Tuesday
Mar232010
Obama and Health Care: Scott Lucas on BBC World Service
Tuesday, March 23, 2010 at 6:38 
I spoke, alongside the Global Post's Michael Goldfarb, with BBC World Service's Newshour yesterday about the passage of the unprecedented health care bill by the US House of Representatives. I found myself in the position (some might say unusual position) of being more optimistic than both BBC correspondent Mark Mardell and Goldfarb, both about the event and about Obama's political future.The item begins from the start of the programme. Julian Marshall's interview with Goldfarb and me begins just after the 6-minute mark.
Reader Comments (24)
Good points (polarisation as a bit of a media construct)...Mr. Lewis!! ;)
@ Scott
Looking with European eyes to the amazing and „unprecedented health care bill” made by Obama with the help of Mrs. Nancy Pelosi – the most newspapers today are busy in pointing out the rifts in the American society – between those who are pro and contra the bill. Well – I don’t wan `t to take the arguments on the side of the “contras“ to serious – because in my opinion they are “ from the really dark side of the moon”. Looking to the long history of the development
of the “health care bill” there is absolutely no doubt - it’s a big success fore Obama.
Success makes stronger – but surprisingly there are a lot of voices saying the opposite. No need for quick answers – but it should be interesting how this great performance will affect other American policy areas.
I agree with that assessment. The use of buzzwords (socialist - "socialized" medicine) almost always leads to exaggeration, hyperbole,...and fear. Wasn't President Nixon's health care plan more radical than Obama's?! Dr. Lucas is probably old enough to remember it. He might know...?
http://www.kaiserhealthnews.org/Stories/2009/September/03/nixon-proposal.aspx
I've never had much patience to try and understand the huge opposition to a (to most europeans and others) simple obvious thing, provide health care to all.
Apart from all the technicalities and hype of the worst republicans, (communists getting their foot in the door... loss of freedom to choose, bla bla), I do seem to have read somewhere, some time ago that the origin of this attitude comes from a sort of weird christian / pioneer interpretation, that is basically : everyone has the freedom to improve their lives, and if they don't, they are lazy bums, and in any case it's god's will (born with some sort of sin).
This cruel attitude goes on with 'we don't care what happens to poor people, but we have charities that help them'. Charity, replaces state financing, and charities keep the state from having any say in peoples' private lives, and gives a bit of relief from any guilt.
Is this true ?
Pessimist -
Unfortunately I am stuck at work and do not have time for a lengthy response, however, while much of the right in the US would have "conservative Christian" values, I think to link any opposition to the Obama healthcare plan to "a sort of weird christian/pioneer interpretation" is a bit of a stretch. I would argue Chrisitians would favor, conceptually the concept of helping those in need (kindness not just being a virtue of Christians but a fundamental belief). Instead my opinion is it stems from the age old argument in the US of "big" versus "small" government. This is the biggest divide between democrats and republicans throughout history. Also could add fiscal policy differences as well, but many of the arguments I hear are more to the concept of what role government should have in healthcare. Personally I am tired of the partisan debates..if you are not aware not one republican voted for the bill (e.g. Obama's "reach across the aisle" efforts have been ineffective at best)...and believe the vote is reflective of this.
To your point about charity...I also do not think this can be applied at a party level. Note many republicans are in favor of extending benefits to the poor, again it comes back to fundamental disagreements about how to do this...government or markets?
Scott
"Dr. Lucas is probably old enough to remember it." from Dave. :) HA HA I am expecting a retort for that one. Come on when was a six year old going to remember who the President was let alone his health plan!!! Agggh geez but it was funny none the less!
Thx
Bill
USSA--United Socialist States of America
The title is more of play on words and an expression of my angst regarding this legislation than it is being 100% the truth. My angst revolves around the fact our government has shown today it cannot handle Medicade or Social Security. What makes anyone think they are going to be succesful handling healthcare considering the aforementioned disasters? I'm sorry this is a recipe for disaster letting government effectively manage 1/6th of our economy. While it will be helpful in some cases I think in the long run the "depedency" it will breed will make it an even bigger disaster than SS or Medicade.
