"I’m going to tell you something – we have fabulous health care in America, just so you know. I think it’s very important – before people start griping about the health care system here – and of course there’s always grounds for complaint – just to compare it with other systems around the world." –- George W. Bush, December 17, 2007, eruditely discussing his own single-payer coverage, courtesy of the US taxpayer.
So… What's this here single-payer health care thing all about anyway?
But first, a moment of silence
A teenaged girl died a couple of weeks ago because Cigna HealthCare, a for-profit medical insurance provider, did exactly what it's compelled to do by law: it chose to maximize its profits by refusing to pay for a liver transplant for 17-year-old Nataline Sarkisyan, whose doctors warned that she would certainly die without the organ replacement.
And they were correct. She did in fact die, just hours after Cigna relented and agreed to cover the costs of the procedure after all. This, too, was a move intended to maximize profits, since the terrible PR that news of its denial of coverage generated could have affected Cigna's bottom line as well, as could damages awarded as the result of a wrongful death suit. So it wasn't a rekindling of the human spirit on Cigna's part that caused the company to reverse its position; that was the result of a serious internal disaster management campaign, run by corporate lawyers and high-level spin-meisters, designed to reduce the impact on Cigna's image and minimize the company's financial exposure.
By law, the only obligation of a publicly owned, for-profit US corporation is maximizing return for its shareholders. That's it. Nothing about good corporate citizenship, the public good, saving lives or anything else that isn't related to jacking up the price per share and maintaining a reasonable P/E ratio.
If Cigna had been operating outside the rules, perhaps we could simply discipline that one company, levy stiff fines, jail a couple of high-ranking execs and serve notice to the rest of the industry that such behavior won't be tolerated. But that's not the case. Cigna was following the rules. The problem is that the rules are insane. That's why this profit-driven disaster of a medical system must be replaced.
We need to dump this murderous system entirely. It's too far gone to tinker around the edges. We simply have to get rid of the profit motive as the driving factor in determining who lives and who dies. We need to decouple the idea of health care from the idea of health insurance, since the two have absolutely nothing in common. For example, listen to Cigna president David Cordani defending the decision in an internal memo that was also made available to mass media.
Nataline Sarkisyan's request was evaluated on an expedited basis using "evidence-based guidelines published by independent physician and medical organizations, as well as expert scientific journals," Cordani said. Translation: We made a life or death decision based on a quick scan of "Liver Transplantation for Dummies" and we backed that up with a little reading on WebMD. Oh, and JAMA, too, and Lancet maybe… And don't forget Dr. Igor Rudinski's best seller, "The Home Guide to Major Abdominal Surgery."
Now back to our regularly scheduled programming…
The pinko commie plot undermining the American way of debt and dying
Now that "Sicko" is available on DVD, millions of people will see it for the first time. If the film's run in theaters is any indicator, most of them will be infuriated as Michael Moore exposes a greedy US medical insurance system run amok, drunk on profits, willing to abandon any last traces of human decency to fatten the bottom line and adept at filtering out patients with acute illnesses that might cost the insurers real money.
The solution Moore advocates is a national health care program, funded by a modest and progressive tax, and generically called "single-payer," meaning that the insurance industry's multiple payers are replaced by a single entity, usually a state or the federal government.
This system would provide universal access to health care for all Americans without the need for private, for-profit medical insurance and the huge financial burden that currently imposes in insurance premiums, deductibles, co-pays, pharmaceuticals, non-covered procedures and "negotiated rates" which somehow never seem to cover the entire bill.
And those people are the lucky ones; they have medical insurance of some sort and therefore aren't usually sentenced to die (Nataline Sarkisyan excepted) or be forced to use the local ER as their primary care facility. That happy fate falls to an estimated 47 million of their fellow Americans, who have no medical insurance at all and must therefore game the system to survive.
And we're not talking solely about the chronically unemployed (although why employment is a condition for receiving medical care remains unexplained and undiscussed). About 75 percent of the uninsured are employed. We're talking about Walmart greeters and checkers, burger flippers, cab drivers, the self-employed, retail clerks, waiters, bartenders, most non-union workers in most trades and an endless list of service economy employees.
These people all have jobs; many have two or three. But they work for employers who can't afford today's obscene medical insurance premiums. Or they work for world-class cheapskates like Walmart, which rakes in many billions each year, whose billionaire Walton family owners occupy a special pedestal among Forbes Magazine's list of richest Americans, but who just can't seem to spare a few bucks to help keep their workers healthy and free from medical debt.
The very words "single-payer" give many of our more delicate citizens the vapors and drive many more into an apoplectic rage. The magic words also cause the last of our cold warriors to dissolve into a frothy lather of anti-pinko invective and start ranting about subverting the invisible hand of the free market.