There certainly has been a lot of fuss lately about the health insurance crisis. A couple of weeks ago in the New York Times Magazine, Sen. Hillary Rodham Clinton—a person who is guaranteed to get a rise out of excitable Americans on both ends of the political spectrum—set forth her case for reform. Again. She noted that the situation has only gotten worse since she was laughed off the rostrum the first time she proposed radical change to a broken system that will not heal itself.
Within the week, the puissant Newt Gingrich wrote to acknowledge that he agreed wholeheartedly with at least one of Hillary’s principles: that reform must focus on the individual. Although he didn’t say precisely what he means (undoubtedly that innovation and change must come from individuals exercising their profit motives, not the fed acting like a nanny state), we were gratified to learn that the issue means enough to him that he actually founded something called the Center for Health Transformation.
When Hillary and Newt agree on something, the end is surely nigh; only the willfully stupid don’t see the mess we’re in. Business leaders are noticing that employee health benefits are the single biggest debit on the company spreadsheets. When the captains of capitalism begin to complain, powerful people begin to listen. But what can the powers and principalities offer, other than flagrant lip service?
It is an interesting impasse. The only way to effect genuine change is to muster sympathy from influential folks who worry about health insurance only in connection with their stock portfolios. We live in times when enlightenment comes in only one flavor—enlightened self-interest—and no politician will take up the cause of real reform until it is clear that such a position will get him power, money, or both.
We wonder why William McGuire, the CEO of United Health Group, is so eager to raise money for George W. Bush. The president is grateful for the hundred thousand dollars McGuire has raised on behalf of his re-election. Does Minnesota’s highest-paid executive know something we don’t about what is required to overhaul health care? We hope so, considering he was paid ninety-three million last year to run the nation’s largest and most profitable health care company.
We like to pick on McGuire, but we know the problem is systemic. Of sixteen corporate officers at United Health, twelve have given a total of twenty-three thousand dollars to the Bush reelection campaign (just one thousand dollars short of the maximum allowed by law), while none have given a red cent to that bleeding heart John Kerry. (Lois Quam, the head of one division who is also married to DFL point man Matt Entenza, played it safe with a harmless donation to Dick Gephardt.) It may also be worth noting that four United Health executives reporting to McGuire bring home a total of $66.7 million in annual salary.
Which begs the question: Just how committed to change can a person be, who is compensated so handsomely by the status quo? And why does United Health make its home in a state where the company cannot legally operate its core business because it is a for-profit health management organization? Perhaps it is to insulate its executives from the public opprobrium their greed so richly deserves.
What is the Republican agenda for treating the health care crisis? It is to blame bogeymen, to distract from real issues with straw men and red herrings. The people presently in control like to claim that what is really driving health care costs are frivolous lawsuits and filing inefficiencies, and an absence of competition in the marketplace.
McGuire, in his euphonious annual letter from the chairman to stockholders, makes grandiose claims about the need for broad societal initiatives, while gloating about the performance of his company. He makes no specific recommendations for change—at least not anything that might ruffle stockholders. What’s really needed, in the argot of the day, is more “science-based decision making” (in other words, more insurance-company bean-counters making even more decisions—it is called actuarial science, you know) and the computer-compatibility of patient files. This is a little like blaming the oceans on the rain.
“Our health care can—must—work better, be more efficient, and truly provide for all people,” he wrote last year. “As a nation, we can and must cover everyone.” And yet he also points out that “the magnitude of the challenges in health care, combined with ideology, lead some to propose preemptive or unilateral decisions.” The clear message is that drastic times require timid gestures.
Let us translate McGuire’s game plan for you: We can squeeze even more money out of the system for our “stakeholders” by continuing to turn up the heat of our rhetoric, while cashing in our stock options, and being careful to do nothing of substance. When the issue is complicated, it’s best to blame the trial lawyers (malpractice chicanery!) and the nurses (lousy filers!), and raise as much money as is legal for political candidates who care about the basic human dignity of massive profits.
On Tax Day, United Health reported record first-quarter earnings and increased margins. Profits are way up. Oddly, the health care situation for most non-millionaires has not noticeably improved.
Leave a Reply