The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Pelosi Paints Insurance Carriers as Immoral

Posted by Alan on July 31, 2009

It’s not easy being Speaker of the House. Just look at the Herculean task Speaker Nancy Pelosi has on health care reform. Her job is to herd 256 Democrats toward a consensus – Democrats who come from diverse districts and, as a result, bring to the House diverse perspectives. Her caucus is currently engaged in a harsh and public ideological battle over health care reform, and specifically on the issue of a government-run insurance plan.

It appears that Speaker Pelosi has decided on a strategy for dealing with this division, and it’s a page out of former-Senator John Edwards playbook. Last year when he was still a candidate for President, Senator Edwards displayed his flair for demagoguery by vilifying insurance carriers as unworthy to be part of the health care reform debate. Now Speaker Pelosi is going further.

Glenn Thrush described the Speaker’s outburst at, Speaker Pelosi was asked about liberals objecting to compromise on health care reform. He quotes her response, "’The public option — that’s where the insurance companies are making their attacks — it’s almost immoral what they are doing,’" said Pelosi, addressing reporters outside of her office a few minutes ago.

"’Of course, they’ve been immoral all along,’" she added. "’They are the villains in this, they have been part of the problem in a major way. They are doing everything in their power to stop a public option from happening and the public has to know.. They have had a good thing going for a long time at the expense of the American people and the health of our country.’"

Remember President Barack Obama’s call for for a civil debate in which “we can disagree without being disagreeable?” Speaker Pelosi apparently missed the memo.

Making the insurance industry the immoral villain may be good politics. The American public and their representatives love having a bad guy to boo. Black and white arguments generate a lot more sound bites than do debates painted in nuanced shades of gray. Slotting insurance companies into that role is a no-brainer. The public doesn’t trust insurance companies concerning health care reform and the industry has shown a startling lack of political skill over the years. Let’s face it, insurance carriers have auditioning for the villain role for years. Congratulations, you’ve got the part.

But should they be cast as immoral? Immoral people are unfit to participate in civil society. They are cast out from the community. They are less than the community. Is this what the Speaker of the House means? Is it what she believes? Is this the kind of language she should bring to bear on an opponent over a public policy issue? And is it really smart politics to describe an opponent on an issue as immoral when that opponent, if she were being fair about it, is backing a great deal of the health care reforms put forward by Democrats?

Speaker Pelosi supports a strong public policy option. I believe she sincerely believes it will “keep insurers honest,” increase competition in the market and help reduce health insurance premiums. She could have used her bully pulpit to educate voters on why she believes what she does. She could explain how a public plan paying less than health care providers actual costs strengthens the health care system in the United States. She could have explained why a public plan needs government-bestowed advantages to compete with private carriers.

Instead she chose the low road of a Glenn Beck. Mr. Beck, however, is an entertainer, not a political leader. His job is to create controversy without regard to reality and, shamefully, to inspire the worst in people. Speaker Pelosi’s job is to legislate and educate. Hers is a much higher calling than Mr. Beck’s. She should be held to a higher standard.

Legitimate concerns have been raised concerning the efficacy of a government-run health plan and its ability to create a competitive market without destroying that market. Speaker Pelosi owes it to the American public to address those concerns. In providing that explanation criticism of the health insurance industry will be be warranted, but such criticism cannot be the entire explanation. Nor does the criticism need to be less than civil.

The Bush Administration made an art form out of casting opponents to its policies as immoral and unpatriotic. Speaker Pelosi used to oppose that kind of politics and she was right to do so. She is wrong to embrace it.


20 Responses to “Pelosi Paints Insurance Carriers as Immoral”

  1. Matt Smith said

    I believe that some type of reform absolutely needs to be passed but the way these politicians are trying to rush things through without reading the bill is just completely ridiculous.

    Over the last several years Senator Jim DeMint and Republicans proposed many bills that would make health insurance more affordable and available.

    How about the bill that was turned down by Obama and Democrats that would have made insurance portable so people could buy it from any state?

    How about the bill that was turned down by Obama and Democrats which proposed $2000 for individuals and $5000 for families to put in their HSAs (health savings accounts) to be able to pay monthly premiums?

