I’m tired of trying to follow all the “journalists” doing their damnedest to pin Hasan Piker to Abdul El-Sayed at every turn. Here’s Katy Tur(d) (married, btw, to CBS News anchor Tony Dokoupil) acting like a true journalist Republican stenographer:
Just wondering when was the last time Katy or one of her colleagues asked a Republican why they weren’t disavowing Nick Fuentes, or Elon Musk, or one of the innumerable other white supremacists in the Republican camp?
Sorry. I know. Stupid rhetorical question 🤦🏻♂️
Also, has anyone asked lately where Mitch McConnell is?
But I digress…
AES does his best to move on, and of course one of the issues he mentions is healthcare. On that account, it makes sense to see what his carpet-bagging, Florida-based opponent Mike Rogers.
This from the Bulwark yesterday (bold emphasis mine):
WE INTERRUPT THIS COVERAGE of Michigan’s pivotal Senate race for some breaking news: Democrat Abdul El-Sayed is not the only candidate running.
He’s got a Republican opponent, former congressman Mike Rogers. And there’s plenty about Rogers that might be of interest to voters, including his positions on health care policy.
True, health care is El-Sayed’s signature issue. The doctor and former public health official is famously an advocate of Medicare for All, the version of universal health care in which the federal government would cover everybody directly, largely displacing private insurance.
But Rogers also has some big, potentially controversial notions about how to change health care. Just for starters, he likes the idea of letting insurers charge copays for routine cancer screenings and some other forms of preventive care—which, under current law, the insurers cannot do.
That might sound like an odd position to hold when voters say they are worried about the cost of living, especially medical bills. But it comes directly from comments Rogers made to a private audience in March, via a recording later obtained by reporter Simon Schuster of Bridge Michigan.
At that meeting, Rogers got a question about what he would do to reduce the cost of health care. He promised to introduce a plan that would “embrace the freedom of the free market” and proceeded to explain that increasing out-of-pocket costs for preventive services was one way to do that.
“You know,” Rogers said, “if you go up and have to pay the doctor $50 for your annual physical, that’s probably okay, right?”
Before we dissect Rogers’ views, I need to go get some aspirin because… MY. HEAD. HURTS.
Ok, I’m back.
Let’s start with Rogers’ high-level idea that to “embrace the freedom of the free market” in healthcare is something that he presumes to be a good thing for Michiganders (and everyone else in the U.S.).
My first list of questions. Is there really a free market” in healthcare? Are government-granted patents on drugs and medical devices part of the free market? Does Rogers want to remove those government-imposed rules that provide Big Pharma and medical device makers with protection from the free market? For more, Dean Baker has been all over the patent issue. Also, when there is only one drug to treat a specific disease, is that a “Free market” situation?
My second group of questions revolves around the reality of healthcare decision-making. I wrote about this last December:
Specifically, I asked… questions:
Why? Because we don’t consume healthcare the same way we buy TVs or gas grills for outdoor barbecues. Here are the fundamental flaws in “consumer choice” when it comes to healthcare:
Patient A is at home and suddenly feels like they are having a heart attack. They call for an ambulance. Are they going to check around for comparative pricing? They may also need to check to see if a specific ambulance service is “in network” based on their insurance, since out-of-network services cost way more and have worse, if any, insurance coverage.
What if Patient A is has a stroke and falls unconscious in public, forcing random Good Citizen B to call for an ambulance? How can Good Citizen B compare prices?
Patient B is on vacation and goes into a diabetic coma. He is taken to the emergency room. Can Patient B ask everyone staff in the ER to hold off on treatment until thry find out if the hospital is in network or if there is an ER at a different hospital across town that charges less?
Patient C has a type of cancer for which there is only one drug that provides effective treatment. Does price transparency matter in that situation?
Parent D is visiting family far from their home. Her son Little Johnny breaks his leg playing in the yard. Is Parent D going to compare hospitals and doctors’ offices to decide where to take Little Johnny for emergency and then ongoing care? Maybe, but not likely.
In the examples above that involve any non-routine care (ambulance service and emergency room service), the patient will be charged for a gazillion other items beyond just the base charge for the ambulance/emergency room: oxygen provision, bandages, syringes, whatever drugs are needed to stabilize the patient, even paper cups (I know - it’s crazy). Will the “consumer" be able to check the pricing and markup on all those services/items? Of course not.
Again, price transparency is a good thing. But price transparency MUST be paired with informed decision-making in order for it to truly have an impact (this is a universal concept - it also applies to buying clothes or food).
I’ve said this before and believe this needs to be repeated ad nauseum, as well as communicated to our elected officials ad nauseum: our patchwork healthcare “system” requires people (not “consumers”) to literally predict the future and guess their future healthcare needs in advance in order to not go bankrupt. THIS IS INSANE!
We are the ONLY developed country that has this “system”. A system that literally bake uncertainty into healthcare decisions - the exact opposite of how a good healthcare system should be structured. Price transparency - while good - won’t change that underlying dynamic.
Want to fix the “system”? Do what other countries do. Have people pay taxes and, in return, provide universal access to basic, quality healthcare at minimal additional cost. Standardize coverage/insurance. Eliminate for-profit healthcare providers and insurers - no other developed country has them.
In fixing our system, I would ask a simple question at every turn: does whatever fix we are considering still require people to guess about the material financial impact of future unknown health needs? If the answer is yes - it’s not a fix.
Rogers’ - and other Republicans’ - view is that making healthcare less expensive will result in unnecessary “over-consumption” by healthcare “consumers”. This is… NUTS. On so many levels.
First, in my experience, people generally don’t like, or want, to go to the doctor unless they need to. My family thinks I’m a wee bit of a hypochondriac, and I still don’t want to just go to the doctor because it’s cheap or free (although who doesn’t like sitting for hours in a waiting room with magazines from 1993 to pass the time?).
Second, Rogers and gang seem to be ignoring the fact that most healthcare spending is done through third-party middleman payers known to the rest of us as “insurance companies”. These middleman organizations don’t really add any value to our healthcare system; in fact, for-profit insurers destroy value by siphoning money out of the system in order to create “shareholder value” and pay C-Suite executives enough so they can afford private jets and multiple homes.
Third, increasing the price of preventive care by allowing providers to charge a fee will, according to standard economic theory (as opposed to crackpot Republican economic theory), reduce utilization (i.e., people won’t get as many once-a-year preventive check-ups). This will likely lead to higher healthcare utilization down the road for those who forego annual preventive visits due to cost. But to Rogers and his ilk, it’s not really about saving money in the long-term, is it?
Finally, as I wrote in the beginning of the previous Post I linked to above, we don’t consume healthcare the same way we buy TVs or gas grills for outdoor barbecues. Parents choose a doctor for the family/kids, and don’t compare prices from other doctors in their town every time they need to go see the doctor. Patients literally can’t compare prices on every single item they are charged for during a hospital stay. And patients obviously have no ability - or desire - to compare prices when they are in distress due to a medical emergency.
Back to AES and the Michigan Senate campaign. Healthcare is AES’ home turf. Along with rising costs on everything else, this is where he needs to hammer Rogers.
That and the fact that he is what every American mom dreams of: the All-American Guy.
Otis Redding - I'm Sick Y'All
