Health care overhaul

1) The compensation that the White House negotiated with Big Pharma ($80B in cost savings over a decade) may not be actual savings for us at all:

http://www.huffingtonpost.com/2009/08/13/internal-memo-confirms-bi_n_258285.html

A memo leaked describing a deal that if the Pharmaceutical Researchers and Manufacturers Association (PhRMA) made $80B in concessions over 10 years for Medicare drug reimbursements, Uncle Sam won't try to drive a harder bargain for future drug prices, won't import cheaper Canadian drugs, and won't move some drugs from Medicare Part B to Part D (thereby reducing reimbursements). But wasn't the whole point to save patients and the government money on exorbitant drug costs? Obviously an industry trade group wouldn't agree to a cost restructuring deal unless it benefited them in the long run. While they may have to give up $80B now to help make Obamacare appear to be paid for, that is a drop in the bucket considering the windfall sales they will reap as the pill-popping Baby Boomers get older. Just for perspective, the 2 biggest pharmas in terms of revenue are Novartis and Pfizer, who combined cleared $100B in revenue in just a single year, 2008. When the memo first broke, both the White House and PhRMA denied it's authenticity, but later probes by the LA and NY Times quoted administration officials confirming that such a deal occurred. Some in Congress were irate that the White House would cut a secret deal without their involvement, and wanted to tighten the screws on Big Pharma to get more for the taxpayers. Not surprisingly, the White House opposed them and said that generous PhRMA has promised enough. Well, according to OpenSecrets, Obama received over $19M in campaign contributions from the health care sector (over double what McCain got, despite Obama having tougher rhetoric on health care reform and reducing drug prices), of which pharma is a big chunk.

2) Is the "outrage" at health care town halls actually a manifestation of blue collar white America lashing out at their impotence in a changing American cultural and economic landscape?

http://www.npr.org/templates/story/story.php?storyId=111922780&ft=1&f=2
http://www.theroot.com/views/birthers-and-jim-crow-20

And of course right-wing radio and the GOP (the stupid wing of the GOP led by Palin at least) are stoking the fires, claiming ridiculous things like Obama's reforms are actually reparations in disguise, Obama is not actually a US citizen (everyone knows he's secretly a Muslim of course), and you and your relatives may have to justify their existence to "death panels" that determine whether you deserve to receive medical care - if the Dems get what they want. And moderate Republican Congressmen are scared stiff of angering the demagogues and populist mob if they make health care reform concessions too. I guess poor white America doesn't feel like America is theirs anymore (as if it ever was), and their "values" are being trampled on with change after change for the worse. What is their place in this unstable, changing world? I am sure current events are scaring college-educated, connected people like us, so one can only imagine how the anger and frustration is boiling over in the Rust Belt or Appalachians. Immigration, gay marriage, bailouts, soft power foreign policy, reforms, climate change, and such fly in the face of what they want America to be - even though the fantasy America they envision for themselves where everyone is free to prosper, no big government meddling in your life, and we are never wrong, has never and will never exist.

One of the Dems major political weaknesses since the Bush years is an inability to reach rural, white, lower income voters (the Dixiecrat voters and such from the JFK/LBJ years that they took for granted). They have tried with outreach by humble-roots white politicians like Biden and Webb, but haven't really had much success. Obama's white support mostly came from educated and higher-income people (UC System, Stanford, Harvard, and Columbia were all top-20 donors to his campaign). It's sad and ironic, because many of the Dems' social initiatives would really benefit poor whites, but conservative media and dogma have persuaded those people to hate the Dems who they think are selling this country down the river. And yet the GOP policies of deregulation, deficit spending, and low taxes contributed to their jobs being outsourced, cost of living rising well ahead of wages, and defaulting on their ARM. Remember the Howard Dean comment that his party has to connect with the voters who drive pickups with the Confederate flag bumper stickers? He got a lot of heat for that (especially from his rivals like Southerner John Edwards), and maybe it cost him the Dem nomination, but his underlying argument was sound, if very awkwardly worded. Though Obama and the Dems seem more scared to tackle the poor white issue than the black-white issue. If the Dems can successfully reach out to that demographic (I highly doubt it after so many years and a widening political gulf), then they would deplete the GOP to what it really is - a party for extremist Christians and rich champions of the military-industrial complex.

