In Sarah’s fantasy realm (not to be confused with my vision of world joy which — admittedly — is a reach goal), we throw out the whole idea of a “debate” and call in a joint CIA-FBI task force to subject the candidates to lie detector tests and interrogate them until their actual views on the issues and their real plans for our country are revealed in their entirety on live national television. And why not? The members of both federal agencies work for us — we pay their salaries. And the truth is a matter of national security. Besides, if Romney gets his way, it sounds like they’ll soon be one merged entity anyway. Will it be called the FIA? the CIB? Oh, no!! Although, yes, please, let’s do away with the TSA child molesters and the DHS a.s.a.p. Plus, we already have a Department of Homeland Security. You’ve probably heard of it — it’s called the Military.
Instead of Jim Lehrer opening up the debate with a polite request for silence, let’s have a masked CIA agent appear out of thin air to get the party started. In the sketch comedy version, could this role of Primary Interrogator be played by Will Ferrell, using the same voice he used when he played the retail store manager who dressed all in black and pulled out his teeny tiny phone while riding on a scooter (it was called Jeffrey’s Clothing Store)? He could face the crowd and greet them with, “Splendid. You’re all here. So I’ll begin the interrogation now.”
Meanwhile, a [very long buffet style] table would fill with ten FBI profilers who would sit behind the Primary Interrogator and take notes on the facial expressions and hidden communication patterns of the candidates so that they could deliver their personality analyses of the two Presidential candidates to us, the People, at the end. And tag team interrogate the candidates during Round Two. Ah, yes. Good cop, good cop, good cop, good cop, good cop, good cop, good cop, scary masked cop, good cop, good cop, good cop. Every time the lie detector test detects “untruthfulness,” a gigantic red neon sign behind the candidates would blink a warning, alternating between bright crimson, “Lying Liar” and neon orange, “Lying Liarpath.” I imagine Will Ferrell with his terrifying golden mask and a megaphone announcing a lie: “LIAR.” And the profilers firing follow-up questions, such as:
“Which loopholes, Governor?”
“Would you be willing to name one?”
“Would you be willing to name one, right now?”
“Would you be willing to specify, tonight, one loophole that you would close?”
“When we say tonight, we do mean tonight, before midnight, because at that point in time, it will officially be tomorrow — do you think you could describe a particular tax write-off that you would eliminate, and describe it in five words or fewer within in the next five minutes? It could be one for a hundred dollars or a thousand dollars or even one dollar or ten cents …. No, the answer has to be yes or no. Yes or No, Governor. The word yes or the word no. One or the other. Right now.”
“Then we’ll sit here and wait till you can think of one.” (Oooh … awkward!)
And none of this Lehreresque, “I’m sorry, we’re way over 15 minutes.” No, bring on the Will Ferrellian, “Time is up. I said time is up. If you don’t stop talking, I’ll waterboard you on live national television. Raise your hand if you want to be waterboarded on live national television. Oh, not so much? Splendid. Shut your mouth. We’re moving on to the next topic.” (To which President Rockstar could point out that he outlawed the use of waterboarding just 2 days after taking office, I suppose!)
And I want major demands for clarification when Romney says he’s going to “give $716 billion back to seniors” on Medicare. Obama missed an opportunity here to explain that the $716 billion reduced from Medicare costs to fund Obamacare was cut out by lowering the amount of money to be paid to doctors and hospitals per service. So if Romney were going to reverse Obama’s action, the $716 billion would go back to doctors and hospitals, not to seniors. When Romney says, “back,” I want the interrogators to demand the form. Via a check? A voucher? A deduction? An extra dessert off the Senior Menu at Perkins? Someone, please, make Romney say — disclose — that he doesn’t want to give a penny back to seniors, he wants to give the profit back to doctors and hospitals.
If we had national health insurance — and I am still sad that not even a public option was included in Obamacare — the health needs of everyone in our nation could and would be met: seniors, the young, the poor, rich, the healthy, the sick, and everyone before, after or in between. And the program could be designed so that your family doctor would be paid the same way FBI profilers and CIA agents are: on salary! Not per service. It is true — conservatives are not lying when they say this — that nearly a third of doctors are no longer taking on Medicare patients because of the rate at which those doctors are being reimbursed per service compared to a private insurer. They miss the point (and oh, how I want the Presidential Interrogators to help them see it … so so badly, my friends …) that, to reference the example in this blog post on Forbes’ website by Avik Roy,
“Wertsch billed Medicare $217 to care for a Medicare patient with a sinus infection whose appointment ran late, because the patient required more time. Medicare reimbursed the clinic for $54.38. Later in the day, a younger patient with the same sinus infection, requiring half the time, was charged the same $217. But his private insurer reimbursed the clinic for twice the amount of Medicare: $108.04,”
the reason the private insurer, as an insurance company — which is a profit-motivated organization — can afford to pay more to the doctor is because many young and healthy people are paying in the same premium for coverage but needing less care than the elderly because they are so healthy. So the insurance company has more money to pay out to the service providers (doctors) because they are making a profit — unlike the government. And the reason the insurance company has so many healthy people? They deny coverage to people with pre-existing conditions (unhealthy people) and drop people in the middle of terrible sickness once they’ve received the lifetime maximum dollar amount in treatment. So who picks up the tab for the unhealthy people? The government. (Ironic, right? The government as the FBI and CIA is also picking up the tab on people who are unhealthy in a “different” way, unhealthy people who want to auction children and fly airplanes into tall buildings. Talk about sickness. And preexisting conditions.)
