Healthcare Debates: The Government Wants to Kill You

On the McLaughlin Group this morning (http://www.mclaughlin.com/), a microcosm of the problems with the current healthcare debate came into clear focus. Conservative Pat Buchanon, who has gotten more reasonable on some matters, was speaking of how Democrats want to assist seniors in suicide or, at its extreme, euthanasia. Monica Crowley was herself chiming in, using our collective fear of government intervention into our lives, warning that bureaucrats are suddenly going to start telling people how to end their lives. Other conservatives have started to call Obama a Nazi or Fascist, lied about the cost and are now showing up at the town hall meetings with their absurd comparison (http://www.washingtonpost.com/wp-dyn/content/article/2009/08/06/AR2009080603854.html). Is there truth in these claims?

The reality appears to be that the government will pay for people to go visit their doctors to discuss their end of life options (including a living will). Why would the Medicare pay for these services? Because, among other things, 24% of the total lifetime costs of Medicare occur in the last year of people’s lives. In other words, hospitals, hospices, drug companies, and the like are making a fortune on that last year of our lives . . . often not by making it better, but by running up bills that do little to improve the quality or length of that life. The second reality is that healthcare costs are now $1.7 trillion a year and rising, which translates to 17% of GDP. That is unsustainable in the long run. And lest us forget, as I have mentioned before, that obesity and the aging of the population over all (remember those pesky baby boomers that are retiring as we speak) are on the rise and thus costs will only balloon further in the future.

Healthcare is big business in America though, and a real role for the government will undermine their profitability. So lobbyists are spending millions, conservative talk show hosts come up with absurd analogies, wingnut operatives disrupt town hall meetings and the entire conservative establishment and its corporate benefactors spread misinformation and fear to undermine necessary reform. We don’t hear of the 30% of pharmaceutical company revenue that goes to advertising, or the shift to palliatives (from curatives) that occurred in the 70s. We hear lies about the healthcare systems in Canada and England, but very little about the even better systems in Scandinavia. And rather than reasonable debate, the mainstream media largely plays along – failing to give people the facts that could help them make informed decisions. Some of these facts include the fact that we have among the lowest life expectancy and higher infant mortality rates of any industrialized country in the world. Aren’t these two pretty big indicators of how good the healthcare system in a country is? And how about the fact that a majority of the population are on some drug or another, even though many of these drugs do little to improve our lives? ADHD only became a national endemic when there were drugs to deal with it. General Anxiety Disorder, Uncomfortable Leg Syndrome, Adult ADD, anti-depressants for children, Phen Phen, Hormone therapy for women, etc., all show how profitability influences healthcare decisions in a negative way. And yet few seem to bring all the pieces together and ask the really important questions. They start the conversation and then it degrades down to what we are witnessing now (http://www.salon.com/news/feature/2009/08/06/healthcare/print.html).

I think it is interesting to consider the conservative movement today within this context. After the election, there was some blood-letting and many argued that conservatives had to redefine themselves. Instead they seem to believe they should return to the Clinton era strategy – bottleneck Washington, undermine reform, challenge every big policy initiative and use lies and fear-mongering to turn the country against the presidency. The problem is hints are again emerging that this strategy is effective. In a country where many take pride in their ignorance or the stone-like quality of their, often uninformed, opinions, framing debates in this way is very effective. This is particularly true with a mainstream media establishment that has lost its heart and tends to report as if there were no facts to confront the he said-she said nature of debates in the political arena. The big problem is we have serious long term challenges that will go unaddressed if this absurdity continues. Beyond healthcare is the still reeling economy, global warming, retirement costs in the coming years, persistent racial inequalities and ongoing income disparity differentials that undermine democracy itself. If we do not soon address these problems, I believe rumors of the not too distant demise of America might not be so exaggerated . . .