Let’s talk about something really boring and horrible, but enormously important: health insurance!
About 10%-20% of my somewhat meager salary goes straight to the villainous CEO of Aetna who uses it to acquire more giant palaces, hunt orphans for sport, sail his fleet of super yachts, and, above all, to buy political and cultural influence (which is why American voters yammer to be fleeced by the vicious con-artists who run our private health care system). This money is counted as “benefits” which come out of my salary before I ever see it, so the scam artists who designed this horrid medieval serf style system can pretend they are not responsible for wages stagnating for the last 3 decades (also it makes it hard to properly assess what health insurance costs unless you happen to be a forensic accountant). Naturally I am afraid to leave my job and do something meaningful with my life, because, if I wasn’t working for a Fortune 500 company, I would have no health insurance and would live a life where one misstep would result in bankruptcy.
Naturally 10%-20% is never enough for the rapacious monsters who run this awful industry–so if anything bad ever actually happens, I have to pay my own money for coverage until I reach a certain cap (I think it is $1500) after which the insurance kicks in and they pay 85% of all remaining costs up to some multimillion dollar cap. I don’t have $1500 so it is all irrelevant: I never go to doctors and I have no intention of ever going to one until I am carried there unresponsive by EMTs. Hopefully I will die before I wake up to be bankrupted, after which point, they will undoubtedly send my heirs (my cats, I guess?) a six figure bill.
I think that is supposed to be a heart, but it looks like Pacman after he touches a ghost
The executive in charge of Aetna (or CVS now?) is a full-on oligarch who is lavishly compensated for denying coverage to you and your family and to your friends and for shaping Aetna into a more efficient monopoly for destroying society (you don’t have to take my word—you can look it up, the last CEO made a half a Billion dollars for combining Aetna with CVS so they could fix the prices of drugs). I am picking on Aetna because it is my insurance company (although I am sure that writing about them without review from a panel of hand-picked arbiters violates some clause of their infinite legalese notices). Also, I think it is funny that their company is named after the Latin name for the noxious volcanic mountain which was the home of Echidna, the mother of monsters in Greek mythology.
If Americans could properly understand what is going on, the real question is whether the masterminds who run health “insurance” in this country would wind up in prison after their ill-gotten gains were nationalized. Alas, just as my health insurance information is 900 pages of incomprehensible legalese which says I effectively have to pay for everything, the entire argument has been framed by these villains as about market choice versus poor people trying to take your benefits. Complexity is the friend of insurance CEOS, who trust that anyone cunning enough to unravel their enormous grift will be smart enough to join them in benefiting from the scam.
Which brings us to the election of 2020, an extinction-level political event which is already rocking the foundation of society. If Trump and the Republicans win (in a critical census year), they will use their power to permanently alter the democracy so that they can never lose. They will also further deregulate the health-care industry and let the rapacious insurance CEOs do whatever they want. They must be stopped. The Democrats can indeed stop them and win everything, but, in order to do so, they will have to run on the popular aspects of their agenda (which are easily summarized in the following polling data from Rolling Stone). The percentages represent the number of responders who thought the idea in question was something which should be implemented:
Basic Income (UBI) of $1,000 a month: 26%
Reparations for slavery: 27%
Decriminalizing illegal border crossings: 27%
Abolishing the death penalty: 36%
Medicare for All that ends private insurance: 41%
Eliminating the Electoral College: 42%
A tax on fossil fuels: 50%
$15/hour minimum wage: 56%
A sales ban for assault weapons like AR-15s: 57%
Raising taxes on incomes above $1 million: 62%
A Green New Deal: 63%
Legalize recreational cannabis: 63%
A pathway to citizenship for the undocumented: 64%
Medicare for All (that want it) — i.e. a public option to private insurance: 70%
This extremely useful but somewhat surprising list has some bad news for people who would like to see the USA copy its (healthier & happier) peer nations and adopt universal free medical coverage. The idea of moving to a free comprehensive system such as Canada or the UK enjoy, scares people because health insurance companies have taught us the true meaning of fear.
