First, there is the debate about fixing this nation's health care. Inside that, there is the debate about the health care debate, whether it is being rigged. Inside that, there is the possibility that Republicans don't care so much about health care, but want to hand Obama a loss. Any loss.
Where to begin?
First off, the lie that we have the best health care system in the world needs to be dismissed. We do not have the best health care system in the world. Look up the statistics on your own. Infant mortality? We rank ninth in the industrial world. Efficiency? Thirty percent of our health care dollars go into the paper work war between doctors and insurers. Etc.
Add to that the power of corporate oligopolies; the drug companies, insurance companies, the physician-owned hospitals and groups of prescribing docs who own radiology centers, etc. We have a recipe for profit, not efficiency nor patient care.
It is important to realize that there is a difference in our "health care system" or lack of it, and the quality of care one might receive from an excellent doctor. That may indeed be world class.
But that is not what we are talking about.
One of the really wrong ideas in this debate is that "the market" will provide health care. It won't. Markets need a tight relationship between money spent and service received. You don' t have a rational market where the payer for service (insurance companies) is not the recipient (patient) of service. Patients want the best care available. Insureres want the lowest cost.
And yet, one of the closest ideas we have to bringing "market" dynamics to the table is being thrown away. Having a "public option" would fit quite well with market economics. If the public option is no good, it will fail. If it is good, it will help bring down costs, while still allowing people to choose.
And we already have "public options." Medicare. Medicaid. Most of the noise about the "pubic option" is based on fear that the gravy train won't stand up to real competition.
Even sending our poor to hospital emergency rooms is a form of "public option." An insanely inefficient option. It slows down "emergency" rooms. It is expensive. It shifts costs, so that those of us with insurance fund the system by paying $6 for a single aspirin. That is a "public option" of irrationality.
It is amazing that Republicans are again able to convince people to scream against their own interests. The men and women working at the gas station and the sporting goods store and driving truck, the retired, and certainly those who have been fired from jobs where they had insurance, should support health care reform. But misinformation, fear mongering and the politics of hate (look at those screaming faces) remain effective weapons.
We can't afford to spend more of our income on health care. It is breaking our finances, draining our future. We can't leave our neighbors without health care: That is immoral.
The time has come to look at alternatives.