Here are some words from Thomas Jefferson to ponder:
"The democracy will cease to exist when you take away from those who are willing to work and give to those who would not."
"The majority, oppressing an individual, is guilty of a crime, abuses ...its strength, and by acting on the law of the strongest breaks up the foundations of society."
Thx
Bill
He was born in '63...if I recall correctly. He remembers the era... His dream car is a 1969 BOSS 429 Mustang, and he grew up watching Richard Petty and Darrell Waltrip make the laps at Talladega.
http://en.wikipedia.org/wiki/File:BOSS429.JPG
Dave,
Just poking some fun!! :) No harm meant! By way the ford's are for wimps. I prefer the Viper!!! Nothing like 600hp to wing around--that is if it's not ranning or snowing--then you better know how to drive sideways!!!
Thx
Bill
"He was born in ‘63"
Snigger - snigger. :) That was when I was in my prime - unfortunately, it has been all downhill since then! :)
Barry
@Bill
"What makes anyone think they are going to be succesful handling healthcare considering the aforementioned disasters?"
At the moment I can`t tell you a democratic country in the world without a "health care" sytem. Take the chance and have a visit maybe in Sweden ore Netherland or wehrever you like to learn how this systems are working - and you will find out a top secret: :)Health care systems and Socialism is the same as a bicycle and a fish - no connections are possible to find. While listening to this discussions I think:
Maybe US is different - its the country of 1Million chances - and even the fish
are riding bicycles. ....:) and Congratulations to your socialistic Presidents like
Nixon ( first try) Clinton ( 1993/4 ) and Obama :)!!
@GUNNI
We here in Australia also have a Health care system. It has a public element to it as well as a private element. ALL people therefore have access to health insurance, whether they are employed or not. All people who have an income (whether that be from wages, investments or business pay a small percentage of their income to be able to access the public side of the health system (both doctors and hospitals). If you wish, you may also take out additional private health insurance which you pay for and which gives you access to private hospitals. .
The public provision of access to doctors and hospitals is good - but not without limit. The private provision of these is better - if you can or choose to pay for it.
I am no "liberal" or left winger - but I can't really understand the deal in the US - such antipathy to what should be a feature of all modern civilized countries.
Political ideology can certainly get out of hand!!!
Barry
@Barry
Its difficult to me to be serious :)- Barry - what you told us it`s enough for some americans to identify you as a reall Socialist :) so take care - exspecially if you
want to make a trip to US. :)
Regards gunny
Here are some words from Thomas Jefferson to ponder:
“The democracy will cease to exist when you take away from those who are willing to work and give to those who would not.”
“The majority, oppressing an individual, is guilty of a crime, abuses …its strength, and by acting on the law of the strongest breaks up the foundations of society.”
********
Bill,
Thomas Jefferson also said, "all men are created equal." It's in that yellow piece of paper that's sitting in the National Archives. I may be a lowly school bus driver, but I do work. I am a lifelong US citizen, I pay taxes and I am entitled to an affordable health care plan. Any government plan would be acceptable to me. I have nothing and a government subsidized plan would be something. I recently failed the Department of Transportation's annual physical exam. Why, you ask? I needed corrective lenses. How much money do you think I lost that week? $200? $300? Nope.... try $500. Not only did I have to buy the glasses, I missed a day and a half of work. I don't get paid when I don't work. I couldn't return to work without the glasses. The doctor also urged me to see an opthalmologist. Yeah, I'll just give him my secret recipe for apricot wine sauce as payment. ....It's not going to happen.
