THE UPHILL BATTLE AGAINST THE STATUS QUO
Reforming healthcare is what marketing people might call a 'technical sale'. It potentially involves knowing details about insurance and lingo. There is a learning curve, an education that has to take place hopefully starting now, because the forces of disinformation will be stronger than ever, as time goes by.
WHO IS FAKING IT?
One of the systems Sicko suggests as a template for a remodeled American health care is the United Kingdom's National Health Service (NHS).Well, until I see it myself, I'll take A.O. Scott's opinion that, although Moore investigates Cuba and Britain, he doesn't approve them as templates for remodeled America. So, this statement is just false.
A WORD ABOUT 'RATIONING' - IS THAT A FIRST AND FOREMOST CONCERN, AT THIS STAGE, OR A FRIGHTWIG PUT ON BY THE RIGHT?
Moreover, a wholesale shifting of healthcare from the private to the public sector simply means replacing rationing by wealth with rationing by number, and a drastic decrease in individual freedom on both sides of the medical equation.
This is unclear, which is unfortunate, when starting out by calling someone (Moore) a 'practiced liar' and 'not too smart'. What does 'shifting healthcare' mean, exactly? No one has proposed that doctors should be employed by the State, as they are in Britain, right?
We don't have just rationing by wealth, we have rationing based on employer. This has to end, one way or another. That is increased freedom. Employers should get out of the business of being insurers. Given how they've abandoned their pension obligations, for instance, it's fairly plain that they are just not any good at it.
There is no reason that a society should enthusiastically tolerate drastic increase in wealth disparity and wring its hands over some redistribution for healthcare, which, in the long-haul, can significantly improve the wealth of a nation by improving the human capital available. A healthy workforce is an economic good.
You'd replace insurance company bureaucrats who deny care with government bureaucrats who deny care.
Economically, we'd pick up all the profits of the insurance companies into public savings. As for being denied care of some amount, that probably always should be on the table, until the nation is much richer per capita. I'll take my chances with a BlueCross-type government agency, than with myriad insurance companies whose job it is to make sure that 'insurance' is a losing proposition for everyone in the pool in general (otherwise, how would they garner a 'profit'?).
MANAGING DRUG DEVELOPMENT COSTS CAN BE SEPARATE THAN PROVIDING ACCESS, EXPERIENCE SO FAR WITH NEW MEDICAL DRUG BENEFIT DOESN'T SHOW 'COST MANIA'
And slashing the profit motive from the drug companies will simply mean fewer new drugs for fewer illnesses....
The European health systems have, of course, been free-riding on private U.S. drug research for decades. Name a great new drug developed in Europe these past ten years.
Yeah, I don't follow that at all. The big pharma companies have gobbled up their European equivalents, in order to create scale. Pharmacia didn't have an empty drug pipeline when it merged with Upjohn or was later acquired (sure, it's Sweedish, but which 'European drug companies' are we talking about?). The French have long been known to have been ahead on the development of many therapies.
Besides, I'd challenge anyone to show just how much basic science is done by major pharma, these days. I'd hazard that a large part of their effort is in other areas - important, but not in the way that is put forward with sweeping praises.
Meanwhile, this simplistic either/or analysis doesn't capture alternatives for managing drug development costs. Not that all of healthcare reform has to occur at once. For instance, what about the proposition that exclusive patents last for, say, 10 years, after which exclusive patents can be extended for another 10-15 years, provided that the government is satisfied that the drugs start being marketed at 'generic' prices. In other words, trade extended patent protection for a price reduction, after the initial patent period. I'm quite sure that companies would be willing to do that. It would bring down the cost of drugs and continue to provide all the powerful financial incentives that are needed to ... to pay for ... let's see, wasteful direct advertising, wine-and-dine the doctor routines, contribute to the political campaigns of everyone, massive issue advertising every 10-12 years, etc.
SCORING POINTS
Oh, and just to make it complete: This is a tradeoff that the Right will deny until they are red in the face, but it's a real tradeoff.
NASTY BITS
And yes, I see no problem with the wealthy having access to better care than the less wealthy.The problem with this is that it's open to interpretation in the worst way [I mean, probably worse than Moore]. I wonder if AS realizes that there are some people who think that the wealthy deserve better health care, even if 'better' is defined in terms of some people having NO access, even basic, not in terms of having, say, Beverly Hills house calls and private hospital rooms?
I have less worry that the Left is going to shut down the lifestyles of the wealthy or super wealthy than I do of those who are more than willing to let 'those without' make do without. This is particularly why the 'Conservative' effort on healthcare is generally baffling as a studied 'viewpoint', as a question of emphasis, or as the 'other side of the coin'.
