Ben Shoemate's Notebook

Say that, all things equal, you could fix a problem for $8000 or fix the same problem for $150. Which would you choose? Clearly, you are not Medicare.

Proloquo2Go is a text-to-speech iPhone app that's meant to aid those with autism, cerebral palsy, ALS, Down Syndrome—pretty much anyone who has a disability that makes speaking a difficult venture. It costs $150.

But Medicare/Medicaid restrictions won't pay for this software or the accompanying iPhone because the iPhone is not a uni-functional device. (A person with autism might play games on it, after all! Or call a doctor!)

One family's alternative, as documented by the NYTimes, is a government-funded $8000 desktop computer that can have no other function than text-to-speech. No emailing doctors. No browsing the web for medical research. So, this pricey clunker sits at home while the family pays out of pocket for the iPhone app that can operate in their real, mobile life.

Medicare acknowledges the situation. They have heard of the iPhone, as they explain in their official statement on the matter: "We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury."

But with the nation's eyes on our healthcare policies, there's never been a better time to reassess such archaic thinking. All things equal, a company like Apple or RIM will always make superior hardware to that of some boutique electronics company, and they'll do so for pennies on the dollar. Even more importantly, these better distributed hardware platforms will be rewarded with greater enthusiasm and expertise from software designers—the real innovators in today's design-heavy electronics industry.

I'm no health care expert, but it's obvious that reform in this sector would be a win-win. Taxpayers would save money. Government programs would aid more individuals. And those being helped would simply be helped better, with more options and ultimately in a way more specific to their particular problem.

But the government can't subsidize a semi-open platform that would drive both technological innovation and market competition. That's crazy talk! [Proloquo2Go and NYTimes]

There’s one thing that all Americans, be they liberal or conservative, Democrat or Republican, rational or loony, seem to agree on. Our current medical system is broken, and needs to be fixed. You can listen to personal experience. You can look at pretty graphics. You can read expert discussion. Health care in the US is in need of Change.

Listening to the current health care debate is unbelievably depressing. It isn’t really a debate about healthcare at all. Instead, it has devolved into a debate about all the conservative boogeymen: big government, high taxes, Obama personally telling your doctor what to do. The “debate” is fundamentally unmoored from the actual proposals being set forth. This is one of the most important public discussions this nation has had in recent memory. The results will directly impact each and every American. And yet, the entire debate is completely incoherent and misleading.

The possibility of a “single-payer” healthcare program has fallen off the table. I’m not sure exactly how or when this option became untenable, but it shows how quickly the efforts of pharmaceutical and insurance companies can reframe a discussion. After all, there are billions upon billions of dollars at stake, which is precisely why it is such a profound issue for our long-term fiscal health. It is not at all surprising that these companies are spending millions to defeat meaningful reform. The essential goal of this reform, after all, is to reduce the amount of money our nation spends on health care (while improving overall care). Which is not at all in the interest of these companies. What is astounding is that they are actually succeeding in derailing the discussion into lunacy.

Now it looks as if a “public option” will fall victim as well, and be eliminated from consideration. An (incredibly vocal) minority has become convinced that the public option will destroy capitalism, and that Obama is the second coming of Hitler. Really. These people live in an alternate Universe. Here is a two-minute summary of the public option by Robert Reich:

As Paul Krugman says, “the argument against the public option boils down to the fact that it’s bad because it is, horrors, a government program.” In addition, “the argument against it is sheer nonsense. It is nothing but the insurance lobby.”

In a few minutes Obama will give a much-anticipated speech on healthcare. We can only hope he is able to change the nature of the discourse. We are at a critical juncture. The whole nation is focused on fixing healthcare. The diagnosis is clear. The patient is in crisis. Prospects for recovery are increasingly slim. Heroic action is needed.

Update: Text of the speech can be read here. Obama made a range of proposals, including a public option. He tells us: “Well the time for bickering is over. The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.” I hope he can.

As if on queue, a Republican from South Carolina interrupted Obama in the middle of his speech, yelling “You lie!”. The irony, of course, is that at that very moment Obama was busy decrying the absurd claims being widely promulgated by those who aren’t interested in civil dialogue, but aim to “kill reform at any cost”. It gives a good sense of the current state of affairs: that a Congressman would actually interrupt the President, and accuse him of lying, to his face, on national TV. And, needless to say, the Congressman was absolutely, unequivocally wrong. And, “surprise”, he receives lots of money from healthcare industry lobbyists, and is basically a nutcase.