Monday, May 8, 2017

Healthcare gridlock: "I've got mine!"

The simple truth of the matter is that most Americans have access to affordable health care.


People who have a secure deal want to keep it.  They don't want others diluting what they have.  They don't want to pay for others to get what they themselves have.

Fox News lets in a little light: hospitals are like flying.  People like their privileges.

Fox and Friends is said to be Donald Trump's favorite show on his favorite network.  We got a glimpse of an underlying reality of the health care policy.  People who have health care insurance through the current system like it and defend it against dilution.

The story was teased, prior to the commercial, by the Fox hostess saying that her upcoming guest tells the story of her husband's 2008 heart attack.   "He would have died if he had had Obamacare!"   

The story was the wife of a Washington Times columnist who had a heart attack at his desk.  He had excellent private health insurance, paid for by his employer, the wife said.  He was in the hospital for two weeks, with several setbacks, but then recovered.  The insurance paid for everything except a portion of the helicopter ride to the hospital, she said.  He got excellent, aggressive treatment, which he needed.   But if he had had second class government paid health care maybe the hospital would not have done so much, she said.  
Obamacare would have killed my husband.   

President Trump's favorite TV show.
The Fox hostess drove home the point:  You must be so grateful there was no Obamacare then because Obamacare would have killed your husband.  She closed with a question for the wife, "Wasn't health care really excellent back in 2008, before Obamacare?"   Yes, the wife said.  'It saved his life."

This little story packs in a lot of elements, including the relentless partisanship of Fox.  But more interesting is the two parts that are unintuitive and provide real insight into the Fox/GOP position.   The first is that it presents the 2008 status quo as the health care ideal, focusing on people with employer paid insurance.  The second is the assertion that had the treatment been paid by the government it would have been worse because government patients would not have gotten the same level of care as private employer-paid insurance patients.

Heritage Foundation study
Note that the majority of Fox viewers are--like me--on Medicare, a government paid insurance program.  The show did not suggest that Medicare paid patients get less care but it said outright that Medicaid paid patients did.   The criticism of Medicaid was not that the taxpayers paid for it; it was that it isn't quite good enough.  

Doesn't this imply that Fox really wants more and better healthcare for everyone, with first class aggressive treatments available for more people?  No.  Wealth and status has its privileges and Fox wants to maintain that social order.   It is not a complaint that Medicaid lacks the public investment.  It is a reassurance to people who have a superior status that their situation is, in fact, superior and worth maintaining. 

Fox understands a practical and political reality: most people in America have healthcare access, one way or another.  Seniors have Medicare, veterans have the VA, and most important, most employees in jobs with larger companies have insurance.  People with political power in America--people who vote or donate to campaigns--generally have worked out some sort of health insurance access for themselves.  

There is an implied loss to the first-in-line status of private paid insurance patients, especially people with superb insurance plans with complete coverage.  Either they might have to share the benefit with mere Medicare patients--or worse, with Medicaid patients--or more generally the level of hospital care will fall to a "government standard" versus a "really great private plan" status.

This is not merely a tax and budget issue.  It is a pecking-order issue, implied and imbedded.  
Passengers like this

The airlines understand the importance of this.   Even for people in the same seating area, the Gold star" passengers board before the "Silver star" passengers who board before regular passengers. They take and fill up the overhead bins.   The implied problem is that new Obamacare passengers will board along with the Gold and Silver passengers, removing the privilege.   Pecking order matters.   People on the cusp of a passenger status routinely intentionally take unwanted flights to get up and over into a higher flight status.

The Obamacare Threat
Fox was not talking to people who lack access to insurance but do not have it.  The story today was not about inclusion.  It was about maintaining privilege, and they are tapping into a strong human desire.   Whatever ones status, employee with private insurance, Medicare, Medicaid, people want to keep what they have.  Obamacare became unpopular when Obama's assertion that if you liked your health insurance you can keep it became untrue because insurers cancelled their own policies.  

 Fox was talking to people who have healthcare access, at whatever level it is, and do not want to share it.  Passengers in coach are admonished not to use the lavatories in the premier cabins.





1 comment:

Thad Guyer said...
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