Posted by: The Amoeba | August 10, 2009

“… a lot of money is made in this country off sick people.”

Your Friendly Neighborhood Amoeba first heard about Wendell Potter about a week ago.

In case you, like me, have been cooped up in a Petri dish and haven’t heard the news until now, Potter is the former health insurance industry executive who, one fine day in 2007, came face to face with the consequences of the policies that he had been helping to sell to We the People. He went to a “health fair” near his home town in Tennessee, and found a fair chunk of the 47 million citizens of these Untied States who do not have health insurance lined up, third-world style, to receive medical treatment from volunteer physicians working out of tents, horse stables, the street.

Two years later, presumably after having ensured himself a comfortable retirement from the proceeds of his princely insurance-executive earnings, he left the industry and is currently engaged in critiquing the firms that once thought him worth penthouse apartments and luxury seats in private jets.

Those critiques are beyond sobering. Much of the press has focused on Potter’s epiphany story. It fits nicely with the theme that the medical system in the USofA is collapsing on account of the greed of a few big, bad men.

YFNA was far more intrigued by Potter’s account of the medical loss ratio. That’s the ratio of payouts (medical claims) to earnings (premiums). That number has to be less than 1 (100%), or the outfit conducting the business is losing money and will eventually go bust. Not even the U.S. Government can afford a medical loss ratio greater than 1 for long.

According to Potter, the medical loss ratio for the health insurance industry in the early 1990s was around .95. In 2009, it’s below .80. In other words, only five cents per dollar of income was set aside for running the company and (of course) profits twenty years ago. Now, it’s twenty cents on the dollar.

Did the insurance company executives decide on their own to do this? Hell, no. This development was forced on them by people who own stocks, who would drop those stocks in a New York minute if the companies failed to squeeze every copper of profit out of their operations. Even if that means dropping coverage for people on the verge of expensive life-saving care, by any means necessary. Even if that means forcing 47 million American citizens to get their health care in horse stalls.

And who, you ask, owns these stocks that are driving the insurance companies to behave in such an immoral manner?

The people who manage your 401k. The ones you’ve likely been bitching about because they lost so much of your money in the last six months.

Yes, dear reader. It’s easy to cast blame for the mess American health care is in on the “mighty” few – when the fault actually lies with that fellow / gal you see in the mirror every morning. As usual.

Way back in September of 2006, the Dudes were forced to confront the realities of health care in these Untied States. Not much has changed …

============

“Ahh … s…!!”

“Expletive deleted to you too, dude. Where the hell’d you learn to sneeze like that?”

“Just tedding you how I feel, dude. Ahhh …”

“Well, think of something cleaner. You want to get us flagged?”

“I don’ staht feerling bedda soon, ain’t gon’ be kickin’ me off the web. Won’ be he’ to kick. We fin’ any doc’s yet?”

“Yeah. Now ask if we can afford any of ‘em.”

“Huh? Wha’aya mean ‘can’ afford’? Wha’s this $250 a mon’ we’re payin’ out for insudance?”

“$250 my ass. Try $325. And a 30% co-pay for everything on top of that.”

“WHAT THE F[mmmfffmmffmmmm]?!?”

“I told you to clean it up, dude! Yech. Read.”

“Can I scream?”

“In your condition? I wouldn’t recommend it. I already have enough washing up to do around here.”

“Soddy. But … ahhh .. s…!!”

“Gesundheit!!”

“Too la’, dude. Wha’ do they thingk they’re messin’ wid? Gas prices?”

“Might as well be. It’s all about shareholders. Profit margins. Make money or else. SOS.”

“I tho’ it was abou’ health, dude! Don’ we have a right to see a doc’ when we get sick?”

“I thought maybe having your head filled up with phlegm instead of the usual empty space would make you smarter. Guess I was wrong. You got as much ‘right’ to health care in this country as you do to a mansion in Malibu. That was the way it was in the Stone Age, and that’s the way it is now. Bring cash. Or stay home.”

“Man, those doc’s mus’ be livin’ real high off all this money.”

“Sure. The ones treating Bill Gates. Or Terrell Owens. The ones treating you and me? Last one I saw spent the entire visit, all 30 seconds of it, bitchin’ and moanin’ about how hard he had to work for so little. I’m surprised he had time or energy to look at me. Hell, I’m surprised I got out alive.”

“You’ not makin’ me very happy, dude. If the doc’s ain’ gettin’ the money, who is?”

“Can you say Viagra?”

“No’ (cough, cough) now, dude. Why don’ we have national health care, like Obama wants? So we don’ have to go through this?”

“Won’t work.”

“Who says?”

“The New Zealanders, for one. They had national health care back in the 80s, but the country couldn’t figure out how to give everybody what they wanted without long waits, short service, and physicians quitting or cracking up. And the rich got tired of waiting so they set up on their own. The rich got richer and everyone else got the shaft. Sound familiar?”

“Wors’ an’ wors’, dude! Wha’s O Ceallaigh gonna do now? He’s gettin’ a bit long in the tooth, y’know.”