The popular mantra among teachers is "I touch the future. I teach." Well, here's mine -- "I transport the future. I drive YOUR children to school." By the way, do you truly believe that distraught mothers looking down on their sick kids would reject affordable health insurance offered through a gov. plan just because a politician calls it "socialist?" It's people like you who are susceptible to such buzzwords because you never think you could ever be in such a vulnerable position. But your kind is always the first to piss and moan about the injustice of your situation.
This country has become a cesspool of political stagnation, with too many people making up lies -- "Reform is always a bad thing." Riiiight......
Dave,
I can't remember what happened last week (just ask those who put up with my absent-minded ways), let alone in the Nixon years.
S.
...but stock car racing and Talladega are always remembered --- some things are too precious to lose.
S.
Dave,
I am sorry to hear about your sitution and I know a sorry is not going to pay the bills. My whole arguement is not meant to attack people like you but against the concept of governement managing it. We needed the reform to curb the greed of the Insurance companies but not for the government to control everything like it plans. My fear is they will manage it into the dirt just like they did SS and Medicade. As for me I have a personal story that relates to this.
When I was born in 1968 I had a very very rare condition that should have killed me. Instead I got lucky because the doctor who operated on me had taken part in some experimental programs that allowed him to save me. That program was not government funded but private and without I would not be here today tormenting all!! :) But I am and it is simply because, in my view, privatized medicine based on profit loss will alawys be on the bleeding edge so as to remain competitive. The fact remains these advancements made to remain competitive and by extension has resulted in the most the most advanced health care in the world. Nationalized health care takes the gain out of it and thus the incentive to innovate has very little focus. This may be harsh but the reality is we have what we have because we keep investing in it to improve what we have. Government does not base it's functions on competition because it has none and thus has very little desire to innovate. Look no further to any former communist state or Iran to see what damage nationalized industry does for the well being of the people it is meant to serve. More government simple means more dependency and less overall progress over time in my view. We needed reform but it should have been more targeted to help those in need like who already contribute to our nation. My fear is this dependency will only create stagnation and over time degrade the quality of health care we can provide.
Thx
Bill
Gunni,
Sweeden has done well with their system and I know the US studied it. However like most systems their issue is the problem of rationing, quality, and dependency. Ironically you know what they did to alleviate this issue was to reintroduce privatiztion!! Maybe at the end of the day a hybrid system that Barry lives under is something that will be the best answer. As for my word of "socialist" it was a play on words. I realize while their are socialistic aspects of the US health care system it is not full blown socialism. My worry, as I related to dave, is the issue dependency, quality, and the fact it will stifle innovation. Government is meant to govern not manage. Private business will always do better because of competition and the fact they will go out of business if not accountable.
Thx
Bill
I was going to stay quiet on the healthcare legislation.
Dave, I have news for you. With this healthcare legislation you will lose a month and a half and not a day and a half to just see an eye doctor. Then you have to wait another month and a half to get your prescription glasses. When you get your glasses you realize you cannot read a thing. You take it back and they tell you things got messed up in the lab when they were making your glasses. It turns out the guy who was making your glasses was in queue to see an eye doctor himself and, therefore, he could read the prescription your doctor had written. So you have to wait for another month to get your correct prescription glasses. In the meantime you are still losing $500 per week because you cannot drive that school bus but what the heck you still have your government healthcare card.
To Non-U.S. readers,
Being for or against this legislation has nothing to do with your political party affiliations, it is not because you as an American are or are not a generous and charitable person, it is not because you do or do not care about those who are still chasing American dream, it is not because you have certain religious affiliations, etc. It is simply a matter of our constitution that afford us the right to choose the size of our government and the power we bestow upon it. Those who oppose this legislation believe institutions that are run by government are inefficient. They believe this legislation that is 2700 pages long not only will not solve the problem of uninsured but it will bankrupt the country. Many lawmakers who voted for or against had not even read this darned 2700- page monstrosity of legislation. Citizens were not given an opportunity to read and digest it.
