Why Do We Need Health Care Reform? Don't Ask George Will

by Wendell Potter — July 3, 2009 - 7:04pm
  • Topics: Pundits, Health, Think Tanks
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    One of the things I hope to do with my post is to call out misleading statements and statistics, outright lies and illogical assertions by opponents of meaningful health care reform—and to rat out the front groups that insurers and other special interests are funding to kill reform or, failing that, shape it to their benefit.

    I'm starting with a biggie, conservative author and columnist George Will, who suggests in his June 28 column in The Washington Post that, because of the complexity and expense of reforming the American health care system, maybe we would be better off just leaving well enough alone.

    Well enough? For him, maybe. He's got a great gig at the Post and as a TV network pundit, and he has sold lots of books, so he probably doesn't have to worry, as most other Americans do, about being just one layoff away from joining the 50 million other men, women and children in the ranks of the uninsured. And even if the Post gave him a pink slip this afternoon, chances are he has stashed enough away that he can afford to shell out the nearly $13,000 that the average annual premium for decent family coverage costs these days (and that was in 2007).

    The median household income in this country is just about $50,000. I'm betting it has been a few years since Will faced paying more than a fourth of his family's annual income—before taxes—just to cover the health insurance premiums. More and more of us also face paying thousands more of our hard-earned dollars in out-of-pocket expenses before the coverage we pay so dearly for actually kicks in. If Will and other critics of real reform just did a little simple math, they would understand why the number of people without insurance is so high and growing so rapidly, and why at least 25 million more of us are now under-insured.

    After telling us we might live to regret trying to reform our dysfunctional non-system, Will makes this assertion:

    "Most Americans do want different health care: They want 2009 medicine at 1960 prices."

    Yeah, that would be nice, and it sure makes for a great quip, but no one I know expects that. Maybe he knows "most Americans" better than I do, but I doubt it. Instead, I suspect he sees the world in much the same way insurance company executives see it from their spacious offices, the windows of their chauffeur-driven limos and the corporate jets that fly them comfortably over "most Americans." When you're at that altitude, it's hard to get a real fix on what most Americans want, much less what so many of them so desperately need.

    To be fair and perfectly honest, I saw the world that way too for most of the 20 years I worked inside the insurance industry. The more money I made and the more perks I was given, the less I thought about the hardships many people face who are not as privileged. It took seeing thousands of people standing in the rain in long lines to get care in a barn just a few miles from where I grew up to finally get it.

    It is true, as Will notes, that many Americans enrolled in employer-sponsored health insurance plans have been able to rely on their employers to pay the lion's share of the premiums. What is also true, but not mentioned in his column, is that fewer and fewer Americans can get coverage through their employers these days, and that of those who can, most are now having to pay a larger share of the premiums and much higher out-of-pocket expenses.

    According to a recent Wall Street Journal story, the number of small employers offering coverage has dropped from 61 percent to 38 percent since 1993. And the way insurers and employers are dealing with medical inflation is to shift more of the financial burden onto the shoulders of working men and women.

    Insurers and their ideological allies, like Grace Marie Turner of the Galen Institute and Betsy McCauaghey of the Hudson Institute, both of whom Will cites as experts in his column and both of whose organizations are corporate funded, say this is a good thing because, they contend, Americans have been insulated for far too long from the real costs of health care.

    That's easy for someone to say who has never had to file for bankruptcy, as millions of Americans have, because the insurance coverage they were counting on didn't come close to covering their medical bills when they got sick or had an accident. And it's easy for a rich, famous and out-of-touch columnist to callously content that all Americans really want is 2009 medicine at 1960 prices, so let's just call the whole thing off.

    Wendell Potter is the Senior Fellow on Health Care for the Center for Media and Democracy in Madison, Wisconsin.

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    No skin in the game

    Submitted by Indypendant (not verified) on August 13, 2009 - 8:05am.

    Mr. Potter is spot on with his comments about George Will. The right loves to say that many Americans have insurance and are perfectly happy with it, but what they don't say is how much these Americans are paying per year for that coverage, or how much of an impact their premiums have on their purchasing power. I think the average family premium is now closer to $16,000 per year and for many people who profess to be happy with what they have, I'd be willing to bet they are paying only a fraction of that cost. In the words of the insurance industry, they have no "skin in the game".

    The biggest problem with the current system is that the costs of managing risk for our entire population are being borne inequitably by too few people. No one who shows up at a hospital needing treatment will get turned away- the costs just get shifted elsewhere, mainly in the form of higher premiums for those who are covered. Moreover, if you work for a small company (like less than 100 lives insured), you are penalized because your small risk pool represents an expensive account for the insurer, so they jack your rates up through the roof. Meanwhile, larger companies with safer risk pools get better deals. How in the world is that fair?

