Percentage change since 2002 in average premiums paid to large US health-insurance companies: +87%
Percentage change in the profits of the top ten insurance companies: +428%
Chances that an American bankrupted by medical bills has health insurance: 7 in 10
—Harper’s Index, September 2009
Capitalists, as my friend Father Michael Doyle says, should never be allowed near a health care system. They hold sick children hostage as they force parents to bankrupt themselves in the desperate scramble to pay for medical care. The sick do not have a choice. Medical care is not a consumable good. We can choose to buy a used car or a new car, shop at a boutique or a thrift store, but there is no choice between illness and health. And any debate about health care must acknowledge that the for-profit health care industry is the problem and must be destroyed. This is an industry that hires doctors and analysts to deny care to patients in order to increase profits. It is an industry that causes half of all bankruptcies. And the 20,000 Americans who died last year because they did not receive adequate care condemn these corporations as complicit in murder.
The current health care debate in Congress has nothing to do with death panels or public options or socialized medicine. The real debate, the only one that counts, is how much money our blood-sucking insurance, pharmaceutical and for-profit health services are going to be able to siphon off from new health care legislation. The proposed plans rattling around Congress all ensure that the profits for these corporations will increase and the misery for ordinary Americans will be compounded. The corporate state, enabled by both Democrats and Republicans, is yet again cannibalizing the Treasury. It is yet again pushing Americans, especially the poor and the working class, into levels of despair and rage that will continue to fuel the violent, proto-fascist movements leaping up around the edges of American society. And the traditional watchdogs—those in public office, the press and citizens groups—are as useless as the perfumed fops of another era who busied their days with court intrigue at Versailles. Canada never looked so good.
The Democrats are collaborating with lobbyists for the insurance industry, the pharmaceutical industry and for-profit health care providers to craft the current health care reform legislation. “Corporate and industry players are inside the tent this time,” says David Merritt, project director at Newt Gingrich’s Center for Health Transformation, “so there is a vacuum on the outside.” And these lobbyists have already killed a viable public option and made sure nothing in the bills will impede their growing profits and capacity for abuse.
“It will basically be a government law that says you have to buy their defective product,” says Dr. David Himmelstein, a professor at Harvard Medical School and a founder of Physicians for a National Health Plan. “Next the government will tell us a Pinto in every garage, a lead-coated toy to every child and melamine-laced puppy chow for every dog.”
“Health insurance is not a race to the top; it is a race to the bottom,” he told me from Cambridge, Mass. “The way you make money is by abusing people. And if a public-option plan is not ready and willing to abuse patients it is stuck with the expensive patients. The premiums will go up until it is noncompetitive. The conditions that have now been set for the plans include a hobbled public option. Under the best-case scenario there will be tens of millions [who] will remain uninsured at the outset, and the number will climb as more and more people are priced out of the insurance market.”
The inclusion of these corporations in the crafting of health care legislation has not stopped figures like Rick Scott, the former head of the Columbia/HCA health care company, from attempting to sabotage any plan. Scott’s company was forced to pay a $1.7 billion fraud settlement—the largest health care fraud settlement in U.S. history—for stealing hundreds of millions from taxpayers by overbilling for medical care. Scott, who made his money primarily from Medicare, is now saturating the airwaves in a reputed $20 million ad campaign that is stoking the anger and fear of many Americans. His ads are coordinated by CRC Public Relations, the group that masterminded the “Swift boat” attacks against 2004 Democratic presidential candidate John Kerry.
“They are using our money to campaign against us,” Dr. Himmelstein told me. “The money for these commercials came from health care interests that collect fees from American patients. We experienced this before in Massachusetts. We ran a ballot initiative for universal health care in 2000 and the insurance industry spent $5 million on it, including the insurance company I am insured by. They used my premiums to smear an idea that 70 percent in Massachusetts, according to polls, favored before this smear campaign. Universal health care was narrowly defeated.”
The bills now in Congress will, at best, impose on the country the failed model in Massachusetts. That model will demand that Americans buy health insurance from private insurers. There will be some subsidies for the very poor but not for anyone above a modest income. Insurers will be allowed to continue to jack up premiums, including for the elderly. The bankruptcies due to medical bills and swelling premiums will mount along with rising deductibles and co-payments. Health care will be beyond the reach of many families. In Massachusetts one in six people who have mandated insurance still say they cannot afford care, and 30,000 people were evicted from the state program this month because of budget cuts. Expect the same debacle nationwide.
“For someone my age who is making $40,000 a year you are required to lay out $5,000 for an insurance premium for coverage that covers nothing until you have spent $2,000 out of pocket,” Himmelstein said. “You are $7,000 out of pocket before you have any coverage at all. For most people that means you are already bankrupt before you have insurance. If anything, that has made them worse off. Instead of having that $5,000 to cover some of their medical expenses they have laid it out in premiums.”
The U.S. spends twice as much as other industrialized nations on health care—$7,129 per capita—although 45.7 million Americans remain without health coverage and millions more are inadequately covered. There are 14,000 Americans a day now losing their health coverage. A report in the journal Health Affairs estimates that, if the system is left unchanged, one of every five dollars spent by Americans in 2017 will go to health coverage. Private insurance bureaucracy and paperwork consume one-third, 31 percent, of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough, Physicians for a National Health Plan points out, to provide comprehensive, high-quality coverage for all Americans. But the proposed America’s Affordable Health Choices Act of 2009 (H.R. 3200 in the House) will, rather than cut costs, add an estimated $239 billion over 10 years to the federal deficit. This is very good for the corporations. It is very bad for us.
The lobbyists have, as they did with the obscene bailouts for banks and investment firms, hijacked legislation in order to fleece the citizen. The five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of this year. The Washington Post reported that up to 30 members of Congress from both parties who hold key committee memberships have major investments in health care companies totaling between $11 million and $27 million. President Barack Obama’s director of health care policy, who will not discuss single-payer as an option, has served on the boards of several health care corporations.
Obama and the congressional leadership have shut out advocates of single-payer. The press, including papers such as The New York Times, treats single-payer as a fringe movement. The television networks rarely mention it. And yet between 45 and 60 percent of doctors favor single-payer. Between 40 and 62 percent of the American people, including 80 percent of registered Democrats, want universal, single-payer not-for-profit health care for all Americans. The ability of the corporations to discredit and silence voices that represent at least half of the population is another sad testament to the power of our corporate state.
“We are considering a variety of striking efforts for early in the fall,” Dr. Himmelstein said, “including protests outside state capitals by doctors around the country, video links of conferences in 70 or 80 cities around the country, with protests and potential doctors chaining themselves to the fence of the White House.”
Make sure you join them.