John John Mackey Takes You Inside Healthcare Reform

And I thought I was indignant.

The healthcare reform debate has brought out two distinct groups of Nazi finger-pointers: on the right are those who paint President Obama as Hitler and his healthcare plan as the second coming of the Third Reich, while on the left are those who think the anti-reformers disrupting town hall meetings are using Nazi tactics. It's out of control.

The Nazis were worse than motherfuckers. They plotted to take over the world and exterminate an entire race of people in the process, and they got a good way toward those goals before getting bitch-slapped so hard the German people have been stigmatized for two generations. Well Germany is back, and fortunately the Nazis did not come with it. So—and I know this is a lot to ask in today's America, but—let's leave off the Nazi name-calling (unless you really are one) and engage in real debate.

But where to start? An issue as big and complex as this one tends to trigger the worst of our culture's verbal diarrhea. It's my opinion that yes, we should find a way to make sure everyone has access to health insurance at a reasonable cost. The government should have a role in that. But I don't necessarily think a giant, single-payer system is the best option right now. It could be, in the future, but not now.

One set of talking points that has received a lot of attention lately is the op-ed piece Whole Foods Chief Executive John Mackey wrote for The Wall Street Journal last week. Mackey drew a lot of criticism not just for his pro-business, anti-reform-as-proposed stance as for infuriating his biggest customer base: wealthy liberals. Oops.

But in a sense Mackey has been the recipient of the same kind of over-the-top antagonism that has been directed at Obama and Democrats. I don't agree with everything Mackey wrote, but at least it's a reasonable entry in the debate about health care reform. Let's take it point-by-point:

"While clearly we need health care reform…."
That's a good start.

"… the last thing we need is a massive new health-care entitlement that will create hundreds of billions of dollars in new unfunded deficits and move us much closer to a government takeover of our health-care system."
Actually the last thing we need is inflamed and hyperbolic rhetoric that obscures the issues and stokes people's unrealistic fears. But it's a fair point that you don't support a government-run health care system. I don't necessarily agree for the long-term, but as I said for right now a single-payer, government-run system is not feasible.

"Remove the obstacles that slow the creation of high-deductible health insurance plans and health savings accounts."
Spoken like a man who's never had to worry about health insurance ever in his life. "High-deductible health insurance plans" coupled with the phrase "health savings accounts" essentially means poor people will still be forced to fork over thousands of dollars they can't afford for medical care. Such a plan would likely lead participants to put off exactly the kind of preventive medical care we're talking about and they'd wind up in the hospital anyway. Mackey even tacitly acknowledges this when he writes, "This creates incentives to spend the first $2,500 more carefully."

Yes, participants in a Mackey plan would be able to set up health savings accounts funded with pre-tax money, but when you're making minimum wage, it doesn't really matter whether the dollars are pre-tax or post-tax; you can't afford it anyway.

"Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits."
Agreed.

"Repeal all state laws which prevent insurance companies from competing across state lines."
Agreed.

"Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year."
Vague, but I agree.

"Make costs transparent so that consumers understand what health-care treatments cost."
Agreed.

"Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility."
You mean like, encourage seniors to meet with their doctors periodically to discuss care as they age, and what care seniors would like to receive as they approach the end of their lives? Oh, wait, that's a "death panel." Now see, I've just engaged in exactly the type of sarcastic, nonproductive rhetoric about which I've been complaining. On a serious note, wouldn't it be great if health care reform obviated the need for Medicare and Medicaid altogether? The processes could be reformed—and the wasteful, old and inefficient parts eliminated—as it was absorbed into a new entity that covered everyone.

"Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program."
Naturally, this would make sense to someone making enough that he's looking to reduce his tax burden. Every little bit helps, I suppose, but I hope Mackey isn't proposing this as the funding solution.

See what just happened? John and I just engaged in a little exchange of viewpoints there. I agree with some of his proposals, but not all of them. I'm certainly not willing to dismiss his entire piece simply because he offended me with the first point he made.

There's room for compromise, people, and debate, without resorting to blatant distortions and lies. This is a serious issue and it should be debated by serious people with serious ideas. Unfortunately that eliminates 90% of the coverage and commentary in the mainstream media (read: Glenn Beck and Keith Olbermann) and about half of what one reads on the Internet (Sarah Palin's Facebook page).

But serious people should be able to muddle through anyway.

The Indignant Citizen