The Sellout

Sen. Max Baucus is in the process of cutting a deal with the insurance industry, and of undercutting the movement for health insurance reform that has gathered so much momentum in these last four years. I don’t know what the final product will be – I only know that unless Democrats can mount severe and direct pressure on Baucus, he will not change his ways. That is, they have to threaten to hurt him.

They have never done this before. I doubt they will do it now.

First, a word about private health insurance: It is structurally incapable of offering universal care. It does a fairly good job of covering people in the workplace. This is because people in the workplace generally are not there because they need health insurance. Consequently, adverse selection is avoided. I have no doubt that, job insecurity aside, most people who have insurance through their job would like to keep it. I have had it myself, and coverage was very good.

Outside the workplace, it’s a different story. There are professional organizations, such as engineers or accountants or small business owners, who are drawn together for reasons other than health insurance. These groups sometimes offer health insurance to their members. But more and more these groups are denying insurance to members due to adverse selection – people joining solely to get health insurance. I was turned down for insurance by the Montana Society of CPA’s because of my preexisting condition. I no longer belong to that group.

Individuals trying to buy insurance on the open market are pretty much screwed. Either they are fairly well-to-do and healthy, or they will not be offered coverage. If they can afford insurance but have one of the hundreds of conditions that qualify as “preexisting”, they’re out of luck.

The health insurance companies are running a business. They have to do what they do, otherwise claims will skyrocket. Premiums will follow, and people will drop coverage, and eventually they’ll be left covering the already-sick at enormous cost. Health insurance companies are not run by bad people – these are smart people who are selling a product that simply cannot meet our needs. I don’t wish ill on any of them. I only want them to find a new profession.

Private insurance is heavily bureaucratic and expensive. They have to pay high commissions to sales people to sift through the population to find profitable clients. They have to generate a profit for investors. They have to avoid paying claims, requiring expert staff to justify the practice of formally denying benefits. And they have to dump their costs – on patients, hospitals, doctors, government, and other insurers.

But there two ways that private health insurance can both meet our needs and be profitable: 1) If coverage is mandatory; and/or 2) if government subsidizes it. But to demand that people buy their product is neither fair nor wise; to subsidize it is to institutionalize their inefficiency.

There is really only one solution in our diverse country: Single payer. But that won’t happen anytime soon. In the meantime, we need a mixed system, with private insurance operating in the employed workforce, and government insuring anyone who wants coverage (with subsidies for the elderly and the poor). This is called the “public option”.

Now comes Max. He’s already taken single payer off the table. Fair enough – it’s not going anywhere no matter what. But yesterday, he had doctors arrested for trying to butt into his private circle of friends. He’s really gotten to be an arrogant dick.

According to Open Secrets, Max’s top contributors, 2003 to 2008 are as follows:

Securities and investment ($1,003,018); Health professionals ($851,141); Pharmaceuticals and health products ($850,131); Lawyers and law firms ($791,004); and Insurance ($784,185).

I didn’t see a listing for “the uninsured and people abused by insurance companies”. So we’re screwed. We spend a great deal of time trying to analyze the impact of campaign contributions – do they influence a politicians vote? I can answer that: Duh. It’s worse than that – every dollar has the impact of two dollars: If Baucus doesn’t collect these dollars, they will go to a potential opponent. He too is a smart business man.

So what is coming down the pipe? Probably we are going to get some sort of universal plan with a mandate that people buy insurance from private companies. Unless 70 House Democrats prevail, there will be no public option. Insurance companies will be required to cover people with preexisting conditions, but this is key: They will be subsidized. Government will pay them to do so. Add one more layer of costs to our already-overburdened system.

Ordinarily a piece like this ends with the words “Write or email Senator Max Baucus. Tell him you want health insurance with a public option.” That’s bogus. First of all, emails are pointless – they are too easy to generate and submit en masse. And letters take weeks to get to him due to the anthrax scare. And anyway, he’s not listening.

Instead, I ask the following of Democrats:

Turn against Max Baucus. Punish him. Hurt him. Call his local office. Don’t even think about being civil. Write nasty letters to the editor. Organize groups to picket his offices, letting the newspapers, who generally support him, know what you are doing. (That way, they can ignore you too.) Vote for his opponent when you get a chance, even if that opponent is a Republican or a whack job. Above all, be nasty to him. Let him know he is a schmuck.

Max is extremely vain, and treasures his image. Tarnish it. Face him head on, tell him what you really think. Don’t stutter.

Max is not a sellout. He never had to sell out. He’s bought, from the very beginning.