January 20, 2010

Later Is Already Here

First they came for our post offices…. and I said nothing.

Then they came for our roadways…and again, I said nothing.

Now they’re coming for our health insurance companies…and I say “Tear them a new one, Barack!”

In a society as large and unwieldy as the one we’ve become, some institutions just naturally lend themselves to standardization and oversight. Back in those yearned-for (and largely non-existent,) days of a “free market economy,” private companies and municipalities regulated and ran their own mail delivery, roads, schools, currency and coinage. Rail lines into the frontier were independently owned and taxed, leading to foundational fortunes for their robber baron owners—and poverty for the local businesses displaced via eminent domain seizures. The food supply was unstable and distribution lines were unreliable and expensive—great for the entrepreneurial and politically well connected, not so great for inter-city, let alone inter-state commerce. Few would argue that nationalizing these entities was a mistake. (I could, but for the sake of argument here, I won’t.)

After Great Depression 1.0, a series of reforms was instituted to ensure a standardization of banking practices, and allow federal oversight of commerce deemed in the national interest—the underwriting of mortgage loans, for example, or speculation in commodities that affected our national security.

Alas, beginning with the “deregulation” of the 1980’s, federal authority over standards and practices were systematically eviscerated by corporate interests with political backing. Savings and Loans were gutted and looted for private gain, and “market forces” I.E. Wall Street and their handmaidens at the Federal Reserve and UST, were allowed to rampage through the derivatives landscape, trampling the SEC and Joe6Pack underhoof as they ran wild.

As we’ve now seen, our once-anticipated retirements have financed the billion dollar bonuses of these cartels. They have enabled the very mergers and acquisitions that looted our pensions, and financed their wars of “containment” — or more accurately, wars of lucrative no-bid contracts and international hedging. Can you say “systematic transfer of national wealth? ”

Remember how hard GWB et al pushed to privatize Social Security and allow “ordinary Americans” to invest their social security accounts in the stock market? Although I ‘m sure their intentions were pure, following as they were, so closely on the heels of the tech bubble burst, one can only imagine the subsequent carnage had they been successful in their attempts.

In this regard we may have been the inadvertent beneficiaries of a literal deux ex machina in the form of the 9-11 attacks, which immediately diverted the discourse—and the cartels’ grubby intentions—and gave Cheney, Inc. an excuse to pillage the national coffers of Iraq instead.

An unregulated and unaccountable finance industry has already taken over our economy and bankrupted our country for the benefit of a miniscule aristocracy. The real estate credit bubble has burst. And now that Medicare is facing insolvency, and the ranks of the uninsured are swelling unsustainably, reform of the health care reimbursement system is a make-or-break moment for the insurance industry. Either they become the trustees of one of the biggest financial coffers on the planet, or they are rendered as irrelevant to the conversation as the recording industry is to music distribution.

This so-called reform bill decides their fate.

As a person caught in the cracks of America’s health care reimbursement industry, I’m in an unique position to comment. Most of my family are physicians, and for much of my 20’s I worked for a private inter-insurance exchange, marketing medical malpractice insurance to doctors and dealing with the subsequent political fallout from established insurers as they attempted, first to discredit, then to hone in on, the doctor-owned company I represented. It wasn’t pretty, but it was, as the owners put it, “a license to print money.” I know how the industry works. More importantly, I know how its insiders operate.

Nonetheless, for thirty-plus years now, I have paid, out-of-pocket, for a private health insurance policy. Let me just say that my experience with them has been less than helpful. (Google: “Mauled By a Bear, Then Mauled By Blue Cross” for the gory details.)

After successfully battling my way back to functionality over the last year-and-a half—a half-dozen surgeries and a fortune’s worth of out-of-pocket expenses later—I find myself both bankrupt and bereft, disfigured and unemployable, without teeth, essentially blinded, and with no way to come up with the onerous co-pays and deductibles I am responsible for paying in order to prompt my insurer to kick in for their share of the repairs. It’s almost like being an FB….