    In addition grants to states were proposed in order to help uninsurable people afford the state high risk plans which cost an arm and a leg. OBAMA AND THE DEMOCRATS TURNED IT DOWN! According to the heritage foundation approximately 22 million uninsurable Americans would have been insured over a 5 year period.

    Obama’s track record of voting proves that he is more concerned with the government having more control than actually lowering the cost of healthcare and helping the uninsured. What more proof do the American people need? He is caught on video telling Americans that he is for single payer and then to turns around and tells us that private industry competition is needed and will remain even with the public option?

    Give me a break…Americans have been lied to enough and see this kind of transparency coming a mile away Alan.

    I’ll take Glenn Beck over Nancy Pelosi, Barney Frank and Obama any day. At least he is concerned with freedom and liberty. After all that is what makes America the most desired place to live on EARTH!

    Yes, an estimated 47 million people are uninsured. Yes, that is quite a large number but how many of these people are unhealthy because of the way they eat? After all most of America is OBEASE! How many have cancer because they chose to smoke? How many when bankrupt because they chose not to buy a very cheap catastrophic health plan even though they were HEALTHY?

    Now those are some questions with meat on their bones! People need to stop looking to Washington and take some responsibility. The uninsured would be a fraction of what it currently is if people decided to take care of themselves.

    Side Note—

    I was just at the DMV at 8 o clock this morning before I got into work. I needed an H6 form (a print out of my driving history) which any competent employee that worked there should have been able to provide me in under 5 minutes. The process took almost an hour and a half because the DMV employee didn’t feel like doing her job and kept transferring me around to different people…that is usually the case with all government run departments in the US.

    I can only imagine the poor service and lack of quality I would receive with a public health option…when doctors don’t get paid what they deserve quality of care and service will die.

    When you have a moment watch this youtube video of a man who goes to the Canadian health clinics with hidden cameras. Unlike Michael Moore’s ridiculous film “Sicko” …this short film used no scripts or large film crews.

    Notice how Michael Moore tries to tie Canada’s longer 3 year life expectancy to the single payer system? This man just doesn’t have a clue.

    My great grandfathers both lived to be in their 90s. This is most likely because they busted their asses for most of their lives in the Cole mines. Exercise is proven to make you live longer.

    We have become a nation of Michael Moores who think they are entitled to free health care and Nancy Pelosi is leading the march!

    Nancy isn’t living in the real world Alan. She is for spending other people’s money on a system that is proven to fail.

    Ok, well 47 million are still uninsured what do we do?

    Easy answer:

    Listen to Republican proposals a little closer and hit the damn treadmill. The 47 million uninsured would turn into a fraction of that.

    And Michael… stop making misleading films and put down the bugers buddy. You may feel different about healthcare if you were not morbidly OBEASE.

    • Matt Smith said

      One more solution. Make illegal aliens pay taxes, after all they cost the USA an estimated 300 billion per year. That’s almost half of the failed stimulus.

      Be nice to have some of those funds for our uninsured citizens.

    • Bart said

      I believe that a civilized society should care for its citizens. But it’s a slippery slope that leads from a society providing opportunity for health care to a citizenry that feel entitled to perfect health. The latter attitude morphs health ‘insurance’ to health ‘assurance’, which is radically different and has far-reaching consequences, especially when politicians are voted into office by catering to public entitlement.

      So, how does a society provide for the health of it’s citizens? If the predominant mechanism is to provide for payment (medicare, medicaid, ‘public option’, insurance companies, etc.), then a private industry-based health care system such as ours will continually raise prices as long as payments continue, thus costs will grow. I’m not sure why this is not obvious to the most vocal public discussants.

      If the goal is to reduce cost, then effort needs to be directed at cost (not payment). For example, consider regulating the margins of cost drivers such as pharmaceutical and equipment vendors, limit profits of insurance companies, reduce administrative costs, enact real tort reform, limit excessive physician compensation, limit hospital profits, etc. These are cost drivers.

