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These days, I'm the director of the American Library Association' s Office for Intellectual Freedom. I'm also executive director and secretary of the Freedom to Read Foundation. See "About Me" for contact information.

Sunday, August 23, 2009

Health care reform: an EMOTIONAL issue

This popped up on my Facebook page: an exchange between Rep. Anthony Weiner of New York, and Joe Scarborough on Tuesday, Aug. 18, 2009's "Morning Joe." You can read about it, and see it, here. A couple of salient quotes from that article:

"Weiner asked some simple, direct questions that no politician, much less Obama or HHS Secretary Kathleen Sebelius, has managed to pose:

'What is an insurance company? They don't do a single check-up. They don't do a single exam, they don't perform an operation. Medicare has a 4 percent overhead rate. The real question is why do we have a private plan?'

"'It sounds like you're saying you think there is no need for us to have private insurance in health care,' Joe asked at one point.

"Weiner replied: 'I've asked you three times. What is their value? What are they bringing to the deal?'"

Later, Joe "even repeated Weiner's points clearly: The government would take over only the 'paying mechanism' of health care, not the doctors or their medical decisions themselves. His ears perked up every time Weiner mentioned that the nonprofit Medicare spends 4 percent on overhead, while private insurers spend 30 percent."

I wrote a column, available here, where I reported on the rising costs of health care in Douglas County -- and the likelihood that they will cost jobs in both the public and the private sectors. Because I knew this was timely, I had my tech staff turn on "comments" on our Drupal-based website. It quickly became apparent that mostly people were far more interested in attacking me, my sources, and any kind of federal government involvement, than they were in considering the underlying system.

One interesting comment was that one of the numbers I'd never seen disputed before -- the fact that our live birth rate is among the lowest in the developed world -- is now claimed to be because of our heroic efforts to rescue prematurely born infants, when the other countries don't. I find that one unlikely, but will keep an open mind till I can track down the actual incidence of premature births, and how many of them die. Could that number possibly be high enough to affect our international rankings? (See comment number 6 for the explanation!)

One of the comments to my column repeated the notion that health care costs are due to malpractice claims, which I've seen soundly refuted a number of times.

I'll be honest: health care reform isn't an emotional issue for me. There are a lot of nations out there who have tried a lot of different systems. When I last looked into this, it seemed pretty clear that the U.S. pays a larger percentage than other developed nations of our Gross Domestic Product on health care, has a larger percentage of people without any health coverage at all, has a higher infant mortality rate (subject to my investigation of this new counter-claim), and despite Sarah Palin's concern about death panels snuffing grandma, our life expectancy is actually shorter here than in, for instance, England, France, or Sweden -- all of whom do have national health care. Clearly, our current system isn't the best around, and I can't imagine why we wouldn't want to make it better.

Most recently, one reader of my column was so upset he wrote my bosses and urged my immediate termination for my "inappropriate political comments," and my "egregious and despicable breach of the public trust."

Clearly, this is a profoundly emotional issue for some. But when people talk about their medical "freedoms," which freedom do they mean: the freedom to pay more and get less? Because that's the way it is.

6 comments:

Debera said...

obivously no person in this world can conpromise with it's health.... it has to emotinal issue...

Debera


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martha said...

I recently came accross your blog and have been reading along. I thought I would leave my first comment. I dont know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.


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The Doug said...

What was your boss's response to the request that you be terminated? Other than, clearly, to not.

Jamie said...

Debera: for sure. But health, and a health care system seem like different things to me.

Martha: hi!

Doug: I have an extraordinary board president. A thoughtful and cautious man, he went back, read my column and its comments, and concluded that in fact I really hadn't voiced a political opinion at all. But he assured the person that the comment would be shared with the entire Board. Fair enough!

tpersephone said...

The rebuttal of the idea that our birth mortality rate is so high is due to our 'heroic efforts' is refuted by simply asking "WHY are there so many premature births here in this country?" -- (and it is higher than elsewhere in the world.)

The answer is: Lack of prenatal care. Usually caused by... wait for it... lack of insurance. The infant mortality rate is highest among African Americans...

Jamie said...

Denver Post, Nov. 4, 2009, p. 6A. Marian MacDorman of the U.S. Centers for Disease Control and Prevention was the lead author of a new report. Among the findings:
* premature births are the chief reason the U.S. ranks 30th in the world in infant mortality, with a rate more than twice as high as infant-mortality rates in Sweden, Japan, Finland, Norway and the Czech Republic.
* about 1 in 8 U.S. births is premature. These are much less common in Europe.
* Premature babies born before 37 weeks tend to be more fragile and have underdeveloped lungs.
*If U.S. infants were as mature as Sweden's are at birth, nearly 8,000 infant deaths could be avoided, and the U.S. infant-mortality rate would be about one-third lower than it is.

* Poor access to prenatal care, maternal obesity and smoking, too-early cesarean sections, and induced labor and fertility treatments are among the reasons for preterm births.

So a deeper look into these numbers hardly vindicates the U.S. health system.