Here's to Your Health

We feel the need to weigh in on the whole health care reform imbroglio. These images of ravening mobs shouting down anyone who even tries to speak in favor of the proposed healthcare legislation--can there be that many lunatics in middle America?

Look, this is a complicated issue. The basic problem is that people who currently have health insurance don't necessarily see a great need for reform; to them (and the Solipsist is a member of this "them"), medical care feels "free." We see a doctor whenever we want, and all we pay is fifteen bucks for an office visit, and a few dollars more for prescriptions. And while we know--on an intellectual level--that the care we receive isn't free--that it does, in fact, cost someone thousands and thousands of dollars--the ironic reality is that, because we feel like it's free, healthcare actually becomes more expensive.

Think of it this way: Imagine you have health insurance, and you have a painful but totally curable medical condition that can be treated either surgically or medically (i.e., with drugs). Either method will be equally effective. The surgery will take care of the problem in an hour but will cost--someone--$10,000; the drug regime will only cost, say, $500, but will take two weeks to cure you. Which course will you choose? You'd probably choose the surgery. Why not? It's not like you're paying for it; in fact, you could argue that you already have paid for it-- in the form of less take-home pay--so you might as well take full advantage of your health insurance plan. On the other hand, if you were paying out of pocket, you'd probably opt for the cheaper course of action.

The way things are now, people have little incentive to choose the most cost-effective treatments. And doctors and hospitals, since they are generally reimbursed for the amount of care they provide, regardless of comparative efficiency, have little incentive to cut costs either. In short, the current system works pretty well for employed people who have health insurance through their jobs (although it could be argued that they might end up with more money in their paychecks under a government-run system), for medical providers, and for insurance companies. It doesn't work so well for the uninsured, for businesses (who struggle to pay for employees' health insurance), and, ultimately, probably for many of the currently insured, too--who will eventually lose their coverage if costs keep rising and employers just decide to stop providing insurance.

So something has to change. And we understand why people might object to various elements of healthcare plans under discussion. Hey, as soon as we hear things like a trillion-dollar price tag, even we get a little woozy. (And the Solipsist says this as a firm believer in universal healthcare. The words "socialized medicine" don't strike scare us. Sure, the term evokes images of third-world cesspools like Great Britain and Canada, but we think the US could possibly make it work.)

What's disturbing, though, is the level of rancor that this issue has stirred up. Seriously, who are all these people who are shouting down their congressmen--not even giving them a chance to discuss the issues? Are there really that many people out there who think that Sarah Palin, for example, knows what she's talking about--or, we should say, believes her own rhetoric--when she claims that President Obama's healthcare legislation calls for the creation of a "Death Panel" to promote euthanasia? Is the Republican party content to be seen as the party of pigheaded anti-rationality? Do they not realize that the style of discourse they are openly embracing would be out of place in a nursery-school playground, much less a town hall forum?

We hope--HOPE--that this reliance on scare tactics will ultimately backfire--that it will further consign the rabid right to the dustpile of irrelevance. We hope that.

We are not particularly optimistic.