Update, 9/27/09: If you support real health care reform, as I do, please take time to sign this petition and ask that the Senate pass the bill that passed Ted Kennedy’s senate committee.

I know this is supposed to be a blog about paper mache – but paper mache has been used traditionally to make political statements, so it’s really only a minor stretch to use a paper mache blog to express a political viewpoint, right?

edit 8/29/09 – I just found this video of Bill Moyers over at the Hullabaloo blog. Moyers says things so much better than I ever can, so I’m fitting the video into this post.

Lately as I work on my elephant (she’s almost done!) and all my other friendly critters, my work hasn’t felt particularly relevant to the issues that interest me the most. I do love animals, and I do love sculpting them, but I’m not just an artist playing around with paper mache. I’m also a citizen with an inside view of how the health care industry works, and for that reason I can see how much misinformation is being spread by that industry to prevent any meaningful reform.

Frankly, watching the current debate unfold is enough to make me sick.

Acme Insurance, Inc.

I’m not a political cartoonist, so I’ll limit myself to this one little sketch of a health insurance executive dressed up in  Daddy Warbucks’ suit and Uncle Scrooge’s top hat, sitting in a pile of our money.

For the rest of this story, you’ll have to create your own images. I’m sure you’ll do a much better job than I ever could.

Picture this:

Picture a very long line of people, some sick, but most of them well, who are waiting patiently for the opportunity to hand their money over to Acme Insurance, Inc. They do this willingly because they believe it will protect them financially if they ever get sick.

A peon working for Acme stands at the front of this long line. He lets some of the people in, and sends some of them away, in accordance with a set of secret rules that say “this persons will be profitable, but this person will not.” Do the people in that line have any control over who is accepted? No.

Now picture another line of people. These are the ones who were accepted by Acme Insurance, Inc. They’ve paid their premiums for months or years, and now they have medical bills they need to pay. Another peon checks the rules. Some of the claims get paid, and some of them don’t. Do you, as a paying customer, have any control at all over which claims are paid and which are not? No.

Now picture all these people sitting at home, opening their mail. They’ve just been told that their premiums are going up and the benefits are going down. Do these people have any say at all about how much the company charges or what benefits they receive? Nope.

But if you don’t quite trust your insurance company to make all these decisions about your life and health and would like to have some say in how your health care dollars are spent, they scream “you’re a socialist” or “you’re a nazi”—or whatever term they think may scare your neighbors the most.

Nice system, isn’t it? That guy in my little sketch thinks so, and he’ll do almost anything to keep us from changing anything—because he and a handful of  his friends are making a bundle off the system, just as it is.

The real debate is not about health care – it’s about who controls the money we deposit towards future health care needs. It’s about who controls the money, us, the people, or a few owners and managers of the health care conglomerates who are required by their corporate charters to maximize profits for the benefits of their stockholders.

Us, or them.

They’ve been doing it so long that they believe they have a right to keep making all the rules for their own benefit. That’s why they believe the public should keep out of health care. It’s why the companies spend so much money (our money) on false claims about the dangers of government (that’s us) health care, and why they hire lobbyist who shower politicians with (our) money if they promise to keep the companies in power.

When I worked for a huge health insurance company myself, our company president rather ironically included in all his speeches a story about how the health insurance industry began. Health insurance, he said, was invented as a way for a community to spread the financial risk of illness, so the citizens in a community could make sure funds would be available so they could help each other in time of need.

Nice picture, isn’t it?

The problem is that our company president was not describing the way health insurance really works. He was describing an imaginary health care system in which the members of the community actually have some control over the money they put into the fund.

Did our company president really believe the nice little story he told so often? Not at all. That’s the last thing the company would want. Our company and every other health insurance company in America spends millions of dollars (of our money) to stop the spread of this type of “socialist” health care. They may use the “community” idea in their ads, but they’ll do anything to prevent true community control of the health care system.

