Tomorrow's Gonna Be Tense

The Supreme Court decides on "Obamacare" tomorrow. This is personally important to me for a few reasons; if they strike down the entire law, I won't be able to stay on my parent's health insurance as long as I can now, and I'm also more likely to be denied health insurance in the future because I have a pre-existing condition. If they strike down the individual mandate, then there's a good chance that premiums will go up because health insurers will keep having to accept high-risk patients without getting more healthy patients to balance it out, and that would suck for me too when I eventually have to buy health care.

So I'll probably blog about it! But in the meantime, ThinkProgress made a really spot-on observation about the reporting over this which focuses on how it will impact the presidential elections in November:

It is, of course, mildly interesting to speculate upon how tomorrow’s decision could influence whether a man who currently lives in a luxurious house in Washington will continue to live there for several more years or will instead be forced to move to a different luxurious house in Chicago. But you know what matters a whole lot more? Whether the Supreme Court decides to strip millions of Americans of their future access to health care. 

Every year, hundreds of thousands of Americans file bankruptcy because they cannot afford their medical bills. Thousands more are locked into jobs their hate because they cannot risk losing their employer-provided health insurance while they have a preexisting condition. According to one study, about 45,000 people die every year because they do not have health insurance. So, in a very real sense, the Supreme Court is deciding tomorrow whether to allow tens of thousands of people to die every year until Congress is able to pass another health care bill. Something, by the way, which took seventy years to accomplish the first time around.

 So yeah. Cross your fingers, folks!

Language and Madness

A picture of Christ Church College in
Oxford, which I keep meaning to write
about but haven't yet.

Did you guys read the Rolling Stone article that came out a little bit ago about the suicides in Michelle Bachmann's district? It was heartbreaking and infuriating and definitely worth a read. But today Feministe had a response analyzing the language different people - the principle, the students - used to talk about the suicides, and it was really interesting.

He argued that using terms like "mental health" takes the responsibility away from the school and puts it on the students - they didn't kill themselves because the school created or allowed horrible conditions, they killed themselves because there was something wrong with them. He used a quote from a girl at the school who went to psychiatric treatment, listing all of the things she'd been diagnosed with as something she "had" - "They said I had anger, depression, suicidal ideation, anxiety, an eating disorder" - even though she experienced them as a part of herself and her experience. He was arguing, I think, that a focus like that on symptoms to be fixed can be dehumanizing and doesn't really address the problem - the things a depressed person actually has to be sad about, for instance. 


I'm not quite sure how I feel about his argument, but it was an interesting way of looking at it, particularly in the particular instance of this school district. I definitely recommend it.

Liberty and Health Care and Stuff

We had a campus speaker for Constitution Day today! Ken Cuccinelli spoke to a crowd of a half-dozen supporters and about 60 protestors in our science building today, inspiring some fabulous chants like "If you don't believe in science, get out of our building!" While I disagreed or was baffled by a lot of what he said, he made one particular argument about health care that I found curious, because I'd seen it just yesterday being argued by Ron Paul.

The idea, as Cuccinelli and Paul explained it, is that back in the good old days, hospitals would provide free health care to those who could not afford it, and then the government stepped in and ruined it by making it law that they HAD to provide emergency room care to anyone who needed it. Cuccinelli argued, in particular, that not only should government completely be out of health care, so that the poor rely on generosity of hospitals, but that hospitals should be able to turn away people whose concerns weren't serious enough and only give free care to cases they deemed emergencies.

The financial problems with Paul's idea that we should get rid of Medicaid and Medicare and people should save for medical emergencies on their own is broken down in this fabulous analysis at Mother Jones, but there was something else about this idea that was just rubbing me the wrong way. Cuccinelli kept talking about how government shouldn't have the right to compel us to buy a product - that requiring people to buy health insurance is taking away our freedom. (He also said that choosing not to buy insurance isn't economic activity. I think the emergency rooms that pay for it would disagree, but that's beside the point.) That's how he kept framing it - our "liberty" to not buy a product, regardless of the consequences to ourselves or the community at large.

What I kept wondering was... is health care really a product? Or if it is, should it be? When someone is sick, I don't think about my liberty to choose what products to buy to make them better. If the means to make them better are available, I think they should have access to them. They have a right to care. (I feel weird typing that - the part of my brain that's been too long in American politics thinks, 'you don't have a right to be healthy! it's too expensive!' But I know I believe that we as a country have a responsibility to give everyone the best care we can, and that means they have a right to it.)

Thinking of health care as a product we have the choice to buy or not buy, like tea (yes, he compared it to the Boston tea party) seems contrary to how we talk about it and how we feel about it. Clearly, everyone is uncomfortable with the idea of just leaving the uninsured to die - we expect them to have some emergency care available to them, whether ensured by by the government or by charity. So we can all agree that people have some right to care, but above that bare minimum, it's a product? That just feels wrong to me. (Not to mention problematic to implement and expensive - emergency care costs more than routine care, and is higher-risk.) I wonder if, rather than fighting litigation battles over the Commerce Clause as used in the health care bill, we wouldn't be better off agreeing that health care is more than just a product. We can even disagree to what extent, but it'll be a better conversation with that as a starting point, I think.

