Caution: Health Insurance May Be Hazardous to Your Health
Lately, I am starting to wonder if Congress should put forward an amendment requiring every health insurance policy sold in America to come with a warning label: "Caution: Health Insurance May Be Hazardous To Your Health."
This idea may seem strange at first, but when you think about it the struggle against the health insurance industry is looking more and more like the forty-year struggle against the tobacco industry that began in the early 1960s and is just now ending.
In 1964, the U.S. Surgeon General published a report linking cigarette smoking to cancer, which resulted in the 1965 Cigarette Labeling and Advertising Act. Starting in 1966, every pack of cigarettes sold in the U.S. carried the warning label: "CAUTION: Cigarette Smoking May be Hazardous to Your Health." They knew back then that cigarettes killed, but the problem was that most Americans did not know it. We still thought cigarettes were good for you because the tobacco industry told us they were good for us.
Likewise with health care, as tough as the debate has been so far, America has only just begun to disentangle itself from the health insurance industry.
Part of the problem with the health care reform debate is the whole idea that health insurance is good for our health. It should come as no surprise that Americans think this way. The health insurance industry does not make obscenely huge profits by selling health insurance that keeps us healthy, but by selling us the idea that health insurance keeps us healthy--such that we keep paying for it right up to the point that our coverage is being denied.
Now we all know better. Certainly it helps to have health insurance to cover the costs of going to the doctor when we are healthy, but the moment we get sick--we now know--the health insurance industry gets busy finding a way to deny our claims, cancel our policies, and otherwise endanger our lives. In the long run, health insurance is not so healthy after all.
By 1970, a half decade of public education had resulted in stronger warning labels on cigarettes, "The Surgeon General Has Determined that Cigarette Smoking is Dangerous to Your Health." By the mid 1980s, after two decades of education, Congress passed a new law called the Comprehensive Smoking Education Act, requiring even stronger warning labels. Boxes now read,"Smoking Causes Lung Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy," and a host of other bone chilling predictions. Cigarettes from that point forward all but said, "Listen, pal. No matter what these jokers at big tobacco say, if you smoke these: death."
It could well be that in order to break the grip of the insurance industry on America, we need a twenty year long process of education.
Imagine if the next time you went to the doctor for a physical, at the end of the exam he turned to you and said, "You're in good shape now, but I need to warn you that your health insurance policy could endanger your life in the next ten to fifteen years." The doctor would then give you three or for pamphlets explaining the various ways that health insurance companies deny claims, cancel policies, and refuse coverage. "There is no cure for health insurance at this time, but for now we wanted to make sure that you were informed." What an eye opener that would be.
Imagine kids in schools giving book reports on the ways health insurance companies endanger American lives. Imagine goofy, "School House Rock" style cartoons where a walking, talking health insurance policy with a folksy accent explained how private insurers process reimbursement denials, how they blacklist children with leukemia, or how they cancel policies when people receiving care from brain injuries hit their coverage limits. Imagine public service posters in schools warning kids not to talk to health insurance salesman.
It took all of these approaches, plus millions of people dying from lung cancer, to break the grip of big tobacco on the American public. Government standing up to big tobacco in 1964 was just the beginning. What finally brought that industry to its knees after thirty years of public education was a combined legal and legislative strategy by the Clinton administration, resulting in historic wrongful death settlements. But even then, cigarette smoking still remained deeply entrenched in American society.
Only in the past few years have most major cities finally passed laws banning smoking in government buildings, the workplace, bars and restaurants. Forty years after the first "Caution" labels appeared on boxes, a set of state and federal policies finally took shape that once and for good curtailed the dangerous impact of cigarettes in our lives.
How many of us are prepared for a forty-year struggle against the health insurance industry? Not very many, I suspect. But we better prepare ourselves.
It may be hard to believe, but we are not much further along than the very beginning of breaking the grip of the health insurance industry on our country. Sure, the current debate has shown how the unregulated health insurance industry went awry over many decades. And yet, only now are we as a nation waking up to the horrific problems this has caused to--and will continue to cause--until we fundamentally change our understanding of it.
Of course, all of this requires the emergence of a viable, long-term alternative to health insurance in its current form--something along the lines of Medicare-for-all, but not hampered by the population formulas currently causing financial problems with the existing program. Maybe it will not take a full forty years to develop a workable solution, maybe it will take less. But even as President Obama gives speeches about the problems with health insurance and Congress sketches out the solution, we are only now completing "step one" of the battle--the step where we begin to realize a product is hazardous to our health.
