Mid-Week Blog: It's Health Insurance, Stupid

There's a lot that bothers me about the debate over the Affordable Care Act and its myriad potential replacements. Most of all, though, everyone should stop referring to it as a health care debate. It's not. A more accurate description would be a health insurance debate.

You can argue that Affordable Care Act (Obamacare) and the replacements proposed by Republicans are about health care, because they impact how it's paid for and how much of it is affordable. But it's all about the coverage, deductibles, out-of-pocket expenditures and such. It's about how health care is made available and delivered and paid for, not about health care per se. Nobody's talking about how to make prescription drugs or hospital visits more affordable, how to cut costs, overhead, obscene profits – it's how to keep those under control by regulating insurance. Doing so, supporters argue, will eventually cut the cost of health care itself. Sorry, but I'm skeptical.

This has nothing to do with health care and everything to do with maintaining the profitability of the health delivery system.

We know the private market can't, or won't, cut costs; there's no incentive. The current system, although an improvement on the previous wild west-style absence of regulation, still relies on the marketplace to set costs and the government to provide subsidies. (All the while, by the way, doing nothing to help those of us who get our insurance through our employer; I am currently paying 15 percent of my income for health insurance; and that's half of the total cost, with The Chronicle footing the rest.)

The only way forward that will be meaningful at all is a single-payer system, the way every other civilized country in the world takes care of its citizens' health care. That allows control over costs of the actual health care as well as insurance. Having my taxes hiked by half of what I currently pay for health insurance to pay for such a system would be well worthwhile. And everyone would be covered; no mandate, no insurance exchanges, no worries about pre-existing conditions.

Of course, the entrenched interests won't let that happen, because it will be the death knell for the insurance, pharmaceutical and health care industrial complex. But there's more of us than there is of them.

While I'm at it, although The Chronicle doesn't as a rule cover the health care – sorry, health insurance -- debate or other national issues, here's a couple of additional gripes for which this forum is perfect.

First, the election commission appointed by President Trump is of course a transparent attempt to justify his loss of the popular vote. Congress should instead appoint a commission to look into the protection of our voting system – from voter data to the actual voting machines – from outside interference. There is, after all, general agreement among those who know about these things that Russians hacked into aspects of the system with the intent of influencing the election. Protecting the systems from nefarious outside players – not worrying about about minor irregularities that might exist.

Finally, I'm wondering if I should apply for Sean Spicer's job. Of course, I don't see eye to eye with the current administration about much of anything, but that would be the point. I'd be honest and up front and give straight answers instead of toeing the line and providing alternative facts. Biggest crowd ever for an inauguration? Naw, of course not. Russia? Da, they are cozy with the president and his peeps. A border wall? Only if Pink Floyd plays on it.  Health care?  Single payer, baby!

So you think I have a chance?