The Black Commentator - Cover Story: Our Healthcare System

For those of you who have been reading our call for a comprehensive national single payer healthcare system in the United States that by-passes the insurance companies and delivers healthcare directly to the people with full choice of doctors, “everybody in, nobody out” here’s a new way to use the word “redeployment.”

Our position is that “the insurance companies are the greatest barrier to our having healthcare in this country. They should be redeployed.

In Tim Carney's book, The Big Ripoff, Carney chronicles why big business loves big government. One reason is that big business often gets loads of subsidies from big government, and that would surely be the case with these new health insurance proposals. Wyden's, Schwarzenegger's and Rendell's proposals are much like Governor Romney's plan that ultimately prevailed in Massachusetts in that they provide subsidies for people to buy health insurance. That, of course, means lots of new business for Blue Cross Blue Shield Association, Kaiser Permanente, United Health Group and other health insurance companies that are members of AHIP. (The American Health Insurance Programs). Wyden's, Schwarzenegger's and Rendell's proposals also mirror Romney's in that they have an "individual mandate" -- that is, they force people to buy health insurance. Well, if everyone has to purchase health insurance that means even more business for big insurance companies.

And that is the crux of President Bush’s proposals – more business for the insurance industry and more troops to protect the oil industry’s lust to control Iraq’s oil wealth.

The insurance companies should be redeployed out of the healthcare “industry.” Healthcare is not an industry. It is a human right as defined under the United Nations Declaration of Human Rights.

REDEPLOYMENT

Where would we redeploy the insurance companies? We can’t send them to Qatar. But we could redeploy them to other kinds of insurance. They are already insuring buildings, cell phones, jewelry, and paintings, as well as providing fire insurance, life insurance, home-owner’s insurance, car insurance, and dozens of types of corporate insurance policies. Together, we could probably list about 1,000 other kinds of insurance they sell.

So, what else can the insurance companies insure? How about furniture? They could insure the sofa against cigarette burns and grape juice spills, baby diaper smudges, and breakdowns due to too many large people playing cards on the sofa. They could insure collectibles – salt and pepper shakers and memorial plates, Hummel figures, miniature frogs, gun collections and antiques that people treasure in their homes.

Or how about this? They could insure us against computer breakdowns, viruses, and email server malfunctions or against rises in gas prices and job outsourcing. These are disasters where we really need some insurance against the contingencies of technology, trade agreements, and foreign policy disasters. I would buy that kind of insurance!

Some of these suggestions are facetious, but redeployment will take some creativity and we know these companies are creative. They have added to their profits constantly by adding new areas of coverage. They can do it again as soon as the people understand and believe that we don’t need them to be in control of our healthcare. Some suggest that healthcare is not the most lucrative insurance for these companies anyhow. Life insurance is much better for them because they sell it to young people and use the money for decades, investing and re-investing and making beaucoup bucks on the policies before people die.

The reason they make so much money now on healthcare is that the insurance companies refuse to pay millions of claims. They require massive deductions and co-pays and caps on the amount of your coverage, and astronomical rises in the cost of premiums on an annual basis. God forbid that you should have a pre-existing condition or a chronic disease like HIV-AIDS or cancer or hemophilia that might cost three quarters of a million dollars per year. They will find a way to refuse payment. The reason so many people have no healthcare coverage is because the insurance companies make so much money forcing these kinds of rules on unsuspecting customers who have been led to believe that they must purchase insurance so that they will be covered – that we can’t do without insurance companies.

But we won’t need health insurance companies anymore. When we have a single payer national healthcare system, we’ll have healthcare without them – much better and less expensive healthcare for everyone, similar insurance as every other wealthy country in the world. We won’t have insurance claim forms, denials, co-pays, deductibles, and ever-increasing premiums. And we will have better healthcare.

What will happen to the insurance company employees? Under John Conyers’ bill, the United States National Health Insurance Act, H.R. 676, these workers will receive severance pay, re-training and the first chance at the new jobs that will be created in providing healthcare to 50 million people who’ve been without insurance, and in the processing of the very simple payment procedure through a single payer system. You and I will have a simple healthcare card for coverage from whatever doctor or facility we need.

How will we pay for healthcare for everyone if we don’t purchase insurance from insurance companies? One immediate savings will be the elimination of the immense costs of the thousands of insurance companies and payment mechanisms and the excesses of the pharmaceutical drug industry. We will save something like $286 billion per year on insurance costs alone, enough to cover all of the uninsured. Big Pharma will have to negotiate prices with a great big entity like Medicare that covers a pool of 300 million people – all of us. The obscene multi-billion dollar tax breaks given by Bush to 1% of the very richest people in the United States would be reversed. And, even though it is not a necessary part of an economic package to provide healthcare for everybody, we cannot have a healthy country as long as we are in this kind of neo-colonialist war. Let’s turn the war money into money for our healthcare needs and other human rights – particularly being sure that an improved and enhanced Medicare and Social Security are solvent and available to us, our children and grandchildren for the next 100 years.

