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You can’t make an omelette without killing a few centenarians

By auguste
Tuesday, June 30, 2009 12:00 EDT
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Perhaps if MDs still took these as payment, like they did when the questioner’s mother was young, we wouldn’t be having this disagreement

The arguments against public health care fall into one of two camps: Lies and obfuscations.

The latter is on display here:

A woman in the audience told Obama about how her 105-year-old mother had a pacemaker installed, against some of her doctors’ advice, at age 100. It had improved her life significantly. Would the president’s healthcare plan ask doctors to take into account qualities in patients like love of life, she wanted to know — qualities that helped convince her mother’s doctors to try the pacemaker despite their reservations about her age?

Obama, as most of us have heard, blew the question. But here’s the thing: It doesn’t matter that he blew the question, because it is, on several different levels and for several different reasons, a nearly meaningless question. First of all, the woman’s mother is on Medicare. This is so nearly certain, it’s almost not worth arguing over, but on the off chance she’s not, I’ll point to the fact that if she’s relying on her or her husband’s contracted pension health care, she’s among the last generations who will be able to count on that, as corporations look for every opportunity they can find to weasel out of such agreements. So government-run health care already paid for one such operation; why should we especially fear that a new public option would be significantly more restrictive?

Second of all, you know who’s terrible – CRIMINALLY TERRIBLE – at taking into account qualities in patients like love of life? HMOs. Some jackass in New Hampshire trying to hit a bottom line, fearful of the next stock-price dip, scares me a lot more than a government worker doing the exact same job, without the capriciousness of corporate America to worry about. There are and will always be bureaucrats in health care. Many of them do, and always will, suck. I’d still rather have them working for me than for some stockholder.

Third of all, you know what’d have been a worse story than the woman’s mother dying at age 100? Eighteen thousand people dying at significantly younger ages. Per year. Because they don’t have insurance.

Eighteen thousand mothers, fathers, sisters, and brothers, dying preventable deaths because insurance was too expensive or flat-out unavailable.

Per year.

Fourth of all, why do we always have to pre-EIGHTEEN THOUSAND PEOPLE A YEAR. This post aside, from now on I’m just going to scream that at the top of my lungs at anyone who questions whether a public option is a good idea.

Fourth of all, why do we always have to pretend that under public healthcare, insurance companies would fold up shop, and that rich people wouldn’t still get their healthcare cookies? Supplemental insurance is always available in countries with socialized medicine, and anyone who’s covered by the magical healthcare policies they seem so in love with would be able to afford such a policy. (The most expensive and thorough coverage I’ve seen quoted in the UK, for a family of four, costs about one-third of what I pay per month for my family of three; it’d take an awfully large tax hike to make up the difference…)

So look, all I’m asking is that we stop listening to idiots making up bullshit about the joys of private vs. public health care. All respect due to the 105-year-old mother, the questioner was essentially posing the health care equivalent of the Jack Bauer ticking time bomb scenario. “If we can get one woman a call from Willard Scott, isn’t it worth allowing 500,000 people a year to go bankrupt and 18,000 a year to die?”

Update: I was writing this late last night and forgot to link to a source for the 18,000 figure…which is too bad, because apparently it’s gone up to 22,000, at least according to the Urban Institute (PDF). The original 18,000 came from a 2002 study by the Institute of Medicine.

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