A doctor's view: escaping the maelstrom
By Samuel Metz
The Oregonian
Inside the Stump
November 03, 2009
Smoking kills. So does the health insurance industry.
In the 20th century our tobacco industry, threatened by associations between its product and a lung cancer epidemic, diverted public discussion to a multitude of highly charged and largely irrelevant issues. It succeeded so well that even now, 50 years later, it still freely markets its dangerous products with only minor packaging concessions.
In the 21st century our health insurance industry, with its product similarly wreaking havoc on public health, diverts debate away from health care to a variety of powerfully contentious (and distracting) issues. And with similar success — the health insurance industry still rides a crest of prosperity.
What’s the difference? Tobacco only affected the 40% of the population that smoked when the cigarette-cancer association began in the 1950s and the 20% of us who still do. The health insurance industry, on the other hand, affects every one of us. Its monopoly of health care financing extracts $500 annually from every citizen for its own administrative costs (not entirely devoted to lobbying and profit — let’s give the industry some credit), causes 45,000 annual deaths from inadequate access to health care (that’s as many as die in automobile accidents), and precipitates most bankruptcies in the U.S. The money spent by our health insurance industry on administration could extend essential health care to every American. But we don’t discuss that, do we?
Our health insurance industry succeeds as well in this century as the tobacco industry did in the last. Witness the congressional “reforms” — all variants on a theme: Make every citizen buy our insurance. And if our price is too high, make our government buy it for them. All hail this great victory for free enterprise. But what about our health?
American spending on health care outstrips every other nation on earth, yet we lead in not one significant measure of public health. Can it be that our doctors, nurses and hospitals are that bad? Or is that we pay for them through private insurance? Our health insurance industry would have us believe our problem stems from spending too little on their profitable insurance, not spending too much.
The most brutal evidence of the insurance industry’s success is the intensity with which all of us debate perennial unsolvable social challenges — the role of government in private lives, how America’s free enterprise system makes us special, whether tax dollars should fund abortion, whether people who work should provide free services to those who don’t, how illegal immigrants sap our country’s strength, the evil of socialist programs in foreign countries, the insidious threat of death panels, and the inherent inefficiency of any government to run anything. In short, the health insurance industry successfully diverts our attention from the root problem — that our method of financing health care through for-profit private insurance is driving our families and government into financial ruin.
So here we are, fighting not with the insurance industry but with each other: healthy against sick, insured against uninsured, libertarians against liberals, employed against jobless. Fear runs amok. Medicare recipients fear reduced benefits. Employers fear compulsory medical entitlements. Unions fear for their negotiated benefits. And everyone fears skyrocketing policy costs and decreasing access to physicians. We are paralyzed with terror.
Meanwhile, health insurance executives dab their collective brows, having successfully diverted us from realizing that their industry created and sustains our dilemma.
Can we escape this maelstrom?
Yes. With the health insurance industry spending $1.4 million daily on distractions, it takes grit to stay on target. But we must. We must demand our elected officials address the only three questions that matter: “What have you done to provide essential health care to all regardless of ability to pay, employment status or medical condition? What have you done to reduce costs? What have you done to improve our health? Everything else is irrelevant.
Can we stop the health insurance industry from killing Americans in this century faster than we stopped the tobacco industry in the last? Let’s hope we don’t have to wait another 50 years to find out.
Samuel Metz is a Portland physician.
http://www.oregonlive.com/opinion/index.ssf/2009/11/post_26.html