Questions We Need to Ask about Health Care reform

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Let’s face the fact that no one likes the health care system. Doctors hate it. Hospitals hate it. Insurance companies hate it. Employers hate it. Insured employees hate it. Uninsured people hate it. The rich hate it. The poor hate it. I can’t think of the last time that someone stopped me in conversation and said, “I just love the health care situation in this country.In my lifetime that has never happened.

Let’s agree one this. It’s completely broken. We all hate it.

If you were to see the true balance sheet of your families expenses, chances are health care would rank #1, #2, or #3. If you are self-employed you know the exact cost of your health care coverage per month. For those of us who get it through our employers we don’t see that monthly bill… but let me tell you, it’s expensive! Typically, an individual is about $300, a couple about $700, and a family around $1,000 per month. Rank that it your balance sheet and you’ll see that the big three expenses in your household are likely housing, health care, and taxes. Whereas housing and taxes largely track with inflation, over the past decade the cost of health care has increased 8-10% per year.

So when your politicians stand up to block reform you need to start asking questions!

If 99% of the people in your neighborhood recognize that health care is broken and needs to be fixed and your congressperson stand against changing the system you need to start following the money trail.

– What kind of money is your politician receiving from the health insurance lobbyists?

– Who is donating to that persons campaign fund?

– When they go to parties, out to eat, or on trips in Washington… who foots the bill?

– Who does their spouse work for? Their other relatives?

– What committee does that person sit on?

– Who are that persons new allies?

– What boards does this politician serve on in their private life?

Follow the money and you will see why elected officials stand in the face of health care reform. This is about money, not politics. Lots and lots of money. These politicians (Democrats and Republicans alike) have to protect the cash cow that keeps their jobs in Washington.

I have a very strong opinion on who broke health care… which is why I am so happy to see who is trying to fix it. My opinion is that the Clinton Administration killed health care in an effort to reform it. In 1992, the Clinton Administration amended the laws for directly marketing prescription drugs to consumers. Suddenly, the air waves were flooded with drug commercials. People would start to go to their doctor and demand a name brand drug. Consequently, the usage of drugs shot up and the cost of prescription coverage began an upward spiral that is still out of control today. Drug companies, driven by Wall Street’s hunger for profit, searched for new drugs to market, and then took full advantage of antiquated intellectual property laws. While no one would argue that pharmaceutical companies shouldn’t profit from their products, no President has taken on the very core issue of out-of-control drug costs. The patent rights of drug companies have never changed. Read up on generic drugs and you’ll see that the drug companies consider cheap equivalents the enemy and not the solution. Ultimately, the drug industry is about money and not about health care. Lots and lots of money.

HIPPA is another Clinton-era health care reform idea that is destroying health care in America. Signed into law in 1996 and enacted, coincidentally, a month after George W. Bush took office in 2000, the law has a great name with a horrible cost. The provisions require health care companies to make their business as inefficient as possible for the sake of alleged privacy and security concerns. Basically, enacting and enforcing the new laws costs billions of dollars per year when health care companies already had a vested interest in protecting privacy, making sure insurance was portable, and making sure digital records were secure. The law just increased the health care industries administration costs by 10% across the board to be certified as compliant. It made doctors get paid slower. It made it more difficult to get quality customer service. It added hundreds of checks and balances for things that weren’t systemic problems. And most of the law made your insurance anything but portable! In the end, HIPAA has only made your health care more expensive.

Clinton’s inability to protect the not-for-profit health insurance (mostly BlueCross/Blue Shield plans) from being bought out by for-profit businesses ruined the balance between quality health care and profitability. In the mid-1990’s regional health care companies started using their ample cash reserves (aka, the holdings of an insurance company) to purchase other regional plans, go public, and liquidate their cash reserves. Overnight, publicly traded companies like Anthem and Well Point bought out not-for-profit companies across the country. (They actually merged in 2004 to make a mega-insurance giant.) During the Clinton administration the number of private not-for-profit health insurance companies went from about 100 to 3-4. These small plans had always lived off reserves in bad times and banked money in good times. They had kept costs low. They had kept rates reasonable. But once these for-profit companies took power they demanded annual profits. Something the industry just couldn’t do every year!

So with rising cost of administrating plans, rising costs of drugs, rising costs of the technology required to live within the laws, and a new requirement to turn an annual profit… where was the only place to get more money? Consumers.

The health care industry has a lot to hide and a lot of interest in making sure fundamental changes don’t occur. They are going to protect their interest. Drug companies don’t want to reform the marketing laws or the patent laws, so their lobbyists will funnel billions to members of Congress they think they can influence. For-profit health insurance companies have actually learned to like the cash-cow known as HIPPA, so they will fill pockets to make sure that doesn’t get reformed. And Wall Street requires both drug companies and for-profit health insurance companies to turn a profit… so they will cough up lots of money to make sure reform doesn’t happen.

I firmly believe Clinton broke  health care. That’s why I’m happy to see Obama trying to fix it. This isn’t Democrat vs. Republican. This is a President acting on behalf of the people of this country who need health care reform today. They can’t wait until 2010.

In the end, if people like you and me don’t ask simply questions and publicize the answers we won’t see health care reform, in any form, happen. Again, this isn’t politics… this is about money to them. (To us it’s about our health as well.) The drug companies and insurance giants want to stay the same!

What about the press? Sadly, I don’t think we can count on the media to chase this story. They are on the take as well. Turn on the radio or TV and you’ll see ads like crazy from the health care industry saying they don’t want reform. It should be no surprise that CNN, NBC, CBS, Fox, or ABC aren’t following the money trail, they are all on the take too.

By Adam McLane

Kristen and Adam live in the San Diego neighborhood of Rolando with their three children.

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