Tuesday, July 28, 2009

tom tomorrow and the basics of health reform

tom tomorrow on health care reform (click to make bigger):

the fourth panel happens to be one of my current fascinations with the health care debate: how many conservative criticisms of the democrat-sponsored bills have no relation whatsoever to what is actually being proposed.

critics on the right regularly compare the reform plan to "socialized medicine" or the systems they have in canada, the UK or cuba, when the plans that have been proposed are none of those systems. i would say the vast majority of criticism in the media doesn't apply at all to any of the actual bills in congress. the critics depend on the ignorance of the public to scare them into believing that "obamacare" is something that it's not.

actually, i'm pretty sure that a lot of conservative mouthing off on healthcare themselves are pretty ignorant about what different health care systems are and how they work. a lot of them don't seem to be aware of even the most basic concepts in the health care world: like the difference between health care itself and health insurance. or the difference between different kinds of universal health care models, like "socialized medicine" (i.e. the beveridge model where health care providers are publicly employed), "single payer" (i.e. private health providers with public insurance), or the bismarck model (i.e. private health care providers and both private and public health insurance with the insurance industry regulated to enforce universality, minimum standards of coverage, and cost control). the bismarck model is clearly what the obama administration is aiming for, but you would never know it from listening to conservatives. that's because most conservatives don't know it either.

anyway, a good summary of the different models is here. our current system is the fourth "out-of-pocket" model, the one that prevails in the poorest countries of the world. however, our system also has add-on elements of beveridge (e.g. the VA system) and single payer (e.g. medicare and medicaid) that apply to only certain people. those other elements do tend to take some of the bite out. if we didn't have them, i wonder if comprehensive health reform would be easier to accomplish.

(TMW cartoon is from here and is via susie. frontline link via yglesias)