On Health Insurance Reform, We’re Right, They’re Wrong. Period.

There is one
underlying question in the debate over health insurance reform that is being
forgotten as we all scream at each other, make demands of our politicians,
and collectively whine when they don't react exactly the way we think they should to the rancor in this debate.


That question is,
"What kind of society do we as Americans want?"


Let me start with a few
stories to think about. These are all absolutely true; they either happened to
me, or people I know, or they were related to me by friends whose word I trust.
For privacy's sake, I'm not using names or identifying them in any way. But as you read these, ask yourself; is this what
America is all about? Is this what we mean when we tell anyone who wants to hear it that we live in a FREE country? Is this really the society the Founders were looking to build when they fought a revolution against a tyrannical regime and then crafted the Constitution?


A 60-year-old woman
is diagnosed with gallstones by her HMO plan doctor. That doctor asks the insurance
company to approve a specialist, and the insurance company does so. The
specialist wants to use shock-wave therapy to break up the gallstones, because
it's far less invasive and dangerous than surgery. The insurance company
refuses to cover the procedure, calling it "experimental," despite
the fact that it's been in use for almost 20 years, and has become a standard procedure when treating kidney stones.  She appeals the decision by the insurance
company, but during the appeal, she has a gall bladder attack. She lives
nowhere near a hospital, so her husband drives her 40 miles and she
undergoes emergency surgery to remove the stones and repair her gall bladder. The surgeon who
performed the surgery made a mistake, however, which led to a second surgery to
repair the damage from the first surgery.


Two years
later, the same woman was diagnosed with cancer. Her physician proceeded to
scare the hell out of her, and he told her things about the cancer that were
patently untrue. She requested a change of physicians, to someone who actually
knew about her cancer, and her insurance company refused. They advised her that she
could change her primary care physician during open enrollment, but most of
them were full, and that once they assigned a specialist to her case, she was pretty much stuck with that specialist.


Do we want a system
in which doctors and patients can't make the right decisions because someone
at an insurance company overrides that decision, based on the false assumption
that they're using THEIR money to pay the medical bills? Here's a clue, folks; the money they use to pay those bills is YOURS, not THEIRS. So, if you have that many restrictions on the use of YOUR money, how free are you, really?


A 46-year-old man is diagnosed with diabetes, and told that he'd probably
had the disease for several years by then. After working at
his employer and paying for insurance for nearly 20 years, when it came time to renew his insurance during open enrollment, he was denied coverage by the insurance
company he had been paying all of that money to for all those years. And because of the little catch-22 that private insurance has developed, he couldn't
get insurance with any other company, either. You see, if you disclose your diabetes, they won't cover you. if you don't disclose it, they won't cover anything, based on the fact that you didn't disclose. If that wasn't bad enough, his family lost their coverage when he lost his. 


Do we want a system
in which someone can pay upwards of $1,000 per month for 20 years, (which comes
to almost a quarter million dollars, by the way, even without interest), and then suddenly
be denied treatment, because he might actually have to use it?


A pregnant woman
in her late 20s has no insurance because her husband's job doesn't offer it,
and she's had health problems in the past that disqualify her from coverage,
anyway. While he doesn't make enough money to afford a private insurance premium, he makes too much  to qualify
for Medicaid or CHIP. She
goes into labor and is taken to the hospital, where the baby develops
complications, and she has a gall bladder attack. Approximately two months
later, she gets the bill, which comes to more than $40,000. She calls the
hospital to make payment arrangements, and tells them she can afford to pay
$300 or so per month, but the hospital says it's not enough, and they pretty
much demand that she take out a loan to pay the bill. But the payments on a
loan would have been a lot more than she could pay, as well, so she and her
husband go into bankruptcy.


Do we want a system
in which someone — someone who chooses to have her baby no less — can be
forced into bankruptcy for  simply having
a baby?

How about the 27
year old guy who was not insured because his congenital heart defect made him
uninsurable in the private insurance market, and he makes too much money in his job to qualify for Medicaid. He's also not "disabled enough" for Medicare coverage. He's riding his motorcycle through a major city, when a pickup
truck runs a red light and smashes him under the front bumper. He actually
survives the accident, but requires almost four months of intense pain
management and physical therapy, and is presented with a six-figure bill by the
hospital. The pick up truck owner's car insurance covered less than half the
bill, and he didn't have enough income to pay the judgment when the motorcycle rider
sued. Essentially, two families were
ruined, and because so much of the bill wasn't paid, the hospital
had to raise its prices to recover it.

