The Bobs are coming.
Unfortunately, I'm not talking about the A Capella group, or anyone from
the Church of the SubGenius. The Bobs I have in mind are all the
“concerned citizens” of hundreds of groups nobody has heard of yet who
are here to assure us that America has the most effective medical system
in the world, anyone who wants anything other than the status quo just
wants to suck on the public tit while denying freedom to everyone else,
and if we let government bureaucrats made our medical decisions for us,
America will end up looking like Auschwitz, the way Canada does now.
The medical insurance industry is gearing up to defend the billions and
billions of dollars it makes from skimming off the top of America's
medical sector. It began gearing up a couple of years back, when it
started becoming clear that whoever the next president was going to be
in 2009, it wasn't going to be another Bush Republican.
That it was Obama should have reassured them a bit. His plan, after all,
was to simply make the government another customer of the insurance
companies so people who are presently uninsured could get coverage. But
he was talking about fair rates and group discounts, and insurance
companies aren't used to back-talk like that from the government, or
anyone else. It isn't a case of “their ball, their rules.” They see it
more as “their GAME, their rules.” They've basically owned the entire
insurance sector since the 1940s, and as they tightened their grip in
the 1960s (Nixon and HMO reform), health care in America began a decline
that today has it listed by the World Health Organization as only the
37th best in the world, one notch ahead of Cuba.
They didn't mind another large captive market, one certain to pay
because the government could cover the premiums. But they did mind that
Obama said they should consider fair rates and group policies.
Their game, their rules. The insurance companies aren't interested in
throwing anyone a bone, and besides, they had the inspirational example
of what happened when the Bush administration told the government it
could no longer negotiate drug prices with the pharmaceutical companies.
Big Pharma is making a fortune on that, even in this economy.
And besides, this is America. No uppity bunch of public bureaucrats are
going to tell them what kinds of deals they offer the American people!
It isn't just greed that drives the insurance companies. It's
desperation. They need to make lots of money, because they owe lots of
money. More on that in a bit.
The last time they had to defend their profits was in 1993, and they
slapped Clinton silly by vilifying his wife, running a series of “Harry
and Louise” ads that showed a middle aged couple fretting over
government costing them their ability to select their doctors or types
of medical coverage.
Things have gotten far worse since 1993 as far as medical care in
America goes. Back then, proponents of private health care could still
say with straight faces that America had the best medical system in the
world, and not face widespread ridicule. Health care was slipping
dramatically, but it was still in the top ten among developed nations.
It still functioned, more or less.
And this time Hillary is nowhere near the healthcare debate. So the
insurance companies have their work cut out for them.
So far they've done a good job of cowing Congress and getting the
corporate media to agree that public health – single payer – is out of
the question. That between 70 and 80 percent of the American population
likes the sound of single payer is of little interest to the
corporations. It's not open for discussion, so shut up, citizens. We'll
decide what you may discuss.
But that broke last week, and in an unexpected way. Senator Max Baucus,
a right leaning Democrat and chair of the Finance Committee, told
reporters that “I think a bill that passes the Senate will have some
version of a public option.”
Right now we're still in the “deathly silence” part of the response by
the insurance companies. They are still rubbing their cheek and gazing
in shock at the little guy who just walked up to them and slapped them.
A “public option,” simply put, would mean that people looking for health
care could choose either the existing rat's maze of profit oriented
insurance company bureaucrats, or opt into a single-payer plan in which
the federal government was the provider and operated on a not-for-profit
basis. Not only would it not have the huge overhead that insurance
companies have (much the way that Social Security's administrative
overhead is less than one tenth that of any private pension provider),
but it would be big enough that it could force doctors, caregivers, and
pharmaceuticals to give it bulk rates.
It seems likely that it would cover “routine” medical care: annual
exams, basic dentistry, run-of-the-mill hospitalizations for appendix,
flu, gall bladders or whatever. Health insurance companies would still
corner the market on catastrophic health care coverage, the sorts of
mishaps that can rack up millions in medical bills.
And of course, people who want private coverage for routine health care
could still get it, if they wanted. Baucus is proposing an opt-out
system, a system that would feature far less complex forms, not deny
coverage based on pre-existing conditions or other technicalities, and
at worst cost about 60% as much. Even worse, the costs might be
subsidized by the government.
In a way, this is even worse than socialized medicine. Rather than just
abolishing the insurance companies – which might strike people as unfair
– it would make the insurance companies COMPETE with the government in
providing health care. If you are having a big debate with your provider
over whether your kid “deserves” coverage for treatment of his
high-mortality cancer, you can compare notes with your neighbor, who is
in the public system, over reliability of treatment and coverage, and
the amount the premiums cost.
On a level playing field, single-payer in which the government is the
insurer costs two-thirds what private health care costs. But with the
other advantages, such as simplified paperwork, group and bulk purchase
rates, and less time spent fighting with doctors and patients over what
treatments should be allowed, it could turn out to cost about half as
much – and that might be subsidized.
Private insurance companies wouldn't have a chance. Even in a country
crowded with morons who believe Windows is better than Linux because
Windows costs $150 and Linux is free, they wouldn't have a chance.
And they are desperate. As noted above, it isn't just greed driving
them; it's fear. Like the rest of the financial sector, they made a lot
of really stupid choices over the deregulated circus of the past 15
years, and as a result have huge debts, the result of bad derivatives
investments. Think AIG. They were only the biggest. Most of the rest are
in as bad a shape. They owe trillions, and are counting on America's
poor, elderly and sick to bail them out. Without the help of frightened,
sick people, they might lose their high-paying positions. Some could
even face jail. You can only imagine the horror.
Parenthetically, GM is a good example. Everyone knows they owed $172
billion when they declared bankruptcy last week. Most people DON'T know
that over half of that – some $90 billion – was owed on failed
derivatives investments. Something to keep in mind the next time your
loudmouthed neighbor starts complaining about how GM was burdened by all
those lazy useless union workers who put in 30 years and now expect to
be paid the pensions they earned.
So here come the Bobs. And, no doubt, an updated version of Harry and
Louise. You'll hear stuff like, “The insurance company may make payment
decisions, but not treatment decisions. If I don't like the way they
decide, I may pay for the treatment, and switch to another insurance
company. You may believe that government bureaucrats make better
decisions on your healthcare than your doctor and you, but I prefer
healthcare decisions be between my doctor and me.” Or “Socialized
medicine is ok if you are willing to accept rationed healthcare with
decisions made by bureaucrats in government. I prefer healthcare
decisions be between my doctor and me.” You'll hear snivels about
socialism, and get asked, “Why do you fear personal freedom and
responsibility?” And of course, the stories of Canadians having to wait
75 years to get a lollipop at the doctor's office. It's a wonder there's
any Canadians still alive, really.
What you WON'T hear this time is average working people listening to
Rush and nodding their heads and saying, “That's sure enough true.” Too
much has changed, and changed for the worse, since 1993, for Rush and
Harry and Louise to jolly, threaten and lie the American people into
supporting the insurance industry. Sixty-two percent of bankruptcies are
caused by medical bills, and seventy eight percent of those HAD medical
insurance. Didn't help when it was needed.
And virtually none of THOSE bankruptcies were caused by failed
June 11, 2009