Michael Ramirez for April 09, 2015

I don’t like it, but I don’t hate it. Universal healthcare is what we need for the betterment of all Americans, the betterment of America.

Not even vaguely true. The right wing is in the same echo chamber they were on election night. It’s by no means perfect, but every president since FDR has tried to untie the healthcare financial Gordian knot without success. This is sort of like how brilliantly Obama has managed the Middle East, or how he has refrained from hurting the economy with the same kind of fiscal nonsense that so captivates Europe and Kansas. It’s amazing a black guy has accomprised so much with such racist vitriol directed at him from day one. Obama will go down as a transformative figure for multiple reasons. The right wing republicans can’t fight the forces of change. They can delay, lie, obfuscate, and undermine. The dogs bark and the caravan moves on. Obama has screwed up lots, no doubt. And deserves potshots at him every time. But the disloyal opposition is virtually insensate when it comes to any of the positive stuff, and red faced with outrage at Obama’s missteps. There’s really no other explanation besides racism. Obamacare was, after all, a Heritage Foundation idea first implemented by a republican in Massachusetts.

http://www.huffingtonpost.com/2013/11/21/us-life-expectancy-oecd_n_4317367.html

Great cartoon, Michael!

If you look at other medical systems in the world many work quite well. The US is not at the top of the heap in many medical care categories except cost. In business one benchmarks and then figures out how to adopt the best practices they find. We just make sure the vested interests don’t have to be inconvenienced by change. We really value our right to be stupid.

I think the point of this for Ramirez is that he gets to draw Obama in a dress. There’s no other point, anyway.

Lefty posters claim Right of center (the Left keeps dragging the center further left) posters or the cartoonist “is in an echo chamber”….when it is the Left wingers who are brainwashed and repeat the mantra constantly.-When you find a phrase in the US Constitution that calls for the central government to provide healthcare or any other service, interfering and remaking the economy into a government provider dictatorship; please post the wording. (and it is not “the general welfare” which is peacefulness for society to do its own things.) FDR started the flood of unconstitutional “provider agencies” with Pensions; today the brainwashed taxpayer ignorantly accepts these unsustainable unconstitutional procedures with passivity and too many even demand it.-Universal government-provided healthcare in the UK and Canada have many horror-story reports of waiting lines, refused care, and citizens dying or being put to death by these “compassionate Lefties”….

“Everyone hates it.” Another neocon generalization. I have health insurance only because of the ACA — and there are millions like me. But trust the GOP to try to abolish it because they don’t like it. But we’re not all shrill, minimally-talented “cartoonists.”

Forgot to mention the subtle but telling effect of depicting President Obama as a woman. The GOP’s way of calling him ineffective, soft and…gas (I am aware of the Lucille Ball statue flap.)

No jab too low.

And another thing: “The designer refuses to alter it.”

Not true. President Obama has, from day one, sought input from any and all on how to improve the ACA. And, as always, the GOP has simply dragged its feat, held its breath, and shrieked “No!”

And they lost anyway. Lead, follow or get out of the way, neocons.

Good to see that Ramirez is back in his Hatred Of Obama groove.

Republicans are going to propose their alternative to the ACA any day now, yes they are!

Just had a meeting on our local medical facilites and doctors, and what’s going on. Patient load has almost doubled due to so many more having insurance. The only “negative” from all the medical folks was a possible loss of profit margin, not profit, by the hospital administrator (a big fan of Bush, but of course that wouldn’t impact his view?).

“I do understand how the Canadian system works. You say your doctor manages your care. If I say you are free but must do as I say, how free are you? Your doctor is free so long as he follows your government’s constraints. How free is that?”

And if your doctor follows Blue Cross’ constraints?

Just two points, because I’m not sure that people in the US really understand how the Canadian system works.1. So far as I know, there is NEVER the case that a government bureaucrat makes a decision about individual coverage. If a treatment has been approved for the province, the person who decides if I get it is my doctor. No one else. No government bureaucrat EVER makes that decision.2. Health insurance is generally the responsibility of the province (the provinces are like the states in the US), NOT the federal government. The provinces have to satisfy the Canada Health Act, but that’s pretty general and doesn’t have a lot of rules and regulations. The rules and regulations are left to the provincial governments. So different provinces can have different systems, so long as they fall within the general provisions of the Canada Health Act.I have more to say, but I don’t want to obscure these two points. It is NEVER the case that a government bureaucrats makes a decision about an individual’s coverage, and the systems are PROVINCIAL not federal.

