Read This Or Die!

There has been a great to-do of late over the state of American health care. That much is indisputable. The problem is that most folks seem to have no idea what the problems actually are, which seems like a reasonable prerequisite to actually solving them.

Watching the current health care debate in the United States is a perfect example of what happens when everyone is wrong. No matter what happens this year, American taxpayers are going to get boned, Washington is going to become more powerful and the insurance and pharmaceutical industries are going to grow even more unnaturally rich.

For the record, Obamacare or the metaphysically vicious Baucus plan is going to change any of that. And while acting like idiots at Tea Parties and drawing Hitler moustaches on the President of the United States might be fun, neither address the potentially catastrophic problems inherent in the system itself.

Unless those problems are resolved in a fundamental way, America is doomed. That might sound like an understatement, but consider what free trade and globalization have done to the industrial sector of the United States.

Yes, a good number of those industries have gone to developing economies like China and India. But not all of them have. In 2005 more North American cars were being produced in Canada than in the United States. That has a lot to do with the fact that Canada has lower corporate taxes and a single-payer health care system. One of the biggest reasons that GM and Chrysler went down that doesn't involve making cars that no one wants to drive is the exploding cost of employer based heath care coverage.

If America would like to continue having an economy not based in bartering chickens and virgin daughters, that has to be reformed in a reasonable way, and so far no one has suggested one.

You might say I'm a dreamer, but I'm not the only one. A businessman named David Goldhill attacks the problem in the September issue of the Atlantic.

Mr. Goldhill lost his father to an easily preventable hospital-borne infection, the kind that kills 100,000 Americans every year - " more than double the number of people killed in car crashes, five times the number killed in homicides, 20 times the total number of our armed forces killed in Iraq and Afghanistan."

And he wanted to know how that could happen in the most advanced health care sector in the world.

His conclusions might shock you because I've never heard serious people ever address them before.

The reason for financing at least some of our health care with an insurance system is obvious. We all worry that a serious illness or an accident might one day require urgent, extensive care, imposing an extreme financial burden on us. In this sense, health-care insurance is just like all other forms of insurance—life, property, liability—where the many who face a risk share the cost incurred by the few who actually suffer a loss.

But health insurance is different from every other type of insurance. Health insurance is the primary payment mechanism not just for expenses that are unexpected and large, but for nearly all health-care expenses. We’ve become so used to health insurance that we don’t realize how absurd that is. We can’t imagine paying for gas with our auto-insurance policy, or for our electric bills with our homeowners insurance, but we all assume that our regular checkups and dental cleanings will be covered at least partially by insurance. Most pregnancies are planned, and deliveries are predictable many months in advance, yet they’re financed the same way we finance fixing a car after a wreck—through an insurance claim.

That's the root of the problem, and I hadn't ever heard a single American point that out. Not one.

When you bill everything to a system designed to cover over only catastrophic events, of course the cost is going to go up. Just imagine what it auto insurance would cost if you relied on State Farm to replace the cigarette lighter in your Volvo. However, no one would fuck with their premiums that way because few people are that stupid.

But the current health care structure demands that Americans do just that when they get the fucking sniffles.

I'm not going to debate the entire Goldhill article point by point because it's very long and I'm very lazy. Besides, if you care about the issue, you should read it all. You may or may not agree with David Goldhill's points, but they are actually serious and worth exploring.

That can't be said of what's happening in Washington this year. That debate is essentially the same as if they all agreed on the premise that covering the World Trade Centre with cake would have prevented 9/11, but the only thing they can't agree on is the frosting.

The "public option" and tax credits to fund the existing system are nothing more than frosting on the World Trade Centre.

This dopey little feature is called "Read This or Die," but that's usually just me being excitable. Let's say that I linked an article about the Iranian nuclear program. Your chances of being killed by a Tehran nuke in the next century are somewhere between slim and none, regardless of what how the program progresses.

However, your chances of getting unexpectedly dead at the hands of a health care system that's built on a fantasy are actually pretty good.