Sunday, October 11, 2015

The Money-Go Round and the Upcoming Democratic Debate

When they say it’s the principle, and not the money, it’s the money.


This week Democrats will go toe-to-toe and face-to-face in the first Democratic presidential debate. Most eyes and ears will be on Hillary Clinton and Bernie.

Will their debate be a love fest on Democratic values attacking big money as personified by the GOP? Will it be a contest on how far left each other will go away from capitalism and towards socialism? Will it be about how much bigger a role government should play in improving the health system? Will it be irrelevant because Joe Biden has not entered the race?

Most polls show Bernie Sanders is gaining ground on Hillary Clinton. Sander’s message resonates around money. In his stump speech, he repeatedly traces the ills and injustices of America to greedy hedge fund managers, corrupt corporate energy and financial titans, and establishment politicians in bed with big money interests and the avaricious 1%.

Among other things, Sander's says we need a revolution – to take America back for the people, by the people, and of the people by spending $15 trillion for Medicare-for-all.

For the health system, Sanders and Clinton solution will be that bigger government is the answer.

In weighing debate proposals, keep three things in mind.
One, Americans increasingly distrust government.

In their minds and in the words of Ronald Reagan, “Government is not the answer, it is the problem.”

Two, easing America’s health problems, including shorter life expectancies and higher infant mortality rates, compared to other nation’s are not due to not enough money being spent on health care(we spend twice what any other nation spends) but to our culture.
On the second point, a nation’s health system accounts for only about 15% of a nation’s health status, life style makes for 30% and other factors – poverty, inferior education, income differences, and lack of social cohesion make up the other 55%(Satcher, D., and Pamies, R. (2006), Multicultural Medicine and Health Differences, McGraw Hill). Therefore, any reform of our system is unlikely to increase the nation’s overall health status. In other words, a nation’s culture and its life style habits determines its health .

Take the problem of obesity. The U.S. leads the world in adult obesity rates at 35.3%. The rate among 34 advanced countries is 18%, and in Asia is 2 to 4%. Obesity leads to chronic diseases - diabetes, hypertension, cardiovascular disease.

Now it may be that U.S. prosperity leads to overeating and obesity. It may also be that poverty leads to overeating on cheap health foods, and lack of quality food stores in poor inner cities and rural areas. It may be lack of good nutrition knowledge among all classes of Americans. Obesity is a complicated multi-causal issue.

Where the money is coming from to finance political campaigns is certain to be part of the Democratic debates. Democrats are likely to argue that money coming from 158 wealthy mostly Republican families is bad for the country because it pares regulations, limits income taxes, capital gains, and inheritances.

This week's debaters will ignore the realities that most of the cause financing Democrats comes from unions, wealthy liberals like George Soros, and Hollywood moguls like Steven Spielberg and Jeffrey Katzenberg.

Conservatives will counter by saying economic growth, not government regulation and heavy taxation, is the surest road to lifting the poor and middleclass out of poverty.

Whichever side prevails, there is no doubt that there is never enough resources or money to go around to finance top of the line health care for everyone or for that matter, to change culture to your way of thinking.

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