“Earlier this year, [the insurance industry] offered a
major concession, offering to abolish policies that deny coverage because of
preexisting coverage. In return, insurers said they want Congress to enact
legislation that requires every American to have insurance . . . many Democrats
back the concept, comparing it to a requirement that all drivers have auto
insurance.”
The analogy is false: One buys an automobile. One does not buy one’s body.
Human beings, like other living creatures, are born with
bodies. The human-history chapters of slavery have at times mutated our
ownership, our rights, concerning our own bodies, but even the vilest
historical practices—including recent practices--have not changed the immutable
physical fact that our bodies are, in the antique phrasing, unalienable. The
body is essential to life; that key fact is almost a tautology.
Health, in turn, is essential to a good life. Granted,
some people heroically strive throughout their lives without the blessing of good
health—generally with far too little recognition, and too often with not enough
support. But exceptions do not invalidate the general rule. The importance of
health has been recognized throughout recorded history, and health for most of
the general population is a key index of the strength of a society.
Not every human being, even in
Admittedly, at least since Descartes most of us have
gotten used to thinking of the mind as the driver in the driver’s seat, i.e.
positioned in the body as vehicle. But setting aside the larger or more
transcendental questions for the moment, the “ghost in the machine” metaphor is
not constructive in discussing health care. One distinction between our
vehicles and our bodies—it is ludicrous that this has to be pointed
out—is that our vehicles can be replaced.
And that, don’t you see, is something of a crux when one
is talking about health care. If only the late
Molly Ivins were alive; if the insurance
companies tried to apply the car-insurance-policy analogy to a recent
amputee, she could take them.
Moving farther from the metaphysical or
transcendental--this key distinction between replaceable and irreplaceable, in
regard to human beings, is more than a matter of sentiment, or even of human
rights. It has to do with the very concept of insuring against risk.
Automobile insurance policies insure the driver only
against risk, against the risk of an accident and heinous consequences (or at
least they are supposed to insure--the quality of automobile policies, like
other insurance policies, actually depends partly on legislation and regulation
state by state). Automobile insurance policies do not insure the health of the
vehicle in the sense of maintaining its health. They do not provide your
automobile an annual physical; most of them, despite what the companies suggest
in advertising, do not even reward good maintenance. There is no genuine
automotive equivalent to an HMO. In fact, our nation's insurance industry has a long and not honored history of going along with the unsafe-at-any-speed excesses that characterized the automobile industry at its worst.
Speaking of health, it might also be noted that
automobile insurance policies are typically no better about paying out claims
in cases involving injury or disability than are other medical-involved
insurance policies—health, accident, disability. The one sector of the
insurance industry that has a genuinely good track record of living up to its
claims, pun intended, is life insurance. That’s largely because death is hard
to fake; therefore, insurance fraud in life insurance is hard to pull off;
therefore the industry has no pretext for evading the payout. Also, weaseling
out of a life insurance payout would be bad public relations even for a highly
capitalized insurance company to weather.
Our public discourse needs more focus and acuity.
Somehow, now that President Obama has welcomed all parties to the table regarding
health care, the public discourse in the larger media outlets has treated the
insurance industry as another ‘health-care provider’, like doctors, nurses,
hospitals and clinics. This is another false analogy. Insurance sales
agents—and I like my insurance agent and think highly of him—are not surgeons.
To require all Americans to buy health insurance would be
a massive transfer of wealth from working people to upper management, from the
middle class to the wealthy and to corporations, from people in most need to
people in least need. In short, it would be another such transfer of resources
in an economy already brittle and destabilized from previous transfers.
And given the track record of our insurance industry in sidestepping contractual good faith—including delayed or denied payouts, vague or arcane claims procedures, retaliatory rate increases, unjust cancellations of policies, bad-faith denials of policies, etc.—to require all Americans to buy from these companies, either with taxpayer assistance or without, would be to engage in a certain outlay of money for a very uncertain return.
As written before, health should be our goal--not health insurance. Insurance--'coverage,' as the corporate media outlets favorably name it--is no more a substitute for health than jobs training is a substitute for jobs.
More on this topic later.
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