(This isn't Part III… this is yet another example of lies the right wing is trying to pass off as discourse. My deconstruction of the lies in the Health Care Bill are Here (Part I) and Here (Part II))
(I was on the Nicole Sanders Show Wednesday night to discuss health care… check it out here… (yes, I know… I need a new cell phone…))
The right wing fart
machine is working overtime on the health care reform bill, lemme tell ya.
The following was sent
by a reader. It's by Radio Gasbag Dennis Prager (whom I'm told is actually a
really nice man, so it will hurt a little putting my rhetorical foot up his
"nice" ass…), and this load of crap is absolutely chock full of misinformation
and false assumptions. He even lies about the number of questions. There are a
lot more than 10.
apparently came from the Jewish
World Review. (Why are so many so-called religious people so dead set
against letting everyone have access to health care?)
As always, the
article I'm responding to is not edited, and my responses are in red…
10 Questions for Supporters of ‘ObamaCare’
By Dennis Prager
1. President Barack
Obama repeatedly tells us that one reason national health care is needed is
that we can no longer afford to pay for Medicare and Medicaid. But if Medicare
and Medicaid are fiscally insolvent and gradually bankrupting our society, why is
a government takeover of medical care for the rest of society a good idea? What
large-scale government program has not eventually spiraled out of control, let
alone stayed within its projected budget? Why should anyone believe that
nationalizing health care would create the first major government program to
"pay for itself," let alone get smaller rather than larger over time?
Why not simply see how the Democrats can reform Medicare and Medicaid before
nationalizing much of the rest of health care?
Okay, the first thing you'll notice that there are four questions in
the above, not one. But they're all based on ridiculous assumptions.
The biggest misconception in the above is based on a simplistic idea
that somehow, all aspects of our health care system are separate entities. Medicare and Medicaid are integral parts of the same health care system as
private insurance, and they are going broke, in part, BECAUSE of private insurance.
See, even people without insurance are entitled to health care at
some point. (He mentions this in a later question, but misrepresents that, too, by the way…) But if they don't have insurance, no one pays the bill. Only,
hospitals and doctors have expenses, so to make up the shortfall, they raise
prices. Got that? Every thirty seconds, someone in this country goes bankrupt
due to health care bills. And when people can't pay their bills, someone else
has to make up the difference. As more and more people are left without
insurance, and as insurance companies refuse to cover more and more claims,
health care delivery people have to raise their prices to compensate. Private
insurance companies can raise premiums. Medicare and Medicaid are paid for with
tax money; they can't just raise taxes to cover the shortfall. And once again; the shortfall is largely CAUSED by the private insurers, who refuse to cover people who need it, and who do their best to not pay claims for people they do insure.
What's causing Medicare and Medicaid solvency problems is
health care inflation, which averages three to four times the inflation rate of
the rest of the economy. But check this out; if every bill was paid, then
health care inflation would drop by as much as 75%, even if no other factors
adjusted. Just cover everyone, and Medicare and Medicaid are saved.
See, here's the stupidity in the above. Medicare and Medicaid aren't
bankrupting society; the private insurance system, which refuses to allow one fifth of
the population from even paying into the system, and refuses to pay the bills
for many of the people it doesn't reject, are bankrupting Medicare and
The next question, about public health insurance "paying for
itself," also stems from the idiocy of thinking that, somehow each part
of the insurance system works wholly independently of every other part of the
Check out these statistics:
- In 2008,
health care spending in the United States reached $2.4 trillion, and was
projected to reach $3.1 trillion in 2012.1 Health care spending is
projected to reach $4.3 trillion by 2016.
- Health care
spending is 4.3 times the amount spent on national defense.
- In 2008,
the United States will spend 17 percent of its gross domestic product
(GDP) on health care. It is projected that the percentage will reach 20
percent by 2017.
nearly 46 million Americans are uninsured, the United States spends more
on health care than other industrialized nations, and those countries
provide health insurance to all their citizens.
- Health care
spending accounted for 10.9 percent of the GDP in Switzerland, 10.7
percent in Germany, 9.7 percent in Canada and 9.5 percent in France,
according to the Organization for Economic Cooperation and Development.
We already spend more on health care than anyone else. Fully 17% of our GDP goes to
pay for health care. Obviously, the money is already there. Only right now, the
expense is being paid by fewer people every year. It doesn't take a
mathematical genius to figure out that $2.4 trillion shared by 300 million
people is a lot cheaper than the same amount shared by 200 million. Plus, there
is no competition in the system right now. Competition will bring prices down,
Look at the stats above. We spend more and get less than every other
industrialized nation in the world for health care. Every other nation spends
less and covers everyone. Wouldn't it make sense to find out what they do and
maybe copy them?
