNews is over: one of the sneering, Leftist editors there got appallingly nasty in rejecting an article I subsequently published here to the usual, decent number of hits. The Institutional Liberal Manual of Style seems to be widely available to dwarfs at places like truthout.org and other caves on the Left Bank of the American river of ideological polarization. (As an aside, in a few days I shall republish excerpts from that article because those sentiments I expressed there are every bit as timely now as they were in the late Winter when I first wrote them.)

With all of the above as admittedly somewhat unshaped background, I nevertheless offered a follow-on comment at Jay Hancock's Blog. To my surprise, it was published this morning in unedited form.

I am herewith offering it to my own readers here at my online properties of Dark Wraith Publishing to the purpose of providing one more means by which I may speak to the debate over health care reform.

The comment by "MrRational" is worthwhile, although I have no particular use for the idea that we cannot take care of the poor, especially the children in this condition, who need basic medical services but who cannot afford to have them on a readily available basis. As a quite affluent society, we can surely afford to take care of people whose earnings make keeping body and soul together a challenge, and those people will number in the many millions, even in an industrialized society such as ours so long as we choose a form of economic organization where there are winners and losers, as well as stark differences in the long-term, even inter-generational fortunes of those two groups.

It is most unfortunate that a "progressively conservative" approach to reform was never in the cards for the debate in Washington; however, as a purely academic exercise, I note three major points that are missing in Mr. Rational's comment.

First and foremost is the matter of price transparency. Doctors, medical centers, and hospitals all hide their prices, which thwarts the very foundation of competition that would cabin those prices within an envelope formed by profitability and affordability. As a professor, I make a big issue of this. Price transparency is crucial if the demand and supply sides are to discover prices that clear markets efficiently; but no serious federal or state proposals have been fielded to mandate publicly available price disclosures for a standard list of medical services and treatments.

Second — and this point goes far, far beyond the health care industry — we are using antitrust laws written in the first half of the 20th Century to deal with markets of the 21st Century and the market power of concentrated industries in an age where "deregulation" has allowed the argument for scale economies to sway regulatory oversight despite overwhelmingly larger, social and economic interests that are harmed by compacted industries. The Federal Trade Commission frets about "unfair and deceptive" advertising, it uses antiquated metrics like the HHI to measure market concentration, and it chases market concentrators after they've become too large to bust (as in the case of Microsoft, and as in the case now of Google).

Third, and finally, the rampant lack of education in basics of economics and business allows far too many people to get by with no understanding of such concepts as "moral hazard" and "adverse selection." This ensures a debate where only Right-wing conservatives bring up these ideas, and usually in offensive ways, making the underlying concepts as loathsome as everything else Right-wing conservatives talk about. If we are to have a truly informed debate, it would be so much better if the dancing, naked clowns of the Right (as I've called them in my writings) would shut up so the legitimate points they are mimicking could be brought up by people who aren't dancing, naked clowns.

Unfortunately, as it now stands, the only health care "reform" being discussed is really just health care repair, and it's sloppy repair done by self-serving politicians. Some things never change.

That's politics.

For the record, I am opposed to the health care reform bill in the form that the U.S. House of Representatives has just passed. I will sharpen my attack as time goes on, but I can assure readers here that those Right-wing clowns in the entertainment industry, along with their Republican sidekicks in Congress, will never be outside the scope of my criticism, either. Nothing irritates me more than intellectual fools and entertainment industry charlatans. They make legitimate debate next to impossible, so I hold them in particular contempt, even as I do the same for the Democrats in Congress who don't have the guts to write a genuine health care reform bill, much less a real, comprehensive overhaul of this country's miserably failed antitrust, financial services, and privacy laws.

I shall write what is on my mind and leave to the Democrats such ideals as compromise and accommodation, which those same Democrats over the past decade have turned into rank, disgraceful appeasement by another name.


The Dark Wraith is officially on yet another roll.