When we were kids we all knew that in a verbal argument some horrible thing would be said about us personally if we persisted, communicating "I don't care what you say because...." ultimately, because your mother wears army boots. In the old days this was an insult, I'm not sure why and certainly there are many honorable moms wearing army boots, but let's not get distracted.
Personal attacks are a distraction, always, EVEN IF they're true. So why do they work? Two reasons: They're simple, and I mean simple in every non-intelligent sense of the word like calling someone crazy or stupid or ugly or a terrorist AND because they play into our fears of being crazy, stupid, ugly. They get the immediate child-like response of am not, inviting the counter attack of are too and suddenly the original issue has evaporated. Unfortunately, they don't solve anything and so there are only two ways to go once discussions have collapsed into name calling: Walk away or try to out name call. Either way, the original problem is the winner, it continues unscathed by all the name-calling, its life intact.
John McCain conceded this election when he started calling Barak Obama a terrorist. Having watched the debates, the campaigning, it became the hysterical last attempt to persuade the American public by using the old "Your mother wears army boots" name calling defense.
Health insurance companies have effectively used this tactic for years. Every time there's a ripple of public awareness that draws focus to their conduct, we start getting a range of responses from it's the doctor's fault for overcharging to it's the insureds fault for getting sick. However, unlike elections, our fears about losing our health insurance have catapulted this argument into a legitimacy never before achieved by the "your mother wears army boots" league of distractors.
Health insurers actually don't care how you live or how long you live, they care about how much they will have to pay for your medical care under their contracts with you. While insureds have swallowed the bait and accuse one another of being the "reason" for increases in the cost of health insurance, whether it's diet, weight, habits or age, the ISSUE of health insurance is never really addressed and emerges from the argument untouched and ready for the next round of health insurance "policy" cuts of benefits for more money.
As we all bemoan our choices during this benefits season, perhaps we can begin to refocus our energies on the issue: The COST of health insurance. Every discussion of this COST should begin with the fact that according the the health insurance industry itself (AHIP), less than half of every premium dollar paid goes to utilization, paying for medical services used by the person paying. You pay a dollar, you get less than a dollar's worth of medical services. This framework will remind consumers that no matter how "good" they are, if they use any of their premium dollars for actual medical services, they are a "cost" to health insurers.
As Obama takes office, I worry that his uncanny ability to calmly address conflict will transform into ignoring the biggest issue threatening the financial and physical health of our citizens, the unmanageability of the health insurance environment. Implementing his plan will have to address the health insurance industry's "Your Mother Wears Army Boots" ploy and distraction and get down to basics: Consumers can't afford the health insurance tax without clear mandates of coverage for illness by health insurance companies. Insurance means covering risk, if this is not done then it is not insurance.
Obama worries me with his expansion of "preventive" care because health insurance companies LOVE covering preventive care, it avoids the real issue of covering the risk of the cost of obtaining needed medical TREATMENT. Preventive care is a finite cost: This is the cost of a physical, a blood test, a mammogram, a screening. These costs are NOT the costs that contribute to the health services crisis. The CRISIS is caused by the cost of treating illness. If we don't demand that every health insurance policy cover all of the costs of the RISK OF ILLNESS for a reasonable amount, we will have been distracted again to our detriment.
For years we have listened to insurance companies tell us that if we don't like the cost of health insurance then we should be healthy. But nobody is healthy forever and while we finger-pointed our self- righteousness at our neighbors who smoke or overeat or have conditions, we didn't notice that health insurers expanded their lists of the unhealthy to include the depressed, the pre diabetic, the anxious, the person who has high blood pressure...you know, anyone who has EVER had any kind of medical event. Now even the healthy are overcharged.
Obama must address those who have disparate health insurance coverage, the sweet deals of government employees whose health insurance coverage is reminiscent of a different time by suspending taxpayer support of such governmental policies for benefits year beginning next year. This will incentivize quicker action as our governmental employees live the same experience we have.
Next, insurance company mandates must make it feasible for a person to have ONE health insurance policy that covers him sufficiently for any medical illness. People just keep buying more and more insurance and getting less and less, this carrot and stick approach is idiotic.
Group insurance, not based on pools of people with different ailments but based on general populations of young, old, sick, well must be supported and encouraged in order to even up the bargaining power of consumers against the huge blocs of insurance companies.
And as for the health insurance companies? When they say it's because you're fat that you're costing us money let them know that you'd rather be slim and healthy but that the issue is covering RISK, not trying to erase liability for covering risk, that's not insurance, that's a TAX. If the dialog gets too confusing we can ask them about their corporate losses from bad investments, stupid heads, why should we pay for that?
