THE BLOG
12/01/2009 05:12 am ET Updated May 25, 2011

If the Insurance Companies Win, We Lose

As the health care debate rages, one thing has become increasingly clear. This battle is not mainly some academic argument about the best approaches to health care policy -- or even a clash of ideological world views. It is a fight over who gets what. It is a battle between the health insurance industry and the rest of us -- as consumers, as patients, as taxpayers.

And one thing about this conflict is certain: if the insurance companies win, we lose.

Fundamentally, the big insurance companies are fighting tooth and nail to make sure they can continue to skim billions off the top of the dollars we spend on health care.

This does not mean that if we win, the insurance companies will lose in some existential sense. If real health insurance reform -- with a strong public option -- is signed into law this fall, we won't have to have a tag day or bake sale for the big health insurers. They are very good at figuring out how to make lots of money.

What is at stake is whether we continue to be the world's greatest health care chumps -- paying 50% more per person for health care and still being 37th in the world in health care outcomes. More importantly, what is at stake is whether the rapacious drive of big health insurance companies to skim off money for Wall Street investors and their corporate CEO's will continue to create health care victims.

Take Stacie Ritter. She's a mother of twins who lives in Pennsylvania.

Both of her daughters, now 11, were diagnosed with leukemia when they were four. They both needed stem cell transplants and other cancer treatments. They did survive, but the treatments damaged the glands that control their growth beyond repair. Their doctors indicated that in order for them to continue to grow normally, they needed regular growth-hormone injections.

But there was a problem. Each time Stacie took her daughter to the doctor for shots, it cost her $440. CIGNA refused to pay.

Stacie and her husband were not about to deny their daughters the right to grow up, so they spent every spare dollar on the injections. In the end, those expenses -- coupled with other costs they had to pay for the twins' cancer treatment -- forced them to declare bankruptcy.

Their story is not unusual. Sixty-two percent of all bankruptcies are caused by medical bills -- and often when an insurance company denies care. People think they are doing the responsible thing for their families. They have health insurance, but then a tragic illness hits and they lose everything anyway.

CIGNA didn't refuse to pay for the kids' hormone injections because it hates kids, or wanted the twins to stop growing. It denied the shots because its principal mission has nothing to do with those kids' health -- it is making money.

Ed Hanway, CIGNA's CEO, can tell you about that. In 2008, Ed made $12.2 million. That's $5,883 an hour. Ed makes more in one day than the average worker makes all year long. He makes 30 times more than the President of the United States.

Ed makes enough each day to cover 106 of those shots.

And for CIGNA, the case of Stacie's twins was not unusual.

Doctors said a liver transplant could save Nataline Sarkisyan's life. But CIGNA wouldn't pay for that either. Nataline died in 2007, just before Christmas. She was 17.

That same year, CIGNA CEO Ed Hanway locked in a $73 million golden parachute for his retirement.

The average transplant operation costs about $250,000. Hanway's golden parachute would pay for 292 liver transplants. Nataline needed only one.

Hanway has a number of homes, including a beach house in New Jersey worth $13 million. Many ordinary Americans are losing their only homes each year because of medical bankruptcy.

Of course Hanway is not the exception, he's the rule. Stephen Hemsley is the CEO of UnitedHealth. In 2009 Hemsley made an astonishing amount of money selling stock in UnitedHealth -- $128,000,000. As you might imagine, he has a very nice house too.

People like Hanway and Hemsley don't provide one iota of health care to anyone. They have simply figured out a way to route billions of our health care dollars through the companies that they control so they can skim some off the top before it is used to pay for doctors and hospitals.

The incentives created by this system also produced Staci's bankruptcy and Nataline's death. These companies hire armies of bureaucrats whose only mission is to deny claims in order to fatten corporate bottom lines. The only relationship those armies of bureaucrats have with health care is that what they are employed to do is, itself, sick.

We're approaching key decision moments in the health care war. Don't sit on the side lines. This battle is about each of us. Any one of us could be Stacie or Nataline. Ask your Member of Congress if he or she lines up with us, or the insurance companies. Demand to know which side he's on. This time they can't have it both ways, because if the insurance companies win, we lose.

Robert Creamer is a long time political organizer and strategist, and author of the recent book: Stand Up Straight: How Progressives Can Win, available on Amazon.com.