America’s War on Empathy: The Health Care Front

http://www.prospect.org/cs/articles?article=health_care_reform_villains

One of the most disturbing articles I have read on the state of American health care was written by Paul Waldman in the American Prospect entitled Health Care Villains. He focuses on the downright evil practice used by insurance companies of “rescission.”

Somewhere in America today, a woman is sitting in her doctor’s office, experiencing the worst moment of her life, as she learns she has breast cancer. Death is staring her in the face. She’s wondering whether she’ll be there to raise her children or meet her grandchildren. But there’s something she doesn’t know as she walks out of the office and begins to plan how to tell her family that she could be dead soon.

What she doesn’t know is that because she was just diagnosed with cancer, her insurance company is launching an investigation of her, in the hopes that they can find a mistake on one of the many forms she’s filled out over the years. One of their employees is poring through her records, and that employee’s job is to see if the company can come up with some rationale, any rationale, for cutting off her coverage, so they won’t have to pay for the treatment for her cancer. And of course, once they do drop her, she won’t be able to get coverage from any of the other insurance companies. Because she has cancer.

In other words rescission is the incredibly profitable “standard operating procedure” for insurance companies WHENEVER you submit a claim to THEN launch a ferocious investigation — mind you, after said company’s been cashing your monthly premium checks year after year — to find the flimsiest but legally binding loophole to declare you have somehow, in some way, violated the terms of your policy so they can dump you. No empathy for your plight. No honoring your long term contract. No honor.

This practice seems to cause no moral pause for the insurance executives, who willfully prioritize profit over patient. Waldman discloses that last week:

At a hearing of the House Energy and Commerce Subcommittee on Oversight and Investigations, Rep. Bart Stupak of Michigan asked executives from three of the nation’s largest insurance companies whether they would commit to ending the practice of "rescission" unless there was evidence of intentional fraud or misrepresentation. They all said no.

The video of this hearing is strikingly reminiscent of the 1994 hearing in which tobacco company executives famously announced their absurd belief that nicotine was not addictive. Only in this case, the executives weren’t saying that they didn’t believe they were destroying people’s lives; they were saying that they had no intention to stop destroying people’s lives.

http://www.prospect.org/cs/articles?article=health_cares_true_price

In another article entitled Health Care’s True Price Waldman observes:

The single-payer and hybrid systems in place in every other country in the developed world have many admirable features: lower costs, universal coverage, and better health outcomes. But what ought to make us most envious is their security — it’s what they have and we desperately need. If you live in Canada or Germany or France or Japan, there are some things you need never fear. You need never fear that your insurance company will tell you it won’t cover treatment for your asthma because you had asthma before they signed you up. You need never fear that you will bankrupt your family because of expensive treatments for a serious illness. You need never fear that you will find yourself without coverage after your insurer dropped you or you lost your job. You might fear getting sick, but you won’t fear that your life will be destroyed by not being able to pay for getting sick.

In the United States, unless you’re over 65, extremely poor, or a veteran — thus, already covered by a government health insurance plan — you do have to fear all that. That’s because the central pathology of our deeply pathological health-care system is that most of us have no choice but to get health coverage from an entity whose sole reason for being is to take our money and then try to avoid paying for our care when we get sick.

[snip]

The private health insurance market is dominated by four gigantic insurers: UnitedHealth, WellPoint, Aetna, and Cigna. In the last five years, these companies have combined to earn over $44 billion in profits; UnitedHealth alone has made over $17 billion in profits over that period. "On Wall Street," the Los Angeles Times has noted, these companies "showcase their efforts to hold down expenses and maximize shareholder returns by excluding customers likely to need expensive care, including those with chronic diseases such as asthma and diabetes. The companies lobby governments to take over responsibility for their sickest customers so they can reserve the healthiest (and most profitable) for themselves."

Feeling outraged? Yeah, these execs are supposed to be the guys who are gonna play nice on a compromised health care program? Obama and his community organizer skills are going to get stretched on this one. This profit-making insurance machine is going to relinquish or significantly lessen its present, over-the-top profit-making? More and more my mind travels to the revelations of that old Canadian documentary, The Corporation, organized around the premise that the psychological profile of a corporation, with its “legal person” status, is that of a psychopath. Self-aggrandizement its only motivator. Empathy-less. Sheer gamesmanship. Get-over-ism. Profit, profit, profit for the sake of the shareholders and extraordinarily self-compensating CEOs and high honchos.

Have integrity and decency totally evaporated from the American business landscape?

http://digbysblog.blogspot.com/2009_07_01_archive.html

Digby on 7/01/09 discussed the often unacknowledged “underinsured” status of most Americans.

Health insurance is supposed to offer protection – both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured.

[snip]

Last week a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers” and dump the sick.

“The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what is essentially fake insurance” Wendell Potter, the former Cigna executive testified.

