Relative to health care reform, let's pretend we're Columbo

First, the evidence behind the suggestion we cannot. One million Americans, as a consequence of disease and accident related health care traumas, file for bankruptcy protection every year. Of those who do, more than 50% had health insurance! Think about what that really means to the economy. Bills, not just medical, don't get paid; doctors' bills, hospital bills, bills to medical equipment suppliers, auto loans, furniture loans, home mortgages, credit card bills . . .. The list and the total sums that are passed along to all of us, to make up for the losses sustained by creditors, is a staggering drag on the national economy.

In congressional hearing after congressional hearing the statistic that right now the national tab for medical care consumes 16% of our gross domestic product. And it's rising! Over the past decade that percentage has grown from around 8% to where it is today. No overseas companies carry that kind of burden. It's as if our domestic companies were 150 pound runners in a foot race with other 150 pound athletes while the US firms alone are each carrying a 24 pound satchel on their backs.

Referring again to the above cited hearings, only seven mega health insurance corporations compose more than 33% of the total market. Because, for more than a decade prior to retirement a few years ago, I was a licensed and appointed life and health insurance representative for all seven, and was quite familiar with each, I will constrain my remarks to health insurance industry issues.

Anyone who has lost a job that had been paying the health insurance premium, and who was confronted by the COBRA cost of that premium understands well enough the difference in the cost of a group plan premium and that of an individual policy. Presently the "average" annual employer-paid health care premium is somewhere around $15,000, and that recently that premium has been increasing 15% per year. By the Rule of 72 (Divide the rate INTO 72, to determine how long it will take for the sum to double), that $15,000 premium will double to $30,000 within six years! Can anyone honestly argue that any employer will be able to pay that, while also retaining the current numbers of full-time workers and/or paying any kind of wage or salary increase?

A Parenthetical, But Extraordinarily Pertinent Question.

Under every federal and state statute, the only function of an incorporated health insurance company is to maximize, in whatever legally permissible means are available to it, the return to its investing stockholders. Indeed, the corporate executives can be investigated by several governmental agencies and sued by the stockholders if they fail to abide that obligation. En route to the fulfillment of that task, insurance companies might be presumed derelict if they pay claims they could otherwise avoid, and if they take on or do not drop subscribers who present an undue risk. Businesses are not in the moral principle or brotherly love business. They are in the money-making business. And that's something all Americans should understand, to the core of their souls.

Originally, the original health insurance companies Blue Cross and Blue Shield were nonprofit. An interesting question to ask someone is "what was the generative purpose they were intended to serve?" Here too, I doubt many know the answer to that one.

What they were not set up to do was to protect the American public from the disastrous consequences of a health related calamity. As is the case today, they were never intended to do that. Rather, they were set up solely to protect the financial interests of but two entities: hospitals and doctors. That is, both were fatigued of the reality and the prospects of being stiffed by non-paying patients; the why of the stiffing being irrelevant.

But there is a significant distinction to be drawn between what a corporation's primary obligation is and the functions necessary to the survival and prospering of a society. Relative to some, morally just, delivery of healthcare to Americans, what mechanism offers the most probable prospect of meeting those ends? The health insurance industry, in its quest to minimize risk and to cut costs by denying claims, suffers extraordinary inefficiencies that result in 30% administrative overhead. No federal program exceeds 7%, while at the same time, those within the federal programs enjoy better actual healthcare delivery results. The relevant question thus seems obvious: While we understand that the private, for profit health industry does a great job meeting its obligations to its stockholders and executives, what socially beneficial good does it provide to the citizens of the United States?

Understand, if an insurance companies denies a treatment or other therapy prescribed by your physician, you do have the right of appeal. But that appeal is to an insurance company panel. Dissatisfied with that, you can appeal further to an outside panel that, by the way, is funded by the health insurance industry. Do the words "fat chance" seem possibly apposite?

But let's say that by some dint of good fortune we get either a "public option," or that the heavens opened up and a deep booming voice persuaded the politicos to pass a government single-payer scheme, and that you were denied a recommended therapy, what recourse would be available to you? Just for starters, there are your elected state and federal representatives. Perhaps you're inclined to the cynical. But compared with an insurance company and its panels who are dedicated to meeting the primary obligations I noted above . . .?

Questions Recap

It might seem as though I pooh-poohed the thorny problem, how to pay for all of this? That's only because I left it for last. The unvarnished truth is that, in large measure, we're already paying for it in unnecessary bankruptcies and all the attending costs they engender, and we're paying for it in the crush the un- and under-insured place on our emergency rooms and clinics, and we're paying for it in the horribly elevated premiums the insurance companies are exacting from us, to accommodate the armies of clerks that their corporate mandated requirements to deny and to cancel coverage whenever it's legally possible require. That said, blood will still have to be shed, to pay the difference, and it's going to be necessary that our elected representatives grow some courage, to wield the swords. The mega-multi-millionaires and billionaires were doing well, thank you, before they were lavishly fêted to the unrequested banquet of the Bush tax cuts. The Congressional Budget Office has forecast that the net consequence to the deficit and national debt would be zero, if just half of the tax monies sacrificed on the alter of helping Bush's "mores and the have mores" were reinstituted.

Finally, here's where I'm coming from relative to reinstituting a portion of the Bush tax cuts on the super wealthy: I don't live in Kansas. I suppose there are some good folks living there. However, as I do not, I can't tell you what's the matter with it. What I can say for sure is that I don't get the first whiff of a vicarious benefit standing next to, or even in the same state with, someone in those upper economic reaches. And in the words of Jesus of Nazareth, "The rich have their reward." I think it's high time we asked them to help their country, the one that provides the environment in which they flourish, and some of the hardworking folks who are desperate for life sustaining medical care.

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