AlterNet: Health and Wellness: Why Does Everyone Bow Down to the Health Insurance Industry? by Barbara Ehrenreich...

Read original...

Bow your heads and raise the white flags. After facing down the Third Reich, the Japanese Empire, the U.S.S.R., Manuel Noriega and Saddam Hussein, the United States has met an enemy it dares not confront -- the American private health insurance industry.

With the courageous exception of Dennis Kucinich, the Democratic candidates have all rolled out health "reform" plans that represent total, Chamberlain-like, appeasement. Edwards and Obama propose universal health insurance plans that would in no way ease the death grip of Aetna, Unicare, MetLife, and the rest of the evil-doers. Clinton -- why are we not surprised? -- has gone even further, borrowing the Republican idea of actually feeding the private insurers by making it mandatory to buy their product. Will I be arrested if I resist paying $10,000 a year for a private policy laden with killer co-pays and deductibles?

It’s not only the Democratic candidates who are capitulating. The surrender-buzz is everywhere. I heard it from a notable liberal political scientist on a panel in August: We can’t just leap to a single payer system, he said in so many words, because it would be too disruptive, given the size of the private health insurance industry. Then I heard it yesterday from a Chicago woman who leads a nonprofit agency serving the poor: How can we go to a Canadian-style system when the private industry has gotten so “big”?

Yes, it is big. Leighton Ku, at the Center for Budget and Policy Priorities, gave me the figure of $776 billion in expenditures on private health insurance for this year. It’s also a big-time employer, paying what economist Paul Krugman has estimated two to three million people just turn down claims.

This in turn generates ever more employment in doctors’ offices to battle the insurance companies. Dr. Atul Gawande, a practicing physician, wrote in The New Yorker that ''a well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That’s how a doctor makes money. It's a war with insurance, every step of the way.'' And that’s another thing your insurance premium has to pay for: the ongoing "war" between doctors and insurers.

Note: The private health insurance industry is not big because it relentlessly seeks out new customers. Unlike any other industry, this one grows by rejecting customers. No matter how shabby you look, Cartier, Lexus, or Nordstrom’s will happily take your money. Not Aetna. If you have a prior conviction -- excuse me, a pre-existing condition -- it doesn’t want your business. Private health insurance is only for people who aren’t likely to ever get sick. In fact, why call it “insurance,” which normally embodies the notion of risk-sharing? This is extortion.

Think of the damage. An estimated 18,000 Americans die every year because they can’t afford or can’t qualify for health insurance. That’s the 9/11 carnage multiplied by three -- every year. Not to mention all the people who are stuck in jobs they hate because they don’t dare lose their current insurance.

Saddam Hussein never killed 18,000 Americans or anything close; nor did the U.S.S.R. Yet we faced down those "enemies" with huge patriotic bluster, vast military expenditures, and, in the case of Saddam, armed intervention. So why does the U.S. soil its pants and cower in fear when confronted with the insurance industry?

Here’s a plan: First, locate the major companies. No major intelligence effort will be required, since Google should suffice. Second, estimate their armed strength. No doubt there are legions of security guards involved in protecting the company headquarters from irate consumers, but these should be manageable with a few brigades. Next, consider an air strike, followed by an infantry assault.

And what about the two to three million insurance industry employees whose sole job it is to turn down claims? Well, I have a plan for them: It’s called unemployment. What country in its right mind would pay millions of people to deny other people health care?

I’m not mean, though. If we had the kind of universal, single-payer, health insurance Kucinich is advocating, private health insurance workers would continue to be covered even after they are laid off. As for the health insurance company executives, there should be an adequate job training program for them – perhaps as home health aides.

Fellow citizens, where is the old macho spirit that has sustained us through countless conflicts against enemies both real and imagined? In the case of health care, we have identified the enemy, and the time has come to crush it.

Barbara Ehrenreich is the author of thirteen books, including the New York Times bestseller Nickel and Dimed. A frequent contributor to the New York Times, Harpers, and the Progressive, she is a contributing writer to Time magazine. She lives in Florida.

The Nation: Travails of the Super-Rich By Barbara Ehrenreich

Travails of the Super-Rich

Go to Original

Travails of the Super-Rich
By Barbara Ehrenreich
The Nation

Friday 31 August 2007

On Labor Day we customarily give a nod to America's underpaid and overworked blue- and pink-collar workers - janitors, flight attendants, forklift operators and the like. But this year let's go a step further and salute the most reviled and despised of the people who make our economy happen, the mere mention of whom causes the average forklift operator to spit on the floor. You are thinking, perhaps, of telemarketers, human traffickers and the fiends who answer the phone when you to try to make a claim on your health insurance. But I'm talking about our CEOs.

Just in time for the holiday, two liberal groups - United for a Fair Economy and the Institute for Policy Studies - have issued a gleefully malicious new attack on our CEO class. They point out that the CEOs of large companies earn an average of $10.8 million a year, which is 362 times as much as the average American worker, and retire with $10.1 million in their exclusive pension funds. The groups further point out that the compensation of US CEOs wildly exceeds that of their European counterparts, who, we are invited to believe, work equally hard.

