Llewellyn
King
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April 9, 2009
Defense Contractors,
Health Insurers: Now Meet Those Too Big To Be Denied
We
have all heard about “too big to fail.” How about “too big to be
denied?”
Step forward two commercial sectors that are certain to get in the way
of President Barack Obama's reform plans – the nation's health insurers
and its defense contractors.
The former are bound and determined to hold their lucrative position in
any extension of health coverage to the uninsured. In this way, a new
health agenda will be designed as much to accommodate the insurers as
the patients and providers.
Likewise, as Defense Secretary Robert Gates struggles to reform defense
procurement and to cancel some weapons systems, he has to deal with the
massive power of the defense giants. In defense, the customer is always
wrong. The vendors, through their congressional sponsors, overwhelm the
department and get what they want, not what field commanders need or
what the national interest cries out for.
Ironically the Clinton Administration strengthened the defense lobby,
and its ability to push around the Pentagon, by orchestrating the
consolidation of defense contractors into a few behemoths, as part of
the downsizing of the military in the 1990s. Norman Augustine, chairman
and CEO of Lockheed Martin from 1995-97, told me that during his tenure,
Lockheed Martin had absorbed 19 small contractors.
The big contractors of today – Boeing, Lockheed Martin, General
Dynamics, Raytheon, Northrup Grumman, BAE and the European wannabe EADS
– have conscientiously scattered their manufacturing among many states.
One program has components made in 44 states. That means jobs, and jobs
mean political clout.
The health insurers, who succeeded in sinking the Clinton health care
reform effort, are ready for some concessions –but only enough to ensure
their dominance. The health insurers and their conservative allies are
experts in predicting the arrival of creeping socialism, unless the
private insurers retain their supremacy in financing and profiting from
the health care system. Ironically, they claim any larger government
role in health care will lead to rationing. Yet it is the insurers who
ration health care now, and if you are in an HMO they ration it
severely, cruelly and sometimes lethally.
A
favorite argument is that health care reform will substitute the
judgment of doctors for the judgment of bureaucrats. One of the more
appalling aspects of the current situation is that the insurance
companies day to day substitute the judgment of clerks for that of
doctors.
The health insurers will not be denied, but they feel it is reasonable
to deny the evidence against them. When health care was in the operating
theater in the 1990s, and Hillary Clinton was poised to plunge in the
scalpel, the insurers rose up against anyone who had evidence that the
system was serving the companies, not medicine and not patients. They
succeeded in banning from the debate what they dismissed as “anecdotal
evidence.” They wanted the debate discussed on a level where they could
dismiss reports of their own shortcomings, and conduct the debate in
terms of capitalism versus socialism.
It
is only now, with business crying out for reform, that the issue is
being aired again.
My
anecdotal evidence is this: I have lived under government-run medicine
in England. It works well enough. The young are favored over the old
there, whereas here the old are favored over the young. Now I am on
Medicare, which is remarkably like being on the National Health Service
in Britain, except I am being favored over the young.
For 33 years, I ran my own publishing company in Washington. After
payroll, the biggest expense was health care. To keep the cost down we
changed the carrier frequently, to everyone's inconvenience and a lack
of continuity. When one employee had a rare and painful cancer, the
insurance company paid for radiation and chemotherapy but denied payment
for painkillers.
For years, AT&T ran the telephone system and ordained that plugging in a
phone could not be performed by a customer, and that black instruments
were all that should be offered. They were, they thought, too big to be
denied.
Robert Gates has shown guts in trying to deny the oligarchs of defense.
Congress will need bravery in denying rent-takers in health care.
Meanwhile, those who are too-big-to-be-denied are pumping dollars into
Washington's K Street, where the lobbyists carry their water.
© 2009 North Star
Writers Group. May not be republished without permission.
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