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In response to Paul Krugman's op-ed piece in the NYT on our busted health care system, Matt Stoller has a compelling post entitled "Universal Health Care Run By Psychotics," which I would retitle "Universal Health Care Run by Hoodlums."  He outlines that we in fact do have a perverse sort of universal health care, in the form of outrageously expensive and inefficient emergency wards — "it just works through pushing costs to states and localities and shunting people to emergency rooms where they die faster and their care costs more," says Matt. 

I'd like to add a sidebar to that.  Yes this is the only form of health care available to most Americans, but with the passage of the Bankruptcy Bill last year that left no exception for those with catastrophic medical expenses, the government became a de facto enforcer for a bunch of medical loan sharks.  Now there is no relief for those who still have means, no matter how meager, to pay those debts — nothing to help them escape working in a form of indentured servitude to their medical creditors for the rest of their lives. The whole system conspires against them — collection agencies, credit reporting agencies and the courts stand at the ready to destroy their credit and redouble their original debts with outrageous interest and collection fees and force them into payment by seizing their assets and their wages with no regard for their medical condition or other mitigating factors in their lives.

Said Ryan Spear writing at TPM:

The infamous “millionaire’s loopholes”—which allow rich filers to hide their wealth by buying mansions or special trust funds—were carefully preserved. At the same time, the bill raises the price of filing even for the lowest income earners and eliminates a judge’s discretion to discharge debts if people go bankrupt due to medical emergencies, job loss, or divorce.

It is a system both draconian and obscene.

Matt's post is also worth reading for a rundown of the players who will conspire to kill any move toward universal health care, most notably Tom Donahue, the Chamber of Whores and the insurance industry.  It's also a good recounting of the missteps made by the Clinton Administration as they tried to please everyone with HillaryCare and ended up pleasing no one.

Says Krugman:

But now is the time to warn against plans that try to cover the uninsured without taking on the fundamental sources of our health system’s inefficiency. What’s wrong with both the Massachusetts plan and Senator Wyden’s plan is that they don’t operate like Medicare; instead, they funnel the money through private insurance companies.

Everyone knows why: would-be reformers are trying to avoid too strong a backlash from the insurance industry and other players who profit from our current system’s irrationality.

But look at what happened to Bill Clinton. He rejected a single-payer approach, even though he understood its merits, in favor of a complex plan that was supposed to co-opt private insurance companies by giving them a largely gratuitous role. And the reward for this “pragmatism” was that insurance companies went all-out against his plan anyway, with the notorious “Harry and Louise” ads that, yes, mocked the plan’s complexity.

Now we have another chance for fundamental health care reform. Let’s not blow that chance with a pre-emptive surrender to the special interests.

He's right.  Appeasement only sowed the seeds that the lobbyists used to destroy universal health care in the first place.  Let's not make the same mistake twice.