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The Guy With The Scalpel? He's My Attorney!

We are off in search of intellectual honesty. Another opportunity to mix religion, politics, and hyperbole into our daily conversations.

Frank O. had been an agent for over 20 years the day I started with Prudential in October of 1979. My desk was next to his. Fifteen months later I was his manager and my desk was in a private office. I asked to spend a day in the field with Frank, not because he needed me, not even because he wanted me. At best, Frank tolerated me. No, I needed to learn what he was doing and how he had survived for so long as an agent.

The first stop was a longtime client of Frank’s. Climbing up the front steps, I noticed that my employee was walking to the side door. The side door? Frank reminded me that we were not related to the client. We weren’t family. We weren’t their friends. We were service providers and service providers enter via the side door.

It was at that moment that I realized how little I knew about the insurance business.

I was reminded of that humbling experience as I watched President Obama and Health and Human Services Secretary Kathleen Sebelius stumble, again, as they attempted to control the delivery and payment of health care. The biggest difference was that I, at age 26, realized how much I had to learn. Our president and his staff seem surprised that their frequent missteps are so apparent and so unacceptable.

My last post, the , addressed the Obama administration’s decision to classify birth control pills, IUDs, the morning after pill, and some forms of sterilization as preventive care. The Patient Protection and Affordability Act (PPACA) includes a provision that preventive care is FREE. That is the government’s definition of affordable, FREE.

The predicted firestorm erupted. The vice president and other committed Catholics in the administration had warned of problems. The White House chief of staff resigned. Last Friday the president announced his solution. As long as you don’t care about the moral implications, the money, how insurance works, or intellectual honesty – it was the perfect compromise.

Everything is still free. The insurance company will pay for it.

(Before we go any further, let me assert that I am totally in favor of most forms of birth control and voluntary sterilization. Let me also remind you that this has nothing to do with me, personally. This is about us, all of us.)

It only took a few hours for the double talk of the compromise to become apparent. Sen. Roy Blunt (R-MO) quickly released a statement via email. It stated, in part:

"It’s clear that President Obama does not understand that it isn’t about the cost – it’s about who controls the religious views of faith-based institutions. President Obama believes that he should have that control. Our Constitution states otherwise.

"Just because you can come up with an accounting gimmick and pretend like religious institutions do not have to pay for the mandate, does not mean that you’ve satisfied the fundamental constitutional freedoms all Americans are guaranteed."

A little dramatic? Perhaps. I suspect that the Supreme Court will be the final arbiter as to whether this crosses the line. But, Sen. Blunt was absolutely right when he called out the president for his sleight of hand.

The insurance companies are just going to pay for birth control pills, IUDs, the morning after pill, and certain forms of sterilization? Really? How do they show that on their books? These are claims that are eventually paid by the employer. And of course, large employers, such as hospitals and universities, are often self-insured. The insurance company simply processes the claims and organizes the market.

President Obama decided that insulting observant Catholics and other people of faith wasn’t enough. He decided to insult our intelligence, too. The president declared that insurance companies should pay for birth control pills, IUDs, the morning after pill, and even sterilizations from company coffers because it will save them money. By eating these costs, the insurers won’t be paying for unwanted, unplanned pregnancies. Ignoring the fact that it isn’t the insurer’s money or responsibility, perhaps we should take this to its illogical extreme. If we want to save money and eliminate unwanted and unplanned pregnancies, why don’t we have the insurers hand out chastity belts? Of course that’s silly, but it is no less honest nor illogical as the president’s suggestion.

It is time to remind you that none of this is about contraception, women’s rights, or even preventive care. It is about creating an environment where private insurance becomes unaffordable and only a government solution will work. Whether that is by accident or on purpose is for you to decide. But if you have someone restructuring the delivery and payment of health care in this country who doesn’t understand the basics of the market and insurance, you might as well have your attorney remove your appendix.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

Dennis Spirgen February 16, 2012 at 01:19 PM
The insurance industry loves to promote the myth that private insurance guarantees the right of each person to control his or her own health care. In fact, the insurance companies significantly ration medical treatment by deciding what they will pay for and how much they will pay. The next time you visit your doctor, ask him why he can only spend five minutes examining you. The answer is that your insurance company will not pay for more time under its "capitation" rules. After thirty years of handling lawsuits for and against insurance companies, I can say with some conviction that the insurance industry does not want an attorney holding the scalpel. It wants to continue holding that scalpel itself.
Dave Cunix February 16, 2012 at 04:18 PM
The insurer may negotiate with providers over the going rate for a particular service in each market. It is still up to the provider as to how long he/she will take to perform that service. For example: The going rate for a hair cut might be $25. Some barbers will rush through the job to get in as many hair cuts as possible per hour. Others will need a little more time to the job up to their standards. You knew the charge was going to be $25 when you sat down in the chair. You hoped that the hair cut would be up to YOUR standards as a consumer. I don't know of anyone who wants an attorney, an insurance company bean counter, or even an agent holding a scalpel. The post spoke to the need for intellectual honesty, not physical dexterity.

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