Okay, let’s get more specific. The province of Ontario doesn’t cover routine PSA tests. I know this because about 20 years ago my doctor at that time thought I should have a PSA test, but he told me it wasn’t covered. Did that mean I couldn’t get it? No, it just meant that I had to pay for it myself. It cost $40 at the time. Well, now it turns out that the medical consensus is that routine PSA tests cause more problems than they solve, because they result in a lot of false positives. My current doctor does not encourage me to get the test, though I still could get it if I wanted to. So I’m not upset that the province doesn’t cover it.-How are these decisions made about what gets covered and what doesn’t get covered? Ultimately, the Minister of Health is responsible, but of course he doesn’t make these decisions out of thin air. There is a panel, not a panel of bureaucrats, but a panel of doctors, and they make judgments about which procedures and treatments make sense. Evidently they decided it doesn’t make sense for the province to cover routine PSA tests. But you almost never hear anyone complain that something isn’t covered, because ALL the standard treatments and procedures are covered. They don’t cover experimental and untested treatments, such as the Liberation Therapy treatment for MS, but there have been studies in Canada to see if it merits coverage, and I think so far it hasn’t turned out to have value. I don’t think they should rush into covering treatments that haven’t been tested.-Of course money enters into these decisions. About ten years ago, the province decided that they would no longer cover routine annual eye exams for healthy adults. Children and people over 65 are still covered, and also adults who have specific health issues involving their eyes. They made this decision because they thought the money could be better spent in other areas; as I recall, the moved the money into increased health care for children.-Of course this system isn’t perfect. But it works pretty well. Everyone is covered, and no bureaucrat, public or private, makes any decisions about individual treatment. I have friends who are going though serious (and very expensive) medical problems right now; they know that they will get all the treatment they need and they will never have to worry about whether or not they are covered. And that’s true for everyone, rich and poor alike. It’s automatic, it just comes from being a citizen. I like that.

Well, I don’t have answers to all your questions. I’m just a citizen, not an authority on the system. I’ll have to check on the tax rate and get back to you. I do know that the system overall is somewhat less expensive than the US system.As for assurances that the money goes where it’s supposed to, the provincial budget is public, and the opposition parties jump on every irregularity they can find. For instance, the emergency helicopter service in Ontario was very badly managed, and the opposition really tore up the government about it. So there is public scrutiny of the system. I doubt that the private insurance companies in the US get that kind of scrutiny.As for the independence of the panels, well, I don’t know, but I don’t see why the government would want them to be less than honest — who would gain, who would profit? And again the public is the ultimate arbiter. If we don’t like the health care we get, we can vote the bums out. I have never heard of a big issue with what’s covered and what isn’t; the questions are (a) overall funding, and (b) the extent of the public/private mix in the system. Those questions can enter into elections. But really, just about every treatment or procedure with any medical support is available. You just don’t hear all that many complaints that such and such isn’t covered. Every year or so, I suppose, there’s a case covered in the newspapers about usually some child that can’t get some exotic cancer treatment. Usually it’s an experimental treatment that’s available in some places and not in others. But these are isolated instances. I gather in the US that different plans have different coverage. That just seems so strange to me. Here it’s all one plan, and with a very very few exceptions everything is covered for everyone. And no one ever has to worry about medical bankruptcy.I don’t know about the ACA in detail, but what I’ve heard doesn’t sound as good as the system here. Better than what it replaced, but not as good as it could be. Canadians in general are puzzled by the resistance in the US to a single-payer system. The Canadian system isn’t the only answer; there are other systems in other countries, and I bet each has its pluses and minuses. But why can’t the US do what every other developed country did long ago?

I certainly don’t feel that I’m in a position to judge the ACA; that’s for people who live with it. But I do see that there are a lot of people in the US who have heard falsehoods about the Canadian system (or systems). I’m not saying that it’s the perfect system, but if people are going to criticize it, they should get their facts straight. And they shouldn’t base opposition to reform of the US system on falsehoods about the Canadian system.