Features > May 1, 2006

Careless Industry (cont’d)

The issue came up again in the 2004 presidential debate when President Bush attacked Sen. John Kerry’s universal health care proposal. Kerry “wants everybody to be able to buy into the same plan that senators and congressmen get,” Bush said derisively, as if the idea of having us commonfolk get the same health care as the elite was too disgusting to consider.

According to a study by top experts in 2005, “the United States wastes more on [private] health-care bureaucracy than it would cost to provide health care to all its uninsured.” As the World Health Organization noted, 15 cents of every dollar Americans spend on private health insurance goes to “administrative” expenses. That is a euphemism for everything from filling out and processing insurance paperwork to padding HMO executives’ salaries. By contrast, when the government spends money on public health care programs like Medicare, those “administrative” expenses only consume about 4 cents of every dollar.

A universal system in which the government is the single payer for everyone’s health care would eliminate most of that bureaucracy and redundancy, save Americans a huge amount of money and still be able to extend high-quality coverage to everyone. For instance, the universal health care proposal put forward by 8,000 doctors in 2003 would save roughly $200 billion a year. That almost matches a report during the same year showing that if American administrative costs were limited to Canadian levels, our country would save more than $280 billion a year.

The only industries universal health care would hurt are the big HMOs and drug companies. In the current everyone-for-themselves system, they can dictate high prices because citizens are not organized into large blocks that can negotiate lower prices. People are divided, and so the health care industry conquers.

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In 2004, the nonpartisan group Families USA was asked to testify before a House committee on the issue of health care.

But of course, the hearing was only a formality, really. Congress had no intention of listening too much to anyone who didn’t come bearing a very large check. Still, the political goons in the employ of the big insurance companies understand that in even the most mundane situations in Washington, the truth must be squelched at all costs. So it was no surprise when amidst the boring proceedings, fireworks started.

Rep. Mike Rogers (R-Mich.) apparently had heard enough about the health care crisis. So in the middle of the testimony by Ron Pollack, Families USA’s executive director, Rogers snapped. “Just so I understand your organization,” he said, “you support rationing, limited drug use, pharmaceutical use?”

It was a nice tribute to McCarthyism—couch an outrageous, unfounded accusation in a seemingly innocent question. The Families USA representative denied the charge. But it didn’t stop there. Like a drooling pit bull snarling at a passerby, Rogers barked, “You support rationing health care for American citizens and limiting the ability for them to have access to pharmaceutical treatment in order to keep costs down.”

Rogers might well have screamed “Communist!” had his time not run out. Why was he so aggressively hurling out deceptive accusations? He was just doing the job he’d been paid to do: Over the previous four years, Rogers found himself in possession of more than a quarter million dollars of campaign contributions from the health care industry. Rogers is just a cog in the industry’s spin machine—a $275,000 cog, but a cog nonetheless. That machine has been effective over the years in one of its most important goals: tarring any government health care initiative as the precursor to “rationing.” So when advocates of government involvement make an appearance anywhere in Washington, the industry’s hired goons can be counted on to shout them down before any ugly truth gets out there.

We are led to believe that because we have a private, for-profit health care system, we don’t have health care rationing in America. But the whole point of most health insurance companies is to ration care, limiting the amount of coverage their patients get in order to save cash. Even the Supreme Court admits that. In 2000, the justices issued a unanimous opinion noting that the existence of HMOs means “there must be rationing and inducement to ration” care. The ultraconservative Washington Times admitted that the court made very clear that “it is the point of any HMO to ration care and within its prerogative to delay tests, avert expensive consultations or refuse experimental care.”

Remember, this isn’t just rationing of non-critical health services. In 2001, for instance, the Sacramento Business Journal uncovered evidence that senior citizens who were receiving cancer treatment were being priced out of their chemotherapy by an HMO that had arbitrarily decided to raise its rates. “For many seniors on fixed incomes the choice is to die or take a shot at physical survival and life in poverty,” wrote the magazine. “This is how the free market rations healthcare. … We have the specter of an HMO effectively turning out the elderly to die.”

Beyond just the sheer corruption and deception of all this is the insulting pretense that these politicians actually care that health care rationing is going on in the first place. They say they oppose a government-funded health care system because it would result in rationing, yet they are the very same people who actually write the policies that force the government to ration.

The truth is, government programs are as good or bad at providing health care as they are given adequate money to do their jobs.

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The health insurance crisis is serious and long-standing, but there are some simple approaches to getting it fixed that don’t require huge giveaways to the big insurers.

One solution is a universal health care system where the government is the single payer. A shorter name for this is “Medicare for Everybody.” As economist Paul Krugman notes, “The great advantage of universal, government-provided health insurance is lower costs.” Medicare, Krugman notes, “has much lower administrative costs than private insurance.”

Another solution is to regulate health insurance prices like any other utility. Because you are legally required to have car insurance, most states regulate the rates auto insurance companies can charge you. It’s clearly not fair for the government to force you to acquire something, yet allow companies to charge you whatever they want for it. It’s equally true that some services—even if not officially mandated by the government—are absolutely essential to life: electricity, for instance. And in those cases, government regulates what companies can charge, so no one is left at the mercy of the profit motive when it comes to life’s essentials. What’s more essential than healthcare? We all need health insurance, but our government does very little to regulate the prices that insurance companies can charge consumers. That is simply wrong. The solution is to regulate health insurance prices like any other utility and stop this kind of profiteering.

