WASHINGTON -- Why are the so-called tea-baggers so angry and frightened by the prospect of health care reform? Why would any ordinary citizen be upset by proposals to modernize and rationalize what we generously call a "health care system"? For most health care consumers, little is more frightening than the "health care system" that currently exists.
Let's leave aside, for a moment, the estimated 47 million or so Americans who have no health insurance. It's easy to understand their predicament. A young, healthy construction worker falls off a ladder and ends up with hundreds of thousands in bills he cannot pay. Or a middle-aged diabetic is laid off and finds herself skimping on doctor's visits because she can no longer afford to go. We hear stories like that often enough to enable us to empathize with the plight of the uninsured.
Yet, it shouldn't take much of an imagination (or much of a memory) to understand the dilemmas faced by many consumers who do have a health insurance policy. While opponents of reform have frightened consumers with warnings of "rationing" if President Obama's proposals are enacted, anyone with health insurance knows that medical care is rationed right now. You only get as much as you -- or your insurance company -- will pay for.
It doesn't matter what you may need. If your insurer won't cover it and you can't afford to pay out of pocket, you don't get the medical care. (The exception, of course, is emergency room treatment, which hospitals are obligated to provide.)
The for-profit health insurance industry is in the business of maximizing profits for their shareholders, and the only way they can do that is to hold down the payments they make for medical care. That means they spend a lot of their time (and a lot of their money) figuring out ways to deny claims.
That's why so many patients find their claims denied after they have spent years paying premiums. You may have faced this yourself: You're at home recovering from an illness, only to start receiving bills for expenses the insurance company has refused to pay. Sometimes, the reasons for denying coverage are in the very fine print that came with your policy. Sometimes, the insurer is just behaving unfairly, hoping you are too sick to fight back.
At recent townhall-style forums held by members of Congress or administration officials, some belligerent tea-baggers have held up signs saying, "What's wrong with profit?" The answer is this: It has no place in the health insurance industry. It distorts and disrupts the provisions of health care, adding costs without adding quality of care.
The health care market doesn't function like the market for automobiles or artichokes or flat-screen TVs. If you don't like the price, you just don't buy. But you walk away from expensive health insurance at your own risk.
There is no real competition among insurance companies, as recent research has shown. In 94 percent of metropolitan areas across the country, the market is dominated by no more than two insurance companies, according to the American Medical Association. Republicans claim that the answer is to provide more competition, but they had years to accomplish that, and they didn't. The GOP knows perfectly well that health insurers fight real competition tooth and nail -- as they are fighting the proposal for a public insurance option.
Some of the tea-baggers may have little recent experience with private health insurance because, from the looks of them, many are covered by Medicare. Why would they object to allowing government to get more involved in health insurance for the rest of us, since they already enjoy the largess of a government program? (Oddly, after decades of conservative government-bashing, many people simply don't understand that Medicare is a government-run, taxpayer-supported program. Or "socialism," as some would have it.)
The tea-baggers aside, most health care consumers know perfectly well that the system isn't working and needs to be fixed. Bring on reform.
(Cynthia Tucker can be reached at [email protected])
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