Monday, November 9, 2009

Socialist Paradise or Corporatist Hell?

I'm promoting Mia's comment on the health-care bill so I have a chance to farble on about it more publicly. She says,

I do applaud Kirkpatrick for voting in line with the majority of those who elected her. I wonder though, if the insurance companies have come out the really big winners here. Mandatory insurance, with a public option that "will probably cost more than private insurance". Even with the added cost of covering preexisting conditions, not charging women more, and whatever else, how many millions of new customers will insurance companies get? I don't see how this is a move toward socialized healthcare, maybe even quite the contrary. Insurance companies will grow in power tremendously. Look how much power they've flexed during this debate. Am I missing something?
I think that if the House bill were to pass through the Senate funhouse and come out the other side more or less unscathed, it will substantially diminish the power of the insurance companies.

First, the public option, contrary to your quote above, will almost certainly operate at substantially lower cost. Profitmaking companies must produce profits for their shareholders, and that can be seen ultimately as a dead loss from the system, meaning higher costs out of the gate. To balance that higher cost-structure, the companies will have to cut corners on personnel and benefits to the customer. Meanwhile the public plan, because it has less motivation and scope for denying coverage, has to focus on reducing costs through prevention and keeping its customers healthier.

An important piece of the picture will be the lifting of the antitrust exemption that insurance companies have enjoyed for so long. This will lead to breakups of the largest companies in favor of local competition.

With more reliable and lower-cost benefits and larger scale, the public plan will then become the biggest player, furnishing more economies of scale and negotiating clout. As in Europe, eventually the private insurers will get mostly out of standard care and into boutique and specialty benefits covering things the public plan can't or won't. They will also have steady customers among the many Americans who can afford to throw away some of their money because they don't trust the government.

One thing we'll still have to fight for in the public plan is coverage of non-allopathic care. We're discovering and rediscovering so much in medicine that's useful and effective but (so far) outside the scope of the Physician's Desk Reference. It will be very important to start building in the acceptance and coverage of treatment and care modalities that are not taught in the medical schools if we are to see any of the vast potential cost-savings and life benefits they offer. With a public plan, which is more focused on reducing costs by making people healthier than reducing benefits to customers, this will be far easier.

Anonymity vs Civility

In the comments, Mia says

I feel like I can't blog on the Courier site anymore since some people called my friends and me moronic, fecal matter, simple-minded, sheeple, full of horse pucky, and all kinds of other really mean stuff. It makes me want to meet them by the swings and kick their asses!
Online spleen-venting has been a problem ever since online communities began, and I've been doing this nearly that long. It's hard to prevent where you want open dialogue, but there is one factor that guarantees it: anonymous posting. Where there is no social cost for acting like a baboon, that's what some people do.

Further, where this element is allowed to spit its bile unfettered, it drives out people who value civil dialogue, and so the proportion of bilious comments inevitably rises. In my experience it slowly rises to a majority and holds there for a certain amount of time, then participation falls off suddenly as the community dies gasping in its own stink. I expect that this will happen with the dCourier comments within a couple of years if editorial policy does not change.

Adding to the outrage is the Courier's capricious editing of the comments, and their failure to understand their own comments policies. Despite the written policy barring them, I see many, many comments that are nothing more than personal attacks on previous commenters. Name-calling is rampant and egregious. And trust me, it will get a lot worse.

I came back to this blog for these very reasons, as I found that my comments weren't safe from editorial screwing around. The name-calling from those who have no better communication tools I don't mind, as it says more about them than me and I have eliminated the reflex of responding to it. I do regret that they drive away sensible people who have less tolerance for this sort of BS, so on this blog I promise to maintain a higher level of decorum.

I encourage everyone who cares about this to demand of the editors that they require registration on the site with a real name or regular handle for all comments, and bar those from commenting who abuse the privilege. This will not eliminate the problem, but it will reduce it by at least three-quarters, I guarantee it.

Editorial: Let's get people back on the job

The unnamed Courier editor offers yet another example of willful short-sightedness today in decrying the administration's efforts to reconfigure our clearly broken health-care and energy systems while people are out of work.

We used to rely on journalists to look into the implications of public issues and supply us with the information we need to see the bigger picture and make better decisions as voters. It seems that those journalists are in the unemployment lines now, too, since corporations realized in the 1980s that all they really need to do to reliably get what they want is buy up the news business, knowing that over time the media organizations would steadily make small changes in policy and mindsets favoring corporate views.

Let's postulate, for example, that a cap-and-trade regime really could "put and end to the coal business," as the editor egregiously misquotes the president. Could he really imagine that the transaction ends with all the coal people out of work? Can he really not see that the shift to renewables will create an order of magnitude more jobs than the modern coal business could ever provide? How could a supposed journalist miss this plain-as-day linkage?

The problem here is that ideology is simply blinding the editor to the facts. He sees what he wants to see (and the person who hired him knew that would happen). The challenge for the reader is to avoid seeing only the bit that the editor is able to see. Bear in mind that the decisions the editor makes in the open on the editorial page indicate the sort of decisions he makes subtly on the news pages.

Today's Chuckle

Prescott and PV officials set up events befitting a visiting head of state for a big dead tree. Am I the only one in town who finds this embarrassingly juvenile on multiple levels?

Not everyone happy with House health care bill

Some editorial decisions just take my breath away. It plumb evades me, for example, how any editor can see news value in person-on-the-street interviews. I know, the "wisdom" of the volk, right? What's true is that 90% of the time you're going to get the wise old volk feeding back exactly what they saw on teevee last night. I expect it feeds an editor's ego to hear people saying what he's been telling them. But what value can it possibly hold for the reader? Somebody splain this to me.

As for the headline, here's today's 'duh' moment.