Whether one is a small business owner or the CEO of a major corporation, or an employee of one, if you have any form of private healthcare insurance, you’re being punked by the health insurance providers. (No, I won’t define that, as Yogi Berra said, “You can look it up.”) The corporate right and their hit-men are using juke moves, to bend you to their wishes, which are simply to avoid any substantive changes to the private insurance status quo. The status quo has the money — employer health insurance premium dollars — continuing to roll in, in trains of Waste Management truckloads.
In the House hearings and in Senate hearings, panels of insurance company execs sat side by side, assuring the committee members how they were dedicated to making health insurance available and affordable to every American. Then, in an eerie kumbaya White House moment, all stood, smiling, with President Obama as he announced the pledges they had ostensibly given him, to dramatically cut medical costs. (Both the alligator and the croc also seem to smile.)
The push is on by the insurers to completely derail what is called the “public option;” the choice the public would have to choose between one of the private plans or from the government. The private ruse makes three wholly false claims.
One lie is that, with the current private insurer system, the patient is not forced to wait long periods for care. Say you need a hip, or knee replacement, or spine surgery. Your surgeon will demand you visit ancillary practitioners for a variety of scans and tests. Depending entirely on the severity of the ailment (How close you are to losing control of your bladder and bowels, for example), it could be three or four months before you actually undergo the surgery. The “won’t have to wait” mantra is a LIE, LIE, LIE!
Another lie is that, with private insurance, nothing will wedge between the doctor and the patient. Listen, every insurer has buildings staffed with clerks whose job it is to tell the physician what that physician may and may not do. (That is not 100% accurate, they tell the physician what the insurance company will pay for, and what it will not pay for, which ends up being the same thing.) These are CLERKS! Or, bureaucrats, if you will. The only difference between them and government employees is the name of the payor on their respective pay checks. But unlike government clerks, the insurance company clerks answer only to a corporation whose interests are diametrically opposed to those of the patient. You can’t call your elected representative to bring heat on the clerk.
The third lie uttered by the insurance companies and their corporate supporters is that, with them, the patient has his or her choice of physicians and other healthcare providers. It doesn’t matter whether one belongs to an HMO or a PPO (Preferred Provider Organization). If it’s an HMO, the patient is restricted entirely to the physician/practitioner-employee of that HMO. Go outside and you’ve got nothing! If it’s a PPO, the patient has an approved list of providers who have contracted with that insurer. While there may be some overlap of providers among the insurers, that’s a purely coincidental phenomenon. The crucial point is that, if — other than for emergencies — you use a provider who is not approved, one of two consequences arise: either you will have zero insurance coverage, or your co-pay will increase substantially; 40% is typical. The very same circumstance arises if you’re out of state and elect to secure healthcare: either it’s zero, or your co-pay goes to 40%, or so.
Every other negative continues to attach to the private insurance scheme. Depending on insurer, as much as 50% of the premium can go to the sum of administrative costs and profit. VA hasn’t averaged much above 5%, and Medicare ranges around 7%, with neither involving a cent of profit. Do not misunderstand, as one who was business-for-self from 1978 until I retired a few years ago, I’ve always been a supporter of profit and the profit motive. But this is your healthcare and the exorbitant burden it places on the American employer to provide it, or you and your employer, if the premium is split. If, as was asserted in one of the recent hearings, the annual premium for a typical family plan averages $12,000, you do the math on the sums the insurers have at stake.
With such sums facing the peril of competing with a government program, it should surprise no one that the insurers will engage any deception. With the cameras off, just three days after Obama announced that the industry had agreed to dramatically cut costs and to cooperate with the government on behalf of finding a solution to the healthcare mess the nation finds itself in, the industry came back to claim it had neither promised nor agreed to any such thing. The head of AHIP (America’s Health Insurance Plans), the insurance industry lobbying organization, said the agreement was only to “ramp up” savings.
(Note: You can view every article as one long page if you sign up as an Advocate Member, or higher).
