Amnesty for Insurers
As a businessperson who is advocating
for a universal single payer solution to our healthcare
system, I propose a subtle change in our argument.
Within the movement, we rail against big bad insurance
companies, tell stories about how they are heartless and mean,
and hold up their leaders as the embodiment of evil
profiteering from the misery of others. I propose that this is
not an accurate assessment of insurance companies, and we are
making a shrill argument that does nothing to influence the
mainstream business community who we need on our side.
Instead, we should realize that insurance companies are simply
businesses like any other. They are working hard to be
profitable and stay viable. They ply their trade, within a
construct of laws and economic realities, just like any other
business. Their CEOs are among the most brilliant and
accomplished business leaders we have.
Those of us who lead companies know that being successful is
not easy. You need to work hard, be creative, and duke it out
with the competition. Nobody hands you anything. There are
laws, rules, and economic realities which you work within and
which you can't control. It's an ongoing struggle in a
constantly changing business, social, and regulatory
environment.
The successful insurance companies are simply playing the game
as best they can with rules they didn't write. When they deny
coverage or fight claims, they are merely playing by the rules
that are currently in force. If a company isn't aggressive and
diligent in examining claims, their more efficient competitors
will put them out of business. Even though it doesn't seem
right, we should respect the success of the insurance
executives and CEOs, and acknowledge their business acumen. As
long as they aren't doing anything illegal, their
accomplishments should be compared to the accomplishments of
any other business leader. The insurance companies aren't the
bad guys; it's the rules of the game that are screwed up.
Am I saying insurance companies aren't bad? No. They are bad.
I'm sure they sit around and have discussions about how to
deny and delay coverage that would shock us. They are probably
even worse than we can imagine. But it's just the way the
system is set up.
For example, my company pays for health insurance, and we also
pay for workers' comp insurance. Whenever one of our employees
is injured, our health insurance company makes sure the injury
isn't work-related before they pay and, if it goes to workers'
comp, the workers' comp looks for evidence that the injury did
not happen at work. Both companies aggressively try to deny
the claim, if possible, and they each believe they are doing
it to keep my company's rates low. They fight each other, and
they do it on my company's dime because we are paying them to
fight each other. They think they are doing it on my behalf!
In the meantime, our injured employee is unable to get well
because neither company is willing to pick up the tab. It's
all a big expensive paper shuffle. The depravity of insurance
companies is a symptom of the problem; it's not the root
problem that we often make it out to be.
It's up to us to change the rules. We need a new game, and a
new system. We need to change the targets for the health care
system. It happens all the time to businesses. The government
outlaws high VOC paint, and paint companies suddenly need to
make low VOC paint. Consumers overnight stop eating pasta, and
pasta companies scramble to respond. The internet bubble
bursts! Stuff like this happens in business all the time. You
can bet your last dollar that the folks who are being
successful in the current system will have the brains and the
creativity to figure out where they can fit in the new world,
and we'll need them.
It occurs to me, for example, that Anita Smith could morph
into a wonderful spokesperson for a single payer system. If
she were running a company that was bidding to deliver
administration for the single payer plan for the lowest
percentage overhead, she would aggressively fight to win that
contract. You can bet that those folks who were successful in
the old system will continue to be successful in the new
system. They don't care if the rules change; they just care
about winning.
The bottom line is that it's up to us to change the rules of
the game. That's what Universal Single Payer is all about—new
rules and a new reality for business. If the rules are
designed right, then the actions of successful businesses will
result in greater health in our society. So I'm suggesting a
general amnesty for insurance companies and CEOs. They are a
symptom. They are not the root problem and we need to go after
the source.
Alan Jacobs 1/15/2008
If you'd like to respond to Alan's
letter, you can do so here.
