Healthcare. What’s the fuss?

by Sandy Cook

What’s the fuss? I mean that question quite literally. I don’t understand the fuss.

I hear the fuss – Lord do I hear the fuss! – but not much of it makes much sense.

From the left I hear a fading argument all in wonk-speak that doesn’t really tell me what they are asking for. None of it is apparently very important since every piece of it that meets opposition seems to be ripe for negotiating away.

From the right I hear accusations that are identifiable fantasy, if one just takes the time to read the various legislative proposals. I also hear that they won’t vote for any bill if it includes such-and-so, so the left gives up on such-and-so, and then the right says, “Well, we’re not going to vote for it anyway.”

The left then responds that even though they didn’t oppose all of the amendments that the right insisted on, they will now not vote for any bill that doesn’t include what they just gave away.     Healthcare. What’s the fuss?
by Sandy Cook

What’s the fuss? I mean that question quite literally. I don’t understand the fuss.

I hear the fuss – Lord do I hear the fuss! – but not much of it makes much sense.

From the left I hear a fading argument all in wonk-speak that doesn’t really tell me what they are asking for. None of it is apparently very important since every piece of it that meets opposition seems to be ripe for negotiating away.

From the right I hear accusations that are identifiable fantasy, if one just takes the time to read the various legislative proposals. I also hear that they won’t vote for any bill if it includes such-and-so, so the left gives up on such-and-so, and then the right says, “Well, we’re not going to vote for it anyway.”

The left then responds that even though they didn’t oppose all of the amendments that the right insisted on, they will now not vote for any bill that doesn’t include what they just gave away.

If there is a center, I guess it is those who are already covered by employer medical plans who don’t think that they can lose them, even if that is not a realistic expectation. The center also apparently includes everyone on Medicare shouting, “Keep the government’s filthy hands off my Medicare!”

Another group in the center, and the one that inspired this editorial, is the group of veterans, many of whom are unable to get in to the VA system, screaming, “Don’t mess with my veterans’ benefits”, apparently lamenting the loss of benefits that they have generally been unable to collect.

One veteran even said – combining both “no-government” arguments – “Keep your g*d d**n government hands off my veterans’ benefits.”

Don’t worry, brother, they are doing their best to keep their hands totally off your benefits – they want to keep your hands off them too, by the way.

Also by the way, there is no VA “Death Book”. The reported brochure is in accordance with US law that mandates giving veterans the best possible advice as they make their decisions about wills and living wills. Only someone who is looking for a fight would find anything really wrong with that brochure.

So I repeat, “What’s the fuss.’

Since no one apparently understands what is being proposed, and no one is willing to give an inch on their fantasies, it is all seemingly as Macbeth says of life, “a tale told by an idiot, full of sound and fury, signifying nothing.”

Now if the left had simplified their message so that we all could understand it, part of the fight would go away. No “public option” and no “co-ops”, and no “cost curves”; just something simple like “Medicare for all” would have worked nicely. It would not have stopped the right from opposing it, but it would have avoided the death-by-a-thousand-cuts that the present proposal is going through.

The argument from the right could then eliminate all of those inanities like “death panels” and “bureaucratic rationing” and “killing grandma”, and could have focused on their single, historical argument that “Medicare for all” is “Socialized Medicine”.

So what’s so bad about state-run medicine? Many people in this world with comparable incomes and equal educations, and who are equally devoted to their inefficient democracies as we to ours, seem to love it.

My parents lived for the last 28 years of their lives under the UK’s National Health Service (NHS). While my Dad did once have to wait five months for an operation on a hiatal hernia, generally they saw their doctors on the day they called or the next day.

They got full treatment including preventive care and all prescriptions, and they probably lived a number of years beyond what they expected because of the excellent quality of their care. My mother had a serious pre-existing condition – yet when they moved to England that was never questioned. As legal residents, but still American citizens, they received many years of excellent care, including three extensive hospitalizations for my mother.

When her time came to die, nurses showed up at the house in the morning and prepared her for the day; her doctor stopped by every afternoon around 4 PM to check on her; two more nurses showed up around 7:30 PM to prepare her for the night. They bathed her, if she wished, changed her bedding, made her comfortable, and made sure that she had her medication to control pain – all in her own home.

The NHS provides these services to everyone for about 1/3 less per citizen than we spend. Infant mortality is lower than in the US (5.0:6.4/ 1,000 live births),and life expectancy is slightly higher (78.7:78.0). At least half of their doctors make as much or more than US doctors. Drug prices don’t compare since prescriptions are free. So if you worry about cost, it seems that they might have the answer.

