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"Stop the Bleeding!" First a Cure, then Recovery for Health Care System
The fact that most other industrialized countries are spending 50% less and receiving better care would seem to indicate that there is a structural failure in our health care system. Wild guess here, but I'm betting that a "health INSURANCE system" simply introduces too many parasites into the effort to provide efficient and effective health care to our citizenry.
I, for one, can state unequivocally that there is not ONE insurance company executive that ever provided for me ANYTHING that can even remotely be considered health care. And this is not a specious argument made in favor of universal single payer health care (at best!) or at least a "public option." It is simply common sense that seeks the elimination of the health insurance industry as the primary "cure" that is necessary to be undertaken before we can accomplish the systemic reforms needed to achieve adequate health care as a right for everyone in the United States.
I watched in amazement one Congressional hearing that included three Health Insurance Company CEO's testifying about rescissions. It was disgusting to learn of the incredibly cruel games they play - accepting monthly premiums from healthy people and immediately dropping coverage for same when they become ill - to preserve and enhance company profits. By their own accounting, over 20,000 "customers" of just these three companies were suddenly denied health insurance coverage at their moment of need per year.
As I watched, my thoughts became centered upon the impact that would be felt if these three execs were to simply "disappear" from our health care system. The removal of the expense of their salaries and compensation benefits of just these three execs from the overall health care "budget" would allow for free health care for my family and the families of my nearly 100 co-workers (with, tangentially, undoubtedly enough left over to cover the salaries of most of them as well).
How many such CEO's are we supporting with our health care dollars? How many duplicative staff and services are we supporting at each of these companies? At what cost in health care dollars being spent?
There is a demand for universal, single payer health care among the grass roots that will not be quieted. It is for reason that people see the same waste and inefficiencies of our "health INSURANCE system" that is so readily apparent to me, and they apply a common sense toward a solution. If we are truly serious about cutting waste, forget about diversionary talk about arbitrarily cutting physicians salaries or other such nonsense. Get the bloodsuckers off our back first, then let's talk about genuine recovery of our health care system.
I, for one, can state unequivocally that there is not ONE insurance company executive that ever provided for me ANYTHING that can even remotely be considered health care. And this is not a specious argument made in favor of universal single payer health care (at best!) or at least a "public option." It is simply common sense that seeks the elimination of the health insurance industry as the primary "cure" that is necessary to be undertaken before we can accomplish the systemic reforms needed to achieve adequate health care as a right for everyone in the United States.
I watched in amazement one Congressional hearing that included three Health Insurance Company CEO's testifying about rescissions. It was disgusting to learn of the incredibly cruel games they play - accepting monthly premiums from healthy people and immediately dropping coverage for same when they become ill - to preserve and enhance company profits. By their own accounting, over 20,000 "customers" of just these three companies were suddenly denied health insurance coverage at their moment of need per year.
As I watched, my thoughts became centered upon the impact that would be felt if these three execs were to simply "disappear" from our health care system. The removal of the expense of their salaries and compensation benefits of just these three execs from the overall health care "budget" would allow for free health care for my family and the families of my nearly 100 co-workers (with, tangentially, undoubtedly enough left over to cover the salaries of most of them as well).
How many such CEO's are we supporting with our health care dollars? How many duplicative staff and services are we supporting at each of these companies? At what cost in health care dollars being spent?
There is a demand for universal, single payer health care among the grass roots that will not be quieted. It is for reason that people see the same waste and inefficiencies of our "health INSURANCE system" that is so readily apparent to me, and they apply a common sense toward a solution. If we are truly serious about cutting waste, forget about diversionary talk about arbitrarily cutting physicians salaries or other such nonsense. Get the bloodsuckers off our back first, then let's talk about genuine recovery of our health care system.
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Thanks for this!
Says it all! And says it well!
Rec'd
August 2, 2009 1:50 PM | Reply | Permalink
Nothing like intelligently-aimed passion. Good post, SJ.
How do you get bloodsuckers off your back though unless you stop providing them blood?
What would happen, I wonder, if everyone who has been paying exorbitant individual health insurance premiums every month for years and years suddenly, all together, cancelled their policies tomorrow morning at 10am?
We have more power to change things than we think we do.
August 2, 2009 2:36 PM | Reply | Permalink
Maybe withhold one month's premium and send the amount to the Baucus campaign fund? Maybe THAT would get us where we need to be?
Actually, there is a gem of an idea in here someplace ... something that would make Alinsky proud! We should find some such campaign that could perhaps embarrass Washington into doing the right thing.
Thanks, gary.
August 2, 2009 4:28 PM | Reply | Permalink
"embarrass Washington into doing the right thing".
This is worth following up on, getting some input. Maybe it is a PR kind of thing, where we try and recruit enough people to to send one month's insurance premium to Baucus' campaign fund instead, call it a health care insurance premium--to insure that Max Baucus won't sell Americans short when it comes to health care.
You can word it in any number of ways.
