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Sunday, June 28, 2009

Health Care as Health Justice

Health Care as Health Justice
Image © Austin Cline
Click for full-sized Image

Now that the government is looking seriously — or half-way seriously — at some sort of health care reform, maybe people will have their eyes opened about the state of health care and health insurance in America. Perhaps they will figure out just how bad the health care system has become and how extensively they have been exploited by the health insurance industry — not to mention the degree of complicity of the politicians who have been the paid servants of the insurance industry rather than the representatives of the people.

Then again, maybe not; but people will only wake up when they're faced with all the problems and stop believing the lies and propaganda which the insurance industry and their political servants keep putting out. If the current hearings and debates aren't sufficient to reveal enough of the truth to enough people, what would it take?

Buying Politicians with Blood Money

The insurance industry of course opposes any reform, and that's why they've tried to offer token concessions. They don't want to be forced by law to treat people justly; instead, they want to continue extracting every last dollar possible out of customers while avoiding paying claims. Their primary concern is maximizing profits for shareholders, not maximizing the health of the people they insure.

This is incompatible with both public health and public justice, but it's also exactly how any other corporation is supposed to be run. This is important to keep firmly in mind because regardless of how unjust or immoral the outcome of such decisions may appear to us from our lowly human perspective, those decisions consistently follow the capitalist, corporate logic which you can find in other industries. It's just that this logic doesn't usually cause quite so much obvious and immediate suffering or death in other contexts.

Some of the profits they make can then be paid to politicians to ensure that this practice can survive. It's the insurance industry's business model of demanding increasing insurance premiums while denying medical claims that must be kept alive at all costs, not the human beings whom the politicians are supposed to be serving.

To accept the insignificant concessions of the insurance industry would be like accepting promises from factory owners to implement voluntary coffee breaks once a day in exchange for not passing laws imposing a minimum wage, a 40-hour work week, basic safety standards, and so forth. Hey, didn't the Republican Party and businesses oppose all of them as well? Accepting such concessions wouldn't have been just and wouldn't have protected or advanced the interests of the workers, so why accept a similarly bad deal for the entire public?

The Best Arguments They Have

When businesses and corporations oppose the imposition of just standards on their practices, they usually manage to offer plausible-sounding arguments — they might be bad arguments, but they can sound plausible if you don't think too much about their implications. In this case, however, the arguments being offered by the insurance industry are outstandingly bad. They are among the worst I've ever seen, and I've seen some really bad arguments. This may be a sign of just how bad the position of the insurance companies really is.

For so long, health insurance companies and their Republican fluffers have insisted that any sort of public health insurance plan would be horrible because the government just can't do anything right. Everything which the government tries to manage turns out worse than it started, while everything run by private businesses is always better (sooner or later) because the profit motive ensures the best possible outcome (which sounds an awful lot like the "Best of All Possible Worlds" theodicy offered by Christian apologists, doesn't it?).

That's why the American health care system is the "envy" of the world — we have the "best" health care system because it's full of innovation and efficiency created by the free market. Apparently, the free market is so wonderful that it produces improved health care by people who are only seeking to improve their profits regardless of the quality of health care produced. Everyone else in the world envies us so much that they know they can't achieve the same thing, which must explain why no one is wasting their time trying to emulate us.

Now, however, the insurance industry is also claiming that if a public health insurance option exists, then so many people will flock to the public option that the private insurance companies will be run out of business. Oh, how sad for the insurance companies! They fear being driven out of business by a public insurance plan which would be hopelessly incompetent and provide significantly worse health care than what the private insurance companies currently do. Huh? The only way awful health insurance from government would attract large numbers of people is if private health insurance is worse. What a way to defend one's industry and business model!

Injustice as a Business Model

It is, of course, their business model which they are worried about. There are lots of possible problems which may accompany government-run health insurance. Few if any of them do not or could not also accompany private health insurance — except of course for those wealthy enough to afford the best possible health insurance. They, however, will always be able to buy supplemental health insurance because if there is a demand, someone will try to create a supply.

The one thing that a government-run health insurance system can avoid which private health insurance cannot is exploitation of the people being insured. Private health insurance companies will put profits for shareholders above the lives and health of the insured unless forced by law not to, but that would difficult to implement and regulate. Government-run health insurance has no incentive to put profits above lives; on the contrary, it has incentives to put lives above profit because that's what the people will vote for.

