Irony, or Why I don't take conservatives seriously, pt. DCCXIII

Politico reports:

Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1 – 28 days after his Jan. 3rd swearing-in.

(snip)

“Harris then asked if he could purchase insurance from the government to cover the gap,” added the aide, who was struck by the similarity to Harris’s request and the public option he denounced as a gateway to socialized medicine.

Understood properly, however, Mr. Harris isn't really being the hypocrite he appears to be. Conservative hostility to health care reform never rested on fiscal concerns. It all comes down to the most fundamental dichotomy of conservative thought: their self-image of themselves as responsible, hard-working producers v. lazy, irresponsible parasites (aka "liberals"). It's why Social Security and Medicare remain untouchable, while health care reform was frequently opposed on the grounds that it would offer benefits to illegal immigrants (surely the most trivial of concerns regarding the financing of health care reform).

Mr. Harris is hard working and responsible. He deserve health care, and he deserves it now. I won't quibble with that. I just wish he would consider that he might not be the only one.


Via The Daily Dish

Those medical decisions ...

Apparently, this can happen in Canada, too: small-minded bureaucrats making medical decisions, instead of your competent doctor. As you can probably predict, it's not a government denying health care - it's the hack at the insurance company.

A Quebec woman on long-term sick leave is fighting to have her benefits reinstated after her employer's insurance company cut them, she says, because of photos posted on Facebook ....

She said her insurance agent described several pictures Blanchard posted on the popular social networking site, including ones showing her having a good time at a Chippendales bar show, at her birthday party and on a sun holiday — evidence that she is no longer depressed, Manulife said.

There's no indication that any medical professional was consulted before deciding to cut off benefits. Anyone competent in mental health could have told them that depression is episodic, or that a depressed person will put on a good face at times, or try to have fun even when it takes an effort. I can't imagine a doctor would try to make a clinical diagnosis based on a handful of photographs, especially non-representative party pics. But then, a doctor doesn't have a financial incentive to deny treatment.

Oh, just to make it creepier: Blanchard claims that she posted those photos under private settings, meaning they were supposed to be visible only to people she had approved. If that's true, every Facebook user ought to be asking how an insurance company managed to get access to them.

[via ars technica]

Cafferty on Canadians

Jack Cafferty points to* this article in the Detroit Free Press which describes how some Detroit hospitals have made deals with the Ontario Ministry of Health and Long-Term Care to provide certain medical procedures that are hard to come by in Canada. He implies that this is a failure of the Canadian health care system.

My pithy reply was: "The Canadian citizen is guaranteed to get treatment, and his government is taking steps to provide it at the lowest cost. The problem here is … what?" Many commenters, I was happy to see, agreed. The point is that the ministry finds an efficient way to meet their citizens' needs and they meet those needs. It sounds like a good thing.

So what does it mean that some Canadians come to the US? Mainly, it means that Canadian hospitals aren't filled to the brim with every medical technology there is in the world. It also stems from the fact that Canada suffers a shortage of specialists; while there is easy access to general practitioners, when you're referred to a specialist there may be more of a delay (not because of any particular bureaucratic inefficiency, but just because those doctors already have full schedules and non-emergency patients get shunted to the back of the queue). Canada could certainly invest more money in its own hospitals**, but with most Canadians living within easy proximity to the US, it's arguably a wise saving of taxpayer money to make use of Detroit hospitals as they do.

The fact that hospitals are jumping on these contracts also indicates that there is an overcapacity in US medical facilities. Apparently we have more doctors and more hospital machines than we can keep busy with the number of patients who have the a) need and the b) means to pay for treatment. One suspects that (b) is no trivial factor.

Some of the commenters want to believe that the Canadian government is failing to provide doctors. This is a confusion that I see popping up all the time: mixing up health care delivery with health care payment. The Canadian government doesn't actually run health care; the hospitals are private and Canadians can still purchase private health insurance. Any hospital can purchase the equipment for these procedures if they have the financial incentive to do so and obviously Ontario is willing to make it worth someone's while to do it. So it's hard - or ought to be hard - to read this article and conclude that government has screwed up medical care.

________________________
* Actually, he mentions it, but doesn't provide a link. C'mon, CNN, you can do better than that!

** It's worth pointing out that there's a limited and specific list of tests and procedures that Ontario is contracting for; it's not like they have 19th Century hospitals.

Let us not come together

These two videos were posted in the comments at Dispatches from the Culture Wars:



And the followup interview with the crazy lady, where she's much calmer and would almost seem to make sense, if you didn't try to understand what she was saying:



What I found fascinating was how the woman almost boasts of how bad her own health care situation is. She claims she's had $15,000 in out of pocket expenses and that her husband works two jobs and has no health insurance. Assuming this is all true, a rational person would be knocking down the conductor to jump on the reform train, but not her. She has higher principles.

Or wait. No she doesn't! Her reasons for opposing health care reform are entirely self-interested: she doesn't want her money going to any illegal immigrants, or to pay for any abortions. She opposes health care reform primarily because some of the benefits may go to the wrong sort.

It's become a peculiar article of faith among conservatives that you can't improve everybody's situation; it's always a zero sum game. I call it peculiar because it directly contradicts one of the fundamental arguments for capitalism: that the rising tide lifts all boats. But I think it's difficult to overestimate the degree to which conservative Americans have been trained to hate and fear everyone else. You know those movies where two enemies find themselves in a situation where they have to learn to trust each other in order for either of them to survive? I'll bet conservatives don't understand those movies.

As Harry said, "I think I can tell who the wrong sort are for myself, thanks."