Healthy Arguments

Relocating this blog to LoadedTerms.com

2009-06-30T16:26:27-06:00

Hello readers, I'm re-locating this content over to Loaded Terms. Please update your bookmarks and Feed subscriptions.

I want to expand my coverage to more issues, including environmental issues, prison reform, and education reform.

Thanks for following thus far!

Copy-and-Paste: Cory Doctorow

2009-06-27T11:01:53-06:00

Personal stories are a great rhetorical device, especially for the kinds of people that remain skeptical, long after the established facts and statistics are spelled out. Cory Doctorow doesn't necessarily have a compelling story, but because of his prominence in the blogosphere, I thought I'd paste in his bit:

I've lived under the Canadian, US, British and Costa Rican health care systems and of the four, I believe that the Canadian one functions best (I'd rank them Canadian, British, Costa Rican and US). My experience with all four includes routine and urgent care. I've had firsthand experience of pre-and post-natal care in Canada, the US and the UK; I've also seen the Canadian, US and UK palliative care system in action.

(more from Boing Boing)

Bookmark for Copy-and-Paste: Debunking Canadian Myths

2009-06-27T10:58:50-06:00

There's a lot of pages out there about debunking Canadian healthcare myths, and this is another good one. For example, Canadians come to the US for healthcare:

Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care.

(more from the Denver Post)

Copy-and-Paste: Roosevelt, Truman, Clinton, and the "Trough"

2009-06-26T18:37:19-06:00

I recently came on a phrase in an article in the journal "Annals of Internal Medicine" about an axiom of medical economics: a dollar spent on medical care is a dollar of income for someone. I have been reciting this as a mantra ever since. It may be the single most important fact about health care in America that you or I need to know. It means that all of us -- doctors, hospitals, pharmacists, drug companies, nurses, home health agencies, and so many others -- are drinking at the same trough which happens to hold $2.1 trillion, or 16% of our GDP. Every group who feeds at this trough has its lobbyists and has made contributions to Congressional campaigns to try to keep their spot and their share of the grub. Why not? -- it's hog heaven. But reform cannot happen without cutting costs, without turning people away from the trough and having them eat less. If you do that, you have to be prepared for the buzz saw of protest that dissuaded Roosevelt, defeated Truman's plan and scuttled Hillary Clinton's proposal.

(via kottke)

Re-Tweet-This: If you were creating a country from scratch, which industrialized country's healthcare system would you choose?

2009-06-26T14:29:41-06:00

Copy-and-Paste: Quality of Canadian healthcare

2009-06-26T13:46:11-06:00

Law 13 of the 48 Laws of Power states: When Asking for Help, Appeal to People's Self-Interest, Never to their Mercy or Gratitude. This is why it's important to emphasize how quality-of-care in America has so much room to grow under healthcare reform. Here's a little snippet about quality-of-care in Canada vs. the US:

On most measures of patient-reported physician quality, Canada comes out slightly ahead of the U.S. The Commonwealth Fund report shows somewhat fewer reported physician errors, lab errors, medication errors and duplicate tests north of the border, and Canadians report more satisfaction with their doctors.

(Read the rest on factcheck.org)

Five tips on how to change the language of the healthcare debate

2009-06-25T23:45:48-06:00

I've been listening to conservative talk radio and FOX News for months now, cringing as they smear Obama's healthcare plans. Since then, I've been accumulating my ideas on this blog, coming up with various ways that we can win the war of rhetoric. I've now summarized these ideas into a short memo that will help us change the terms of the debate.

Five years ago, I was inspired by George Lakoff's Don't Think of an Elephant, which offers suggestions to progressives on how better to frame political debates. Immediately it is clear that he uses his own advice as he refers to his audience as progressive instead of the smear-word liberal. The book was a cult hit when it came out, but unfortunately the advice was too late for John Kerry's election.

