WE NEED HEALTH CARE, NOT HEALTH INSURANCE

I’ve noticed that there is often confusion between “health care” and “health care insurance” in the current common lexicon. In today’s world the two phrases have become, sadly, almost synonymous. Well let me clarify, “health care” is treatment that saves lives and helps people get better when they are ill or injured. “Health care insurance” is a scam that has been perpetrated against the American people. Now my last statement is a pretty controversial one, but I urge you to keep reading allow me the opportunity to justify it in a few paragraphs.

The foundation of health care insurance, the basic economic model upon which it is based, is flawed. It isn’t flawed in terms of making money, it does that, perhaps too well. However, it IS quite deficient in terms of paying for care to make people better. First, insurance companies only make money by figuring out how to avoid providing people with the care they need, after all, care costs money. Second, insurance companies have an army of agents, customer service people, healthcare gatekeepers, and executives all of whom have to be paid. A whole bureaucracy including fat cats with multimillion-dollar salaries, and even stockholders who expect dividends—all of this paid for with the money we think is going toward paying for our healthcare. But all of those millions, folks, they aren’t going to doctors and hospitals.

The really tragic part of health care insurance is the wreckage it leaves in its wake. We see it now in America, and you probably know people who have been its victims. Patients who, even with insurance, can’t afford to get all of the care they need, or can’t afford the medications that are required for their treatment. There are health care consumers who have insurance but have had to sell or mortgage their homes, or dramatically reduce and contract their lifestyles so that they can pay their portion of their health care costs. One might ask, what’s the point of having health care insurance if even with coverage a serious illness or injury means you will face financial ruin? And the even more obvious question—What’s the point of having health care insurance if you can’t afford the health care you need?

So, you see, it’s just a scam--another example of the basic bait-and-switch bunko stuff that has existed for centuries, but in a modern new package. All of the things we all think we are getting when we pay those premiums, well those aren’t really what we get when we’re sick or injured. In reality we are get far less—much less than our money’s worth.

Now the country is moving to repair the system. On the whole that’s a positive thing. But there is concern about who is at the table. The insurance companies have their agenda, and one can expect them to have that “the business of business is business” mentality, which would be based on their ability to maintain profitability. Why?

During the last several decades the basic economic model of health care has changed. Do you remember when your local hospital was a nonprofit organization? I know a lot about nonprofit organizations and they exist for the benefit of the communities they serve. During those same decades the American people were sold a bill of goods about nonsense like “public-private partnerships” along with a lot of right-wing pap about how business does everything better than government. Well, I’ve worked in government and in the private sector and I’ve seen some darn good organizations and some ridiculous ones on both sides.

Let me say out loud something that you will realize is right as soon as I say it. Working for profit is no guarantee of quality products or services. Poor quality stuff represented to consumers as something better than what it is can be found in every shopping mall. And poor quality service has become commonplace in modern America. So if this is what we experience every time we shop or try to get something fixed, why would be believe that BUSINESS is the solution to all of our societal problems? Our job as citizens is to recognize when they are feeding us lies, and politicians, especially those on the political right have been doing lots of this about how business can save us. What business can do is make money. Then those same businesses that make more money are beholden to the politicians, and can give them even more money not to listen to us or care about what is good for us. Is that something we want to support?

Besides, government does lots of things well. People performing as part of a government workforce maintain our birth records, pick up our trash, deliver our mail, and do little things when they have to like defeating the Nazis and the Japanese because they want to take over the world. There is a lot of American pride about what we can do when we set our minds to it, and you know, we can do some things pretty darn well. We can do those things either publicly—as a government effort—or privately.

It makes little sense to involve the private sector in things where profit isn’t the primary motive. Because if we involve the private sector in things where profit isn’t the primary motive, then profit will become the primary motive, and that is exactly what has happened in health care. The goal of helping people to get well, or recover from an illness or injury has been displaced by the profit motive, by multi-million dollar salaries for fat cat executives, and by making money for stockholders. We don’t need profit to be part of our health care system. We shouldn’t be paying health care CEO’s a hundred million dollars a year, and we don’t need stockholders wanting dividends or demanding that management behave in a ways that impress Wall St. to make stock values increase.

As I said, an important change that has happened in the health care system in America in the last several decades is that it has switched from being not-for-profit (or nonprofit) to being for profit. So now that the time has come to reconstitute health care in America, we have to ask, what do we want? Do we want health care sold and managed as a commodity, on a for-profit basis to make money? Or do we want health care managed as a utility the way Los Angeles County manages water and power, or other user-owned systems operate solely for the benefit of their users?

We have seen many changes in the health care system in America, and most of them haven’t been good. We used to beam with pride about having the most admired system in the entire world. Just a few years of for-profit management has changed that, so when are we going to catch-on to the fact that we need to rethink the foundation, the fundamental model of how we organize and manage health care? The system should exist for the medical well-being of everyone, and the financial well-being of no one. Eliminate the fat cat executives, the stockholders, the army of people paid to deny us care, process our “claims” and then kick us out of the program because our health care needs are too costly. All of those people are paid, and they are eating up the money that we need to be spending on surgery, medicines, and expensive machines that can see inside our bodies. Those people are unnecessary. They provide no health care, and they are draining essential economic resources from a system that desperately needs money to make us well.

Last but not least, we need a system that takes care of everyone, that doesn’t blame or victimize people because they get hurt or sick, or have genes that result in illness, or they get cancer. We need a system that doesn’t bring people to economic ruin because they need health care. We need a government overseen, managed, contracted or operated system that will take care of people who need taking care of, and do it with regard to efficiency, but without regard to profit, and with great compassion and concern. We need a system that works to make people better, and that exists only for the purpose of making people better. We don’t need a system that makes a few greedy people rich by denying care to the rest of us and undoing what once made the American health care system the most respected and admired in the world.