The "Health Care" Fallacy
By Susan C. Strong
When it comes to health insurance, both of our remaining Democratic
presidential candidates seem to be pushing a fallacy. Giving private
health insurance plans the name "health care" is a very disturbing
piece of faulty framing. There is a very big difference between private health
insurance and the hands-on "health care" doctors, nurses, and medical
facilities actually provide. Moreover, most of the health insurance solutions
being proposed right now are based on an even bigger fallacy-that turning more
of America's health insurance coverage over to private insurers will produce
good "health care" for more people. There's a lot of evidence that
path will just make our current health insurance crisis worse, as Robert
Kuttner, co-editor of the American Prospect and well-known economics
journalist, has already told Amy Goodman on Democracy Now
(http://www.democracynow.org/2008/2/8/examining).
Kuttner says that because of their fundamental business structure, turning more
of America's health over to private insurers will still "have all this
paperwork, still have all the profit by private insurance companies, still have
doctors being given incentives to go for the reimbursable
procedures. And as a result, the cost-containment pressures hit patients. They
come in the form of less care, rather than in the form of less waste."
In another just published piece, "Is 'Cookbook Medicine' Crippling the
U.S. Health System?" Philadelphia journalist Christopher Moraff quotes
Professor Steffe Woolhandler, of Harvard University, an authority on the U.S.
health care system, saying "The U.S. health care system is failing because
we have adopted a for-profit, market-driven model. Americans die younger and pay more for their care than nations
with non-profit national health insurance"
(http://www.alternet.org/healthwellness/77763).
And that is not even the half of it. Back in 2007, Michael Moore's film, Sicko,
reached a broad public audience with home truths about the way the private
health insurance business really operates. He documented the fact that a
cross-section of Americans, rich and poor, have already been rejected for or
denied the health care they thought they had paid for by their supposedly
friendly health insurers. The reason? Sicko offered clear testimony that
the American private health insurance industry, unlike normal business, actually
can only make its money by refusing to provide the product it supposedly
sells. [Emphasis added by Steve
Love for Congress campaign.]
That's fraud. (It speaks volumes that back when the health insurance industry
really got started, reputable fire and life insurance companies refused to get
into it, because they couldn't figure out how make an honest dollar from it. An
insurance business can only make money if only a few of
its clients actually need to be paid claims before the premiums paid have
covered all of the costs. But everyone needs health care, a lot of the time.)
Right now, these businesses still protect their profit margins by capriciously
refusing to sell or provide their product to members of the public
Fresh confirmation of these facts has just come from recent news about efforts
by Blue Cross to get doctors to rat on patients retroactively
re supposedly unreported pre-existing conditions (San Francisco Chronicle
2.13.08), and New York Attorney General Cuomo's action against 17 health
insurers for defrauding their clients (San Francisco Chronicle,
2.14.08). But here we are in 2008 with new "health care" proposals
that still rely on this same fundamentally fraudulent health insurance model.
Moreover, there is new evidence that despite the life and money saving promise
of medical DNA testing, most people who have reason to try it fear doing it,
because they are afraid of being discriminated against by health insurance
companies (New York Times, 2.24.08, p.1). Medical authorities say this
is creating a serious bar to the next big revolution in improved, cost
effective health care.
As for proposed regulations against abuses by private companies, those will
likely be no real firewall either, because the injured person will still be
forced to try to sue to prove discrimination under any new statutes, at the
same time that they are mortally ill, broke, or by that time, dead. And that
includes people who are at risk of getting caught in the trap of getting sick,
losing jobs, then being denied new employer-linked or private health insurance
on the same old grounds of "pre-existing conditions," camouflaged by
some new, legal sounding escape clause or stopped by federal law that already
makes successfully suing HMOs for negligence unlikely.
It's true that when the real solution, the one the American public
overwhelmingly wants, is mentioned--medicare for all-- the usual
conservative framing bugaboos of "big government control,"
"socialized medicine," and "more taxes" pop up. And
then there's the huge lobbying power of the private health insurance
industry. But we have a lot of strong framing ideas in our corner too,
based on hard facts about the way the private health insurance business
operates: dangerous fallacy, fatal contradiction, shameless fraud, fiscal
waste, criminal abuse, profiteering at the expense of the public's health, or
selling out America's health-- in short, a clear case of Robert Reich's classic
phrase, "rot at the top"-- that has now infected the body politic,
too. This is the American nightmare, and those who say we can't have what we
really want instead are giving up way too easily.
As for the conservative frame machine, the phrase "health care"
doesn't provide any real rhetorical cover from Republican attack anyway, since
public subsidy to private insurers is involved. (Unless, of course, they too
are happy to see the unaccountable private insurance industry fatten unfairly
and excessively at the public trough.) Why not just start arguing for honest,
accountable, and fair public health insurance we pay the government for
instead? We citizens need to come right out and say clearly to all of our
candidates and representatives, "We need a fair, non-profit, public agency
like Medicare to be the one insuring all of America's most
important resource--our health." We're certainly not going to be
able to do what it takes to get out of our growing economic mess if we can't
get well and get to work on it. Most Americans are fed up with private health
insurers, and they will heartily agree.
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Reprinted with the permission of Susan C. Strong, Ph.D., Founder and Executive
Director of The Metaphor Project (www.metaphorproject.org). The Metaphor
Project has been building
progressive capacity to reach mainstream audiences since 1997.