Morning Musings

I took some time to catch up on my blog reading today, and here's what I'm thinking about...

The New York Times has a beautiful opinion piece from a few days ago titled The Good Short Life. It's written by a man with Lou Gehrig’s disease, who writes thoughtfully and compellingly about deciding to end his life when he's no longer able to take care of himself, rather than have it extended through expensive medical care. It reminded me of a film that came out recently that I want to see, How to Die in Oregon, about the same thing. I think Clendinen, the author of the New York Times piece, is right that we don't really know how to deal with death. Thinking about it makes me kind of uncomfortable, but I appreciated his honesty and his beautiful writing.

Treehugger has a post about a city that offers people the opportunity to trade in their car in exchange for a lifetime of free public transit. As someone who aspires to live in the city and never own a car, I love that idea - though, I guess as someone who hopes to never own a car, I would also never qualify for the free transit! Damn. Still, I think it's a good idea in that it'll reduce the number of cars in use and increase demand for public transportation, which will hopefully allow their public transit system to grow and be more efficient. I do wonder if it might be best for an offer like that to include access to a program like ZipCar - using public transit takes very careful planning, and there are situations where you need to be able to get somewhere quickly on your own terms, I think.

Finally, today's Cheat Sheet at the Daily Beast featured the headline "Wife Cuts Off Husband's Penis." This made me roll my eyes and wonder why I was supposed to care, but then it occurred to me: Why are stories like this of wives' violence against their husbands so much more talked about and widely publicized than (much more common) violence by husbands against wives? Lorena Bobbit was often referenced in high school, but I can't think of any men equally infamous for attacking their wives, and I'm sure it's not that they don't exist. How strange...

Health Care Statistics

I've mentioned before that I don't really understand the health care debate. It's confusing and made up of all manner of deeply engrained systems, attitudes, etc., and furthermore much of the actual intelligent commentary is covered up by people screaming about Death Panels and Nazis and waving signs about abortion, so you have to go digging to even find out anything that's for real.

Today I decided to go digging for statistics, and found that the World Health Organization has a nifty thing where you can pick your country, pick your variables, and get it all laid out on a nice table. So I picked the US and some countries that I'd seen on that Michael Moore movie "Sicko" and some countries that I just think are kind of cool.

For example, one of the variables I picked was "Government expenditure on health as percentage of total expenditure of health." Most countries were in the 70-80% range, so the government pays 70-80% of all money spent on health care. Switzerland was the lowest European spending at 60%, and the United States fell in around 45%. But then the next variable was "Government expenditure on health as percentage of total government expenditure," the US and Switzerland had the highest percentages. I have no idea how that works, and it seems weird. And then there was another column on out-of-pocket expenditure that made even less sense to me - I think I misunderstood what exactly they were calculating - so I ignored it.

We had the highest overall adult mortality rate, by quite a bit, and also for mortality rate from cardiovascular disease, and second highest for mortality rate from injuries, and highest for non-communicable diseases. We had the lowest life expectancy by several years under two different measuring systems, and the highest infant mortality rate - more than three times as high as several other countries.

The money stuff I don't really understand. But something is obviously messed up, and how badly it's messed up seems to be getting lost in all the back-and-forth yelling going on.

It kind of sucks, and I don't feel informed enough to begin to know what to do about it. Except perhaps move to Europe.

The Health Care Debate: I Don't Understand It

This morning I decided I should put a blog post that wasn't college-related or a funny picture, and set off reading my blog roll trying to find something I might want to comment on. I found a bunch of posts on the health care reform stuff, which you may have noticed has been rather big news lately - not the actual contents of the bill so much, no one really cares about those, but the things people say on Twitter about it and the fact that pseudo-grassroots-y protests of conservative crazy have been going on, complete with people carrying (legal) assault rifles and horribly misspelled signs.

Actually, a blog post about how the media's dealt with the not-so-spontaneous demonstrations outside of town halls would be interesting. But I found a bunch of posts about the actual contents of the bill, and decided to check those out instead.

I proceeded to get really confused.

Here's one about the dead public option and how we don't need it anyway, and here's another one about consumer protection in the bill. It all sounds good - no discrimination based on pre-existing conditions, no gender discrimination, no dropping coverage for the seriously ill - but shouldn't it be like that anyway? Everything I know about the health care system I learned from that movie Sicko, so I get that it's messed up, but if these basic things are the awesome reform we're working on it must be pretty seriously messed up. And what about uninsured people, again?

The bill that's being debated right now is a thousand-some pages, and rather complicated. This is, perhaps, which media coverage has focused almost exclusively on rumors and protests. But because of that we're not getting a clear idea of what the problems we're trying to fix are, and how we're going about it. Fail.

So then I gave up on blogs and turned to Washington Post, which ran an article about how video games can help mental illness. This is awesome, and I think health care reform should cover a new PS3 for me.