      Matt makes an excellent point of individual accountability, which is a politically unpopular idea that is rarely mentioned in the current discussion of entitlement-based solutions. Examples: tax breaks for jogging three times a week, for not smoking, for keeping weight down, for controlling blood sugar and blood pressure, for complying with physician-recommended health guidelines, etc. Such personal health accountability would eliminate the need to spend billions on the consequences of ‘bad living’.

      Or how about re-connecting the finances of the health care consumer (patient) with the provider as follows: Allow consumers to ‘bargain shop’, such that they take bids or get cost estimates for defined services. For example, cost out various providers’ fees for managing hypertension or removing a gallbladder, etc. If the patient consistently selects the lowest cost options (compatible with their sense of quality), then she/he gets an insurance premium reduction. Such a plan would put some economic power in the hands of the patient and would force providers to display not only prices, but quality.

      In these scenarios, the role of the government is not one of decision maker or controller, but one of policy enforcer that promotes the civilized notion of a society taking care of its citizens. I believe this is a higher standard for government.

      But eventually, a guiding principle for understanding the value of health care is defining quality, but this is an entirely different (and more important) debate.

  2. ProsDoc said

    PS A GOLD STAR on the forehead for Pelosi not knowing the difference between IMmoral and Amoral….too good!

  3. ProsDoc said

    Can anyone answer this? Years ago, probably before the 1990’s, I remember when we didn’t have all this mess. When I went to the Dr.(or took my kids)(1970’s – 1980’s), I paid a small office fee visit of $6.00 to $15.00, the insurance provider was billed for the rest if there was anything to bill. Dr’s were trained to truly take care of their patients. Health care was so safe and cost effective. No one was sent home too early from a hospital stay. The Dr’s office help concentrated on helping patients and the Dr. deliver A+ service.
    Why was everything changed to an Insurance run system….that rapes patients for cash…and NOW the Government wants to run healthcare? My God, they can’t run anything. Everything the Gov’t touches turns brown….medicare, medicade, SS, Housing, VA care for Vets, and the list never ends. The politicans in Washington live in an Ivory Tower, never do without anything, and get us to pay for it all…wow…I wish they’d do that for me.
    Anyway….what was wrong with the old system of Dr’s being in charge of patient care? There was no such thing as having to go to 3 different specialists for a health problem, have 3 sets of x-rays or MRI’s, etc., file 1,000 different insurance forms and wait till an insurance provider “SAID” yea or nay on treatment. Insane.

  4. Pelosi has never played nice when it comes to what she wants. Her actions in vilifying the insurance companies are the immoral ones. A big bloated federal insurance option is not the answer here. It is unfortunate that she is playing politics worse than many to push what I would call a socialist agenda.

  5. I find it incredible that politicians are quite willing to villify insurance companies that pay doctors far more for procedures than government run medicare or medicaid will pay. Many medical practitioners limit or will not accept medicaid patients because the remuneration is too low for them to run their practice. Government does not need to get into the health insurance business. They need to provide significant tax incentives for the working uninsured to purchase their own health insurance.

  6. Personally I would like to see a little more about the specifics of the plan than hear about politics as usual. Has anyone read the 1000+ pages of this proposal? Are there any specifics? I think the American people can decide as to whether it is beneficial or not once they have some of the facts. Is it because they are not addressing the problem, but only using it to get some political sound bites.

  7. Harris said

    Alan, as usual a great article and to James Thornton I must say you make some outstanding points. I have been on the inside of a major US insurance carrier for most of my career and frankly, they do have some good people and they want in may cases to do the right thing. The problem is, much like Wall Street, they have become so profit motivated and are require to provide in many cases higher ROI than any other industry that the smaller companies and of course individuals are getting hurt.

    James brings up recision which is a travesty, but the bigger travesty is the fact that most companies who are fully insured are looking at a minimum 10 – 20% increase every single year to maintain their coverage. This applies to fully insured cases as well as self funded cases. Think about that, in 4-5 years you are looking at the cost of healthcare in a particular group doubling which forces them to move to another plan which requres tons of new paperwork and administrative costs which raise everyone’s premiums. There is no loyalty in this business anymore, its not financially possible! To combat that all of the large payors are pushing their sales and service people to try and raise deductibles and copays or introduce what I call “gotcha” plans that have hidden cost that show up for certain procedures and tests. This practice can have devastating results with the average employee and their family. Everything is based off of loss ratio, meaning the amount of claims paid against premium dollars paid. But since they are grouping plans of certain sizes together by region, I have seen instances where a plan is running at a 70% loss ratio (70 dollars spent versus 100 dollars of paid premium) and still the payor is asking for a 10% increase so they can give a couple of points to another company who isn’t running as well.

