Health Insurance isn't

From the New York Times Editorials:

Congressional committees heard a lot this month about the devious schemes used by health insurance companies to drop or shortchange sick patients. It was a damning portrait — and one Americans know from painful personal experience — of an industry that all too often puts profits ahead of patients.

As health care reform moves forward, Congress must impose tighter regulation of companies that clearly are not doing enough to regulate themselves. Creating a public plan could also help restrain the worst practices, by providing competition and an alternative.

A House oversight subcommittee took a close look at a particularly shameful practice known as “rescission,” in which insurance companies cancel coverage for some sick policyholders rather than pay an expensive claim. The companies contend that rescissions are rare. But Congressional investigators found that three big insurers canceled about 20,000 individual policies over a five-year period — allowing them to avoid paying more than $300 million in medical claims.

The companies typically argue that the policyholders withheld information about pre-existing conditions that would have disqualified them from coverage. But the subcommittee unearthed cases where the pre-existing conditions were trivial, or unrelated to the claim, or not known to the patient. When executives for the three companies were asked if they would be willing to limit rescissions to cases where the policyholder deliberately lied on an application form, all said they would not. This tactic will not be ended voluntarily.

If only I could believe it is not true. But of course it isn't. The insurance companies, doctors, pharmaceutical companies all have no financial interest in you being healthy. The insurance company wants only to take your premium, not to pay a claim on it. The doctor is rewarded financially only if you are one of the many people shuttled through his office (and only if your insurance— or you!— will pay). Pharma only makes money if you take the high-margin pill.

If we are to solve the problem of health care costs in the context of a market-based system, we have to change the profit incentive to one where your care-giver makes money when you don't need care.

Otherwise, we're probably better off with single-payer. Yeah, there will be rationing. We already have that today. We just have a different name for it. We call it poverty.

Just chew on that for a while.

Padilla & Lebron v. Yoo

In a very short item, Glenn Greenwald notes that John Yoo (he of the infamous torture memos) lost in district court a ruling on a motion to dismiss the case filed against him by Jose Padilla and Estela Lebron. Greenwald seemed particularly amused that Judge White (a Bush the Younger appointee) quoted the Federalist No. 8 (as penned by Alexander Hamilton) thusly:"[War] will compel nations the most attached to liberty to resort for repose and

security to institutions which have a tendency to destroy their civil and political

rights. To be more safe, they at length become willing to run the risk of being

less free."

Now, I'm not completely sure, since I haven't memorized that one yet, but my experience with Hamilton's contributions is that Hamilton wanted a more powerful executive. (Goes and skims) It is ironic then that of the Federalist papers or other citations from the Founders, Judge White quoted Hamilton in denying this motion. Hamilton is about as sympathetic a voice for a strong central authority as it was possible to be in those times. Yet here he is, telling us that we may think it a good idea to sacrifice our freedom to ensure our safety, when faced with external threats. You can't be sure, because he doesn't say, if he thinks this is a good thing, a bad thing, or simply an inevitable thing. But I think most of us today realize what a Faustian bargain it is— doomed from the start.

It is unfortunate, then, that the authoritarians of today appear to take Hamilton's words as prescription rather than proscription. You'd think they'd grasp the difference.

Health care for all, please.

What confuses me most about our system is the notion that the profit motive can be an effective motivator for someone to treat people that are sick, when the long-term goal of health care ought to be to prevent people from being ill in the first place. There's no incentive in our current system to do this (save general good will).

If you could structure the profit motive so that care-givers are rewarded for keeping people healthy (which is not the same as keeping them from seeking treatment, as many insurance companies seem to think), then a private system makes sense. Otherwise, single-payer seems the only sensible approach to the goal that I, at least, appear to share w/Scott: treat everyone regardless of ability to pay and don't bankrupt them while doing so.

If the insurance industry goes out of business in the process, that's too bad. At least while *they* are looking for work they won't get sick without being treated!

It was recently reported that more than 60% of bankruptcies are due to the debtors medical bills.  As far as I can tell from what was written about the study, this may not include those whose bankruptcies are caused more or less by failing to be treated adequately for addiction, which is in my experience a strong contributor to the bankruptcies I'm familiar with.

The simple truth is that until we solve the problem of people losing their credit worthiness, their livelihoods, and their homes because they cannot afford the illness they have contracted, we are wasting the talents and skills those people can contribute.

If you agree, please let your members of Congress hear from you.  Single-payer health care is being demonized as "socialized" medicine, and is thus being ignored.  But it is the only system that has a chance to prevent the kinds of tragedies that health-care related bankruptcies bring.  And it is the only system that has a chance of ending the absurdity of our system today: that there is a profit motive to have more sick people rather than fewer.