August 2, 2009 9:27 PM | Reply | Permalink
Best to reconsider the real nature of an insurance company first: It is a vehicle for the generation of investment capital. "Coverage", such as they may provide, is what they see as part of their cost of doing business, and is to be minimized to the greatest extent possible.
Begin from that premise and things look very different, do they not?
August 2, 2009 3:07 PM | Reply | Permalink
and what if they were to suddenly lose a large chunk of that investment capital? See my comment above.
August 2, 2009 3:09 PM | Reply | Permalink
It would certainly have an adverse effect on premiums for everyone else, for starters.
August 3, 2009 10:48 AM | Reply | Permalink
That is why when they pay a claim for health care, the insurance-world term for that payment is: "LOSS." That says it all. When they pay for your X-Ray, your cast, or any other medical treatment it is to them, only a loss.
August 2, 2009 3:15 PM | Reply | Permalink
Thanks, OG! The "for-profit" nature of the health insurance business is so antithetical to providing good health care that it is indefensible. Don't believe me? Just look at the arguments they make against universal care. Such as "A 'public option' is unfair because the insurance companies won't be able to compete." Or boogie man stories designed to instill fear that are so incredibly bogus that you know the person advancing them is being intellectually dishonest.
You can't blame them for trying these fear tactics and simple b.s., however. By definition, it's otherwise a pretty tall order to refute common sense with any application of logic or reason. So, cue the GOP talking points. They have alotta' practice at defying reality, and there are enough profits to be protected that Baucus and a few other Dems can be purchased to join in the effort.
August 2, 2009 4:37 PM | Reply | Permalink
Time to take the profits out of our health care system.
The idea of slowly stripping it away from them is likely to create a long strung out, fierce political battle for some time to come.
Better to fight for the best (not claiming it is perfect) of a single payer system if we are going to have to go through such tough struggles anyway. At least then we have a chance of ending up with what we truly need.
August 2, 2009 5:49 PM | Reply | Permalink
Congress would issue a resolution stating that all for-profit insurance companies and hospitals would become not-for-profit entities within a specified period of time. The specified period of time would be for restructuring, liquidating, whatever.
The new not-for-profit entities would be set up according to strict guidelines.
Shareholders of the newly defunct entities would be compensated a certain percentage on the dollar by the federal government, in effect, a bailout.
Laid-off employees would get first dibs on jobs associated with digitizing patient records.
Laid-off employees would be given extensions on unemployment benefits/food stamps, etc. providing they demonstrate they have actively sought other work.
I'm sure I've left out stuff.
Hoping and wishing for not-for-profit health care isn't going to make it happen. Envisioning and discussing the process by which to make it happen is a step toward realizing it.
I'm neither an economist nor a business person. The recommendations above are just to get us out of the "wishing" mode.
BTW, Synch, this is in no way a criticism of your comment. I'm glad you brought it up.
August 3, 2009 12:33 PM | Reply | Permalink
By their own accounting, over 20,000 "customers" of just these three companies were suddenly denied health insurance coverage at their moment of need per year."
I just picked this because I wonder what the 'real' number is. A computer could take all their insured's and take out those who died. The the computer would take out of those numbers the number of people who were denied coverage or a procedure or whatever.
I bet you some home computer could handle this. ha
There are so many issues here well delivered by you.
On executive pay, the CEO's are bad enough but I learned that there are more under the top tier who are in on the theft in the corporate world. This along with more hidden thefts like stocks or reimbursement of expenses or their own 25000 dollar health packages.
Good post Sleepin.
August 2, 2009 5:55 PM | Reply | Permalink
Thanks, DDay! You know how I feel about exec compensation, campaign finance reform, and the excesses of Wall Street and our corporate "citizens." They all come into play in the health care reform debate - and none of it in our favor.
It all makes for a good fight for the populists, no?
August 2, 2009 6:16 PM | Reply | Permalink
SJ, you are talking about what I am talking about.
Lots of support in the right quarters that just has not bubbled up to the surface yet.
Only for easy reference to my anecdotal example without copying it here do I refer you to my post today:
http://tpmcafe.talkingpointsmemo.com/talk/blogs/wvbiker/2009/08/where-are-the-doctors-on-healt.php?ref=reccafe
August 2, 2009 7:46 PM | Reply | Permalink
Has anyone thought of filing a complaint against the insurance industry for practicing medicine without a license? So why not make one the next time you are denied a treatment for a disease by a voice on the telephone.
August 3, 2009 1:06 AM | Reply | Permalink
Usually, the person denying health care is a physician. Sick, ain't it?
August 3, 2009 5:39 AM | Reply | Permalink
Keep on fighting em Sleepin! Excellent post!
August 3, 2009 11:14 AM | Reply | Permalink
We have been conditioned to be driven by fear.
What TPM Gary suggests would send a powerful message, which is effectively: "Give me liberty or give me death."
Being willing to cancel our policies, or at least to put the payments in escrow, may get to the heart of what being a patriot is supposed to be about -- being willing to risk one's own safety for the betterment of the whole, with no guarantee that that risk will ensure success.
