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Health Insurers and Their Pavlovian Ideologues Disrupt Health Care Reform
I'm grateful to obey and miguelitoh2o and all the others who have written recently with such clarity and passion about the abuses of our health insurance industry.
In light of such information about Insurance Company abuses, it seems puzzling that the insurance industry lobbyists can actually mobilize people to disrupt town hall meetings on behalf of the insurance industry. Yet, it shows that these corporations can be strategic actors in the marketplace even as they are so inept at serving it.
If anything, the insurance lobby is pretty good at framing the debate with inflammatory rhetoric. Terms like "big guvmint," "socialism," and other triggers are thrown around like raw meat by these corporate organizers, with result that their "pavlovian populist idealogues" strain at the leash to just "git me a Congressman" when invited to do so on command at these meetings.
These people at the Town Hall Meetings are angry, to be sure! But if they would only take a minute to realize it was the corporate handlers who had actually sand-papered their assholes with practices like rescission and other abuses, they would turn their anger on their masters and really sink their teeth into the problem. With the insurance company parasites dispatched thusly, we could then anticipate some GENUINE health care reform and abandon this silly notion of INSURANCE INDUSTRY reform.
Someone please explain: If the objective is to be health care for everyone, what role does "insurance" have to play? Stated another way: If we are to collectively provide health care for all - with no limitations on pre-existing conditions or "exposure to risk" - what need is there to insure against "loss." In adopting universal coverage, aren't we determining that we are in fact going to accept the "losses" as part of our compact with our fellow citizens that we will be there for them (and us, too!) in their time of medical need? Or are we going to continue using health care dollars to "pay premiums" (contributions toward corporate profits - and lobbying!) to cover only healthy people?
Yeah, I'm angry too. But if I were to go to Washington with pitchfork raised, my first stop would be on K Street, not Congress. And if I were to choose to disrupt a meeting, it would not be at a gathering of citizens discussing matters with their elected officials. No, it would be in some corporate board room where I could righteously give a full-throated expression of the contempt I feel for the parasites who stand between us and genuine health care reform.
At the very least, I want returned to me the health care dollars I contributed as insurance premiums that are now being used to organize houliganism at these Town Hall Meetings. And then I want these insurance industry parasites to get off my back!
In light of such information about Insurance Company abuses, it seems puzzling that the insurance industry lobbyists can actually mobilize people to disrupt town hall meetings on behalf of the insurance industry. Yet, it shows that these corporations can be strategic actors in the marketplace even as they are so inept at serving it.
If anything, the insurance lobby is pretty good at framing the debate with inflammatory rhetoric. Terms like "big guvmint," "socialism," and other triggers are thrown around like raw meat by these corporate organizers, with result that their "pavlovian populist idealogues" strain at the leash to just "git me a Congressman" when invited to do so on command at these meetings.
These people at the Town Hall Meetings are angry, to be sure! But if they would only take a minute to realize it was the corporate handlers who had actually sand-papered their assholes with practices like rescission and other abuses, they would turn their anger on their masters and really sink their teeth into the problem. With the insurance company parasites dispatched thusly, we could then anticipate some GENUINE health care reform and abandon this silly notion of INSURANCE INDUSTRY reform.
Someone please explain: If the objective is to be health care for everyone, what role does "insurance" have to play? Stated another way: If we are to collectively provide health care for all - with no limitations on pre-existing conditions or "exposure to risk" - what need is there to insure against "loss." In adopting universal coverage, aren't we determining that we are in fact going to accept the "losses" as part of our compact with our fellow citizens that we will be there for them (and us, too!) in their time of medical need? Or are we going to continue using health care dollars to "pay premiums" (contributions toward corporate profits - and lobbying!) to cover only healthy people?
Yeah, I'm angry too. But if I were to go to Washington with pitchfork raised, my first stop would be on K Street, not Congress. And if I were to choose to disrupt a meeting, it would not be at a gathering of citizens discussing matters with their elected officials. No, it would be in some corporate board room where I could righteously give a full-throated expression of the contempt I feel for the parasites who stand between us and genuine health care reform.
At the very least, I want returned to me the health care dollars I contributed as insurance premiums that are now being used to organize houliganism at these Town Hall Meetings. And then I want these insurance industry parasites to get off my back!
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BOOM BOOM, OUT GO THE LIGHTS!
You got the Trillion $$$ question, Sleepin' --- "What role does "insurance" have to play?"
I keep asking that. I know the gibberish they keep throwing back, but it's the question people really need to ask. What role does insurance play? What do they DO? They're not the doctors or the nurses or the drug manufacturers... so what the hell are they offering, in return for their hundreds of billions?
Damned if I know.
August 8, 2009 12:47 AM | Reply | Permalink
Apparently quinn is bitter about health insurance because his policy won't cover plastic surgery, and only 2 hours ago he was just another smiling Canuck with a fish in one hand and a moustache in the other.
And now look at him! It's like Elephant Man with an inverted trunk poking hideously into his brain!
August 8, 2009 1:07 AM | Reply | Permalink
Thanks, quinn.
It's such an obvious question, but I think it's also the reason that single payer (and now "public option") is so carefully (and vigorously!) marginalized from any discussion. After all, if these were given a fair hearing, the insurance industry would be compelled to justify their role in "health care."
