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.


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