    The other issue that blew me away was health and wellness. Big Payors have terrific health and wellness tools to offer. The problem is, guess who gets to use these programs? You guessed it only the plans that were running at 70% loss ratio! The plans that were spiraling and seeing significant utilization and rate increases were not offered these programs, ie the ones who needed them the most.

    Of course the individual and family market is where the real sad situations are happening on a daily basis. If you have any type of pre-existing condition or take any type of expensive medication you are really out there on your own, there are really very little options at all. And I am not talking about sick people, I am talking about healthy people who have hypertension or take an ADHD drug or are dealing with a mild case of anxiety. These are people that want coverage, would be willing to pay more and want to be in the system that can’t because they are deemed to be too big of a risk. I’m sorry but that just stinks and The good news is that addressing this area appears to be “universally” supported by both parties.

    • Thanks to all of you fellows for your thoughtful replies, and thanks especially to Alan, who I think sets a tone in this blog that is inspiringly polite and anti-incendiary. In an era where many of us get news from MSNBC or FOX, ostensibly to educate ourselves but perhaps more realistically to get that joyful little spurt of blood lust best triggered by invective that demonizes our enemies.

      Perhaps Conan the Barbarian put it best when asked to summarize the means to a purposeful life:

      “Crush your enemies, see them driven before you, and hear the lamentations of the women!”

      Perhaps to this short list, modern man might want to add “Secure stock options and a robust ROI.”

      Most of the topics that bellicose males (and the rare bellicose woman) like to bandy about seem to be political or religious in nature, and to be honest about it, in most cases fairly remote. I, for one, think that invading Iraq, for instance, was a mistake, but I have no friends or relatives fighting there, and whatever effects this conflict may or may not have had upon my life have been indirect if even that. Ditto for abortion, gay marriage, etc. I have my opinions about such matters, but so far, these have not had terribly personal impacts on my life.

      The health care dilemma is one of the first political/economic issues that has had a hugely direct impact on me in a very personal way. I make my living as a freelance writer and have, since 1984, been able to support my family in a reasonably middle class way by the sweat of my, well, prefrontal lobes. As an entrepreneur of sorts, and arguably one of the few Americans left that comes close to even remotely manufacturing anything (albeit intellectual property, with perhaps a bit of irony on the adjective here), I am one of those small-business types that the free marketeers pay lip service to: hard working, self sufficient, risk taking. I employ a transcriber for my interviews, albeit she is–like me–an independent contractor. Don’t get me wrong: I don’t mean to hold myself up as an example of anything particularly admirable, just a regular example of a self-employed person who has thus far managed to support a family, pay his taxes (at twice the social security rate of employees, mind you, because I have to pay both the employer and employee contributions, or about 15 percent of my pre-IRA gross adjusted income to SS.) I also employ my wife.

      A number of years ago, my accountant suggested I could give my wife and her family healthcare as a benefit of being my employee. Note: I am one of her family members. The benefit here, assuming I set up this complicated reporting arrangement I still have trouble understanding, is that I could not only deduct health insurance premiums but also all out of pocket costs as a business expense to me. This not only lowered my adjusted gross income, but it also significantly lowered the portion on which I had to pay social security tax, my single biggest hit.

      This spring, I got audited, partly because of this, starting with tax year 2006. Getting audited, parenthetically, is a nightmare, and it didn’t help to hear from my accountant that the IRS, under the Bush administration, was ordered to essentially forget trying to audit Hedge Fund managers, because they, and the laws shielding them, were beyond the ability of most IRS auditors to grasp. Instead, they were dispatched to shake money out of little guys like me, with our home office deductions and our healthcare deduction “schemes,” etc.

      The good news: after numerous run arounds with the IRS, they admitted that the health care deduction was kosher, and they decided not to pursue it. They did knick me on my home office square footage, factoring our more or less unused basement space into the total denominator, reducing the fraction.

