Oh however will we pay for health care? By paying the true cost

I'm presenting this section from the July 17 entry on The Daily Howler fully and without comment, other than to say it's mind-boggling that more people don't see the ridiculousness of the current "debate" about health care in America.
The atrocity in the room: How much extra will we rubes have to pay to get what everyone else already has? Sorry: To get what everyone else already has--at half the price we're already paying? We're not sure what the answer will be. But bowdlerized versions of that question have been in the air all week.
Yesterday, the AP began explaining the $1.5 trillion price tag (over ten years) it had put on the current House health reform bill. (For their explanation, click here.) This morning, the Washington Post leads page one with the CBO's latest gloom:
MONTGOMERY (7/17/09): Congress's chief budget analyst delivered a devastating assessment yesterday of the health-care proposals drafted by congressional Democrats, fueling an insurrection among fiscal conservatives in the House and pushing negotiators in the Senate to redouble efforts to draw up a new plan that more effectively restrains federal spending.
Under questioning by members of the Senate Budget Committee, Douglas Elmendorf, director of the nonpartisan Congressional Budget Office, said bills crafted by House leaders and the Senate health committee do not propose "the sort of fundamental changes" necessary to rein in the skyrocketing cost of government health programs, particularly Medicare. On the contrary, Elmendorf said, the measures would pile on an expensive new program to cover the uninsured.
Though President Obama and Democratic leaders have repeatedly pledged to alter the soaring trajectory--or cost curve--of federal health spending, the proposals so far would not meet that goal, Elmendorf said, noting, "The curve is being raised." His remarks suggested that rather than averting a looming fiscal crisis, the measures could make the nation's bleak budget outlook even worse.
Numbers are going to move around, and Elmendorf's testimony will be read different ways. For ourselves, we'll just marvel again at our society's Ongoing Agreement to ignore the atrocity in the room.
What's the atrocity in the room? It's the astounding amount of wasted money involved in our current arrangements. Yesterday, the Post referred to "President Obama's ambitious drive to overhaul the nation's $2.3 trillion health-care system." We don't offer what follows as a criticism of Obama. But let's consider what that amazingly large number means:
Let's assume that our society is currently spending $2.3 trillion per year on health care. Since we're spending twice as much per person as other developed nations, about $1.15 trillion of that money is essentially "wasted" spending. Some of it goes to pay the middle-class salaries of middle-class people engaged in (useless) paper-shuffling at insurance companies. Some if it goes to doctors who perform useless procedures. Some it goes to insurance and pharmaceutical companies in the form of large profits.
But, in the larger sense, it's all wasted/misspent. And let's enjoy a bit of straight talk: That much misspent money is an utter social obscenity. And yet, that remarkable sum rarely gets discussed as we try to figure out how much more we'll have to pay--to get what everyone else already has. That astounding amount of misspent money thus becomes the atrocity in the room.
It's isn't Barack Obama's fault that this obscenity goes undiscussed. The liberal world has taken part in this gimmicked discussion for many years. But that misused sum does represent a true social atrocity. And alas! When it gets discussed at all, it tends to get discussed in the manner which follows.
Chrystia Freeland (The Financial Times) appeared on last night's Ed Show. She said more than is normally said:
FREELAND (7/16/09): This president likes to talk about the best being the enemy of the good, and is very much someone who is focused on achieving what is achievable. Having said that, I agree with you that the public option is really essential for true health care reform.
One of the nightmare outcomes that you could have is some sort of reform which is a half measure and ends up making things worse. I think the way you could get to that would be maybe to have coverage extended, but not to have action taken to bring down the costs, which is one of the things that the public option could do.
One of the really the ridiculous things about the American health care system, if you look at it from the outside, is America spends more on health care than other western industrialized countries, significantly more, but actually has equal or, in most cases, worse outcomes. So you should be able to have reform that gives more coverage and costs less money. I think it has to be the target that the president aims for.
Freeland, a Canadian, correctly noted that our system is "really ridiculous" ("if you look at it from the outside"). Well guess what, rubes? The situation Freeland describes remains deeply ridiculous if you look at it from the inside! But almost no one ever does. Freeland herself understates the insanity a tad--and her host, Ed Schultz, moved directly to a different consideration.
In that presentation, Freeland offers a bit of obvious logic. If the US pays twice as much as other nations for similar health care outcomes, "you should be able to have reform that gives more coverage and costs less money" (our emphasis). In the short run, it wouldn't be easy to accomplish that outcome; any actual "overhaul" of our profoundly ridiculous system would involve economic dislocations. But it's rare to see anyone make the obvious case Freeland offered last night. When she did, she understated the lunacy a tad--and Schultz moved instantly on.
Classicist Norman O. Brown got very hot in the mid 1960s. In his very hot book, Love's Body, he described how societies die:
BROWN (1966): I sometimes think I see that societies originate in the discovery of some secret, some mystery; and end in exhaustion when there is no longer any secret, when the mystery has been divulged, that is to say profaned...And so there comes a time--I believe we are in such a time--when civilization has to be renewed by the discovery of some new mysteries, by the undemocratic but sovereign power of the imagination, by the undemocratic power which makes poets the unacknowledged legislators of all mankind, the power which makes all things new.
We don't recall what that means any more. But we will say this: Societies die when they can no longer see, or discuss, what is standing right before them. A ludicrous, deeply disordered discussion continues in today's Post.