And so the strategic effort has been to create an assumption that the insurance industry is a natural component of any health care system. Health care providers? Yes. Hospitals and Clinics? Absolutely. Support staff involved in direct patient care? Of course? Administration to organize and oversee the health care effort? Goes without saying. But insurance execs and actuaries and investments and numerous multi-million dollar CEO compensation packages and high rise office buildings and golf courses? I can't see how any of it actually relates to healing the sick. It don't take a socialist to know that there is a great deal of health care monies presently being spent that could be put to better use elsewhere if we're serious about providing universal health care.
In fact, an honest examination of the insurance industry "contribution" to health care makes single payer a slam-dunk argument. And if you are an insurance corporation, that is to be avoided at any cost regardless of how many health care dollars you have to spend in lobbying to kill such an idea.
August 8, 2009 1:23 AM | Reply | Permalink
And it don't take no weatherman to know which way the wind blows.
And right now, it's blowing Obama out to sea.
August 8, 2009 1:40 AM | Reply | Permalink
Have you read HR 676? It is a Draconian bill that would require that every single provider covered under its Oh-So-Benign auspices convert into a nonprofit or public entity within 15 years.
Further, it doesn't really address many of the structural">http://www.cms.hhs.gov/reportstrustfunds/downloads/tr2008.pdf">structural deficiencies the current system currently suffers under.
Medicare-for-All was never going to pass for those reasons and others. That isn't to say that Medicare shouldn't have played a role in the reform effort. Had it been positioned as the "public option" instead, I suspect there would have been much less resistance since the program is widely popular on the left and right.
Just not as the only choice.
August 8, 2009 10:37 AM | Reply | Permalink
As I would expect, you introduce many sidebar arguments that include alot of the issues that we SHOULD be discussing in the search for real health care reform. These are a lot of the talking points you have relied upon to carry on your crusade to save the insurance industry, or at least divert attention from the insurance industry and the fundamental question of the uncertain contributing role they would play in providing universal health care.
You have pretty well established yourself in these pages as the most vigorous apologist for/defender of the health insurance industry. I was therefore hoping you would stop by to answer the essential question: What role do insurance companies play in a universal heath care system?
(NOTE: Having engaged in intellectual whack-a-mole with you in the past, you will notice I emboldened the essential question to focus a response. I look forward to hearing back from you.)
August 8, 2009 12:59 PM | Reply | Permalink
Of course it is a sidebar when you don't agree. Apparently only those things you want to discuss are worthy of discussion. Sounds a bit too much like the Rapture Right for my tastes, but irony isn't your thing.
Health insurance companies will play the same role they play in Switzerland and Germany and the Netherlands. The same role they play in many countries around the world that don't rely on single payer systems.
I have yet to apologize for a single thing the insurance companies have done. Not once. That is a lie and you make them with such relative ease that I am not really sure you read anything I actually right. I have said more than once that health insurance companies MUST be heavily regulated and barred from most of what they consider standard operating procedures now. If they can still make a profit without killing their clients, I don't think it is the government's role to take-out industries that aren't regulated properly.
Of course, it is much easier for you to paint caricatures of my opinions because then you don't actually have to respond to what I write. You toss out some ad hominem attacks, sketch a totally mistaken view of my "opinion" on the subject and then set up a straw man that you can knock down.
Patented ideologue behavior.
August 8, 2009 3:11 PM | Reply | Permalink
umm... the question, jason? Perhaps an answer to the question?
Not France. Not Germany. Not Mars. But here, in the United States. No more whining about "ad hominems" or "ideologues" or such. No more feints about how tough you would be in regulating the insurance industry.
All I ask is for a straightforward response to a straightforward question: Just what service would health insurance industry provide that would be of value in a universal health care system?
If there is a good answer to that, I would appreciate opportunity to consider it. But I'll bet dollars to donuts that it does not involve turning over the whole thing to the industry without AT LEAST some kind of public option. Methinks you know this as well, and thus the whack-a-mole continues.
August 8, 2009 3:26 PM | Reply | Permalink
I answered the question. You just didn't like or understand the answer. Let me slow it down:
We have one choice right now and you can't seem to accept it. We need to fix Medicare, design a workable public option and bring the insurance companies to heel. The legislation currently working its way through committee accomplishes many of those goals with the exception of really addressing Medicare. I have provided you with links to the Medicare Trustees own report that says it isn't sustainable, yet you want to give it to the entire country because you are convinced it would be better than what we currently have.You are entitled to your opinion but that doesn't make it fact. HR 676 was a fatally flawed from the get-go and for you to put all your advocacy eggs in the basket smacks of a naivete that is odd given your advanced number of years. I guess age doesn't necessarily deliver wisdom or even the ability to make objective judgments based on real numbers. I am sorry if you haven't taken the time to actually read the legislation in questions, but the summaries are actually pretty good to get an overview of what is actually being discussed in Congress.
How about you look at those bills and we can have a conversation based on what is actually being done in Washington rather than what you think should be done based on an obviously limited understanding of not only our own reforms but those undertaken around the world, most of which are a public-private hybrid like the one that is likely to make it to Obama's desk.
August 8, 2009 4:07 PM | Reply | Permalink
From a macro level, how is this lower cost possible?
