Health Care/Integrity

When I wrote my last entry, about three months ago, I had written some brief observations about the proposed ‘health care reform’ legislation, and said that I would write more about it shortly.

Three months later, the legislation has passed the House and is now under debate in the Senate.  The Republicans hate it, but since the Democrats have 60 of the 100 seats, how the Republicans feel about it doesn’t matter.

Basically, the scheme is that all Americans will  be required to carry health insurance that meets certain standards, either on their own account or through their employment.  If they don’t have a satisfactory plan, they will have to pay a penalty to the Feds.

In addition, health insurers will not be able to discriminate against people with pre-existing conditions.   That sounds really nice, but we already have a rule like that in New York, and one of the main effects of it is to make health insurance preposterously expensive, as it encourages normally healthy people to wait until something goes wrong before buying insurance.  I once priced health insurance on an individual direct-pay account for my family: it cost over $2500/month.  I was able to make a better deal than that, but it’s still very expensive.  Most assessments of the new legislation concur that it will raise health insurance  costs for most Americans.

Meanwhile, it doesn’t seem to do anything to actually contain health care costs, other than to cut Medicare reimbursements, something that has been on the books for several years, but is always overridden by Congress so that it has no practical effect.  And the heavy lifting of actually providing coverage for people who legitimately couldn’t afford it is accomplished by expanding Medicare and Medicaid.

I would have understood, and even supported, a measure that would bring a Canadian-style system to this country, complete with measures to contain costs, as long as such a system did not preclude one from purchasing health care with one’s own funds or private insurance.

But we can’t do that, because we want to have our cake and eat it too.

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Friday night, I watched the movie Kate and Leopold with my wife on the tube.  (Silly question:  when I ultimately get a flat-panel TV to replace the big heavy Sony in our bedroom, will I still call it ‘the tube’?)  In the movie, Leopold, the Duke of Albany, is transported from 1876 to 21st-Century New York City to great comic effect.

What’s so funny about a guy from 1876?  He speaks contemporary English; his dress is overly formal by our standards, but not too outlandish.  But what makes Leopold funny is that he has what seems to us as an exaggerated sense of integrity and honor.

He speaks the truth when we in the 21st Century would issue jaded cynicism.  He is asked to promote a product, and when he discovers the claims made about it are false, he flatly refuses.  Most people today would either go forward with the promotion (one has to earn a living, after all), or make an exaggerated show of refusing (you see, people, I have integrity!).

Perhaps integrity and honor have beome anachronisms….

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