Unfortunately, the mess and the mayhem have just begun; whether we were for it or opposed it. Problems are too many to enumerate here. Needless to say that State after State is lining up to bring legal action against Federal government on constitutionality of this legislation with regard to Commerce Clause. I assure you this will go all the way to the U.S. Supreme Court for decision. In the meantime we the citizens, whether for it or not, will have to pay the litigation cost.
In my view we need to find a way to help those who do not have access to medical care. The legislation that passed, however, is the wrong medicine for both people who currently have medical coverage and those who do not. There were better ways to do the job and this was not it. A government-run healthcare program is a poison and not a cure.
I have a better plan to cover people like Dave. Under my plan Dave chooses his insurance company, his own doctor and the lab that makes his corrective lenses/glasses.
@ Megan
I highly estimate your strong – worded contributions - I read all of them in the last sad months with all the stirring events. Maybe with your permission I would like to take your last comment into a broader context. At first it’s possible to say: If you compare - just as an example – the history of Iran and the US you could say: America is a Baby – boomer – more than 300 million people with an average BIP of 46.000 Dollar per inhabitant
and they are youngsters – just only 221 little years old. And what is interesting to us: The process of Nation – Building is still not finished. JF Kennedy put it into that famous question: What can you do for the country and what is the country doing for you?
And that’s the point you told me/us: The understanding of the function of state in the US is different if you compare it to others.
At second your lively description about the destiny of the “poor” wearer of glasses is convincing – like always.:) But I think that your example didn’t gave an answer why Nixon, Clinton and Obama were busy to start developing health care:
a. Health care in the US is very expensive – to much money for the poor
people
b. The current regulations are unethical
c. How can it be that people’s health is just only a question of money?
d. The relevance of money in the most views is highly overestimated
e. Current regulations are saying in clear words: If you are poor,
You are a substandard member of society
f. How can it be that health is a question of charity?
Just some thoughts to think about the tasks of the state and the duties of the government.
My impression: The ferryman Obama will make it. By the way – I can’t imagine
the new Iran without a state run health care system – it should be one remedy
to redistribute the income of the state – but that’s only a opinion of an outsider.
Best regards gunni
"I have a better plan to cover people like Dave. Under my plan Dave chooses his insurance company, his own doctor and the lab that makes his corrective lenses/glasses."
*********
Megan,
The American people are tired of fighting with insurance companies. They don't want to hear that a CT scan or MRI scan they are about to receive will not be covered by their insurance plan. And insurance companies don't want to pay for these services if they really are unecessary. And doctors don't want to conduct a battery of tests in the hope of avoiding a possible lawsuit due to mis/wrong diagnosis, which also drives up the costs.
The status quo is not acceptable.
Megan,
Well said and probably one of the best short arguements against gov't run healthcare I have come across to date. I think to many people think to much in the short term instead of the relly gauging the long term effects. The fact remains government is not as accountable as private industry and thus it will degrade over time. Yes more will get access but the question will be is the quality going to stay the same.
What was also further frustrating about this whole event was how the Obama administration rammed it down everyone's throats. Poll after poll showed the majority of Americans did not want this plan and yet they still went forward with it using tactics he said he wouldn't employ if elected. To boot he said jobs was his number one priority yet healthcare turned out to be his foucs!!?? Argggh!!! And to think, me being a Republican, I was one of his biggest supporters--I feel betrayed.
Thx
Bill
gunni,
a. Health care in the US is very expensive – to much money for the poor
people
Yes but more often than not when in critical situations they get the care they need. It is not perfect but they don't always get turned away. I do agree health care costs are way to expensive and the way to combat this is to tackle in the Insurance providers. I say that because Insurance carries, under the protection of federal and state laws, largely operate as monopolies within their states. The best answer to this is to allow carriers to compete across states. Doing so will decrease costs. A perfect example of "real competition" doing this was the deregulation of the airline industry that spawned the discount carriers. When this was done airline cost became afordable for many more. Health care can do this as well but it can only be done by stripping the monopoly powers of Insruance companies.
b. The current regulations are unethical
Very big point and I touched on it above. Another issue the draconian rules on who gets insurance and who does not. The whole rule of pre conditions needs to be revamped so insurnce companies cannot use this to avoid providing coverage.
c. How can it be that people’s health is just only a question of money?
