Here at Daily Kos, we all know that something needs to be done to address the current crisis relating to the lack of decent affordable health care. Our political leaders are waffling, when they seem to have any understanding whatsoever of the problems faced by middle-class and working class Americans. Anyone with even a cursory understanding of how health care is provided here and in other countries recognizes that our "system" of health care is bloated, inefficient, ridiculously expensive, fails to insure that people get care when they need it, and is more concerned with profit than the needs of the public. At this critical moment, those leaders of ours who seem to understand the need for at least a viable public alternative to private insurance need our support. There is one clear way for us to make our voices heard; below I suggest a drastic way to catch the attention of policy makers, and the reasons why I think this might become necessary.
I am worried that without dramatic action on the part of a large number of Americans, there will be little but cosmetic change to our fiasco of a health care system. There are too many wealthy and powerful vested interests in play here, too many trillions of dollars at stake. A lot of those dollars are used to influence politicians, and even to convince our fellow citizens that, against all objective evidence, "the US has the best health care system in the world". What would gain the attention of health policy experts and our political leaders, many of whom seem to lack any understanding of just how serious this situation is for many of us?
What I propose is this: an effort to convince as many people as possible to consider dropping their private health insurance, ideally in a coordinated fashion. This is, as I noted above, a very drastic, frightening suggestion, with potentially serious consequences for anyone who elects to do so. But I believe that this would be the single best way to confront the entrenched interests that dominate the health care debate today.
A coordinated campaign to stop doing business with private insurance companies would further the viability of a true public option in several ways. First, it would underscore the dissatisfaction of the public with our private health insurance options. Second, it would be more than a symbolic statement; a large number of people willing to risk the consequences of being without coverage would dramatize their commitment to a public health care system. And finally and perhaps most importantly, it would cause significant financial effects on the insurance companies themselves.
The latest surveys show that around three quarters of Americans support some sort of public health care provision. If even a small percentage of them could somehow make their wishes known to the President, their Senators and their Congresspersons, that could have a huge impact. Imagine if hundreds or thousands of letters arrived at each Senator's and Representative's office, detailing the writer's intention to run the risk of going without insurance because our current system of coverage is so completely broken. That might cause enough legislators to sit up and take notice that such a drastic step would not be necessary.
However, I suspect that the entrenched interests have enough influence among policy makers to force action. Of course, people with serious or chronic medical conditions should not drop their coverage, that is if the insurance companies have not dropped them already. For many of us, our premiums are so expensive, and our coverage so poor, that the short-term risk might be quite low. After taking into account high deductibles and co-payments, and the common practice of denial of coverage whenever possible, many of us would actually come out ahead. That's not the point though, as I may discuss in a followup.
Of course, dropping one's health insurance would certainly expose one to substantial financial risk. An accident or catastrophic illness could be, well, catastrophic in a financial as well as medical sense. But this is actually a strength of this approach; sending letters and e-mails is all well and good, but going to the wall and risking money is something that our political leaders can understand and appreciate. This would not be action akin to a handful of disgruntled tax protesters dumping out teabags, people who follow this route would be taking a real risk to support a principle they believe in.
Finally, if enough people followed this action, the predatory insurance companies themselves would be adversely effected. Above, I suggested that those who have a clear current need for their insurance should probably not even consider dropping their coverage. Even better, in the context of applying pressure on the insurance companies, if you currently need your insurance to pay for treatment not dropping your coverage is actually helpful.
How's that? Well, if you're using your insurance for much more than routine physicals and the occasional virus, the insurance companies don't really want your business. In the mid-1990's I did some work with an HMO which I shall not identify looking at patterns of expenditure on their clients. My task was to link their huge patient database with geographic identifiers so we could map the results. Anyway, while processing the data files, I came across a variable labeled "Lost Revenues". I didn't know what that meant, so I called up their data people for clarification, and was told that that was the term for "any money returned to the client."
"Lost Revenue". Essentially, the insurance company considers every dime you pay them to be legitimately theirs. If you feel you need some to pay your medical expenses, you damned well better be sure you fill out every form, cross every 't' and dot every 'i', or the company will figure out some way to avoid that revenue loss.
So how would it be beneficial for healthy folks to drop their coverage and those with a need for services to keep theirs? Because that is exactly the opposite of the business model of for-profit insurance. Charge people for a service they don't use, and get rid of any troublemakers accounting for too much "lost revenue." What I'm suggesting is, the most profitable assets, er, customers, take their money and leave, while the people who actually need service stick around to get what they can. If enough people did this, the insurance companies might feel the pinch, and perhaps change their opposition to a viable health insurance plan for real people.
So, thanks for reading my meandering tale. What do you think, am I way off base here? Would anybody seriously even consider abandoning their flawed safety net, let alone actually cancel their coverage? Hopefully, something good will happen before we have to find out, but if it does, I'll be pleasantly shocked.