In 1972 there was a made-for-television spoof of B Grade Westerns called “Evil Roy Slade.” John Astin played the most dangerous outlaw in the West. In the film, Slade falls in love with woman named Betsy Potter who decides to reform him.
“You don’t have to be Evil Roy Slade,” she tells him. “You can change.” After thinking it over, Slade tells her she’s right. “I could become Evil John Ferguson, Evil Fred Noland or Evil Lee Rich.”
I’m reminded of that fictional conversation every time I hear certain people discuss the role of health insurance companies as they relate to healthcare in the United States. It’s as if most people have been so brainwashed they can’t imagine a system in which the health insurance industry doesn’t make all the rules – while we are expected be grateful they will take our money.
The industry decides who will be insured, what the insurance will cover and how long the people who are insured will remain insured. We have forgotten that health insurance evolved as a means of minimizing financial risk for the insured, while making a profit for the insurance companies – but not a guarantied percentage. That’s why it’s called risk.
The original concept was that people who bought insurance were betting that their healthcare would cost more than the annual premiums; insurance companies sold the insurance, betting that the combined premiums of all their clients would be more than what they would pay out. The concept requires risk for both parties.
Today in this country, the healthcare insurance industry has created a system under which they take almost no risk because they can pick and choose the young and healthy while excluding the sick and elderly and have convinced most of us that if we rock their boat healthcare will somehow vanish.
Our way or the highway is how it is presented to us. They call it free market, but it isn’t. In fact, preventing a free market is why the industry pays out so much money to keep lawmakers voting their way. Insurance industry apologists are putting up the same tired smoke screens to obscure the problem. Let’s examine them.
Untaxed medical accounts. It is a ludicrous concept. If people had the money to save, they would buy the insurance.
Tort reform. This is a joke because the percentage of money paid out by insurance companies in huge settlements is miniscule and the insurance industry knows it.
Insurance company competition across state lines. This would be laughable if some didn’t take it seriously. It wouldn’t change a thing because the insurance companies all use the same standards and the fix is in. Look at the “competition” now because that’s what it will look like if even if barriers are taken down.
What insurance companies know and fear is meaningful regulation; nationalized healthcare is the boogeyman they have raised to frighten us. The solution is simple and it can be real, competitive and done in a free market.
For it to work, though: all insurance companies have to take all applicants, including those with preexisting conditions, to spread the risk. And insurance companies cannot be allowed to cancel policies for reasons known only to them.
If you want real competition, regulation will give it to you. Without the deck stacked in their favor, individual companies will have to actually find ways to cut costs and sell more insurance than their competitors. It has worked in other countries and it will work here, if we can pull the fangs of the insurance dragon.
Wednesday, September 02, 2009
Monday, July 20, 2009
NO TIME LIKE THE PRESENT
The health industries are doing a full court press against changes in health care, as they always do. This time there seems to be a bit of desperation, a little less confidence, in the industries and among their congressional flunkies.
When only the poorest are affected by a lack of good health care, there isn’t much pressure on elected officials to rein in the health industry. These days, the price of insurance is beginning to damage the middle-class backbone of America. Professionals who had good insurance are losing it because businesses are being forced to compromise.
The insurance and pharmaceutical lobbies are using scare tactics and threats of impending socialism, as usual. The commercials they fund are stressing the danger of government bureaucrats who are not doctors making medical decisions for anyone with any type of government run health coverage -- which sounds a lot like insurance company policies.
These commercials focus on the “failed” European and Canadian systems, long lines at the doctor’s office and longer waits for a specialist. A central point is the claim that Canadians are flocking to the United States for treatment. It’s an easy claim to make without statistics.
The opposite claim can be made that U.S. citizens are moving to Canada for affordable healthcare, which also happens -- and with just as much certainty. No statistics are available for that argument, either. Most people don’t boast about becoming expatriates.
Lumping European health care systems together is ludicrous, because each country has arrived at a different solution -- The Netherlands, for instance has an affordable, workable system, a mixture of government and free enterprise. What the Europeans have in common is that they chose to do something.
The American insurance industry is making much of isolated cases where people on lists got worse. A friend of mine recently said, “They at least have a list.”
My friend was right. Working Americans who can’t afford insurance have emergency rooms, which are expensive and wasteful. A bandage is slapped on and they are told to consult their family doctors for follow-up -- which works if you have a family doctor.
Even in an area where tremendous savings and real competition were possible, the insurance and pharmaceutical lobbies blocked it. If the Social Security Administration -- the largest single user of medicine had been allowed to bargain with drug companies in a competitive manner, the competition would have driven prices down immensely.
Unfortunately, Congress, acting for big donors, torpedoed efforts to inject very real competition into industries that want no competition. It has almost become a cliché that forcing members of Congress to buy their own health insurance like everyone else would bring immediate changes, though it’s true.
On November 19, 1945, 7 months into his presidency, Harry S. Truman gave a speech to the United States Congress proposing a new national health care program. He said, "The health of American children, like their education, should be recognized as a definite public responsibility."