How many people would be willing to do that? Unlikely for the Boomers, who already have known health care concerns. But what if our twenty, thirty and forty-somethings, or at least those among them without known health issues -- did as you suggest? How many million policies being canceled or payments escrowed would it take to effect change? Wouldn't they risk less by doing that than being sent to Iraq and Afghanistan?
Or is the point to "give me liberty or give me death" that the message has to come from those most at risk?
Would we Boomers risk it all? It's a question worth thinking about.
August 3, 2009 11:52 AM | Reply | Permalink
We spend about twice as much per capita as all the other industrialized democracies, each of which provides coverage to more citizens and achieves better health outcomes.
Do excessive charges from the private health insurance industry contribute substantially to this excess? You betcha.
But most of the excess is not due to insurance excess. If private health insurance disappeared tomorrow, our costs would still greatly exceed those of other nations and would remain on an unsustainable trajectory. In fact, public expenditures (Medicare and Medicaid) are growing faster than health care expenditures as a whole - http:// www.concordcoalition.org/issue-briefs/2009/0521/long-range-forecasts-health-care-costs-ominous-and-maybe-even-optimistic
The greater portion of the excess is attributable to increases in services within healthcare itself. Some of these reflect demographic changes as well as valuable technological advances, but other nations confront these same issues. What is excessive here resides to a large extent in a disorganized system of duplicate or unnecessary facilities, tests, and treatments based on a fee for service paradigm that incentivizes excess. In some cases, this entails excessive profits for physicians or other providers, but much more often, it involves facilities that make little of no profit, and in some cases (some rural hospitals, for example) are struggling to make ends meet. It is the system as a whole, rather than most of its individual providers, that is responsible for the inordinate and rising costs.
This unfortunate reality tells us that adequate reform must encompass not only insurance and drug costs, but must also eliminate resources that in individual cases are blameless but which in aggregate are burdening us with an unsupportable cost burden. It additionally requires replacement of fee for service with something else - perhaps "fee for value" as advocated by some, or even in some cases a system of capitation or salaried providers. This will be extremely diffiult and wrenching, which is why none of the reform proposals address it adequately.
August 3, 2009 11:53 AM | Reply | Permalink
Trying the link again -
http://www.concordcoalition.org/issue-briefs/2009/0521/long-range-forecasts-health-care-costs-ominous-and-maybe-even-optimistic
It works in the preview pane. If it doesn't work in the comments, try copying the URL.
August 3, 2009 11:57 AM | Reply | Permalink
Another reason there are more tests, etc., is that most people seem to show more respect for their cars than they do their bodies.
They maintain their cars so they're not left stranded somewhere.
If we extend that notion to our bodies, i.e. maintain the body so it doesn't leave us stranded, there would be much less demand on the health care system.
There needs to be a fundamental shift in how we think of our bodies. If we showed the same respect for our bodies that we do all our stuff, we would be much better off.
This revelation occurred after reading the comments to Stilli's post.
August 3, 2009 12:45 PM | Reply | Permalink
Not much to disagree with here, Fred, although I think you continue to diminish the impact extraneous insurance costs place upon the degree of health care we receive per dollar spent.
You otherwise miss my point, which is to say there must be priorities here. First, we must fix the systemic problems ("Stop the Bleeding") by eliminating insurance as our method of payment and getting the other for-profits under control or out of the system as well. Only then can we be effective in tackling the other problems such as you outline toward making a recovery in the health of our health care system.
August 3, 2009 5:55 PM | Reply | Permalink
Thanks, SJ, for this post. It's compelling.
Discussions I've had about health care reform invariably conclude that health care has to become non-profit. It seems most people accept that.
It also seems we're going around in circles vilifying the insurance companies. They are within their rights, at present, to engage in the despicable practices that are just coming to light to make those profits. Is that moral or just? Most of us think not.
As more of our population becomes aware that people just like them are being denied care through tricks and technicalities, there will be more social pressure to demand the change necessary.
I really don't think the larger population has given the issue much thought -- yet. But they will.
The task now is to extend the non-profit health care system concept to specifics. How can it be done most efficiently to minimize adverse impacts on employees and limit the cost to the taxpayers i.e. in a shareholder bailout. Once codified, it has to become central to the discussion. That's how it will become a reality.
August 3, 2009 1:10 PM | Reply | Permalink
Whereas I believe it is possible to begin showing the specifics on the way in which we can transform the system, I believe it is most critical at present for the leadership to keep the message simple - kind of like "The Emperor (Insurance Companies) has no clothes!"
These milquetoasts we have in Congress need to gain some courage and stand up to the for-profit sector and make the populist argument that they are bleeding us dry while offering nothing in return. There is need for righteous anger among the populace to toss these parasites aside, and we need leadership that knows how to inspire same to good effect.
So far, I've seen very little in the way of true leadership on the issue. And it pisses me off! ;O)
Thanks for your comments. We'll get where we need to be, but only if we continue the discussion and never give up until we have genuine solutions in hand.
August 3, 2009 6:03 PM | Reply | Permalink