Has anyone else noticed a certain recurrent theme to the insurance industry’s contributions to the discussion of health care reform? Over and over I hear corporate reps for insurance companies insist they’re really for universal health care, or would be if it weren’t for certain difficulties…and then follow up with utterly bizarre descriptions of what those difficulties are. Not just the kind of fibbing lobbyists are known for, like exaggerating increasing health costs or portraying government bureaucracies as aiming to deny you treatment while ignoring the insurance bureaucracy’s policy of aggressively denying you treatment. But really weird stuff that makes no sense, like explaining that universal health care will raise insurance costs.
Or rather, stuff that makes sense only with the unspoken equation of insurance with health care. Listen carefully the next time one of the talking heads is an insurance rep. They speak as if anyone with insurance has health care, and anyone without doesn’t. Neither point is correct. Having insurance doesn’t mean the insurance companies will pay up when it’s their turn; just ask the Americans cut loose after years of paying premiums because—whoops!—they got cancer. Next to American horror stories, exaggerated or downright fabricated horror stories of Canadian and British health care (such as the Canadian woman featured in scare ads talking about having life-threatening brain cancer when she instead had a brain tumor blurring her vision with pressure on her eye) pale in comparison. Nor does being uninsured mean going without health care; just ask our veterans. Or our senators.
More to the point, a public health care option such as Europe and Canada employ would make health insurance obsolete for a vast majority of cases. (The public option also happily eliminates the paradox of unequal risk that bedevils health insurance generally, by placing the entire population into the same risk pool.) If you can walk into the doctor’s office, get treated, and send the bill to the fed (ultimately paying for it through taxes), you don’t need insurance. Insurance is for people without the means to pay for health care otherwise. Universal care doesn’t require universal coverage, which is precisely what insurance companies hope you’ll forget.
Surely corporate reps lobbying before Congress, or lobbying the public via the news media, deliberately conflate the two. Conflating care with coverage allows them to dissemble about higher expense: if you mandate universal coverage, you’ll have to subsidize poor people needing sufficient coverage, obviously—but if you mandate only universal care, you don’t. Conflating care with coverage lets them conceal the whopping 15% of medical costs that go to insurance costs, helping avert universal care legislation that would torpedo insurance companies if passed. Conflating care with coverage also plants the seeds for a massive corporate handout, if Congress, eager to be seen to do something, can be persuaded to pass universal coverage legislation instead of the universal care bills that face such stiff resistance.
But weirder still is the story I read today from a guy whose brother is an insurance salesman, who isn’t speaking for the cameras, or to the powerful, when he makes bizarre non sequitur statements about universal care. And he refuses to grasp the idea that universal care can be had without universal coverage. It’s just a big, throbbing blind spot hanging in the center of his world view: “Of course a massive insurance system is necessary; without insurance, no one would be covered.” Covered, no. But treated, quite possibly. Which is really the aim of health care reform, isn’t it?
Upton Sinclair quipped: “It’s hard to get a man to understand something when his salary depends on not understanding it.” True, true. The remedy, then, is to address the remaining 99%+ of America whose salary, in a very real if indirect sense, depends on understanding the issue. And, because attempts to muddy the waters will not die out of their own accord, that means carefully distinguishing between universal care and universal coverage every time the subject comes up.
