Wednesday, August 19, 2009

Private, For-Profit Health Insurance Companies are Self-Contradictory

Private, for-profit health insurance companies are self-contradictory. They cannot pursue profits - try to make as much money as possible - and support necessary health care. I know this from first-hand experience.

Years ago, when our son was a little boy, he contracted a type of pneumonia that did not respond to the usual courses of antibiotics. After several rounds and weeks of fever on and off and on, his doctor decided to admit him to the hospital. You can imagine how upset my wife and I were. As we were talking about this, in the doctor's office, we heard him talking to our insurance company - Empire Blue Cross Blue Shield. "No, no, he's a professor. They're not those kinds of people. This is legitimate, I can assure you," our doctor said to Empire on the phone. (I was professor then not at Fordham.)

This went on for about 10 minutes. Finally, our doctor got Empire's agreement. By this time, we had walked out into hall, and he saw that we had heard the conversation. He shook his head sadly, and said, this is what you have to go through....

And I couldn't help thinking - let's say I hadn't been a professor. Let's say we were "those kinds of people" - people who had been paying premiums, but for some reason were not held in high regard by the insurer. Our son's hospital bills would not have been covered?

Our son did finally get an antibiotic that worked in the hospital. But my wife and I learned an important lesson about health insurance that day: the companies that provide it it are mainly in for the money. Accordingly, they do anything they can to limit their expenses. That's just good business.

I had actually learned this about insurance companies (actually, a car company that provided warranties) years earlier, when I was driving a new Oldsmobile to another school. The car up and died on the highway - the engine expired. When I got on the phone, later that day, to the car warranty company, I was treated to "do you have any proof that you were driving your car safely"? I replied that unless Oldsmobile which had happily taken my money for the car and the warranty now paid for the car's repair, and I was assured within an hour that this would happen, I would go to the media and tell them about their shoddy way of doing business. And I would have - but some supervisor called me back 10 minutes later and apologized for the first conversation. "He was only doing his job," he said of the first guy I had talked to. Exactly. Of course he was, and that was the problem. Just good business. Limit expenses.

The car was aggravating. The repairs were just about money, for me as well as Oldsmobile. But health coverage obviously can be a matter of life and death.

We can no longer afford to leave such matters in the hands of people and companies whose main goal is not to protect health but make a profit. I'm all in favor of making money. Profit and capitalism continue to do great things. But they've failed in this country to give adequate health care, even for people they accept in their plans.

It's time to break loose from these hopelessly conflicted, oxymoronic for-profit health insurers. And vote out of office anyone who opposes this long overdue, humane, clearly rational reform.

Government programs are certainly not flawless. But at least they don't work against their own stated goals.
Post a Comment