      I am providing too much detail here, I know.

      But the point is, from 2006 to 2009, my family’s individual monthly health insurance premiums went up from $940 per month to $1711.50 per month–and this for $500 deductible on every member of our family (I am 56; my wife 51; my sons 20 and 16). It doesn’t cover dental or optical. For an article last year on dental implants that I wrote for AARP: The Magazine, the University of Pittsburgh Dental School agreed to give me 4 new molars for those that had cracked over the years, at a discounted cost of $7500. The total cost, with premiums and out of pocket, that year: close to $31,000. This on a pre-tax, pre-deduction, pre-business expense gross income that, because of the sinking economy, had shrunk to somewhere between $60-70K. Our property and school taxes alone kicked in another $12,000.

      The good news is that I can’t see having to pay too much in federal or state income tax on the theory that you can’t squeeze blood from a dessicated turnip. The bad news is that my family has become, well, a dessicated turnip.

      I have researched my healthcare alternatives till I am blue in the face. I even asked Alan to advise me directly. The closest I can find to something remotely affordable is one of those HSA $10,000 deductible plans, and I am by no means guaranteed of qualifying for this.

      I should add that all of us are quite healthy. I placed 4th in the world last year in the 400 m. freestyle in my age group in masters swimming. Other than the dentist and a very occasional mandated doctor visit before he will refill Rx’s, I haven’t seen a doctor in literally seven years.

      My wife goes only for routine pap smears and the like, and refill visits for her Rx’s. My sons have each gone maybe once a year–for sport’s physicals that are a prerequisite for the high school cross country and track teams. None of us smoke, drink, or have problems with obesity. We are not Terry Schiavo’s waiting in line for a decade of care in the ICU!

      However, my wife and I both take statins and antidepressants, and for this reason, we have been told we are uninsurable. Moreover, we have also been told that it’s risky to even APPLY for a different policy, because if we are denied, we will have to tell all other insurers this, or face recision if by some miracle they choose to insure us.

      Meanwhile, the insurance we have now has been climbing absurdly in price every year, and we cannot make any changes in the terms: take it or leave it.

      For those of you with good coverage through work, whose interest in this debate is more theoretical (government can’t do anything right; free market competition is the savior of all sinking ships; or what have you), I only ask you to acknowledge that are many, many of us out here in our country, who may work as hard as you work, or who may love their families as much as you love yours, who are faced with a descent into the bottom of the lower middle class or deeper, all because of this rat trap called the private individual health insurance market.

      For just one moment, if you are capable of empathy, forget the Big Societal or Big Philosophical Public vs. Private, Liberal vs. Conservative arguments, and put yourselves in my shoes.

      What would you do?

      What should I do?

      Please, I am honestly and with all the grace I can muster, beseeching your advice.

      Thanks for those who can offer me hope.

      • Nosedoc said

        Mr. Thornton, you have in your personal vignette illustrated why the Republicans must not be obstructionists to effective health care reform, and why the Democrats must be realistic about how cost savings are to be achieved (i.e., eliminating the tremendous areas of wasted resources). Americans are not getting adequate value for their health care dollars, and until this is properly addressed, including the politically less-palatable aspects to either side of the aisle, the system will continue to founder and the American middle class will continue to suffer. With reduced spending comes the ability to eliminate (by mandate or not) the pre-existing conditions clauses, especially for people with easily-managed chronic diseases like asthma, hypertension, depression and hypercholesterolemia for whom medication and/or lifestyle modification make these diseases relatively innocuous and inexpensive to control, and without crippling the private health insurance market or bankrupting the U.S. Treasury.

        As for what to do? You’re doing it–getting your story out. Continue to educate yourself on what is really going on in Washington, which special interests are involved in the process and how they each may be aiding or inhibiting the creation of meaningful reforms. While this blog is a wonderful outlet and resource, don’t stop here. Send emails and/or place phone calls to your Congressman and Senators. Attend a “town meeting” with your Congressman if he/she is having one and speak your mind. Tell your friends, family members, business associates, etc. about this blog and (if you are comfortable) discuss the issues with them. Encourage them to get involved as well. There are some encouraging signs that things will get better for you and your family, as progress has been made in both houses of Congress, and all of the major players are still at the table.

