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Sikh Perspectives On Health Care Reforms


Jun 1, 2004
The US Congress is on their August recess and most have returned to their home constituencies. The atmosphere throughout the country is becoming increasingly polarized over the issue of healthcare. From Palin’s stupidity in labeling Obama’s plans “downright evil” (I almost don’t know what is worse – her attempt to ‘inflame’ sections of the public through such incendiary language or the fact that she is still unaware that there is NO “Obama plan” – Obama has left the process to the branch of the government that is suppose to make laws – the Congressional legislative branch) to Obama’s call for sanity and an end to “outlandish” claims against the process, the partisan hackery has already begun.

So now we open up a discussion here. What we are going to attempt to do is what, unfortunately, is not happening in the rest of the country – an honest discussion. Instead, we have had partisan hacks yelling “Socialism” and others yelling “Fascism” with divisions based on well-known party allegiances, rather than real interests. Will we be successful here?

Healthcare has been discussed before, but as the topic is taking center stage in the United States, it is an opportunity to use our community capital. In the United States, Sikhs are far over-represented in health services. From doctors to nurses to physical therapists and everything else, we occupy a broad expanse of the health care sector. What are our opinions on health care? What are the opinions of our brothers and sisters from UK, Canada, India and other countries, which have very different systems?

Some Background:

I’ll begin with a basic sketch. Here are some numbers provided by the BBC:

* 47 million uninsured, 25 million under-insured
* Healthcare costs represent 16% of GDP, almost twice OECD average
* Reform plans would require all Americans to get insurance
* Some propose public insurance option to compete with private insurers

The system in the US currently is already a mixed public-private system. Most people fall under the “private” system where various companies provide healthcare as well as profits for their shareholders. Some nonprofit healthcare groups also exist, but those providing coverage the vast majority fall under the private systems. Premiums continue to go up with age. Companies have been largely profitable with large portions of peoples’ premiums being paid in executive salaries and corporate profits.

President Obama has called for a “public option” from the Congressional proposal in his push for “health-insurance” reform. The “public option” is to be a government-sponsored “option” that will compete with the various private and nonprofit packages, although it will not be available to all. Government programs already exist – including Medicare (for the elderly), Medicaid (for low-income adults), and SCHIP (for low-income children). The “public option” is to keep the companies ‘honest’ in terms of their competitiveness.

What has been largely left off the mainstream news networks corporate-financed ‘debate’ is the push for a complete overhaul to a “single-payer” system, as seen in Canada and many other countries. Obama has mentioned in the past that he supports such a system, but does not believe that it a true possibility.

Everyone seems to agree that reform is needed. What it will like is still anyone’s guess. The basic problems are well-known, but the moneyed interest and special interest groups attached to the issue as well as partisan hackery serve to complicate the issue. A recent exposure by a whistleblower insurance insider, Wendell Potter, the former head of Public Relations for CIGNA, one of the nation’s largest insurers, is a MUST WATCH in understanding the current interests of various health insurance groups:

“I didn’t intend to [speak out], until it became really clear to me that the industry is resorting to the same tactics they’ve used over the years, and particularly back in the early ’90s, when they were leading the effort to kill the Clinton plan.”

On efficiency…

BILL MOYERS: Why is public insurance, a public option, so fiercely opposed by the industry?

WENDELL POTTER: The industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate. The Medicare program that we have here is a government-run program that has administrative expenses that are like three percent or so.

BILL MOYERS: Compared to the industry’s–

WENDELL POTTER: They spend about 20 cents of every premium dollar on overhead, which is administrative expense or profit. So they don’t want to compete against a more efficient competitor.

On profits above people…

BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, “I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors.” How do they satisfy their Wall Street investors?

WENDELL POTTER: Well, there’s a measure of profitability that investors look to, and it’s called a medical loss ratio. And it’s unique to the health insurance industry. And by medical loss ratio, I mean that it’s a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry’s been dominated by, or become dominated by for-profit insurance companies. Back in the early ’90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

On a free market system…

BILL MOYERS: So how can you object? How can we object when an insurance company wants to increase its profits? That’s a serious question. I mean, it sounds like a set-up but it’s a serious question.

WENDELL POTTER: It’s a very serious question. And I think that people who are strong advocates of our health care system remaining as it is, very much a free market health care system, fail to realize that we’re really talking about human beings here. And it doesn’t work as well as they would like it to. Yeah, there’s nothing wrong. And I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.

It must be obvious by now what my opinion is. Although I cannot claim I have a “Sikh opinion”, my opinion is informed by my understanding of Sikhi. I do believe that the principal of “sarbat da bhalla” calls for insurance and proper care for everyone. Personally I, too, am an advocate for a single-payer system, but believe that a bonafide “public option” is the best way to go in the present political climate. If the “public option” proves successful, as the health insurance companies morbidly fear, then there will be progression towards a single-payer system. If they can honestly compete, then they have no reason to worry. Time will tell, however, I do encourage all of our readers to get inform themselves of the conversations and play a role in this necessary domestic conversation. I just hope we can go beyond slogans, hackery, name-calling, and fear-mongering (the always used ‘government bureaucrat’ that will supposedly decide whether your health care is rationed or that you will get necessary treatment, forgetting that in the present system a ‘corporate bureaucrat’ is already making that same decision).

As many in our own community have their own vested interests tied to the current state and profits, it will take special courage from them to see a possible reduction in their salaries in order to do what is best for the country. How many would be willing to do that? I would be interested to find out. So let’s hear from the entire sangat – inside the US and out – as we gather here.


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