Occam's Razor

The Republican Party could save a lot of time if they would just come out and admit it: they hate people not like themselves. They sure do not like Democrats, which is understandable, but they really loathe the poor. They actually seem to relish the fact that the ranks of the poor keep swelling. They seem to enjoy seeing them miserable.

It is clear Republicans figure that poor people do not deserve health insurance. To paraphrase the musical The Music Man, their message to the poor is, “You can have all the health insurance that you can afford buy for yourself.” The minor fact that if you are poor you may not even be able to afford to keep a roof over your head, let along pay hundreds of dollars a month in health insurance premiums, clearly doesn’t faze them at all. If they cannot afford to health insurance, then screw ‘em. It’s their own damn fault for being poor and all.

In rural Virginia last weekend, thousands of poor people lined up days in advance to get free health care at an annual clinic held at the Wise County Fairgrounds. They cannot afford health insurance. Preventative health care? This is as close as it comes for these people, assuming they are lucky enough to be seen at all. In many cases this “care” is more reactive than preventative. One woman reports that a visit last year saved her life.

“They done an ultrasound and told me that my gallbladder was enlarged and was ready to burst and it could kill me,” Miller recalls. “They told me if I hadn’t got help when I did, literally I could have died.”

Forty seven million uninsured Americans, roughly fifteen percent of the population, are priced out of the health care market. The number goes up every month as more people lose or can no longer afford health insurance. Even if you are employed, it is hard to maintain health insurance when premiums keep climbing at two or three times the rate of inflation. With nothing to change the dynamic, this simply means that more people will become priced out of health care every year.

And the Republican Party’s response? Kill any attempt to reform health care! They figure this will undercut President Obama and help them get back into power. It sure will not make them any more popular with the swelling ranks of the uninsured. But that doesn’t matter, you see, because this is all about principle. “Socialized medicine” is bad. You can tell it’s bad because of the excellent health insurance “system” we have right now, the best in the world, they claim. Surely, we don’t want to change such a perfect system? Anyhow, doing so would violate their free market principles. Apparently violating free market principles is not a sin when it comes to, say, crop subsidies, but it sure is when it comes to health insurance. Instead, it is much better if we all continue to engage in a Darwinian struggle for health care. The well insured or deeply moneyed get to rise to the top of the heap. If lack of affordable health care means that the poor die young and disproportionately, well, to quote Ebenezer Scrooge, “if they would rather die, they had better do it, and decrease the surplus population.”

Many of these same people are all about protecting the sanctity of life at all costs, providing, of course, that no portion of their taxes goes to support anyone once they are born.

My wife is a friend of two lesbians, Nancy and Annie, who live in the Amish country in Lancaster County, Pennsylvania. The two women have been partners for a quarter of a century and would be married if they could but, of course, Pennsylvania does not allow gay marriage. Both women are incredibly impoverished. They live in a house built in the 19^th century that should be condemned. Annie has a terrible case of adult diabetes. Because she is disabled, her health insurance is Medicaid. Her “free” socialized medical care of course leaves much to be desired but is much better than Nancy’s. Nancy has no health insurance at all. She feels lucky to have a job. Over the years, she has spent many anxious months unemployed and trying not to be thrown out on the street. She is currently working two part time jobs, neither of which allows her to purchase health insurance. Even if she had the option, the premium would likely be way above her reach.

Nancy’s health care plan is to trust to luck and when necessary visit the emergency room and plead indigence. Of course by then any condition she has is very chronic. She recently spent two weeks in the hospital. Because she had no insurance and could not afford to see a dentist, she developed an abscessed tooth. The infection spread to her lymph nodes, which swelled grotesquely and caused a lung to collapse. She spent two weeks in the hospital and is fortunate to be alive. She could not afford to pay her hospital bill of course, so it was passed on in the form of higher premiums to those patients with insurance. Meanwhile, she was unable to care for her nearly immobile partner. My wife was one of a handful of friends who tried to care for her partner while she was in the hospital, driving three hours each way.

This is “the world’s best health care system” that Republicans want to keep. Even if not perfect, this “system” must be far better than this scary thing called “socialized medicine”. You know how bad socialized medicine is because Medicare is “socialized medicine”, which means retirees must hate it, right? Well, no. In fact, seniors give Medicare high marks. The fact that someone pays the bills of the uninsured, and that someone is effectively those of us who are insured, is not socialized medicine, so it must be okay. Reality rolls over them like water off a duck’s back. It is far more important that they can see the doctor they want at a time of their convenience because they have money and are insured. Those others do not deserve the same privilege because they cannot afford it, so screw ‘em. They try to scare us with stories about the evils of socialized medicine in Canada yet put up blinders at the millions of stories of like my wife’s friends that happen every day in this country.

The truth is that if we modeled the Canadian health care system in the United States the vast majority of us would get better health care than we do now and we would pay much less for it. Moreover, we would not be worrying about being dropped for a preexisting condition, or whether we can afford the co-pay, or whether we can afford to get a regular checkup. Wondering if we could afford to be sick would be one less thing to worry about.

The unreasonable ideology on health care reform is unnecessarily killing and bankrupting us. This must change. However, it will not happen on its own. We must do more to make this change happen. I suggest you do what I did this weekend. Write a letter to your senators telling them about the importance of real health care reform, or better yet call them up on the phone. Tell them they must vote for real health care reform that includes a public option. Tell them you will vote them out of office in the next election if they do not. Insurance reform, the “compromise” that seems to be emerging in the Senate, does nothing to ensure that health insurance will be affordable. Nor will it do anything to constrain its costs.

We need a public-plan to help hold the insurance companies feet to the fire. We also need a public plan to make sure some health insurance plan will always be there. The government must be the insurer of last resort. Your life and mine may depend on it.