Barbara's Blog

We Have Seen the Enemy — And Surrendered

Bow your heads and raise the white flags. After facing down the Third Reich, the Japanese Empire, the U.S.S.R., Manuel Noriega and Saddam Hussein, the United States has met an enemy it dares not confront – the American private health insurance industry.

With the courageous exception of Dennis Kucinich, the Democratic candidates have all rolled out health “reform” plans that represent total, Chamberlain-like, appeasement. Edwards and Obama propose universal health insurance plans that would in no way ease the death grip of Aetna, Unicare, MetLife, and the rest of the evil-doers. Clinton – why are we not surprised? – has gone even further, borrowing the Republican idea of actually feeding the private insurers by making it mandatory to buy their product. Will I be arrested if I resist paying $10,000 a year for a private policy laden with killer co-pays and deductibles?

It’s not only the Democratic candidates who are capitulating. The surrender-buzz is everywhere. I heard it from a notable liberal political scientist on a panel in August: We can’t just leap to a single payer system, he said in so many words, because it would be too disruptive, given the size of the private health insurance industry. Then I heard it yesterday from a Chicago woman who leads a nonprofit agency serving the poor: How can we go to a Canadian-style system when the private industry has gotten so “big”?

Yes, it is big. Leighton Ku, at the Center for Budget and Policy Priorities, gave me the figure of $776 billion in expenditures on private health insurance for this year. It’s also a big-time employer, paying what economist Paul Krugman has estimated two to three million people just turn down claims.

This in turn generates ever more employment in doctors’ offices to battle the insurance companies. Dr. Atul Gawande, a practicing physician, wrote in The New Yorker that ''a well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That’s how a doctor makes money. It's a war with insurance, every step of the way.'' And that’s another thing your insurance premium has to pay for: the ongoing “war” between doctors and insurers.

Note: The private health insurance industry is not big because it relentlessly seeks out new customers. Unlike any other industry, this one grows by rejecting customers. No matter how shabby you look, Cartier, Lexus, or Nordstrom’s will happily take your money. Not Aetna. If you have a prior conviction – excuse me, a pre-existing condition – it doesn’t want your business. Private health insurance is only for people who aren’t likely to ever get sick. In fact, why call it “insurance,” which normally embodies the notion of risk-sharing? This is extortion.

Think of the damage. An estimated 18,000 Americans die every year because they can’t afford or can’t qualify for health insurance. That’s the 9/11 carnage multiplied by three-- every year. Not to mention all the people who are stuck in jobs they hate because they don’t dare lose their current insurance.

Saddam Hussein never killed 18,000 Americans or anything close; nor did the U.S.S.R. Yet we faced down those “enemies” with huge patriotic bluster, vast military expenditures, and, in the case of Saddam, armed intervention. So why does the U.S. soil its pants and cower in fear when confronted with the insurance industry?

Here’s a plan: First, locate the major companies. No major intelligence effort will be required, since Google should suffice. Second, estimate their armed strength. No doubt there are legions of security guards involved in protecting the company headquarters from irate consumers, but these should be manageable with a few brigades. Next, consider an air strike, followed by an infantry assault.

And what about the two to three million insurance industry employees whose sole job it is to turn down claims? Well, I have a plan for them: It’s called unemployment. What country in its right mind would pay millions of people to deny other people health care?

I’m not mean, though. If we had the kind of universal, single-payer, health insurance Kucinich is advocating, private health insurance workers would continue to be covered even after they are laid off. As for the health insurance company executives, there should be an adequate job training program for them – perhaps as home health aides.

Fellow citizens, where is the old macho spirit that has sustained us through countless conflicts against enemies both real and imagined? In the case of health care, we have identified the enemy, and the time has come to crush it.

Fear of Restrooms

I don’t suffer from fear of flying – it’s fear of airports that cripples me. Anything could happen to you in an airport: You could be apprehended by the TSA, the DEA, and, as we just learned from the Larry Craig case, by the vice squad. I’m at the point where I’m beginning to develop subsidiary phobias – to Cinnabon, Sbarros, and, most recently, airport restrooms.

I don’t know whether lesbians hook up in airport ladies’ rooms. Judging from my lesbian friends, they don’t hook up at all. They fall in love, move in together, and start devoting themselves to home improvements. But if they do, on occasion, cruise airport restrooms in the manner of a U.S. Senator, what signaling techniques do they use? And could I have inadvertently been employing them?

Because, face it, how many of us knew that the way to attract a fellow male stall-dweller was by tapping your foot and swiping your hand along the floor? Just three days ago, in DFW (Dallas/Ft. Worth airport to you infrequent flyers), I was in the ladies’ room performing the well-known automatic-faucet-activating gesture: frantically waving my hands, palm down, under the faucet, hoping to activate the sensor. Then, just before screaming, “Why don’t they let us turn on our own damn faucets?” I realized that the hand-waving could be a signal and that the lady at the adjacent sink could be an officer of the law. I hastily abandoned the effort to wash.

Once – and I admit this with some trepidation-- I even consciously communicated with the occupant of an adjacent stall. What I said was: “Could you pass me some toilet paper?” Then I reached down under the partition separating us to collect the proffered paper. Now I realize it would have been wiser to leave the restroom unblotted, because a hand reaching into one’s stall is surely a Craig-like signal.

