Friday, April 23, 2010

NV-Sen: Suzy Lowdown & Barter-care... Seriously



Progress Now Nevada has a new "Chicken Sue" action item up, and I really like their explanation of why Suzy Lowdown's "Barter-care" system doesn't work.

Sue Lowden (aka Chicken Sue), Nevada Republican candidate for Senate, thinks that the way to deal with skyrocketing health care costs is to have people barter with their doctors to trade good and services for health care.

While casino owning multi-millionaires (whose home has eight bathrooms and six fireplaces) might be able to pay cash for serious medical care, most people can't. In fact, we're pretty sure that's why the health insurance industry exists in the first place!



Now blog-master Steve Friess, who we're usually in awe of, actually tried to rationalize "Barter-care" yesterday on his blog. And while the arguments on the surface may seem to make sense, further analysis just destroys any argument that bartering makes any sort of sense.

- What if one has little or nothing to barter with? There's a reason why we've had 47 million uninsured Americans: The vast majority of them can't afford health insurance. So what makes us think they can afford to barter? Bartering means one has valuable goods to exchange for other valuable goods.

- What if one is already too sick and/or disabled to offer services? I know the next line of argument is: "Well, they can offer to paint a house or mow the lawn!" But come on, what if we're dealing with a cancer patient or someone with a broken back or an Alzheimer's patient? Should we expect them to try to mow the lawn or paint the house?

- What if the doctor just won't take a chicken or an offer to paint the house? These days most doctors work as part of management teams, and these management teams are far less likely to be able to offer special deals for their patients than those in private practice. Since all the doctors in the management team signed contracts spelling out acceptable rates and discounts, they can't just break the contract and put the business in jeopardy to barter. And by the way, this is also why paying cash most often doesn't work in reducing costs, either.

While many doctors may be compassionate people willing to help those in need, the staff still need to be paid and the medical suppliers expect to be paid. This is why neither bartering nor "pay-for-cash discounts" work as an entirely new health care system. And if you don't believe me, read what Steve Sebelius has to say this week.

Now of course The R-J is ignoring this story because it doesn't help their "anointed one", but all the rest of us reality-based folks have been (rightly) mocking Suzy Lowdown's "Barter-care" as ridiculous. But if the GOoPers really want us to take "Barter-care" seriously, then... Well, they still look ridiculous. Only this time, it isn't even funny. Unless one is super-rich and/or perfectly physically fit AND has a doctor in a private practice that doesn't have to deal with HMOs, "Barter-care" just doesn't work.

Now contrast this with the health care reform package that Harry Reid helped pass and President Obama signed into law last month. Take a look at the many benefits coming here to Nevada starting this year. I mean, just look at what we're getting.

What Health Care Reform Means for Nevadans:

No discrimination against people with pre-existing conditions.
Ban on insurance plans dropping you if you get sick.
Ban on lifetime coverage limits and caps out-of-pocket expenses.

What Health Care Reform Means for Seniors:

Closing the Medicare Part D donut hole – an immediate $250 rebate; 50% discount on brand names next year; and fully closed by 2020.
Free preventive care under Medicare – no co-payments and deductibles.
Help for early retirees – temporary coverage for ages 55-64.

What Health Care Reform Means for Women:

Ban on gender rating that results in higher premiums for women.
No discrimination for pre-existing conditions such as having had a C-section or being the victim of domestic violence.

What Health Care Reform Means for Small Businesses:

$40 billion in tax credits for small businesses to help them offer employee coverage.
The same access to quality, affordable coverage that large firms have today.

Now yes, we know the final package isn't perfect. We've talked about this extensively here. However, it goes a long way to set up the framework for a workable universal health care system and it's far superior to anything Suzy Lowdown and her GOoPer buddies are proposing. This is something we need to remember as discussion continues on "Barter-gate" and the coming GOoPer attempts to make it sound rational. It isn't rational, it doesn't work, and we're far better off leaving in place the historic health care reform legislation passed last month and instead building upon it to improve it.

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