3/13/2009

The Insurance Mafia



Support the National Health Insurance Act (HR 676)!

By Jamie York

When Bill Clinton was in his first term as president in 1992, he vowed to revamp the health care system in the United States. He held up a single insurance card and said that under his plan every American would have one of those cards. It was to be the only insurance card a person would need because Clinton was advocating a single payer health care system and every American was to be covered. In addition, that card was to be imbedded with a memory chip that would hold all of one's medical records, including medical history, test results, digital XRAYs, Pet Scans, MRIs, dental and optometrist records -- anything that pertains to one's well being. Present your card to a health care provider and you will be taken care of. No other insurance needed.

Clinton's plan immediately drew intense fire from the multi-billion-dollar insurance industry, so, rather than stick up for single payer as rational and viable, he backed down with his tail between his legs and asked Hillary to work with the insurance industry and come up with a new plan. Of course, this secret new plan, conceived behind closed doors in consultation with insurance industry tycoons, soon became known as "managed care." Hillary's managed care plan is really nothing more than an ineffective cost-containment plan and has nothing to do with providing quality health care coverage for every American. There are still more than 33 million Americans without any coverage whatsoever and the quality of health care in 2009 is even worse than it was when Clinton first became president.

During the 2000 presidential campaign, George W. Bush and Al Gore talked about the cost of prescription drugs for seniors, but neither candidate dared to mention a single payer health care system and no reporters stepped up to challenge them about it. Clinton made a lot of enemies when he held up that single payer card and his administration never fully recovered from it. Similarly, in 2008, as Barack Obama was running for president, he initially said he supported single payer health care, then began talking about health care “reform,” which is a code word for same-old same-old. In a March 26, 2009, town hall meeting, Obama said that he wanted to reform the system that is already in place. Like Bill Clinton, Obama cried “uncle” on single payer.

When I think of the insurance industry, I think about a Mafioso requiring small business owners to pay them protection money in order to gain immunity from violence. What is the difference between paying the Mafia for protection from violence and paying an insurance company for protection from illness? The only difference I can see is that the Mafia are regarded as criminals and their activities are illegal while insurance companies operate freely as legitimate businesses and their activities have become accepted.

Today, we are expected to pay for protection against illness, motor vehicle accidents, fire, flood, theft -- you name it and some insurance Mafioso will accept your money for protection against it. If, after buying food and paying our bills and taxes, we cannot afford to pay for such protection, then we could be denied emergency health care services or we could be left literally with nothing but the clothes on our backs. To me, the idea of paying the insurance mafia for health care protection is particularly unnerving because I believe that food, shelter, health care and education are essential for human survival and should be considered birthrights, not simple privileges for those who can afford them. For most people, there is little left after we pay our monthly bills, yet insurance premiums keep going up. The premiums I paid to my former health care HMO -- Kaiser Permanente -- doubled during the Clinton administration, so I then dropped Kaiser for a Prudential plan that had cheaper premiums but required more out-of-pocket payments in case of illness. As long as I didn't get sick and have to pay high out-of-pocket expenses, I could pay the monthly premiums. After changing jobs, however, I was without insurance coverage for nearly a year, then I enrolled in an employer's Blue Cross plan with a very high deductible, but I soon received a letter informing me that because I hadn't had continuous insurance coverage they would not pay for any pre-existing conditions until I had been enrolled in their plan for one year. It was an important reminder to me that insurance companies are in business to maximize their profits.

While I am in favor of a health care system that is free from the cradle to the grave, I also realize that in a capitalist economy, health care is not a birthright but is a privilege under the terms of the free market. Pay the insurance mafia or do without. Proponents of the current health care marketplace argue that a "socialized" health care system will somehow take away their freedom of choice regarding which doctors they see and which treatments are offered. But under managed care, as more physician practices are gobbled up by corporate chains, it is nearly impossible for many patients to see the doctor of their choice and the treatment options for most standard procedures are often dictated by the chain, not by the doctor. How many of us have heard the familiar mantra: "I'm sorry, Dr. Jones is not available on those days, but I can get you in to see Dr. Smith in two weeks." Under single payer, the doctor-patient relationship will come first, as it should. Hospitals are also hiring their own staff of doctors -- called "hospitalists" -- and are excluding many local family doctors from having hospital privileges. If you have to be admitted to the hospital, your own doctor may not be able to see you there and the hospitalist may not order the tests you need in order to save money for the hospital.

A single-payer health care bill now before Congress is HR 676. This bill, sponsored by Rep. John Conyers (D-MI), would give every American expanded Medicare coverage that would also include eye care, dental and long-term health care. A federally-regulated single payer health care system will not be a free system -- we will be taxed for it -- but it will provide efficient, streamlined health care for all Americans by eliminating the profit-taking and high administrative costs of the mafia system. It will save billions of dollars. Of course, the insurance mafia and their supporters in Congress and in the media will go to great lengths to scare the public away from single payer. They will scream “socialism!” They will wave the flag and argue that privatization equals free choice while single payer equals a return to "big government." The truth, however, is that in the current private system -- the mafia system -- 35 percent of health care costs are administrative. These administrative costs include marketing, insurance company profits, CEO salaries, pre-authorization panels and billing clerks. When a doctor orders a test on a patient -- a CT or PET scan, for example -- the cost of the procedure is inflated to pay these high administrative costs. Single payer will help to streamline the health care system by eliminating the administrative "middle man" from the doctor-patient relationship; as a result, the cost of exams will be lower and doctors will be free to practice medicine without bureaucratic interference from the insurance mafia.

It is time to end the reign of the insurance mafia and put single payer on the national agenda. The mainstream politicians and the collaborative "lapdog" media are not going to bring up the issue of single payer, so it's up to the public to support HR 676 and tell their representatives to back it also.

1 comment:

  1. But I love waiting in line for a doctor. A two year waiting list for a lung could be our birthright! I think we would all be happy to have second rate doctors. What's your problem?

    ReplyDelete