“Oh, he’s got it all figured out. Carries these.”

“Sax … i … tox … Wha’s tha’, dude? Wrinkle pills? Li’ botox or somethin’? OC tryi’ not to ge’ ol’?”

“Y’might say that. No, they ain’t wrinkle pills. But believe me, they’ll cure what ails him. And he won’t be asking his great-great-grandchildren to be paying his medical bills.”

“But wha’ abou’ me, dude?”

“We google ‘the flu’, dude. And hope.”

Swine flu, dude?”

Did not.”

“Did … don’ do dis to me, dude!!”

  – O Ceallaigh
Copyright © 2006, 2009 Felloffatruck Publications. All wrongs deplored.
All opinions are mine as a private citizen.

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Responses

  1. First thing I noticed about Potter was that he didn’t grow a conscience until after he was rich.

    So, is there a solution to what ails us — aside from your suicide pills?

  2. he didn’t grow a conscience until after he was rich.

    Q, the same thing could be said of Gandhi, or Francis of Assisi, or … well, name your favorite “saint”. Science has lost its impartiality, because its practitioners are no longer independently-wealthy Victorian gentlemen, but people who are one failed grant away from the breadline (and thus become subservient to the grantors). The moral compass is mounted on a pedestal of gold.

    is there a solution to what ails us?

    if there were an easy one, I’m sure it would already be in place. I fear that the solution is not easy, and that, were it to be presented to Us, We would reject it … hell, We are rejecting it, to judge from the reports of health care “debates” (mostly campaigns of disinformation and smear) taking place around these Untied States as this is written.

    Here’s a partial list of things that I think need to be addressed.

    1. Undo Milton Friedman‘s declaration that “the business of business is solely to make money”, reestablishing the principle that businesses also have moral and ethical responsibilities within their communities.

    Unfortunately, in order to enact this recommendation, society needs first to decide what is “moral” and “ethical”. In the post-WWII deconstructionist world, most moral/ethical codes have been revealed to be – or have been accused of being – the thinly disguised self-interest of [name your favorite enemy].

    Friedman, I suggest, said “everything is based on self-interest, let’s just, as business people, be up front about it.” Yes, that amounts to worship of Mammon – but, as Richard Dawkins spent a whole book declaiming, God is a jerk; how bad can Mammon be? (See 47 million Americans without health insurance.)

    2. Teach people the truth about money.

    As you know, I think that the two most important keys to success in adult life need to be taught to children early, often, and rigorously. Those two things are Sex and Money. The former is barred from most primary and secondary schools, and the latter, if it is taught at all, is relegated to a dreary one-term class at the end of senior year, when all anybody (including the teachers) hopes for is to get the hell out of jail.

    This is just fine by the businesspeople who make their yacht payments by selling the promises of Sex and Money to the graduates of our deliberately-gutted public education system.

    3. Replace “emotion” with “reason” in all purchasing and major life decisions.

    It’s been declared (was it by Gordon Gekko in Wall Street?) that the two driving factors in American business are “greed” and “fear”. Both of which are emotions, indeed among the rawest of emotions. As part of the education about Money noted above, the idea needs to be instilled that it’s not about “what you want”, it’s about “what you can afford”.

    Needless to say, if American consumers started actually making rational decisions about job choices, purchases, investment strategies, etc., that would throw those American businesses that aren’t already there into bankruptcy. Marketing 101: “If the customer is allowed to think, you’ve lost the sale.” Even our charities (cf. “Make A Wish Foundation”) focus on our powers of wishful thinking rather than on the facts of the case. Our media, our entertainment, even our educational systems feature expressing emotions over managing facts. Our professional sports leagues used to permanently expel “bad actors” because, in a “moral” world, promoting a- and anti-social behavior was a ticket to extinction. Now, the “bad actors” are promoted to the hilt, because they’re seen as the best possible path to profits. Short of them taking their clothes off and assaulting the cheerleaders, that is.

    We have allowed ourselves to be persuaded to gut our public education system, because this gutting is precisely what those who prey on our greed and our fears desire. Not least, those who make their money selling the fact that our universities will provide, for a mere $30K per year (not including the lost wages from the job the student could be working at, and could, in primary and secondary school, have been prepared to work at), the 8th grade education that should have been provided in (shock horror) 8th grade.

  3. I dunno, man. Friedman makes a lot of sense to me. All the companies, as you point out, are owned by people so why can’t they maximize profits and let the beneficiaries try to behave morally with the proceeds.

  4. […] over ways to fix the national disgrace that is our current health care “system” focuses, not on facts and figures, but on […]

  5. […] “Which no one in America cares a flying fickle finger of fate about, except in my role as cash cow. Sorry, but last I checked, moooo was not in my vocabulary. Neither was health insurance, like 50 million of the rest of us.” […]

  6. […] goody! Yet another ploy by the profiteering health insurance industry to jack up premiums, shaft services, and blame all the problems on […]


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