Should Congress solve the organized crime problem by passing legislation to subsidize the Mafia and force all Americans to pay for Mafia protection or be fined for not doing so? If not, then why should Congress try to solve the health care insurance problems by subsidizing the industry that causes those problems to begin with, and forcing all Americans to pay them for protection against the high costs of getting sick? Especially when it is the health insurance companies that are most responsible for those high costs.
Is it fair to compare health insurance companies to the Mafia? After all, there is a difference. The Mafia usually steals its money from healthy people, whom they sometimes kill in the process, whereas the insurance companies make their money from denying benefits to the sick, who often die as a result. The Mafia operates illegally; the insurance companies operate legally. In fact they help write the laws that regulate them and provide millions of dollars in funding for the election campaigns of those who enact those laws. Unlike the bribery employed by the Mafia, the insurance industry’s payments are Supreme Court-sanctioned “free speech,” protected by the U.S. Constitution.
For many years our nation’s private health insurance companies have proved beyond a reasonable doubt that competition and free enterprise, which work so well in other industries to keep quality high and prices low, does not work that way in health insurance. That is because these companies cannot control the costs of medical care, they can only add to them the costs of their own bureaucracies with their multimillion dollar payments to top executives. And because the more money they bring in with premiums and the less they spend on benefits, the more they make.
The Senate bill rewards these companies with millions of new customers who are forced to buy their health insurance from them, and subsidizes those same companies with billions of dollars of taxpayer money to pay for those who are too poor to pay the high costs of premiums required for those companies to make exorbitant profits.
They made record profits in 2009, totaling $12.2 billion — a 56% hike over the previous year for United Health, Wellpoint, Aetna, Humana, and Cigna. To make these enormous profits they kicked 2.7 million older and sicker Americans out of their healthcare plans last year.
Do these companies deserve to be subsidized with your income tax payments? Do they even deserve to stay in business?
But what, you might ask, is the alternative? The most effective is for Congress to pass Medicare for All — a single-payer system guaranteeing universal coverage, such as they have in France. Yes, the French pay higher taxes, but they receive many more benefits for those taxes, and they aren’t required to purchase insurance from commercial companies. But what is the quality of their health care? According to the U.N. agency concerned with this subject, France has the best health care in the world.
Many Americans are against paying higher income taxes. What they don’t realize is that they pay for health insurance one way or another, and it will cost them and the companies they work for less in a noncommercial, public, single-payer plan than it will cost if health insurance goes through a profit-making system. And under a single-payer plan, everyone would be covered automatically.
Would this be a government takeover of medical care?
Not at all. The federal government would not provide any medical care at all except, as now, for veterans. Americans could go to whatever doctors or hospitals they chose, as long as those hospitals and doctors accepted Medicare, just as it is now for senior citizens.
Would there be long waits for medical care, hospitalizations, and surgeries? This is not a problem in France and doesn’t have to be one here. We could put the money we save by getting rid of the high costs of the private insurance companies into scholarships to train doctors and nurses and to the purchase of needed medical equipment and facilities.
Would this be socialism? Doctors would continue to work in private or public practices. Private, public, and nonprofit hospitals would continue to exist. So this certainly would not be socialized medicine. But you could call it socialized insurance, if you want. Certainly it is government-controlled, nonprofit, tax-supported, automatic medical insurance for all. Whatever you call it, it would be a vast improvement over the inhumane, immoral, profits-before-people medical insurance system we now have in place.
As Dr. Marcia Angell, a Harvard medical lecturer and former editor-in-chief of the New England Journal of Medicine, said in an interview with Bill Moyers about the current Senate bill: “What this bill does is not only permit the commercial insurance industry to remain in place, but it actually expands and cements their position as the linchpin of health care reform… Not only does it keep them in place, but it pours about $500 billion of public money into these companies over 10 years… and it mandates that people buy these companies’ products for whatever they charge. Now that’s a recipe for the growth in health care costs not only to continue but to skyrocket.”
She continued: “The President’s absolutely right that the status quo is awful. If we do nothing, costs will continue to go up. People will continue to lose their coverage… Things will get very bad. The issue is, will this bill make them better or worse? I believe it will make them worse.”
The Senate bill is very bad legislation and it should be defeated. We should really have Medicare for All, but the compromise could be a public option for those who want it. It is not a question of giving up the good in an effort to achieve the perfect. It is a matter of giving up the bad to try to achieve something much better.
Fred Flaxman is the author of Sixty Slices of Life … on Wry: The Private Life of a Public Broadcaster.