Monday, September 28, 2009

Brave New Commercials?

I'm not 100% certain how I was added to the e-mail distribution list of a New York City organization called The Private Health Insurance Must Go! Coalition (PHIMGC), also known as Healthcare-NOW!, but the e-mails since the debate over U.S. healthcare reform began in Congress earlier this year have been almost non-stop. In fact, I've deleted most of them, because I frankly don't have time to attend rallies in Manhattan to protest for a government-run healthcare plan (I work in the suburbs and live in the city, although my office is moving to Manhattan at the end of the year, which I'm psyched about). Although I find the organization's objective of "education and advocacy organization that addresses the health insurance crisis in the U.S. by advocating for the passage of national, single-payer healthcare legislation" perhaps a bit more leftist than I believe. For example, I am not of the opinion that healthcare reform is contingent upon a single-payer, government-run system, as I believe that meaningful reform CAN actually be achieved with private healthcare insurers, in much the same way as healthcare systems function in countries like Switzerland or the Netherlands (to name two countries with universal healthcare coverage that is operated by private enterprises).

Having said that, I also believe that the age of continued corporate welfare we've observed for more than the past decade has to end -- soon. We simply cannot afford to continue giving-away tax dollars to companies that set up subsidiaries around the world to minimize the amount of U.S. taxes the companies pay and then call themselves "multinational" corporations, in spite of the fact that 90% or more of their revenues are generated on U.S. soil. The U.S. is now so controlled by corporate and special-interest lobbyists that any genuine discussion of the reform issues seems to be largely absent from the current debate. All that seems to be on the table right now is how to add 46 million new people to what is arguably the world's most overpriced, inefficient and dysfunctional system. Many lofty claims about how billions will be saved with electronic medical records have already been called into question by such respected medical journals as The New England Journal of Medicine. But the future of many genuine "reforms" to this dysfunctional "system" (a term I use very loosely) are relatively few, and the outlook for passage of those seems questionable at best. As the Massachusetts experience demonstrates, universal healthcare coverage by itself does not reduce out-of-control costs that have grown significantly faster than the rate of inflation for decades, and that type of "reform" merely adds more people to the system, often at significant taxpayer expense.

I do believe that I'd personally be better covered under Medicare, for example, than I am with my present healthcare plan (my third new plan in the past 3 years with the same employer -- the same employer I've been with for the past 9 years, incidentally). Ironically, at a January 2009 rally in Holmdel, NJ, President Obama stated: "Let me be exactly clear about what healthcare reform means to you,” the president said. "First of all, if you've got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you."

Really? That sounds like pure BS to me -- and I'm one who might be inclined to side with the President! I have experience to prove it!

The President has since retracted somewhat from that claim, instead stating "When I say 'If you have your plan and you like it, ... or you have a doctor and you like your doctor, that you don't have to change plans, what I'm saying is the government is not going to make you change plans under health reform." That admission was made to ABC News when the President was pressed on that issue.

Maybe, but with the current system, the choice still will not lie with the individual.

Back to the reference I made about possibly getting better coverage under Medicare, the truth is, given my age, unless I go into acute renal failure, the possibility of my getting coverage by Medicare seems increasingly unlikely, perhaps ever. Congress even likes to talk about raising the age of Medicare eligibility to prevent insolvency of that system by 2019 thanks to a massive baby boom flooding into the Medicare system with fewer workers wages being taxed to pay for it, and if (and when) that happens, me and many others my age (or younger) could realistically die before EVER being covered by Medicare.

On the other hand, I understand the logic behind the arguments made by the insurance industry, and let's just say, I'm not convinced. At issue: a mandate to buy healthcare insurance by everyone, the so-called "individual mandate". The core argument is that only by requiring younger, healthier consumers to buy into the system can costs be contained. But this is not like driving a car, and requiring insurance coverage (ironically, my auto insurance premiums include a line-item for "uninsured motorists", something which has always p!$$ed me off, since mandatory coverage is theoretically supposed to address that) should not be a mandate for life, which is not a luxury like an automobile actually is. Healthcare Now! refers to this as a "mandate" and "subsidize" plan. The mandate part means that the government forces you to buy the insurers' defective product. And the subsidize part means your tax dollars will be handed over to the insurers, boosting their bottom line.