Do want a system in
which the people who need health care coverage most are denied it, and the
healthy are forced to pick up the tab when something tragic happens?

Now, after looking at these stories, and the hundreds of others you've heard throughout the course of this debate, if you have a heart and a brain, you're left with one simple question:


What do we want the
United States of America to be, exactly?


Do we want an
advanced society that takes care of its people, or one built
on a Social Darwinist  framework, in
which the poor and infirmed are cordoned off into their own little areas and
left to fend for themselves? I know that seems like a false choice, but listen
to the rhetoric of the opponents of health insurance reform, and the latter choice seems to be the one they favor. They say they want health care reform, but they
never actually propose anything, and they seem to like the system the way it
is, which is the Social Darwinist model described above. They are dead set against a pubic insurance option, but the only other way to fix the health care financing system in this country would be to
force private insurance companies to cover everyone, including high-risk patients at a pre-set cost they can afford, and to force them to pay every non-fraudulent health care bill. Sorry folks, but even neocons would agree; forcing private companies to do
the things necessary to make society work, regardless of their ability to pay for it is not capitalism, anyway.


Is the neocon vision
of the country really where we want to live?


I was just 10 years
old when Senator Robert F Kennedy was murdered. But even at the age of 10, his
life and spirit had a profound impact on me; more than makes sense, even to
me.  How does someone like that have such
an incredible impact on someone so young? I actually took a break from
a family crab feast that Saturday, to go down to the railroad tracks in
Halethorpe, Maryland to watch his funeral train pass.


What it is, I think,
is a spirit that seems to be largely missing from politics these days, and it's one
we need back. It's encapsulated in a quote that I memorized many years ago, and
always remember whenever I hear a cynic tell me why this nation can't do something:


are those who look at things the way they are, and ask why… I dream of things
that never were, and ask why not? 
Robert F. Kennedy


That's a really good
question to ask about health insurance reform. Why not?


This debate isn't
about the bills that are before Congress. It's not about which members of Congress are for or against the
public option, or for or against co-ops. It isn't about the statistics that
confirm that 62% of bankruptcies have medical bills as a major component of
their economic peril.  In fact, this
isn't even about money, because as a nation, we have plenty of that.  It's not about taxes; the amount we pay in health insurance premiums is a tax, and it's crippling those who are forced to pay it. It
isn't even about debt.  This country has
plenty of money, if we'd stop treating the richest in this country like royalty. Come on, folks; we've borrowed $1 trillion to fund an absolutely moral
war in Iraq over the last seven years; anyone who says we can't find $1 trillion
over the next ten years to make sure that everyone who needs to can go to a
doctor is just plain lying to you.


This debate is about
lives. Not money;lives. It's about individual freedom. Do we want a
society in which it's okay to walk by a man dying in the street because we have
our own lives to live and he should have made better decisions when he was
younger, as the cynics on the right seem to think, or are we better than that?
Don't we have a responsibility as a society to make sure that man sees a doctor
and at least has a shot at continuing to live?


I  find it
difficult to believe that a society in which a significant proportion of its citizens
have been trained in first aid and CPR simply wants its people to die.  I find it difficult to believe that a society
in which more than four-fifths of the population claims a belief in a single
God that preaches mercy would simply look the other way as tens of thousands of
people are allowed to die simply because they don't have enough money in the
bank. According to the Old Testament, the New Testament and the Koran,
followers have a moral OBLIGATION to help the afflicted, regardless of how much money they have.


So why has this
issue become all about money? Why does there seem to be no moral component to
this debate? We obviously have the ability to pay for health care for everyone,
because we do it now. So, if there is a flaw in the system that sentences tens
of thousands of people to death and suffering, why is there even a controversy
over finding a way to fix it? Have we become so enamored with our warped view
of "capitalism" to even realize that it is, in fact, killing us? (And yes, I put
"capitalism" in quotes, because nothing about our health insurance
system resembles true capitalism in any way.)


