Saturday, October 24, 2009

It’s Time to Name Names

By Alexander Prisant

Not unlike Barnum & Bailey or the Ice Capades, the fire-eaters, dancing bears and tight-rope walkers of the Health Care Road Show have wended their way through our TV sets, our frontal lobes and a town near you, for months. And months.

We’ve missed a bunch of Congressional and White House deadlines, changed direction more times than that and still don’t know when or where we’ll wind up.

One of the questions now must be: Why?

If the original objective was simply to make this a healthier place for most Americans in a cost-effective way—at least up to the standard of, say, Austria or Australia, why can’t we just do what they do? It's true that in a recent poll, Nevadans called the man they elected--Senate Majority Leader Harry Reid-- as spineless. But that's too simple to explain it all.

The real answer is: this Road Show is not actually about health care at all. It is about the Great Divide that bedevils every major debate in this society. The same divide that hung over a nation when it debated a Civil War, the Gold Standard, Social Security, Civil Rights and so on.

This is about National Interest vs. Self Interest. There are a lot of health care stakeholders, but if we’re honest they’re not all altruists. Most doctors want to make good money. Most patients want “Cadillac Health Care” (whatever that means) for their own family. Most nurses would like some more sleep and more rational shifts, all of which cost money, and finally, there are the private heath insurers. Their goal is more transparent—greater profits than Goldman Sachs with executive pay that would ---and does—make Ben Bernanke blush.

Most of these stakeholders do genuinely see some direct benefit in a healthier America, but it may at last be time to stop this Obama-speak that infers we’re all in this together. Because we are not.

Having personally lived in four European and Middle Eastern nations with slightly differing forms of single-payer national health care and having enough chronic illness to get inside these systems first- hand, I am still perplexed as to how my care suffered in any way because there wasn’t a non-medical middle-man in a bad suit with a profit motive, between me and my doctors. Where did I lose out? On a larger scale, I‘ve yet to figure out what entire element of good national health care practice goes wanting in those systems, because those middle-men aren’t around.

(Astonishingly, the absence of any cogent debate on this point in America hasn’t prompted a single press conference heckler to wonder out loud what private health insurers do for their money and why it helps anybody for them to push paper around. A hundred countries get on just fine without that fifth wheel at all. But Americans don’t seem to want to know.)

So it may be time to say what we all secretly know about the 800 pound elephant in the room—some health care stakeholders are in it for the nation; while some are possibly a bit more involved in protecting their wallets. They see the American body politic, anatomically, as their Profit Center.

The following insurers include some that tried to attack the Baucus bill at the very last minute for the ignoble reason they wanted his mark-up to include even stiffer penalties for the “stragglers” not plumping in new premiums to insurer coffers in a new system (nothing about national interest in that line of attack). These folks had no concerns about whom, how or whether anybody received health care in the bill—just the demand that everyone pay premiums—to them. (What? Current profits of 63.1 billion for just one insurer aren't enough?)
So here are some of those billionaires, complete with teasers that speak to their personas:

Aetna - Paid $470 million to settle a physician-led class action suit for short-changing consumers and doctors.

Cigna - Refused a liver transplant to 17-year-old Nataline Sarkisyan, by calling the treatment “experimental” in 2007. The result: Death.

WellPoint – Sued the State of Maine for $9.5 million for insufficient profits from state residents, after increasing profits by 88% in previous 3 years. Was the 1st insurer to oppose Gov. Schwarzenegger’s plan to provide coverage for all Californians in 2007. $10- million/year CEO Angela Braly refused to allow treatment or even speak with Melanie Shouse, a WellPoint member with Stage 4 breast cancer, this month--during the Senate health care debate.

Blue Cross – Sam Pullen’s altruistic, sit-down protest cost him 5 days and nights in Los Angeles’ Central Men’s Jail this week, simply because Blue Cross refused to reconsider its policy denying 20% of life-saving treatments to its own subscribers. Even after Pullen’s release, Blue Cross has flatly refused to speak with him.

Humana – According to the California Nurses’ Association, Humana, like its fellow insurers, denies an average one in five physician requests to treat patients at risk of death. Government statistics estimate such refusals and non-insurance cases result in over 45,000 needless deaths in the US every year.


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