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Health Care vs. the Profit Principle
It's always nice to see the President take a principled stand on something. The man formerly known as "43," and now perhaps better named "29" for his record-breaking approval rating, is promising to battle any expansion of government health insurance for children -- and not because he hates children or refuses to cough up the funds. No, this is a battle over principle: private health care vs. government-provided health care. Speaking in Cleveland this week, Bush boldly asserted:
I strongly object to the government providing incentives for people to leave private medicine, private health care to the public sector. And I think it's wrong and I think it's a mistake. And therefore, I will resist Congress's attempt ... to federalize medicine...In my judgment that would be -- it would lead to not better medicine, but worse medicine. It would lead to not more innovation, but less innovation.
Now you don't have to have seen SiCKO to know that if there is one area of human endeavor where private enterprise doesn't work, it's health care. Consider the private, profit-making, insurance industry that Bush is so determined to defend. What "innovations" has it produced? The deductible, the co-pay, and the pre-existing condition are the only ones that leap to mind. In general, the great accomplishment of the private health insurance industry has been to overturn the very meaning of "insurance," which is risk-sharing: We all put in some money, though only some of us will need to draw on the common pool by using expensive health care. And the insurance companies have overturned it by refusing to insure the people who need care the most -- those who are already, or are likely to become, sick.
I once tried to explain to a Norwegian woman why it was so hard for me to find health insurance. I'd had breast cancer, I told her, and she looked at me blankly. "But then you really need insurance, right?" Of course, and that's why I couldn't have it.
This is not because health insurance executives are meaner than other people, although I do not rule that out. It's just that they're running a business, the purpose of which is not to make people healthy, but to make money, and they do very well at that. Once, many years ago, I complained to the left-wing economist Paul Sweezey that America had no real health system. "We have a system all right," he responded, "it's just a system for doing something else." A system, as he might have put it today, for extracting money from the vulnerable and putting it into the pockets of the rich.
But let's not just pick on the insurance companies, though I wouldn't mind doing that -- with a specially designed sharp instrument, over a period of years. Sunday's Los Angeles Times featured a particularly lurid case of medical profiteering in the form of one Dr. Prem Reddy, who owns eight hospitals in Southern California. I do not begrudge any physician a comfortable lifestyle -- good doctoring is hard work -- but Dr. Reddy dwells in a 15,000 square foot mansion featuring gold-plated toilets and keeps a second home, valued at more than $9 million, in Beverly Hills, as well as a $1.4 million helicopter for commuting.
The secret behind his $300 million fortune? For one thing, he rejects the standard hospital practice of making contracts with insurance companies because he feels that these contracts unduly limit his reimbursements. (In a battle between Aetna and Reddy, it would be hard to know which side to cheer for.) In addition, he's suspended much-needed services such as chemotherapy, a birthing center and mental health care as insufficiently profitable. And his hospitals are infamous for refusing to treat uninsured patients, like a patient with kidney failure and a 16-month-old baby with a burn.
But Dr. Reddy -- who is, incidentally a high-powered Republican donor -- has a principled reason for his piratical practices. "Patients," the Los Angeles Times reports him saying, "may simply deserve only the amount of care they can afford." He dismisses as "an entitlement mentality" the idea that everyone should be getting the same high quality health care. This is Bush's vaunted principle of "private medicine" at its nastiest: You don't get what you need, only what you can pay for.
If government insurance for children (S-CHIP) isn't expanded to all the families that need it, there is no question but that some children will die -- painfully perhaps and certainly unnecessarily. But at least they will have died for a principle.
13 Comments so far
Show AllSign the petition for HR 676:
http://www.sickocure.org/
Organize folks in your area - website with tons of resources:
http://www.healthcare-now.org/
$2,000,000,000 spent killing innocents every week in iraq.
how pro-life of you.
how conservative.
how compassionate.
when this dipshit was selected as president, he inherited a $5 trillion surplus.
now a $4 trillion deficit
way to go, stupid.
I'm a retired attorney. I spent most of my legal career fighting with insurance companies. Workers comp insurance, health insurance, auto insurance, all of it. Of course I've also fought with health insuarnce companies on my own behalf and my wife's. My overwhelming experience of dealing with insurance companies is that of their massive incompetence. They routinely make decisions and pursue policies that violate the law, their own contracts with policyholders and common sense. On simple administrative matters, they simply do not know what they're doing.
A couple of examples. I had a client several years ago who had been hurt on the job. The case was clearly one of federal jurisdiction, but the insurance company spent something like $100,000 in attorney and expert witness fees in an unsuccessful attempt to prove otherwise. The man's claim was worth about $60k and they ended up spending upwards of $200k (including my fees and expenses) on the case solely because they were too stupid to recognize a straightforward legal issue.
Example #2: Two years ago, my wife and I changed our health coverage, but the company never sent us a policy or a list of "preferred providers." Despite numerous attempts to obtain same, we've never gotten either. Here is how this seemingly simple thing now stands: because we live in a rural area and only receive mail at a PO Box, we cannot receive our policy. They only send policies to physical addresses and they won't send it by UPS or other delivery service. That's according to some people I've talked to at the company. Others say that's not true and they can "request" that it be sent to our PO Box. It's a minor thing, but why can't they get it right?
Need I repeat? Insurance companies are incompetent; they can't even do simple things that any company should be able to do. Their incompetence costs them large sums of money. The first case is an obvious example of this and my own small matter has cost them over two hours of various employees' time.