2. President Obama
reiterated this past week that "no insurance company will be allowed to
deny you coverage because of a pre-existing medical condition." This is an
oft-repeated goal of the president's and the Democrats' health care plan. But if
any individual can buy health insurance at any time, why would anyone buy
health insurance while healthy? Why would I not simply wait until I got sick or
injured to buy the insurance? If auto insurance were purchasable once one got
into an accident, why would anyone purchase auto insurance before an accident?
Will the Democrats next demand that life insurance companies sell life
insurance to the terminally ill? The whole point of insurance is that the
healthy buy it and thereby provide the funds to pay for the sick. Demanding
that insurance companies provide insurance to everyone at any time spells the
end of the concept of insurance. And if the answer is that the government will
now make it illegal not to buy insurance, how will that be enforced? How will
the government check on 300 million people?
Seriously, this is a lot more than one question. Let's start with
the ridiculous misrepresentation of what Obama actually said.
If Prager is pleading ignorance about this, I don't buy it.
Insurance companies refusing to sell you a policy because of a pre-existing
condition has nothing to do with any of the questions that he poses after. I mean,
for Chrissakes, is it even possible for these people to be honest?
When an insurance company refuses to sell you a policy, EVERYONE
ELSE in the system gets to pay your bills when you finally need care.
Understand? That's what he's referring to. Tell you what, Dennis; fill out an
application for insurance at your work and check off the box that says
"Hepatitis B" and watch what happens. They'll turn you down, and
there is nothing you can do to get coverage. Period. That means, if you get the
flu and you don't have the cash to pay for treatment, everyone with insurance
pays for it. It also means that, if you show up at the hospital for treatment,
they have to treat you, and someone else pays the bill. Well, someone else pays
the bill after you go into bankruptcy court and have the bill wiped out.
And Dennis? Everyone who buys health insurance IS healthy. Got that?
If they're not healthy, they don't get insurance; no one will sell it to them.
That's the problem with the system. The people most in need of health insurance
don't get insured, because the private companies won't take "the
Now, let's look at the ridiculous comparison with car insurance,
shall we? Can anyone see the logical fallacies in the above? The first one is
obvious. If I go to a shop with a car that's been in a serious accident I am
not entitled to have it repaired or replaced, if I have not paid for insurance.
On the other hand, if I have been turned down by every health insurance company
available because I have a "pre-existing condition," and I end up in
the ER with a heart attack, the hospital is required to treat me.
See the difference? We have a right to life-saving and
pain-relieving health care, regardless of our ability to pay. We do not have
the right to have our car repaired.
The life insurance question is a red herring for the same reason the
car insurance question is insane; your next of kin has no inherent right to
receive money upon your death.
Dennis also seems to misunderstand the purpose of insurance, which
may explain the rest of this idiocy. Here it is again:
"The whole point
of insurance is that the healthy buy it and thereby provide the funds to pay
for the sick."
No. That's not the purpose of insurance. The purpose of any
insurance is so that a large group of people can pool their resources, and not
go broke if something bad happens at an inopportune time. In the case of health
insurance, everyone is entitled to health care at some point in their life,
should they need it. Only a large swath of the population is forbidden from
paying into the insurance pool.
Now, the last question is actually not a horrible one. Eventually,
it will be necessary to make everyone buy health insurance at some point,
because everyone needs to be covered. But first things first; right now, let's
just make sure everyone who wants insurance has it, because that will make
insurance far cheaper for everyone.
3. Why do supporters
of nationalized medicine so often substitute the word "care" for the
word "insurance?" it is patently untrue that millions of Americans do
not receive health care. Millions of Americans do not have health insurance but
virtually every American (and non-American on American soil) receives health
The first question above is also a pet peeve of mine. This reform
isn't about "health care;" it's about "health insurance,"
and getting everyone covered. So, that part of the first question is actually
The disconnect comes, because he refers to people in favor of reform
as "supporters of nationalized medicine." The current bill, and even
the discussions of "single payer" health insurance, do not involve
nationalizing medicine. The medical delivery system is not the problem. We have
some of the best medical facilities and medical professionals in the world in
this country. The problem is the tens of millions of people who are denied
medical insurance in this country, and the hundreds of billions of dollars
uninsured people cost the system every year, causing the entire system to
spiral out of control.
