Waiting for an Epiphany

I recently had my first colonoscopy. While I was sitting in the waiting area with six other men, all of us dressed in dark blue hospital gowns, with locker keys around our wrists, not one of us venturing to say anything, I began thinking about health insurance and health care, and why the insurance system in the United States is so haphazard, cruel and inefficient. Thirty minutes earlier I had plunked $250 down for this procedure because my Aetna insurance, provided by my employer, does not completely cover a colonoscopy, even though it’s a vital tool in the early detection of cancer, the treatment of which, as most everyone knows, can be extraordinarily expensive. In terms of medical care, requiring a $250 deductible makes no sense; in terms of Aetna’s profit, it makes total sense.

And that, in a nutshell, is the great American health care dilemma. Everything is fine and dandy until a corporation’s desire for profit smacks head on into a patient’s need for medical care. Insurance companies love “subscribers” who pay premiums and never get sick; they hate “patients,” particularly those who need blood transfusions or organ transplants. To put that another way: insurance companies make money by collecting premiums and denying care.

Sitting there in my blue smock, I thought about the 535 members of Congress who enjoy comprehensive, taxpayer-provided health coverage. Not only should average Americans envy the lucky folks in Congress, we should also ask: if a “public” health insurance system is good enough for our elected representatives, why isn’t it good enough for everyone?

Have you ever heard a Congressman or woman complain about access to health care or the quality of the care provided? I haven’t. And it almost goes without saying that they don’t sweat deductibles, pre-existing conditions or pre-authorizations – in other words, the frustrating, often mystifying health insurance tango that most Americans (at least those fortunate enough to have health insurance) must endure in order to access the care they need.

Ours is a fouled up, inefficient, piss-poor system. I’d like to believe that our elected officials will experience a collective epiphany and realize that the United States spends too much money per capita on health care, that health care outcomes are frequently laughable, and that it’s time to let go, once and for all, of the myth that the private, for-profit model is not just the best way to go, but the only way. Conservatives thump the drum and bang the gong for the “free” market approach to health care, when it’s obvious to most Americans that the market is controlled, manipulated and fixed by a few major players who do not have the best interests of the public at heart. In this respect, health care is exactly like the banking system: a game rigged by the few for the benefit of the few.

Every time any momentum builds to reform the financial or health care systems, the drumbeat against the idea begins on talk radio, on Fox News, from the lobbyists who prowl the halls of the capital looking for politicos they can influence (actually, “bribe” is the correct word) with hefty campaign contributions, and from the “experts” who appear on Meet the Press and Face the Nation. We hear cries of “socialism,” “communism,” “Bolshevism,” not to mention horror stories from Canada of patients forced to wait three weeks to have a wart removed. We don’t hear the flip side news that those same Canadian patients receive the primary care they need to prevent minor ailments from becoming major health problems, or that they can afford the prescription medications they need without having to take out a second mortgage or sell a child into slavery. Among industrial nations, only Americans are forced by an inhumane insurance system to choose between medicine and food.

Conservatives believe that, outside of waging war (and with warfare being outsourced to companies like Blackwater and Halliburton even this former government monopoly is slipping away) government – federal, state or local – cannot do anything right, let alone manage something as complex as medical insurance. The popularity and success of the Medicare program makes no impression on conservative true believers, just as Wall Street pyramid schemes are not viewed negatively enough to insure that reasonable external controls are passed into law; conservatives would rather believe that the bad guys can regulate themselves.

There will be no collective epiphany on health care. The industry lobbyists and their craven puppets in Congress will see to that. The bill that finally emerges from Congress will be watered down, convoluted, ineffective, weak, and utterly reliant on “voluntary” rather than mandated reform. In other words, lots of sizzle but no steak. While the legislation may improve the lot of a relative few, it will do nothing for the struggling many. At the end of the day, the insurance companies and financial interests will still maintain control, though the Obama Administration will claim a great, epochal victory.

Sooner or later Americans will mature as a people and see the error of our ways. We may be a second-rate nation by then, living in the shadow cast by China and India, but we’ll get there because there won’t be any other choice.