San Marcos Mercury | Local News from San Marcos and Hays County, Texas

September 21st, 2009
Freethought San Marcos: How ‘Sicko’ and ‘Sick For Profit’ get it right

Freethought San Marcos: A column

I like Michael Moore, probably because he’s a fat white guy like me, but also because he’s found a way to make a good living telling us about the contradictions in our culture, contradictions that we could overcome if we had the will to do so. I had not seen “Sicko,” his documentary about the failures of the American health insurance system, until this week. Wendell Potter, the former CIGNA executive who is now speaking out against the industry in which he worked for decades, said that Moore “got it right” about the industry in “Sicko.”

In spite of all the reading I have done about the health insurance issues over the past year, I found his documentary compelling, and I learned a few things. I did not find “Sicko” heavy-handed or unbalanced. Moore looked at the American system and contrasted it with the health care offered in Canada, France, England, Guantanamo Bay (the health care provided to al Queda prisoners), and Cuba. In each of these places, the care was far superior to what most Americans receive, both in how the care is accessed and its quality. Except for Guantanamo, the other systems he looked at had better outcomes as measured by infant mortality and longevity.

None of this was new to me. What was new was hearing from people who were not burdened by the system that provided their care. They did not have to think about it. They were comfortable with it. They took it for granted. It helped uncomplicate their lives. They could not understand the American system that argues with its patients about whether they can receive care, that makes receiving care difficult, and that often denies care to increase the profits of the health insurance companies. The American system was beyond the understanding of the Canadians, French, Brits, and Cubans Moore interviewed.

The brief (under six minutes) video “Sick For Profit,” by Robert Greenwald, covers some of the same ground as does “Sicko,” but without time for as much elaboration or irony, focusing on CIGNA, whose CEO makes $102,000 per hour. As a result of rising premiums and deductibles, denial of medical care to their insureds, and cancellation of hundreds of thousands of their customers, the top ten health insurers increased profits 428% in the last ten years. “The three largest insurance companies saved $300,000,000 in the last five years by dumping the sick,” Greenwald reports. Meanwhile, “U.S. workers’ out-of-pocket medical expenses have risen 93% since 2000.”

CIGNA and other health insurance companies often refuse treatment for life-threatening conditions until the person dies. Greenwald’s short documentary focuses on the profiteering of such companies, profiteering that is endemic to a system that encourages such exploitation of its customers by making a commodity out of what should be a service available to all.

Greenwald’s message is that health insurance reform, to be reform at all, must prohibit health insurance companies from refusing to renew policies if you become sick and prohibit those companies from refusing coverage because of pre-existing conditions. To see the video, go here.

In another short video produced by Brave New Films, Robert Reich, the former Secretary of Labor and now professor at the University of California at Berkeley, explains the public option. It is one health insurance plan that you may choose along with any private health insurance plan available in your area. If you find that the public option costs too much or provides inadequate coverage, you can have the Blue Cross-Blue Shield plan, or the Aetna plan, or the CIGNA plan, or the Scott & White plan, whatever private plan is available in your area. The public option would not be subsidized, but it would save money by negotiating prices in the health care marketplace just as any private company can do. The public option will be able to negotiate successfully, however, only if it is nationwide in scope.

Any plan (such as health care cooperatives) that is not national in scope will not have the ability–the scale and marketing leverage– to negotiate reasonable prices for its insured members. The co-op plan in Sen. Baucus’s bill, which was just made public, will not allow co-ops to contract with large employers, so they can’t compete with private insurers in the largest market, which prevents them from getting the purchasing power that would come from serving corporate customers. And they can’t set national payment rates for their members the way Medicare does, so the health insurance industry is being protected from competition with co-ops. The Congressional Budget Office reports that health care co-ops under the Baucus plan “seem unlikely to establish a significant market presence in many areas of the country.” Under the Baucus plan, co-ops would not reform the current system.

Reich’s message is that there are powerful groups with a huge self-interest in seeing that real reform fails: “They are the drug companies, the insurance companies, and political operatives who are more concerned about the political fight than in fixing a broken system.” Reich says that their strategy is to confuse and scare people enough about change to make many people, perhaps most, “decide to stay with a flawed system that everyone hates. They want to scare you and they have plenty of money and plenty of political partisans to do their dirty work.” His advice to all who want health insurance reform is to make their voices heard. This may be the last chance to do so for a very long time.

The health insurance companies must make a profit. That is the business model they follow. They can make a profit only if they deny needed medical care. We are the ones to whom they are denying that care. Without a not-for-profit public option. there will be more deaths–from 18,000 to 22,000– this next year caused solely by the profit-seeking behavior of the health insurance companies.

If Americans want a public option as part of our health insurance system–and the polls say that they do–that will happen only if Americans demand a change. The only thing that has ever defeated organized money is organized people. Join with others by participating in Sick For Profit, Public Citizen, Healthcare-Now!, American Medical Student Association, Campaign for Better Health Care, Families USA, Health Care for America NOW!, Physicians for a National Health Program, Service Employees International Union, Single Payer Now!, the Gray Panthers, Consumers Union, or any of the other groups working for a public option open to all. Links for these groups can be found easily through an internet search.

Everyone’s well-being is tied together with every other person’s well-being. When the system denies health care to one, it hurts us all–in the pocketbook. When people without health insurance must wait until they are really sick before going to an emergency room, the costs are 10, 20, 30 times more than a visit to a doctor’s office. Everyone pays for that emergency room visit through higher medical charges and higher insurance premiums to make up for the uninsured’s unpaid emergency care.

One of the prevailing sentiments among the people interviewed in “Sicko” is that we, the people of the United States, have a duty to one another to provide a way for all Americans to get good quality health care. This is the attitude of virtually all Brits, whatever their political views, who see that there is a moral obligation to have a system that leaves no one out of one of life’s necessity–indeed, often a necessity for life itself. People in small countries and large, western and eastern, in both the northern hemisphere and the southern hemisphere, feel a moral obligation to create through their governments a way to pay for health care that assures it is available to all. Is the American character really so different from the rest of the peoples of the world?

While I don’t believe that the American character is different, I do believe that the overwhelming influence of America’s corporations, focused solely on greed as the guiding principle of life, has skewed our democracy so that it does not serve the needs of our people in the way that the democratic governments of other countries serve their people. For the first time in my life, I have warm feelings toward France. But I have nothing but loathing for the billionaires and their corporations, and their toady politicians, who want the status quo because it will make them wealthier–damn the people’s needs.

© Freethought San Marcos, Lamar W. Hankins

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