Right now, the conservatives are winning the war of words on healthcare, but we can turn the tide. Here are five message control suggestions for healthcare reformers:

1. When they mention socialist medicine, you mention unregulated, profit-driven, fragmented, capitalist medicine

When the opposition mentions socialist medicine, almost every time it kills the conversation. But it doesn't have to play out that way. Just as socialism evokes Stalin, Mao, and Che, why can't you evoke the robber-barons of the early 20th and late 19th centuries? Just as Americans are suspicious of socialist icons overseas, they're also suspicious of capitalist pigs at home, from Enron-types to Big Oil and Big Pharma.

The opposition is getting away with being the underdog party that will say "No" to socialist medicine. So it's our duty to reveal what they're implicitly for, which is essentially profit-driven, capitalist medicine. Ask the rhetorical question, "Why should providing health insurance be a profit-driven enterprise?" "Would you want to face an insurance company that has all the money and incentives in the world to deny your claims?"

2. Stop using the word public

When the opposition talks about privatized healthcare, they're subtly playing on Americans' fears about privacy invasion. When they talk about public healthcare, they're invoking Americans' fears of public services, like the DMV or welfare. Instead, try to appeal to patriotism using terms like National health insurance.

3. Stop referring to Europe and Canada

70% of Americans do not have passports. So in the average American's mind, the grass isn't greener on the other side, precisely because they've never seen it. The European label was political death for John Kerry in his failed 2004 bid for president. Likewise, Michael Moore didn't endear anybody by showing how Cuba's healthcare is so much better.

If you have to mention a comparative system, maybe mention Australia, a country that the cowboy types of America can identify with. And say something along the lines of this:

Health care doesn't have to be exclusively socialist or "capitalist". The Australian system is a good example. Everyone is provided with free public health care and about 40-50% also have private health insurance. You have the benefit of efficient, effective "capitalist" healthcare, and the safety net of the public system if something like what you described were to happen.

(source)

4. Instead of focusing on healthcare reform, start talk about insurance reform

The opposition has been playing on many Americans' fears that Obama is just causing too much change too much fast. The opposition talks about healthcare reform in terms that have nothing to do with Obama's proposal. It's almost a fact in conservative talk that Obama wants to put doctors on government payroll or that Obama wants to run the healthcare industry like he's "running" GM.

Also, the fact is most Americans are happy with their healthcare. That is probably the number one hurdle in changing the hearts and minds of Americans on this issue. It's the Lake Wobegon effect, where the average American believes their healthcare is above-average.

However, by referring to what Obama's reform plan is mostly about—insurance reform—you can localize the scope of the change. I think ordinary people have an intuitive sense that the insurance industry as a whole is corrupt and needs reform.

5. Instead of universal healthcare, talk about comprehensive healthcare

You have to tip-toe around people's fear of health welfare. Expanded coverage is something people agree with publicly, but in private, they would rather save their tax dollars.

By mentioning comprehensive healthcare, you invoke ideas of better health quality for individuals, which is actually very much a part of this. Small business owners, for example, who have been providing limited or no health insurance to their employees, have been clamoring for precisely this kind of reform.

Plus, you also remind people that perhaps their coverage may be limited. How many of you, when choosing your health insurance plan, had to make compromises and trade-offs? With national, comprehensive health insurance you won't have to do that. Rather you get more freedom and choices. What can be more American than that?

RT: Instead of gov't-run, public health insurance, call it National or American health insurance

2009-06-25T19:20:14-06:00

Copy-and-Paste: What happened to small businesses?

2009-06-25T16:59:06-06:00

This is an angle that didn't occur to me, but could be really powerful if mentioned on conservative talk shows:

You hear a lot about how small businesses would get crushed by raising taxes on the wealthiest 1%, or how small business will be crushed by excessive regulations, or how small business would be crushed by a carbon tax or cap & trade. But those same people who claim to stand up for small businesses disappear when we're dealing with something that does crush small businesses - the no-win scenario of either letting the employees who feel like your family go without benefits, opting for the "split the baby" solution of getting a high-deductible or high cost-sharing plan that you know will be insufficient, or subjecting to yourself to the slings and arrows of outrageous insurance monopolies, where the only safe prediction is that your costs will go up.

