Health care reform's dirty deadly secret is denial of treatment. It's one of the private insurance industry's most insidious methods of protecting its profit margins at the expense of human lives. The real death panels. And nothing in any of the current health care proposals seems to address it.
For a concise explanation, I've previously linked an October article in the Los Angeles Times:
By requiring insurers to cover everyone, regardless of pre-existing conditions, healthcare reform will make it more difficult for insurers to control their costs, or "bend the cost curve," by avoiding sick people.
And given that any true reform will eat into the industry's obscenely exorbitant profits, the obvious answer will be for them to compensate by covering people they previously wouldn't have, but simply refuse to pay for expensive treatments, no matter how necessary. Pre-existing conditions would be acceptable, because paying for treatment of those pre-existing conditions still would be optional.
"There are going to be a lot of denials," said insurance industry analyst Robert Laszewski, a former health insurance executive.
Expanding the public option know as Medicare will help those over 55 years of age, but not even exchanges would help everyone else. As I previously wrote, the Times article pointed specifically to the heartbreaking case of Nataline Sarkisyan, the seventeen-year old who died when her insurer wouldn't pay for her needed liver transplant. Her parents sued, but the case was thrown out because of a legal loophole that currently effects about 132,000,000 people, who are insured by their employers. That loophole remains open, and there is no evidence that the current proposals will close it.
In October, Democratic Congressman Adam Schiff, of California, said there weren't the votes in Congress to close the loophole, and there is no reason to think anything since has changed. Schiff had an obvious solution: a public option. Forcing private insurers to compete would necessitate that they improve their service.
"Companies would be that much more scrupulous to ensure they provide the care necessary, because if you establish the reputation for denying care, there are not many buyers wanting your plan," Schiff said.
The article then used two more examples to illustrate the point. Ephram Nehme and Glen Ossiander both were being treated for hepatitis at UCLA. Both, like Sarkisyan, needed liver transplants. Both faced long waits, in California, but both had the opportunity to get their livers much quicker, in Indiana. Nehme's private insurer refused to pay for an out-of-state operation. Fortunately, he was able to pay his own way, although the bill was more than $200,000. Ossiander also received his life-saving operation. Because he had Medicare, which he supplemented with some private insurance. A hybrid public option, but one that many still won't be able to afford.
It comes down to this: with a public option, people like Nehme and Ossiander would be covered; without a public option, not only will people like Nataline Sarkisyan still be left to die, but there will be more of them. Because private insurers only want to make money, have no consciences or scruples, and will deny such life-saving treatments to more and more people. So, mandates without a public option, and with no protections against denial of treatment, will be doubly cruel. Because people will be forced to buy into a program that won't give them the health care they need. Such a system effectively would be telling them that their lives don't matter, but their money does. Their own government effectively would be telling them that their lives don't matter, but their money does.