What about keeping bureaucrats out of health care?

When they try to scare you by saying a bureaucrat will decide how much money a public option will cost and what services it will pay for, remember that’s when they’re talking about you. You, as a citizen of this country, would be given the opportunity to help decide what rules a government-run program would follow. Is that really all that scary?

Right now…

Right now, the insurance company decides who can participate and who can’t, and the rules they go by are a secret. You have no right to know what their underwriting rules are. If you’re denied coverage you may never know why, and you may not be allowed to appeal their decision. In fact, if you call a local insurance company and ask them if you would be accepted based on your current or past medical condition, the customer service person you talk to could get fired if she gives you an honest answer.

Right now, the company decides what is covered by their policies, and what is not. When the people pass a law requiring that all policies in their state cover certain conditions, the companies do everything they can to circumvent the law if it affects their profits. This has happened over and over again, and there is little any individual can do about it. But when it comes to decisions that could affect your life and health, they say “trust me.”

Right now, the company decides if a claim will be paid or not. They do not have to tell you or anyone else what percentage of their claims are processed incorrectly due to common errors or because their lawyers make a “mistake” when they interpret the laws your state has passed to regulate them. If you think your policy should cover a claim that was denied, you must call same people who denied it in the first place, and be willing to put up a fight. In many cases, fighting the insurance company if they really don’t want to pay your claims would cost you more money in legal fees than you could possibly afford.

Right now, if your application for coverage is accepted, the company gets to decide if any claims fall under their “pre-existing condition” exclusion. They can decide to not pay a claim based on their determination, even if you have never been diagnosed with that condition before. They can even cancel your coverage completely, because they were unaware of your unprofitable condition when they first accepted you.

Right now, the company can raise your premiums by as much as 22% or more, while also reducing the benefits that are covered in your policy. You, or your employer or your union can protest the change only by canceling the policy and purchasing a new policy from another company. But since every other company in your market has also raised their premiums and reduced their benefits,  the choices are somewhat limited. If you do switch, you may then be subject to brand-new exclusionary periods, during which you pay your premiums but can claim no benefits.

Right now, doctors and hospitals can charge different amounts to different people for the same services. It is extremely common for a provider to accept $100 from an insurance company or Medicare, while they charge $500 or more for the very same services if the bill is paid by an actual person.

When you need services from  an emergency room doctor, you have suddenly entered into the realm of the “under-insured.”

That’s because  providers who don’t sign a contract with your insurance company, (and emergency room doctors, anesthesiologists, and other some other specialists rarely do), will hold you responsible for everything left over after your insurance pays their percentage of a “usual and customary” amount determined by the insurance company. Believe it or not, you could end up with a bill for as much as $30,000 for one night in the emergency room, (this actually happened to a friend of mine), even if you have excellent coverage.

That’s why millions of insured people in this country are just one accident or sudden illness away from losing their homes and life savings. It only happens here, in America.

And all this assumes that you actually have insurance. Millions of people don’t, either because they can’t afford the premiums and don’t work for a company that offers a group policy, or because the companies won’t cover someone with their medical history.

When you hear someone telling a scary story about how awful it would be if “the government” takes over health care, stop and think for a moment. Remember—”we the people” are the government. If we pay a large chunk of our monthly income towards future health care costs, shouldn’t we have some say about how that money is spent?

So—here’s the bottom line in the current health care debate: Who do you want in charge of that huge pile of money? A corporate executive who’s paid millions of dollars a year to maximize his company’s profits—or you and your fellow citizens.

The only way we, the people, will ever have any control of that pile of cash is through a public option. The co-op idea is a sham, written by the insurance industry, and it must be rejected. I urge you to support the members of congress who have pledged to support the public option.

If you agree (or disagree) you can have your say in the comments section below. But please be nice. This is a family-friendly site. And if you’ve figured out an artistic way to present these arguments, I’d love to see what you’ve come up with.