Saturday, July 28, 2007

Health care wars and the lies the for-profit racketeers tell us

Health care is either a right or a privilege: Ultimately, that’s going to be the central question regarding any efforts at health care reform

As Michael Moore’s “Sicko” continues to draw huge crowds and spawn spontaneous health care reform advocacy groups all across the country, the health care industry is planning to hit back hard.

They’ll attack Moore’s credibility, discredit the movie’s core thesis, hammer on the horrors of government control, provide a list of uplifting bullet points detailing for-profit medicine’s contributions to the good of society, conduct endless push polls, create case studies detailing the horrors of other countries’ health care systems, and build a phony but cogent case for continuing the American way of medicine, along with its disgracefully inequitable delivery system.

For-profit medicine – insurance, medical facilities, specialized equipment manufacturers and the like – was a $1.3 TRILLION business as far back as 2000, and it’s safe to say that figure has only increased in the seven intervening years. The companies who have a stake in maintaining that massive revenue stream will do whatever it takes to convince Americans that they would be crazy to modify or dismantle “the best health care system in the world.” As always, PR and advertising will be the preferred weapons of mass disinformation.

Back in the early ‘90s, the “we’re number one” myth’s public faces were a folksy old couple named Harry and Louise, who polluted TV advertising every evening for months reciting industry propaganda and spreading fear of “radical” change that could place our very lives in jeopardy. All this as the ill-fated Clinton health care plan gradually sank beneath the combined weight of its own complexity and the groundswell of public opinion, taught to them by Harry and Louise, against reforming such a perfect system.

This time though, things are a bit different. Anger is everywhere and sharply focused on the source of the problem. Nearly everyone’s had their own personal HMO moment by now, and it’s likely going to take more than the estimated $100 million Harry and Louise campaign to sway public opinion industry’s way. But never underestimate the vast amounts of money the health care racket is willing to spend to keep its front-row seat on the gravy train. They would have spent 10, 20, 30 times the $100 million Harry and Louise cost and still considered it a bargain, given that they retained their ability to bilk consumers out of trillions for another decade and a half. And that kind of money buys some very clever, skillful media strategists and professional opinion manipulators.

Observers of the fine art of manufacturing consent are eagerly waiting to see how the health care industry slithers its way out of this latest assault on its revenue stream. One thing is certain, as the mass media sages like to say: If things get serious enough that Congress actually moves Dennis Kucinich’s HR 676 single-payer, universal-access plan out of committee and onto the floor for a vote, all of us will be the targets and/or victims of the most egregious assault on critical thinking and common sense since the Supreme Court ordered the Florida recount stopped because the results might be prejudicial to Bush’s contention that he had won the state’s electoral votes. And that’s a tough one to beat.

Here are some of the industry's most treasured talking points to scare us into compliance and empty our pockets in service to the god of market-based medicine.

The “S” word
Might as well get it out in the open, because as soon as somebody raises the topic of a taxpayer-funded universal-access health care system for the U.S., the chorus starts bleating “socialized medicine; socialized medicine” like a combination of Chicken Little and the last Cold Warrior, until everybody starts looking under the bed for Commies and subversives.

Fact is, we’ve already got socialized medicine. It’s called Medicare, and it’s absolutely astounding how the subversive evils of socialized medicine for people aged 64 years, 364 days, 23 hours, 59 minutes and 59 seconds are magically transformed into an untouchable entitlement program when the clock ticks one more time.

It’s both comic and tragic to watch our elected representatives fall all over themselves in an effort to defend Medicare while denying its very nature. Comic because only a clown would try so hard to avoid the taint of socialized anything while advocating tirelessly for that very thing. And tragic because the rest of the world doesn’t have to do the free market orthodoxy dance, and gets better and far more affordable health care as a result. We can only look beyond our borders with appreciation and envy as other populations get healthier and ours gets more sickly and desperate by the year.

And here's the crowning insult: The US taxpayer already foots the bill for the bulk of all health care expenditures in this country. A seminal Harvard Medical School study shows that, in 1999, the US taxpayer shouldered the burden for just under 60 percent of all health care costs nationwide. That percentage represented $2,604 per capita at the time, which means government spending on health care in the US was higher than total per capita health care expenditures in any other country -- including those with single-payer, universal-access national health care systems. So we're paying for national health care; we're just not getting it.

