I had CNBC on a little while ago and caught the CEO of CIGNA, one of the few remaining Health Insurance companies, explaining that the “breakup fee” for a failed merger attempt – in the $Billions – don’t recall how many – doesn’t really matter because the company is sitting on so many more billions of dollars in cash that, well, that breakup fee just doesn’t matter. His paycheck – his obscenely giant paycheck making thousands of dollars a minute – is another but we won’t tackle that today.
It instantly made me feel ill. Those billions of dollars sitting around – and being used to pay things like “breakup fees” are a huge part of the cost of the SickCare insurance we’ve been watching Congress struggle with. The CEO went on to name the lucrative – HIGHLY LUCRATIVE parts of his business – Employer Health Insurance – much much much cheaper for larger companies than you and I, as small business owners, have to pay, Medigap – all those sick old people we keep hearing about – highly lucrative, and Medicaid – again – highly profitable. So, they are highly profitable in every sector except for those of us who have to buy our own.
Do you remember back before the ACA – before you had insurance – how much more you had to pay if you paid cash than your friends got billed for the same exact procedure if their insurance paid for it? That’s the “Rip-Off” premium insurance companies charge the little guys who can’t defend themselves against the giant insurance companies.
So, that brings me to my conundrum. It does all boil down to deciding who gets to profit. We like to say that everyone is entitled to food, clothing, and shelter. Those are “entitlements” – things that every citizen of the United States has a right to have. We’re talking about adding SickCare to the list of things that formally, governmentally, we are entitled to.
There have been several ways of dealing with entitlements. Take food for example. Our whole food program was an outgrowth of the BIG CRASH. Farmers were going broke – which was just fine in the beginning, the banks were making a killing on taking people’s farms. Then the market for the farms dried up. The banks took them but nobody would buy them so the banks were stuck with this property. They went crying to their politicians, large checks in hand. In response, their politicians began our current Crony Capitalistic Corporate Welfare System. Systems have always wavered between giving people the goods and services or giving them the money to buy those goods and services on the open market. The former limits profit in the private sector, the second does not.
A lot of people were starving after The Great Depression and farmers had a lot of extra produce they couldn’t sell. The Government bought it and distributed it to the hungry. This was known as the “Surplus Commodities” program. People who were deemed needy would collect their share of these Surplus Commodities at a distribution center. Then the economy straightened out and they developed Food Stamps in 1939. People bought the stamps and the stamps entitled them to buy food – specific items or categories of food – at a discount. Prosperity ended the program in 1943. Food stamps didn’t start up again until Kennedy started it up in a very limited way. LBJ made it permanent and national BECAUSE THERE WAS AN AGRICULTURAL SURPLUS. Once again, this program was never started up – either time – to help the poor. Helping the poor was merely a way of helping a certain segment of the population with disproportionate political influence.
So now we have SickCare. Nothing has changed. The whole single-payer vs. providing corporations with $Billions to keep in their bank accounts – supporting a whole giant industry that costs us collectively $trillions in OVERHEAD COSTS is the real crux of the fight. When people talk about “health care,” a term I refuse to use generally because I view it as a marketing lie, it’s generally in terms of how costs are rising. What they are talking about to a great extent is that the OVERHEAD costs of SickCare are rising. They insisted that the ACA would add “trillions” in “overhead” costs. This is a time of massive movement to technology and machines. “Overhead costs” are paper shuffling costs and wages at the bottom aren’t going up. That means the bulk of these billions or trillions, depending upon the scope of your view, is upper administrative – in other words – enriching the UBER rich.
It’s long past time to re-evaluate who we are as a country, agree, or compromise, on who is “entitled” and what they are entitled to. Then the biggest question of all is how much profits should play into the provision of entitlements. There have to be serious incentives for the insurance industry to reduce the “overhead” as it seems to apply mostly to executive benefits if they are going to be a part. Keep in mind that the entire “insurance” industry has evolved into a primary function of maintaining the gate between people and medical services. The entire cost added by the insurance industry really has no purpose at all once you decide that SickCare is something everyone is entitled to.