I will go to my Guvmint Death Bed not understanding why the so-called public option is as distasteful as it is to so many people; I suppose if public libraries were being proposed now they would be characterized as the place where Adolf Hitler and the Devil go to check their e-mail between job interviews. But I do know that if this country continues to choose misery over health, these exceptional cases are going to become the norm. I foresee the rise -- and for all I know it may already be happening -- of a new breed of public relations practice that specializes in preparing hard-luck medical cases for public viewing. And fundraising.
It'll start small, when a local p.r. practitioner like me hears about a local case that's going south because of uninsurance or underinsurance and makes a few suggestions. (Indeed this has happened to me.) But it could grow. The demand is certainly there. I foresee a national 501(c)3 (perhaps called The Public Option) that lets donors "adopt" a medical patient in the way that overseas aid agencies have long used the faces and narratives of adorable foreign children to provoke sympathy. The Public Option's tagline will be "Just send us the bill" and that's what we'll do: we'll try to negotiate prices down so as not to waste donors' money, but after dickering as long and hard as humanly possible, we'll pay. When the claim is settled we'll send the patient a little certificate with a picture of a smiling fish on it that says, "You're off the hook!"
Hang on... hasn't the fish already been used as the symbol of a rapidly growing charitable movement? One that took the most generous impulses of the ancient world and packaged them into a humanistic philosophy? Didn't they have some really good copywriters who drafted brand language around treating our neighbors as we wish to be treated? Whatever happened to those guys? I'll have to have a trademark attorney look into it.
As you know I lived in Japan for a few years, and at the time, I was covered by their “Public Option.” It worked pretty well, but there are two caveats, 1) government institutions run much better in Japan, and 2) I was a lot younger and therefore healthier back then. The worst I faced was a few stitches. The “hospitals” looked like something out of a 1950s Twilight Zone episode – you know, the one with the beautiful blond woman whose plastic surgery is a failure, and all the doctors and nurses have pig faces?
ReplyDeleteHaving just dealt with the post office and the DMV, the fear here is that the public “Option” will become “Mandatory,” have the balance sheet of Medicare, and the service profile of the aforementioned agencies. And oh yeah, “Death Panels.”
The question to ask, then, is why Japan has better management, and bottle whatever they're doing. Certainly companies have asked this question and made changes to their practices as a result. The truth, as you know better than anyone, is that Japanese management isn't quite what it's reputed to be. But if there are improvements to be made to public-sector management in the U.S., and if Japan can serve as a role model, then let it. In my opinion the first thing to do is to stop making the completely baseless ideological assertion that public-sector employees suck BECAUSE they're in the public sector. Some people will always suck and some people will always be wonderful regardless of what kind of workplace they are in. And the suck/wonderful ratio will always be highest in places like Iraq and New Jersey where corruption distorts expectations and makes people ornery. Go to pay your water bill or buy a stamp in Portland and your opinion of public-sector workers will change.
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