The State Of The Union – Why The Big Question Of The Day Is “What The Hell Is Going On In America?”

Republicans. They Never Really Did Get The Hang Of Brinkmanship.

Republicans. They Never Really Did Get The Hang Of Brinkmanship.

When I was a teenager, there was a drama on the BBC called “Threads”. It was about what might happen if there was a nuclear war. I vividly remember the scene where the bomb is actually dropped. A young man stares at the mushroom cloud blossoming above Sheffield. “They’ve done it” he says, as he literally wets himself, “They’ve bloody done it.”

This scene was all the more frightening for the people who watched it because there was every chance, back then in the Eighties, that it might become a reality any minute. Though there would have been many who wouldn’t have mourned the destruction of the city of Sheffield too deeply.

I imagine many people in America are feeling the same way as the fictional young man standing in the shadow of that mushroom cloud. Mouthing the same words of disbelief. “They’ve done it, they’ve bloody done it”. Or whatever Americans say instead of “bloody”. Freakin’ or something, probably.

The Republicans have gone for the nuclear option and actually shut down government rather than pass a particular piece of legislation. As a Brit, I find this all very perplexing. I’m not perplexed by workings of American politics, of course. We have a bi-cameral system over here too, though our country is run by the Civil Service really. Our politicians could all evaporate in a puff of smoke tomorrow and everything would run pretty much as normal. The Queen signs all of our laws into existence. No President or elected officials necessary.

What confuses me is the subject of the contentious law. Is Obama trying to ban personal profit? Introduce a Glorious Five Year Plan? Or, heaven forbid, outlaw guns? No, he is not. He is attempting, in the best way he knows how, to cure the sick. Not in a New Testament sort of way. In an “establishment of the National Health Service” sort of way.

The Republicans have blocked him in the most spectacular fashion possible. Rather than allow the tiniest speck of socialism to pass into law, they have effectively shut down America. Nearly a million Government employees will have to take unpaid leave. It will cost the economy at least a Billion dollars.

The question in my mind is this: why is health care the odd one out in the various services delivered to the American public? Everything else is already delivered on socialist lines. Paid for by taxes and free at the point of delivery. Education is free, and indeed compulsory. Nobody receives a bill from the Fire department when its fire tenders’ hoses stop a home from burning to the ground. Insult is not added to injury by the police presenting an invoice for dealing with the victim of a violent mugging. So why is health care such a different political animal?

Now this is the point where I usually offer a clever explanation, usually with a comic call back to something earlier in the piece. That’s not going to happen today, I’m afraid. I’m genuinely stumped. None of the theories I’ve been able to formulate make the slightest bit of sense.  The explanation can’t lie in the interests of Big Business. All centralised health care would mean to Big Business would be guaranteed Government Money on top of all the private health care dollars. After all,Britain has luxurious hospitals too for those who can afford private health insurance subscriptions.

It’s not like the USA will be prone to the “health tourists” that we get in Britain either. That is, people from other countries who come to our shores for free treatment because the people of Britain happen to believe that if you are ill, you should have access to a doctor. In America’s case, Mexicans tend not to be let into the country in the first place and the Canadians have free health care anyway.

Perhaps the Republicans don’t want to be in charge of a healthy country. Perhaps they fear that the principle of “Mens Sana In Corpore Sano” might take effect and that people might come to their senses. They might open their eyes, investigate the “part of a well regulated militia” clause of the Second Ammendment that everyone conveniently ignores and start doing something about Government ineptitude by force of arms.

No, there is only one feasible explanation that I can think of and I don’t like it very much. The behaviour of the Republicans only makes sense to me if America is confusing “technologically advanced” with “civilized”. The measure of any civilized society is how it looks after its poor,  its sick and its vulnerable. So if America is willing to elect people who would rather shut the country down than make sure sick people are able to get medical treatment, then America has to be one of the least civilized countries on Earth.

I’m trying to avoid this conclusion because it does actually make me feel quite sad. Considering its military might, America hasn’t really invaded that many places. Not if you compare it to Great Britain, which invaded pretty much everywhere when it was in charge of things. America has invaded the whole world culturally though.