Single-payer would involve one CEO (Cabinet Secretary?) and staff. No one would be compensated more than $400k/year plus benefits (by law) How many different Insurance Company CEO's and staffs would be supported under your proposal? And at what rate of compensation? How many more office buildings and related infrastructure is required to house and support the redundant staffs of the Insurance Companies under your proposal?
The Federal Government is prohibited from engaging in any lobbying activities. How many health care dollars would continue being spent on lobbying and marketing activities by the combined Insurance Companies under your proposal?
The Federal Government would not bleed profit from dollars spent on health care. How many health care dollars would be issued as profit for these companies under your proposal?
There is no shortage of such questions that arise intuitively whenever the argument is given that the insurance industry can do it all cheaper. According to Consumer Reports, one in every four health care dollars now paid as premiums is used to cover overhead and marketing costs in addition to covering investor profits for these Insurance Companies. That's no small chunk of change, and it begs the question as yet unanswered: HOW can the insurance industry manage universal health care cheaper than a single payer?
No ad hominems offered here, jason. No ideologic extremism. Thus, I leave you with no excuses or room for another round of whack-a-mole. You've said it's a cheaper solution. Please answer the question "How is that possible?" I'm truly curious, and welcome your reply.
August 9, 2009 2:11 AM | Reply | Permalink
From a macro level, there are a number of examples of private companies providing social services at a lower cost than the government. Most of those organizations are nonprofit and heavily regulated, yet they do on shoe-strings what the government is unable to do with an unlimited trough of unaccountable cash. The Defense Department only has a single "CEO" yet they seem to waste money without a problem. In fact, they made it an art form. As had every executive department in one way or another.
The Washington landscape is literally riddled with fraud, waste and abuse.
The health insurance companies already have buildings and people and infrastructure, much of it paid for. They won't need to invest a single dime to make the changes we need made, beyond investment in new medical IT infrastructure, which will actually lower their costs long term. What they need now are comprehensive federal mandates on what they must be covered as a bare minimum plan and the cost they are allowed to charge for it and what practices will no longer be acceptable. That will automatically change the math from the top to the bottom and make them compete on lowered costs as a way of making more profit or even being able to survive. No billion dollar paydays in a properly regulated health insurance environment.
Health insurers need a baseline and a very strict daddy.
That one is just funny. The federal government is being sucked dry by lobbyists already so I am not sure why would they engage in such activities? The federal government bleeds red ink like we have a slashed femoral artery, so not having a profit motive is clearly not the magic answer for organizational excellence.When money gets DC, there is no daddy because nobody votes in primary elections. The Congress wastes money like a drunken Sailor.
They are spending two and half billion on the new Department of Homeland Security headquarters and consolidating all their eggs in a single basket overlooking Washington from across the Anacostia River. That is in addition to all the othe multibillion dollar projects going on there and throughout the federal government.
How many buildings will your new Department of Homeland Health need?
You keeping pointing to the way the system currently operates as an excuse to not make the changes being negotiated in the Congress and to use single payer instead. I have explained why I think the current proposals making their way through committee will solve many of the things you mention as well as pointed out why single payer is not the best first step for our current problems nor is it the panacea you suggest given the actual legislation and how it is written.
In other countries who have solved some of our same challenges by instituting many of the solutions we are considering, the private insurer field narrowed considerably and most health insurance companies ended up nonprofit. For instance, Germany has a bout 200 companies vying to service the needs of German citizens.
I am OK with that as well for the reasons I have mentioned. I am OK with many of the compromises coming out of the Senate, as I suspected I would be.
You advocate for a bill (HR 676) that is fatally flawed and would not have delivered the return we would need given all the problems I have noted. Making health care insurance for 320 million Americans the responsibility of a US government agency will not magically fix the myriad of problems with our government at all levels and in all agencies. You would put our entire health care system into the hands of the same people who paid $400 for a hammer? You do realize that those things still go on all the time, albeit in more subtle ways.
This debate will not succumb to your continuining need to label everything Obviously This but Certainly NOT That.
August 9, 2009 9:28 AM | Reply | Permalink
To get away from being squeezed by margins, I included my response below. Thanks for the substantive arguments offered here.
August 9, 2009 3:54 PM | Reply | Permalink
Via Yves Smith who characterizes the health insurance industry's actions in crafting this faux reform as reported in Business Week "nauseating".
August 8, 2009 1:37 AM | Reply | Permalink
Thanks, Ellen (I think?)
Reading these articles you linked to affirm for me that my intuitive skills are still reliable; that you indeed do not need a weatherman to know which way the wind blows.
I've had my misgivings about Obama's handling of this issue from the start, and nothing has caused me to grow comfortable that universal health care is in fact the primary objective here. Relinquishing the health care reform debate to the insurance industry and to K Street would be tantamount to turning the repair of the Wall Street disaster over to the Wall Street Execs, you know?
Oh, wait....
August 8, 2009 2:00 AM | Reply | Permalink
From the article in Business Week (my highlight):
We should be concerned about "a level playing field?" This is a patently ludicrous complaint if the objective is to devise a more cost-effective health care system. It suggests a warning against a public option "monopoly," but it cannot follow through with a public harm that would result. And for good reason. Unlike private sector monopolies, it is not likely that a public option would "jack up insurance rates" upon eliminating the competition. There is no profit incentive to drive such an outcome.
