When reform will happen

In 1993, as the health care industry moved into complete encapsulation by the concept of "managed care," I made the following prediction:

For profit health care continually drains resources from the delivery of services in order to fund owner's equity. The result is that the insurer is left with three options: reduce coverage, raise premiums, or some combination of the two. Eventually services will be reduced and premiums raised to the point that the whole system is untenable. At that point insurers themselves will start to call for reform. What they will seek is to dump their costly products and get out of the market. Then we will have single payer coverage

Anthem Blue Cross has just fired the first major shot over the bow of government in the engagement of this process. The first people to be dumped from the market will be individuals, people whose risk cannot be spread out over a group. Next will come (actually this has been going on quietly and slowly for a while) the en masse dumping the sick and elderly from the rolls of the insured. Finally, insurers will complete the process of dumping employer provide coverage by intentionally raising rates to the point of rebellion.

In essence, the conservatives are right: we simply need to let the invisible hand of the free market direct the future of health insurance. The surprise for them is that ultimately we will end up with a state run system and it will be at the behest of the free market they so cherish. Of course there is the minor issue of the untold misery of those caught while the invisible hand is patting itself on the back. But hey, what the fuck. I mean didn't Stalin teach us that the suffering of millions is okay if the right people want it?

A homicide detective I heard once said that "Murder is about three things: sex, money or power. Sex is about power, money is about power. All murder is about power."

And that is what we are talking about in regards to the process of health reform: death (isn't it murder?) in the service of power. We will get reform when that death is no longer profitable.

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