Sunday 25 August 2013

Unhealthy

The US Congress doesn't seem to be doing very much these days, or at least, it's doing nothing linked to its supposed raison d'etre.  Partisanship is at an all time high.  Republicans are terrified of being unseated by Tea Party activists, and so are moving hard to the right; Democrats are rallying around President Obama, while secretly nursing thoughts that alas, he's turning (or has already turned) into a bit of a letdown.

About the only thing that is happening in Congress is a relentless campaign by the Republicans to repeal or sabotage the Affordable Care Act, more commonly known as Obamacare.  The Democrats repeatedly knock these attempts back, so it's all completely pointless, but there's no prospect of it stopping any time soon.


It's hard to find any Republican in Congress who can articulate just what it is that the party so hates about Obamacare, aside from the Obama part. And actually, a lot of it wasn't even Obama's idea in the first place.  He borrowed a lot of it from the health plan that Mitt Romney introduced when he was Governor of Massachusetts, though that's not something that Mitt can afford to take any credit for now, unless he wants the Tea Party hounding him out of politics.   


For insights into the right's "thinking" we have to turn to the commentariat.  One columnist on healthcare who's never short of an opinion (though often short of facts) is Mark Steyn.  He has possibly penned more misleading and outright mendacious words on this topic than on any other in recent years, which is really saying something. 


I know it's bad form to quote yourself, but here's something I wrote in response to a Steyn piece back in July 2009, before Obamacare made it onto the statute books: 

Steyn is spectacularly (and maybe deliberately) missing the point of Obama's reforms. He notes that life expectancies are very similar not only in the US and "socialized" Europe, but even in countries such as Bosnia/Herzegovina. His take on this fact is that there would be no real health benefit for the US in moving toward a more European health care model. But surely the real question is this: if Bosnia achieves a life expectancy of 78 years while spending a small percentage of its small GDP on health care, what good does it do the US to spend 16% of its much higher GDP to achieve the exact same outcome?


Steyn's back at it again this week, in his regular column on National Review Online.  A lot of it is the usual knockabout stuff, but this paragraph really jumped out at me:  

The parallel public/private systems of Continental Europe cost about 10 percent of GDP. The Obamacare monstrosity blends all the worst aspects of a private system (bureaucracy, restricted access, co-pays) with all the worst aspects of a government system (bureaucracy, restricted access, IRS agents) and sucks up twice as much GDP, ever less of which is spent on “health care” and ever more on the intervening layers of third, fourth, fifth, and sixth parties.


I don't know how that reads to you, but to me it seems as if Steyn is contriving to lay the blame for the bloated cost of the US healthcare system on Obamacare  That's nothing short of outrageous, though very much par for the course where Steyn et al are concerned. 

Obamacare is starting to have some perverse and undesirable effects, as Steyn is quick to point out. Most notably, workers at the lower end of the pay scale are finding their terms of employment are being manipulated so that their employers don't have to take on the burden of contributing to their health care.  But if, as it appears, the authors of the Affordable Care Act underestimated the venality of the business sector, is that a reason to conclude that no reform of the health care system should be attempted?

Even Steyn does not appear to want to go that far.  In his final paragraph, he bemoans the total absence of any real thinking on the subject on the part of the Republicans.  And he muses about whether Obamacare might have been set up to fail, so that voters would be ready to embrace "single payer health care" (i.e, a government system) by the time the 2016 election rolls around.  That's far-fetched, but as an aging population puts ever more pressure on already bloated US health care costs, something almost as drastic is going to have to be done, sooner rather than later   

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