  8. Alan, I agree that your blog is extremely well-written, balanced, and for the most part exceedingly fair to all sides in this often rancorous debate. I don’t mean to sound like an apologist for Nancy Pelosi here, but I think that in the zeal to keep the discourse civil, you must not lose sight of the fact that some of what health insurance companies have done is, by any reasonable definition, clearly immoral, if not outright evil.

    I watched Bill Moyer’s interview tonight with the former head of PR for Cigna, a non-disgruntled “whistle blower” of sorts who testified before Congress about some of the policies that, though legal and in the interest, presumably, of shareholders, are by no means moral or in the interest of patients.

    The most egregious of these, of course, is recision. The video showed several leading health care CEO’s being grilled at some Congressional hearing, and one by one each was asked if he would publicly declare that his company would no longer practice recision unless the “violation” was found to be intentional fraud.

    One by one, the CEO’s said they would NOT make that promise. It was almost impossible to watch this spectacle and not be reminded of the outright fraud perpetrated by Big Tobacco executives who swore, under oath, that they believed nicotine was not addictive (as well all know now, internal documents show they knew this, and manipulated nicotine levels and potency and speed of delivery since at least the 1960s. In fact, when Marlboro practically over night gained a huge jump in market share by adding ammonia to, in essence, free base the nicotine in their cigarettes, the executives claimed the did this to add “a roasty toasty flavor” to their product. Ammonia? A flavor additive? Seriously?

    I understand that you and many of the readers of this blog are insurance brokers and in this capacity serve many clients exceedingly well by helping them negotiate the Scylla and Charbydis of the fine print of insuance contracts and the like. I understand that it is difficult to embrace the fact that the industry you earn your livelihood may have an immoral side to it.

    But I think if you really look at this from the point of view of people who have been paying, in good faith, for years, only to have their policies rescinded when they have a huge need for a medical procedure that will cost the company big bucks, you must concede that this is immoral behavior.

    As much as the industry talking points have been blasted into the public’s ears, often through Republican and right wing radio Charlie McCarthy ventriloquist dummies, it does not make these true.

    By the way, Marcia Angel, the former editor (if memory serves) of the New England Journal of Medicine, has also called the private health insurance industry evil. I don’t mean to pile on here, but it would be interesting to see what future historians make of the behavior of today’s private health insurance industry. I wonder which industry, indeed–health insurance or tobacco–will ultimately contribute more sickness to the nation’s citizenry.

    Final point: cancer cells and infectious agents alike, absent checks on their reproduction, are free to propagate themselves wildly within the body. In a sense, they “win” the evolutionary game, at least for a while, by successfully placing more of their genes in the next generation. Once the host body dies, however, the short sightedness of this selfishness becomes apparent.

    Private insurers in general, and their highly paid executives in particular, can continue for a while to enrich themselves at the expense of many, many of their fellow countrymen–at least for a while. But eventually, when the system collapses and drags down the country with it, no doubt heaping the same contempt on their heads as most Americans now feel for Wall Street traders, Pelosi’s adjectives “immoral” and “evil” will pale in comparison to the invective (or worse) raining down upon these guys shameless heads.

    • Mark Goodman said

      A bit over the top but points well taken. Few recisions happen after paying premium for several years. They happen fairly quickly because those who are intentionally get one over on the industry submit claims fairly quickly. Sometimes an agent will commit the fraud by completing the application and saying sign here. CEOs’ are correct to say under current regulations they would still allow recisions. They are being honest and its legal.

      The entire health care discussion is not about morality but about money. The treatments and cures may have outstripped our ability to pay for it. All developed countries are facing similar issues.

      I have said numerous times that the simple cure for pre-ex and recision is legislate it. There is an impact to cost in doing this but it eliminates a big issue. If you mandate coverage then you can mitigate some of the cost impact.

      The government sponsored plans have at least on a balance sheet basis performed miserably. Medicaid keeps through more money after a bad concept and Medicare reduces reimbursements which simply make private insurance more expensive.