Instead, the downside to a public option that is enumerated is that the insurance industry itself would be eliminated as a non-competitive (i.e. "more expensive") entity - and this is according to Ross speaking on behalf of the insurance industry! It is a credible complaint ONLY if the primary objective here is to protect and preserve the insurance industry, letting efficiencies be damned.
I argue instead that the elimination of waste and inefficiencies in providing universal health care is paramount. If that means the elimination of the health insurance industry, then I suggest they should start looking for PRODUCTIVE employment while getting the hell outta' our way.
And, besides, what is the alternative the insurance industry would offer in providing universal health care? Is it their suggestion that the Federal Government would subsidize the purchase of insurance policies to cover the 47 million people who presently don't have insurance? What would we gain here? We would pay the tab to provide health care coverage for everyone regardless of prior conditions and whatnot under such a system. But then we should also suffer great additional cost of ensuring that there also be monies provided as returns to shareholders (profits), overhead, and lobbying budgets for private insurance corporations?
According to Consumer Reports, we already pay as much as 25% of our health care dollars to insurance companies to cover their lobbying expenses, overhead, and profits:
It will be extremely difficult to find ways to fund universal health care. Tacking on as much as a twenty-five per cent surcharge for corporate welfare is an additional cost we simply cannot consider - regardless of how much of our present health care money (our "premiums") the insurance industry passes out in Washington.
August 8, 2009 5:57 AM | Reply | Permalink
Just when I thought this thread would diverge into ludicrous comments about quinn's avatar, here we are again with "holy healthcare."
But what is it exactly that makes healthcare so "holy?"
Is it the image of little crippled Billy now sprawled in a filthy hovel somewhere deep in Alabama, his tiny fingers gnawed away by rats and his eyes pecked out by pigeons (those sinister birds!) because healthcare CEO Phineas B. Evil won't pay for Billy's operation?
And he's only two years old!
Forget the dying planet! Forget nuking North Korea! Forget schools and infrastructure and unemployment and hundreds of thousands of foreclosures every month!
Okay! Your wish is granted! All that shit is forgotten! And besides...
The economy already turned around, because payrolls are shrinking slower than expected!!! And the homeless and unemployed ain't on the internet, because they got no computers! And a million dead Iraqis ain't on the internet because they got no life!!! And a million extinguished species ain't on the internet because they got no opposable thumbs!!!
And now...
Let's talk about...
Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare! Healthcare...
Let's talk about...
Holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy holy... healthcare!!!
August 8, 2009 1:54 AM | Reply | Permalink
Or perhaps we should just ignore it and now surrender to K Street, so we can then sequentially surrender to them on labor issues, on climate change, on energy independence, on defense spending reform, etc., when THOSE issues take their place on the legislative agenda.
For better or worse, the time to make the fight for legitimate health care reform is NOW! And pardon my insolent attitude if I insist on taking an offensive position in favor of true health care reform before this game ends and we move on to the next one.
August 8, 2009 2:08 AM | Reply | Permalink
What if what we get is a weak but surprisingly expensive "public option?"
That would be...
Weak because everything about Obama is weak, and...
Surprisingly expensive, because the public plan will be where every other plan dumps it's gomers.
And no, you don't have to tell me about the wonders of single-payer, because yes, I have opposable thumbs...
But if you absolutely have to mention single-payer, and it isn't in a sentence that also contains a reference to unicorns...
You must be drunk.
August 8, 2009 3:12 AM | Reply | Permalink
I'm guessing there is a cogent idea or argument in here someplace, but damned if I can find it beneath the apparent attempt at sarcasm.
In the event you are actually attempting to advance the discussion, ruta, please regroup and respond to the question as presented: What role does the insurance industry play that could possibly contribute to a universal health care plan?
August 8, 2009 4:50 AM | Reply | Permalink
Golly, I'll really have to "regroup" and think hard about your baffling question!
Although it may have escaped your slow-footed perspicuitiy, "universal healthcare" is already in force in the United States, just as the the slightly-more-intelligent-than-almost-anyone-who-blogs-on-TPMCafe former President George W. Bush once reminded you "nattering nabobs of negativity."
It's called "emergency rooms in public hospitals," and all of them are required by law to treat anything that anyone can drag through their doors.
The only problem with this form of "universal healthcare" is that it totally sucks!
On the upside, health insurance plays a very significant role in it, since anyone who can get medical attention anywhere else would have to be insane to go anywhere near a public ER, and it's fair to say that health insurance ordinarily keeps 270,000,000 insured Americans out of public emergency rooms.
But since I like you, SleepinJeezus, I 'll give you a little "added value" along with the preceding vocabulary lesson, and remind you that "universal" was already a misnomer for what you're actually talking about, and even my very instructive example of how healthcare insurance can contribute to "universal healthcare" would have to be supplemented by some provision for...
Approximately 3,000,000,000 human beings who do not have access to public emergency rooms in American hospitals, or any other medical venue.
But let's forget about them, just like we always forget about them, and get back to the transcendent issue of how to improve our own system, and how to make life a little bit easier and a little bit more convenient and a little bit safer for us, us, us, because...
Nothing else really matters.
August 8, 2009 12:53 PM | Reply | Permalink
Again with the obtuse attempt at sarcasm, rutabaga. What's up with that?