And, in what they must think is their cleverest point of all, the UFE/IPS folks state: "The 20 highest-paid individuals at publicly traded corporations last year took home, on average, $36.4 million. That's...204 times more than the 20 highest-paid generals in the U.S. military." You know what we're supposed to think here: Wow, but generals have all that responsibility! They're responsible for national security, or at least for conducting the wars that increase the threats to our national security and thus help justify ever greater increases in our national security apparatus!

But someone has to speak up for our beleaguered CEO class, and let me begin with that spurious comparison to the top military brass. Could we put patriotic emotion aside for a moment and look at this in a hardheaded, bottom-line sort of way?

Suppose you are the general responsible for all the service people in Iraq, about 130,000, and suppose you manage to lose every single one of them in some ghastly miscalculation. With the death benefit for the family of one dead soldier running at $100,000, your mistake will cost a total of $13 billion. Sounds like a lot, I know, until you consider that a hedge fund manager or financial company CEO can lose that much in a single afternoon, without anyone even noticing. There is simply no comparison between a general and a CEO.

That's a side issue, though. The real point, which the CEOs and their usual defenders are strangely reticent to make, is that it's damn expensive to be rich, and extravagantly expensive to be super-rich. Before you start playing your air violins, consider the costs of maintaining as many as five different homes, some of them as large as 45,000 square feet, most with swimming pools, tennis courts, guest houses and wine cellars requiring constant supervision.

The poor whine about having no home at all, or maybe a two-bedroom apartment for a family of six. They should just think for one moment of the tribulations involved in running four or more mansions, each with its own full-time staff. There's the problem of getting between them, for example. A friend of mine, of very modest means himself, consults for a billionaire couple who commute between London and Los Angeles by private jet, with their dogs following in a second private jet.

But much of what we know about the extreme costs of wealth comes from Wall Street Journal columnist Robert Frank's recent book Richistan. The ultra-rich, drawn largely from the CEO class, require staffs of about forty to fifty people, including not only cooks, maids and nannies but "lifestyle managers" (to set up the entertainment schedule) and - in a throwback to the original Gilded Age - butlers. It's the butler's job, among other things, to deal with any issues that may arise from the proliferation of homes. For example, if the boss is in Palm Beach, Frank reports, "and wants to send his jet to New York to pick up a Chateau LaTour from his South Hampton cellar, the butler makes it happen, no questions asked."

Nor are the ultra-rich in a position to cut back on their expenses - by, say, running down to the supermarket for a $12 bottle of Chardonnay. If they were to do so, their friends would despise them. As Frank explains, the Richistani word "affluent," meaning someone with less than $10 million in assets, translates into English roughly as "scum."

A mean-spirited critic of the ultra-rich CEO class might grumble that the rich should simply find a new circle of friends. But who exactly might these new friends be? If you were in the $100 million-in-assets set, you could hardly consort with the class of people for whom a pittance like $10,000 might be a transformative sum, possibly allowing Granny to get her insulin and the children to have warm winter clothes. People of that class could not be trusted not to pocket the silverware or rip out the gold fixtures in your powder room. They might even make a lunge for your throat.

PBS: Bill Moyers Journal..Interview with Barbara Ehrenreich...

Bill Moyers Journal . Transcripts | PBS

Watch video...

Barbara Ehrenreich - After studying theoretical physics at Reed College and earning a Ph.D. in cell biology from Rockefeller University, Barbara Ehrenreich joined a small nonprofit in New York City in the late 60's, advocating for better health care for the city's poor.

She began researching and writing investigative stories for the company's monthly bulletin, and as she explains in her biography, "There was no decision to become a writer; that was just something I started doing."

What Ehrenreich calls her "big writing break," was a cover story for MS. MAGAZINE about feminism and heart disease, which lead to steady essay writing and opinion pieces in MS., MOTHER JONES, THE ATLANTIC MONTHLY, HARPER'S and other magazines.

In 2001, she released perhaps her most influential book, NICKEL AND DIMED: ON (NOT) GETTING BY IN AMERICA, which chronicles the year she spent working low-income jobs and living in low-income housing. She writes:

"We would stop at a convenient store for quote 'lunch' and people just didn't have money in their pockets. By money, I mean, two bucks. That's when I realized that people...were not eating because they couldn't afford to. And I asked this one girl...'How do you get through a whole day without eating?' And she said, 'Oh, I get faint by the end of it, I feel dizzy.' So, that's no good."

Ms. Ehrenreich has since released many additional books including BAIT AND SWITCH: THE (FUTILE) PURSUIT OF THE AMERICAN DREAM, based upon her undercover work as a white-collar job seeker, and her latest book, DANCING IN THE STREETS: A HISTORY OF COLLECTIVE JOY, which focuses on our species' desire for collective joy.