They Are Not Wishing You Well

In the world of politics, as in the Mideast, nothing is what it seems. The best example is the rejection of a federal health system and the support for a system of health cooperatives by some denizens of the depths of Washington politics.

I estimate that a federal health system option would be a rousing success, putting pressure on health insurers, hospitals, health systems and others to rein-in excessive costs and to focus resources on the people who really count - patients. Health cooperatives, in limited areas, have demonstrated that they can do a good job. But in dealing with nationwide insurers, nationally organized health care providers, national or statewide health care and hospital systems, and other vendors of care, the cooperative model holds no promise of success and will represent, what insurers, hospital systems, health systems and others described above want - an impotent isolated series of cooperatives, which hold no competitive threat, or fail miserably.

Alternatively, the health cooperative system might allow health care redlining which results in areas with adverse health statistics to be abandoned by health insurers with the patients shunted to health cooperatives which cannot afford the sudden mass of very sick people shifted to their rolls. If insurers are forbidden to underwrite, that will not prevent them from choosing not to do business in a particular area or with a particular employer or group of employers.

The call for the cooperatives in Congress is not a call for cooperatives to succeed, it is means of torpedoing a federal health system option. It is a means for insurers to remain insulated from real competition, to allow health care systems to roll merrily on building grandiose suburban facilities as monuments to their executives and donors, to allow certain physicians to order unnecessary tests and provide unnecessary procedures, to cause health care costs to inflate, and to otherwise generate the fiction that these Congressional spokespersons, lobbyists and other interests have the public's good at heart, when that is not the case. They have their own campaign funds and political supporters interests at heart. After all, they get their care through the federal employee system and that's just not good enough for the rest of America.