I don't think ANYONE - even the GOP, Blue Dog Dems, or their sponsors - has promoted the present situation of ER health care delivery by default as the model for universal health care.
In fact, it provides an opening to talk about the "hidden costs" of our present system, wherein we too often allow the health insurance industry to skim premium payments from healthy people off the top and leave the rest of us to provide care for the sick in our ER's.
And yes, rutabaga, health care reform is the "issue of the day" as determined by the legislative schedule. Get used to it, and quit trying to so strangely mock attempts by myself and other activists to focus attention on this issue.
August 8, 2009 1:12 PM | Reply | Permalink
Since "sarcasm" is apparently the only rhetorical trope familiar to the awfully sincere and self-righteous Mr. SleepinJeezus, an "activist" attempting to "focus attention on this issue," when "this issue" has already dominated the news month after month after month...
I might as well try to accommodate my comments to his limited arsenal of put-downs, and deploy something more like actual sarcasm than a reference to billions of people who don't have access even to the most primitive medical care, and say...
Thanks for posting this deep and insightful essay.
Harharharhar!!!
August 8, 2009 3:19 PM | Reply | Permalink
Morning Jeebus
The only thing the insurance companies can use as an excuse is the number of people they employ.
Of course when one considers that they employ people to mostly harass doctors and hospitals and do their damnedest to withhold care from their paying clients, one can then assume that it is a vehicle merely in place to make wealthy stockholders wealthier.
We already have a respected institution that does that. Wall Street. We don't need two wealth transference machines. They've grown far too greedy. Huffington had it right when she described them as pigs at the trough. (Sorry Miguel)
They are gluttons.
August 8, 2009 8:49 AM | Reply | Permalink
Thanks, cheekhen! It's great to hear from you!
When one considers just how much money they are tossing around Washington, it becomes apparent that they are not alone in being pigs at the trough. The Blue Dog Dems, for example, are playing the game to the hilt, and it's paying off for them quite well.
What I find particularly annoying is that our health care dollars (insurance premiums) are now being used by these corporations to detonate true health care reform. Their campaign contributions and intense lobbying efforts are all being paid for out of our health care dollars (our "premiums"). Kinda like being required to purchase your own noose.
Pigs provide value. These characters are more like tapeworms or other parasites who threaten to kill the host unless we initiate a cure. Single payer would certainly remove them from the system - as they fear - and would thus provide the healthiest outcome for us all.
August 8, 2009 9:10 AM | Reply | Permalink
It seems the existing companies, by an act of Congress, could be forced into not-for-profit status. They would be given a period of time in which to restructure or liquidate.
The government would subsidize part of shareholder payoff.
Many employees would keep their jobs, but those laid off would get first dibs on jobs digitizing patient records.
Employees who lose their jobs would be given extended unemployment benefits.
The new non-profits then would be responsible for servicing regional insurance pools.
Everyone in the region pays in according to income. A variety of plans would be available, but all would have to adhere to caps on copays and deductibles.
Okay, it's a fantasy. Wresting health care from the clutches of capitalism, although the ethical and moral thing to do, is not likely to happen in our greed-driven society.
Thanks for the post, SJ.
August 8, 2009 9:17 AM | Reply | Permalink
Great comment!
August 8, 2009 1:21 PM | Reply | Permalink
Thanks, LisB.
August 8, 2009 1:29 PM | Reply | Permalink
There is really no alternative cindy, unless we are going to surrender this democratic republic to the feudal lords altogether. It ain't just about health care. This debate has focused remarkable attention upon just how much the corporations own our government. We should be angry, and we should be doing all we can to establish We the People as the only constituency on the Hill.
As it is now, we've got what Reagan offered as trickle-down. The corporations and the wealthy take it all with the help of their hired Congress, and we await their largesse in passing it along. What we get instead doesn't feel so much like a "trickle down" of benefits, but rather more like a golden shower. Doesn't do much for me, and I surely wish it would stop.
August 8, 2009 1:41 PM | Reply | Permalink
Until it becomes illegal for legislators at the local, state, and national levels to be bought and paid for by those feudal lords nothing will change. They have a symbiotic relationship -- they keep each other in power.
To get that change, campaign finance laws (minus gaping holes) must be enacted and enforced. Why would legislators want to do that? This would require massive public outrage. Right now too many people are either resigned or inured to business as usual.
August 8, 2009 2:12 PM | Reply | Permalink
It's really very simple. They generate investment capital at the expense of those who are denied the coverage they pay for.
August 8, 2009 12:06 PM | Reply | Permalink
That's as succinct an answer to the question as I've ever seen grouch.
August 8, 2009 1:23 PM | Reply | Permalink
So why the f-ing hell am I the only person saying things like this? If that meme went wide even the bozos disrupting town hall meetings on behalf of the insurers and others would do a 180 and start storming the HQ's of these parasites.
How do we get that out there?
August 8, 2009 2:27 PM | Reply | Permalink
I share your frustration, OG. Where's the outrage?
August 8, 2009 2:37 PM | Reply | Permalink
Okay, grouch. Now you've got my attention. You're right.
Most people don't understand how insurance works. I had never thought about it until recently.
For starters, almost every newspaper is running stories about town hall meetings. This is the perfect opportunity to reference one of those stories in a letter to the editor and include your apt summary of the insurance companies' reason for being.August 8, 2009 2:42 PM | Reply | Permalink
Grouch, here's the letter I just sent to the editor of my local paper:
Thank you for the inspiration and the verbiage. (Hope you don't mind...)
