What We Really Have to Fear about Health Care

By Patricia Lee Sharpe

We’ve been ruthlessly conditioned  to be afraid—to be absolutely terrified—of medical decision-making by government bureaucrats.  But we’ve got much worse instead:  employees rigorously trained by insurance companies to deny as many requests for care as they can get away with.  The less care you and I get for our  premium money, the happier (which is to say, the more profitable)  the private insurance companies are.

The Balance Sheet

SO:  You thought you would die but you didn’t.  Much as your insurance company tried to deny you access to testing, surgery and recuperative services, to say nothing of the precise drugs your doctor wanted you to have, you won the battle.  You got the care you needed and you are on your feet again.  You rejoice!  Your family rejoices.  Your friends rejoice.  Your employer rejoices.  Your doctor is happy.  Even a few drug companies are happy; you will be taking their products for x amount of time.  And, of course, your dog wags its tail, madly.

Meanwhile, your insurance company makes an entry in red, in the loss column. This year you are  a red blot on the balance sheet.  Next year there will be more red.  Ditto from now on, perhaps. You have been a mere profit or loss center for the company all along.  Now you are an out and out liability.  No matter how long you have been paying premiums to your insurance company, you would be better off dead, from its point of view, and it will drop you as soon as possible—or raise your rates until you are forced to drop out.

In short, those scarey death panels exist.  They obey your private health insurance company.  And people die every day because care has been denied.  Not just granny, folks.  People in every age bracket.

Why on earth have we Americans been so patient with this callous laissez-faire route to health insurance?  Private companies have no fiduciary interest in taking care of us.  Their only legal responsibility is to make money for their share holders, who would be up a very dry creek if we switched to a universal single-payer system.  Insurance companies might survive if a responsibly-structured public option were introduced, but to compete they would probably have to be satisfied with lower profit margins.   How do we know?  Medicare is much cheaper to administer, a fact that tends to get lost in the fancy deck shuffling that goes for health care cost analysis.

The Real Fears We Live With Now

Not surprisingly, then, insurance company adverts have done a good job of making too many of us afraid of change.  If you poor schmucks think the present system is less than perfect, they declare, what’s on the table as reform will be a whole lot worse.  It’s the old devil we know vs. the devil we don’t know argument.  The industry flacks get us so roiled up over fantasy fears that we forget the deep awful fears we actually live with.  Here are the very real dreads that keep us awake on bad nights:

• We worry about care being denied.
• We worry about being underpaid (or not paid) for supposedly covered costs.
• We worry about losing whatever coverage we have as soon as we make a claim or two.
• We worry about bankruptcy from catastrophic costs whatever our  coverage.
• We worry about losing insurance if or when we lose our jobs.
• We worry about the ever-increasing cost of coverage, even if we are employed.
• We worry that Medicare will be taken away or diminished.

All in all, then, the present system fills us with fear and anxiety and uncertainty.  How can reform in the direction of  adequate coverage for everyone possibly be worse?  And speaking of those anxieties, we should be furious about the totally unnecessary fear that’s being flogged—the notion that Congress is likely to do something radical to Medicare.  It won’t happen.  Gutting Medicare would be political suicide, even for Senators and Representatives who receive shockingly huge contributions from the health insurance industry.  Medicare has been a terrific program and people know it, though too many of us tend to forget that it’s government run.  Those bureaucrats, bless them.

The Fears We Don't Need

Ah yes, the final fear—that universal high quality cradle to grave health care will cost too much.  It will bankrupt the country.  But we know that isn’t true.  The proof is out there, if we care to listen, if we care to take it in, instead of letting the insurance industry frighten us with the tired old S-word.  Other countries with advanced industrial economies achieve high quality health care for half the current cost of care in the U.S.  And most of those countries have better health demographics than we do.  We don’t have to find a uniquely American path to those results, however ego-flattering the notion of doing it our own way might be.

In short, what we really have to fear about health care reform is no change or industry-pandering cosmetic change.  And so, dear Senators and Representatives, will you choose to represent your constituents who need reliable affordable health coverage, or or will you let yourselves be bought off by the fear-mongering insurance industry?