Now the final statement made after the fallacious question, is
outrageous. The millions of Americans who don't have insurance do NOT receive
"health care." They may receive emergency care if their arm is
falling off, or their condition becomes so bad they need a machine to live, but
to call that "health care" is absolutely immoral. Health care is
going to a doctor when you start feeling bad, or when you first notice a lump
or a strange mole. And tens of millions of people don't have that option. In
fact, millions of people are turned away from health care every year because
they don't have insurance or the ability to pay.
Not only that, but tens of thousands of people who HAVE insurance,
and discover that lump or mole, LOSE their health insurance as a result of
daring to contract some sort of ailment that is on their "list." How
many WITH insurance avoid reporting an ailment, because they're afraid the
insurance company will
A whole lot of people don't get "health care," and for him
to insinuate that they do is a level of ignorance that is unconscionable for a
"nice guy" right wing talk show host.
4. No one denies that
in order to come close to staying within its budget health care will be
rationed. But what is the moral justification of having the state decide what
medical care to ration?
This is may favorite technique used by right wingers to
"prove" their point.
Hey Dennis; I deny that there will have to be rationing. And there
are many like me out there, I assure you. Therefore, your arrogant claim that
"no one denies…" is absolute crap.
Now, let's talk about this whole concept of "moral
justification," shall we?
The state will decide what medical care it will COVER. That is not
the same as rationing. Rationing is what the private health insurance companies
do now, to maximize profits. Do you even know how an HMO works? Its entire
premise fits the very definition of rationing. The insurance company pays a
medical corporation a certain amount of money each year for each patient they
take on, and the corporation gets to keep everything they don't spend. That is
rationing. And if you have ever had to use your health insurance, you have
undoubtedly heard them recommend a cheaper alternative procedure to a doctor.
There is nothing in the health care reform bill that would ration
anything. If you mean they will only cover basic health care, and not pay for
Uncle Joey's new nose, or Aunt Marlene's sex change, you're probably right. But
that's not rationing. What insurance companies are doing right now is
As for this "moral justification" crap, just who the HELL
do you think you are, asking for moral justification from anyone else, when you
are advocating against making sure that 47 million people who are currently
uncovered, are covered.
What's your "moral justification" for advocating in favor
of a status quo in which one family per minute is thrown into bankruptcy
because they can't pay their medical bills?
What's your "moral justification" for advocating for a
system in which private insurance companies deny insurance coverage to people
who need it, because they are likely to have to use it?
What's your "moral justification" for advocating for a
system in which a person can pay hundreds of thousands of dollars in premiums
for 30 years, and have nothing to show for it if he loses his job through no
fault of his own.
What's your "moral justification" for advocating for a
system in which fewer and fewer people are forced to pay higher and higher
premiums every year, to cover costs incurred because the people the insurance
companies refused to cover got sick?
I could go on. There is no "moral justification" for
health care rationing. So why have you been so quiet about it when private
companies have been doing it with impunity for many decades?
5. According to Dr.
David Gratzer, health care specialist at the Manhattan Institute, "While
20 years ago pharmaceuticals were largely developed in Europe, European price
controls made drug development an American enterprise. Fifteen of the 20 top-selling
drugs worldwide this year were birthed in the United States." Given how
many lives — in America and throughout the world – American pharmaceutical
companies save, and given how expensive it is to develop any new drug, will the
price controls on drugs envisaged in the Democrats' bill improve or impair
The answer to this question is a resounding "no." There's
no other answer. Private insurance companies control prices now; they don't pay
full price for drugs. No one is interested in putting drug companies out of
business. But can we get real about the profit situation at those
"poor" drug companies? When Medicare introduced its prescription drug
plan, big pharma's profits soared $8 billion in just
the first six months alone. That's just the INCREASE folks. The top ten
pharmaceutical firms made
a profit of $80 billion in 2007. That's PROFITS, folks. That hardly
indicates that they have an overwhelming burden to overcome with their research
Now, if the big drug companies made that much money when the
government added 40 million Medicare recipients to the market, why would adding
47 million other insured individuals, many of who are denied insurance because
they're sick, reduce their profits? And if price controls cause their profits
to stagnate somewhat, or even go down a bit, are we supposed to leave 47
million people uninsured, because it would mean Pfizer might "only"
make $15 billion, instead of $20 billion? Are you honestly dense enough to
think these companies will go out of business if they can "only" make
$40 billion instead of $80 billion?
