Taylor Armerding

Taylor Armerding is an independent columnist. Contact him at t.armerding@verizon.net.

CNHI News Service

I guess we can thank Jimmy Kimmel for the health care debate getting some “oxygen” this week amid nonstop headlines about President Trump at the United Nations, North Korea’s nuclear program, the lousy audience for the lousy, self-absorbed TV stars awards show, and the continuing string of hurricanes.

Not that the comedian should be thanked for bringing any substance to the debate. He has a compelling personal story, but millions of other Americans also have compelling personal stories, and using individual anecdotes to craft public policy for the whole country is about the worst way to do it.

Not to mention that Kimmel is no more – probably less – of an expert on the complexities of health care than President Trump, who is relentlessly mocked for being clueless about it. Kimmel cares primarily about his own family (almost sounds like “America First!”), which is as it should be. It also makes it obvious that his attack on the most recent Republican proposal is motivated by self-interest, not national interest.

That said, if Kimmel is the main reason there is going to be a debate on Monday over two competing proposals, that is a very good thing. The two options offer a pretty stark choice.

Republicans led by Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., are mounting a last-ditch effort to pass something they can claim is a “repeal and replace”of Obamacare before Sept. 30, after which, due to arcane rules, they can’t advance legislation without any Democratic votes.

Democrats – a few of them, anyway – just launched what has always been a gleam in the eye of Sen. Bernie Sanders, the self-described democratic socialist from Vermont — the “Medicare for All Act of 2017.”

It calls for single-payer, “universal” coverage – the single payer being the government.

Not that either is likely to pass anytime soon; there is not a snowflake’s chance in a climate-change hurricane that Republicans will move their bill before Sept. 30.

It is already generating mass hysteria, the same kind of “Republicans-are-mass-murderers” rhetoric invoked the last couple of times there was an effort to repeal what has now apparently become the health care jewel of the civilized world — Obamacare.

There is no immediate chance for BernieCare to pass either. For the next 15 months at least, we still have a Republican Congress.

All of which ought to provide enough time for a debate that gets deeper than bumper-sticker slogans, personal insults and absurd accusations. CNN is sponsoring a debate between Graham and Cassidy, and Sanders and Sen. Amy Klobuchar, D-Minn.

I doubt that it will, but here are at least a few things that ought to be on the table:

- This is much less about health care than it is about money. Yes, the two are necessarily entwined, but as has occasionally been pointed out, spending more does not guarantee better outcomes. The U.S. already leads the world in per-capita health care spending but ranks 12th – dead last – in life expectancy among the 12 wealthiest industrialized countries.

While life expectancy is obviously a function of more than health care, you’d think all that money would at least put us somewhere in the middle.

So, it is worth noting that our alleged Obamacare paradise is not delivering a paradise of health, in spite of the megabucks it costs.

It is also worth a skeptical look when interested parties – hospitals, “advocates,” physicians and other providers – start screaming about how if they “lose” billions of dollars, it is patients who will suffer.

I think it is more their wallets that will suffer. Think about what happens when people are paid for what they produce, rather than by the hour. Productivity soars.

Think about the possibilities if providers have to live within a budget, instead of being paid by the procedure, with the guarantee that the feds will cover 90 percent of their bill. Who would be motivated to control costs with that kind of a deal?

Along the same line, it is worth noting that since Obamacare became law, mortality rates, which had been declining for decades, have risen for eight of the top 10 leading causes of death including respiratory diseases, injuries, Alzheimer’s, diabetes, kidney disease, suicide and, No. 1 on the list, heart disease.

No, that doesn’t make President Obama a cruel, heartless mass murderer. But it should temper the outlandish claims that he has improved the health of Americans.

Graham must be feeling some whiplash. When he is saying nasty things about President Trump, which he has done rather regularly, he is the toast of the Washington bubble.

He gets multiple, softball interviews on the major networks as “one of the few adults in the room.” Now, suddenly, he’s a monster bent on mass murder.

Do you really think that’s his goal? Maybe listen to him directly, rather than his media and Democratic “interpreters.”

Sanders won’t say how we (yes we, not he) will pay for his dream. That’s because “taxing the rich” will not be nearly enough.

Some of his acolytes say it will be simple – taxes will go up about 4 percent, but all of our current out-of-pocket costs will be eliminated. The average family will end up paying about a fifth of what they do now.

Magical! We’ll get every medical service we want (since rationing care or limiting choices would be cruel and murderous) for 20 cents on the dollar we were paying.

It’s just that reality again intrudes. Bernie doesn’t want you to notice that his home state’s single-payer system collapsed several years ago because it cost too much. Efforts to establish it in blue-blue states like New Jersey and California have failed.

That is mostly because even Democrats know they can’t make the sale when the customers, who are the ones who will get stuck with the bill, actually see the bill.

Taylor Armerding is an independent columnist. Contact him at t.armerding@verizon.net.

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