Follow Jeffrey Feldman on Twitter: www.twitter.com/JeffreyFeldman
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Believe it or not, there exist things in this world that limit choice, and they may actually not be a government (don't have a heart attack). Many people without insurance worked years and years to save up for a house (whether or not they were qualified to buy a house is completely another matter and we do have to deal with that reality now and in the future). Their choice to not have insurance was limited by their overwhelming desire to have a family home, the white picket fence that symbolizes the American dream. These people are the construction workers, service industry workers and white collar middle class people that are now so few in America. If you believe they always have a choice of job, home and health every moment of their lives then you are plain wrong. Many people sacrifice some of those choices for others.
If it is you belief that the government shouldn't provide insurance for those who bought a home, save for their childs college expenses, or pay a landlord rent to live day to day, or work 55 hours a week in a restaurant serving you, then that is your perogative and you may be right. Argue against a bill or those who are for it, but NEVER EVER assume your reality is everybodys reality. Never.
I think the main problem with healthcare reform is that "healthcare" has become confused with health insurance. Workmen's compensation, social security and flood insurance are not really insurance. they are payor and accounting structures, this is because society needs to provide collective protection for these risks for everybody, but they are uninsurable on any actuarial basis. So is health. All an insurance scheme does is hide denial of health to poor people. If this is our collective national goal, i.e, the selective denial of health to certain classes, then just admit it and modify the current "insurance" scheme. Otherwise universal single payor healthcare, no matter what you want to call it, is the only way to include all citizens.
Extend Medicare to everybody and be done with it.
End the Health Insurance racket.
Yes and the doctors will stop practicing because they can't earn a living. In socialized medicine countries the best and brightest aren't pursuing medicine any longer.
Talk to your doctor and see if he or she makes any money from a Medicare patient.
I doubt very much that doctors "can't earn a living" with the rate that Medicare pay out.
Could you give me a solid figure of what medicare pays out for a consultation please?
Then we'll take it from there - with doctors seeing 25+ patients a day....you do the math and see if they "can't earn a living" from that.
Your logic is flawed. Medicare's reimbursement rates are appallingly low - but that wouldn't have to be the case if everyone was covered. With everyone covered, rather than just the elderly, and the money that would be going to the insurance companies paying into a single payer plan instead, reimbursement rates could be raised significantly. Doctors could still earn a living and fewer people would be dying. Win-win.
Agreed with above.
The concept of EVERY type of insurance is that people pool their money just in case something happens to someone. Rates for insurance go up when there isn't enough people to cover the 'something' that happens. Some people say its socialist (kinda weird how that works). If a not for profit public option is appealing enough, especially to healthy young professionals without long term careers (most can only do temp work these days anyway) and older blue collar workers who can't afford private insurance, then it will be cheaper and just as efficient.
And ron46032 is spreading the usual anti-socialist rhetoric that has failed in every other developed country. If you want to be smug, think of something original and relevant, there's a lot of ways to attack the bill, read up.
What the Democrats have come up with so far will leave millions without adequate coverage and fail to contain costs.
Better ideas:
1. Expand health savings accounts
2. Let consumers buy health insurance across state lines
3. Revisit the antitrust law exemptions enjoyed by the health insurance companies. Why protect these behemoths from honest competition?
4. Equalize the tax treatment of employer provided health insurance and other health care insurance.
5. Reform tort law to discourage defensive medicine.
Not gonna work - not without some cost controls for the medical industry in there. Medical costs are rising by what, twice what other costs are? Nothing you suggest addresses that.
You do realize tort reform restricts the right of all Americans to sue? If you think there's no out-for-himself lawyer out there that would love to take that on in the future just to make a name for himself then you're fooling yourself. A representative never wants to have to tell a constituent that theres a law that says you will only be awarded X amount of dollars for an issue that may have cost him or her a X amount of LIMBS.
health saving accounts would be better utilized by patients and require more thinking and learning BUT anything is better than government intrusion into my health. I don't trust or believe anything the administration is saying because int eh long run "medicine is the arch stone to socialism" Lenin
Well put. Expanded health savings accounts plus catastrophic health insurance available for purchase across state lines would go a long way toward solving our problems.
Wouldn't this whole health/health insurance situation be improved if Americans just got of their lazy butts, changed their lifestyles, and did everything they could to avoid health problems in the first place?
Of course there are unexpected health problems, the condidtions that come with aging, accidents, etc., but how much of our health care costs come from simply choosing negative lifestyles? If we all decided to "pursue health" tomorrow, by next year we will have cut these costs by at least one third-or more. We can start with that. Not all of this problem comes from evil insurance companies.
Wait a minute, blame yourself for your poor health. This is America, why blame yourself for your bad choices when you can blame an insurance company?
Mr. Feldman,
Great article. You can bolster this argument with research -- I've seen research that concluded people who have difficult billing problems after healthcare have more negative health outcomes.
