20101106

If the Politicians Were Serious...

About what they claim to care about, here are the things that would happen.

If they truly cared about the deficit, they would seriously overhaul Medicare Part D (the prescription drug benefit) with two simple provisions: allow Medicare to negotiate drug prices, perhaps even allow imported drugs (I don't think this needs to be done if the negotiation part is implemented, but it wouldn't hurt, either way), and eliminate drug companies from marketing directly to consumers.

Medicare Part D is a huge contributor to the deficit (trillions of dollars already, from what I've read). As I undertstand it, the program reduced prices by less than 25%. However, their drug prices are several times as much as the Veteran's Administration (which can negotiate group reductions) pays, and the VA is a small fraction of the size of Medicare. Eliminating the direct marketing of drugs would also cut costs, because there would be less demand for drugs. Much of current demand would is driven by people going to their doctor and saying, "Will this help me?"

Another thing that proves the deficit hawks are full of crap: they never put military spending on the chopping block. The US military budget is currently about the size of the budgets of the rest of the nations in the entire world. It shouldn't even need to be argued that that is too much, it's so excessive. Cut out the wars (nation-building is not what our military is, or should be, about), and eliminate many (most?) of the costly acquisition programs, most of which have little or no military benefit until a WWII-scale conflict comes along. And there are better ways of preventing a conflict of that magnitude from coming along than hoping that our armament scares anyone considering such a conflict. It's called diplomacy.

What else would the Democrats do if they truly cared about protecting the little people?

Close Guantanamo and Bagram prisons, immediately. Having them is innately dictatorial. The idea that our justice system can't handle small numbers of criminals is ludicrous. This is one point where Democrats do not have the courage of their convictions. Republicans say, "These people are some of the most dangerous people on Earth", and Democrats just roll over instead of saying, "We have no evidence of that. If we did have evidence of that, we could easily convict them of a crime, and throw them in supermax prisons like we do with all the other very dangerous people". Are these people, without the backing of a wealthy country, more dangerous than Nazi war criminals were? The idea is absurd on its face.

Modify the health care overhaul to include a public option. If they wanted to keep it simple, they would just expand Medicare. How so? Well, an easy way, and I'll credit this one to David Brin, is to automatically cover all children under, say, sixteen. Too young to work? You've got coverage. Medicare is far more cost-controlled than general medical care, so it would help cut down the rising cost of care for everyone.

But having a true public option would do an even better job of cutting the cost of medical care for everyone. I would envision it as something everyone would want, but that the rich would want to supplement. So the existing insurance companies would evolve into something closer to boutiques, for covering stuff that the government can't, or won't. It would take a while, of course; many people would want to keep their existing insurance (and, to be clear, they should be allowed to do so; I'm not in favor of 'thou shalt'-style legislation). Some would keep it for the rest of their lives. More, though, would only do so until they saw how much more expensive those plans (or, more to the point, care under those plans) were than the public option.

For those scared of the public option, or something like it, consider this. When your insurance company is currently looking at whether or not to pay for a procedure, they have a profit motive to deny payment. A government bureaucrat, on the other hand, would not have that incentive. They would actually be less biased than your current provider. So to which would you rather trust your health?

If the small-government types really meant that they wanted a smaller government, they would end the dragnet surveillance that we know is going on within the government (probably within the NSA). They would also get rid of warrantless wiretapping. That warrant, you know, is a way to show that you actually have a reason to be surveilling someone. Otherwise, you're just on a fishing expedition. Ditto those National Security Letters. And we know for a fact, from FBI Inspector General reports, that those have been abused repeatedly (odds are, far more than those IG reports show).

Alright, I think I'm ready to stop ranting, and maybe to go back to sleep.

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