Thursday, June 25, 2009

Public health care option? Hell, yes!


The debate over health care reform is well underway, and one thing is perfectly clear: when it comes to influencing legislation, the health care insurance industry has a hell of a lot more pull with Congress (and especially the US Senate) than does the voting public.

An NBC/Wall Street Journal poll released on June 17th showed that 76% of respondents felt it was either "extremely" or "quite" important to "give people a choice of both a public plan administered by the federal government and a private plan for their health insurance." Seventy-six percent. That's a whole lot of support. You'd think that our elected representatives would be trampling each other to get in front of that parade.

Well, if you did think that, you'd be dead wrong. Here's why: all those billions of dollars that those of us who have health insurance pay in premiums every month, aside from paying for the yachts and private Lear jets of corporate executives, also pad the pockets of K Street lobbyists. And these lobbyists use that money to "lobby" (or, "bribe" as it is sometimes called) our congressional representatives.

Ostensibly, the objection to a public option for health care is that it is too expensive. But these protests generally do not make mention of the enormous costs associated with having 47 million uninsured persons in America who rely on emergency care as their sole recourse when they get sick.

Other objections point to inefficiencies in the two government administered health care related programs: Medicare and Medicaid. Well, government could always be streamlined and made more efficient. However, having worked in private industry for over 20 years now, I can tell you that inefficiency, sloth, and shoddy workmanship are hardly the exclusive purview of government. The amount of money I have seen squandered in private industry is staggering.

(As a side note, Republicans, who claim to not believe in government solutions only compound the problem when they are in charge. Their belief that government can't work is self-fulfilling.)

If we are going to have a health care solution for the country, it must either be implemented by government or private industry.

But, what is the function of private industry? It is to make a profit so that the profit can be distributed among shareholders. Therefore, it is in the insurance companies interests to deny as many claims on health insurance as possible.

There have been reports of health insurance companies offering bonuses to claims adjusters for denying claims. (You can read one such report here.) That is, the more claims an insurance claims adjuster denies, the bigger his or her bonus. Why? Because fewer claims mean bigger profits! As long as the profit motive is part of health care decisions, abuse and corruption are going to be rampant.

Government, on the other hand, does not have the profit motive. A bureaucrat does not make more or less money by denying a claim for health care. A bureaucrat's salary is not dependent on the success or lack of success of a private enterprise. Therefore, decisions about people's health care are not made with an eye toward increasing profit for the corporate entity.

Note that this does not mean that we shouldn't pay doctors an excellent salary. Doctors, nurses and health-care professionals should get top dollar for their work. But insurance company executives? Shareholders? If we remove the profit motive from health care the cost savings will allow us to pay health-care professionals more.

Also, by removing the profit motive, it seems more likely that poorer communities will get better health care facilities. In Oregon, the facilities at smaller communities are often exceedingly poor. Why? Because private corporations do not see any profit in investing expensive medical equipment into communities that have no money.

In the end, it all comes down to this question: Should a person's access to health care be dependent on his or her ability to pay? In other words, are rich people entitled to better treatment and better health than poor people? Or, taking a step back even further: Are there people that matter and people that don't?

And this: bribed Senators (Democrats and Republicans) can obfuscate and protest all they want, but it seems that the public is clear about what it wants. These trying economic times have made everyone aware and fearful about their vulnerability. Shrieks about encroaching socialism and out-of-control government expansion don't convey the same dread as does the fear of a cancer diagnosis or a sudden, massive stroke.

Besides, President Obama's proposal is to include a public option to private health insurance. This option would compete with private health insurance companies. And every good capitalist welcomes competition. Right?