The AFL-CIO and its community arm, Working America, just released their 2008 Health Care for America Survey. Most of the 26,419 online respondents are insured, employed, and college graduates -- those, the report explains, most likely to react positively to America's health care system.
But with its pie charts and tables, enhanced by 489 "heart-wrenching stories about the effects of this broken health care system on them and their families," the report is like a PDF version of Michael Moore's movie "Sicko." Of course, it's to be expected that many of those who took part were prompted by the chance to air their grievances.
One of the premises on which Senators Clinton and Obama are running is the extent to which they feel our pain. In fact, Hillary consented to an in-depth interview on her plans for universal health care with Kevin Sack of the New York Times.
When taking either of their plans into consideration, one must first disabuse him or herself of the notion that, if implemented, you're going to walk into a doctor's office like in England and out again with nary an exchange of cash nor any paperwork. Both Obama and Clinton's versions of "universal" coverage call for a bill that would require Americans to buy health insurance.
Require? Who doesn't want health insurance? A few twenty-somethings too blinded by their partying to picture the illnesses they're courting? For many others, the heart is willing, but the pocketbook is weak.
Then Sack writes, "Mrs. Clinton said she would like to cap health insurance premiums at 5 percent to 10 percent of income." We're not trying to pick on Hillary -- she's catching enough grief as it is -- but that doesn't sound like much in the way of relief.
Sacks adds: "She has previously said that garnishing wages would be one option" to guarantee participation. Garnishing wages?
Already you can feel yourself hyperventilating. It's like finding out after an emergency room visit that the attending physician wasn't on your plan. Or when doctors shoot bills -- which by all rights should be sent to your insurance company -- out to you like baseballs from a pitching machine.
It's not quite as bad as all that. "Refundable tax credits would help make the newly mandatory policies affordable for low- and middle-income workers," Sack writes. Also, "Government insurance similar to Medicare would be available to all consumers." And, of course, Hillary "would require insurers to cover every applicant regardless of age or health status."
Meanwhile, Obama at least understands that concerns about premiums is paramount. Mandating coverage only for children, he opposes requiring us to buy insurance until it's affordable.
To achieve that end, Hillary suggests rolling back President Bush's income tax cuts for those who earn more than $250,000 a year. Not to mention taxing everybody's favorite whipping boy, the smoker.
But there's one cost-cutting measure that Hillary, Obama, or, for that matter, anyone championing universal health care won't touch. As one of the respondents to the Health Care for America Survey said, "Everybody deserves high quality, affordable health care."
That's an easy sentiment to sign on to to. But don't "high quality" and "affordable" operate at cross-purposes to each other? In other words, measures such as increasing taxes and reducing administrative costs -- such as dismantling the apparatus devoted to denying claims -- may not be enough to shore it up.
In fact, it's time to ask ourselves: Does universal health care really mean that we're entitled to all the health care in the universe?
A critical factor sending health-care costs rocketing into the stratosphere is medical technology. For example doctors prescribe tests, MRI's and CT scans like they're handing out candy at Halloween. While reassured, the patient can't help but suspect that the doctor's underlying motive is either the promise of kickbacks from the medical technology industry or bullet-proofing the doctor from malpractice suits.
Is there a way to intercept this knee-jerk response on the part of doctors in hopes of keeping costs down? Yes, but it requires a leap of faith from a public conditioned to believe that the technological assigns a precision and accuracy to our random existences which we can no longer do without. Besides, to many of us, prosecuting a successful malpractice suit is the equivalent to winning a state lottery.
What if we freed doctors from concern about medical malpractice except in the face of criminal negligence? In other words, to keep costs down why not enable them to diagnose the old-fashioned way -- by using their know-how and experience?
But the faith of doctors in technology rivals that of their patients. Like pilots who are instrument-rated, the last thing they want to do is turn the clock back to the days when they flew by the seat of their pants no matter what the visibility. Their diagnostic muscles, if ever developed, may have have long-since atrophied.
In full hyperventilation mode by now, we ask, "What? Trust doctors?"
That's a barometer of how far health care in America has fallen in our eyes. Doesn't anybody remember those halcyon days when we trusted no one more than our doctor?