October 15, 2009

• Wake the fuck up, American citizens

  The S-Word and Dr. Kevorkian’s
  Accountant

  Health care Rx from my socialist fire
  department

  Thursday 15 October 2009
  by: Greg Palast, t r u t h
  o u t | Op-Ed

  
  Wendell Potter tells Greg Palast health insurers’
  dirty secret. (Photo: BobFest)

  Tell me where it hurts,
  Mr. President.

  What’s killing you, Barack, is what’s killing us
  all: an evil germ called “Medical Loss Ratio.”

  “Medical Loss Ratio”
  [MLR] is the fancy term used by health insurance companies for their slice,
  their take-out, their pound of flesh, their gross – very gross – profit.

  The “MLR” is the difference between what you pay an insurance company
  and what that insurer pays out to doctors, hospitals and pharmacists for your
  medical care.

  I’ve totted it up from the raw stats: The “MLR,” insurance
  companies’ margins, is about to top – holy mama! – a quarter
  trillion dollars a year. That’s $2.7 trillion over the next decade.

  Until the 1990′s, insurers skimmed only about a nickel on the dollar for
  their “service,” Wendell Potter told me. Potter is the CIGNA insurance company
  PR man who came in from the cold to tell us about what goes down inside the
  health insurance gold mine. Today, Potter notes (and I’ve checked his accuracy),
  porky operators like AIG have kicked up their Loss Ratio by nearly 500 percent.

  The industries’ slice is growing to nearly a quarter of your insurance
  bill. All of it just paperwork and profiteering.

  President Obama is
  never going to pull the insurance company piggies from a trough this big,
  especially when the industry has made room for Congressional snouts.

  So what’s the Rx? Easy: Kill the pigs and call the fire
  department.

  The only solution to Loss Ratio piggery is to kill the
  pigs: eliminate health insurers from the health industry entirely.

  We
  can’t cure our ills, as our president has attempted, by attacking the problem
  ass-backwards. No, Mr. Obama, we don’t need HEALTH INSURANCE for
  everyone, we need HEALTH CARE for everyone. There’s a giant difference.
  Instead of concentrating on PAYMENT, we need to focus solely on providing
  the health SERVICE.

  From my London days writing for The Guardian,
  I can tell you the British do NOT have national health insurance. They have a
  National Health Service.

  The government builds hospitals, hires
  doctors and, when you need the service, you just go and get it. It’s kind of
  like the fire department. When your house is on fire, you don’t call your fire
  insurance company, you call THE FIRE DEPARTMENT. We care first about the
  service, not the payment.

  The British government hires the
  doctors, like firemen, and Brits use them, like firemen, as they need them.

  It works. My mother-in-law, a nurse, on a visit to England, was stunned
  at the speed, quality and absence of mad paperwork to fix her broken arm.

  But, you might say, that’s, that’s SOCIALISM! Well, yes, it is.
  And I’m not afraid to use the S-word: Socialized Medicine. Just like America’s
  Socialized Fire Departments. (Fun fact: socialized, i.e. publicly funded, fire
  departments were ‘invented’ by the revolutionary Ben Franklin.)

  And
  Yes We Can get socialized medicine passed into law.

  Really.
  It’s simple: we sneak it in with the kids.

  We can learn from Lyndon
  Johnson’s sale of Socialist Medicare. Johnson knew that no one could argue that
  Granny do without a doctor. Can the “Pro-Life” Republicans now tell us that
  pregnant moms and children ages 0 to 3 should be denied care? Therefore, to the
  Medicare program for those 65-or-older, we simply add “Kiddie Care,” for those
  from Negative 9 months through age 3.

  But instead of the wallet-busting
  Medicare system, in which doctors and hospitals are paid for each suture, bag of
  blood and pat on the head, Kiddie Care will be provided by Kiddie Care Service
  salaried doctors.

  How do we get doctors (who now AVERAGE $240,575 a
  year) to take well-paid, but not pig-paid, posts? We grab’m while they’re young.
  We pay doctors the full cost of their medical education; and we treat them as
  humans during internship, not as in the current system where interns are treated
  as medi-slaves. In return for the public paying for their medical education, the
  public gets the young doctors’ ten-year commitment to work for the health
  service at a reasonable salary.

  That’s not my invention. The
  free-education idea for staffing a national health service had long ago been
  proposed by that wily old dog Ted Kennedy. (Damn, we miss him.)

  Once the
  first wave of three-year-olds are about to turn four and their families face
  having to buy them health insurance, these millions of parents will become an
  unstoppable army of lobbyists screaming for the extension of Kiddie Care to age
  four, then to age five, then to age six and so on. Get it?

  Yes, Mr.
  Limbaugh, I am another bleeding heart trying to sneak socialized medicine into
  America. Yes, I am trying to rid us of the “free-market” insurers who are
  causing the bleeding. Health insurers are as useful to our health care system as
  a bicycle is useful to a goldfish.

  Free-Market Fantasia

  There ain’t no such thing as a “free market” in medical care, as there
  is a free market in food. You can eat peanut butter instead of dining at
  Maxime’s. But you can’t tell the surgeon, “No thanks, I can’t afford a new
  kidney this week – I’ll just have a broken arm.”

  A free-market
  for-profit insurance system means that, when you need a new pancreas, your fate
  is left to an insurance company computer programmed by Franz Kafka, Dr.
  Kevorkian and his accountant. It’s you versus the Medical Loss Ratio. Good luck.

  In olden days, doctors would attach leeches to suck a patient’s blood.
  Today, we have insurance companies’ Medical Loss Ratio. Both can kill you. If
  Obama and America want to end this sickness in the body politic, start with Dr.
  Kennedy’s sure-fire cure: a national health service for kids – and get rid of
  the bloodsuckers.

  ***

  I Quit: A Personal Note

  I
  learned of the Kiddie Care solution during my brief and ill-starred tenure at
  the Center for Hospital Administration Studies at the University of Chicago
  “Billings” Hospital. I couldn’t make up that name. Years later, they hired
  Michelle Obama as their vice president for community affairs.

  In my
  time, three decades ago, “Billings” handled the affairs of that poor community
  by shipping the uninsured, sometimes bleeding, to poor-folks hospitals. One
  wounded patient died on the poverty shuttle.

  I quit, and swore that one
  day I’d write about it. I just did.

  *********************
  
  Forensic economist Greg Palast is author of the New York Times
  bestseller, “The Best Democracy Money Can Buy.” His investigations for BBC TV
  and Democracy Now! can be seen by subscribing to Palast’s reports at www.GregPalast.com. Hear Wendell Potter
  tell Greg Palast about health insurers’ dirty secret here.

  • 10:26 pm
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