My opposition is libertarian. Some individuals truly cannot afford the system, even with subsidies, and others prefer not to buy into the Western medical system, preferring naturopathic and/or homeopathic treatments and generally live lifestyles that do not follow conventional medical practices (these are the granola-eating, Birkenstock-wearing, commune and co-op types, who have a right to their opinions provided these behaviors do not endanger the lives of others, such as children) If you recall, a court ordered parents of a type 1 diabetic child to provide insulin after ruling it was effectively parental negligence. In fact, those parents made a critical mistake for failure to understand there is a critical difference between type 1 and type 2 diabetes, but in general, most are more informed about their choices than the average citizen. Should these individuals be obliged to buy into a system the do not wish to use (and have no intention of using) or is inconsistent with their own beliefs? Unlike auto insurance, they cannot simply choose alternative transportation methods, including walking.

Interestingly, deliberations last week on the healthcare reform bill introduced by the Senate Finance Committee seem to raise the possibility that an "individual mandate" could potentially be weakened, perhaps significantly. One group opposed to "individual mandates" isn't surprising: Republicans criticize any "individual mandate" provision as an affront to individual liberty. That's the first argument they've made that I'm inclined to agree with!

The Wall Street Journal reports that Senator Max Baucus, the finance committee's chairman, actually proposed reducing a fine that he originally proposed for uninsured Americans who fail to comply with the mandate. The newspaper writes "That raises the possibility that some healthy Americans will do the math and conclude that it is cheaper to remain uninsured -- paying the fine and avoiding the coverage premiums."

So why doesn't the logic behind an "individual mandate" convince me?

Have a look at the following videos created by another organization called "Sick for Profit":

Now, ask yourself if these don't raise questions on the legitimacy of this argument. Before we get there, have a look at an actual TV commercial by the healthcare insurer CIGNA:

Now, have a look at the following parody commercial produced by Brave New Films, a San Francisco-based "progressive" organization that claims to have "created a quick-strike capability that informs the public, challenges corporate media with the truth, and motivates people to take action on social issues nationwide" who produced the CIGNA parody commercial:

One has to wonder if lavish CEO compensation, and consistent profitability (even while the rest of the economy is struggling) should raise questions about the legitimacy of the industry's claims on the universal mandate issue.

Now, it might seem that CIGNA, the company whose former PR executive, Wendell Potter, blew the lid off his former employer's business model by testifying before Congress by admitting that denial of claims is a business practice aimed at maximizing shareholder value. He also repeated this statement value on PBS' Bill Moyers program (see my post here for more background), is the sole recipient of this critique. CIGNA is probably an easy target because the CEO of that company is compensated quite a bit more generously than many of his insurance company CEO peers.

But rest assured, CIGNA isn't the only company being targeted. There are also videos on Sick for Profit's website about Minnesota-based United Healthcare, too (see here) including the CEO of that company's lakefront McMansion in the affluent suburb of Wayzata, MN. There is little doubt that others, like WellPoint, Aetna, Humana and others are also on their radar screens.

The real question all of this raises is just what the final bills will look like? Already, we know that Congress has taken drug price negotiation for Medicare, in part because of the industry's deal with President Obama, off the table.

Interestingly, The Wall Street Journal reported that business seems to be parting from its traditional allies in the Republican Party on healthcare as companies and big corporate lobbyists are lending tentative support to a congressional overhaul that so-called conservative lawmakers staunchly oppose.

I would refer back to my argument that a reform bill need not address EVERYTHING. This is very much a work-in-progress, and will take consistent changes. But a recent Wall Street Journal/NBC poll (see here) should guide our lawmakers on what the public sees as critical: namely, that pre-existing conditions cannot be used to deny coverage (by a wide margin, no less) while the "individual mandate" is very low on the list. Let's just hope that our Congress can see through the lobbyists and focus on the issues that matter to their constituents, or they could pay for it when elections come!

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