August 8, 2009 4:22 PM | Reply | Permalink
We'll see what America is really about, hey Zeus. Good post.
August 8, 2009 1:22 PM | Reply | Permalink
Wow. One picture ...
August 8, 2009 1:27 PM | Reply | Permalink
Nice find, there, peeg...
August 8, 2009 2:25 PM | Reply | Permalink
I hung that during the 2000 recount.
E Plurbius Unum
August 8, 2009 5:34 PM | Reply | Permalink
Just walk away. As long as they keep taking in our premiums they will have the power to control the debate. Don't be a victim, form physician co-op's and cut them out of the financial circle.
Bitching at Congress obviously isn't having a positive effect.
August 8, 2009 2:20 PM | Reply | Permalink
This is really about a lot more than just health care. The U.S. is part of a world community where we face some stiff global competition. If we can't figure out a way to get a handle on health care costs we are sunk. Having our costs running double other western industrial nations isn't going to bring jobs back - ever. All the complainers of labor costs in the U.S. have to take healthcare into account. It is a very significant piece. Without jobs the healthcare we might have isn't going to do us any good. Healthcare is a major feature of every global economic unit. Countries who provide it most efficiently for all citizens at the best cost will have a healthy population and be able to compete.
Healthcare has to be figured as a national cost of doing business. That means changing it from being a profit center to a cost center.
August 8, 2009 2:24 PM | Reply | Permalink
And I retain remarkable faith that we are capable of getting the job done - if only we could get the monied interests outta the way!
There are a lot of really difficult questions that need answers and alot of creative solutions that need to be put in place. If we were to assume an adult perspective we could fix this, and we'd all be healthier for the effort.
Great remarks/perspective tpc. Thanks!
August 8, 2009 2:34 PM | Reply | Permalink
A wild idea. Since we will all eventually get seriously sick, and we will all therefore need healthcare, consider the following.
The government runs on money. The insurance industry runs on money. Healthcare costs money. Who pays them all? We do!
So, Monday march down to your HR office and change your witholding status to 'exempt' in anticipation of coming health care expenses. If enough do this, they will listen.
August 8, 2009 2:32 PM | Reply | Permalink
I like the concept, however depending on how this bill is crafted, we will likely be required to buy in to the existing insurance market. So there's not really enough time to make that expense hurt the industry before some kind of healthcare refor bill is passed. If we're lucky we'll be able to opt into a public option allowed to pay medicare rates. If we're not given a strong public option, this bill will be the biggest publicly financed windfall for the insurance industry of all time.
August 8, 2009 3:00 PM | Reply | Permalink
Something I saw elsewhere in another blog: How would the Court view a law that all - everyone - must purchase a private health insurance policy as a requirement of citizenship? It's an interesting question that almost begs for a public option as a means of avoiding an overwhelming legislative mandate in support of private businesses.
August 8, 2009 3:16 PM | Reply | Permalink
Just say no. Then follow up with your action.
August 8, 2009 4:15 PM | Reply | Permalink
Sleepin' Jesus.
You've hit he nail on the head in this post. Single Payer has to be the ultimate goal. But I will take a Public Option for now. I have nothing to add that you have not argued masterfully already.
August 8, 2009 2:55 PM | Reply | Permalink
Thanks, ripper! I would settle for a public option, as well.
What I will NOT do is pretend that my support for a public option is not accompanied by a belief that it will eventually lead to single payer; that indeed the insurance industry will not be able to compete and will have to get out of the way of a more efficient system.
After all, the long-term health of the insurance industry is simply not found on my list of priorities here. Health care for all Americans is.
August 8, 2009 3:07 PM | Reply | Permalink
I aappreciate the legitimate passion for reform expressed in this thread, but I also believe that some misinformation is being perpetuated.
First, regarding the proposed public option, it would cost taxpayers nothing, since it's self financed through premiums. The proposed legislation requires mandatory insurance, private or public (with a few exceptions), and requires all insurers to meet minimum standards for benefits offered, and to accept all applicants, without discriminatory charges based on health status. Therefore, the public option can't serve as a dumping ground for applicants rejected elsewhere, because rejection will be forbidden.
Second, the critics are correct in stating that on a level playing field, the public option would ultimately drive all private insurers out of business and lead to a "government takeover" as claimed. Whether or not that's desirable is beside the point in terms of the debate, because Congress won't accept it, and the American people, in polling data, indicate that they prefer a public/private combination to an exclusively government run system.
Most nations that do better than we do utilize various public/private hybrids. For example, France, often touted as having the best system for quality at affordable prices, publicly insures everyone to a certain level (about 70 percent), with almost everyone then adding private insurance to avoid inordinate out of pocket expenses. We might do something like that here eventually, but it is not what is being proposed currently.
Finally, universal or near universal insurance is an essential ingredient of all effective healthcare systems worldwide. Insurance is a communal risk-sharing mechanism, whereby everyone pays into the system, with those fortunate enough to need little in the way of medical care subsidizing those unfortunate enough to encounter both illness and high medical bills. The question is not whether insurance is needed - it is - but who does the insuring, under what regulations, and with what oversight. The experience of other nations tells us that it is not single payer per se, but a strong role for the public sector as insurer and/or regulator that guarantees effective and affordable healthcare for all.