(from the NOW! Blog)

Latest-Obama: Why nobody should get in the way of change

2009-06-25T16:50:11-06:00

Obama's common sense assessment is spot on:

Premiums have been doubling every nine years, going up three times faster than wages. So the notion that somehow we can just keep on doing what we're doing, and that's okay, that's just not true.

(from Washington Post's Most Want Health Reform But Fear Its Side Effects)

Re-Tweet-This: The best insurance is knowing that your provider doesn't have a profit-motive

2009-06-25T16:46:44-06:00

Copy-and-Paste: Your healthcare dollars hard at work

2009-06-25T16:44:36-06:00

If the status quo, profit-driven healthcare industry was so defensible and great, why do they need spend a third of a billion dollars on campaign contributions?

To enhance their clout, insurers, drug producers and other parts of the health industry have made over $372 million in campaign contributions to lawmakers since 2000, according to a report released Wednesday by Common Cause, the nonpartisan public interest group. Nearly half the total -- $178 million -- has gone to members of House and Senate committees that oversee health programs. They have also spent over $3 billion lobbying, with their annual expenditures growing yearly, the study said.

(read rest of the AP's article, The Influence Game)

Copy-and-Paste: Technological inefficiencies of profit-driven healthcare

2009-06-25T13:08:16-06:00

Technology issues seem to help sway independents. For example, when Obama delivered a great talk at Google, a few of my entrepreneur fence-sitters started evincing positive feelings toward him. Likewise, here's a easy snippet that can lay things out about the technological inefficiencies of profit-driven healthcare:

Technology Review has some thoughts about why the health care industry has been so slow to adopt IT, while quick to embrace high technology in care and diagnosis. Hypothesis: making medical records available for data analysis might expose redundancy, over-testing, and other methods of extracting profits from the fee-for-service model. My take is that it might also make it much easier to gather and evaluate quality of care information. That would be chum in the water for malpractice suits.

(read rest of the slashdot entry)

Re-Tweet: An appeal to American's love of military

2009-06-24T01:28:55-06:00

If socialized medicine is so "Un-American," why aren't vets rushing out of VA Hospitals and into the great, profit-driven healthcare system?

Copy-and-Paste: Quality of VA Hospitals

2009-06-24T01:05:37-06:00

In the healthcare debate, often the conversation comes to whether the government can do anything right. Here's an article with a lot of copy-paste-worthy paragraphs that should set the argument straight:

Yet here's a curious fact that few conservatives or liberals know. Who do you think receives higher-quality health care. Medicare patients who are free to pick their own doctors and specialists? Or aging veterans stuck in those presumably filthy VA hospitals with their antiquated equipment, uncaring administrators, and incompetent staff? An answer came in 2003, when the prestigious New England Journal of Medicine published a study that compared veterans health facilities on 11 measures of quality with fee-for-service Medicare. On all 11 measures, the quality of care in veterans facilities proved to be "significantly better."

(link to the rest of the Washington Monthly article)

There's many more paragraphs like that in there.

Once again, Obama speaks to us like adults

2009-06-23T20:15:47-06:00

Part of why I voted for Obama is because I knew he could sell anything. He has a way with words. Not only that, though, he persuades by appealing to our higher-order thinking. This most recent example is refreshing and on point:

If private insurers say that the marketplace provides the best quality health care; if they tell us that they're offering a good deal, then why is it that the government, which they say can't run anything, suddenly is going to drive them out of business? That's not logical, they should be able to compete.

(link to reuters article)

Instead of "healthcare reform," maybe start talking about "ending profit-driven health insurance"

2009-06-23T15:53:53-06:00

Unfortunately, when many Americans think healthcare reform they think "socialist medicine." They think of "doctors on the government payroll." They think of their hospital transforming into the DMV. What people don't realize is that most of what healthcare reform consists of is health insurance reform.

Instead of letting Republicans badger the public about their sheepish "free market solutions," counter with the idea of "ending profit-driven health insurance."

Ask any doubters the rhetorical question, "Should insurance really be a profit-driven industry?" And then pause to let it sink in. I think most people can see why a profit-motive in insurance would be shady. Just like most people see that profit-driven greed in the finance and banking industry is what led to this latest economic downturn.

