The Profit Motive

Do we truly want the “profit motive” to be the prevailing energy for everything? For example, is it the Christian intention that only “profitable churches” are useful? Are only the pastors who are profitable doing “God’s” work? Is that the way Muslims, or Jews evaluate a Mosque or Temple? If we pursue the religious teachings of virtually all religions and especially Christian denominations to take care of the poor…can that ever be profitable? Of course not!

How is medical treatment for the sick much different? Do we really want the treatment of the sick, especially those who happen to also be poor, to be based on profit? If it’s a member of your family, and a life saving medical procedure that’s needed, do you really want it to be premised on whether you can pay for the procedure with an adequate percent of profit added to the cost? I doubt it!

We are sooner or later going to have to recognize that the necessity of profit shouldn’t have a prominent place in medical care. Sooner or later we’re going to have to recognize that the INSURANCE COMPANIES are the problem. I don’t know how many ways there are of telling this story. But, to those reading…the insurance companies have legions of employees who are dedicated to doing one thing and one thing only…denying your claim. The ruse works like this. You file a routine claim for an annual check-up for one of your small children. You’ve had coverage since the birth of the child, so why would you think the doctor’s visit wouldn’t be covered. But, then you get a denial of the claim back from the insurance company.

Unfortunately, many people would go ahead and accept liability for the bill themselves and try to figure out how they would get the funds to pay their doctor or health provider out of the family budget. However, since you work for a large company you challenge the denial through your company’s administration office. The insurance company advises you they turned down the claim because you had ambiguously answered a question on the insurance application about whether the child was eligible for alternative insurance. A question that simply requires a yes or no answer…but, they say you answered ambiguously. But, you’re a single mom. The father has never been involved in the child’s life. How could that have been the case…especially after the insurance company had paid for several regularly scheduled check-ups in the child’s life?

The answer is, of course, there was no ambiguity. The insurance company was only testing two theories. One, maybe you wouldn’t dispute the denial and go ahead and pay the claim. And, two, if you don’t pay the claim they still get an extra 30 to 120 days use of the money while you straighten out their confusion and/or fight the denial.

You say this couldn’t happen. Oh, it did. And, it happened in my own family. It happens in a lot of other families too. It’s time to declare that healthcare is not a place for obscene profits. It’s a place for care and compassion. It should be driven by profit. The least of my worries is whether a private insurance company can compete with a government sponsored plan, or a non-profit plan. I also don’t think the Mega Churches are doing all of God’s work. I think a lot of small congregations who aren’t “profitable” are tending to the teachings of Christianity.

Or…how about you want to buy medical insurance...so, you contact several companies to see what’s available. However, your young son who experienced an infantile seizure is uninsurable because of this pre-existing condition. You have the money to pay the premium…but, can’t get the coverage. Not in America, you say. Oh, yes…in America. Again, this happened to one of my own family members…so, I’m not speaking in the third person or creating a straw man argument.

Then of course, there’s the issue of obtaining a catastrophic policy during a period of unemployment. You find out that you have a malignant tumor on your small intestines and the insurance carrier wants to insist you had a pre-existing condition and just didn’t tell them. Oh, you finally get coverage after you threaten them with bad faith and tell them to prove you had the condition and knew when you took out the policy. Once, again…this happened inside my own family. We had the ability to challenge the insurance company…but, what about the family or individual who doesn’t have that ability.

Then the best of all…you have what is supposed to be the best health insurance money can buy. You fall from a transit authority bus and suffer a fall. The fall results in a compound fracture of your arm. The bone is exposed to the pavement. The city bus driver, being a good employee, immediately calls 911 to request an ambulance. When you get the bill for the ambulance service…the insurance company denies the claim because the ambulance service wasn’t a plan provider. Now, get that picture once again. This is a medical emergency…but, the vendor of an emergency service has to be a planned provider. What kind of insurance is that? I’m not making this up folks…this all happened to my family…not the family next door or somewhere on the other side of the country. And, I don’t think I’m on an island out here. I think this is happening inside of your family too if you just ask around. It’s not doctors, hospitals, nurses, or care providers that are causing the problem with healthcare in this country…it’s the insurance companies.

There are plenty of businesses that are legitimately “profit” driven. But’ they don’t all have to be that way.

I say good riddance to them.