Health Insurance Follow-up

For Part 3 of my health care series, as promised, I conducted an interview with Bruce Benton, an insurance broker out here who works with Anthem Blue Cross, Signa, all the major health insurance companies. He was President of the Los Angeles National Association of Health Underwriters and served as Vice-President of Public Affairs for their California state board. This was supposed to be a conversation in which I’d get some insider perspective on what’s wrong with the health insurance system. I indeed did get background information, quite a lot of it actually, but this interview turned out to be much more complex than I’d anticipated. Why? He turned out to be a conservative.

This really threw me off because in all my interactions with him, Mr. Benton has been remarkably cool. And I don’t usually associate conservatives with being “cool,” so this was a surprise—we’ll just call him my friendly neighborhood Republican. Despite this pulling me in an entirely different direction, it was quite illuminating to hear the other side’s point of view. I have serious problems with what he said, but I felt he shared his opinions in earnest and that deep down he’s not a bad guy. It still freaks me out though, mainly because of how out of touch, intentionally evasive and judgmental a lot of his comments seemed to be. In any case, this interview raised brand new questions for me about the health care problem and put me face to face with why there’s so much controversy in Washington. I think I finally have a clue about why the Capitol can’t seem to get anything done—Democrats and Republicans are in many ways living on different planets.

So here’s what we’re gonna do: I’m going to give you my analysis of what he had to say, along with some clips from the interview, and then I’ll present responses from one of my favorite See Level pundits. So without further ado:

Here’s What I Think

Part #1:

Question: Is the health insurance industry what the media purports it to be?

Benton:

No. The health insurance industry isn’t primarily concerned with stockholder profits and equity, it’s just an easy target. Non-profits act the exact same way in how they assess risk, collect premiums, etc. These companies are really the good guys-- they’re in a difficult position and doing the best they can with the resources available.

So what about all the money they’re raking in? No no, corporate executives are just easy targets too. Consumer perception is the real problem; in seeing the industry’s high salaries and 10-15% rate increases each year, lots of people start thinking senior management should take a pay cut. The impact of their salaries on what you pay every month is extremely insignificant and besides, it’s not our business to dictate how much someone in private enterprise should pay themselves. We shouldn’t go after the health insurance industry’s means and ends because profits are the sign of a vibrant marketplace. In reality, health insurance people are just trying to make a buck like the rest of us.

Benton 1; Benton 2 (click to listen)

Rebuttal: While I agree that the insuring millions of people, keeping costs down for everyone and making profits must be really tough, let’s be honest--the health insurance industry isn’t hurting for money. The practices they use, including on young, healthy people trying to do the right thing, are without a doubt earning them a very pretty penny. That’s a lot more than “just doing the best you can.” To minimize how much these companies are motivated by personal financial gain would just be naïve. And that fact that oil and prescription drug companies were brought up as similar industries just doesn’t lend a lot of credibility to stating that health insurance companies are benevolent.

Now, while I agree that our monthly premiums don’t mainly consist of senior management payroll, I do believe that corporations have to be accountable to their customers. If the cost of health care is rising and our premiums are rising along with them, why should the boss still get his 15 million dollar bonus? Since we’re the ones cutting the check, don’t we have a right to ask these questions and deserve honest answers?

On another note, about the statement that published information in the media isn’t true-- there’s a reason health insurance companies like Blue Cross constantly make the news. Part of being a reputable journalist is that you don’t publish writing without facts, so if a health insurance company shows up in the New York Times for doing something wrong, it’s not because the paper made it up. This whole notion that highly regarded press organizations publish things they randomly made up is ridiculous. It’s the sort of crap Ann Coulter writes about… and the kind of thing that makes me wish I could raise just one eyebrow. Actually, when it comes to Republican ideology, I often think about how much I wish I could do that.

Part #2:

Question: Okay, so what about Blue Cross? They’ve been in the news quite a lot recently and they’re the largest individual health insurer in California. Are they just good guys too?

Benton:

You know all those cases Anthem Blue Cross has been sued for, well the truth is that all of those individuals who won their cases were actually at fault. Those previously insured members lied on their applications to get insurance. If they hadn’t deliberately concealed smoking, heart conditions, etc. Blue Cross would never have insured them in the first place. Innocent company investigations exposed their lies, so Blue Cross dropped their policies—something they had every right to do. Those members got exactly what they deserved. About the legal mess? Blue Cross got unfairly convicted for exercising their rights as a company.

Benton 3 (click to listen)

Rebuttal:

This argument makes no sense. First, here’s the back story. Anthem Blue Cross, the same health insurance company I wrote about in Health Care Part 1, has consistently been in the news for illegally rescinding members’ health care coverage when they’ve become very ill and run up high medical bills. Despite all the aggressive lobbying I’m sure went on, numerous impartial courts have convicted them and assigned millions of dollars in fines for these illegal practices. So considering all this, it would make sense that the prosecution had quite a bit of evidence that Anthem BC was indeed doing something very wrong. Now I wouldn’t begin to say that I have more inside knowledge of these cases than the people who tried them in court and won. If Blue Cross was ruled against in all those individual cases, I’m inclined to agree they had some culpability. Regardless, we're supposed to respect and uphold the decisions made by our courts of law and generalizing that Blue Cross was somehow right and all those people were wrong certainly does not do that. In Mr. Benton's statement, I also sensed a tinge of that Republican “you made it up” claim that I talked about before. So now, not only is the New York Times a bunch of biased haters, but apparently so is the California Supreme Court. Good to know.