Much as the rest of the world hates to admit it, a lot of countries really do look to The States for inspiration, or at least for a guide as to how our own futures might go. It is the country in which anything can happen. Unfortunately, as we have just seen, it is the country in which anything can happen, including the Government shutting itself down like some sort of huffy computer. As the saying goes : when America sneezes, the world catches a cold. This is one infection we Brits don’t want. Mind you, we’ve got free health care, so maybe it won’t be so bad after all.

© Copyright Michael Grimes 2013

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About thedailygrime

At that awkward age - too young to be a grumpy old man, but just acerbic and downtrodden enough to have an opinion. Read it here.

5 responses to “The State Of The Union – Why The Big Question Of The Day Is “What The Hell Is Going On In America?””

  1. eden baylee says :

    What a complete clusterfuck, and I’m being polite here.

    The crux of the Republican mandate is to make Obama look bad, at any cost, because like you, I can’t for the life of me figure out their opposition. God forbid the people of the US should have affordable healthcare.

    “Obamacare” is actually a pejorative term coined by Republicans to take the focus off what is the Affordable Care Act. It’s so much easier to attack the president, to call him a socialist, to make him out to be naive.

    It’s a hell of a lot harder to break down why the richest country in the world cannot care for their own citizens.

    PS. I have friends in Sheffied, so I’d hate to see it blipped off the map 😉

    eden

  2. thirdnews says :

    You are wrong in your thinking that everything is free; indeed, any goods and services in your country, or elsewhere, requires a payment. The debate in the US is who pays, why, and the quality of care.

    You are also incorrect with respect to fire services but you have stepped on an excellent example as to the ‘how and why’ argument and choices.

    Presently, parts of the US does have private pay fire services, but the traditional fire department through taxation is most common, than the lesser known service found in rural area (your villages). The first requires no personal responsibility (this in changing with nuisances fines), in fact, you are not obliged to insure your property (subject to mortgage restrictions), and the latter fire service is opt-in.

    In lieu of the burden of taxation, the private pay homeowner is charged a yearly fee, and has the freedom not to so, but, whilst, without a valid contract, the fire department will rescue persons, they will not save your personal property, nor pets.

    Much like paying privately for fire services, healthcare responsibility demands (or at the very least encourages) behavior that benefits society, because the person willing to assume risks is likely engages in no abuse or neglect, and other preventive strategies.

    Foreigners observing the US healthcare debate need to first understand that no person may be refused treatment at any private, or public hospital (by law) but as in the case of the fire service example, their basic needs are met.

    The problem arose, in that mandated medical welfare rates do not fully pay for itinerants, and consequently, the medical community recognized that their losses could be cost-shifted to the vulnerable private payer –ergo, the 10K bill for a broken bone scenario.

    Understand that rates for medical services are not standardized, and indeed the majority who receive their insurance via employment are also paying for services at different per-negotiated rates. In fact one insurer may have an agreement to pay their contracted hospitals ten thousand dollars for a appendectomy, while another insurer, may have negotiated a rate of 5 thousand –it is that varied.

    Naturally, the pool of ‘private payees’ (those who opt-out of insurance but have the means to pay) was always small, and their has been a secondary cost-shifting of unpaid goods and services to pool insurance AKA, employment insurance. Consequently, there has been an interest in true cost sharing of the unfortunate but your invisible politics got in the way, and resulted in the further involvement of lobbyist seeking their share of the pie. Unfortunately, the resulting in rules and regulations have that not only increased pricing, but further put a wedge between the patient and doctor.

    The collaboration between special interests, the medical community, and politicians have also resulted in absurd rules and regulations increasing the cost for the practice of healthcare too. Best exampled in the mandated paperwork/procedures were Obamacare is forcing doctors to go from the ridiculous 18,000 codes to 140,000:

    A sample below:

    http://www.emrandhipaa.com/emr-and-hipaa/2011/09/23/crazy-and-funny-icd-10-codes/
    R46.1 is “bizarre personal appearance”
    R46.0 is “very low level of personal hygiene”
    W22.02XA, “walked into lamppost, initial encounter
    W22.02XD, “walked into lamppost, subsequent encounter”
    V91.07XA, “burn due to water-skis on fire”

    With respect to your question, “So why is health care such a different political animal?” For varied reasons:

    It turns out, the “spreading of the risk” is really not a device to help
    society’s less fortunate but a regulatory program that depends on the young laborers to pay for the bulk of everyone’s care.

