Dwight was new to my small business, but had worked for a similar company doing the kind of work we did and he was good at it. He’d been with me about a month when he asked for an aspirin to suck on. He had a bad tooth and his dental appointment, at a public clinic for the poor and un-insured, was weeks away. Unlike many of his co-workers, Dwight’s tooth didn’t get in the way of a good day’s work.
I nearly fell down that Sunday afternoon when his young daughter called my cell phone to tell me that Dwight had died. I was buying some tools and supplies for the next week’s work and probably made a scene on the floor of the hardware store when I burst into tears and repeatedly screeched “What? How?”
Officially, we’ll never know the answer since the family couldn’t afford an autopsy. We all speculate that the tooth was worse than Dwight had let on and that it had poisoned his bloodstream and led to organ failure — a condition called sepsis. According to estimates by the University of Rochester Medical Center 750,000 cases of severe sepsis occur each year, more than congestive heart failure, or breast cancer, colon cancer and AIDS combined. It begins with an infection that triggers an inflammation response throughout a person’s entire body. This whole-body response to infection – termed sepsis – produces changes in temperature, blood pressure, heart rate, white blood cell count, and lung function. Half of all people diagnosed with sepsis will die.
At that point in time I could afford to offer my employees medical insurance but Dwight hadn’t passed the 90-day waiting period. Truth is I don’t know if he could have passed the medical questionnaire required to qualify for coverage.
Since employee life insurance was bundled with medical, his family had to postpone his funeral twice while they raised money to bury him. Everything I had (and then some) was already in the business or I’d have written the check myself.
Seeing both sides of the fence
Health care reform gets very personal to me as a result of being a small business owner who used to be an insurance company executive. I have a view from both sides of the fence.
Dwight’s story tells the personal side. From the insurance side, I remind readers that the American courts have decided a corporation’s primary LEGAL responsibility is to its shareholders, therefore insurance companies must put their profit motive first — before quality of care, before anything. Regulations are in place to mitigate this profit motive, but they’re just speed bumps.
We set private insurers in the business of earning “money gotten at the expense of others’ lives or suffering,” which is blood money by definition. We Americans do this because we worship the market. We don’t have a healthcare system in this country, we have a market for it.
Author Thomas Frank’s book One Market Under God walks us through the development of our cultural ethos that says we must leave everything to the markets. The mantra “Markets are good, government is bad” is why we’re in this healthcare jam. After all, markets are interested in profits and profits only; service, quality and general affluence are different functions altogether.
According to Frank, here’s what Americans have come to believe: “You must liquidate the past; you must privatize, deregulate, and de-unionize; you must trust the market implicitly and allow the market to dictate every aspect of your existence. Only when you commit yourself fully, when you give it all to the market, will your voice be heard; only then will the little guy be empowered.”
He then reminds us what happens when the markets rule: “The market will give you a voice, empower you to do whatever you want to do – and if you have any doubts about that, then the market will crush you and everything you’ve ever known.” Didn’t Lehman Brothers a year ago illustrate that?
In last year’s PBS Frontline special Sick Around The World, journalist TR Reid walked through how parts of the US healthcare “market” resemble the “systems” of other countries:
- VeteransAdministration = British NHS
- Medicare = Taiwanese system
- Employed people with workplace insurance = German system
- Any poor country = Americans not covered in one of the above
Limits on the magic of markets
If the crash of 2008 taught us anything it’s that we don’t REALLY trust markets. If we did we wouldn’t have bailed anyone out and fallen into a Depression that would have made the 1930’s look downright prosperous.
Time to carve out an exception to the wisdom of the markets in this healthcare debate. The market is just a market, not an omniscient, benevolent diety, and certainly not a responsible government guided by a collective conscience.