By James Fieseher, M.D.
Portsmouth (N.H.) Herald, Dec. 26, 2013 Anthem: (n.) a song or hymn of praise or gladness. Anthem is also the name of the premiere health insurer in New Hampshire. There are many people in New Hampshire who believe Anthem is the model of health care. They believe that Anthem, and private health insurance companies like Anthem, rather than the government, should be in charge of your health care. Do they have a point? The Affordable Care Act (ACA) has had an inauspicious roll out, including President Obama’s “lie of the year” stating: “if you like your health insurance, you can keep it.” We have been told that we can’t trust our own government. Indeed, the two parties in Congress trust each other so little that they can’t make even the smallest of compromises. Should we turn the clock back and go back to the days of unrestricted private health care coverage? Do we really want the system that we had just five years ago? During President Bush’s administration in 2008, before the ACA was even a gleam in candidate Obama’s eye, Angela Braly, the CEO of Anthem’s parent company, Wellpoint, voted herself a 51 percent pay raise. Being a responsible businesswoman and knowing how to properly balance a budget, she then promptly raised insurance premiums 39 percent to pay for her raise. What does the CEO of a health insurance company do to merit a 51 percent pay raise — during the biggest recession since the Great Depression of the 1930s? Anthem made health care less affordable and less accessible for individuals and businesses struggling during the recession. Anthem did not improve health care. In fact, Anthem didn’t even provide health care. People who have Anthem health insurance are among the healthiest and wealthiest Americans; after all, you can’t get health insurance if you can’t afford it or have a pre-existing condition. She “merited” a pay raise because Anthem made a profit during the recession by collecting more money from its customers than it paid out in benefits. That represents the successful model of health care touted by the private insurance advocates. Anthem and all health insurance companies do not actually provide or even insure health. They cover medications for hypertension and diabetes, but don’t provide for counseling or the dietary factors that prevent or cure obesity, hypertension and diabetes. Exercise, a clean environment, proper dental care and mental health screening and counseling are all essentials for health management that are not covered by private health insurance companies. They manage disease, not health. Shouldn’t we have a health care system that rewards leaders who actually improve health care? Don’t we want a health care system that prevents high blood pressure, diabetes, strokes, cancer and cardiac disease? We should give raises to the health care insurers who make care more accessible and more affordable. Certainly, we should blame our politicians for focusing on all the wrong aspects of health care. We have a president who states he wants to improve health care and then promises people they can keep their faulty health care plans. We have Republicans who want to repeal the ACA and replace it with smaller, more expensive coverage dominated by businesses like Anthem. We have Democrats who cobbled a weak health care plan together and then weakened it further during implementation. But in truth, the fault lies with us, the voters. We’re fanatic about not raising taxes to pay for improved health care, but say nothing when a business “taxes” us with a 39 percent increase in premiums and then decreases coverage. We dismiss a “government option” where we actually have a say in policy and are silent when a private entity that we can’t control dictates our health care. If government is not the answer, what is? We need a national discussion about health care. Heck, I’ll even take a state or local discussion. We need to look beyond the ACA at what really matters in health care. It’s time to make a list of those qualities that improve health, improve accessibility and lower the cost of care. We need to be honest with ourselves and our neighbors and keep all our options on the table. Then, we need the courage to change the status quo to make it work. Now that deserves an anthem.
James Fieseher, MD, FAAFP, is a Portsmouth resident. http://www.seacoastonline.com/articles/20131226-OPINION-312260368
By James Fieseher, M.D.