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Here comes Bob!
And Harry! And Louise!

by Bryan Zepp Jamieson
June 6, 2009

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 derivatives investments.

Posted: June 11, 2009

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