A gathering spot for warriors fighting for their special-needs children

If you're one of the many who have come to the realization that your public school system is out to get away with doing the absolute minimum for your special-needs child and is not actually interested in helping or educating your child, join the crowd. Bring some passion and some factual evidence and step into the fray.

Monday, November 9, 2009

The law of unintended consequences is a bitch, part II

So this is how it's going to shake out. The new Health Care Reform Act will put the screws to insurance companies, forcing them to stop dropping customers who get sick, making them pay claims for pre-existing conditions (congratulations, smokers--enjoy some free chemo!) and taking away the geographic protections these companies have long enjoyed.

But if you take away the conditions that allow a company to be profitable--and those mentioned above are some pretty big fucking conditions--the company may not only become unprofitable, it may go bust or (at the very least) decide it wants out of the health care niche.

So what happens when private insurance companies see a surge in their cost of doing business? Do we really just think they'll suck it up and keep doing business as usual?

If they want to raise rates but the government tells them they can't, what will happen then? No government can tell you you must stay solvent despite a cataclysm in your industry.

Okay, so maybe that's a little dire. Let's just say the private insurance companies stay in business, but see their margins shrink dramatically. What happens then?

First of all, they will pass their increased cost of doing business onto us in the form of even more intense scrutiny of claims, even more diligent efforts to deny coverage, and even more "lost paperwork" than we have to deal with now.

I don't know if you realize it, but insurance companies use the same business model that rebate-fulfillment vendors use. They make it so fucking hard to collect that you just give up. Or at least they hope you will give up and go away.

Can insurance companies make it even harder on us than they do now? You bet your ass they can. Can you even imagine the next level of hell underneath being treated the way insurance companies treat us now? Does the Dante chart even go down that many levels?

This is where you Fantasy-Island Democrats usually start whinnying about the public option. Well, the public option is being pitched to us as a small, niche operation that would not seek to gather in many of us who are privately insured now. Even the GAO says that initially at least, the Public Option will probably be  a prohibitively expensive choice for most of us now using private insurance.

But if our private insurers go out of business, we will not have to come over to the public option? What other choice will we have?

And if and when this influx of reluctant new customers causes the public option to grow monstrously big, how will this new, ostensibly self-sufficient enterprise succeed and remain solvent when its direct competitors--private firms run by smarter and more successful people--couldn't?

There's only one way.

We'll have to constantly bail it out with more and more public money.

Meanwhile, what level of service do you think you are going to get from a government-run insurance company that has grown way beyond its original projected size, into that realm where it is literally unmanageable?

Visualize, for a moment, your current typical insurance company customer service interaction. Now imagine how it would be if a disinterested, undertrained and underpaid government employee was handling your claim.

Now imagine it's five years hence, and the government program has quintupled in size, and it's running a huge deficit because it's a government program so of COURSE it's running a huge deficit, and panicky administrators are trying like hell to rein in spending; starting, it appears, with your life-or-death kidney transplant.

Look, maybe it'll all work out, and I mean that. I am not rooting for it to fail; I'm rooting for it to succeed.

For one thing, there is no doubt that the insurance companies have been playing us for a long time. They've been unforgivably cynical--and even malicious. It's easy to see why: it is a wildly contradictory thing to simultaneously tell a patient you're going to provide good benefits, yet tell your shareholders you're going to spend the least amount possible on that patient's care, and yet that is what private-sector insurance companies do.

It would be easy to look at these private insurance juggernauts and say, fuck you, I hope you get it in the neck, and root for them to suffer a slow, painful death--like, for example, newspapers, and, one still hopes, cable TV providers.

But given the following choice, which would you choose?

1. Profit-driven private sector customer service rep, trying to do whatever she can to avoid paying your claim; feeding you one bullshit lie after another (i.e., the status quo);

or,

2. Languid, union-protected government employee, yawning noisily as she tries unsuccessfully to find your patient record so she can refer you to an appointment 14 weeks from now with a Caribbean-degreed "specialist."

This is actually the choice we are now being asked to make. Fortunately, there is a third choice: make a shitload of money and pay cash for your care whenever possible.

You'll be able to get fine care and see really good doctors this way, but it'll be extremely expensive.

Don't worry about the assholes who say Obama will prevent doctors from moving to the private sector and providing "elite" care for cash. In this country, nothing is stronger than the profit motive, and our society's elites are not easily dislodged.

We have capitalism in our veins, and it'll prevail. And that means it'll prevail at election-time, too.

Doctors are, and should be, affluent relative to the population at large. They will be able to raise a lot of money for some candidate. Don't worry about doctors. Their biggest obstacle is their own desire to do good for people. But if you really piss them off, they might remember that they have a lot of money and a lot of clout, and they might figure out how to use it.

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