Sotomayor and Health Care Reform

In her financial statements, Judge Sotomayor reveals she has $10,000 credit card debt and $15,000 debt for dental care. If she liquidated her cash accounts, the judge could wipe out her debt but be cash poor--this despite having a net worth of $1 million, almost exclusively her house. I'm very sympathetic to the dental debt since it is the one health area for which I constantly face financial ruin. Dental insurance simply does not pay for things like root canals, crowns, inplants, gum and bone treatments. Yet, in some ways, I can play a type of triage--letting the teeth go--which people with serious medical conditions can not. Over 60% of personal bankruptcy is the result of medical bills.

In a country where there is so much resistance to even teaching evolution, it still amazes me that our political economy elevates social darwinism as its ethos. The debate over health care reform is simply not going to deal with the root problem why the United States is number 37 in terms of health care in the world. Washington is already filled with armies of lobbyists to preserve the very lucrative status quo--which might at the end of the day get tweeked somewhat. But make no mistake when the debate begins in earnest, the fog of war will confuse voters in a way we have yet to see in all the plans submitted by the Obama Administration.

The New Republic printed an article that summarizes the problems. The Kaiser Foundation, which monitors closely attitudes to health care, reveals in its various surveys that there is a sharp discrepancy in the attitudes of health care professionals and the average voter. Universal coverage is widely endorsed by the professionals, but not so among Republicans and Independents. A majority of voters believe those who have no insurance should be able to go to the emergency room. Since all of us pay $1,000 per person already for the uninsured, it's worth examining this assumption.

Last year I had to be admitted to the emergency room because I felt I was having a heart attack. The hospital insisted on conducting a battery of tests, kept me in the hospital for two days because I was running a fever, and finally concluded there was nothing wrong. Great! However, when I finally got the bill, which was almost all covered by insurance, the cost for the uninsured would have been $12,000. Naturally, Blue Cross-Blue Shield pay a substantially lower negotiated rate. Consider the fees if a heart attack had really occurred and additional procedures would called for. The uninsured person would be facing catastrophic costs, which they would be unlikely to pay. Going bankrupt if you have a heart attack? Have we really sunk to such a low level?

The idea that a person should go bankrupt for one medical event should be intolerable to our society. With the D.C. Run Against Breast Cancer, we learn that 1 out of every 8 women will get breast cancer of some type. How many of all these women are uninsured and what are their options?Are these women faced with radical masectomies as the only cost-saving option? The lunacy of our medical system is directly linked to our view that it is another capitalist enterprise and not a public good.

It is ironic that Republicans are resisting any single payer option because, as Senator Grassley of Iowa was candid enough to admit, millions upon millions of Americans would desert their current insurer. The progressive caucus in the House, which consists of 80 members, is trying to educate their supporters that there is simply not enough votes, even in a Democratically controlled House to pass a public option. Bernie Sanders of Vermont has taken the time to try and educate progressives that the Senate is far, far more conservative than the House and that the way the Senate will try and kill the public option is by adopting Sen. Snowe's offer of putting a seven-year trigger in the bill, which would mean that if insurance companies didn't fulfill their obligations, then there would be a public option. In short, a Hail Mary pass, hoping that the political situation will change to prevent such an option. Bernie Sanders may be offering something eminently sensible--allowing for several states to implement the single-payer option as a pilot project. Apparently, this was how Canada gradually introduced their national health system. Hopefully, they'll start in Vermont and Maine so I can escape stoogeland.

When the real debate begins, expect to hear the calls that making health records electronic will be a massive invasion of privacy. Although no one barks about the NSA having all your bank and credit card information. 40% of health care costs in the United States are administrative. Ironically, this is one area where Medicare and Medicaid are more efficient than the private insurers. Republican senators have used the analogy that one wouldn't want to eat at the Senate cafeteria. But they neglect to mention they have the best health care courtesy of the government. We should really ask them to put their dollars where their mouths are--drop your congressional benefits and pay out of pocket for your private health insurance.

The noise level in this debate will be awesome and the deliberate misinformation put out by the private medical industry will dwarf any effort to date by the private sector. At the end of the day, there will be many face-saving gestures and some minor concessions whereby the Administration can claim victory. But be warned, the health industry is now close to the number one sector in our economy and it wants to remain that way.