Only medical “extras” such as cosmetic procedures are not covered, but one can even get those under optional private plans. Those plans can also get you into a private hospital, get you a world-renowned specialist (rather than just the very good specialist at your local hospital) and can get you a private room while the NHS patients are in wards and semi-privates.

My folks got the same care as Stephen Hawking (yes he is a Brit) and as any member of Parliament.

What does all of this have to do with veterans?

What if we didn’t have to depend on the VA for normal medicine, as so many of our veteran brothers and sisters must? What if those ills were taken care of by a universal system? Then the VA could concentrate on those medical problems that are the direct result of service – not just combat – all service; physical trauma, mental trauma, and service-induced disease.

For those of us on one of the TRICAREs the savings on prescriptions would be slight since we can get our medicines free at a military facility, or 3 1/3 cents a pill for generics and 10 cents a pill for brand name. But while my four drugs cost me $24 total every 90 days, the same four drugs in US pharmacies cost my fellow Americans from $294 at the low end to $874 at the high end. Somewhere, buried between my cost and theirs is the true cost, if you can find it.

For the normal citizen whose employer covers @70% of his or her premium, based on 2008 data, family care costs $1,025 a month, and individual plans cost $365/month. That $760 the employer pays for family care could go to increase salaries, lower prices, and enhance competitiveness. Yes taxes would go probably go up slightly, but I’ll bet it would be a lot less than the comparable commercial premium.

The VA Healthcare work load would drop significantly, and waiting lines for healthcare would dry up. Of course, such a change would have to be accompanied by a complete attitude overhaul, changing the goal from denying as much care as possible to allowing as many in as possible. Service connection would be the key, and the connection would be obvious, although perhaps still difficult in the case of environmentally induced disease. [This wouldn’t improve the VA’s performance on other benefits, but it might free up some resources to deal with those too.]

Veterans should be fighting for such a system, instead of fighting someone to get “the coverage we all were promised at enlistment”, which no Congressman or bureaucrat seems to understand or care about. We could just go to our ordinary doctor and get taken care of.

Perhaps many veterans want this benefit to remain exclusive because it represents a reward for the very real sacrifice that they made many years before.

One argument they shouldn’t be using is that they don’t want a bureaucrat between them and their doctor. Guess what? You have one there already. The difference is that the insurance company bureaucrat who is servicing you right now makes his points by denying you service – by maintaining or improving his company’s “loss ratio”. Many even get bonuses for keeping you a sick as possible.

At least the government bureaucrat doesn’t have his pay tied to your ill health and misery. If you are in Medicare, TRICARE or VA or any combination thereof right now, you have a government bureaucrat on your healthcare case anyway, and in my experience with two of those, it hasn’t been bad at all.

Instead of trying to get into the VA system to get all of your medical problems taken care of, the government could take care of paying the veteran’s monthly “Medicare for All” premium. To be fair it should be in varied amounts such as say 25% for those who serve one enlistment, 50% for ten years, and 100% for a career through retirement. You would still go into the VA system for service connected trauma or disease, but you would go in without waiting since requests for ordinary healthcare would not be choking up the waiting lines.

The reward for service would still be there, it just would come in a different form. It is the benefit that is important, as are the results for the veteran, not the form that it takes.

I know that many veterans organizations oppose such a plan. USDR, an organization I respect very much, has charged that any attempt to blend these operations would “devalue the service and sacrifice” of veterans.

I respectfully disagree.

We veterans did not fight for ourselves, we fought for our country. Our country includes all of our fellow citizens and all legal residents. We fought so that they might have the right to life, liberty and happiness. What greater happiness can we offer than a relief from the worries and concerns of personal and family healthcare, and the disasters that can accompany it.

We can fight once again for life and happiness and none of this in any way threatens us as veterans nor our democracy – it doesn’t make us a socialist country.

If we were to fight today for universal healthcare, and be satisfied that both our service connected conditions and, through fee-relief, our sacrifice were recognized and accommodated, we would be continuing our fight for our fellow citizens almost at no cost to ourselves.

True patriotism includes service to one’s country. We served them before – let’s serve them again!

“We cannot live for ourselves alone. Our lives are connected by a thousand invisible threads, and along these sympathetic fibers, our actions run as causes and return to us as results.”