We will have much better benefits for everybody and we will pay less. H.R. 676 calls for a payroll premium based on our income, and we will get much much more including preventive care, our own doctors, nurses, hospitals, surgeries, pharmaceutical drugs, long-term care, mental healthcare, drug treatment, optical and dental, durable medical equipment and more.

AUGMENTATION

So what did the President’s plan propose? Here’s another one of those words being used for the escalation of the war in Iraq. Condoleezza Rice introduced the word “augmentation” to avoid the word “escalation.” A rose by any other name is basically the same, said Shakespeare. “Augmentation" means increasing the number of U.S. troops being sent or re-sent to Iraq.”

The President proposed an “augmentation” of the profits of health insurance companies and the cost of healthcare to all of us. This would be a new plan that would require everybody to purchase insurance from the insurance companies, a clear escalation. Some people would get a tax break and others in the middle class would have to pay more taxes to cover the money needed for those who didn’t have insurance. Employers would be encouraged to drop their coverage even though this coverage has been an agreement between labor and management as a part of employee pay for many decades. Unions agreed to forego raises during WW II and began to get health insurance instead. The billions generated by raising taxes on those middle class families who have “excessive” insurance coverage (Bush called them “gold-plated policies”) would go to the insurance companies. The language the President used was that “the government should be responsible for the elderly, the children and the disabled only". According to Mr. Bush, everyone else should purchase coverage from private insurance companies.

Bush mentioned several times in his speech that the private healthcare insurance companies have served us well and that using the market to solve our problems is the way to go because this arrangement has worked so well! If the figures from the prestigious Institute of Medicine are used to analyze the period that Bush has been in office (The IOM says 18,000 people die each year, simply for lack of health insurance), then we are talking about 144,000 needless deaths as a result of this arrangement. The insurance companies have fostered a greedy, failed, healthcare payment policy that we must reject.

Bush also said we have had many victories in Iraq because of his policies and all we need to do is to send a few more troops (with a target on their back) to make it work better this time. It is not necessary to recount the numbers of dead as a result of this failed policy. Like I said, “More of the same.”

Bush’s healthcare offerings included sending federal money to some of the states to get money to the uninsured so they could purchase insurance (from the insurance companies, naturally); Health Savings Accounts are another scheme designed to enhance the market. You turn your money over to Wall Street firms to invest so you can get a tax break. Then you pay out of pocket for your own healthcare as long as possible. Then when you become too sick, you have to cash in your HSA and use it to pay your healthcare bills, providing you have saved enough.

Another scheme Bush spun for the State of the Union was an exemption from payroll taxes for as many as 100 million people, those covered by their employers. This money would help those families purchase healthcare insurance from the private market. I won’t even speculate on how much money it would cost families to pay for private insurance into the future if we keep the for-profit system in control. It seems to me that one/third of the people in the United States and the money they (we) pay into Social Security and Medicare, would be eviscerated. These are the basic savings and healthcare plans that have made it possible for millions of elderly retired people to survive and to move out of abject poverty. If we don’t all continue to support them as the big insurance pool for all of us, then many of us will face a bleak future of unrelenting poverty in our older years, particularly since worker pension plans are being destroyed.

As usual, the President’s proposal calls for “personal responsibility” for your healthcare – “You are on your own.” This proposal was really clever since the President and his cohorts have been wanting to destroy Medicare and Social Security for a long time. It is a very seductive plan because we’d all like to pay fewer taxes. We’d like to pay fewer taxes until we think seriously about the importance of some of the programs supported by our taxes. As we know, the Bush administration has tried to destroy all of the benefits of a responsive government – just to name a few --safe water, a clean environment, good roads, good police and fire protection, effective schools, prosecution of crime, air traffic safety, weather reports, a response to global warming and other programs we really need such as housing support for those who need it. The President’s advisor, Grover Norquist, creates and promotes Bush policies that would “drown government in the bathtub” and leave us all “on our own.”

“The Nation” magazine has an interesting article in their book review section by George Scialabbra. (January 29, 2007) He notes that the economic troubles of the 1930s taught most Americans an obvious lesson: sharing risk makes everyone more secure. Earlier this month, “The Nation” came out in support of John Conyers’ H.R. 676 single payer bill that would provide a single payer national healthcare system for everybody in this nation, a true poverty-reduction plan that would help all of us.

Think about this. How many of the uninsured aren’t even able to work and pay payroll taxes? How many are too sick to work or have lost their job, or need mental healthcare or treatment for addictions such as alcohol or drugs, or have small children and no child care facility, are battered and almost emotionally defeated, or other innumerable reasons why people cannot afford to purchase private healthcare insurance? The obvious lesson is that we are all better off if we share the risk of healthcare disaster across the whole 300 million of us, so no one goes without.

THE SURGE

Let’s reject the SURGE in Iraq and the SURGE toward protecting the unearned profits of the insurance companies. Let’s ignore the surge of well-intentioned plans across the country calling for more investment in the market and private insurance business to cover healthcare since they are just more of the same. They provide no plan for cutting the costs of the insurance-driven healthcare system– Massachusetts, Vermont, Maine, California, the American Health Insurance Plans program combined with Pfizer, the AARP, the Business Roundtable, Families USA, and other such groups -- The elements of these plans include: