From the Cleburne Times-Review:
Michael Mager: The history and meaning of managed health care
I recently wrote a story about a woman who donated a kidney to her husband so he could get off dialysis. The woman then developed diabetes and, because it was a pre-existing condition, her health insurance denied her claim. So she was then reduced to asking me to write an article about her so she could raise money for an insulin pump that would keep her alive. It was clear to me this woman did not understand the meaning of ?managed? health care. Let me explain.
Managed health care was an idea that came about in 1971 to rein in health care costs. The grandfather of prepaid health insurance as we know it today was probably Henry Kaiser. For those of you who are unaware, the word ?kaiser? in German comes from the word ?caesar? in Latin, which means ?king.?
Today, Kaiser?s little insurance company is called Kaiser Permanente, which can be translated as ?Permanent King.? So we can see that from the outset the goal of managed health care is not to help people manage to be healthy, but rather to help a few people like Henry Kaiser manage to permanently live like kings. Are you starting to get the picture?
Clearly, such people cannot manage to live like kings if such companies pay for ridiculously expensive things like insulin pumps. At a cost of roughly $5,000, we would be asking some insurance executive to do without a hot tub on the sun porch of his or her home. How could such an executive manage without it?
Instead, patients like the one I have already mentioned are asked to somehow manage to get along without an insulin pump or a heart transplant or some silly prosthetic arm or leg or they can manage to go begging for what they need to stay alive.
In 1971, President Richard Nixon, a man well known and loved for his warmth and compassion for his fellow man, signed into law the HMO Act of 1971. The act would increase the number of HMOs from 30 in 1970 to 1,700 six years later. What this means is basically that 1,670 CEOs of HMOs managed to make a bunch of money so people with pre-existing conditions could not cheat the system out of frivolous stuff like chemotherapy for cancer.
In 1973, it was Nixon?s generosity that created the HMO Act of 1973 that forked over $375 million in federal funds to help those floundering insurance executives who could barely manage to keep their yachts afloat in Biscayne Bay.
HMOs have done much to help the world?s problems. As Ebeneezer Scrooge said, ?The better to decrease the world?s population.? It was as clear to Nixon as it was to Scrooge that HMOs have served to relieve us of unwanted cancer, AIDS and sickle cell anemia victims who would otherwise manage to keep the corporate nabobs from reaping huge bonuses and who might even steal beds from alcoholic congressmen who send naughty e-mails to congressional pages.
In short, the idea of managed health care is to deny benefits to sick people, especially middle class people who somehow managed to get sick. The nerve of them. Wealthy people also manage to get sick but they usually manage to pay their hospital tabs with debit cards or shrink-wrapped stacks of dollars that they keep in their wall safes.
Poor people, of course, also manage to get sick, but somehow the government usually manages to pick up their tab. So, what about those of us in the middle class who don?t have enough in our debit account for a pack of Juicy Fruit gum and who have jars of pennies, not wads of currency in storage? What about people who have no health insurance at all ? like my wife, who works in a doctor?s office? What about people with pre-existing conditions like the unfortunate 32-year-old mother of two little girls mentioned at the beginning? Well, the answer for them is simple. They can all somehow manage to drop dead.
Michael Mager can be reached at
817-645-2441, ext. 2338, or features@trcle.com.
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