    • Nosedoc said

      I agree with Mark G. that the core points are well taken, albeit to a greater emotional degree than is necessary. The insurance industry is not immoral but amoral–morality is simply not on the radar screen. This is business, plain and simple, and executives in the industry are not cultivated with the same fiduciary duty for their subscribers as health professionals are (the vast majority, anyway) for their patients. Even the Medical Directors, who are physicians, have left the clinical arena for a reason–they generally don’t reap the same personal rewards from direct patient care as their colleagues. Mark is also accurate about pre-existing conditions–it is fraudulent for someone to go without insurance until they are diagnosed with something requiring expensive care and only then subscribe for health insurance to have the insurer pay the bills.

      Public health priorities that are by their very nature morally good need to be explicitly laid out by the government in the form of regulation. The government has always been a better creator and enforcer of rules than it has been an administrator of large-scale social programs. While Speaker Pelosi clearly prefers we tear down our entire system and replace it with a larger version of Medicare, the smarter and more efficient approach would be to “rehabilitate” our insurance, health care delivery and medical tort systems so that health care can be delivered appropriately, generously and cost-effectively, while preserving the free-market identity of the system overall.

  9. Mark Goodman said

    I think this all got started when the President started calling it Health Insurance Reform. It allowed the Speaker and her supporters broad latitude in slamming a large target. It’s easy to get people riled up against the insurance industry since they see larger pieces of their pay checks or income going to them every year and most see higher out-of-pocket costs in spite of higher premiums. Horror stories abound even though many are generated by unscrupulous companies that a prudent person should never have dealt with. Yes carriers make mistakes or more to the point people in the company make mistakes. Everyone tries to minimize mistakes but in the real world they are unavoidable.

    It’s amusing that people who slam the post office, IRS, the military, etc. for their inefficiency think a government run plan will bring nirvana.

  10. besthealthcarerates said

    Thanks Alan a great post.

    She seem to think that a governement run health option will solve our problem? It will not even come close!

    The problem in this country is HEALTHCARE COST!!!!!!!!!
    Healthcare costs are driven up by LIFESTYLE CHOICES!!!!!!!!!!!

    Yes we spend more on healthcare than any other country and we lag in life expectancy. But we consume more junk food than anybody else. Obesity rates in the US are at 40% of the population. The obese population cost 40% more in healthcare and medications.

    Bring down healthcare costs and you bring down medical insurance costs!

    A government run option is a band aid, it will cloud the real issue NOT FIX IT!
    We do need affordable medical insurance for everyone in the US, I wish they would deal with the real issues i.e obesity, hospital over billing, defensive medicine, inefficient medical record systems, prescription fraud & drug abuse etc….

  11. Rick said

    “I believe she sincerely believes it will “”keep insurers honest””.

    I could not disagree more. She would have the government option compete in a dishonest way by under paying providers, and having that underpayment cost shifted to her competitors making them uncompetitive. Nancy Pelosi is the one that is dishonest. Her goal of a single payer plan is schrouded in this so-called “government option” “to keep the insurer’s honest”. What is in this House plan to keep the government option honest?

    • Nosedoc said

      It provides a system with a mega-bureaucracy, and the patients will suffer as will the honest practitioners and taxpayers. The providers who would do well financially are the ones who adapt the fastest in “gaming” the system if not committing outright fraud (like many Medicaid providers do now). There would be no winners outside the bureaucrats themselves.

      • Doug said

        I agree with your point. The federal government can run up all the debt they want and then pass laws that will regulate the insurance companies into nonexistence. This is a first step into a single payer system. If they were sincere about competition they would allow insurance to be sold across state lines.

  12. Nosedoc said

    “Only a Sith speaks in absolutes.”–O.W. Kenobi in Star Wars, Episode III

    I think we should thank Speaker Pelosi for demonstrating to us that:

    1. She doesn’t know the difference between the definitions of “immoral” and “amoral”, and how each should be interpreted and applied.

    2. She has no intention of allowing private enterprise to play a role in the administration of health care in the U.S., despite the fact that the most effective single payer systems in the civilized world are state-owned but privately administered to keep bureaucratic inefficiency to a bare minimum.

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