It is hard not to be horrified as Congress bends the health care regulations from the rhetoric of “repeal and replace” to the reality of “reveal and disgrace.” What is it in the national character that allows our representatives to throw millions off health care to fund a tax cut for the rich? To understand this, I think we have to divide the truly wealthy into two groups: the declining number of patricians with a sense of noblesse oblige and a second group, whom a writer friend of mine characterizes as “those for whom too much is never enough,” who seem to have gained the upper hand in the corridors of power and who are totally indifferent to the lives of others.
Despite his praise for initiative and enterprise in “Democracy in America,” de Toqueville identified the latter group in an 1831 visit to Flint, Mich., his only visit to America. Looking at the behavior of the businessmen on what was then the frontier, he wrote, “It is not only Indians whom the American pioneers take for fools. We were ourselves every day victims of their extreme avidity for profit. It is true they never steal. They have too much intelligence to do such an impudent thing. Yet, I have never seen the owner of a hotel of a big (European) city overcharge with such shamelessness as those inhabitants....”
Poor Flint. In the ensuing 186 years, the top 1 percent continued in their blatant exploitation and lack of concern for others in the community, whose poverty was the subject of Michael Moore’s “Roger and Me” and the recent poisoning of the water system. Looking at the swamp-draining crowd and the 1 percent’s proposed massive tax cut, it is obvious that we’re not going to get health care reform unless we buy them off somehow. One might say this is impossible, but if we look elsewhere, there may be a way to provide a health care system that is run for the benefit of everyone, including our friends north of the border, while still satisfying the rapaciousness of the 1 percent and their minions in Congress.
All we have to do is outsource our health care management to Canada, an obvious solution if you believe in the free market of ideas. A look at the numbers shows the practicality. In 2014, Canada spent $5,292 per person on health care. The United States paid $9,403 for vastly inferior services. The savings of $4,111 per person totals out nationally at a little over $1.4 trillion. So, if we pay the Trudeau government around half a trillion dollars over and above their costs to run the system, it leaves nearly half a trillion to pay off all the multi-million dollar payouts to the individuals who currently run the health care industry largely for their own benefit, with the same amount left to spend on public good. Instead, Tom Price, the current man in charge of health care, in answer to a question about insurance companies reporting that the Republican plan won’t work in any form, proposed on ABC that, “All they have to do is dust off how they did business before Obamacare.”
This would take us back to the era when we witnessed the perfect trifecta of insurance company greed. Remember the $1 billion-plus golden parachute for “Dollar Bill” McGuire, of United Health Care, paid in 2007 after the S.E.C. settled on an options dating scandal that had forced his resignation, and the $1 billion-plus settlement for fraud by Rick Scott (now governor of Florida) and his former hospital company, Columbia/HCA? And in 2009, the New York attorney general sued several insurance companies for a computer billing scheme provided by Ingenix Inc. that deliberately underpaid hospitals, health care providers and their patients to the tune of $2 billion to $3 billion per year between 1994 and 2007.
Describing the state of affairs in the pre-Obamacare era, Elizabeth Warren, then a professor specializing in bankruptcy at Harvard Law School, coauthored a 2005 article setting forth the financial impacts of sickness and injuries on families and individuals, perhaps the first major health policy writings on the subject of medical bankruptcy. Warren and her co-authors found that 1.8 million to 2.2 million Americans underwent medical bankruptcy and that 75.7 percent had insurance at the onset of illness. Inadequate insurance coverage, gaps in coverage and the unavailability of insurance because of pre-existing conditions were major factors in medical bankruptcy. The score? U.S. medical bankruptcies per year: 1.8 million to 2.2 million. Canada: 0.
As Warren said in her work on the Consumer Financial Protection Bureau, you can’t sell a toaster that has a one in five chance of bursting into flames, but you can sell risky subprime mortgages and misleading insurance plans. “And for families who get tangled up with truly dangerous financial products, the result can be wiped-out savings, lost homes, higher costs for car insurance, denial of jobs, troubled marriages, bleak retirements, and broken lives,” she said. The same goes for the dangerous health care policies currently proposed in Congress, which should respect that the public just isn’t buying it.
John Hulls is a former Light columnist and Point Reyes Station resident now living in Point Richmond.