Where's the "moral justification" of continuing to deny
coverage to 47 million people, so that 10 drug companies can make an extra $40
billion in profits every single year?
Oh, and one more thing; the reason most of these companies are
located here is because of the generosity of the US government when it comes to
research money. They still SELL drugs in all of the countries that control
prices. And they make a profit in those countries, as well.
6. Do you really
believe that private insurance could survive a "public option"? Or is
this really a cover for the ideal of single-payer medical care? How could a
private insurance company survive a "public option" given that
private companies have to show a profit and government agencies do not have to
– and given that a private enterprise must raise its own money to be solvent
and a government option has access to others' money — i.e., taxes?
You know I don't really give a shit about the answer to the first
question. Private insurance companies have had a veritable monopoly for many
years, and they have abused it. The only concern advocates for health care
reform have is to make sure that every single person in this country is covered
by insurance, and to control costs.
But to answer that phenomenally asinine question anyway, the answer
is of COURSE private insurance companies can survive and make plenty of money.
Look at how they make money now; they make it by refusing to cover people who
might actually need health care. They can still do that, if they want. The
difference is, those people will now be able to sign up for a public option.
The funny thing is, if Dennis would read the bill, he would find
that private insurance will be offered alongside the public insurance option,
which gives insurance companies the chance to actually compete with the public
option directly. Plus, insuring everyone will eliminate that pesky double-digit
inflation that has plagued the health care industry for decades.
Not only that (and this is something I never hear mentioned by right
wingers — wonder how come?), but insurance companies pay for drugs and
procedures. Um, won't their expenses drop, with the government getting into the
act and working to keep prices low? I mean, if the government limits the price
of a 30-day supply of a drug, doesn't that also potentially reduce the cost to
the insurance companies, as well?
I would also point out to Dennis that the concept of private
insurance as a profitable enterprise is relatively new. Up until about 25 years
ago, almost all private health insurance was non-profit. And strangely, it
worked better then; go figure.
But the bottom line is if private insurance companies can't make
money and they go by the wayside as a natural course of things, then so be it.
But this would be the first country to see that happen. Most countries with a
national health insurance system still have a healthy private insurance system,
as well. In fact, if the system was "rationing," as Dennis claims
WILL happen couldn't private insurance make a boatload of money filling in
those rationing gaps?
(Right wingers really don't do logic much…)
7. Why will hospitals,
doctors, and pharmaceutical companies do nearly as superb a job as they now do
if their reimbursement from the government will be severely cut? Haven't the
laws of human behavior and common sense been repealed here in arguing that while
doctors, hospitals and drug companies will make significantly less money they
will continue to provide the same level of uniquely excellent care?
See how right wingers think? I actually had one of them tell me
yesterday that the American Dream was to become rich. No shit. I bet you had no
idea that all of those teachers, police officers, firefighters and soldiers
were actually giving up on the American Dream to do what they love. I bet they
But there's an even more insidious notion in effect here.
BILLIONS OF DOLLARS of health care bills go unpaid every year, and
most of them are incurred by people who are refused insurance, or who don't
carry any because they think they're indestructible. But there are also a
significant number of bills that go unpaid insurance companies refuse to pay
the bill for their insured. In many hospitals, as much as 30% of their bills go
unpaid in a given year. Plus, the administrative costs for getting paid by
private insurance has gone through the roof, while Medicare and Medicaid have
streamlined their processes.
Therefore, the assumption that the government will cut their
reimbursement is a red herring. Will hospitals be able to increase prices by
20% a year, as they do now? No, but that's because they won't have to.
The problem with our system is, we have a health care delivery
system in which outcomes are the most important thing. For the most part,
medical professionals care about their patients and they go through the things
they go through because they love medicine. Yes, they want to live comfortably,
but their goal, for the most part, isn't to make a million dollars a year; it's
to heal sick people.
On the other hand, private for-profit insurance companies make money
by denying care. They don’t care one little bit about outcomes; in fact, if you
die before you use up all of your premium, they make even more. They make money
by NOT paying for things.
With 47 million people covered who aren't covered currently, health
care providers will collect MORE money not less. With inflation back to normal,
they can better anticipate and plan. They can eliminate much of their
administrative overhead. And with increased competition, private insurance
companies will be forced to at least consider outcomes in their business
In other words, Dennis. Doctors, nurses, and everyone else, will
probably make MORE money with LESS hassle.