This issue shouldn't
even be controversial. Our current health care financing system is an
embarrassment, and it is not worthy of a society that sees itself as


How free is a
society, when an ever-increasing segment of its people can be ruined, financially and otherwise, by illness or injury? How free is a society when health care is seen
as a privilege, reserved for those with the cash on hand to pay a doctor? How free
is a society in which those who want to start businesses can't do so, because
they can't afford to pay for its workers' health insurance, and therefore
can't afford to hire the best workers? How free is a society in which a worker is
forced to stay at his current job to keep his current health plan in force,
because a change of jobs puts his coverage at risk? And how free is a society
in which a person can pay hundreds of thousands of dollars into the health
insurance system over the course of 30 years, 
lose a job, get sick or injured a month later, and be forced into
bankruptcy court? How free is a society in which that same worker can continue
working, but be denied coverage, should the insurance company decide they don't
wish to continue coverage?


The current reform
bills now being seriously considered by Congress will fix all or most of these
problems, and go a long way toward making our country free again. Health care
reform will pass; mark my words on this. And every single politician who votes
against this thing will be in political peril if he or she votes against it. This country is about to become free again, and anyone
who tries to stop it will be run over in the attempt. Here's another Bobby Kennedy quote to consider:

People say I am ruthless. I am not ruthless. And if I find the man who is calling me ruthless, I shall destroy him.

This is only the
beginning of the reform movement that's happening, my friends. Enjoy it. But feel free to run over anyone who tries to stop it. We're right, they're wrong. That's all there is to it. 


On Health Insurance Reform, We’re Right, They’re Wrong. Period. — 6 Comments

  1. I have been making good use of your pieces to counteract the lies I hear from opponents of Health Care Reform. I cross check with the actual HR3200 and your links have been very helpful. Today there was an opinion piece in our local paper which reiterated some of the lies and then went on to promote a group called “Coalition to Protect Patients Rights in Virginia” The group claims to be non partisan and non political and made up mostly of doctors and nurses but it just doesn’t smell right. If they are really non partisan, why do they use Alan Caruba’s analysis to spread lies? I am wondering if you know anything about them. I suspect insurance and pharmaceutical support. They want to forstall the entire health care reform and claim it needs to be slowed down “to protect patients.” Thanks.

  2. You’re right, Mike. I’ve noticed that coming from the White House, as well. They have completely changed the references to Health Insurance Reform, and it’s about time.
    I’ll definitely check out the progress in that incredibly socialist liberals state, Utah… thanks…

  3. If you watch cable news at all, you’ve seen the ads for “health care reform”, now being called “health insurance reform”. “It is an interesting subtle switch in language”. Mike Oliphant runs a small Utah health insurance website http://www.BenefitsManager.net and http://www.dentalinsuranceutah.net whom deals with people day to day struggling to find affordable coverage. “I think it’s important to not understate the huge difference in meaning between “health insurance reform” and “health care reform”. Let’s not lose focus on the need to reform a broken health care system which includes not only health insurance carriers but also billing practices of medical providers. Why isn’t TORT reform part of the national discussion? Studies show that alone could lower costs by 15% for both the medical professionals and health insurance carriers (Humana). Perhaps the federal government should take notice of what Utah has accomplished with first step of health insurance reform and promises for reform in the medical provider arena. Several interesting changes took place with the passage of H.B. 188. House Speaker Clark has championed the need for change while recognizing the experience of the private health insurance sector. To see more about this visit http://www.prweb.com/releases/utah_health_insurance/health_care_reform/prweb2614544.htm

