It appears that whatever changes this “health care reform” process brings about will be set up to serve the health insurance industry. They will get the two things they want most – subsidies, and mandates that we buy their products.

There is not much time left before the IRS begins demanding insurance certificates from us as part of our tax return. In the meantime, I think it a good time to inflict the only damage that we can. If you are reasonably healthy, take 17 months and 29 days off. Enjoy life, pay yourself a bonus for once.

If you are at risk, if you are ill and have insurance, hang on to it, and cash in on it to the largest degree possible.

Let’s temporarily turn the cash machine around. It is all we will have left after the Democrats are done reforming things for us.

I was once fake-employed in order to qualify for a group insurance policy for me and my wife through Aetna. Because my “employment” was in Colorado, and we lived in Montana, there were no networks available, and all of our coverage was with doctors of our own choosing. (Aetna limits which doctors you can see in Colorado.)

I did what health insurance and “free” market apologists said I should do with regard to my wife’s knee – I shopped it around. She needed a total knee replacement. I called Bozeman Deaconess to see how much it would cost, they couldn’t say. I called Aetna to see how much they would cover, they couldn’t say. But they did say this: They would only cover the primary surgeon, and not the assistant. I told the hospital about that, and they said they didn’t care, that they don’t do surgery without an assistant on hand. Since we were not in the network, we’d have to pay deductibles, co-pays, the assistant surgeon, and anything else the insurance refused to cover for any reason. Our exposure was open-ended, and so decided not to have the surgery at that time.

So we were smart consumers, and did just what Aetna wanted – we didn’t have the surgery on their watch.

Over the past ten years (or more) I’ve had quite a few interactions with people who believe in “free” markets, and unrestrained capitalism and trade. Many of these people believe that we are all isolated individuals, each of us responsible only to ourselves and bound to pay our way. Any program paid with public funds is a form of forced charity, and any tax on an individual a form of theft.

It’s an odd set of perceptions and, fortunately, only a few people carry things to such extremes. What stirs my curiosity is not the libertarians/Randians who carry these views, but rather those who take advantage of such ideologues.

In the health insurance business, people often make cold and calculated decisions – to reject people for coverage, to rescind coverage when someone gets really sick. But I’ve observed further in the business world that there are certain people whose whole life ambition is to “win” the game, to accumulate as much as possible. They don’t seem to care about anything else. They don’t care who they deceive, who gets hurt, who is bankrupted. Such people would feel at home in the health insurance business.

I suspect these people are sociopaths. Dr. Martha Stout, a Ph.D. at Harvard, thinks that as much as four percent of the population are sociopaths of varying degrees. Others put the figure lower, as low as one percent. The number might rest somewhere between 1-4%.

Who are these people? I’ve met quite a few, as we all have, though we don’t know it. We might think that they tend to go into the serial killing business, but most lead much more mundane lines. The military, the cops – those seem likely professions of choice, but cops and soldiers are on the lookout for them and try to keep them out. Oddly enough, according to John Seabrook (Suffering Souls
The search for the roots of psychopathy, The New Yorker, 11/10/08), most find a place for their life’s work in business.

Sociopaths don’t have much else to do but amass wealth. They don’t care about relationships (though are often good at faking them). For most of us, relationships take up a lot of time. For sociopaths, there are better things to do. It’s all about ‘the game’.

So “free markets” are a natural fit for sociopaths. Who wants rules and regulations? Who wants to be fair? Who wants to enforce an honest deal or protect a consumer? Free markets pit ordinary, kind, compassionate and trusting people against sociopaths, who know how to win. They accumulate fortunes, and want more.

Sociopaths intent on accumulating wealth usually manage to place themselves at pivotal points where money changes hands. So we have entrepreneurs who do nothing but scout for various business activities, whatever the current fad. They are not driven by lvoe of a product or inventiveness, but rather to be where the action is. They need to be in the game, to be doing something where there is active trade, to cash in, to make as much as they can, and then get out.

In health care it is likely sociopaths who don’t give a damn about health “care” and form insurance companies.Those companies, after all, make their money by denying health care to clients. Hence we have “Dollar Bill” McGuire of United Health Care, who collected $1.6 Billion in salary from that company for one year’s labor.

In the United States, more so than other countries, we tend to let these people have free reign. We look up to them. The mere act of amassing a fortune is seem as a sign of worthiness. Imagine the same amount of money amassed by thousands of people making a decent living by forming a labor union – that sort of activity, though it is essentially the accumulator’s act spread over more people, is frowned upon.

Wealth accumulators are not wealth creators. Quite the opposite. There is no harm in taxing them at high rates, of throwing them in jail when they misbehave. (I imagine that Bernie Madoff has some sociopathic tendencies.) In our strange world, a poor person goes to jail for stealing a pack of cigarettes,while people like Jack Welch, a man who ruined the lives of hundreds of people by sending tech jobs overseas, is honored. Then there is “Chainsaw Al” Dunlap, who makes his living by firing people. Do I suspect these men are sociopaths? Yeah, I do.

Of course I speak broadly, as many men (and women -oddly,most sociopaths are men) men are simply good at what they do and are normal in other ways to boot. But if indeed 1-4% of us are sociopaths, and if sociopaths have nothing to gain in love and life itself, then it is highly likely that they are the ones who put work themselves into pivotal positions to cash in on the rest of our labors.