It Took a Nixon to Open the Door to China
Why on earth has Obama and the Democratic leadership ruled out the
"single-payer" model, the one Canadians love so much?
I'm sure he wants Americans to believe that he is not a fanatic, a radical,
who intends to impose a socialist regime on the country. I'm sure he
knows that this perception is ridiculous. I'm sure he knows that the
insurance industry and some doctors' organizations and conservative talk
radio and Fox News and the Republicans will spend millions and millions of dollars to try
to convince Americans that Canadians hate their health care system (in spite
of some studies that show up 97% of Canadians would not trade our system for
theirs) and that Canadians are dying in unparalleled numbers because we
can't get doctors or treatment (in spite of our longer life expectancy) and that our breast implants are not as firm
or ample as good old all-American breast implants.
So why has Obama rolled over on this one? He's afraid of a brutal,
divisive fight. He wants to be bipartisan. He wants to unify
America.
I always thought that if a liberal Democrat took George Bush's approach to
the Iraq war and applied it to health care, the U.S. would have a
single-payer, universal health care plan in a matter of months. Nobody
wanted the Iraq war. Nobody thought it was a good idea. Nobody
believed Saddam had anything to do with 9/11. Did that stop Dick
Cheney? Not on your life. He just steam-rolled the idea through
Congress and the Executive branch and refused to compromise or bend until he
got his way. Above all, he threatened to paint every wavering Democrat
as an unpatriotic wimp if they didn't join in.
Now, if an idiot could do that with a bad idea-- why can't a genius like
Obama do it with a good one?
To answer my own question: because Cheney's opponents were intelligent,
reasonable people who were not given to hysterics and mudslinging.
They wanted to compromise. They wanted to seem even-handed and fair to
President Bush.
Obama's opponents are well-funded shrieking harpies who will lie and distort and stop
at nothing to take political advantage of any issue.
Perhaps it is going to take a Nixon (or a John McCain?) to change America's
health care system for the better. (The story is that if a Democrat
had tried to establish diplomatic relations with "Red" China the way Nixon
did in 1972, the Republicans would have revolted en-masse and created a
constitutional crisis of insane proportions. But Nixon, who was
trusted by the conservatives, was able to achieve remarkable results because
everybody thought that if old arch-cold-warrior Nixon thought it was okay,
it must be okay.)
From the Washington Post, June 11, 2009In the
final two years of a patient's life, for example, they found that Medicare
spent an average of $46,412 per beneficiary nationwide, with the typical
patient spending 19.6 days in the hospital, including 5.1 in the
intensive-care unit. Green Bay patients cost $33,334 with 14.1 days in the
hospital and just 2.1 days in the ICU, while in Miami and Los Angeles, the
average cost of care exceeded $71,000, and total hospitalization was about
28 days with 12 in the ICU.
Some differences can be explained by big-city prices, acknowledged
Elliott Fisher, principal investigator for the Dartmouth Atlas Project, "but
the differences that are really important are due to the differences in
utilization rates."
Much of the evidence suggests that the more doctors, more drugs, more
tests and more therapies given to patients, the worse they fare -- and the
unhappier they become, said Donald Berwick, president of the independent
research group Institute of Quality Improvement.
The kicker here is that there is evidence that the more treatment a
patient receives late in life, the less happy he or she is.
I believe it.
Anyone who has spent time in a hospital or nursing home can't help but
believe it.
Billions of dollars of health care spending in the United States is
guided by a very simple and pernicious logic: don't you love your
mother? (Or father, or grandparent, or...). And if you love your
mother, don't you want to do everything possible to extend her life?
Everything? Even if the odds of the treatment actually extending her
life or improving her quality of life are not very good?
I'm sure some
elderly people simply want to live for as long as they possibly can even if
it bankrupts their families, but I don't believe most of them want
that. I think most people in their 70's and 80's accept that life
comes to an end eventually and probably hope, more fervently than for
anything else, to die in peace, close to friends and family, and without
unbearable pain. They don't want to spend their last weeks or months
strapped to a bed with tubes going in and out of every orifice, nauseous,
drugged out. And they don't want pallid substitutes for pain
killers because the pharmaceutical industry has succeeded in establishing a
monopoly over drugs.
The average American works hard all of his life, buys
a house, builds up his assets, sends his children to college, saves
something for retirement, spoils the grand kids, and then, just when he
thinks he's survived the economic snake-pit of American capitalism, the
health care system sinks its fangs into him and sucks him dry. If you
want to leave something for your grandchildren, you need to drive your car
off a bridge before you become incapacitated.
Perhaps one of the most depressing facts of American life is that the
medical-industrial complex has managed to convince many Americans-- and
almost all talk radio hosts-- that the cruelest, least fair, and least
efficient health-care system in the Western World is actually the best.
They stand there bankrupted and ruined, dropped by their insurance
companies, buried under piles of arcane incomprehensible forms, denied
critical treatments because their insurance companies simply refuse to pay
out... and they look at us Canadians and go, "Oh my god! You have to
wait three weeks for an MRI?"
All Contents Copyright
© Bill Van Dyk
2009 All Rights Reserved
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