Wednesday, November 17, 2010

An Unholy Alliance: Health Care and Insurance Companies

I just read an interesting post about a new book by Wendell Potter, a former communications director for Humana and then CIGNA, two of the nation's largest health insurers. Potter's book has a very long title: Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans.  I haven't read the book (I plan to do so) but I have read the transcript from Potter's interview on Democracy Now about his book.  It's a fascinating interview and the following assessment by Potter of the health care reform legislation really caught my attention.
WENDELL POTTER: They do. And that’s why this will not be repealed. They like a lot about it. This legislation, we call it "healthcare reform," but it doesn’t really reform the system. There are a lot of good things in there that does make some of the practices of the insurance industry illegal, things that should have been made illegal a long time ago, so that—
WENDELL POTTER:—for that matter, there are good things here. But it doesn’t reform the system. It is built around our health insurance system, as the President said. And they want to keep it in place, because it also guarantees that they will have a lot of new members and billions of dollars in new revenue in the years to come.
The Health Care Reform Act (HCR) didn't go far enough but it certainly moved forward. Potter's key point is that the legislation didn't reform the health care system. Of course it didn't. The climate in this country wasn't conducive to totally throwing out the health care system and building a new one from scratch. Anyone who honestly believes that such a massive overhaul was  possible in one fell swoop is terribly naive. Congress was never going to pass such a bill in 2010. Change is a process and the more intensive the change, the longer the process. The 13th amendment ended slavery in 1865 but 90 years later Jim Crow laws were the norm. The Brown decisions in 1954 and 1955 said that separate but equal was inherently unequal but my local school system was among those that did not fully integrate until 1971. I don't advocate that change should occur slowly but experience has taught me that it generally does. The question now is what do we do next? There is little to be gained from decrying what wasn't done as we cannot time travel backwards and change anything.

Our most significant problem is that health care is a for profit industry in this country. In spite of the right's constant assertion that the HCR act is socialized medicine, it is far from such. A major obstacle to reform is that Americans have an exceptional fear of anything that even smells of socialism, which most wrongly equate with communism. I don't think that Obama ever stood a realistic chance of getting HCR passed that included a single payer plan or the loosely defined public option.

I don't disagree with the many disappointed progressives who assert that there is an unholy alliance between government and business. I do disagree that nothing has been gained via the current HCR. It's far from perfect but I think that our focus needs to be on generating specific ideas for how we advance the movement to a single payer plan or at minimum a plan that includes a public option. I think that it's important that we, the citizens, develop specifics as to what we want rather than continuing to engage in bemoaning what we do not have. I think that we all need to share ideas and engage in some useful dialog.

From my perspective we have a public that has a significant number of members who continue to believe lunatic ideas such as there are death panels as a result of HCR. There is a general public suspicion that HCR is a socialist plan that will destroy "the greatest health care system in the world." The politicians are playing on those fears. It seems that a key component is mounting a PR campaign to dispel myths and fallacies about what HCR does. I don't think that our side has done PR particularly well in the past and we need to change that.

There is also a need to disseminate powerful and clearly stated information about the reality of our health care system; certainly we have highly skilled medical professionals and excellent are in or medical facilities. However, a lot of Americans don't have access to that great health care which I contend makes declaring ourselves to have the greatest health care system in the world meaningless. We have to work on showing the people who are in deep denial that the health care system is broken. We have to redefine what health care is. Ideally the focus of health care should not be profit but providing preventive care and treatment as necessary. It sounds simple, but the opposition to the moderate level of reform of HCR demonstrates that there are a lot of Americans who do not adopt this belief.

We have to deal with the reality of the current beliefs regarding health care reform. We have to take seriously the ongoing opposition expressed against HCR as passed because it's not just elected officials with a vested interest in maintaining their relationships with the insurance industry who oppose HCR, it's also a lot of the people who stand to benefit from health care reform. People who are acting against their own best interests.

By the way, when I say "we" I mean anyone who believes that our health care system does not serve the needs of all of the people and is need of a major overhaul. We have to become the public voices advocating for change. We have to become a public force that can be pointed to as representing a counterpoint to the very loud voices who decried health care reform as President Obama struggled to push through some level of reform. The Republicans continue to insist that the public doesn't want health care reform and they point to the Tea Party and other voices from the right who loudly protest any government input into health care. We are also the public and we need to make our voices heard and not siphon our energies off to engage in supporting third party candidates who stand no chance of winning and sulking in the corner because the road to reform has more curves than we expected.


Charlene said...

I love that continued statement about America having the greatest health care system in the world. We do of course for the rich. If you have unlimited money you can get the latest most sophisticated care. The rich will universally survive all disease or injury as opposed to the poor. That is not a great health care system. That is a boutique health care system.

I have said from the minute this reform was passed by the Congress and ignorant pawns of insurance company ads began to rail against it, that in 2014 if not shortly thereafter the GOP will claim they are responsible for passing the bill and we should vote for them because of it. Now they call it Obama Care. Soon it will be GOP Care.

Health insurance is a concept that we accept universally. Those who cannot afford the ever increasing premiums depend on luck or the Grace of God.

As to a single payer or public option being socialism, no one remembers the definition of Socialism is Government ownership of production. If we have single payer the citizen owns health care and government manages it. Either way; keep things as they are or make the changes we need to make, we the people are paying for health care.

The poor person who has diabetes and does not receive care to keep their glucose levels even will eventually present at the ER and need surgery or life support. To believe that is not being paid for by all of us, is naïve. Treating people with ongoing low tech health care is much smarter and cheaper.

Nance said...

I heard about this book and put it on the Gottahaveit List. In fact, it sounds like I NEED to read it, because I'm confused: it's the big insurance corporations who had financed and scripted the anti-HCR push; they financed the Republican campaigns heavily; they stand to benefit from all the new business they can expect; they hate the restrictions on them in the law as it stands; they...are the fourth branch of American government, basically.

How anyone can think the system wasn't broken is beyond me. In fact, I don't think there actually WERE people who knew anything of the system and believed it was viable; everybody had stories of abuses they knew of personally. I'm convinced that the entire tea party "platform" was mass urban mythology turned mass hysteria.

I applaud your prudent approach. And I think we will have to live with the law for a few years (if we can protect it from rape or repeal), in order to see where to intervene next to improve the system it creates. My wish is that we might actually find out what we have here before we change it.

Nance said...

P.S. Leela James came on while I was writing that comment. I dropped EVERYTHING to scroll up and make sure I had recognized her correctly. I've only heard her music a few times, but it was love at first listen! I must now head over to iTunes and grab some Leela!

Mark said...

In retrospect (admittedly 20/20) the stimulus should have been all infrastructure/job creation, not 1/3 tax cuts. With a lower unemployment rate, Obama could have then advocated now for the new revenue coming from the expiration of the Bush taz cuts to go totally to a Medicare-for-all system, each year adding a new age group, i.e. 2011, 55-and up, 2012, 50-55, 2013 45-50 etc. He would have co-opted the very population that ended up providing the base of the Tea Party.
Obama starts with compromise instead of ending with it. We'll never know if we could have had European-style healthcare--Obama didn't even fight for it. There was a willingness from the beginning to mollify the insurance companies, as opposed to harnessing the enormous public hostility toward them.
Obama has dreadfully underused the bully pulpit to educate the people and to engage the enemy. He's so phobic about confrontation--but that's what politics is, choosing your enemies. If you don't enjoy the fight, you're in the wrong line of work.

Entre Nous said...

Well stated :}