One often quoted statistic, every 30 seconds another person goes bankrupt in America due to a health care crisis. Another painful statistic: 60 Americans die each day due to inadequate health care.

http://informationclearinghouse.info/article22915.htm

Joel Hirschhorn sounds the alarm about the corruption and incompetence of the present private insurance system:

On the cost side, what is the problem? The current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Its main function is not to provide quality health care for all people but to make huge profits for companies. Private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing. Thirty cents of every dollar is not going to doctors, nurses, medicine, medical personnel; it is going to bureaucracy and administration plus exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. More efficient public programs such as Medicare, Medicaid, and the VA are administered for far less money, less than 10 percent.

From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. William McGuire, the former head of United Health, several years ago, accumulated stock options worth an estimated $1.6 billion; CIGNA CEO Edward Hanway made more than $120 million in the last 5 years. CEO compensation for the top seven health insurance companies now averages $14.2 million. Over the last three decades, the number of insurance administrative personnel has grown by 25 times the number of physicians.

Hirschhorn uses the word “insanity” to describe our system, ranked 37th in the world according to the World Health Organization. We get so little for so much spending, he asserts. We spend 40% more per capita than the second most costly national system. A “quality chasm” exists, he concludes.

What we are now witnessing in Congress and the White House is a total, ugly capitulation to the money and power of the private health insurance industry. If the private health insurance industry maintains its stranglehold on the national system, then taxpayers will pay even more money for the worst national health care system in the world, if Congress makes that costly insurance available to more Americans by using government money.

http://www.alternet.org/healthwellness/140990/hey_progressives,_join_forces_to_fight_the_health_insurance_industry!/

According to Karen Dolan Physicians for a National Health Program report with the Single Payer universal non-profit plan “The potential savings on paperwork, $350 billion per year, are enough to provide comprehensive coverage to everyone without paying more than we already do.”

Dolan explains that most healthcare advocates would agree that the single payer plan would be the most profound remedy for the U.S. health crisis. But they will also claim it is not politically possible. She uses the word “dead” to describe its status and encourages the teaming of both camps of progressives to work together, those wanting the single payer and those pragmatically pushing the public option, i.e., both public and profit systems combined.

Like both camps above, I too believe that the only real solution to our health crisis is a universal, single-payer, “Medicare for All” approach. Only through a public system that puts patient care and not corporate profits as the bottom line can we achieve the promise of health care as a human right, and effectively bring down exponentially skyrocketing healthcare costs at the same time. Even the best public option runs the risk of being the dumping ground of the nation’s sickest people while only slightly cutting overall administrative costs. A public option system does not achieve the goal of health care as a universal human right.

A public option may indeed be crafted in such a way to become the wedge that ultimately wins the prize, as public plans under-price costly private plans. The public option could offer public plans designed to adhere strictly to the Congressional Progressive Caucus’ laudable principles of universality, affordability, equality. They could be carefully constructed as to be so cost effective that the Republicans fear that they will crowd out private insurance due to their affordability becomes a reality.

But a public option could also be crafted in such a way to expressly prohibit that outcome by allowing private insurers to cherry-pick the healthiest patients, eventually bankrupting a public plan stuck with the nation’s sickest people. If private insurers are allowed to continue the current practice of cultivating and covering the healthiest Americans, the sickest will be dumped into a public plan, thus creating a financially unsustainable situation for the public plans.

So the political and business elite are so powerful that the admittedly best program for the common good is not seriously “on the table” and the pitfalls of a compromise, which is not even guaranteed, are discouraging.

http://d-day.blogspot.com/2009/07/health-care-lobbyists-and-journalism.html

Dday writes of the incestuous cronyism between government and insurance and pharmaceutical companies which obstructs the US joining other industrial nations in universal coverage.

… today the Washington Post writes about the hundreds of former politicians and staffers-turned-lobbyists for the health care industry, fighting tooth and nail against systemic reform.

The nation’s largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues, according to an analysis of lobbying disclosures and other records.

The tactic is so widespread that three of every four major health-care firms have at least one former insider on their lobbying payrolls, according to The Washington Post’s analysis.

http://digbysblog.blogspot.com/2009/04/goldilocks-journalists-by-digby.html

To add insult to American public injury is the excellent insurance coverage our gated-community Congressional elite enjoy, which, as Digby points out, is coverage we as taxpayers are paying for. She spells it out.

As soon as members of Congress are sworn in, they may participate in the Federal Employees Health Benefits Program (FEHBP). The program offers an assortment of health plans from which to choose, including fee-for-service, point-of-service, and health maintenance organizations (HMOs). In addition, Congress members can also insure their spouses and their dependents.

Not only does Congress get to choose from a wide range of plans, but there’s no waiting period. Unlike many Americans who must struggle against precondition clauses or are even denied coverage because of those preconditions, Senators and Representatives are covered no matter what – effective immediately.

And here’s the best part. The government pays up to 75 percent of the premium.

We as disenfranchised citizen-victims of a corrupt and incompetent healthcare system should be asserting our anger, our truth, our needs and our RIGHTS to our heretofore empathy-less power brokers.