Calhouns Can(n)ons

Calhouns Can(n)ons for May 1, 2009

Oh, Look, It’s Chip Kahn. Prepare to Die

If you’re of that certain age most likely to really need good, reasonably priced healthcare, you’ll probably remember “Harry and Louise.” They were the brilliant work of Chip Kahn who, in 1993, was a lobbyist for the insurance industry who pitched an idea to advertising executives to create a national ad campaign to defeat any efforts to fix or reform our health delivery system. Bill and Hillary Clinton’s newly proposed health plan was the primary target, but the insurance industry wanted any and all talk of reforms likely to interfere with their profits killed.

Well, Chip – and Harry and Louise – were the ones to do it, with ads featuring two actors huddled around their kitchen table staring at a "Clinton Plan" book the size of the New York phone directory on steroids, wringing their hands and expressing terror that if the Clinton health plan became a reality, they’d -- GAAKKKK! -- “lose choice” and be forced by government goons into an implied hideous medical gulag or worse, an HMO of some kind.

The ads terrified the nation, as intended, and all discussion of reforming our medical system stopped dead. Ironically, into the void waltzed employers (wishing to save money) and insurance companies (wishing to make more money) with the end result that over time, insurance profits soared into the stratosphere while more and more employers shifted their employees health benefits to HMOs (no choice) or to increasingly limited health plans (no choice), or disappeared altogether (truly, no choice).

And now, once again, health care coverage is on the table and so Chip Kahn is back. But instead of being a hired gun to protect insurance companies, this time he’s President of the Federation of American Hospitals (a lobby group) and his job is to protect the hospitals that are being hammered because his previously successful efforts to stop health care reform in its tracks resulted in more and more uninsured people showing up in emergency rooms, an untenable situation that is eating the hospitals alive.

Well, Chip is not alone in realigning his (paid for) loyalties. For generations, one of the strongest lobbies against any kind of health reform or national health insurance has been doctors via the AMA. Even a whisper of reform immediately received the sobriquet of “Socialized Medicine,” with doctors declaring, “You don’t want some Washington bureaucrat making health decisions for you, do you?” Until it finally became clear to doctors that it wasn’t Washington Bureaucrats making the decisions, it was some health insurance number cruncher with a green eyeshade but without any medical training telling doctors what they could or could not do to treat their own patients, then drowning them with paperwork while their patients died from delayed or refused treatment.

Well, they’ve all seen the light now, running full page ads urging Americans to get serious about fixing this medical mess, along with the wolves in sheep’s clothing – the insurance companies themselves. Strange bedfellows, indeed.

The March 23, 2009, Newsweek story makes the coming “national discussion” about health care stunningly clear: “Yet veterans of earlier battles recall there was great enthusiasm, too, when Bill Clinton first raised the need for change. It makes sense for all parties to be enthusiastic in the early going, if only to be in a better position to defend their interests. As the Cato Institute’s Michael Cannon quipped recently to USA Today,‘they all want to be at the table because they don’t want to be on the menu.’” Adds Brandeis University health professor or Stuart Altman, “ . . . the Clinton effort went ‘all downhill . . when they started to put meat on the bones.’ He expects opposition to mount again. ‘Everyone is supporting this until it comes time for them to pay, he says.”

And there it is, with one key added wrinkle during this go-round: Americans must decide whether they want their health care to be a for-profit luxury, or a not-for-profit right. In other words, should the focus be on creating a system whose primary concern is making money for insurance company stockholders and CEOs, or should it be focused on delivering the best-care-for-the-dollar service for the consumer? Which type of system We the People pick will make all the difference.

As for Harry and Louise, they’ll be back in some other form. Chip Kahn says he won’t be bringing them back, but you know somebody will. They were an extraordinarily effective tool that was used to protect extraordinarily powerful vested interests.

As for the vested interests of the average American, it remains to be seen who will show up to protect those. Did the recent economic meltdown finally alert enough people to just how fragile and frayed their health care coverage actually was – one job away from being uninsured altogether? Or just how many strings of their safety net had been snipped away in the name of profit? Or that they were one illness away from financial ruin?

If that awakening hasn’t occurred, then Harry and Louise will appear to frighten and bamboozle them back out into the cold with shoddy, for-profit, overpriced, unaffordable bad insurance. Or leave them again with no health coverage and then, insult to injury, stick them all with the entire bill . . . . again.

It’s enough to give you a headache, but nowadays, who can afford an aspirin?