Careful What You Wish For

Hope this is what you wanted.
Hope this is what you had in mind.
'cause this is what you're getting. -- Tool, Ticks & Leeches

Sandra Day O'Connor is finding out what a lot of Americans have known for years -- that we do not have a functional health care system, we have an insurance system. I suppose it would be easy to simply brush this away with the sheer blistering contempt of the first commenter in that post, but personally I'm actually kind of bemused.

I sort of get the same vague sense of unease I would from, say, a mining disaster in a deep red state, small towns festooned with ribbons and vigils and other such totems, maybe a preening asshole of a mine owner trying to convince everyone that his unsafe death pit wasn't his fault. Isn't this what you wanted, the unfettering of free markets from pinhead bureaucrats and regulatory obstruction? Didn't your guy promise you that since business always knows best and proceeds accordingly, that you are better off with an industry that scoffs at pissant fines that pile by the hundreds, written in scrip by a toothless oversight agency?

For once, I'm actually not being mean or sarcastic -- wasn't this the idea, at the end of the day, in backing self-styled free-marketeers, in giving them responsibility for keeping an eye on inherently dangerous industries? You voted for people who were pretty upfront about their desire to return to a Gilded Age industrial oversight policy. Remember? Hey, here's an idea -- let's trust gross polluters to clean themselves up. Let's let mine owners cut corners and treat fines as the cost of doing business. What could possibly go wrong?

It's the same with the health-care industry, except even more so, since it obviously affects everyone pretty directly, and both parties are more or less firmly ensconced within the desires of the insurance, pharma, medical, tort reform, or finance lobbies. They are certainly not in thrall to the "let's see if we can help people without grinding forty bucks out of them for an aspirin" lobby.

It's a problem to the extent that the simple "has insurance/has no insurance" dichotomy actually illustrates very little. Plenty of people have practically useless insurance policies, for which they pay through the nose. This is not exactly a secret, but politicians are never going to bring it up. It's much easier to gin up sentiment with some "single-payer" substitute that ignores costs, keeps the insurance/pharma guys squarely in the loop, and will only end up further stratifying an already balkanized (as the Mahablog post aptly puts it) system.

And again, one has to ask Justice O'Connor of all people, whose vote put these numbnuts in office, what the hell did you expect? Not that there are nearly enough Democrats with the balls and/or brains to stand up the industry, but when you yourself put the foxes right into the damned hen-house, and were proud of that shit, don't be so surprised when the inevitable happens.