Insurance providing should be just as boring as banking. There should be no fancy tricks, no financial wizardry, and no crafty litigators to make banks or insurance companies rich. "Health insurance deniers" shouldn't become millionaires because they're great at rejecting claims.

Your health insurance provider had three times as many lawsuits last year than the national average

2009-06-23T15:44:46-06:00

Would you even know if I was lying?

This represents a fundamental problem of profit-driven health insurance.

I found a website that provides reviews on health insurance, (and all other kinds of insurance) and I found out that my insurance provider had many more unsatisfied customers than average. I also went to my state's Department of Insurance website and found out that it had three times as many legitimate complaint filings than average! And I've been with my insurance provider for 16 months! I'm definitely changing now.

Do you know how your health insurance provider stacks up? I'd bet you probably don't.

The health insurance market is inherently dysfunctional. Normally, in a good, efficient, free market, there is an "invisible hand" at work because the consumers can vote with their money. The problem with health insurance is that you don't get a chance to test the true quality of your health insurance until it's really dire, and usually near the end of your life.

I bet most of your co-workers don't know the quality of their health insurance. I bet a huge percentage don't even know who their provider is. Do you even trust that your company would find the best provider? Did you participate at all in the selection process?

I think corporate-sponsored health insurance has been one of the biggest market hacks by the insurance industry. Most people couldn't tell you from memory how much of their paycheck goes to pay for insurance.

I think the biggest challenge for healthcare reform in the US comes from the Lake Wobegon effect. On the radio, Rasmussen mentioned that while most Americans know something is wrong with healthcare in the US, 70% of Americans are happy with their healthcare. In other words, an above-average number of Americans think their healthcare is above average.

We need to convince Americans that their healthcare probably stinks, and that they just don't know it yet because they haven't had it really rough. They haven't had to take their insurance company to court.

Copy-and-Paste: Stop talking about Europe. Start talking about Australia.

2009-06-22T20:29:35-06:00

One thing that killed John Kerry's candidacy is the label "European." European. It's like a swear word in American politics. It's a proxy label for effeminate, weak, and socialist. So when it comes to lobbying for healthcare reform in the US, maybe instead of referring to how great things are in Europe (or Canada), how about referring to Australia.

This idea was spurred on by a comment on philosophistry:

Health care doesn't have to be exclusively socialist or "capitalist". The Australian system is a good example. Everyone is provided with free public health care and about 40-50% also have private health insurance. You have the benefit of efficient, effective "capitalist" healthcare, and the safety net of the public system.

I've already copied-and-pasted that twice in the past 24 hours in order to unblock people's obsession with the black-and-white phraseology of "socialist medicine."

Australia is much more appealing to the slow-to-move, silent-majority, conservative America. If we're going to get healthcare reform, we have to make it popular among at least some of the cowboy-types. The ones that associate America with the Marlboro Man. I think Australia somehow has that kind of cred. It's got an expansive landscape and seems very "Wild West." It seems manly.

So let's stop talking about Canada and Europe. And let's start invoking Australia.

While Obama's poll numbers are still overall favorable, we still have to remember that conservatives are the single-largest ideological group. And besides, I want as many Americans to buy into this, rather than just have it forced onto us by the Obama-Pelosi juggernaut.

The latest Krugman

2009-06-22T18:18:09-06:00

Esteemed economist Paul Krugman echoes the idea that unregulated, capitalist medicine is bad medicine.

Now nobody is proposing that Americans be forced to get their insurance from the government. The "public option," if it materializes, will be just that -- an option Americans can choose. And the reason for providing this option was clearly laid out in Mr. Obama's letter: It will give Americans "a better range of choices, make the health care market more competitive, and keep the insurance companies honest."
Those last five words are crucial because history shows that the insurance companies will do nothing to reform themselves unless forced to do so.

Read the rest of Krugman's column.

Market forces had their shot. They've had their shot for centuries. Ask any conservative what they think of healthcare in America, and they won't deny that it's broken. When you ask them how to fix it though, their response is a sheepish and vague "use market forces," which to me translates into, "let the robber-barons run the show."