8. Given how many
needless procedures are ordered to avoid medical lawsuits and how much money
doctors spend on medical malpractice insurance, shouldn't any meaningful
"reform" of health care provide some remedy for frivolous malpractice
Ok, finally… not a silly question. Only, it really has nothing to
do with health care reform. Yes, there should be malpractice insurance reform.
Although having worked in the legal industry for quite some time, I can tell
you the monetary effect of the lawsuits isn't as great as the right would like
you to believe. If there's a problem, it's with insurance companies. Truly
frivolous lawsuits never make it to trial. But insurance companies are very
quick to settle pointless suits, because they can then cry about the terrible toll
they take on their bottom line, at the same time they raise premium rates.
But I'll talk about this later. This is about insuring the
uninsured; malpractice insurance reform is a separate issue.
9. Given how weak the
U.S. economy is, given how weak the U.S. dollar is, and given how much in debt
the U.S. is in, why would anyone seek to have the U.S. spend another trillion
dollars? Even if all the other questions here had legitimate answers, wouldn't
the state of the U.S. economy alone argue against national health care at this
Of all the questions they ask, this is perhaps the dumbest one.
We're not spending ANOTHER trillion dollars. And the fact that these
people think we will actually demonstrates the depth of their ignorance on this
We already spend 17% of our GDP on health care. It's estimated that,
if we do nothing, that will increase to 20% of GDP by 2016, even assuming a
nominal growth rate of 2% per year. Last year, we spent $2.4 trillion on health
care, which comes to $7900 per person. (Here are more dry stats, if you
would like to read them.) The average family health insurance premium is
now more than $15,000 per year. The CBO estimates that, unless we cover
everyone, that amount will increase about $1,800 per year for the next 10
years, which means the average family premium will top $30,000 per year. And
that's all assuming that the number of uninsured only increases a little.
What this plan will do is spend some money on the front end to save
us a whole lot more in the long run. The trillion dollars Dennis is on about is
over TEN YEARS. We spent 2.5 times that much in the last year alone. And since
health care spending is expected to be close to $4 trillion per year by 2016,
the $1 trillion we spend on this over the next ten years will probably save us
at least twice that much. Here's a chart
from the CBO on how much health care is projected to increase if nothing is
done. That promises to be far worse for the economy than taking control of the
out of control bus and slowing it down a little. Here is the CBO's
preliminary analysis of HR
3200, the original House bill. Go to page 2; over the course of the entire
10 year period, the total effect on the deficit is $239 billion. Total. That's
10 years. And that's before the tweaking that is currently going on in the
But here's the bottom line. While we're spending $1 trillion as a
country over 10 years, the average family who decides to keep their private
insurance will save most of that $1,800 per year increase per year for at least
seven of the ten years. Health care inflation will drop back to the normal
range. And overall health care costs will drop a lot for several reasons.
People will be covered, and will be able to be treated for a condition before
it becomes expensive. Doctors will be able to treat patients properly the first
time, and won't have a bureaucrat from a private insurance company overriding
their judgment and demanding a "cheaper" method of treatment.
This is something the government is not used to dealing with these
days, and something the right wing can't wrap their heads around; it's an
attempt to secure the healthy care system for the future. It's an investment.
10. Contrary to the
assertion of President Obama — "we spend much more on health care than
any other nation but aren't any healthier for it" — we are healthier. We
wait far less time for procedures and surgeries. Our life expectancy with virtually
any major disease is longer. And if you do not count deaths from violent crime
and automobile accidents, we also have the longest life expectancy. Do you
think a government takeover of American medicine will enable this medical
excellence to continue?
We are not healthier. That's an outright lie. We are 37th in the
world in health care performance, and 72nd in overall health, of the 191
nations surveyed by the
World Health Organization. If you don't want to believe the WHO, the Commonwealth Fund ranked the 19
most advanced countries in the world and placed us last. Our infant mortality
rate is dead last in the industrialized world. Our life expectancy rate is not
longer; we're actually the only industrialized nation in the world in which
life expectancy has DROPPED in the last 20 years. There are actually pockets in
this country, in inner cities and rural areas, in which life expectancy figures
are comparable to those in sub-Saharan Africa.
Since no "government takeover of American medicine" is
planned, by any stretch, this is your typical right wing straw man. But the
government will be setting up a public health insurance system, and everyone
will be covered if they have health problems. That means all of the people who
are currently not able to go to a doctor because they can't afford it will now
be able to go to the doctor. It means all of those people who can't get health
care until such time as they are in dire need of emergency care, will be able
to get treatment before they get to that point.
So the easy answer is, covering every American with health insurance
will make us healthier.