The health insurance industry is firmly behind “Medicare for those who want it.” They will use it as they have been trying to use “high risk pools.” They will deny coverage to everyone with a costly health care problem and dump all such people on the state (which will, additionally, not be able to influence prices in a meaningful way). When Medicare goes bankrupt, they will then say “see! We told you” and fix the system so that everyone must pay an even higher premiums, deductibles, drug-prices economic rent. It goes without saying that they will make the rules more onerous and impossible to comprehend.
Here is a (somewhat loose) artist’s conception of how we look thinking about this stuff
I don’t know how we can move beyond this (although I am doing what I can by writing incandescent political articles which will probably get me in trouble instead of writing about Gothic art). Pathetically, I am not even entirely sure how correct some of the things I am saying are. The issue has been hopelessly mangled into a mess where professional health-care experts can’t figure out what is going on. How are the rest of us supposed to figure it out?
So Americans are voting for multi billion dollar companies and their crooked CEOS to pocket more of their money all so that we can have shorter more fearful lives that are filled to the brim with confounding paperwork and legal fights. It is unconscionable! Maybe the Republicans are what we deserve.
Remember this post?
There is of course a final option. The CEO of Aetna could just buy a bunch of flounder art for his mansions, in which case I would have no choice but to drop my angry talk and simply praise him as a gifted business leader (although it should be obvious from this jeremiad that these people have stupendous money-making prowess). I am waiting to sell out! Until the offers begin to pour in though, we will have to do what we can to make the system better (and to preserve the rapidly diminishing money spent on scientific research, which is what makes health care worthwhile to begin with). Let me know what you think down below. Maybe we can change some of those polling numbers before 2020 gets here!
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August 14, 2019 at 6:05 AM
K Hindall
Medicare for All won’t help. I am on disability, and for the first two years, I was on Medicaid and getting real health care, even if I did have to go to specific providers. Then I was forcibly moved to Medicare (the day after my rheumatologist *finally* agreed to an MRI of my mysteriously aching joints—of course, that was canceled the next day).
I haven’t had real medical care since. I get the once-a-year Medicare “wellness check,” which is free, and try desperately to get nothing else. I am supposed to have an eye test every year (I have diabetes—doubtless because there’s sugar in nonsensical things, such as fresh meat). I got it this year because I thought I might be having a retinal detachment, the symptoms of which are very similar to the much less serious posterior vitreal detachment, which is what I luckily have. I will, however, be paying for that privilege for the next year because I can’t afford to pay the bill at once. I had to write one medical group (if you go to the emergency room, everyone who speaks to you sends a separate bill), and tell them they’re too late to get a cent until December, when the heat assistance arrives, because I have to pay utilities instead.
Because of my health conditions, particularly diabetes (which does NOT run in my family), my GP wants to see me every three months. I canceled the next appointment and told her that unless she’s paying for it, there will be none but the wellness check.
Our area has a wonderful free clinic, but I can’t go there because (get this!) I have health insurance! As far as I can tell, no health insurance is better than Medicare.
And meanwhile I must support my sister, who has been denied disability on the grounds that it’s been too long since she worked (she was a full-time student and then discovered her field had disappeared while she was getting educated for it). Never mind that Asperger syndrome is by definition from early childhood at latest, so she’s been trying to work all her life despite being disabled.
And of course to the “America, love her or leave her,” I say, “And go where?” I have wanted to emigrate to Canada for more than fifteen years, but I have never been able to meet the economic requirements to do so.
Personally, I think it would be kinder to put the poor up against a wall and shoot us than subject us to this system. If Trump gets a second term, I’ll probably get to find out firsthand.