  4. It is NOT about money, no matter how much you pretend it is. Before I address your ignorant tax/freedom rhetoric, I’ll talk about practicality.
    We’re already spending the money on health care. We spent $2.7 TRILLION last year, and will spend even closer to $3 trillion this year. The problem is, MOST of the money comes from us in the form of “private insurance,” and those people are absolutely gouging us, in the name of profit. In other words, genius, we’re paying a tax to cover people who get sick or injured and need medical care and can’t pay the bill. Premiums have doubled in ten years, while health insurance profits have increased fourfold. During the same period, 20 million more people became uninsured. Forget the immorality for a second; does that sound like an economically sound system to you? Up until my son went into the Army, my insurance premium was a little over $1000 per month. If I’d had another kid or a wife, my premium would have been $1500 per month. That’s $18000 per year. And that’s a tax. You may not call it that, but that’s what it is. The difference is, if I pay a tax one year, and lose my job the next, I still get all of the services I’ve been paying for all along, even if I can’t pay taxes that year. With private health insurance, I can pay $1500 a month for 30 years, and if I miss one $1500 payment, the other half million dollars is history.
    I’ll tell you what else, Mr. Tax-Obsessed; 10 Years ago, Medicare and Medicaid covered a little over 20% of all health care costs; now, it covers a third; in ten years, it’ll be paying for one half. And that’s with medical costs damn near doubling in that time, if nothing changes. Know what that means? Of course you don’t, because it’s not contained in your Fox Noise talking points brochure. What it means is, the private health insurance system is sucking down far more tax money than a public insurance plan, if you’re determined to talk about this in purely monetary terms. As they lop people off the insurance rolls, WE the taxpayers are picking up the slack. The REASON Medicare is going broke is because private insurance companies are only choosing to insure the healthy, and the government is picking up the slack. In other words, if nothing else changes, genius, Medicare taxes will have to double, on top of your private insurance company tax, which will average a 10% increase every year for the foreseeable future.
    Now, about this ignorant crap you spout about taxes and freedom. The right to life is written in the law; it’s not subject to quotes, as if it doesn’t really exist. The right to basic medical care has always been a right in our system. Every doctor who’s ever treated someone has taken an oath that says, basically, that if you end up on his doorstep in need of treatment, he or she must treat you. It’s always been an accepted right of civil society, and everyone in this country is entitled to it. It’s a part of pretty much every human rights treaty this country has ever signed, as well. Period.
    And no one forces you to pay taxes. If you don’t want to pay taxes here, feel free to find any other country in the world that will allow you to live there and pay no taxes. But if you’re going to live here, and use our facilities, you’re going to pay for them. And no one gives a rat’s ass if you like what we spend the money on. My kid is serving in Afghanistan right now, because the president you probably voted for twice started the war and then proceeded to screw it up. I don’t get to ask for a portion of my tax money back, do I? We live in a democracy, which means the majority decides how much they want to pay in taxes, and what we want to do with the money. This country is currently nearly $12 trillion in debt, and all but about $1 trillion of that was accumulated by people like you, who think we should hand over large contracts to wealthy companies, start wars and enact legislation without paying for it, and then handing our kids the goddamn bill. You have no right to whine about taxes, seriously.
    As for destroying people, my silly friend, look at the difference between our side and yours on this debate. I would also remind you; Social Security works like a charm. The Civil Rights and Voting Rights Acts brought us a black president in 40 years. Medicare works. The New Deal works. The one time since 1932 that your side of the aisle was in charge, they tried to dismantle all of that, and threw us closer to a depression than we have been since your same ideological brethren put us there last time. We will NOT let you do it again. The Republican Party will be back, but your side’s heading back to the fringe where it belongs.
    Liberty is about responsibility, not entitlement. Why do you people not get that? The founders created this government for us to use to make society better. That does not mean making the rich richer. It means making the society more egalitarian, and increasing opportunity for everyone. That we allow ANYONE to die because they don’t have the money to live goes against our professed religion (84% profess a belief in God, last time I looked), and it goes against our Constitution. And that’s because it’s morally wrong. Period.

  5. Milt asks:
    So why has this issue become all about money?
    Answer: because it is all about money. Specifically, it is about the government using force to take money from some people to support others, and force to dictate the terms under which trade is allowed or compulsory. It is not that there is no moral component to the issue, but that there are multiple moral components, about which people have different understandings and values. Freedom and property rights vs. health care “rights.” The former require that you protect people from the use of force and fraud against them. The other requires that you use force against some innocent people to take property from them to give it to others, or stop them from engaging in voluntary trade with others, or forcing them to engage in involuntary trade.
    Both “moral” issues are valuable and important. To neglect one, and to “destroy” those who refuse to neglect it, might be considered a third moral issue. What do you think?
    And as you answer, remember – once you say it is right and good to destroy those who disagree with you, because you have the power on your side (majority political sophistry/power/votes, in this case)…there _will_ be a time when the shoe is on the other foot, and you are the one being destroyed. Imagine if Bush III (or their equivalent) wins the next election. Be careful the powers you give to your politicians, because the “bad” guys inherit the powers you relinquish/assign to the “good” guys.
    It has happened before, with over 100 million civilians killed by their own governments in the 20th century. It can and will happen again if we are not tempered in our rhetoric and vigilant about protecting the innocent from force.