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Insurance Companies are the Problem

Updated: Jun 9, 2019

by: Barbara Peterson April 28, 2019

My husband has spent a lifetime fighting to breathe. His allergies and asthma have been a constant battle: seeing different medical specialists, having various tests, and trying a wide range of medications. It wasn’t until his late 40s when he found a medication that made a significant improvement in his breathing. Dulera turned him from being a multiple-daily user of a rescue inhaler to someone who hardly ever uses a rescue inhaler, and from being someone who went to the emergency room a couple times a year for severe asthma attacks to someone who hasn’t been hospitalized even once.

That’s the good news. The bad news is, in their infinite drive to increase their own profits at the dangerous and severe cost to working people, our insurance company decided to stop covering Dulera. My husband has been reduced to the following options: pay $350/month for the medication, go without, or go with a substandard medication that the insurance covers but that will diminish him to suffering severe breathing issues again. My husband, who owns his own business, a small family-owned and operated Portsmouth, NH retail store for over 60 years, cannot afford to be healthy.

Our story of health insurance problems began several years ago. Like many other families and individuals, our insurance premiums have risen significantly each year. Approximately 10 years ago, we could afford for him to be on a Gold plan so his prescriptions were covered. When the premiums went up, he switched to a Silver plan where his prescriptions were only moderately covered. So, we were paying as much for the Silver plan as we had for the Gold, but he was getting far less coverage. When the cost of that plan increased, he switched to a Bronze plan. Again, far less coverage for the same price as we had originally paid for the Gold plan. Just recently, his insurance dropped Dulera, which means we are paying high premiums, getting little coverage, and now he has to pay out-of-pocket for the one medication that finally enabled him to live a healthy lifestyle.

No one deserves to suffer from inadequate healthcare coverage, regardless of their socio-economic position in society. Yet, my husband doesn’t even fit the GOP stereotype of someone suffering from inadequate healthcare. He’s a college graduate who works full-time, he’s married to a college graduate who also works full-time; he owns his own home, pays all his taxes (and he wouldn’t even mind releasing his tax forms!), has helped put both his children through college, and he contributes positively to his community with a small, family-run business that provides quality service and products with integrity and decency. If middle-class, hard-working families and individuals cannot afford quality healthcare in this, one of the wealthiest and most powerful nations in the world, something is fundamentally wrong.

The underlying cause of my husband’s and so many others’ problems in accessing affordable, quality healthcare is insurance companies. Robert Kuttner explains in his book, Everything for Sale, that when insurance companies adopted the market model, profit was the bottom line, and it rules every decision in place of care for patients.

No hospital should turn away patients in emergencies. No one should want for basic medical care because of limited purchasing power. Children should be vaccinated against preventable diseases. Basic sanitation should be universal. We embrace some of these principles out of a sense of fellow feeling and shared community. As empathic creatures, we may allow market forces to determine whether some people can never afford filet mignon, but not whether some people must die because they can’t pay the doctor… Much of the recent history of health policy in the United States has been a hapless effort to bring “market efficiency” and “pro-competitive reform” to a sector that is inherently extra-market. (pp. 110-111)

In a society where everything is for sale, we risk harming individuals’ general wellbeing. Essential products and services – such as education, firefighting, public parks, prisons, postal services, highways, museums, national defense, and healthcare – should lie outside the market because they provide for the public good. Once we privatize any of these, the market demands of profit over all other considerations destroy the chances that these necessary products and services will be affordably available to all persons.

Approximately 10 years ago, my husband and I paid $450/month for health insurance for our family. Currently, we pay $1300 for far less coverage for just the two of us. Each year, the plans have gone up in price and offered significantly less in coverage. As Kuttner claims, the most efficient way to make money in the health-care business is to avoid sick people or to limit care – maneuvers plainly at odds with our social objectives (p. 111). So long as insurance companies have an overriding say in what healthcare costs, and as long as they are run as for-profit businesses, most working Americans will not be able to afford quality medical care.

Single-payer healthcare that provides a high-level of basic services, promotes cost saving programs such as those that offer fitness training, nutrition education, preventative tests and screenings, check-ups, dental cleanings, and immunizations. Preventative programs save people from seeking emergency care, by far the most expensive way to receive medical services. Additionally, it frees small businesses from an expense they typically cannot afford, which encourages and supports entrepreneurship, the backbone to a growing economy. Furthermore, it allows employees the freedom to change jobs, giving people better opportunities for job satisfaction, which leads to better work performance.

If we look at healthcare as a universal human right, we are obliged as a nation to ensure that all Americans have easy access to high-quality, affordable medical care. The nature of markets, however, is that they create gains for some and serious losses for others. We may be able to justify this when it comes to luxuries such as jewelry, designer clothing, messages, luxury cars, lavish vacations, and other non-essential goods and services, but we cannot, or should not, justify it when it means only some can afford the healthcare they require while others lose the ability to seek needed medical services.

Healthcare is a public good. Insurance companies, who are driven by competitive market forces, should not be allowed to determine who can and who cannot receive medical care. Some things should simply not be for sale, namely, those things that people require to enjoy their fundamental and inalienable rights to life, liberty, and the pursuit of happiness. Subjecting healthcare to the greed of a market-run insurance industry jeopardizes people’s inalienable rights. And that is as un-American as it is immoral. Private insurance needs to go, or at least, it needs to be relegated to the role of providing supplemental services to those who can both afford it and want it. If we truly care about the wellbeing of our people, and if we are committed to holding true to those natural human rights outlined in our Declaration of Independence, we need to get rid of market-driven insurance companies and, instead, provide healthcare universally as a public good.

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