More of the usual scare tactics
In late 1993, during the alleged U.S. health care debate, a conservative academic and columnist named Thomas V. DiBacco wrote an article that was picked up by a number of daily newspapers and whose headline read, “Health Reform Could Kill Individualism.” This is in sharp contrast, one supposes, to the current system, which only kills actual people while leaving prevailing free market ideological mythology in place.

But this is the kind of inane argument advanced by privatized health care apologists, as if anyone in his or her right mind gives a tinkers damn about the merits of individualism, American-style, while they’re busy dying on a feces-stained, urine-soaked mattress because they exceeded their lifetime benefits cap and couldn’t afford a hospital bed where they might get treatment, or even a hospice where they might at least die with dignity.

Other phantom phobias and industry favorites include:

• Single-payer will force us to ration health care. Nonsense. Health care is already rationed in this country. Or more accurately, it’s auctioned off to the highest bidder. To the shock of no one, study after study shows that the rich tend to recover from illness far faster and far more completely than the middle class, who in turn are doing way better than the poor. A single-payer plan erases those class distinctions, which may well offend the 4 or 5 percent of the population able to pay out-of-pocket for premium medical care, but will put the rest of us on an equal footing.

Poverty as health risk is borne out by a late-‘90s Tufts University study, which concludes that poverty is the single most dangerous risk factor in America – ahead of genetic predisposition, bad habits, dangerous jobs, extreme sports and poor diet combined.

Which leads us to the inevitable: According to a study released in May 2002 by the Minnesota-based research firm Institute of Medicine, approximately 18,000 Americans die each year because they lack the basic medical coverage necessary to get proper health care. Only in America is lack of private health insurance a capital crime.

• Single-payer will cost too much and raise taxes. Nonsense. The current debacle costs each American more than anyone else, anywhere else in the industrialized world. And payment doesn’t end at the pocketbook; there are some things you simply can’t put a price tag on, like recovering from an illness because you had the right care from the right people at the right time. Managed care, by making sure that none of the above happens without throwing a huge bureaucratic hissy fit, is simply a cruel hoax. After all, if they were so effective at controlling costs, health insurance premiums wouldn’t be rising by double-digit percentages each year.

• Single-payer will kill choice of physicians. Nonsense. Managed care killed your freedom to choose a long time ago. If your doc is in the plan, great. If not, you’re paying a fair percentage of your own medical bills along with your bloated premiums. Single-payer, on the other hand, doesn’t place any restrictions on who you see, despite industry propaganda to the contrary. And logically, if all docs are operating under the same rules and are paid by the same entity, why should there be any questions about freedom of choice? The argument makes no sense.

• Single-payer will create an army of government bureaucrats who will have control over our health care needs. Nonsense. There’s already an army of bureaucrats in charge of our health care. The difference is, private health care industry bureaucrats advance up the corporate food chain largely on the basis of how well they control costs – which is code for how often they’re able to deny coverage without incurring lawsuits. Public bureaucrats, such as Medicare administrators, are also graded on how well they measure up to their job descriptions, although those descriptions rarely include how effective they are at killing off their clientele.

• Single-payer will turn over our health care to the people who run the post office. Nonsense. For all their well-documented inefficiency, the fact is the Feds do many things pretty well – one of which is the Medicare system, which only takes about two or three cents on the dollar to administer, as opposed to the 25 to 40 percent overhead we pay the industry parasites so they can deny us coverage.

Moreover, many things are just too important to be subjected to the bottom-line mentality. Police and fire departments are perfect examples. Both are single-payer, universal-access services provided to the public through a modest tax on all so that individuals don't have to pay for private security or face bankruptcy because of a giant bill for privatized fire-fighting services if their house goes up in smoke.

And really, why would anyone want the air traffic control system privatized? There you are suspended seven miles in the air when the captain comes on the intercom and tells you that Glutco Air Traffic Solutions, Inc. has just laid off 40 percent of its workforce, including most of the people who staffed the control tower at the airport you're heading to.

