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As Long as We Remember...

April 2, 2009

On the other hand…what’s better?

Tony Soltero

Health care exists for the purpose of keeping people healthy. Well, duh. A simple and stupefyingly obvious statement, most would agree. And, yet, it’s not a sentiment universally shared by everyone.


In the minds of health-insurance executives and their many puppets on Capitol Hill, the entire purpose of health care is to generate income and profits for a few stockholders and corporate boards of directors. Maybe some people will get helped by the services they provide, but that's not the primary thrust of a health insurer. The entire focus is on maximizing profits – the actual health of customers is a tangential consideration at best.


Think about it. The less service a health insurer provides, the more money it makes. The quicker their policyholders die, if they contract a serious illness, the fatter the insurance industry's bottom line. The more we suffer, the more private jets they can buy.


There is no more stark built-in conflict of interest in America. We entrust our health-care coverage to institutions which benefit most when they deny it to us. Professional claims denial is actually a career track within most health insurance providers.


In a nutshell, this is why health care in America is such a disaster by Western standards, despite the fact that we have many of the world's best and most dedicated doctors and nurses. We routinely rank at the bottom among industrialized countries in most health-care indicators – life expectancy, infant mortality, vaccination rates. We pay twice as much as Canadians and Europeans for health care – and don't get anything remotely resembling value for the extra expenses. Third-world countries like Costa Rica and Cuba are embarrassingly comparable to us in most health measures.


America ranks 50th in the world in life expectancy at birth, well behind countries like Jordan and Bosnia. We're barely ahead of Albania.


And this is all a natural consequence of health care being regarded within our culture as just another opportunity to make money. Insurance companies make all the decisions – not doctors.


The political class in this country has been avoiding dealing with our health-care shortcomings for decades. The last serious attempt at reform, by President Bill Clinton in 1993, was shot down by the health-insurance lobby. And they've only gotten richer since – which figures, because health care for Americans has gotten more and more expensive during that time.


But the problems are too acute now to kick that can any further down the road. The gross inadequacies in our health-care system are beginning to affect the upper-middle class now – and historically, that's the point at which political leaders actually begin to pay attention.


So, health care reform is occupying a prominent place at the Obama Administration's table. The president himself has set a goal to pass major health reform by the end of this year, leaving the details to Congress. And many proposals are being floated.


But for health-care reform to have any meaning whatsoever, there needs to be a public option in place – essentially an expanded Medicare available to all. It is perfectly fine to have open competition among private insurers. We have very little of that today. But private insurers still have an incentive to deny coverage and care to "high-risk" patients, and, in many cases, won't even insure them at all, or will do so only at exorbitant premiums.


A public option is imperative to cover those who would otherwise fall through the cracks. But there are powerful forces opposing it – the insurance industry, of course. They don't want a public option because – gasp – people might actually use it and like it.


It's hard to understand where their fears reside. After all, part of conservative dogma is that the government never does anything right, so the insurance industry need not be worried that a public health-care option would be much of a threat. Nobody would pick them, after all. But they are worried. Gee, maybe a government health care plan might actually be pretty popular after all? Obviously, conservatives don't believe their own platitudes.


If private insurers were confident in their product, they needn't worry about a little government competition. But because they're more concerned about making money than about keeping people healthy, it's understandable why they fear they might lose customers.


Only a public option will keep private health insurers honest. Anything less and all claims of health care "reform" are a sham.


We're about to find out how serious the Obama Administration is about health-care reform.


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