What is power? pt. 5: health insurance simplified

Published online 16 August 2009.

This diary is inspired by Slinkerwink’s diary of earlier today.  Slinkerwink was trying to elaborate on why “The Public Option Is Non-Negotiable.”  Now, I love Slinkerwink’s diaries because they are ringing calls to action.  But upon encountering some rather mushy comments in the comments section, I felt obliged to respond with a diary of my own, with an attempt to explain how power operates in the health insurance industry.

(Crossposted at Docudharma)

Slinkerwink says:

Here’s what we’re going to do on Monday.

1. We’ll be calling the White House to let them know that we find regional co-ops unacceptable, and that they would NOT lower the costs of health insurance for Americans! We’ll let them know that the public option is the line in the sand for us, otherwise it’s a mandated bailout of the junk insurance industry with no real affordable options.

2. We’ll go to Democratic townhalls, ask our lawmakers to stand strong for the public option and the Medicare drug price negotiation because without these two essential provisions, there will be no cost containment on private insurance premiums.

3. We’ll point out that regional co-operatives are ineffective, and that Blue Cross Blue Shield once was a non-profit organization that got privatized, taken over, and premiums started to rise because of one factor: greed from the company board. Where’s the assurance that the same won’t be done to regional co-operatives?

4. We’ll ask them to take the Pledge not to vote for any health care reform bill that doesn’t include the public option because without it, our monthly premiums will NOT be affordable.

Slinkerwink frames this issue in terms of whether or not our insurance premiums will or won’t be affordable, and issues an admirable call to group empowerment.  Let me suggest that the health insurance discussion be framed directly in terms of power — our power, versus theirs.

Follow the money

Step 1: you pay your insurance premium

Step 2: your insurer donates money to politicians with some of the money from that premium

Step 3: the politicians who received money from your insurer craft legislation

Step 4: the legislation imposes “individual mandates” upon everybody, forcing them to buy insurance from, among other groups, your insurer

This, then, is how political power translates into profits.  The insurers buy legislation which favors their financial interests.  Shall we take a look at the politicians responsible for “health insurance reform”?  Let’s start with the big ones:

Max Baucus received donations from these groups:

  1. Schering-Plough Corp $86,200 Pharmaceuticals
  1. Blue Cross/Blue Shield $62,350 Health Insurance
  1. New York Life Insurance $59,150 Life & Health Insurance
  1. Aetna Inc $51,250 Health Insurance


OK, now here are my questions:

  1.  Do you imagine that Baucus is going to craft legislation which will in any way endanger the financial interests of the above-listed groups?
  1.  Do you imagine that, if Baucus somehow did craft such legislation, these health insurance/ Big Pharma groups would continue to donate money to Baucus’ campaigns?
  1.  Are these groups going to want something for the money they donated to Baucus’ cause?

In sum, Blue Shield and New York Life and Aetna ARE going to get their money’s worth from Baucus.


Now Kent Conrad:

1 DaVita Inc $47,900

18 Blue Cross/Blue Shield $14,500

DaVita makes dialysis equipment.  You already know who Blue Cross is.  Of course, a more general overview of Conrad’s financial position tells us more:

Health Professionals $251,283
Pharmaceuticals/Health Products $185,700
Hospitals/Nursing Homes $182,016
Health Services/HMOs $151,015

Now, Conrad has told us that he won’t vote for a public option.  Of course, as Millineryman points out, Conrad’s own health care has been publicly funded for the past 28 years.  So it’s not as if he actually dislikes the stuff — he just doesn’t want the rest of us to have any of it.

Well, OK, you all can actually go to Open Secrets yourself, and find out who’s getting what.  The fact of the matter is that if the health insurance industry didn’t think it was buying legislation, it wouldn’t be spending this sort of money.

Get it?  Your insurance premiums go to legislation which isn’t in your best interests.

Now, in a previous diary, I criticized both House and Senate versions of the health insurance bills under consideration for proposing “individual mandates.”  Individual mandates mean just this: YOU WILL HAVE TO BUY HEALTH INSURANCE WHETHER YOU WANT TO OR NOT.

As insurance costs escalate, you will probably only be able to afford health insurance with such high deductibles that it doesn’t really cover you for anything.  You’ll have to buy it.  This amounts to being a forced donation to the health insurance industry, a “head tax” if you will.  You lose power, the insurance industry gains power.

And what will the health insurance industry do with your head tax moneys?  Why, it’ll buy more legislation favorable to its financial interests!

(This effect, of course, will not matter with a public option open to everyone — in that case you would have access to insurance which would not fatten a special interest.)


So — if you want to have any way of fighting back against the special interests who have hijacked your access to health care, you will insist upon a public option which can be purchased from day one by anybody and everybody.  All other bills will disempower you for the sake of empowering the insurance industry.  You don’t think they buy power with your money?

And — if it turns out that the health insurance industry has bought enough of Congress to kill off the public option, your best bet is to work to kill off reform for this year.  Let me take a second, here, to rebut counterarguments against this.

  1. This is by no means our “last chance” to enact health care reform.  There will be further chances.  Part of the problem is that we are trying to get legislation we want with the old historic bloc, the historic bloc which pledged its soul to neoliberalism.  We organize a new bloc, we’ll get what we want.
  1. The idea that this isn’t “realistic” merely sacrifices the long-term goal of a single-payer system, the best option on the table, for a “reform” which is in fact a step backward, toward accomodation with the insurance parasites.
  1. Sure, there are people out there who would benefit from some of the less-publicized provisions of “health care reform” — ending recission, for instance, or ending the denial of coverage to those with pre-existing conditions.  The problem, of course, is that “maintaining coverage” means being able to afford premiums, and so it hardly matters if you “qualify” if you can’t afford the premiums.  With no public option, as Slinkerwink points out, you will have no real cost containment.  And with no cost containment, at some point either a) you won’t be able to afford the premiums or b) the policy won’t really cover you.

This is about the future.  With mandates and no public option, at some point the insurance companies will be empowered to alter the deal further in their favor.  And since they already know how to buy legislation, don’t think they won’t do it.

And this is about power.  Our power, not theirs.


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