    Lastly, what I find most perplexing is that someone like George Will would fail to understand how the current system hampers entrepreneurship and limits American competitiveness. People are afraid to start their own companies or move to better jobs because they can't afford the health insurance. Companies have to pass the costs of insurance on to customers...doesn't George get this? Either he is just not paying attention or he's bought the line of the insurance industry. I'm betting on the latter.

    So you are mad because

    Submitted by Anonymous (not verified) on August 12, 2009 - 6:33am.

    So you are mad because George Will makes enough money to pay for his health care? Why don't you make more money and pay for your own darn health care?

    inequities

    Submitted by Anonymous (not verified) on August 13, 2009 - 7:43am.

    At the heart of the matter lie the basic inequities that exist within our current system. Read the history books about the robber barons and see if there is not some similarity to the CEOs for example. The disequilibrium is the problem. I urge you to think carefully and not simply give a knee jerk reaction. If you are one of the lucky ones who can afford health care, that is awesome. However, do you believe that makes it ok, or even good, to ignore the fact that others cannot? Do you honestly believe that health care is a commodity that should depend upon the value that society has placed upon you? Open your heart and stop worrying about opening your wallet. If you fear that helping others will give you less than either you don't have much, in which case, one would think you would sympathize, or you have not considered the humanistic side carefully. Be thankful you have what you have and imagine those working hard to get even the mininimum necessary to survive. And don't kid yourself, they are working hard. For every person who is not working hard to live on the low end of the scale, we can find a person on the high end who 'works' by playing golf and taking people out to dinner. Of course, there will always be some hierarchy, but we have allowed it to go on too long.

    Health Care Reform

    Submitted by Thomas Radich (not verified) on August 1, 2009 - 2:12am.

    Dear Mr. Potter,

    I am grateful for your courage to speak out on the Healthcare issue and expose the efforts by the Healthcare Industry to derail real healthcare reform. Unlike the belief's of Frank Lutz & his Republican counterparts that a Public Option will lead to rationing, I know as well as they do that we already have rationing with the current Industry run system!

    I have also asked my German friends what their opinion is of Germany’s Healthcare system and they said they were very satisfied with the service and care they received when they lived in Germany. Unlike Frank Lutz’s talking points they did not experience rationing or government interference with their healthcare while living in Germany.

    Please keep speaking out and working to dispel the miss-information & propaganda perpetuated by the Healthcare Industry and their Republican supporters. Below is a letter I sent to Senator Feinstein on this topic.

    Sincerely,
    Tom

    Dear Senator Feinstein,

    I just want you to know that I support President Obama’s suggestion for including a Public Option in the Health Care reform plan. The main reason I can think of as to why someone would not support a public option is that they are too close to the health care industry and maybe accept too much money and or support from this industry. I wonder what their position on this subject would be if all elections were publically funded and they could not accept any money or support from the health care industry?

    First of all I do believe that health care is a right and not a privilege. With this premise in mind then maybe the basic heath care providers should operate as “Not for Profit” organizations and should not be set up as for profit businesses? I urge you to work for the American citizens and put their interest first before the Health Care industry in this debate and restructuring of our health care system.

    If you take the side of Republicans like Representative John Boehner and the health care industry then I will be very disappointed in your position and you will lose my support as well as my other Democratic friends support. We will work to get Democrats elected who truly support the citizens of this country and not special interest like the Health Care Industry!

    Sincerely,
    Thomas Radich

    PS: It seems to me after listening to the debates on health care reform, Cap & Trade & reform of the financial institutions by Congress, that the only hope for real reform in any area is to get money out of politics. The special interest groups seem to have much more influence over Congress than the American People. I urge you to also support campaign finance reform & I support publically funded elections.

    Why Not Compassion vs. Cost?

    Submitted by Gary Namie (not verified) on July 29, 2009 - 10:55am.

    Glad that a former insider has entered the fray. It doesn't matter when you, Wendell, saw the light, but that you did and are willing to share your perspective in a very public way.
    Why can't we re-frame the criterion for change. Now, it's all about cost and minimizing profit (only for those on our side). But it is essential to dare the disbelievers to call up that nationalistic fervor over Americans as compassionate and caring (a powerful myth that is probably now only rarely true). Your experience at the "expedition" made the U.S. appear like a 3rd world country. We can be no better as a nation than how we treat the poorest among us. Wonder if the pundits could gravitate toward the bumper sticker-length mantra that "We Owe Health Care to Our Fellow Americans"? We need to counter divisive slogans with other ones.
    "Socialized" programs for society are no more threatening compassion for the sick and helpless. And we are all helpless thanks to the insurance industry's grip on access to health care providers.

    health care reform

    Submitted by Anonymous (not verified) on July 15, 2009 - 4:21pm.