Taking people's money then refusing to provide the health care customers thought they were paying for is clearly unjust, but doing so successfully is how the private health insurance companies continue making a profit. They think they have a right to make money by helping their own customers into early graves (or at least early disability), but the system needs to be changed to eliminate both this false "right" and the attitudes which have generated the belief by so many that they are entitled to such a "right" in the first place.

New Propaganda Poster Site: Whenever I've been asked about the images I create here, I've had trouble directing people to them — never mind the best ones — because they've all been buried in the General's archives. I've long wanted a place where they could all be gathered together for easy search and reference and, finally, I've created one. I'm not satisfied with everything yet, but it's far enough along to tell people about.

This does not change anything about my posting here. This is still the primary site for publication of my sermons and posters. Reposting on the other site will lag publication here by several days (so just about everyone who's going to read a new sermon will have done so by the time I repost it on my site).


  1. Excellent post, holmes! I would just quibble with one point. The insurance companies are actually not really run for the benefit of their shareholders; they are run for the benefit of their executives and board members. One of the reasons that corporate capitalism is failing so severely right now at avoiding economic catastrophe is that corporate executives and boards have figured out how to game the system so that shareholders get fleeced while executives and boards get massive payouts.

  2. I think that was just an excellent comment Prof, but I would quibble with several points. It has never been about the shareholders, but the beautiful people, the special people who have worked so much harder than the others. They are entitled to so much more than the "have nots."

    Everybody knows that the "have nots" would have more if they had just worked harder, been born in the right families (who can you blame for that?), and done just so much more to earn their privilege and benefits. Everybody knows providing healthcare to people that haven't earned it is just one more slippery slope to nobody doing anything for anything. It is accepted an conventional wisdom that people just aren't going to bust their asses unless they're starvin and in pain. To treat the "sufferin would defeat the whole purpose of the suffering, after all. There has been a lot of mcmansions built on this suffering what would you and Clinismfascist have them do, let them fall into disrepair? It takes a lot of pain and suffering to maintain these lifestyles and give the suffering masses something to aspire to. They need these aspirations wihout which they all would probably just lay down and die.

  3. It's worth noting that the "government can't do anything right" argument only seems valid when the government is run by people that enter public office presuming exactly that.

    When individuals with some faith in the power of a government to execute the citizenry's collective will, things seems to go pretty well. It was an act of government that ended slavery. It was government that instituted universal literacy. It was government that built the highway system, the Hoover Dam and put a man on the moon.

    Government does a pretty good job when the right people are in charge.

  4. Dear Comrade Clineskibergdorfmannerfeldeisenweisel:

    I was you, bub, I'd be seein' to my own health, 'stead of worryin' about them lunchbox proles that can't afford to get taken care of. You're like all, "boo hoo, Timmy needs an operation or he's gonna die, Mr. Scrooge" and I'm like, "Well, fuck the little bastard. His legs are wasted but his liver an kidneys are in great shape and, hey, let's face it, there's never too many young hearts for the voracious appetites of the DorkLordCheney.

    Like I said, though, you need to be worryin' about your own health. When I catch up with you, your liver is gonna be pate' mofo!

  5. Thomas, Which act was that, that ended slavery? The minimum wage, maybe? Help me out here.

  6. A shining / mind-bottling example which epitomizes the disfunction of privatized healthcare:

    The prescription stop-smoking medication Chantix can cost upwards of $15 per pill. The corse of medication last appx. two to three weeks. For lower income individuals, often those whose employers do not provide healthcare and are unable to purchase it on their own , this pricing structure is cost prohibitive.
    If corporations were sincerely interested in the long-term health of their clients why is this small, upfront investment in preventative medicine not covered with a single copay or subsidized in some manner?
    Thinking about it more... Maybe smoking and nicotine addiction are pre-existing conditions. Yup, since the brain naturally (or without outside stimulus) produces nicotine receptors although we are not born addicted we are born with the propensity for addiction. Hmmm, I bet we could justify not cover all sorts of illnesses (cancer anyone) based on this new theory of what does and does not constitute a precondition.

  7. This US health care debate seems infinite...

  8. Wow nice post..

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We'll try dumping haloscan and see how it works.