Akascribe A personal blog covering all manner of subjects

With all the weighty political issues swirling around the U.S. in recent years, it’s bizarre that the current health care reform debate has inflamed the most passion.  I mean, there have been, by my tally: (1) Two Ongoing Wars, one of which (Afghanistan) was started on valid principles but waged poorly, and which now threatens to bog us down in the kind of quagmire that dragged down two great empires, and the other (Iraq), which was started on false pretenses, often conducted in violation of international law, and has exacted an ungodly toll in lives, money and moral standing; (2) Domestic Fiscal Policy, i.e. the compiling of massive deficits from a combination of tax cuts and huge non-infrastructure spending (See Item 1); (3) Energy Policy, aka a failure to invest in new technology or otherwise regulate a dirty, non-renewable 19th Century power source (petroleum), thereby both enriching and putting ourselves at the mercy of foreign oil producers (See Items 1 and 2); (4) Environmental Policy, where we stuck our head in the sand about global warming, thereby both missing an enormous high-tech business opportunity and quite possibly rendering our planet unfit for habitation by our grandchildren; (5) Various “Family Values” Issues, such as abortion, same-sex marriage and affirmative action (each too complex to summarize here); and (6) Education, where we have made some noise about teaching better but don’t have the money or resolve to do much about it (See Items 2 and 5). And there were plenty of others.  But what really gets people onto the streets, screaming bloody murder at their members of Congress? Whether to provide a public option to private health insurance. Go figure.

Part of the reason, we are told, is the core culture of America.  We are still a young nation, founded on a frontier mentality where people don’t want to take orders from Washington and don’t want to be taxed more than absolutely necessary.  Personally, I don’t buy it.  That kind of Jeffersonian ideology went out with the New Deal.  People want and expect the government to provide them with all sorts of goodies, from the so-called basics (national defense, police and fire protection) to infrastructure (interstate highways,  safe water and sanitation) to cheap food (subsidized corn and dairy products) to psychic enrichment (NASA’s space program, National Parks).  Just not, apparently, health care – seemingly one of the most basic necessities of life.

So what gives? I hate to be cynical, but I have to believe it’s because the Democrats are finally in power and have an opportunity to do some real good, despite the laundry list of policy obstacles that I enumerated above.  And for some ideological Republicans, the idea that overall success would further diminish their political viability is so unpalatable that they are willing to drag the whole country down with them.  Now if that isn’t cynical, I don’t know what is.

As to the specifics of the health care debate itself, I must confess that the issues are so complex that I haven’t been willing to wade into the minutiae.  My elected representatives are in favor of reform and that’s good enough for me – I’m willing to let the policy wonks hash out the details.  The fact that the current system is broken is so obvious that a right-winger would be much more credible arguing that President Obama wasn’t born in Hawaii or that Darwin’s theory of natural selection is misguided.  But if anyone out there is still in doubt about how medical costs in the USA are untenable, let me provide one personal anecdote as Exhibit A.

We recently got a referral from our son’s pediatrician to see a surgeon for an elective procedure.  We made an appointment for a consultation, where we were asked to provide lots of personal information (health history, insurance coverage, etc.) but were not charged a consultation fee or co-payment (nor were expecting to).  Once in the consultation, the doctor confirmed that insurance would not cover the procedure at issue and he spent half an hour happily discussing the details, encouraging us to contact him again if we had any further questions.

So imagine my surprise when we received a statement from Blue Shield, stating that the doctor had billed them $652 for the informal consultation!  My wife shook her head in similar dismay, so I immediately called the doctor’s office.  After leaving multiple messages, his billing assistant finally called back and “explained” that this is the way their office handles consultations.  I “explained” that this was not acceptable – we had not been informed in advance that the consult would be other than free.  Oh no, she said – if we preferred, we could be billed a $100 consultation fee, otherwise we would be responsible for a $25 co-payment and Blue Shield would pay the difference (from $652).  At this point, I figured I had either uncovered the most blatant insurance scam in history or was losing my mind, so to handle either situation I called our pediatrician (who happens to also be a family friend).

Now it gets worse.  She was initially as troubled as my wife and I were by what had transpired, so she promised to talk to the surgeon personally.  But when she called back a couple of days later, she was singing a different tune – basically echoing the billing assistant’s statement that “this is the way it’s done” even though it seems odd.  I probed her a little – how can this make any sense? – but it was like she’d already drunk the moral Kool-Aid and wasn’t going to admit what was now painfully obvious: the system had corrupted two otherwise fine and decent physicians.  Things have apparently gotten so bad for doctors that they have no way to survive other than go along with these sorts of smoke and mirror accounting shenanigans.  With the result that few can afford medical insurance (we’re both self-employed and are barely hanging in there) while the insurance company CEOs bring in multi-million dollar salaries.

Then I read that Whole Foods is being boycotted because John Mackey, its CEO, has been so brazen as to write an op-ed piece for the Wall Street Journal suggesting eight issues the Obama Administration should consider in the health care reform debate without adding to the deficit.  Huh?  I quickly read the editorial and found myself, a card-carrying liberal, agreeing with most of it – read it for yourself.

Mackey proposes such zany notions as: Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts.  Or, Make costs transparent so that consumers understand what health-care treatments cost. And, Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.  Treason!  Revolution!  Citizens, man the barricades!

So it isn’t just the opponents of health care reform who have wigged out.   Some of the so-called proponents are losing it too.   If all these folks would invest as much energy in eating better and exercising more (another one of Mackey’s calls for action), they’d unclog the arteries in their brains and we’d probably save enough in health care costs to fund Medicare until 2012 – when we can re-elect President Obama to finish cleaning up the mess he inherited.