I've been arguing with Republicans about including a public option in the current health-care reform proposals. Here's how the argument seems to go:
Republican: We can't have a public option, the government is going to ration health care. They'll decide your life isn't valuable enough, refuse to pay, and you die. I read that if Steven Hawking had lived in England the Government would have pulled the plug on him and let him die.(1)
Me: Your care is rationed now, by an insurance company that profits if you die. Walk in front of a bus and they can decide to cancel your coverage because you forgot to tell them about the doctor you visited for a wart ten years ago. If you don't like the way government rations health care, you can stick with the insurance company that rations your care now. By the way, Hawking is British and has lived there his whole life.
Republican: But it'll be the government running it. They can't do anything right.
Me: They won two world wars, the cold war, put a man on the moon, funded DARPANET (which turned into the Internet), educated a generation with the GI bill, and built the Interstate highways.
Republican: Yeah, but they will be inefficient because the government is running it.
Me: Why is that?
Republican: Because the free market always does things more efficiently.
Me: Leaving aside the recent debacle in the financial sector, the government is better at collecting debt (2) and more cost effective at delivering medical services, look at the (3)Medicare Advantage Program.
Republican: Everyone will love the Government program so much, that private insurance will be destroyed.
Me: You mean the inefficient, bureaucratic, rationing system will be so loved that by everyone the free market system won't be able to compete?
Republican: This plan doesn't address the real root of the problem.
Me: No, it get the 46 million uninsured into the insurance system, stops you from losing healthcare if you lose your job, stops you from being unable to buy insurance if you have a pre-existing condition, and makes an attempt (which I'll admit is weak) to begin to control costs.
Republican: No, the problem is run away malpractice suits make Medicine too expensive.
Me: Malpractice costs are less than 2% of total healthcare spending(4).
Republican: There aren't really 46 million uninsured. That includes illegal immigrants.
Me: Of the 46 million uninsured, only a fifth are immigrants (5). I think that we'd all agree that legal immigrants deserve the right to health insurance, but assuming that we want legal immigrants to be left out of our insurance system, that leave 37 million citizens with no health insurance. A number that is growing. We've got to do something about it.
Republican: Yeah, but whatever we do we can't have a public option, the government is going to ration health care. They'll decide your life isn't valuable enough, refuse to pay, and you die.
(1) "Hawking is British and has lived there his whole life. He’s a professor at Cambridge for crying out loud."
(2) "The study – supported by an independent review -- showed that it is reasonable to conclude that when working similar inventory, IRS collection is more cost effective than the contractors."
(3) "The plans now cost the government about 14% more per person than does regular Medicare, according to a recent analysis by the Medicare Payment Advisory Commission, which recommends reimbursement rates to Congress."
(4) "represents less than 2 percent of overall health care spending."
(5) "Mr. Rove claims that one-fifth of the uninsured are illegal aliens. I can’t find the basis for this claim (which, if the numbers in the latest Census report are correct, implies that all noncitizens are illegal immigrants)."