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Back in the mid-90s, as the internet was beginning to take off, I took a college class about information technology and its impact on modern society. The moment that stays with me most from that class is a bit about the medical insurance industry. Some documentary we watched showed people very concerned about their personal health information, because if certain details of their medical conditions got out to insurance companies, it was possible that a) they would not be able to get affordable health insurance, b) they might lose health insurance they already had, and c) they might not be able to get health insurance, period, leaving their health at the mercy of what they could afford.
In other words, for some people, doctor-patient confidentiality can be literally a matter life or death.
What makes my blood boil is that the insurance industry is cheating. In a way, all insurance is a gamble. You are “betting” that paying a substantial fee every month will, in the long run, will be cheaper than the cost of medical treatments you may need now or in the future. And insurance companies are betting the opposite, that the cost of your medical bills will be less than the sum total of your monthly premiums. Of course, you rarely “win”, even if the odds pay off in your favor: an insurance company payout means your body is in trouble. “Woo hoo! I get a free medical treatment, and all I needed to do was get heart disease! (and spend 40 hours on the phone, jumping through insurance company hoops!)”
But rather than accept this wager and risk the odds, the insurance companies rig the game. First of all, they do their best to not pay for your medical treatments. Just as a casino would save money by boarding up the winings tray at the bottom of their slot machines, insurance companies use loopholes and technicalities to keep their cash from paying your bills. I haven’t seen “Sicko” yet, but I’m told there are scenes of people who are paying good money for their health insurance, only to find out that it doesn’t actually cover them if they get sick! Secondly, insurance companies try not to issue policies to people who may actually need medical treatment. And lastly (well, they probably have a much larger bag of tricks than this), they try to rid themselves of existing customers who are costing them money. They cheat at gambling by trying to eliminate risk altogether and abdicate all responsibilities, as if they were not a business providing a service in exchange for money. If they had their way, customers would simply mail in their checks, receive nothing in return, and die quietly when they could no longer afford it.
Which is what makes this so sleazy. Blue Cross (whose corporate parent Wellpoint made over $3 billion in profit in 2006), sent letters to doctors in California, encouraging them to violate doctor-patient confidentiality and snitch on their patients, in attempt to give Blue Cross grounds to cancel coverage for patients with certain health conditions (interestingly, one of the “health conditions” mentioned by Blue Cross is “pregnancy”).
But we do have a happy ending to this particularly scumbaggery: the California Medical Association publicly blasted Blue Cross, Arnold Schwarzenegger blasted Blue Cross, Hillary Clinton blasted Blue Cross, the media picked up the story, and Blue Cross has announced it will stop sending the letters. Not because of the morality or criticism, of course, but because they have “determined this letter is no longer necessary”. Right.
Of course, this leaves every other problem with America’s health industry intact.
In the past decade, a number of the labor struggles in the US have been tied explicitly to the matter of health insurance. Employees demand it because they can’t afford medical treatment otherwise, and employers try to jettison it to keep costs down and profits high. I keep wondering if one of these days we’ll see a coalition of businesses form to push for nationalized health care, to do away with this issue altogether. Maybe we’ll see a battle between auto companies, grocery stores, retail chains, and white collar corporations, doing battle with insurance companies for legislative change. Probably not, but it makes me scratch my head a little why all non-insurance businesses aren’t following this path.