Bill Moyers’ Journal on 7/10 was about Health Care Reform. I don’t know what Mr. Moyers’ political leanings are, but he presented quite a case against the “status quo.” His guest was former Cigna executive Wendell Potter, who helped spearhead the campaign against the 1993 health care reform efforts, and against the points laid out in Micheal Moore’s 2007 documentary about the failings of the American health care system, “Sicko.” I’ve never seen the movie, but I want to see it now after reading what Mr. Potter said about it:
BILL MOYERS: Was it true? Did you think it contained a great truth?
WENDELL POTTER: Absolutely did.
BILL MOYERS: What was it?
WENDELL POTTER: That we shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.
You know, we have more people who are uninsured in this country than the entire population of Canada. And that if you include the people who are underinsured, more people than in the United Kingdom. We have huge numbers of people who are also just a lay-off away from joining the ranks of the uninsured, or being purged by their insurance company, and winding up there.
And another thing is that the advocates of reform or the opponents of reform are those who are saying that we need to be careful about what we do here, because we don’t want the government to take away your choice of a health plan. It’s more likely that your employer and your insurer is going to switch you from a plan that you’re in now to one that you don’t want. You might be in the plan you like now.
But chances are, pretty soon, you’re going to be enrolled in one of these high deductible plans in which you’re going to find that much more of the cost is being shifted to you than you ever imagined.
That’s the real truth of the matter, and one that has affected me as a State of Oklahoma employee. I am constantly seeing our health insurance change every two to three years as they get a new “lowest bidder.” I keep seeing deductibles and co-pays rise, medicines re-categorized to a higher tier, and the base cost to me go from fully covered by my employer, to now having to pay a percentage out of my take-home pay.
If you ever hear someone say “government run health insurance puts a bureaucrat between you and your doctor,” please tell them it’s already happening. Tell them how some insurance executive already makes these decisions, not in the best interest of their enrollees, but in the best interests of Wall Street investors. I’m not talking mom and pop with a few shares of Aetna, I’m talking big Goldman-Sachs style hedge funds that wield enormous financial power. Mr. Potter again:
BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, “I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors.” How do they satisfy their Wall Street investors?
WENDELL POTTER: Well, there’s a measure of profitability that investors look to, and it’s called a medical loss ratio. And it’s unique to the health insurance industry. And by medical loss ratio, I mean that it’s a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry’s been dominated by, or become dominated by for-profit insurance companies. Back in the early ’90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.
So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they’ll punish them. Investors will start leaving in droves.
I’ve seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street’s expectations with this medical loss ratio.
For example, if one company’s medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that’s ridiculous. And it’s horrible.
BILL MOYERS: That they’re spending more money for medical claims.
WENDELL POTTER: Yeah.
BILL MOYERS: And less money on profits?
WENDELL POTTER: Exactly.
Moyers and Potter continue on, so I advise you to read the whole thing. It’s pretty stunning and revealing of how private insurance works. Remember, this isn’t some lefty libtard whack job, this is a former executive at a big insurance conglomerate who used to actively fight against health care reform. He’s now fighting for it.
Finally, Mr. Moyers addressed the Washington Post hosting a private dinner with alleged access to “insiders” of the health care reform process. In other words, using their journalistic “integrity” to sell access to the highest bidder:
According to one poll after another, a majority of Americans not only want a public option in health care, they also think that growing inequality is bad for the country, that corporations have too much power over policy, that money in politics is the root of all evil, and that working families and poor communities need and deserve public support when the market fails to generate shared prosperity. But when the insiders in Washington finish tearing worthy intentions apart and devouring flesh from bone, none of these reforms happen. Oh, they say, “it’s all about compromise, all in the nature of the give-and-take of representative democracy.” That, people, is bull the basic nutrient of Washington’s high and mighty.
To which he makes his final, salient, and most profound point:
It’s not about compromise. It’s not about what the public wants. It’s about money, the golden ticket to “the select few who actually get it done.” And nothing will change. Nothing. Until the money-lenders are tossed out of the temple, and we tear down the sign they’ve placed on government the one that reads: “For sale.”
Please, read the entire transcript, and judge for yourself.
p. s. – Many I know will chastise me for writing this, but I don’t care. Health care reform must happen. The current health care system has screwed me over repeatedly, especially with a wife that has rheumatoid arthritis. Even my son’s birth was not covered by insurance because it was a “pre-existing condition.”
The insurance person told me when I signed up full-time at my job that I could add “anyone, any time.” Then when I went to add my wife before we conceived, they said “Oh, you can only add at the beginning of the fiscal year, or when there’s a ‘qualifying event.'” I asked if becoming pregnant was such a thing, and was assured that it was. Then when I went to add her when I suspected she was pregnant, they denied her outright, citing her rheumatoid as a factor and saying pregnancy was a “pre-existing condition.” So, we payed for the whole nine months out of our own pockets, but not before looking over the hospital bill and finding $2,400 in unnecessary charges that they were most likely hoping to bilk some insurance company out of, then bilk me out of.
So I don’t have any reason not to say this: big health insurance companies and the current “system” can kiss my ass.