Part #3:

Question: What are some of the biggest problems with the health insurance industry?

Benton: All those people trying to get free health care. Americans want health care when they need it, but lots of them don’t want to pay for it. Too many choose not to be responsible or accountable by buying health insurance and our lack of mandate to purchase it affords them that option. But those people get sick just like everyone else, so their bills get paid by the responsible people who actually buy health insurance. We live in a country that says “we cannot deny you critical emergency care at a hospital when you need it.” People think that means they can go without insurance because if they have an emergency, they’ll be stabilized at an ER. Without assets, they’ll just file bankruptcy and think "Bang, I’ve had free health care.”

Benton 4 (click to listen)

Rebuttal:

Yes. I’ll bet that’s exactly what millions of Americans are scheming. Let me first point out that he decided to point fingers at us first and not talk about any wrongdoing by the health insurance companies. This is ridiculous. Considering the sheer amount of reform legislation Congress tries to pass every year and how often insurance companies make the news, it’s not like they’ve got it all together. Is it really true that most of the 6 million uninsured people in California are that way because they’re trying to cheat the system? So the uninsured and the people who won their lawsuits against Blue Cross are all just irresponsible cheaters and liars?

Also, in this talk about how insurance is expensive because we the insured are the recipients of cost-shifting, I’m not hearing much about the health insurance companies absorbing costs. I hear about hospitals going bankrupt because they treat too many uninsured patients, I see my bill every month, what about the corporate execs? How are they doing their part-- is this “just the best they can?” Their paychecks suggest otherwise.

I also kind of got the feeling that Mr. Benton seemed to kind of disapprove of our national policy that ERs have to admit people who’re having a medical emergency. It was almost as if he wanted to say “Unfortunately, we cannot deny you critical emergency care, but we would if we could. It would be much cheaper that way.” Good to know how the other side sees it.

Do you hear that too?

Part #4

I asked if universal health care might be a viable option to alleviating our health care woes, to which Mr. Benton gave me some valuable information about how instituting this system would change the health care landscape. Using other countries as examples, he told me how there becomes a severe need for rationing of care based on the country’s inability to fund health care for everyone, especially at the levels Americans are expecting. In addition to significantly higher taxes, universal health care is also known to bring long wait times for essential treatment (3-6 months), and it’s common to see patients pass away while waiting for medical care. While I’m not convinced we should give up on the idea altogether, this information made sense to me and seemed very objective.

Mr. Benton then included this statement about the American consumer mentality: Benton 5

So, is this what the conservatives really think of us? Not only do some of us try to steal health care, but we want the best of everything and never want to pay for it. We’re selfish-- we want the latest technology when we're ill, we want to “keep our family members around forever,” all without footing the bill. And like a bratty kid, we bite the hand that feeds us—we blame health insurers and how much they earn when we don't like our monthly premium. So I guess that’s what they think of us, we’re just a bunch of spoiled brats.

Are we? Now I understand and agree that Americans are notorious for wanting something for nothing. I see it all the time, especially here in L.A., but I have real trouble accepting that our health care problems are all our fault. I’m not so sure the American people are deep down just a bunch of users who take what they want and totally disregard how it affects other people. Do most people not buy health insurance because they’re irresponsible and don’t care if someone else has to pay when they get sick? Are we that base? I don’t know, I think people don’t buy health insurance mainly because they can’t afford it. My premium is $316/month right now and while the national average in 2004 was only $189, that’s still a lot of money for a great number of people. I also understand that we too often look to health care to make our pains go away and sometimes to save our lives and the lives of our loved ones, but can you blame us? Modern technology has taught us that when a person contracts a terminal illness it doesn’t automatically mean their life is over. There’s a chance that they’ll survive because of medicine and powerful new treatment options, and when that person is our mother, father, sister, why is it so unforgivable that in those times we'd want everything to ourselves? Doesn’t love and desperation make everyone a little selfish?

What most offends me about these conservative opinions is the lack of humanity. I re-read and re-listen to them and I just don’t hear empathy, I don’t hear “we’re on your side, we’re all in this together.” In fact, I hear the opposite, “look and what you did,” "you did this to yourself," not “what can we do to contribute?” There’s no benefit of the doubt, just this ugly assumption that underneath it all, you’re nothing but an user.

This all makes sense—look at the Bush administration and how it’s flagrantly disregarded civilian rights and common human decency. All along I’ve sort of known this is what the Republicans think, but to have it in my face makes me even more scared for this country. This is what we’re up against; no wonder people voted for Obama. He still seems like one of us, like he’s on our side, and that is giving people hope that government might not have to be a game rigged against them. This speaks to the core of who we are as people, how we want to be treated by those who represent us and what role government can play in making our lives better.