As many of you know, I live in a remote area without public transportation. Imagine the fun of trying to recover from devastating injuries (I was discharged from hospital after 36 hours in the ICU,) without a visiting nurse to help out, or any way to pay someone to get you to a doctor for follow up—and forget PTSD counseling. Imagine the horror of discovering that the $1,200+ per month of non-generic pharmaceuticals you need to save your eyesight and battle your necrotizing facial bones are not covered by your insurer—or available through any private or public subsidies. Imagine your insurer denying “medical necessity,” time after time and forcing you to figure out how to pay for time-sensitive treatment out-of-pocket—then trying battle their legal department for reimbursement. Or holding up payments until your doctor dismisses you for “obtaining medical services under false pretenses,” or claiming that services they pre-approved were in reality not approved – after the procedure has been performed and billed. Ad infinitum. That’s private insurance.

Now imagine trying to stay strong enough to recover under such unremitting psychological torture. Those who watched their 401(k) disappear as the market tanked, knowing there wasn’t a damned thing they could do about it because the market was rigged, know precisely what it feels like.

Yet insurers expect their insured to pay their premiums every month, whether or not we deem them “reasonable and customary.” And with no accountability to their customers, there’s nothing we can do about it either. The federal government, for all its many faults, couldn’t get away with this. They are, after all, accountable to the voters, and there are reliable mechanisms for appeal.

Is this broken “insurance” system what you want for your cancer treatment a few years down the line? How about for when you’re dealing with the aftermath of your first stroke? Keep in mind that Medicare as we now know it, will be, is being rationed. Whom do you want in charge of the rationing?

Quite honestly, I do not believe that medical care is a ‘”right.” I’ve always eaten a disgustingly healthy diet, kept myself extremely fit, and never smoked a cig in my life. I resent like hell having to subsidize people who are too lazy to take even minimal responsibility for their own good health, and those who refuse out of “political conscience” or just plain cheapness, to do their part in maintaining America’s national medical system by buying a health insurance policy and paying their fair share. And don’t even get me started on people who “hire” illegal labor under the table and then expect the rest of us to pick up the costs of educating those workers’ children and caring for their health needs.

Thirty-two million of us Baby Boomers are about to retire. Medicare is about to go under. The labor base that we’ve been expecting to support us through our old age is unemployed for the foreseeable future—and most likely until we all die off and give them the jobs back. The stock market is about to implode for real (no TARP bailouts this time,) and pensions are going to evaporate into the ether—whether they’re inflated into vapor, or simply “modified” away as the tax base dwindles and quasi-public entities like GM, declare bankruptcy. And in the midst of all this, twenty-three layers of middlemen stand –palms outstretched—between our wallets and our doctors.

Now, I personally happen to think that being able to send a letter three thousand miles across the country in three days—for 42 cents—is a pretty good deal. I am heartened that local school districts in Kansas do not get to teach their students that Jesus walked with the dinosaurs as part of the accepted curriculum. It gives me actual hope that Congressmen Daryl Issa (R. CA.) and Phil Angelides (D. CA.) have stopped foaming at each other long enough to form a tag team to smack Wall Street over the head with a Congressional folding chair. That Representatives Alan Grayson (D. FL.) and Ron Paul (R. AZ.) have outflanked Barney Frank to take on the Fed. That Representatives Dana Rohrabacher (R. CA) and Dennis Kucinich (S. OH.) have united from really opposite sides of the aisle to rail against funding anymore death and destruction in Afghanistan.

And now we have Scott Brown in Kennedyland while Bill Clinton urges Massachusetts’s voters to “take back the Tea Party.” Maybe with a little luck we’ll see Sarah Palin joining forces with Bernie Sanders to oust Ben Bernanke. (Hey, a girl can dream…. )

What I’m seeing here is our federal government finally beginning to lay off the partisan bickering and starting to demand some accountability in our national institutions. If We the Citizenry egg them on a bit more, maybe they’ll get the idea and put the thumbscrews to the bandits who are holding our medical system hostage as well.

Seriously folks. The system is broken. We’re going to have to raise taxes to pay for the repairs. Rationing is already a fact of life and is about to get a lot more stringent—forcing us to confront some hard ethical choices. And we’re going to have to do this NOW, because later is already here.

So what it comes down to is this: who do you, personally, want to administer your health care in the last third of your life? A profit-oriented, unaccountable cartel like the ones that have run our country’s economy into the ground, sold US out to every foreign interest with two shiny pennies to rub together, and siphoned off our savings and our grandkids’ future? Or the good old reliable, plodding-but-fair, hold-the-bell-and-whistles US Postal Service?

Why look! It’s snowing down there on the creek road, and here comes Gus in his beat up old 4WD—with my my snail mail….

by ahansen




Bits Bucket For January 20, 2010

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