For the last six years, between September 01 and today, my main airport worry was that I might look or act like a terrorist. No dangling earrings or dark lipstick, was my rule, though I had no hard evidence that female terrorists prefer them. No anxious glances at the uniformed personnel. No reading Guns and Ammo; instead carry Real Simple and Martha Stewart’s Living. No tantrums when the TSA confiscated my eyeliner. But now I see that my efforts to look less like a terrorist might have made me look more like a, heaven forfend, lesbian.

Short of some undisclosed evidence that the 9/11 killers were closeted Wahabist gays, you may wonder, as I do, why – with the “threat level” at an ominous orange – agents of the law are being deployed to detect people of alternative sexualities. Larry Craig was apprehended by a man apparently consigned to spend his entire day on the can, watching for errant fingers. Possibly this fellow has some intestinal issues which made this a necessary posting. But, sphincter control permitting, could he not have been more usefully employed, say, interviewing passengers as to their willingness to blow themselves up to score some theological point?

This is what El Al, the Israeli airline, does, and it’s believed to have the tightest security in the world. Its security people no doubt have bathroom breaks, but they spend a lot of their time on their feet too, interviewing prospective passengers: Why are you traveling? Who will you be seeing? Why aren’t you carrying any tourist books? El Al doesn’t rely on interviews alone of course. They also confiscated my baggy of peanuts, though who knows what havoc you could wreak with them.

The official justification for the security measures that have made air travel so scary is that they keep us safe – and, beyond that, free. But I’d feel safer and a whole lot freer if I didn’t have to worry about accidentally impersonating a gay person. I’d feel freer still if I knew it didn’t matter, travel-wise, whether I was gay or straight. If lesbians want to cruise the ladies’ rooms for quickies, which I very much doubt that they do, and if one of them should hit on me, which I find even more unlikely, I can always say, “Uh, not right now, I’ve got a plane to catch.”

As for the fellow who unintentionally revealed the presence of the sex police in our airport restrooms: I’m hoping Larry Craig comes back and comes out. This will no doubt involve a tearful public renunciation of his past homophobia and a lifetime membership in the Log Cabin Republicans. But he’ll meet plenty of guys, and in the end it will be so much easier not to have to pretend to take a leak every time he needs a little loving.

Freshpersons, Welcome to Debt!

Welcome to Fleece U., where our mission is to take feckless teenagers such as yourselves and turn them into full-fledged citizens of our economy, meaning, of course, debtors.

Many life-changing things will happen to you in the next four years. You will make lasting friends, including perhaps the love of your life. You will drink more than you ever thought possible and bitterly regret it in the morning. You will lose your virginity, if you happen to have brought it with you.

Our stellar faculty ardently hopes that along the way you will be amazed by calculus and charmed by the tipsy conversation between Alcibiades and that wily old radical, Socrates. There is also a general expectation that you that you will come out of here with some hazy notion of spelling and grammar.

But never forget that your real purpose here is to shake off the pointless freedom of youth and assume the burden of debt. To this end, we have just raised our tuition in an attempt to keep up with such top-of-the-line institutions as George Washington University (now weighing in at $39,210 a year, or $50,000 with room and board). You will find us also charging a plethora of additional fees – a “student activities fee,” a “technology fee,” and an “incidentals fee.” In addition, we will be experimenting this year with a “snow removal fee,” a “lecture hall seat-use fee,” and the installation of pay toilets in the dorms.

It would be short-sighted to resent these fees, since they provide valuable experience in bill-reading, and will come in handy when you confront your own personal monthly utility statements. At present we do not charge any additional tuition for this training in bill-reading, though we are considering adding a special “fee fee” in the future.

Another thing that will help ease you into the status of debtor is the price of your textbooks – about $120 to $180 for a new, graffiti-free copy. True, this seems high when you could buy a hardcover of Harry Potter and the Deathly Hallows for $20 or less, but the aim is to teach you that a book is something to treasure (and, again, we charge no extra fee for this lesson.)

On average, you will graduate with a respectable-sized debt of $20,000, which will enable you to establish your all-important “credit history.” If we have succeeded in our educational mission, you will be a first-rate debtor, capable of making minimum monthly payments much of the time. As fresh offers of credit cards and home equity loans pour in, you will beam with pride at your achievement.

Please note carefully that Fleece U degree cannot guarantee you a future income that will allow you to pay off your debts. Many of our most promising graduates are now, three or four years later, working for $8-12 an hour serving up lattés, counseling disturbed youth or creating business computer networks. They are set for a lifetime of debt, and we are proud that they first began to accrue it right here, on our lovely mock Oxfordian campus.

We don’t have to remind you not to stigmatize debt as a condition associated with poverty. In 2006, for the first time, the average household’s debt exceeded its income. By becoming a debtor, you will have entered the American mainstream! We have confidence that you will go on to mature effortlessly from college debt to car loan to mortgage to medical debts occasioned by the ever-growing gaps in coverage.

You will see the value of all this debt when the day comes, as it inevitably will, when you wake up and ask yourself, “Who am I and what am I doing here?” You will be tempted to take long walks, read the Upanishads, or try out for a new career as a trophy spouse.

In a crisis like this, you could easily spend thousands of dollars on life coaching and motivational DVDs. But you won’t have to, because you’ll have debt to keep you going. You will get up, shower, and toil faithfully in your cubicle year after year until, in the fullness of time, your family acquires the debt for your interment (at which point we trust you will have remembered Fleece U in your will.)

So think of debt as the great motivator. Think of it as our gift to you. Because for at least the next academic year, we are not even thinking of charging for it.