You gotta love capitalism!
Bleeding us with more leeches
Geov Parrish - workingforchange.com
10.08.02 - Here in Washington State, amidst the port shutdown and the Great War Debate, a different story slipped through the news last week: Premera Blue Cross wants to become a for-profit company.
Uh-oh.
Our state's largest health insurer wants to raise money by selling shares, and the state government is salivating at the chance to collect extra taxes (back and future) from a for-profit corporation. Democratic Gov. Gary Locke and lots of Olympia legislators love the idea, just like they did when the state's second-largest insurer, Regence Blue Shield, proposed the same thing a few months back. Nobody will suffer but us customers -- which is to say, everyone who needs health care at one time or another -- which is to say, most everyone.
That's not the official line, of course, which enthuses about improved service and rates and blah blah blah. Bullfeathers. As with most privatization schemes, this has been a trend sweeping the country, and it's been a disaster everywhere it's been tried. On this score, consider those flaming Bolshies, the Washington State Medical Association. WSMA's CEO, Tom Curry, notes dryly of the idea that "We're not aware of any place in the country where these conversions have improved things for plan subscribers, patients, doctors, or hospitals... The experience nationally is that plans that convert to investor-based operations use their capital to acquire other plans."
This can't be all that surprising. How much rocket physics do you need to understand that when more parasitic, profit-seeking middle people are plunked into our hemorrhaging health care system (insurers, drug companies, medical suppliers, hospitals, docs, etc., etc., etc.), we patients lose more blood and bleed to death even faster? When a company like Premera calculates that all that money will be available to pay those extra state taxes, and they still expect to come out way ahead, that tells you all you need to know about how much of your health care costs would be reimbursable in the future.
Premera, of course, claims that when their share prices go up, everyone will benefit. Two problems: one, their share prices might not go up. Second, there are other companies swimming in these waters, and they are, in fact, constantly eating each other. In Maryland, a massive grass roots advocacy movement is fighting a proposed buyout of a local nonprofit by a big for- profit chain. In Kansas, the state attorney general has turned down a bid by another large national for-profit company to buy the nonprofit Blue Cross and Blue Shield; the state's Supreme Court will hear the company's appeal early next year. In California, activists are fighting off a bid by Regence and a Chicago-based insurer, Health Care Service Corp., which operates in Illinois and Texas. Combined, they'd form the nation's largest nonprofit health insurer -- but if they jointly switch to for-profit, activists charge, it may enable them to evade the extra taxes budget-crunched states like Washington (and dozens more) are dreaming of. The worst of both worlds.
I don't care about the suffering of budget-stressed legislators; I care about the suffering of people with health problems, minor or severe. I'm a bit sensitized on this issue. As regular readers may know, I've had two organ transplants, a stroke, and a permanently compromised immune system, and that means prescription drugs. Expensive ones. Last week, the same day this hit the news, I wrote a check to my local independent pharmacy (bless them for carrying me through this mess) for $11,986.05.
That staggering total -- a fair chunk of my annual income -- is what we know so far of the extra bill for the five months when my previous insurance carrier terminated my policy without notifying me, my discovering it, and my being able to get into our state's high-risk pool (since private carriers now, thanks to these same state legislators, deny coverage to people who are actually at risk of getting or staying sick). Mine is a convoluted story, involving settlement of a previous class-action lawsuit for breach of contract; I had no legal resource when my insurer screwed me, thanks to the settlement negotiated by the then-sitting state Insurance Commissioner, a woman who traded on her largely unearned reputation as a "consumer advocate." (In most states, the Insurance Commissioner is an insurance industry hack; it doesn't take much advocating to stand out in this field.) Pay up.
Fortunately, I have enough healthy days that I can (obviously) at least work part-time from home. Many chronically or seriously ill people cannot, and they, like I, will die without their drugs or labs or treatment or whatever. And we're the minority; far more common are people being nickeled and dimed and dollared out of health care they thought they were covered for, thought they were insured for, thought they'd paid for, and discovered that the fine print ruled otherwise. Those big marine critters like blood. Ours.
It's been a full decade since the Democrats abandoned national health care reform, and after 9/11 they've essentially given up as well on the farcically ineffectual Patient's Bill of Rights. However, there are, in the absence of national leadership, rumblings of state-by-state reform. Both Maine and Vermont are in the process of fighting off industry court challenges to plans that would offer deep discounts on prescription drugs to those in need. After years of frustration trying to get versions of comprehensive health care reform through lobbyist-dominated state legislators, activists In Oregon have put a universal health care proposal on the ballot next month, Measure 23 would essentially create a single statewide health plan for virtually all residents, including those now with inadequate or no insurance. The biggest obstacle: the price tag, estimated at a whopping $20 billion per year for a state with only 3.5 million residents.
Thing is, the price tag for the current, open market approach to health care is far higher; the United States spends far more per person on health care costs than any other Western democracy (all of which have some combination of subsidized, public-private health care systems). What we get for all that money is a wildly uneven distribution of services. Some folks get state of the art health care, and others get none; how folks manage to negotiate the system depends on education, income, your job, whether you're sick or not, personal support systems, and, sometimes, pure luck.
None of that should matter, but it does. A seriously ill octogenarian shouldn't have to be able to jump through endless bureaucratic hoops and legalese to get health care; many can't, and many people die in this country unnecessarily because they can't afford preventative care, they can't get access to acute care services, or they can't figure out how to get services they're actually entitled to. Parasites like Premera and Regence make millions by threading such loopholes; transforming such outfits into shareholder- driven corporations can only make a horrid situation worse.
How telling is it that state legislators, faced with for-profit conversion schemes by health insurers, seem to care more about quick budget fixes than peoples' lives -- now and for the indefinite future, on this and any number of other issues? Anyone who works in health care -- the provision of it, not the necessitating of it -- can vouch that inserting more pressures for profit into the system is a bad idea. The AMA and state medical associations were once the most radically conservative of health care advocacy groups. A decade's worth of doctors no longer being allowed to practice medicine changed all that.
Bills like Oregon's Measure 23, with some form of universal health care, have to be the way out, but by all appearances it'll be a long time before such systems become a national standard. Too many politicians can still be bribed. As a consequence, our bodies are reduced to business opportunities. Some of us have better payoff potential than others. For the ones whose illnesses don't promise lucrative returns, well, I guess we'll just go away and die now.
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