Friday, February 26, 2010

Just die quickly

That is the message Republicans have for you if you can't obtain health insurance due to pre-existing conditions. ER doctors should just refuse to treat poor and uninsured people, Minnesota Gov. Tim Pawlenty says, and let them die on the street outside the ER doors.

There's two problems with this scenario:

  1. People do not just voluntarily die on command of Republican assholes. They (or a distraught relative) take somebody else out with them, probably some nurse or minimum wage rent-a-cop who had nothing to do with it, but they won't just go peacefully just because Republicans hate anybody who isn't rich like them.
  2. Doctors aren't in business to kill people. If someone shows up who is in need of medical assistance, they're going do what they can.
Of course, what Pawlenty was really saying was not, "let's kill poor people!". What he was really doing, in the context in which he was speaking, was speaking in code -- "let's kill all them thare suspiciously dusky folks what speak that furriner gabble and takes our jobs!". Plus trying to make an excuse to not give the hospitals the uncompensated care Medicaid money they're due. But really, why aren't people getting the picture yet? If you're not rich, the Republicans hate you and want you to die. How many more Pawlentys do we need saying that before people, like, get the picture? Like Alan Grayson said, the Republicans' health care plan is don't get sick, and if you get sick, die quickly.

-- Badtux the Baffled Penguin


  1. OK, Badtux, I popped over here when I saw you commenting at Murphy's blog because you seemed like a somewhat reasonable fellow. But this post is just lying demagoguery as bad as anything from the GOP side. Pawlenty proposes refusing to admit, not those without insurance, those who can't pay, or those who are black, but those with minor conditions... who might be white, wealthy and insured. Now, Pawlenty's plan might be good or bad, it might disproportionately impact the poor or it might not (we'd need to see the details, wouldn't we?), but your characterization of it is pure partisan malice. What childishness.

  2. I reserve the right to be an ass on my own blog even though I try to be reasonable on other's blogs :). And you are correct, my characterization of Pawlenty's statement is pure partisan malice. On the other hand, it is pure partisan malice that is motivated by actual behavior of Republican assholes. When you connect the dots, it becomes clear that "just die quickly" is the only policy prescription Republicans have for health care for those who are in the lower quintiles.

    I've pointed out the realities of health care economics here in the past -- that health care simply does not work as a free market enterprise because sick people use 15+% of GDP yet earn less than 1/3rd of that, meaning that the only way health care works with modern expensive medicine is via pooling, whether private or public, where well people pay for the care of sick people with the understanding that if they themselves get sick, they will be cared for also. I've also pointed out that once you start pooling to create health insurance, unlike other insured commodities on the market, there is no free market limit on the price of health care because people place an infinite value upon their own life -- unlike, say, a car, where the total payout in a car accident will be limited to the price of the car, there simply is no limit to the value that people place on their own lives because you only get one of them, you can't buy another one if you lose this one. So people look for the *best* medical care for life-threatening illnesses (which, incidentally, account for over 3/4ths of all health care expenses), not the *cheapest* medical care, because what use is cheap medical care if you *die*?

    The end result is that, if Republican "free market" nostrums are prescribed, "just die quickly" is basically what the Republicans are saying to everybody who isn't in the top two quintiles because the current health care system is in a rapid upward spiral of costs. My point is that a market, as such, simply cannot operate in the context of life-threatening illnesses. There is no fundamental market transaction involved here because there is no price that can be assigned by the "customers" to the commodity they are "receiving" (their life).

    If the Republicans had limited their policy prescriptions to things where a market could actually work -- such as, say, the market for routine colonoscopies and mammograms -- I might think they had some policy prescription for health care other than "just die quickly". But it is quite clear from everything they've said that Republicans view their own lives as being worth more than the lives of the mere untermenschen, and wish the untermenschen wouldn't keep clamoring for the same access to health care that the ubermenschen get. Those peasants need to learn their place!

    That is the context into which I place Pawlenty's statements. You apparently place them into some other context. So it goes.

    - Badtux the Healthcare Economics Penguin

  3. Tux -

    I find your response to the accusation of "lying demagoguery" to be quite unreasonably reasonable.

    Are you feeling OK. Should I worry?

    And there's more than just this little video clip to bolster your position - hence your connect the dots reminder.

    Truth is, Pawlenty has a rather rich history of idiocy.

    Which is a part of why
    JzB, the partisan malice, childish trombonist

  4. @Gene

    I wonder what the lt. governor of South Carolina meant when we should stop feed poor people because it allows them to breed. Seems like the conservative message is clear... die quickly.

  5. I've been saying it for ages... let the twits who think it's okay to deny care to the poor go try their luck with emergency rooms for their medical care (hell's bells, Shrub told everyone to do this in 2005 or 2006, if memory serves), and then they can bitch that the working poor is a drain on society that should just die quickly so they can ignore us sooner.

  6. One of the interesting facts I came across when researching the issue of what was causing America's high medical spending was that the marginal cost of providing non-critical care via emergency rooms was actually much less than receiving non-critical care in other settings. The deal is that hospitals already have the emergency rooms to handle critical care and must have doctors and nurses in that emergency room able to handle anything that an ambulance might drag in, and putting those doctors and nurses to work during the time they're not handling critical care to also handle non-critical patients causes minimal additional expense to the hospital. In fact, the Medicaid uncompensated care payments that hospitals get for caring for the non-critical patients actually subsidizes the care for critical care emergency patients, since hospitals are basically dividing the total cost of operating the ER across *all* patients, even those with non-acute problems where the incremental cost is minimal, and then claiming this represents the true cost of treating the non-critical patients. WTF, truth doesn't count when lobbying for funds, I guess.

    In short, Pawlenty's plan even if it *was* about reducing ER expenses is Massive Fail from an economics point of view, hospitals would save less than 5% of their ER costs if non-critical patients were excluded. The reason hospitals are closing emergency rooms is not because of the non-critical patients. It's because of the uninsured guy who comes in dying of a heart attack that they have to go in and immediately do a surgical procedure to save his life and then pop him into the very expensive ICU for a few days until he's back on this side of the living, that's what's costing the big bucks and causing emergency rooms to close, because that's a huge chunk of change having an uninsured patient take up that bed where they could have an insured patient filling their coffers instead. The ER could treat 10,000 walk-ins with the sniffles for the cost of treating a single life-threatening illness coming in the ER doors.

    Anyhow, just another data point for believing that Pawlenty has another agenda other than cost savings for hospitals...

    - Badtux the Healthcare Economics Penguin


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