"What is health care isn't a 'right,' as we've been saying for years? What if it's more like a blight?"
-Barbara Ehrenreich, The Progressive, February 2000, pp39-40
Yes insurance companies are hideous and incompetent, but so is everyone else. Hospitals, labs, medical equipment, drugs, the AMA are all monopolies or oligopolies who oppose any competition and charge exhorbitant fees for questionably usful therapy. Not really a free market at all, but one where government makes rules that benefit and preserve the status quo.
At the same time, physicians who treat root causes rather than symptoms, and use alternative or "unapproved" methods that just happen to work and cost far less by several orders of magnitude than "approved" conventional therapy, are losing their licenses through the action of state medical boards. EVEN WHEN THEIR PATIENTS TESTIFY TO THE BENEFITS OF THE TREATMENTS!!! Can't think of a better way to keep other physicians from trying those methods.
If insurance companies had any brains they would be encouraging physicians to investigate and use these modalities. Not only would costs plunge, the need for high priced specialists and drugs would decline. Best of all, doctors would be able to actually spend time with their patients.
For more info: www.healthfreedomusa.org
and www.wrightnewsletter.com (both sites managed by M.D.s)
The problem is systemic and basically incurable as long as our society continues to operate according to the principle that only profit matters. Unhealthy (for humans, animals, the earth) habits, behaviors, products drive the economy, so how can we bracket a special area called "healthcare" and expect that this one sector will operate according to a different, morally responsible ethic?
Sorry. Ms. Ehrenreich's quote is "What IF health care isn't a "right'...what if it's more like a blight?"
If I made the money from human misery, suffering, death that insurance companies do it would be called extortion---but then I can't afford to get in on the bidding for the best government money can buy.
For-profit health care can only result in one OR the other: Profit or Care. Since insurance companies control the gates of compensation, they determine which motive succeeds.
I read a poll that a "narrow" majority of Americans prefer a private insurance system over a single payer government plan. Can that be serious? I've also been advised not to refer to HR 676 as Medicare for All because quite a few people are not happy with Medicare. I can understand that, it's underfunded, and I think people fear that any government plan would end up underfunded and they would find themselves struggling to find doctors that would accept them. HR 676 does forbid any private plans from competing with any services offered publicly. The public seriously needs to be educated, but the media will never do that.
Thank you, Ms. Ehrenreich, for that excellent article.
The health care system should be re-titled the health care denial system. It is structured to deny access to treatment for the undeserving poor. In a moral universe God would afflict the rich with cancer, strokes, diabetes, and the poor with cuts and bruises, plus the occasional head cold.
The poor have to take responsibility for their own problems and not look to the Government for handouts accoring to the Gospel of Compassionate Conservatism, Book 2, Chapter 7, Verses 17-25.
Why would anyone in Congress want to change the system? They have the best medical coverage that money can buy (our taxes) for life.
RE: UNIVERSAL HEALTHCARE - IT MUST BE FEDERAL, NOT STATE
Blogger Kevin Drum summarizes a recent argument that universal healthcare must be implemented at the Federal level to work:
OVER STATED....Ezra Klein has a piece in the current issue of the Washington Monthly about (surprise!) universal healthcare. But this one's a little different. Massachusetts recently passed a universal healthcare law and California is seriously thinking about one, and this has provided liberals with the hope that maybe by starting at the state level they can eventually build a consensus for a full-blown national healthcare system. But Ezra suggests this is a fool's errand:
The idea of giving universal health care a little more time in the laboratories of democracy may sound tempting to certain cautious, bipartisanship-loving Beltway observers. But letting states continue to take the lead would be disastrous, for one very simple reason: providing health care for all citizens is one of those tasks, like national defense, that the states are simply unequipped to manage on their own. The history of state health reform initiatives (and there's quite a history) is a tale of false hopes and great disappointments....Universal care advocates must be realistic about that, and think hard about how to convert the energy in the states into a national solution before the current crop of novel experiments fail — because fail they almost certainly will.
The rest of the piece explains what happened when Washington, Hawaii, Tennessee, and Oregon tried implementing universal healthcare plans in the early 90s (they all fizzled) and suggests that this failure is inherent in anything done at the state level.
This strikes me as correct. The Massachusetts and California plans are politically helpful because they're the brainchildren of Republican governors, which makes it harder for Republicans to demonize the concept itself. The danger, though, is that failures do nothing but set back the cause, and the problems with state level plans are unfortunately pretty numerous. For starters, they're almost inevitably cut back during recessions when costs grow (because more people are out of work) and state finances are strapped (because tax receipts are lower) — and the cutbacks usually provoke a death spiral that's irreversible. State plans also attract the chronically ill in disproportionate numbers, a version of adverse selection that prompts death spirals every bit as effectively as recessions. Finally, most states don't have the clout to make the necessary regulations work. Insurers can simply pick up their ball and go elsewhere — and they do.
None of these problems affect a national program. The federal government can run deficits during recessions; there's no adverse selection because the entire country comprises the risk pool; and insurers have no choice but to play by the rules. There's nowhere else for them to run off to.
The state programs currently underway or under consideration might provide useful data points for a future federal program. But the odds are heavily stacked against genuine success. Caveat emptor.
http://www.washingtonmonthly.com/