3) So much for a public insurance option:

http://news.yahoo.com/s/ap/us_health_care_overhaul

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Thought this was amusing and on-topic:

http://www.hulu.com/watch/89817/the-daily-show-with-jon-stewart-glenn-becks-operation

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LOL thanks M! He just has to be outraged about someting, even both sides of the same issue. I didn't realize Beck changed networks (not that I watch either). I would love to see a Battle Royale between Beck, Hannity, Rush, Savage, and Poppa Bear to see who is the biggest conservative propagandist prick alive. Oh, almost forgot to include Malkin vs. Coulter for the undercard.... jello wrestling.


If Beck thinks we have the "best health care" in the world, he must be taking too much oxycontin after his ass surgery (it was a complex procedure to make him an even bigger asshole).

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The WHO last ranked national health systems in 2000, and probably won't again because the metrics are getting too complex, but here were the rankings for those who haven't seen:

http://www.photius.com/rankings/who_world_health_ranks.html

1 France
2 Italy
3 San Marino
4 Andorra
5 Malta
6 Singapore
7 Spain
8 Oman
9 Austria
10 Japan
11 Norway
12 Portugal
13 Monaco
14 Greece
15 Iceland
16 Luxembourg
17 Netherlands
18 United Kingdom
19 Ireland
20 Switzerland
21 Belgium
22 Colombia
23 Sweden
24 Cyprus
25 Germany
26 Saudi Arabia
27 United Arab Emirates
28 Israel
29 Morocco
30 Canada
31 Finland
32 Australia
33 Chile
34 Denmark
35 Dominica
36 Costa Rica
37 United States of America
38 Slovenia
39 Cuba
40 Brunei


Life expectancy from 1997-99 (and it's much lower for African-Americans and the poor):

Rank Overall life expectancy

1 Japan 74.5
2 Australia 73.2
3 France 73.1
4 Sweden 73.0
5 Spain 72.8
6 Italy 72.7
7 Greece 72.5
8 Switzerland 72.5
9 Monaco 72.4
10 Andorra 72.3
11 San Marino 72.3
12 Canada 72.0
13 Netherlands 72.0
14 United Kingdom 71.7
15 Norway 71.7
16 Belgium 71.6
17 Austria 71.6
18 Luxembourg 71.1
19 Iceland 70.8
20 Finland 70.5
21 Malta 70.5
22 Germany 70.4
23 Israel 70.4
24 United States 70.0

Rank Country or territory Infant mortality rate
(deaths/1,000 live births) Under-five mortality rate
(deaths/1,000 live births)
1 Iceland2.93.9
2 Singapore3.04.1
3 Japan3.24.2
4 Sweden3.24.0
5 Norway3.34.4
6 Hong Kong3.74.7
7 Finland3.74.7
8 Czech Republic3.84.8
9 Switzerland4.15.1
10 South Korea4.14.8
11 Belgium4.25.3
12 France4.25.2
13 Spain4.25.3
14 Germany4.35.4
15 Denmark4.45.8
16 Austria4.45.4
17 Australia4.45.6
18 Luxembourg4.56.6
19 Netherlands4.75.9
20 Israel4.75.7
21 Slovenia4.86.4
22 United Kingdom4.86.0
23 Canada4.85.9
24 Ireland4.96.2
25 Italy5.06.1
26 Portugal5.06.6
27 New Zealand5.06.4
28 Cuba5.16.5
29Channel Islands ( Jersey and Guernsey)5.26.2
30 Brunei5.56.7
31 Cyprus5.96.9
32 New Caledonia6.18.7
33 United States6.37.8


Total health expenditures as %GDP, 2000-05:

