Oprah & Michael and the Health of the Nation
“Logical errors are, I think, of greater practical importance than many people believe; they enable their perpetrators to hold the comfortable opinion on every subject in turn.” - Bertrand Russell
I just finished watching an episode of Oprah. The topic was the state of health care in the US. Primary guest was Michael Moore, because of his documentary “Sicko”. Other guests included a spokeswoman for the health insurance industry who, I must say, maintained her dignity and eloquence throughout in the face of relentless, albeit polite, attack from Oprah, her guests and the audience. Now, let me say at the outset that nothing here should be construed as support or apology for the health insurance industry of America, which I suspect, but cannot prove, is populated and managed by venal, larcenous rogues.
What fascinated me about this show was that it was a perfect illustration of the depths to which critical reasoning has plunged in the past few decades. I will try to cut through all the wringing of hair, gnashing of teeth, and emotional verbiage and present just a couple of the basics:
Assumptions/problems:
1. 45 million Americans have no health insurance.
2. Insurance providers frequently cheat their policy holders by not providing the coverage they expected and thought they were paying for.
The solution according to everyone, save the insurance spokeswoman: Nationalized health care a la Britain or Canada or others.
Is it just me, or did a 600 pound non sequitor just enter the room? Is there not something missing in this argument? Something like, say, addressing the problem! If 45 million are uninsured, why? Deal with that symptom of that disease before instituting a complete redefining of the relationship between practitioners and patients. If insurance companies are committing fraud, prosecute them. Throw a few executives in jail for 20 years. The fraud will stop.
On the latter point, nobody actually stated overtly that the companies are committing fraud. It was just implied. One delightful exchange came when the parties discussed the case of a woman who needed a bone marrow transplant which was to cost $400,000. I believe. The insurance company agreed to pay only $150,000. of that. The insurance spokeswoman averred that, very often such problems arise because the companies have determined what a procedure can be delivered for but the facility delivering it in the specific instance charges excessively. At that Ms O yelled repeatedly, “I need the transplant. Pay for it! I need it now. I don’t have time for comparison shopping!” Very emotional. Very persuasive. And very specious. Not even the insurance spokesperson bothered to point out the obvious: hypothetical patient Ms O would have had lots of time for comparison shopping when buying the policy but was probably too lazy to even read it. Again, if the companies are violating the terms of the agreements they enter into, avail yourself of your legal recourse against them. If they are not (i.e. if the woman’s policy indicated a $150,000 limit for that procedure or contained wording permitting that limitation) then we are to expect them to assume financial responsibility for the policy holder’s negligence?
It went on thus, with one rhetorical question being raised repeatedly: Should profit play a part in something as fundamental and vital as health care? Gee, I don’t know. Should profit play a part in something as fundamental and vital as food? Potable water? Warm clothing in northern climes? Heating oil? Shoes?
I have found that all such discussions of health care have one thing in common: They make me sick.
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March 1st, 2008 at 6:21 am
From your comments, I can deduce the following:
1. You are a Republican
2. You have never had to battle the health care system
3. You have some income from the healthcare industry
Healthcare and lives should be in he hands of doctors, not in those of bean counters at health insurance companies. All healthcare companies should be not for profit, and should not be licensed in this country otherwise.
If you insist that healthcare should be privatized, then patients should have legal recourse to sue for negligence and for lack of coverage when warranted.
We have a healthcare crisis in this country, and if your head is so far up your butt that you can’t see it, then take a good sniff.
March 1st, 2008 at 10:40 am
Dear S. Skolnik.
I think that I, too, can make a couple of deductions:
1. You are rather annoyed.
2. You did not read this post carefully nor any of my other politics-related posts at all.
I will address the points you raise in turn.
1. No, I am not a Republican, nor a Democrat, nor a Green, nor a Libertarian, nor anything else.
2. Correct. I have never had to battle the health care system of the U.S.
3. I have never earned or otherwise received one penny from any health care system anywhere.
As to the other points you raise…
“Healthcare and lives should be in he hands of doctors, not in those of bean counters at health insurance companies.”
Health care and lives are in the hands of individuals. Doctors are the experts we usually choose to help us with that care and their moral and legal obligation is to meet our needs to the best of their ability. Health care is not in the hands of corporate bean counters or corporate executives. What is in their hands - what they are responsible for - is the financial well-being of their owners. Their moral and legal obligation is to maximize profit to the best of their ability within the framework of the law and the contracts with their clients.
“…patients should have legal recourse to sue for negligence and for lack of coverage when warranted.”
I do not know what you read in my post that would make you think I believe otherwise. That is exactly one of the points I stressed. Perhaps I can make the point stronger by saying that I believe there should not simply be ordinary legal recourse but a fast-track provision to deal with emergency cases where time is of the essence and the policy holder cannot wait for the glacial movement of the court system. An arbitration system for speedy interim adjudication of dispute should be established.
“We have a healthcare crisis in this country, and if your head is so far up your butt that you can’t see it…”
There is a health care crisis for those who have inadequate insurance or no insurance. For others, there is no crisis. Again, in my post I stressed that what should be addressed is the root causes of there being so many people unable to purchase adequate coverage. What I view skeptically is the panacea of government funded universal coverage. Proponents are always quick to point to Canada as an example of health care Utopia, but they do so without looking at or seeing anything other than its universality. They ignore matters of quality and workability.
The situation in the U.S., it seems to me, is that the country has first rate doctors, first rate hospitals, and first rate medical technology but they are not equally accessible to everyone. The problem in Canada is that there is equal access for everyone to second rate medical care.
Whatever personal problems you might have with your insurance provider, I hope you manage to solve them. I would say though, as someone from a universal-care-heaven country, that government operated medicine is not likely to satisfy you. If you really question that, ask yourself how good American highways, bridges or other federal government owned and operated infrastructure is.
JB