The official mission of the Department of Health and Human Services is to “protect the health of all Americans and provide essential human services, especially for those who are least able to help themselves.”But protecting the health of all Americans really isn’t on the agenda in our corrupt political system. The same politicians in Washington who preach about the “culture of life” and “moral values” are too addicted to health care industry cash to care about people who can’t afford to see a doctor.

What is on their agenda is clear: more tax breaks for the wealthy, as 18,000 Americans die each year at the hands of our profit-at-all-costs system; more billion-dollar federal contracts for Halliburton, as one in six Americans can’t afford to see a doctor; and more corporate giveaways as the government cuts back programs for the truly destitute.

We do not have a government dedicated to “protecting the health of all Americans,” as we are told. We have a bunch of bought-off frauds pretending to care about ordinary Americans, but really only interested in protecting the health of one thing: the insurance industry’s bottom line.

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• Reader Comments

  I haven’t read the book so my commments may misdirected — I hope so.

  If the rest of the book’s answers as to how “to take it back” are similar to the ones in this excerpt we are still going nowhere.

  I agree with his assessment that a lack of health care is a huge problem. The REAL problem ( the one the title points to) is that we ordinary unlobbied citizens have lost our representative government. The answer I hoped to hear was how we take government back.

  I often see and hear solutions presented to many issues, but dispare of getting any elected officials to impliment them.

  We are about to relect in November about 80 to 90 percent of the people who have done a truly unremarkable job so far. (Well, no remarks fitting for children and ladies to hear anyway.)

  In two more years we will choose once again from a pathetic field of candidates. From the last three we got these memorable quotes:

  “Read my lips, no new taxes.” and “I don’t have the vision thing.” (G.H.W.B)

  “It depends on what is IS.” and “I did not have sex with that woman, Monica Lewinski.” (W.J.C.)

  “Mission accomplished.” and “I don’t read newspapers.” (G.W.B.)

  Posted by whattheheck on May 1, 2006 at 2:57 PM

  Of course national health care makes perfect sense. Anything is better than the current system. The health care system is sucking as much surplus dollars out of the productive economy as the energy industry.  The US automakers are by far hurt the most with $1,500/vehicle cost addition due to health care costs.  When I was a construction laborer eleven years ago the Laborers’ International Union added $3.00/man hour to the wage bill to cover health insurance costs.  That is an effective 15%/hour raise for the entire staff just for health care.  The health care corporations are greedy and are raising costs just to gain record profits. They’ve stolen enough. It’s not about doctors, nurses, or other providers.  Most of the health care cost increases do not going to their salaries or fees but to the corporations. Who needs the corporate takeover of health care?  I just heard a story of a young surgeon who did a complex nine hour spinal surgery on a cancer patient who was denied post operative physical therapy because she was not expected to live and the money was viewed as wasted by the HMO. The surgeon, who received only $900.00 from what was assuredly a six figure precedure, was understandably livid at the HMO’s disregard for his patient’s recovery chances.  We need health care for people not for profit in this country.  We need it now!

  Posted by cabdriverinchicago on May 2, 2006 at 2:13 AM

  The problem with healthcare is Americans are “FAT & LAZY”. 

  When I went to Europe on a business trip for 2 weeks ... I couldn’t beleive it when I got off the plane in NYC.  Walking down the concourse I looked at my boss and I said “what do you notice?”

  He said “everyone is fat”. 

  If your fat and don’t exercise you drive up the cost, plus all of the illegals, plus all of the fraud, plus all of the lawsuits.

  Posted by tina1 on May 2, 2006 at 2:22 AM

  The problem is managed care which wastes hundreds of billions of dollars on administrative and other redundant costs which could be saved in a single payer system. More people would have access to care and the money lost through delinquancy would be saved by a more stable system of collecting and charging for premiums and by taxing to fund the system.  We would spend less per capita and insure more people. Also, certain fees for procedures should be regulated.  Health care providers should have more say in policy than corporate suits.  A public trust could administer the funds for the system which allow free choice of health care providers and decisions about care and confidentiality between doctor and patient would be better preserved in this system than under managed care.  I personally found it appalling that 18,000 people die unnecessarily every year of curable illnesses when Managed Care CEOs are raking in millions of dollars while there is 15% uninsured and unchallenged waste in the private corporate system.  Where are all those “pro-life” hypocrites on behalf of the unnecessary deaths of real live uninsured infirm of America?  As usual, real human life is not their true concern!

  Posted by cabdriverinchicago on May 2, 2006 at 7:56 AM

  One study a few years ago estimated that of the nearly $400 billion spent in the private US health system in administrative costs alone in 2003, a single payer system would have saved as much as $286 billion or nearly $7,000 per uninsured in the US at that time.  The number of uninsured in the US in 2003 was officially estimated at over 41 million people or 15% of the US population.  The administrative cost savings gained by shifting to a single payer system could have easily paid for a comprehensive health coverage program for the entire uninsured population many of whom are children!  The argument for such a system is irrefutable and will become more so as employer health costs price US goods and services out of the market and/or leave more people uninsured.  A single payer system along with some kind of modest regulation with regard to medical fee increase rates should currently allow for total comprehensive health care coverage for all US citizens.

  Posted by cabdriverinchicago on May 2, 2006 at 8:34 AM

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