In a perfect world you would have a point but the fact remains costs will always dictate the course of events. The people, government, and providers have limited funds and to ingnore the money issue is a recipe for disaster. Costs hold people accountable and to ignore it will only delay and worsen the problem down the road. Money is also a motivator for innovation. You take the prospect of gain out of it why in the world would the health care bother coming up with better care if then know they cannot recoup costs or make a profit.
d. The relevance of money in the most views is highly overestimated
See my point above.
e. Current regulations are saying in clear words: If you are poor,
You are a substandard member of society
That is an over generalization. In the US opportunity abounds. It is up to the individual to take advantage of this to maxmize his or her potential. I grew up with out much but worked my ass off to put myself through college to get were I am. Yes I had better conditions than some and that comes into play. However, I do have friends who started far worse off and yet somehow eclipsed what I have done. Their simply motto is "the opportunity is there to be taken if you have the will to do it." It is not my fault some are not willing to do what I or millions of other Americans did to achieve what they got. I also treat everyone the same regardless of their financial well being. Poor or rich does not register in my mind when dealing with another person. What registers is a person willing to work for what they want out of life. It is not always equal but do you really want to live a life were everything is equal and we are all just drones in a monoculture.
f. How can it be that health is a question of charity?
For those who can't afford it today it is often given as charity and the US is one of the best in the world doing this for its own citizens and others around the globe. However I still believe people must work for it as they do for anything in life. The more effort put in almost always gurantees a better product or service than that given freely. The old saying fits well--"you get what you pay for." Charity as we have seen also breeds dependency on the handouts. It is why the welfare states in Europe have a huge issue with it. They even have people who have stated on talk shows the benefits are so good it make no sense to get a job because they would have less money.
"...it should be one remedy to redistribute the income of the state"
This statement is a key point of socialism and one I am strongly against in a society like the US. It was also one of my main sticking points with Obama. Why on earth should I have to pay for someone else who more often than not is unwilling to work for what I have? This again harkins back to my description of a drone like monoculture society. Yes captialist societies create immense income gaps but what most miss is the bar for all is dramatically raised including the poor as well. Our poor in the US would be the middle class in many parts of the world! Redistributing wealth unchecked is plain and simple socialism and takes the incentive out of everything. You take that incentive out you inturn take the foundation out of captialism and free markets. What is their to work for if everyone gets the same. The US got to the level it has because our society encourages all to be individuals and to work for everything they have irespective of "communal gains." The simple premise was the gains of individual responsibility/liberty would be far greater than that of socialism. I would have to think the success of the US clearly demonstrates this. It is no mystery that the countries that employ free markets, captialism, and individual liberty are the most succesful. On the other end of the spectrum the socialist, monoculture, and group rights countries clearly lag behind everyone else including the access and quality of health care. In the end while the civilization born out of the constitution of the US has its flaws it has also by far provided much better for its people than any other over time. We all about change but you have to show us something actually works and socialism is not the answer.
Thx
Bill
"To boot he said jobs was his number one priority yet healthcare turned out to be his foucs!!?? Argggh!!! And to think, me being a Republican, I was one of his biggest supporters–I feel betrayed. "
******
This is a related issue. Legal and illegal immigrants can have free access to health care, but I can't. And both Dems and Republicans are happy to provide a fast-track pathway to citizenship, and they know the toll this is going to take on the health care system. Question -- What will be the first things to go as these workers age? Answer -- back and knees. The vast majority of immigrants work in construction and agriculture. See the point I'm making? Legalizing 20 million (or more) immigrants will add to an already strained health care system. I am not against immigration, but this issue should also be as the forefront of the debate on health care.