Rank Location 2000 2001 2002 2003 2004 2005

1 Marshall Islands 22 19.1 18.4 16.3 13.2 15.4
2 United States of America 13.2 13.9 14.7 15.1 15.2 15.2
3 Niue 8 38.1 11.1 12.5 15.5 14.5
4 Timor-Leste 8.8 8.6 8.5 9.2 10.3 13.7
5 Micronesia (Fed. States of) 9 9.8 9.1 10.7 11.7 13.5
6 Kiribati 11.6 12.3 12.6 13.7 13.7 12.7
7 Maldives 6.8 6.8 6.6 7.2 7.8 12.4
8 Malawi 6.1 7.8 10 12.8 12.8 12.2
9 Switzerland 10.3 10.7 11 11.4 11.4 11.4
10 France 9.6 9.7 10 10.9 11 11.2
11 Germany 10.3 10.4 10.6 10.8 10.6 10.7
12 Jordan 9.4 9.6 9.3 9.3 10.1 10.5
13 Nauru 11 10.8 10.6 10.3 10.4 10.3
14 Argentina 8.9 9.5 8.9 8.3 9.6 10.2
15 Austria 10 10 10.1 10.2 10.3 10.2
16 Portugal 8.8 8.8 9 9.7 10 10.2
17 Greece 9.3 9.8 9.7 10 9.6 10.1
18 Canada 8.8 9.3 9.6 9.8 9.8 9.8
19 Sao Tome and Principe 6.3 9.1 8.6 11.9 12.1 9.8
20 Belgium 9.1 9.3 9.5 9.5 9.7 9.6

Health expenditures per capita, OECD nations 2000:

Rank Countries Amount
# 1 United States:$4,631.00 per capita
# 2 Switzerland:$3,222.00 per capita
# 3 Germany:$2,748.00 per capita
# 4 Iceland:$2,608.00 per capita
# 5 Canada:$2,535.00 per capita
# 6 Denmark:$2,420.00 per capita
# 7 France:$2,349.00 per capita
= 8 Belgium:$2,268.00 per capita
= 8 Norway:$2,268.00 per capita
# 10 Netherlands:$2,246.00 per capita
# 11 Australia:$2,211.00 per capita
# 12 Austria:$2,162.00 per capita
# 13 Italy:$2,032.00 per capita
# 14 Japan:$2,011.00 per capita
# 15 Ireland:$1,953.00 per capita
# 16 United Kingdom:$1,764.00 per capita
# 17 Finland:$1,664.00 per capita
# 18 New Zealand:$1,623.00 per capita
# 19 Spain:$1,556.00 per capita
# 20 Portugal:$1,439.00 per capita
# 21 Greece:$1,399.00 per capita
# 22 Czech Republic:$1,031.00 per capita
# 23 Hungary:$842.00 per capita
# 24 Slovakia:$690.00 per capita
# 25 Mexico:$491.00 per capita


Putting that all together, we see that we are paying a ton for health care and health outcomes that far lag behind those evil socialized medicine nations in Western Europe, Asia, and Canada. Maybe one can argue that America's lower life expectancy is also due to lifestyle (overeating, stress) and culture (guns, car accidents), not just health care. While that may be true, our smoking and binge drinking rates are much lower than most of Europe, yet many of those nations outlive us. But the biggest, most shameful metric is infant mortality. That is pretty much an even playing field to judge. Unless American mothers are prone to pregnancy complications and unhealthy parenting (no strong data to support that), it's the responsibility of the health care providers to monitor fetuses, birth those children, and make sure they have a good chance to reach adulthood. Our I.M. rate is 50% higher than France and double Japan's. Unacceptable. Especially when you consider that we commit 15% GDP to health care vs. 11% for France, or $4.6k per capita vs. France's $2.4k. Maybe that's not fair since France is ranked #1 by the WHO. But still, look at the other nations that devote >12% GDP to health care. They're either small or poor, which means they don't have much GDP to spread around anyway. We have the largest GDP, so we're wasting incredible amounts of money on sub-prime care.

Critics of Obamacare are not allowed to say that he is tampering with a great system, because the evidence is just not there. They can criticize Obama reform for cost, scale, rules, and planning, but even Mitch McConnell said that the GOP knows our health system needs some sort of reform too, it just depends on what shape it takes. So only a cretin (no offense to Greeks from Crete) would think that we're doing fine on the national level. Sure Ted Kennedy and Patrick Swayze are getting the "best health care in the world", and best care will still be available (even under a single-payer system) to those who can pay for it out of pocket, but on average the US has a long way to go before we can crown our asses (Dennis Green-ism).