11/27/2009 05:12 am ET | Updated Nov 17, 2011

The HealthScare Debate

Does anybody like their health insurer? Why all this misplaced outrage about the threat of taking away corporate obstacles to our health care? The strategy of the opponents to health care reform is to co-opt the almost universal anger people feel at their health insurers (if they have one at all) and direct it at those who would fix it: right emotion, wrong target. Health insurance makes us angry all right, with its denials of coverage for pre-existing conditions, restrictions on the doctors we can see, huge premiums larded with insurance company profits and executive salaries. If you dislike bureaucracy, then you should really hate the byzantine one imposed upon us now by health insurance companies.

The device being employed is one paranoid people use: projection. You see your own flaws in others, not yourself: the pot calling the kettle black. Who is interfering with the doctor-patient relationship? Not Medicare. Not the proposed new government health insurance plan. No, it is the insurers who have 'panels' of preferred 'providers.' If your doctor isn't on the list, you can't see him or her without paying out of pocket. Out of pocket - out of luck. Who is depriving sick people of health care, the so-called 'death panels?' Government bureaucrats? No, the government is helping to provide care for anyone over the age of 65 - Medicare. It is private insurers who won't enroll people with or cover those with pre-existing conditions, who deny approval for life-saving procedures, and who make it difficult to get medications. They are the ones who tell you that you don't deserve to live.

The big bad joke is that the private health insurers force us to stagger into seniority, and then let the government take over paying for health care if we are lucky enough to make it to age 65. Government has more incentive to give good health care, because the Medicare system takes over at 65, and has to pay for health care from that point on. In fact, we spend half of our health care dollars in the last year of life. All the private insurers have to do is get you through adulthood providing the minimal amount of care while getting fat on premiums you pay throughout your working life. Then, having extracted 27% of premiums on their overhead, executive salaries, and profit, they turn you over to the despised government plan that works fine with one-tenth the overhead, 2.7%. That would be Medicare.

Health care costs are the leading cause of bankruptcy in the United States. Such bankruptcies simply do not occur in Europe, with universal government-financed health care. Wouldn't you rather have a bureaucracy that actually has an incentive to maintain your well being? Good outcomes save Medicare money. The private insurers do not care about your health, just their profits. They simply want to invest your money while they have it (premiums) and you don't (benefits). The longer they delay and deny, the more money they make. We need Medicare for all.

So the health scare mongers accuse the government of what the private insurers are now doing. The anti-change 'protesters' are angry and they're not gonna take it any more. The only problem is that the private insurers have already taken it, and the anti-reformers are angry at the wrong people. Their strategy is the ancient one of scapegoating - mobilize all that real anger and point it at an innocent target. Who is rationing health care? The private insurers are - right now. That's a scary thought.