    It turns out, political lobbyist have guaranteed that an intrusive personal information gathering program with questions like “how often you fuck?” is now part of my healthcare. Why the government needs to force the doctor to ask this question, and other invasive personal inquiries is a mystery to me, but I’m damn sure its profitable to someone.

    It turns out, lobbyist representing businesses in the healthcare industry are going to profit at my expense, and as a result I will pay more for less care, and the unfortunate will be in the same shitty place because eventually, the money will run out, and they will be the first to fall under restrictions of care

    It turns out, Affordable Health Care Act (Obamacare) is not so affordable -I like many have been informed that the promise the President made about being able to keep your insurance isn’t true. I have been offered three more expensive options that I do not want because they include services that will never be required.

    It also turns out, doctors and hospitals are opting-out of low insurance refunds and are not going to automatically accept the new Obamacare insurance that I was forced to buy, and I will have to pay cash if I want to use their services, or keep my records private that will now be shared with a ridiculous amount of governmental agencies.

    BTW, the politics with respect to the government shut-down is an even longer reply but I suggest you read the POV of both sides , and further investigate the discrepancies to come to an educated conclusion.

    • thedailygrime says :

      This is what happens when you do everything by committee. Congress hasn’t passed a budget fully and on schedule since 1997. I think they were inspired to do this by the “I’ll tell you what I want, what I really, really want” line in the excellent Spice Girls hit “Wannabe”. They really, really wanted to pass a budget, and therefore they did.

      In Britain, we successfully pass a budget once every six months. The reasons for this are twofold. Firstly, the budget is devised by and implemented via a single man, the Chancellor of the Exchequer. He takes his plan, concealed in a red leather briefcase, into the House of Commons – the lower house of our bi-cameral system. He then reads out exactly what the budget will be. There is no vote, although there is a great deal of booing when he announces a raise in petrol duty and a great deal of cheering when he announces that he is freezing the levy on whisky and cigars. He ALWAYS raises petrol duty and he NEVER raises the levy on whisky and cigars.

      Secondly, as a country, we HAVE to successfully pass a budget every six months due to not having a pot to piss in.

      The reasons we don’t have a pot to piss in are also manyfold. Poor money management recently during what was very obviously an unsustainable boom, the squandering of our North Sea Oil revenue, but mainly it is down to paying for the National Health Service. You are right, “free” healthcare is really fucking expensive. But Brits wouldn’t have it any other way. Norman Lamont, one our previous Chancellors of the Exchequer, once famously said : “The NHS is the closest thing Britain has to a National Religion”. Any political party who overtly dismantled it would be un-electable for a generation. This is why the current Tory government – they’re our equivalent of the Republicans- is currently covertly dismantling it. The NHS is more and more being split into “NHS Trusts”, which are effectively independent businesses, albeit government funded ones.

      In our rural areas, the fire service is paid for by local taxation and staffed by highly trained but entirely unpaid volunteers. Insurance companies in Britain used to offer private fire protection, but we got rid of this system and went for a more centralized “if it’s on fire, just fucking put it out” approach around about 1825.

      Will Obamacare cost a lot of money? You bet your ass it will. But if it goes through, it will finally let America join the list of civilzed countries. A list which, it pains me to say, includes France.

      Thanks for showing an interest in my blog

      Mike.

      • thirdnews says :

        We do have a pot to pee in, unfortunately, it is provided by the Chinese. Frankly, those of us with the foresight to be concerned with the consequences, could use a vomitory instead

        France is civilized? Lol

    • Matt Precey says :

      Thank you thirdnews for the most lucid explanation of the Obamacare refusenik position I have hitherto come across. Lobbying is the enemy of evidence based policy making. Grimesy – you’re attracting a better class of commenter these days!

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