August 8, 2009 3:05 PM | Reply | Permalink
Thanks for your patience, Fred. Keep hammering it in. This is not an easy issue to fully comprehend. You've done a remarkable job of explaining it.
August 8, 2009 4:12 PM | Reply | Permalink
Great comment. Hopefully SJ will listen when it comes from another democrat, but I somehow doubt it.
August 8, 2009 4:15 PM | Reply | Permalink
To expand on one of the points I made above, a public option and private insurance could coexist in stable fashion if they each established a separate niche by offering different products. Presumably, the public option would provide basic essential services, while private insurers would be allowed to compete among themselves for various forms of supplementation. That seems to have worked elsewhere, and has left reasonable territory for the private insurers to occupy.
August 8, 2009 6:08 PM | Reply | Permalink
Thanks so much for this, fred. You have hung some meat on the bones of the argument that there is perhaps a role for the insurance industry to play in a universal health care system. I remain unconvinced, but you have provided the foundation for an honest, vigorous back-and-forth discussion of the type we should be having about health care reform. It is this kind of honest, logic-based discussion through which consensus is a possibility.
What I find particularly interesting relative to this blog is that you seem to concede that at least the public option is a critical component of ANY health care reform. It is an intuitively obvious conclusion, and you confirm that intuition here.
The insurance industry - and their apologists/promoters/tools - forfeit all credibility in the debate with their insistence that the industry cannot accommodate any such competition from government. Self interest cannot ever be allowed to trump logic and reason if we are to arrive at meaningful solutions. And the insurance industry lobby has shown pretty consistently that they are all about self-preservation and enhancement of profits while promoting "health insurance reform."
August 9, 2009 12:19 AM | Reply | Permalink
Pretty much.
If they continue to exist it should be with caps. it should be understood that modest profits will be tolerated but making millions off the sick is wrong, immoral, and unacceptable. If they don't like the new rules, well, there are plenty of people that have no problem with modest profits.
Maybe it's for some new corps. These have existed for a lifetime already, and more. They represent unfair competition over people because they don't die. That is why, corporations, until quite recently, were dissolved after 75 years.
Common Sense.
August 9, 2009 1:44 AM | Reply | Permalink
Single payer advocates loose all credibility in the debate when they insist that government is simultaneously incapable of regulating the health insurance industry yet remain capable of running health insurance for the whole country, all evidence to the contrary.
August 9, 2009 9:37 AM | Reply | Permalink
And insurance corporation advocates lose all credibility when they insist that government is incompetent, yet propose that the solution to Health Care Reform is to get Insurance Companies under control by passing and enforcing effective regulation of the industry.
At the very least, jason, it is a circuitous complaint, no? More appropriate for a blog on campaign finance reform and government reform than here, although it certainly highlights the difficulties we confront in enacting ANY real change in the health care system.
August 9, 2009 4:01 PM | Reply | Permalink
I have neither advocated for insurance companies nor said the government was incompetent. I am still waiting for you to provide a quote where I have. It is very easy. See the little "permalink" link? Piece of cake.
What I have said, since it seems to have slipped past you, is that the government is in need of some drastic overhaul that precludes it being able to run a program of this nature as it is written in HR 676. I do think Uncle Sam is more than capable of regulating the health insurance industry just as it does any dozen of other industries in the US.
It is only the last thirty years or so that our regulatory structures have really broken down. For the fifty before that they worked great.
August 9, 2009 4:08 PM | Reply | Permalink
Really outstanding post and comments Sleepin, never seen it said better.As to question "What role do insurance companies play in a universal heath care system?" The answer they already know themselves is ZERO, hence their battle for survival and to stave off the awakening of people to their uselessness in a post private health insurance world. Dinosaurs ferociously snapping at the falling snow.
August 8, 2009 3:34 PM | Reply | Permalink
Line of the day, Dondi. And yes, this is a great post with great comments -- it's been a joy to read it.
August 8, 2009 3:49 PM | Reply | Permalink
Thanks, LisB. Even an "ad hominem attacking ideologic liberal extremist" doesn't need a weatherman....
Sometimes, in fact, common sense serves us well, but only if we are sufficiently vigilant to see through assaults on common sense.
I find the arguments put forth by the insurance industry to be just such an assault ... and insulting, too!
And, also.
August 9, 2009 1:05 AM | Reply | Permalink
Thanks, DonDi. That's high praise coming from one who writes so well about these issues on your own blog.
And I agree with LisB. That's DEFINITELY the line of the day. Saying it all in such few words is exquisite poetry.
August 9, 2009 12:28 AM | Reply | Permalink
(The following is written in response to jason everett miller's substantive arguments presented above)
Thank you for your direct response to the discussion items. Your clarifications of generalizations previously made serve as an opportunity to engage in an examination of the issues, and I thank you for it. I will attempt to respond in order as follows:
You seem to propose a transition wherein CIGNA, for example, is going to transform into a lean and mean, non-profit "Sisters of the Holy BeJeeberz" charity. This is a real stretch - pretty hard to swallow as a legitimate assumption that leads to cost savings. The CEO's directing the present lobbying effort are all about preserving their compensation packages, their perks, and the rest of their corporate culture including corner offices in high rise office buildings. You might think it's credible that they are now somehow implying that they will join the convent for the betterment of all society, but I think their testimony on rescission (Note testimony in particular at @4:50 in the clip) and their other activities indicate they are all about preserving the status quo.
