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Saturday, June 27, 2009

The American Nomenklatura and the Health Care Debate

In a previous post I discussed the fact that Obama has no interest in restricting himself or his family to any government controlled health care system.

While Obama thinks that your medical care may have to be discontinued and you may just have to take painkillers until you're dead; for himself he has other plans.

Without question, the most damaging moment for Obama came when he acknowledged that in spite of the rationing implicit in his public health care plan, he would still pay out-of-pocket to obtain the best health care for his family. As reported by ABC’s Jake Tapper, “President Obama struggled to explain today whether his health care reform proposals would force normal Americans to make sacrifices that wealthier, more powerful people – like the president himself – wouldn’t face.”

I wrote my Senators and Senator Jim Webb (D-VA) replied. Part of his e-mail is reprinted below.

Dear [Moneyrunner]:

Thank you for contacting me regarding health care reform. I appreciate your taking the time to share your views and concerns.

As you know, addressing the health care crisis in our country is a top priority for me and my colleagues in Congress. There are 47 million Americans without health insurance and millions more that are underinsured. Health care costs currently consume more than $2 trillion per year and are estimated to reach over $4 trillion by 2017, jeopardizing family budgets and the long term financial stability of our system. Despite these huge expenditures, the United States ranks 42nd in the world in life expectancy, according to the U.S. Census Bureau, and our health care system ranks lower than many countries on quality, access, efficiency, equity, and preventative care. We must improve the value and availability of care while addressing the increasing burden health care costs are placing on American families. Providing all Americans with access to affordable health insurance also means that the cost of uncompensated care for the uninsured will not be added onto the costs of the insured.

I believe that everyone in this country should have access to health insurance that is affordable, that provides adequate coverage, and that is always available. We can do this by producing better information regarding treatment, promoting health and preventing disease, and creating incentives so that all Americans can receive quality health care. We can offer Americans better, more affordable health care choices while allowing those who are insured to keep their coverage. We should also closely examine the role that health insurance companies play on the rising costs of health insurance in this country.

As the Senate continues to debate health care reform, please be assured that your views will be very helpful to me and my staff. I hope that you will continue to share your views with us in the years ahead.

For people with short memories, Jim Webb defeated George Allen based on a smear campaign run by the media surrounding the term “macaca,” a word that was classified as racist despite the fact that no one had ever heard of it. Shortly after assuming office there was an incident with a handgun owned by Webb, a crime in Washington DC, that no one was ever charged with.

Note that the letter starts Webb’s argument with the statement that there is a health care “crisis.” There is not. Everyone in the country has access to health care, and very good health care.

Second, there is a fake statistic about the uninsured, and a reference to the underinsured” (whatever that means). According to the article in Investor’s Business Daily, 18 million of those uninsured have incomes over $50,000 per year and 20% of all uninsured have incomes over $70,000 annually. They simply decided not to buy insurance. A further 27% of the “uninsured” are illegal aliens. Another 20% are uninsured for a few months a year.

Is it really a good idea to tax working people to subsidize those who refuse to pay for a necessity they could easily buy? Is it a good idea to tax working Americans to pay health insurance for illegals?

The answer, of course, is no.

Then Webb raises the issue of the quality of our health care with the spurious life expectancy statistic. At first glance it seems that the best health care should create longer life. And it does. But there are other factors like lifestyles, diet and heredity that have much more of an effect than health care on longevity. A study by the National Center for Public Policy Research concludes that:

There is no relationship between life expectancy and spending on health care. Greece, the country that spends the least per capita on health care, has higher life expectancy than seven other countries, including Belgium, Denmark, Finland, Germany, Netherlands, the United Kingdom and the United States. Spain, which spends the second least per capita on health care, has higher life expectancy than ten other countries that spend more.

More robust statistical analysis confirms that health care spending is not related to life expectancy. Studies of multiple countries using regression analysis found no significant relationship between life expectancy and the number of physicians and hospital beds per 100,000 population or health care expenditures as a percentage of GDP. Rather, life expectancy was associated with factors such as sanitation, clean water, income, and literacy rate.8 A recent study examined cross-national data from 1980 to 1998. Although the regression model used initially found an association between health care expenditure and life expectancy, that association was no longer significant when gross domestic product (GDP) per capita was added to the model.9 Indeed, GDP per capita is one of the more consistent predictors of life expectancy.

Yet the United States has the highest GDP per capita in the world, so why does it have a life expectancy lower than most of the industrialized world? The primary reason is that the U.S. is ethnically a far more diverse nation than most other industrialized nations. Factors associated with different ethnic backgrounds - culture, diet, etc. - can have a substantial impact on life expectancy. Comparisons of distinct ethnic populations in the U.S. with their country of origin find similar rates of life expectancy. For example, Japanese-Americans have an average life expectancy similar to that of Japanese.10

Which leads me to the issue with the new nomenklatura - a term that seems more and more applicable to members of this government and administration (tax cheats galore).
In my reply to Webb, I raised the issue of special treatment for government officials who are specifically exempted from the regulations that are in the proposed health care bill that's under consideration.

I do not want the government to determine when my quality of life is such that giving me a pain pill and wait for me to die is the most cost effective way of dealing with my medical condition. That is not my way of putting it, that was president Obama during this ABC infomercial who made that statement. That is the way that countries who have government health care deal with serious medical problems as people age.

Furthermore, I want any system that applies to me to apply to you and all the other people in political power. Again, President Obama said that he would opt out of any government mandated program for his own family. How about you, Jim? Do you and members of Congress and officials in this administration have access to special treatment at Walter Reed or other special government hospitals that we, the public, can't access? The Russians had a name for that class of people: the nomenklatura.

I await his reply.

1 comment:

Anonymous said...

I, too, am a Virginian and have written both senators on occasion. It never fails that I receive in reply a "form email" that may or may not answer my question. It wouldn't surprise me if you get the exact letter from Webb a second time in reply to your question.
Phil in Alexandria