    We need reform when there are so many people who can't afford reasonable health care, and insurance is largely a racket business. I am concerned about WHAT kind of reform we will have, because it isn't fair to make the public pay through the nose for the health care of people who choose to smoke, eat excessively, get unnecessary abortions, and many other lifestyle choices that result in high health care expenses.

    ...people who choose to

    Submitted by Mutternich on July 18, 2009 - 7:22am.

    ...people who choose to smoke...

    You mean people who got sucked in by tobacco company marketing and peer pressure as kids and then found themselves hooked as adults, just as the tobacco companies intended? If we had a government-run single payer system, the government could simply bill the tobacco companies annually for the money it spent on care for tobacco-related illnesses, plus a suitable multiple of those companies' marketing budgets. That would be a more humane and more just solution, and one that would help more to get rid of smoking altogether, than simply withholding coverage from smokers.

    ...get unnecessary abortions...

    Who'll pass judgment on which abortions are "unnecessary," some committee of James Dobson clones? You'd better hope not, unless you as a taxpayer are willing to foot the bill for the many times larger social services costs the unwilling and likely unprepared mother will require for years to come. Oh, and you might want to stop covering Viagra but not contraception as well.

    "misleading statements and statistics"

    Submitted by Dara (not verified) on July 13, 2009 - 9:48pm.

    Mr. Potter,
    I appreciate your argument about George Will's column, but I encourage you to be more careful in your own claims, especially given your desire to "call out misleading statements and statistics." You write "chances are [Mr. Will] has stashed enough away that he can afford to shell out the nearly $13,000 that the average annual premium for decent family coverage costs these days... The median household income in this country is just about $50,000. I’m betting it has been a few years since Will faced paying more than a fourth of his family’s annual income—before taxes—just to cover the health insurance premiums." But the dollar amounts that you're comparing come from groups that aren't comparable. The "average annual premium" you reference is not an average across all families; it is for a family of four, and median income households are more likely to only have three people in them. I'm also guessing that the "average" annual premium is a mean, not a median, and while I don't expect that the mean and median health insurance costs vary as much as the mean and median incomes, it's still not clear to me that it's appropriate to compare a mean cost with a median income. You also shift from families (for the premium cost) to households (for income); families and households are not equivalent, as the members of a household need not be related. I agree with your overall argument, and the general thrust should still be true if you use more accurate comparisons (although probably a bit less dramatic). If you're sloppy about these kinds of category shifts, though, you're telling Mr. Will and others that it's OK for them to be sloppy too. And of course for some people, it may not be sloppiness; it may be a purposeful decision to mislead others by shifting among non-interchangeable categories while glossing over the fact that the categories aren't interchangeable. Thanks for your work. I was glad to see your interview with Bill Moyers, which is what lead me here. We need more people to join you in speaking out.

    "misleading statements and statistics"

    Submitted by Dara S. (not verified) on July 13, 2009 - 8:07pm.

    Mr. Potter,
    I appreciate your argument about George Will's column, but encourage you to be more careful about your own claims, especially given your desire to "call out misleading statements and statistics." You write "chances are [Mr. Will] has stashed enough away that he can afford to shell out the nearly $13,000 that the average annual premium for decent family coverage costs these days... The median household income in this country is just about $50,000. I’m betting it has been a few years since Will faced paying more than a fourth of his family’s annual income—before taxes—just to cover the health insurance premiums." But the dollar amounts that you're comparing come from groups that aren't directly comparable. The "average annual premium" you reference is not an average across all families; it is for a family of four. In contrast, the mean household size is 3. I'm guessing that the "average" annual premium is a mean, not a median, and while I don't expect that the mean and median health insurance costs vary as much as the mean and median incomes, it's still not clear to me that it's appropriate to compare a mean cost with a median income. You also shift from families (for the premium cost) to households (for income); families and households are not equivalent, as the members of a household need not be related. I agree with your overall argument; I just think that you need to be more careful about these category shifts -- if you're sloppy about this, you're telling Mr. Will and others that it's OK for them to be sloppy too. And of course for some people, it may not be sloppiness; it may be a purposeful decision to mislead people by shifting among non-interchangeable categories while glossing over the fact that the categories aren't interchangeable. Thanks for your work. I was glad to see your interview with Bill Moyers, which is what lead me here. We need more people to join you in speaking out.

    Universal Health Care

    Submitted by SeaClearly (not verified) on July 12, 2009 - 2:59pm.

    My response to the supposed Health Care debate (which leaves out single-payer views): http://seaclearly.wordpress.com/2009/06/19/health-care-solved-are-you-poor-sorry