Truman was not able to do what he proposed, of course. Today a meaningful attempt to put healthcare on the same level as national defense is being pushed by President Barack Obama. He is as close as anyone has come to changing a broken system. Whether he succeeds or not probably depends on those of us at the grassroots.
The only thing that frightens professional politicians is the fear of losing the next election. We can be quiet or we can speak out. I suggest the latter.
When only the poorest are affected by a lack of good health care, there isn’t much pressure on elected officials to rein in the health industry. These days, the price of insurance is beginning to damage the middle-class backbone of America. Professionals who had good insurance are losing it because businesses are being forced to compromise.
The insurance and pharmaceutical lobbies are using scare tactics and threats of impending socialism, as usual. The commercials they fund are stressing the danger of government bureaucrats who are not doctors making medical decisions for anyone with any type of government run health coverage -- which sounds a lot like insurance company policies.
These commercials focus on the “failed” European and Canadian systems, long lines at the doctor’s office and longer waits for a specialist. A central point is the claim that Canadians are flocking to the United States for treatment. It’s an easy claim to make without statistics.
The opposite claim can be made that U.S. citizens are moving to Canada for affordable healthcare, which also happens -- and with just as much certainty. No statistics are available for that argument, either. Most people don’t boast about becoming expatriates.
Lumping European health care systems together is ludicrous, because each country has arrived at a different solution -- The Netherlands, for instance has an affordable, workable system, a mixture of government and free enterprise. What the Europeans have in common is that they chose to do something.
The American insurance industry is making much of isolated cases where people on lists got worse. A friend of mine recently said, “They at least have a list.”
My friend was right. Working Americans who can’t afford insurance have emergency rooms, which are expensive and wasteful. A bandage is slapped on and they are told to consult their family doctors for follow-up -- which works if you have a family doctor.
Even in an area where tremendous savings and real competition were possible, the insurance and pharmaceutical lobbies blocked it. If the Social Security Administration -- the largest single user of medicine had been allowed to bargain with drug companies in a competitive manner, the competition would have driven prices down immensely.
Unfortunately, Congress, acting for big donors, torpedoed efforts to inject very real competition into industries that want no competition. It has almost become a cliché that forcing members of Congress to buy their own health insurance like everyone else would bring immediate changes, though it’s true.
On November 19, 1945, 7 months into his presidency, Harry S. Truman gave a speech to the United States Congress proposing a new national health care program. He said, "The health of American children, like their education, should be recognized as a definite public responsibility."
Truman was not able to do what he proposed, of course. Today a meaningful attempt to put healthcare on the same level as national defense is being pushed by President Barack Obama. He is as close as anyone has come to changing a broken system. Whether he succeeds or not probably depends on those of us at the grassroots.
The only thing that frightens professional politicians is the fear of losing the next election. We can be quiet or we can speak out. I suggest the latter.
Tuesday, July 07, 2009
DO WE REALLY CARE WHAT’S AHEAD?
If you think human beings appeared instantaneously on Planet Earth 10 thousand or fewer years ago, you should probably skip the rest of this piece and save yourself the aggravation. It’s about some aspects of human evolution -- the brain in particular.
If the brain is viewed through certain imaging devices and a snake is put in front of us, our brains light up like Christmas trees; if somebody tells us the odds of Earth being struck by a meteor in the next 1000 years are high, a little spot twinkles. Our brains are more geared to primitive fears than to future threats -- because they evolved that way.
Most of us have never been bitten by a snake, the majority of snakes are not a threat to us, anyway, but the part our brain that process the information takes no chances. The fear of snakes is something that must be suppressed with practice; the brain is able to ignore future threats all by itself.
A prime example was what Katrina did to New Orleans. Engineers and city officials knew the levees would not hold under the strain of hurricanes at a certain level. A lot of the city was bowl-shaped and everyone understood what would happen when (not if) water poured in. Still, every year after hurricane season passed, people put the danger out of their thoughts.
Millions still smoke cigarettes, aware that there is a connection with cancer. However, since it isn’t usually an overnight disease, it can be easily ignored -- unlike a snake hissing in front of us or a growling mountain lion. Most smokers have periods of fear, but all it takes is for the next chest x-ray to come in clear to relegate cancer to a distant threat.
Our nonchalance about the future is also why so many of us don’t floss after every meal, eat properly, save money or keep our houses in good repair. In my own case, it’s why I will agree to appear almost anywhere to give a talk if it’s at least 2 months in the future.
Reduced to its simplest terms, we are still using a brain that evolved to protect us from wild animals while living in a period where we need to focus on the future because there are some real problems looming ahead of our race.
Until 40 thousand years ago, another species called Neanderthal shared the Earth with Homo sapiens before vanishing, probably because they could not compete with our species. We now understand that we shared 99.5 percent of our DNA (Deoxyribonucleic acid) with Neanderthal. The differences were minute but we survived and they did not.
Maybe they were less able to look forward than we are. Rest in peace
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