"Regulate the health insurance giants," chanted the reformers.
"Stop denying coverage to sick people," they demanded. "Stop jacking up premiums," they cried. "Health coverage for all," they bellowed.
It was an impressive show that the health care reform movement put on last week at a hearing before the Senate finance committee. It was especially impressive because those doing the chanting, demanding, crying and bellowing were not aggrieved outsiders, but the ultimate insiders - the health insurance giants themselves!
When the dogs begin demanding leashes, you now that something unusual is afoot.
Indeed, two things are afoot. First, the public is fed up with our country's insurance-dominated health care system, which cares first about corporate profits and only secondarily about the health needs of America's people. As a result, we pay more for health coverage than any other country, yet the quality of care we get ranks 37th in the world (below such countries as Malta, Morocco, Chile and Dominica).
Insurance companies maintain a massive money-sucking bureaucracy that exists essentially to say "no" to policy-holders who need approval for treatment and to say "hell no" to anyone who can't afford the ever-escalating price for those policies. In the richest country in the history of the world, 47 million Americans are uncovered, and many millions more have "coverage" so thin that it leaves their families out in the cold for most ailments. This is why 76 percent of the people said in a March poll by the Pew Research Center that our health care system either needs "fundamental changes" or needs to be "completely rebuilt."
Which brings us to the second factor in play: political change. Americans have been angry about the insurance-run system for years, but neither party produced results. Bill Clinton botched reform in the early '90s, spooking Democrats so badly that, for years, they wouldn't even attempt major reforms. George W. Bush and congressional Republicans never met an insurance company they wouldn't hug, take money from and serve faithfully, so they've simply ignored the people.
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Last year, though, Barack Obama, Hillary Clinton, John Edwards, Dennis Kucinich and other Democratic presidential contenders raised the reform flag high, ultimately carrying it into the White House.
Today, redoing the health care system is on Washington's front burner, including plans for a public insurance option to extend coverage to middle-class working families. This public entity would provide a missing level of competition, lower costs and instill some honesty in companies that had been gleefully profiteering on the present system.
Like vampires, health insurance corporations shrink from sunlight, so they have rushed an army of lobbyists to Washington in a desperate attempt to stave off this public option. However, they recognize that they are widely despised across the land and that even some Republican members of Congress will no longer stand for the status quo (as one Democratic leader noted, "Status quo is Latin for 'The Mess We're In'").
Thus, we're being treated to the delightfully dizzying sight of insurance executives begging Congress to harness them with new regulations. "We are comfortable with that," said the head of America's Health Insurance Plans (AHIP), the industry's chief lobbying group, which heretofore has ferociously opposed any and all protections for consumers.
Of course, AHIP members are wiley masters at slipping out of regulatory harnesses - remember, these are the people who hire roving packs of lawyers trained to write and enforce incomprehensible insurance policies that boil down to this: "Thank you for paying us to do our damnedest to stiff you."
In exchange for accepting such "regulation," AHIP wants Washington to require everyone in the country to buy health insurance from Aetna, Humana, United Health or its other members - with taxpayers covering the annual premiums of those who can't afford the policies. In other words, these private corporations would get a government-guaranteed market. What industry wouldn't be "comfortable" with that?
In the interest of America's health, insurance giants should never be made to feel comfortable. At the very least, real reform requires a public insurance option to assure competitive integrity - and to put some "care" back in health care.