[NYTr] Why Does Everyone Bow Down to the Health Insurance Industry?

[All the News That Doesn't Fit]

sent by Ed Pearl

Alternet - Sep 24, 2007
http://www.alternet.org/healthwellness/63352/

Why Does Everyone Bow Down to the Health Insurance Industry?

By Barbara Ehrenreich

Bow your heads and raise the white flags. After facing down the Third
Reich, the Japanese Empire, the U.S.S.R., Manuel Noriega and Saddam
Hussein, the United States has met an enemy it dares not confront --
the American private health insurance industry.

With the courageous exception of Dennis Kucinich, the Democratic
candidates have all rolled out health "reform" plans that represent
total, Chamberlain-like, appeasement. Edwards and Obama propose
universal health insurance plans that would in no way ease the death
grip of Aetna, Unicare, MetLife, and the rest of the evil-doers.
Clinton -- why are we not surprised? -- has gone even further,
borrowing the Republican idea of actually feeding the private insurers
by making it mandatory to buy their product. Will I be arrested if I
resist paying $10,000 a year for a private policy laden with killer
co-pays and deductibles?

It's not only the Democratic candidates who are capitulating. The
surrender-buzz is everywhere. I heard it from a notable liberal
political scientist on a panel in August: We can't just leap to a
single payer system, he said in so many words, because it would be too
disruptive, given the size of the private health insurance industry.
Then I heard it yesterday from a Chicago woman who leads a nonprofit
agency serving the poor: How can we go to a Canadian-style system when
the private industry has gotten so "big"?

Yes, it is big. Leighton Ku, at the Center for Budget and Policy
Priorities, gave me the figure of $776 billion in expenditures on
private health insurance for this year. It's also a big-time employer,
paying what economist Paul Krugman has estimated two to three million
people just turn down claims.

This in turn generates ever more employment in doctors' offices to
battle the insurance companies. Dr. Atul Gawande, a practicing
physician, wrote in The New Yorker that ''a well-run office can get the
insurer's rejection rate down from 30 percent to, say, 15 percent.
That's how a doctor makes money. It's a war with insurance, every step
of the way.'' And that's another thing your insurance premium has to
pay for: the ongoing "war" between doctors and insurers.

Note: The private health insurance industry is not big because it
relentlessly seeks out new customers. Unlike any other industry, this
one grows by rejecting customers. No matter how shabby you look,
Cartier, Lexus, or Nordstrom's will happily take your money. Not Aetna.
If you have a prior conviction -- excuse me, a pre-existing condition
-- it doesn't want your business. Private health insurance is only for
people who aren't likely to ever get sick. In fact, why call it
"insurance," which normally embodies the notion of risk-sharing? This
is extortion.

Think of the damage. An estimated 18,000 Americans die every year
because they can't afford or can't qualify for health insurance. That's
the 9/11 carnage multiplied by three -- every year. Not to mention all
the people who are stuck in jobs they hate because they don't dare lose
their current insurance.

Saddam Hussein never killed 18,000 Americans or anything close; nor did
the U.S.S.R. Yet we faced down those "enemies" with huge patriotic
bluster, vast military expenditures, and, in the case of Saddam, armed
intervention. So why does the U.S. soil its pants and cower in fear
when confronted with the insurance industry?

Here's a plan: First, locate the major companies. No major intelligence
effort will be required, since Google should suffice. Second, estimate
their armed strength. No doubt there are legions of security guards
involved in protecting the company headquarters from irate consumers,
but these should be manageable with a few brigades. Next, consider an
air strike, followed by an infantry assault.

And what about the two to three million insurance industry employees
whose sole job it is to turn down claims? Well, I have a plan for them:
It's called unemployment. What country in its right mind would pay
millions of people to deny other people health care?

I'm not mean, though. If we had the kind of universal, single-payer,
health insurance Kucinich is advocating, private health insurance
workers would continue to be covered even after they are laid off. As
for the health insurance company executives, there should be an
adequate job training program for them - perhaps as home health aides.

Fellow citizens, where is the old macho spirit that has sustained us
through countless conflicts against enemies both real and imagined? In
the case of health care, we have identified the enemy, and the time has
come to crush it.


[Barbara Ehrenreich is the author of thirteen books, including the New
York Times bestseller Nickel and Dimed. A frequent contributor to the
New York Times, Harpers, and the Progressive, she is a contributing
writer to Time magazine. She lives in Florida.]