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Monday, December 14, 2015

Privateering in Medicaid

The Right Wing in this country learned to rip out a page from the strategy of progressives. If they take their abusive agenda's, call them "reform" and throw in words like "reform", pay lip service to the programs "service needs", and use big words, they can fool most people reading their articles into thinking they are talking about the real thing and not simply privateering on a source of public revenue. It all sounds good until you dig into the reality of their proposals.

Privateering in Health Care

But whatever they call it, it remains privateering and kleptocracy. When folks enrich themselves at the public expense, while degrading "delivery", even if they call it "reform" it remains a pile of Bovine Processed Straw. Indeed, if these ideas weren't so useful in conning the public into giving up health care as a right for "healthcare as a privilege -- of the privileged". What Krugman is calling "Zombie Economics"

"Zombies against Medicare"

A good example of RW argumentation is found in Joseph Antos' article called "Improving Health And Health Care: An Agenda For Reform" in his "Health Care Blog." [http://healthaffairs.org/blog/] Where he writes:

"On one side are those who tend to promote more federal control and government regulation over insurance markets and the organizations delivering services to patients. On the other side are those who are more inclined to support consumer incentives and market mechanisms to improve the value and quality of patient care."

Sounds nice, eh? Who can be against the "freedom to shop?" or Consumer choice in health care. After all Patients should be able to choose their doctors and get the best possible service delivery. And of course in the hands of privateers, this is much preferable to "gubbornment regulation" of healthcare. Until you find that the details mean that that "freedom to shop" excludes most working people from participating in the so-called "market" for those without power and means.

Except:

  1. The idea that the choice is between "Government regulation" and market mechanisms" is a false choice. Health Care, at least when it comes to hospitals and 90% of us is a field with constrained resources.
  2. Health care involves extreme market power for favored drugs, drug dealers and providers -- which includes denial of consumer choice in favor of sales power -- as we've seen with recent examples of drugs developed with public money being priced at rates of over 1000$ a pill.
  3. Specialist Doctors might like this, but "market choice" really means "pay to play" -- and is a death sentence for the majority of people priced out of these markets.
  4. The "work makes you free" argument, "right to shop" argument and the notion that people should have the absolute right to enjoy the fruits of the labor of those they rule, are all part of Ronald Reagan's war on FDR's Second Bill of Rights and Four Freedoms. These are cynical arguments.

I was going to go over this this article point by point, but then I remembered Krugman basically was arguing with Jo Altos. Krugman is referring to Joseph Antos and his fellow pseudo-experts when he writes about "Zombies Against Medicare" [http://www.nytimes.com/2015/07/27/opinion/zombies-against-medicare.html?_r=0]

"It’s the very idea of the government providing a universal safety net that they hate, and they hate it even more when such programs are successful. But when they make their case to the public they usually shy away from making their real case, and have even, incredibly, sometimes posed as the program’s defenders against liberals and their death panels." [Krugman]

Nevertheless one has to agree that:

Empowered Citizens, Not Government Agencies, Should Control Health Care

Altos says

"It is our firm belief that U.S. health care would be far better, of higher quality, and less burdensome economically, if citizens, in their roles as patients and consumers of health services, rather than the national government, were ultimately in charge of making the important decisions of how to allocate scarce resources."

But the only citizens with that kind of "market power" are privileged citizens (the wealthy). Yes, health care is of higher quality and less burdensome economically if citizens are ultimately in charge -- through democratic participation in government! When a system is optimized for Doctors, Administrators, and privateers -- it degrades from the Point of View of patients and consumers. Without the outside pressure of a free press, elections, citizen oversight and organizations dedicated to the health care mission -- and not to the profit motive first. or based on Zombie arguments!

Rather than go point by point over Jo's Zombie arguments. Suggest you read Krguman's article. Nothing Jo says is original. It is the usual RW effort to destroy anything that benefits 90% of us, and for what? Because it is unaffordable? No? Because there is this idea that only some people deserve to live a life.

"What Medicare’s would-be killers usually argue, instead, is that the program as we know it is unaffordable — that we must destroy the system in order to save it, that, as Mr. Bush put it, we must “move to a new system that allows [seniors] to have something — because they’re not going to have anything.” And the new system they usually advocate is, as I said, vouchers that can be applied to the purchase of private insurance." [Krugman]

But that is always a lie. A single payer system, can be well run. And in most cases is a more efficient and cheaper payment system, with lower overhead costs than a privatized privateering system like the one we have, where costs are shifted in such a way to maximize Administrative pay, rents, interest and other rents. And everyone is forced to pay for overpriced services.

Further Reading

Krugman: "Zombies Against Medicare" [http://www.nytimes.com/2015/07/27/opinion/zombies-against-medicare.html?_r=0]

Article that Krugman was referencing:
Five Zombie Economic Ideas That Refuse to Die by John Quiggin
https://www2.bc.edu/~chemmanu/phdfincorp/Five%20Zombie%20Economic%20Ideas%20that%20Refuse%20to%20Die.pdf
Related Article
Privateering on Higher Education

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