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Originally Published: 2/5/2009


By Gregory Wood


It is no accident that the World Health Organization rates the United States 37th in health care viability. A balkanized health care system favors the exploitation of the public. Not to put too fine a point on it, but ignoring the suffering of our most vulnerable citizens, while destroying the middle-class, is profoundly anti-democratic.


As with all forms of municipal “service,” the terms can be, and are, gamed and exploited through constricting democratic input and influence on management. As a model, it is called a “hydraulic economy.” It is a captive market where influence is controlled at the “spigot” of an essential service. 


Control is not exercised by the end-users, the vast majority who utilize the service. Those who hold sway, the primary constituents, are the profiteers, not those most in need. 


Further, the profiteers are not hospitals or doctors, as you might expect. They are the insurance companies, banks, the net of large corporate donors and high administrators, who inflate and exploit profit from the sick and dying. Insurance companies are not just one more corporate player among doctors and health care providers. Insurance companies are so large they own the banks, the hospitals, the politicians and, more often than not, the media. It is absolutely clear that insurance companies have no accountability to the public. That has got to change.


Is there really no “fair market value” regarding medical services? Of course, costs go down with volume! If insurance companies can have actuarial tables for insurance rates, they must certainly have them for the average costs of medical services worldwide. It is relevant here to note what could be called “addictive model logarithms” that were used by cigarette manufacturers. They were used to vary the nicotine levels in cigarettes in order to promote addiction and dependency. With a captive market via addiction, pricing can be inflated at will to almost any extent. In a similar way, the insurance industry uses fear and deprivation of services to establish helpless dependency and limitless inflation of “costs.” 


Insurance companies can be best understood by comparing their “service” to a casino racket with all the rules favoring the house. They are gaming fear with the vicious intent of ignoring the poor and robbing every middle class family of their remaining assets. It is an amazing scam hidden in plain sight. Wealth is siphoned off. The context is never understood. The players are never seen. The terms are never questioned. It is like shooting fish in a barrel. 


Insurance companies, therefore, have unimaginable amounts of money to buy the conscience of legislators, administrators, and those who would inform us. Since this, at root, involves an almost inconceivable cynicism at the expense of our loved ones, everyone is in denial and extorted into the game. Once understood, however, fear could change into a productive anger if directed toward the intent of serving the common good.


Ultimately these are democratic issues. If the connections between insurance companies, the media, and the gargantuan concentrations of wealth that they represent go unrecognized, citizens will never get a grasp of political terms necessary for our informed democratic participation in responsive and representative health care service.



Gregory Wood is the owner of Forest Books in San Francisco.



© The Issue Wonk, 2009



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