Dear Insurance Adivisor,

Thanks for reading!

Your assumption in your comment is that Medicare Part D was actually intended to help people. I do not believe that. I think everybody in Washington was just flailing away at the problem, maybe meaning well, maybe not, but ultimately lacking the gonads to do something the insurance industry would not like. The result was what you see. Of course it doesn’t help–it was not meant to help. It was meant to give the folks in Congress something they could wave at their constituents to say, “See, I’m fixing the health care system.”

The most important point I would like people to take from this blog is that the pyramid scheme we call health insurance is based on denying health care to sick people. That is how it functions. If it actually paid for health care for sick people on a regular basis, it would not make a profit for its shareholders. I covered that in “The Gamble” and “How We Got Here.”

It sounds like you have experience with Part D. Can you look at that thing and tell me with a straight face that it is about helping sick people? Very close to every human over the age of 50, much less 65, has at least one chronic health condition. Most of us have several. Part D pays a fraction of the yearly cost of standard drugs for most people with chronic conditions. Then it says, “Sorry, you’re on your own.” That’s the thing they call the Doughnut Hole. Then coverage kicks in again for people with truly catastrophic expenses.

Part D is designed not to cover most seniors’ drug costs. I do not see any other way of explaining the situation that makes sense. It is intended to pacify people, so that they think something is being done about their situation, while at the same time not actually paying for what people need. The intention is to keep people from building up enough outrage that they will lean on their so-called representatives to do something that endangers profits.

We have no example in this country of what it would be like to have a rational and compassionate health care system. As long as we allow the insurance industry to use our own fear of death to blind us, by threatening to take away what little we have, we cannot begin to develop something that would actually work. If we, individually and collectively, can take a deep breath and say, “Yes, I know I am going to die someday,” then the threat that the insurance industry is holding over our heads evaporates. Do you remember the character in Monty Python’s Life of Brian who was about to be stoned to death for saying the name of God? He’s giving John Cleese’s character a hard time, and John turns to him and tells him he had better stop saying the name of God or else. He replies, “What have I got to lose? Jehovah! Jehovah!” and starts dancing around the stoning-ground.

We can free up our imagination and come up with something we actually want. Maybe it will be a nationalized system, or maybe it will be some kind of public-private hybrid. For myself, I do not see anything wrong with people making a decent living providing health care. But whatever it is, the insurance model has simply got to go. Basic human decency requires it.