That's how I'm going to start posing the issue now. It's a David-and-Goliath battle between Obama and the centuries-old robber-barons of the healthcare industry. How do we deal with the healthcare robber-barons? How do we dispose of them?

Update: This was actually not the "latest" Krugman column, but it was new to me.

Copy-and-Paste: Why is American healthcare so expensive?

2009-06-22T01:17:00-06:00

If you're interested in promoting healthcare reform, copy this paragraph somewhere, then paste it whenever an argument about healthcare reform comes up. Or better yet, start a blog or send an e-mail.

Why is the U.S. healthcare system so expensive? Administrative costs, marketing and profits account for 22 to 31 percent of the U.S. healthcare dollar (I recently heard Edward Kennedy say these costs were 33 percent, but I have not seen documentation of that number). By contrast, overhead costs in single-payer systems (including Medicare) typically are 3 percent.

(via Alternet)

Profit-driven medicine means unregulated medicine

2009-06-22T00:53:32-06:00

Another problem with the American way of doing healthcare is that hospitals underreport bad doctors. ABC has details in their article on Medical Horror Stories.

When Dr. Robert Ricketson found he had no titanium rod to use for the back surgery he was performing, he opted to stick in a screwdriver instead. Three corrective surgeries later, his patient was left a bedridden paraplegic. It turned out Ricketson had previously lost his medical license in Oklahoma and Texas, but was still able to find work in Hawaii.
Problem doctors are to be reported to the data bank by state medical boards and hospitals. But a new study by Public Citizen says hospitals, particularly, are failing to do so.

It was estimated that there would be between 5,000 and 10,000 doctors reported to the data bank ever year. In fact, the average has been only 650 cases a year, according to Public Citizen.

"About half the hospitals in the country had never reported one doctor out of the couple hundred-thousand doctors that are on the staffs of those hospitals," said Dr. Sidney Wolfe, the director of Public Citizen's Health Research Group.

"It's just not believable. The only answer is: The hospitals aren't doing their job disciplining doctors," he said.

Freedom comes at a price. It means less regulations. Less eyes watching the system to make sure it doesn't mess you up. Is that how you want your freedom-based, capitalist healthcare to function? Where everything is driven by "best-bidder" ethics?

Capitalist medicine is inefficient. Socialist medicine is not.

2009-06-20T23:24:28-06:00

It's silly that they tout Obama's plan as socialist medicine. I get it. The idea is to conjure up images of government bureaucracy and inefficiency (think DMV or the Post Office). But here are the facts:
FACT: capitalist medicine is inefficient.
FACT: socialist medicine is not.

Cynthia Yockey writes a colorful essay about "socialist medicine" in Pajamas Media.

It's juvenile to call it "socialist medicine." Why don't I call the conservative way "capitalist medicine." What I love about capitalist medicine is how efficient it is. Check out this graphic:

Get it straight: capitalist medicine is inefficient. Double-check that graphic if you're confused.

We spend the most out of any developed country and yet we don't see the benefits. Why is that? More free market isn't the answer.

I understand the purpose of calling it socialist medicine. It's to evoke long lines and rations. It's to conjure up images of government inefficiency (like waiting at the DMV or Post Office).

That's clever. But what about the inefficiency of capitalist medicine?

How about the long lines you will face 20 years from now when you're in court trying to fight your insurance company for coverage. Or what about the rationing of decent nursing homes for your parents because they simply aren't affordable in this country. Why are hospitals so crowded in America? It's because capitalist medicine is taking us for a ride.

FACT: capitalist medicine is inefficient.
FACT: socialist medicine is not.

If you're confused, re-read.

60% of bankruptcies in 2007 were from medical bills. Why this should freak you out.

2009-06-20T21:15:41-06:00

Even if you "do everything right," this should still concern you, because most of the debtors were well-educated, owned homes, and had middle-class occupations. Oh, and three-quarters had health insurance.

Three-quarters! Isn't health insurance supposed to protect you from this? Do you know how many bankruptcies were filed by members of your health insurance provider? Do you know how big their legal budget is in order to not have to pay you money?

Non-Americans in developed countries do not have this anxiety.

Link to the study.