Your DoD example does not reflect favorably at all on your assertion that private industry does it better. It has become, after all, the "military-INDUSTRIAL complex" that Eisenhower warned us about and that we have ignored at our peril. The revolving door, the no-bid contracts, and the other corrupt (yet surprisingly legal) accommodations to Halliburton, Boeing, and all the other corporate interests that own our DoD would indicate that the more closely we surrender government responsibilities to the private sector, the more wasteful and corrupt the systems become.
Little argument here. But simply caving in to the special interests in foregoing genuine health care reform to make certain the special interests are served does nothing but perpetuate the problem. At its essence, government is us. If we fail to overcome "fraud, waste and abuse" it is because of our failure to effectively act upon it. Lending credibility to the insurance industry lobbyists as the "professionals" who should direct the health care reform effort to the exclusion of organizations such as the California Nurses Association and other legitimate professional experts simply promotes "fraud, waste and abuse."
How does this complaint comport with your argument that the Insurance Industry will become a contributor to the social good after we whip them into shape with proper regulation? What effect might these lobbyists have on such regulatory reform?
The point still stands: Single Payer (Federal Government) would not include expenditures on lobbying and marketing as a bucket into which we pour our health care dollars.
Please review this response to the point made, and I think you would have to agree that this is pretty thin gruel presented as an opposing argument. Redundant corporations and their staffs would undeniably require redundant office facilities and its support. And it is unreasonable to assume that present facilities would simply be "donated to the cause" as a non-expense, even if we assume that these bought-and-paid for facilities will be home forever to the corporations. (After all, what is an insurance company if not a major consumer of real estate for the next "latest and greatest" architectural masterpiece to call "home?" It's a HUGE part of their corporate culture.)
In the absence of any substantial argument otherwise, I will consider that you have ceded the point about redundancy being inefficient.
And you complain about strawman arguments? Nowhere have I advocated for HR 676, nor have I pretended to propose a final solution to the very complicated effort to reform our health care system. In my estimation, HR 676 is flawed for many of the reasons you have outlined. But these are structural complaints, not the conceptual critique between Single Payer and Corporate Run Health Care that is first required to be made.
My activism on the topic has been very closely focused upon seeking an answer to a few fundamental questions, such as:
1.) What role does "insurance" play in a universal health care system, the objective of which is to provide health care coverage to everyone? What are the "losses" we would "insure" against in this scenario?
2.) Single Payer; Corporate Run; or a combination of the two? It is possible to cast aspersions on both government AND corporations for the ways in which both entities bleed money due to fraud, waste and abuse. But discussions about correcting these problems are premature. We must first determine which prospect presents the most efficient model for a system, and then exercise our responsibility to correct any fraud, waste and abuse problems, be it through regulation of the private industry or Progressive reform of government. (NOTE: NEITHER of these corrections are possible without serious government reform.)
I'll match you two such anecdotes of corporate waste for every one you care to make about government. What is instructive here, however, is to recognize that this is an argument based upon ideology - from one who so wilfully and regularly discounts others for being "ideologues."It is not me who has the "ad hominem attack" whine at the ready as a standard part of my debate repertoire, and I do not propose introducing it now. It's such a transparent diversion, after all, and contributes nothing to these discussions.
I include this quote here, however, to point out that you give as good as you get. 'nuff said.
August 9, 2009 3:52 PM | Reply | Permalink
I am trying to point out to you the facts that you dismiss in your fervor to implement Medicare-for-All. This entire comment is yet again another example of your inability to argue your point with actual facts from the legislation being proposed.
You insist insurance companies will never be reigned in yet refuse to accept the evidence of that very thing in multiple countries around the globe who face the very same issues we have and instituted many of the same solutions we are currently discussing.
Your love of Uncle Sam is kind of perverse given the government's performance in a vast number of areas. I have yet to say corporate America doesn't need a huge and sustained foot up their ass, but you seem oddly unwilling to admit that that the federal government is in need of the exact same thing.
Further, as to ideology, Fred said the exact same thing I have and yet you respond much more cordially and sensibly. You continue to be a hypocrite and unable to recognize your own poor behavior when I go out of my way to be non-ideological in how I am viewing this debate.
I am just about done responding to your nonsense unless it is patently false instead of merely naive.
August 9, 2009 4:17 PM | Reply | Permalink
Point, set and match, my friend.
There's been a whole lot of substantial discussion here focused upon a few simple questions. The answers sure don't look good for the Insurance Industry or its lobbyists and tools.
Your rant only serves as exclamation of your failure to support your arguments in favor of corporate control of health care. That is, of course, my opinion but I am willing to allow the record to stand in support of that opinion for anyone who cares to review it in this blog and its comments.
August 9, 2009 5:31 PM | Reply | Permalink
Glad to see acknowledged my victory. Perhaps you can win the next round.
By the way, I am still looking for the quote that shows my advocacy for corporate controlled health care. I don't think that is the end goal of the current legislation.
If it is such an obvious opinion of mine, surely you could provide a single link.
August 9, 2009 8:38 PM | Reply | Permalink