Insurance companies use a very old tactic (it's not limited to healthcare, it happens in other types of insurance as well): overwhelm and harass with paperwork in order to avoid paying the claim or to get people to go away with a much smaller claim. That $450 billion in administrative expenses we pay every year goes to help the insurance companies do the best job harassing sick people that they possibly can. They are always coming up with new and more inventive schemes, too, so the general warning about them being hazardous -- as opposed to specific consumer warnings that simply give people a woefully false confidence that they have knowledge to help themselves -- is a brilliant antidote.
Perfect answer!
The health insurance industry motto:
Remember the 3 Ds - Delay, Deny, Drop!
The IRS is much better at it than any insurance company. And you guys WANT the Government option. The IRS has made harassment into an art.
Exactly, Insurance is a racket...!
So is politics.
Tennis anyone. You know that you don't have to play if you don't want to.
My insurance premium (I'm self-employed) costs me more than I earn. I pay it for one simple reason: I'm afraid not to. I don't pay for my insurance so that I can go to the doctor if I get a sinus infection, although I certainly use the benefit if I need it. I pay for insurance so that if the doctor finds a tumor, my care for that serious event will not wipe out my entire net worth.
I could pay my own way for ordinary care, and if I had the "choice" Ron keeps nattering on about, I would. I'd get a high deductible and; catastrophic care and pray that I weathered the two years until Medicare without a serious health event.
Why don't I do this? I tried. I applied. No one will take me.
Wait till you're 63, Ron, and then tell me how wonderful your "choice" is when no one who's able to say no will insure you. I got my current insurance through a professional group and they took me because there was an open enrollment window.
The idea there should never be a guy in an office getting between you and your doctor is a pleasant fiction. The only question is whether that guy in that office is working for a profit-making entity or for the government, which, dear Ron, is at least elected by the people. Who elected Cigna?
Please, remind me again - what exactly does the health insurance industry do for us? What are we buying at an incredible and ever increasing cost?
A chance to further your life if you chose. You don't have to participate though. In the end, you will die anyway. The question is about timing.
Cute. Very cute prose. Except whereas smoking has been scientifically shown to cause cancer, you do not present a single shred of evidence that outcomes for those under private insurance are worse than those publicly insured.
I am not sure I follow the comparison to tobacco. Afterall our government never used an individual mandate to force all of us to buy the lethal product as part of the solution.
I just spent a weekend with some older seniors. They talked about how many medications they took as if they were merit badges ... and there was no questioning or research of what their doctors said or prescribed. So sad. As a nation, we are so brainwashed. Augh!
We drug our kids just as much.
Insurance is socialism run by capitalists. Unfortunately, Americans - from the President on down - have been thoroughly mind-conditioned into the acceptance of it as the only way to deliver health care.
There's a huge difference. I have options of who I want to be my insurer if I chose insurance. With Government run anything, I have NO choice. This includes theft of my resources by Government.
my "insurance" is self funded by the coorporation I work for and administered by a health insurance company. I have NO choice at to which health insurance or health care scheme I get.
but theft of your resources by a health insurance co. is okay?
what "options" do you currently have? in KY, where i live, there are 3 health insurers authorized to do business: humana, united, anthem. these 3 get together, fix prices before the fact, so that i can apply for insurance to any of the 3, & i will get basically the same quote for the same crappy, denial-riddled, outrageously overpriced "health" insurance. pray tell, what kind of choice is this? either pay off the gangsters holding all the cards or die?
Then that would seem like good motivation to use the public option while you need it, but as soon as you get a job where you can afford private insurance, you switch to it. That's why the public option is so important.
You're not paying attention.
The insurance companies have been granted exemption from anti-trust laws. The "choice" think you have is merely and illusion as in any given market only one or two players have complete control. (Of course, that is IF they deem you worthy of being granted insurance at all - I am one of those unlucky many who, though perfectly healthy, was denied coverage - couldn't buy it at any cost.)
I just shake my head when I hear someone try to say that offering a "Public Option" would take away anyone's choices. All it does is ADD a choice - a choice that many don't have right now.
I can agree that if our Congress passes a bill without a Public Option but mandates that we MUST buy the insurance from the companies that have been raising premiums by double digits, raising deductibles, denying coverage, denying claims and dropping those who get sick - I would consider that theft!
Why do we have to pay for benefits from our tax money, France pays 3000 per person and has the best health care in the world. We already pay over 7000 per person in america and they want us to be forced to pay the crooks more. We need new people running our govt.They forgot our money is not their money, its for citizens not govt. or corporations to ensalve us...
http://online.wsj.com/article/SB124958049241511735.html
My word - a pregnant woman had to drive 30 miles to get to a hospital in France. That never happens in America.
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