August 14, 2019 at 11:28 AM
Wayne
Thank you for the disturbing but illuminating story of your travails within our system. I am so sorry you are caught up in the perverse maze & I sincerely hope you find the care you need despite the hurdles. I am sure you have tried all sorts of different thing, but have you reached out to some of the professional NGOs & non-profit organizations which help and advocate for people who are having trouble making the system work? A quick search turned up the Center for Medicare Advocacy, which seems to help with outreach and with individual claims/problems, but I have heard there are other such entities at local and national levels.
August 15, 2019 at 8:59 AM
K
Wow, someone who gets that I have actually tried many things! I have not, however, tried that particular one, so thanks much for the lead!
We did used to have a very good place, the Southern Tier Care Coalition, but they took a big whack in their funding, and every caseworker ended up with three times as many clients. They became no help whatsoever, which was very frustrating as they had been the most useful member of my support network. I suspect the standard Republican stratagem of cutting funding to the point an agency can do nothing and then saying, “Well, this bunch isn’t doing anything!” and shutting it down altogether.
August 15, 2019 at 2:01 PM
Wayne
We are seeing that strategy manifesting itself in every walk of life. It is part of the cynical “government is the enemy and should be defunded” strategy which I warned about in this sad 2016 electoral endorsement. Unfortunately, they seem to be doubling down on that same strategy–and government is definitely not working right (since the people in charge of it are dismantling it for their own personal aggrandizement).
August 14, 2019 at 7:02 AM
hooftales
This is as you say, incandescent 🙂. If only someone with your humor and insight could be president. Though I wouldn’t wish that on my worst enemy. Wait ! Our worst enemy IS the current president🤪what a conundrum.
August 14, 2019 at 11:55 AM
Wayne
Lol–I think it is hard to manifest a sense of humor as a leader. (It is funny and sad to see an essay from back when we had earnest presidents who tried to look after interests other than their own). Hopefully the next president will be crafty and smart enough to curtail the sick joke which the health insurance marketplace has metastasized into!
August 22, 2019 at 2:44 AM
Robert Smith
Private health insurance helps you to gain more control over your health. If you want any treatment or an operation, you have more control over how quickly it’s done and where. Having health cover means that if something unexpected comes up, you’ll get treated quickly.
August 25, 2019 at 4:34 PM
Wayne
Well you must be an administrative genius, because I feel like I have NO control at all over my health care unless I am willing to read reams of fine print and then hire a team of lawyers to fight with soul-sucking privately funded bureaucrats over baffling legalese and convoluted payment traps.
August 27, 2019 at 7:11 AM
Robert Smith
Informative post!! Insurance companies offer an attendant allowance to adults accompanying the insured at a hospital, provided the insured is a child. In most cases, the number of days for which an insurer pays the attendant allowance is fixed.
August 27, 2019 at 11:25 AM
Wayne
Thanks Robert! Every bit of information helps out. I didn’t know about attendant allowances and it’s good to hear about them. I feel like understanding and reimbursing all sorts of care is an issue which has a lot of new attention from society as we figure out how to reform a variety of malfunctioning or under-performing systems.
October 22, 2019 at 6:29 AM
Robert Smith
This extremely useful but somewhat surprising list has some bad news for people who would like to see the USA copy its peer nations and adopt universal free medical coverage.
October 22, 2019 at 9:05 AM
Anonymous
Sorry, but if you can’t afford the insurance, it does not matter what benefits it has. And there’s no one so completely without control as someone who has to forgo medical treatment entirely because they can’t afford it.
Before touting private insurance, you should experience how the other considerably-more-than-half lives.
October 22, 2019 at 9:10 AM
K Hindall
My apologies. I don’t know how I managed to post anonymously above. It was not my intent.
October 22, 2019 at 11:00 AM
Wayne
No worries K Hindall. You can chime in anonymously, or by your name…or by a pseudonym! I am surprised “Pierre Delecto” and “John Barron” and “Mayor Pete” aren’t here talking about how beautiful private insurance is and how Americans just love paying hundreds of billions of dollars to have crooked middlemen deny life-preserving medical services we have already paid for.