I and many others have written about the shift in the reform debate from focusing on “health care” to focusing on “insurance.” The reason is simple: In any good argument against the status quo, there needs to be a clear enemy — a problem that must be fixed. In general, people like health care. It is insurance companies that typically trigger negative thoughts among many in the public.
But insurers aren’t taking any of this lying down. They make big money in health care, and changing the status quo threatens that. So, of course, they push back with their own lobbyists and have worked diligently over the years to make financial contributions to key members of Congress. [As an aside, I just completed a two-day seminar on ethics in health services research. I think Congress should be required to attend next year.]
The fight will be won by whichever side is able to make the bigger push, and money and power favor the organized and entrenched health care interests — especially the insurers under attack. The only way to fight back, is to generate enough of a public outcry that it drowns out the insurance lobby. So far, that’s not quite happened, but Rep. Henry Waxman (D-CA) is out to change that.
He’s written letters to every major insurance company asking for information on the salaries, stock options, perks, retirement funds, and other financial considerations for all insurance industry executives earning more than $500,000 a year. He’s also asking for information on their products’ premiums, their revenue, claims payments, and more. The point: To find out just how bad the insurance “bad guys” are, and share that information with the public.
I think it could work. People certainly haven’t taken well to greed and corruption when it has been exposed in other industries (Enron, Bernie Madoff, and the like come immediately to mind). Americans tend to value hard work–and often categorize the poor as lazy and undeserving–but when they see that some very outwardly successful, exorbitantly wealthy individuals have risen to great heights without merit the results are even worse. These sorts of people are not poor, but the illegitimate means of achieving their wealth leads them to become social outcasts. Depending upon what Rep. Waxman uncovers, and just how widespread and damning the information is, private insurers may suddenly find that they are facing a terrible public backlash, and health insurance reform may find new life.