Industry happy talk and the leaked BC/BS memo
To balance the fear mongering, there will also be continual recitation of happy talk platitudes about how the health care industry is constantly striving to improve service, expand covered procedures, control costs and otherwise incrementally improve the Best Health Care System In The World.

Here are a few “positive spin” talking points excerpted from a leaked Blue Cross/Blue Shield memo written by a communications VP named Barclay Fitzpatrick regarding the anticipated “Sicko” backlash.

• The Blue Cross and Blue Shield Association (BCBSA) and the 39 Blue Cross and Blue Shield companies are committed to improving the U.S. healthcare system for our nearly 100 million members through continuous innovation that reflects the ever-changing healthcare landscape and the needs of the consumer.

• The Blues recognize the need for improvement of both the coverage and delivery of healthcare. But the divisive tone set forth by Michael Moore and his movie "Sicko" is not helpful. Positive change to our healthcare system can be best achieved through shared responsibility, not recrimination. To ensure Americans have access to the best healthcare that is both timely, efficient, and of high quality, requires the collective contribution of all stakeholders -- consumers, providers, employers and the government.

• The Blues participation in the Health Coverage Coalition for the Uninsured is a primary example of how the broader healthcare community is working together to reduce the number of uninsured in the United States.

• The Blues are working on myriad initiatives that ensure Americans have access to quality and affordable healthcare. Each day, Blue Plans across the country are bringing healthcare value to their members in a number of ways such as new advances in health information technology and greater access to cost and quality information.

The Blues, indeed. You can read the entire memo here, which includes the priceless, oft-quoted line “You would have to be dead to be unaffected by Moore’s movie,” and links to a letter from Moore in which he challenges Fitzgerald to a public debate – which will happen about the time my mortgage is paid off.

Beyond the PR wars
After the character assassinations and scare tactics and ads extolling the overarching wonderfulness of the for-profit system, we’ll eventually be presented with a clear choice: Continue to squander huge sums of money on a scam that is systemically incapable of providing decent health care for all. Or follow the lead of every single other industrialized country – and quite a few who aren’t even close to industrialization – and create a fair, universal-access, single-payer system that doesn’t limit its services to those with the fattest wallets.

Most of the rest of the world has decided in favor of the latter. Thus far, the US has taken the former position. It’s up to us, the tens of millions of individuals most affected by this hideous, malevolent, soulless system, to force our representatives to obey their constituents because, other than a few gutsy people like Dennis Kucinich, Congress certainly isn’t going to do this on its own. After all, when has altruism ever been a property of governments, particularly when so many of our alleged representatives are so well paid by the health care racketeers to look the other way.

The for-profit medical system, along with its accomplices and employees in Congress and the executive branch, has managed to con Americans into believing and even parroting the industry's talking points that tout the inherent wonderfulness of privatized health care. This is a sad tribute to the death of critical thinking and the ascendancy of PR and advertising to take its place.

But despite the best efforts of our bought-and-paid-for political "leaders," who are delivering exactly the kind of government you'd expect in an insanely corrupt bribocracy, they can only keep the peasants down for so long. "Sicko" has unleashed decades of pent-up rage at the sheer inhumanity of the American health care model. It's hard to find anyone who isn't furious at the profits-over-patients ethos that drives that model and -- happy, happy, glorious day -- they're finally starting to organize. There will be hell to pay if politicians continue to ignore this issue, or offer half-baked faux solutions that seem on the surface to be improvements but, according to the fine print, only serve to protect and perpetuate the status quo.

Health care is either a right or a privilege. Ultimately, that’s going to be the central question regarding any effort at health care reform in this country. And when the dust finally settles, after another 18,000 or maybe 36,000 Americans die from lack of health care, it's increasingly likely that the industry parasites, the rabid free-marketeers, the privatization zealots and the paid apologists for this deadly system will be the ones left behind.

A version of this article first appeared in Online Journal July 6, 2007. Go here to read my follow-up on the Journal, or just scroll down an inch or so and read it here.

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