♫No one knows what it’s like
To be the bad man
To be the sad man
Behind blue eyes
No one knows what it’s like
To be hated
To be fated
To telling only lies
The New York Times ran an article this morning that has been sparking some commentary in the blogosphere. In a piece that was essentially The Who’s “Behind Blue Eyes” put to paper, we were presented with a sad tale of how we should feel sorry for the insurance industry, who are, in fact, the real victims of the health care debate.
I, for one, was wondering when someone would have the courage to stand up for the little guy, the Stephen Hemsley’s of the world.
Most reactions to this piece focused less on the overall theme of playing the victim and more on the admission contained therein (emphasis mine):
“I believe we’re getting the pushback because we are standing up for what we believe in,” said Cheryl Tidwell, 45, Humana’s director of commercial sales training. “We believe there’s a better way to control costs by controlling utilization and getting people involved in their health care.”
Now we know they aren’t talking about controlling costs to the customer, since health insurance premiums have skyrocketed far above the pace of inflation, the vast majority of personal bankruptcies in this country now come as a result of medical costs, and since it isn’t unheard of for an insurance company CEO to pull in $819,363 every single day of the year, or to be sitting on over $744 million in stock options, or to retire with a $73 million golden parachute. The insurance industry also spares no expense in throwing hundreds of millions of dollars into their lobbying blitzkrieg against health insurance reform. Suffice to say, these “savings” aren’t being passed on to consumers.
So they are controlling their costs, to maximize their profit. And how do they admit to controlling costs? By “controlling utilization”. What does that mean exactly? Well we know what “control” means. It means they, the insurance company, makes decisions. It means the insurance company has the power, all the control.
So what about “utilization”? The utilization of what exactly? Well there are two types of “utilization” that the insurance industry likes to control, because controlling them just so happens to keep their costs down, and their profits plump:
|A)||Insurance Utilization: This is the type of “utilization barrier” that effects nearly 50 million Americans. The premise is that if you can’t afford to give the insurance industry their pound of flesh, or if you are sick enough that the insurance industry doesn’t make a big enough profit in treating you, you don’t get insurance, period. This keeps their costs down. Your costs? Who cares? All that matters is that insurance companies don’t have to let you “utilize” their product–health insurance.|
|B)||Treatment Utilization: You can’t go to this hospital, you have to go to this one in your “network”. You can’t get this treatment because it isn’t listed on the approved list from your insurance company. Woah, you are really sick, are you sure you never had headaches before? Ever? Do any of those sound familiar? This is where the insurance industry controls which treatments you get to utilize, if any at all, based on their cost-benefit analysis. If it doesn’t benefit their bottom line, they don’t sign on the dotted line. And then you don’t get your treatment. By controlling the “utilization” of treatment, they are making all the decisions. And they are right, it does keep costs down: their costs. (Oh, did I mention that the CEO of insurance industry giant CIGNA “earned” over $120 million in compensation in the last five years alone?)|
So that, in a nutshell, is what the euphemism “controlling utilization” actually means. And they control utilization constantly. Millions of Americans are denied coverage for specific illnesses or treatments every year, and millions more are denied any coverage at all.
The funny part is that when these very same people make up horror stories about what will supposedly happen if we even get the option of choosing public health insurance, they call this exact same thing RATIONING.
Get it? When the private insurance industry refuses to cover you, or makes decisions about what treatments they will and will not allow you to receive, that is called “controlling utilization” (and that happens in the real world, every day). Yet when the government will supposedly pull the plug on grandma, even though she is already on (and would continue to be on) Medicare, and is most certainly not being forced into death now nor would she ever be, that is called rationing care (and socialism, Nazi eugenics, death panels, and I’m sure about every other thing liars can dream up to spoon-feed gullible people–oh, and this rationing is only happening in fantasy land).
So that was the little gem buried in the NYT puff piece about what a hard knock life it is for the insurance industry–they admitted that they ration care, right now, and have been for as long as they’ve been doing business.
But perhaps my favorite part of the column is where they really get out the violins for employees of these insurance companies, to get us to see that they aren’t monsters, or in their words, “We are human beings, too.” It is really fit to be in the Merchant of Venice (daydream sequence begin):
Hath not a[n insurance industry employee] eyes? Hath not a[n insurance industry employee] hands, organs, dimensions, senses, affections, passions; fed with the same food, hurt with the same weapons, subject to the same diseases, heal’d by the same means, warm’d and cool’d by the same winter and summer as a [human] is? If you prick us, do we not bleed? If you tickle us, do we not laugh? If you poison us, do we not die? And if you wrong us, shall we not revenge? If we are like you in the rest, we will resemble you in that.
*Tear* Beautiful. I hope they do a remake of Evita next.
But of course this is all a straw man, because this anger at insurance industry greed isn’t directed at the employees of these mega corporations, who are by all accounts just trying to make a living by doing what they are told. They are, after all, just doing their jobs. It isn’t their fault that their job is to decline people coverage to save the company money. That is the one and only goal of a corporation, is it not? They are accountable to their investors, their shareholders, and no one else.
That is the bottom line–The corporation is a beast designed for a single purpose: to make profit and make people (investors) rich. And these employees, the ones being humanized so beautifully in this NYT column, are just cogs in the wheel, and if they refused to do it some other person (faceless bureaucrat, to use the hypocritical language of the conservatives) would fill their spot in an instant. And to their credit, many former employees of the insurance industry, haunted by the things there were made to do in the name of profit, have come forward and spoken out against insurance industry practices, like Dr. Linda Peeno in this ad from American’s United for Change:
So no, it isn’t about the little people, it is about the entire beast. Has anyone suggested that these people, the employees themselves, are evil? Do reformists think that these people, or even the executives in charge, get up in the morning with the goal of killing people and ruining lives? Of course not. They do what they do best: maximize profit, at all costs. The human lives destroyed are just collateral damage. Some of them, mostly those at the very top, are very much okay with this, and defend it vigorously. Others are haunted and find that they can’t bring themselves to keep doing it.
This isn’t about them, it is about an industry that is indeed evil, if not in intention, undeniably in effect. Just because a corporation is made up of people, are we not allowed to blame the whole?
That is the funny thing about the concept of “corporate personhood”– corporations have long fought to enjoy all the rights and benefits of being treated as a living, breathing person, but without any of the costs, like mortality, and now, apparently, blame.