The 800-Pound Gorilla in the Lifeboat: Part One

Sometimes, I feel like we’re all on the Titanic when it comes to US healthcare. We’ve hit the iceberg, and we’re in the lifeboats. It’s cold and it’s dark out here in the North Atlantic. Help will come.

Oops. Wait. Why is the lifeboat sinking? There’s an 800-Pound Gorilla in the boat?!?

Who the hell let him in here? Our boat needs to lose 800 pounds or we’re all going to die! We can either throw Mr. Gorilla overboard, or Mr. Gorilla will toss humans overboard.

Who is the 800-Pound Gorilla? The Health Insurance Companies. And in the Senate plan, Mr. Gorilla gets to stay; 800 pounds of patients will have to go into the icy cold, dark water. Hopefully they’ll die quickly … before the sharks get to them.

When asked to choose between your life and the health insurers, the Senate doesn’t blink: they choose the Gorilla.  You get to go overboard.

As the Senate tries to vomit up a new health plan, they know the health insurers will continue to be “Stakeholders.” Why? Because the fix is in. They have the best suits on K Street. Everyone is in their pocket. Lawmakers on both sides of the aisle take their campaign dollars and deliver the expected  votes.

Health Insurers should not even be a “stakeholder” in health care. Why?

Healthcare is a humanitarian endeavor. Health insurers are a for-profit business; they will charge what the traffic will bear. To do otherwise imperils them as a for-profit company. They have to stay in the lane of making money; care givers have to stay in the lane of patient care.

There’s a clear understanding in a humanitarian endeavor like medicine: highly-trained people are well compensated for relieving human suffering. In return, they do not charge “what the traffic will bear” in order to feed their greed.

A for–profit health insurer has no mandate to do good. Their only mandate is to return money to their investors (after having paid their execs like maharajas).

They contribute NOTHING to patient care and suck 35% out of the system to pay their 500,000 employees who push paper, not wheelchairs and hospital beds.

Our admin costs are 35%. Think what would happen if we threw out the insurance companies, put 5% into admin (like other first world countries) and put the rest into patient care. We cover everyone with no new money.

If you had to choose between paying paper pushers or the people who deliver care, who would you pay? Yes, well, Congress isn’t rational. They’ll pick the insurers.

Health insurance popped up as a benefit in the late 1940’s, as a form of compensation in lieu of raises. First, we had mutual companies; owned by policy holders, overhead was low. As dollars flowed into healthcare, greed came along. Doing well while doing good wasn’t enough for some people. By the 1980’s, I heard one HMO CEO say to me, “We own the patients, so we make the rules.”

What, exactly, does the health insurance industry add to patient care? Right. It was only a rhetorical question.

More importantly, what do the “cost cutters” cost? Twenty-five percent of healthcare dollars goes to the health insurance industry, according to Bloomberg. Click here for details.

In the First World, the USA ranks DFL (Dead Effing Last) in quality of healthcare … but HIGHEST in administrative costs. Click here for details. The higher the health care administrative costs, the less the quality of care. 

But you already knew that. Don’t you run a crazier maze to get care every year? Don’t you pay more for less care every year?  Have you hustled to just get coverage? How many pharmacies do you have to call to find out what you’ll pay for a pill that’s 4 cents in France?

So, what do you know?

  • We’re getting ripped off by the health insurers
  • We can cover everyone with no new dollars with single payer
  • Health insurers are behind most of the criticism of single payer
  • The higher the admin costs, the worse the care
  • There are 500,000 people between you and your doctor or hospital that contribute nothing to patient care; indeed they deny and delay care
  • The 800-pound Gorilla in the lifeboat is health insurers
  • Right now, Congress looks like they’ll choose to throw millions overboard to assure the health insurers stay in the boat.

Next up? I’ll discuss the fantasy of “I’ve got mine” in healthcare.