Another plug for universal health care

Inspired by this Krugman piece.

It is quite simply retarded that we don't have universal healthcare. And when I say retarded, I don't mean retarded in an abstract liberal sense of justice sense of the word, though certainly that applies. I mean retarded in the very practical and economic sense of the word. First, a little background:

In the beginning, America had an awesome health care system. Doctors were well paid and respected, and American hospitals were the best in the world. Unfortunately, due to increases in the sophistication of treatments (and therefore cost) as well as an ever-aging population (proportionally), health care costs started to climb. Enter the HMOs. The HMOs were created by fucktard MBAs who saw an opportunity to make a buck. They said to the world, "Hey! You know what? The reason your health care costs so much is those greedy doctors are purposefully overcharging you, are needlessly administering unnecessary procedures, and are generally responsible for all that is wrong with health care! If you give us your money, we'll make sure you pay less for your health care, and we'll deal with those mean old doctors by strictly regulating what they can and can't do to treat you, and thereby we'll trim all the fat off of the health care system and everyone will live happily ever after!"

So we did. Except the problem was that the premise is and was totally and utterly false. The problem was never the doctors, and even if it had been, it turned out that the administrative overhead of figuring out what kind of treatment was covered for each and every patient and negotiating with doctors about it and so on and so on and so on created such a massive beaurocracy that any savings that might have existed were utterly overshadowed. To give you some perspective, in the current American health insurance world, about 30% of every health care dollar goes to administration. Also remember these are businesses, so they want about 25% of every dollar to be profit. So you're left with less than half of every dollar actually going towards your care. In comparison, places like France and Canada spend only about 10% on administration, and the rest goes to care. Don't we have an awesome system?

Enter universal health care. Why is this a good idea? First of all, we live in a society where you get treated even if you can't pay for it. So despite healthcare becoming too expensive for a lot of people, those people still get sick, they still go to the hospital at the last possible moment, and they still get treatment. Which you pay for. And, in fact, if they had gotten proper preventative treatment, they might not have needed that expensive ER visit which, again, you paid for. So there's one win for universal healthcare: supplanting last-minute drastic treatment for cheaper preventative treatment.

But more important than that is cutting out all the goddamn administrative overhead. Since each HMO has to maintain its own administrative army to handle the load, there's a huge amount of duplicated administrative effort. If you consolidate everything into one entity, you cut out the duplication, which is a huge savings. You also save by allowing an entity like the state of California to negotiate drug prices en masse for reasons similar to how your employer can get lower health insurance rates than you can as an individual. And finally, you can trade in the profit margin for, at worst, some governmental inefficiency. So you save money. Do you hear me people? YOU SAVE MONEY. AND YOUR EMPLOYER SAVES MONEY. WHICH HELPS THE ECONOMY GROW. YOU GODDAMN FUCKING IDIOTS.

Opponents will tell you one or both of two things: a) that you're increasing the size of government and that government is inherently evil and does nothing good for anybody, and b) that the system will drastically increase taxes. With regard to a), you only believe that if you're stupid and listen to Republican rhetoric. Certain things work better when the government runs them or at least regulates them. Certain things don't. Sometimes you can get a better result if you hand the problem to the markets and let the equilibrium fall where it may. Other times you can't. The current fucked up system is what we got when we let the markets play their little game. That experiment ostensibly failed, among other reasons because at core we aren't a completely morally corrupt people and place all kinds of restrictions on the nature of health care that have weird (and usually negative) effects in the free market (as in the last-ditch ER visits mentioned above). Let's talk about better solutions now, m'kay?

With regard to b), the argument is specious. Technically, yes, taxes would increase. But the overall cost would actually decrease. Why? Because you're already paying for health care in a different form. Right now your employer pays a premium directly to (likely) an HMO on your behalf. Economics will tell you that, on par, you basically split that cost with your employer. All we're talking about here is shifting that premium to a tax that would go to the state. And, per the reasons mentioned above, making that shift in the system would actually save everyone a fuckload of money.

How much? Roughtly $8 billion for the state of California alone.

So why don't we have centralized healthcare? Two basic reasons:

1. Republicans have convinced everyone that any government program is a priori a bad idea, and
2. The HMOs have so much money that they are a significant force in governmental lobbying, and damn wouldn't you know it? They were the 9th highest donors in the 2004 election cycle and gave 68% of their money to Republicans. Funny that Republicans think HMOs are just fine, huh?

Yet another failure of American society you can blame on Republicans. :)

So write your representatives. Or, you know, don't, because money talks in Washington and you don't have any. So be like me and be silently pissed off at the utter stupidity and gullibility of the human race.