Hours into the U.S. House’s predictably shallow and frustrating hearings on President Obama’s language about Americans being able to keep their health insurance, I thought of a character whose perspective I trust, Crocodile Dundee, who offered a conundrum in the movie of the same name when he told a would-be thief with a switchblade, “That’s not a knife. This is a KNIFE.”
I remembered Dundee’s impressive all-purpose hunting knife and the street thug with his much-smaller switchblade slinking away.
I took the challenge and admit it took a while to connect the analogy and realize it was the perfect framing. The detractors never questioned the efficacy of the product they defended, its suitability for its purpose. The debate never addressed “insurance” — its name, definition or performance history.
“Insurance” that is “INSURANCE” follows the twin principles of shared risk and shared responsibility. Shared risk involves a distribution of the costs of providing health care across large numbers of participants who include the healthy and the sick — all ages.
By this definition the private sector hasn’t had health “INSURANCE” for decades. Tens of millions have been denied access because they are or have been sick or because of age or where they live or ability to pay. Forty-five thousand die yearly because “insurance” excludes them. (It fits that the “insurance” industry didn’t fight the creation of Medicare, happily conceding the least healthy demographic to public care.)
More often than we know, carriers force employers to fire employees if they, or covered dependents, become expensively sick. I’ve personally known two individuals abandoned at desperate times. Al was let go by a tearful employer/friend, coerced by his “insurance” company when Al was diagnosed with stage 4 melanoma with a hopeless prognosis. Jerry, “Employee of the Year” for the past two years, was fired for “incompetence” when it was known his newborn required long-term expensive care.
Otherwise highly qualified potential employees are rejected — by order of “insurance” carrier — because of pre-existing health issues, limiting job opportunities. There are yearly and lifetime caps on coverage. Policies are dropped at will. Most disturbing are the thousands of “insurance” company employees who ferret out reasons to dishonor contracts. Remember the breast cancer patient who, after the initial surgery, discovered her policy had been dropped because she failed to disclose a medical consultation for teenage acne?
Truth is, having “insurance” has never guaranteed coverage, and, at some level, most in the private sector have endured that anxiety.
For-profit “insurance” has no useful function in health care. It funnels our money, a process increasingly directed to profits, not service. Establishing themselves as capricious gatekeepers, “insurance” carriers have routinely siphoned off 30-35 percent of our precious health care dollars. It’s worked magnificently. Recall several years back when federal regulators intervened to block the retiring United Healthcare CEO from realizing his billion (that’s a “b”)-dollar severance package. You can imagine the size of their lobbying budget and its impact.
One of the most valued books I own is “Deadly Spin” by Kingsport native Wendell Potter, whose conscience made him resign his high-six-figure job with Cigna. As head of corporate communications, he was responsible for Cigna’s version of the spin by which “insurance” corporations have limited health care and deceived Americans. The front cover endorsement by Bill Moyers is unsparing: “ ... an exposé ... that reveals why real health care reform didn’t happen, can’t happen and won’t happen until that power is contained.”
The cost has been exorbitant. It’s a shocking and important read written by a brilliant, courageous, compassionate man to whom we’re indebted.
The Affordable Care Act restores the name INSURANCE to the industry which long ago abandoned, solely for greed, its own twin guiding principles. Pre-existing health problems can no longer be a barrier. There will be no carrier-imposed yearly or lifetime caps on coverage, but yearly out-of-pocket caps will exist to protect consumers (no more bankruptcies due to illness). No arbitrary cancellations are allowed. Preventive care is free. Costs and benefits are weighted in consumers’ favor. That’s INSURANCE.
Back to Al and Jerry. Al’s girlfriend Rita worked for the Forest Service. She asked the insurance rep about spousal coverage for a new husband with a terminal illness and the answer was “full and immediate.” Rita proposed. Al not only had state-of-the-art care but was offered a job with the service, which he fulfilled superbly for seven unlikely and well-lived years. The state of Arizona teamed with the federal government to care for Jerry’s baby, which continues to this day. The profit seekers never could exercise their cruelty in the public purview.
Obamacare deserves all the space it requires to get past its current hurdles and prove its mettle. Doing its best to stand in the way of our only path to authentic health INSURANCE, we have the most ideologically extreme and dysfunctional Congress in history, masqueraders as threatening to our health as the behemoth industry still spinning its ill-named phony product. The street thug’s switchblade shriveled in the presence of the real thing.
We have the real thing now and it‘s vital we protect it. There are thugs who intend to take it away (including our own representative).
Jennie Young of Elizabethton is a retired language arts teacher.