Would it be so bad if primary care physicians — general practitioners we go to when we want a check up or have an infection — and ER doctors were government employees? Paid on salary? And were offered bonuses for preventing recurring accidents and illnesses, and maintaining the existing good health of their patients? Everyone, sick or healthy, would be in the same pool, causing an average between the two figures mentioned above for the treatment of sinus infections (which were $54.38 and $108.04; the average works out to be $81.21) but it would probably be even higher because, just as in the insurance company pool, there are more healthy than unhealthy people in the pool of our country. But we’d remove the profit motive for the physician to patient-load (like carb-loading before a marathon) in order to make more money by taking as many patients as possible and shorten visits to the minimum required, and the other profit-motive which is to skip any lifestyle change recommendations that could prevent more billable, charge-able, profit-from-able visits in the future? Doctors, really consider this: a 5% matching savings account (Thrift Savings Account) and only 6.2% social security tax instead of the 12.4% you pay when you’re self-employed, and other great benefits like paid vacation and sick time, and how awesome would it be to have no overhead costs, such as paying rent for the clinic space, the wages of your receptionist, nurses, etc.? No, it wouldn’t be ideal for specialists, in my opinion, but if we think of how the CIA and FBI work — for the greater good of the entire country — then you can see how establishing an agency of highly trained physicians, motivated to protect the People from illness and serve them by helping them to achieve and sustain excellent health, could be considered a success strategy. And wise. Especially if we want to really truly take down type 2 diabetes and heart disease, two totally preventable diseases that are killing people! In the same way WMD’s do.
This kind of system would restore the healing element of practicing medicine to the doctor’s lifestyle too. Instead of feeling impelled to drive up the number of patients and the number of visits and treatments, the doctor would truly act as a conduit for healing. Still not convinced? Consider the fact that no one has to pay Due Process Insurance which would be calculated on how likely you were to eventually have criminal charges brought against you at some point or other in your life. The 5th Amendment guarantees everyone the right to due process in a court of law (a trial where evidence has to presented that proves guilt) and the 6th Amendment guarantees that, “In all criminal prosecutions, the accused shall enjoy the right … to have the Assistance of Counsel for his defence.” Yes, you get a lawyer, and if you remember from TV, “if you cannot afford one, one will be appointed for you.” So, we get a lawyer if we need one. Why not a doctor? The Justice System is socialized: our tax dollars pay for criminals (er … alleged criminals) to have a public defender. And all the judges and clerks and everyone else involved in the process part of due process are paid their salaries with money that was collected through taxes. What is a doctor but a judge of disease, coming up with an opinion/diagnosis and a sentence/treatment plan?
Obamacare is a great start, and I was amazed the President got that much transformation of the system passed into law. And as far as the popular ideas for single payer health care currently stand, I’m glad none of them were on the table because the greed element remains as long as primary care doctors who would ideally feel called to prevent illness still have a financial incentive (a motive if it were a crime, which it ought to be) not to. There’s still a lot to be done and I look at it in the light of, “Look how much the President accomplished in four years with a divided Congress during the second half. How much more will he accomplish in four more years?”
On a primal note, what’s interesting about how the President did not defend himself — or counter-attack Gov. Romney — on Wednesday night is that the lack of the act of self-defense often indicates that we simply do not feel attacked. So we might truly be experiencing an attack — with words as weapons in this case — but in the very confident person’s perception of what’s happening, there is no genuine threat, thus no genuine need for self-defense.
Some said that the President’s manner could only be described as “subdued” during the first presidential debate, but I saw a man granted the acceptance of things he cannot change. He was surprised by the bald-faced lies from his opponent, but only slightly and only for a second. I saw a man resigned to his fate, one who knows that in the end, his occupation for the next four years will be determined by the collective caprice of a nation. After all, he can’t make us google the lies. And no one’s going to force us to see the truth either; after all, we don’t live under a fascist regime. Wednesday night, I saw a man (not a perfect man, as he reminded us) who has come to terms with the inevitability of life’s whims, and who, with a shrug of consent, knows that either way, what was true before he became president will be true after: he was and will be a husband, he was and will be a father, and every Oct 3, he will celebrate the anniversary of his marriage to the woman he adores and the woman he mentions every time he speaks in public directly to the people. She was the first thing he said. Literally, his first point: “There are a lot of points I want to make tonight,” said the President straight out of the gate, “but the most important one is that 20 years ago I became the luckiest man on Earth because Michelle Obama agreed to marry me.” This matters to me, possibly as much as my gratitude for the good parts of Obamacare and my disappointment over his reneging on the promise to close Gitmo. It matters because it means that the President finds his identity primarily in his ability to love and is, perhaps unconsciously, acknowledging that although everything else about life is transitory, love isn’t.
At the end of the day, Chris Rock says it best.
“If you’re voting against Obama because he can’t get stuff done it’s kind of like saying, “This guy can’t cure cancer. I’m gonna vote for the cancer.”