Sunday, July 12, 2009

Health care debate: It's all about the money

By Jamie York

Obama’s “public” insurance plan is not single-payer. Not even close. “Public plan” is a carefully chosen title that likely originated in a PR firm somewhere. Remember, perception is everything in politics. The word “public” brings to mind words like “we” and “us,” words that make us think the plan might be something we would like.

But hold on there, Hoss. First of all, Obama’s plan is a law requiring that everyone have insurance. All 47 million people who do not have health insurance will be required to have it. From this starting point -- and never mind for now that different states have different mandates as well -- it is just a matter making things fit, of twisting and tugging, pushing and pulling, and figuring out just how private insurance companies will fit into this cesspool too kindly referred to as a "system." If you already have insurance through an employer, then you will keep that insurance, no matter how good or how lousy it is. Dental and eye care are usually treated separately in employer health policies -- although they without question affect one’s overall health and should be included. If you have a stroke or some long-term affliction, don’t expect any insurance plan to cover you without a limit. You may be covered to a point, but read the fine print. You will likely have to buy a separate policy for long-term care as well as dental and eye care.

Here is how the “public plan” is shaping up: If you do not have insurance now, you or your employer will be given a choice between private insurance and government-run insurance. This is being portrayed as “competition” between private insurers and the government to “keep private insurers honest.” There is no way of telling right now what will be included in the final draft of the plan, as there is so much insurance industry lobbying going on to influence the outcome. According to Bill Moyers,(7/10/09, PBS) “three out of four of the big health firms lobbying on Capitol Hill have former members of Congress or government staff members on their payroll -- more than 350 of them -- and they’re all fighting hard to prevent a public plan, at a rate in excess of $1.4 million a day.” Wow, how do common people compete with that?

If you are one of the 47-million Americans without health insurance now, you are probably out of work, earn a low wage, or your employer does not provide insurance. In other words, you can’t afford it even if it were offered by your employer. In that case, the public plan is shaping up so that the government will subsidize an insurer for the amount you cannot afford. If you are employed, this will likely be done through your employer, which will have to compare prices of public and private insurers then choose a plan. The government will subsidize the insurer and your employer will take the rest out of your check to pay the balance. Put your calculators away, though; you won’t even see the money.

If you already have private insurance through an employer or you get Medicare or Medicaid, then your insurance may not change. But look for substantial rate increases because, after all, someone will have to pay the costs of implementing the public plan. Why not you? Remember, the private insurance industry -- or “mafia,” as I call them -- is not in the health care business; they do not exist as a public service so we can be happy, healthy citizens. Make no mistake: They are in the money-making business, just like a bank, and will continue to make decisions about your health based on what is economical for them. Expensive treatments and tests, chronic illnesses, and long-term care may not be covered. Your claims may be denied. Expensive medications you need may be limited or denied. Or you may be arbitrarily dropped from coverage.

Now, if you are “truly needy” (as President Ronald Reagan was fond of saying around the same time he declared that a dollop of catsup on a school-lunch tray counts as a second vegetable) then you will get Medicaid under the public plan. About 14 million truly needy people would qualify for Medicaid immediately. But there will also be a sizable group of homeless and undocumented workers falling through the cracks without any insurance at all. Will they get emergency care? Will they be put in prison for failing to obtain insurance? Under single-payer, if you need treatment you get it for the simple reason that you are human and living in the United States. Not so with the public plan. The for-profit insurance mafia remains in control because President Obama said the system is already in place and would be too difficult to change.

This part really chaps my hide. Too difficult, you say? You’ve got to be kidding! These are Americans you are talking to here, Mr. President. We may be grossly undereducated about our own history as a nation, but we don’t give up just because something is deemed too difficult by a career politician. Generally speaking, if a proposal cannot be completed within an election cycle, then it is deemed too difficult for politicians to accomplish. Politicians see progress in terms of their own election cycle. Programs that pay-off in months rather than years get the top priority, even though they are not best for the nation. But of course, the health care “debate” is not about what is best for the nation. It is not even about compromise. But it is about who has the most money to spend. “That’s how it works,” Moyers continues. “And it works that way because we let it. The game goes on and on and the insiders keep dealing themselves winning hands. Nothing will change -- nothing -- until the money lenders are tossed out of the temple, the ATMs are wrested from the marble halls, and we tear down the sign they’ve placed on government -- the one that reads. ‘For Sale.’” If the insurance mafia is against the public plan, which would leave them basically intact and in control, then the boat they really want to sink is single-payer.

The start-up costs for single-payer will be large, but it will save money in the long run. In a single-payer system, we will all be covered from the cradle-to-the-grave. Expanded Medicare-for-all. Everyone in, no one out! Single-payer will eliminate the health insurance mafia and patient billing. Job markets will be shifted. People will have to be re-trained. Hospitals will have full staffs to reduce the RN-to-patient ratio. Nursing homes, too -- now owned by private owners trying make a profit -- will benefit by hiring enough staff to properly care for this growing population as the baby boomers begin to reach old age. Opponents of single-payer say that it is “socialism.” They say that a socialist will be standing between you and your doctor making sure that he or she practices medicine to their satisfaction. That is what insurance companies do now, so this image is turned on its head and used as a scare tactic for people who have been taught the ignorant notion that socialism always has to be something bad that restricts freedom just because it cuts off the flow of money to greedy insurers.

Don’t expect the media to provide you with fair and accurate information regarding health care options up for consideration. Turn on just about any cable channel and you will see ad after ad telling you which drugs to ask your doctor for. The stations are heavily invested in the insurance mafia system and do not want to lose this lucrative source of revenue. Same is true for magazines you might find on the newsstand. Ad after ad from Big Pharma. Even groups like AARP will not provide complete, fair information. AARP is deep into the insurance business, from its famous Hartford auto insurance plans, to Geico, Foremost and New York Life. You don’t bite the hand that feeds you -- not for truth, not for fairness, and certainly not because it is the right thing to do. It’s all about the money, folks. Money, money, money.