EMIL AMOK’S TAKEOUT–WDAAAT* ABOUT LUIGI MANGIONE AND HEALTH INSURANCE
*What does an Asian American think
By Emil Amok Guillermo
I just got implants. Dental ones. But all is not well.
For a key back molar, my health insurance company does not honor implant oral surgery. Says it’s not medically necessary. Apparently, chewing, or as they say, mastication, in the act of feeding is considered cosmetic.
It is cosmetic when I eat too much.
A molar, however, is essential unless I’m slurping my favorite vegan ramen.
It’s not like a hockey player’s missing tooth that requires implantation. Now, that’s cosmetic.
So, I begin this column mad, but I do not advocate murder. I run amok in my columns, but I do so metaphorically.
There are other ways to get at the healthcare companies. You write letters to the insurance company, to Congress, maybe to your local television consumer reporter. Certainly, you vote for someone who advocates “Medicare for All.”
None of that amounts to a sexy manifesto.
But do you assassinate someone? Not in America.
Still, I do understand the frustration of Luigi Mangione? We all do.
Here’s where the insurance companies are wrong.
THE WAY THE SYSTEM WORKS
When insurers treat rejected insureds’ claims in dot-matrix style form letters or communicate to us like we’re just a number to them, where’s that sense of loving humanity for all those premium dollars we’ve paid them?
They don’t really care about you.And they communicate that with every form letter.
Insurance is all about money.
Not about people.
Actuaries are paid the big bucks to figure out the odds. And then they charge the correct premiums that sit in a big pool of money ready to be paid out when people get sick.
But if insurers set the numbers right, they never have to.
They’re like health bookies. We pay them money. They’ll “cover” us. Just don’t get sick, and everyone’s happy.
What a deal.
When we pay monthly and are insured, and we stay well, all that money keeps sitting in that insurer’s big pool of cash earning interest—for the company. They loan it out and invest it. And profit from it. That’s why billionaire Warren Buffet is in insurance. And his mascot is a gecko. Cute but still a reptile.
It’s all about money. Not the premium paying human customer.
Your “lucky day” comes when you get sick with a legitimate claim.
Then they pay out. But it’s all figured in. It doesn’t hurt the insurer if they’ve done the numbers right. They’ve taken all your premium dollars from that big pool of money and are making what Rush Limbaugh used to call “confiscatory profits.” It’s a pittance compared to the payouts.
So stay healthy, pay your premium, and stay healthy. Everyone’s happy.
Now when you’re rejected, it’s only because the insurers screwed up the numbers. Too many people got sick. In that scenario, when you want some of that pool money back, forget it. They will fight you for it until it’s no longer profitable.
Insurers only gladly pay you because they’ve made so much money from your fellow customers who gave them money and stayed well.
But if we all got sick, forget it. They will fight us to the death.
MEDICARE-FOR-ALL?
That’s the way it works now. But the system would work better if they’d only add the word “universal” to the phrase health care. That means everyone’s in the pool. And everyone means everyone (remember the move for worker mandates?)
The bigger the pool, the better the coverage.
Actuaries would still have to figure how much would be paid based on the illness experience of the customers. But the law of large numbers has a point where everyone is happy. Insurers and customers. It only works when the largest number of people are in the pool.
So why don’t we have “universal” health care insurance?
Oh, you mean “socialized medicine”?
Because capitalists want to have their own insurance companies and have their own smaller pools to make their own big profits.
Older people have the best health insurance in the form of Medicare, which is one big pool of people over age 65 run by the government. It’s the reason “Medicare-For-All” has been a battle cry for consumer advocates. It works, covers everyone, and is considered the best by industry pros. And the private insurers are trying to horn in with the misnumbered “Medicare Advantage.” It’s cheaper than Medicare when you’re well, but the advantage disappears when you’re sick.
Overall, the corporates like the way the system works now for the rest of us, where you pay more money in premium than you ever get back because you’re well.
Or they simply deny claims because the corporation needs to stay even healthier than you.
This is the system Luigi was mad about. And he has a point. It just shouldn’t be made with a ghost gun and a bullet.
Now, is he a terrorist, as recently alleged by New York District Attorney Alvin Bragg? A terrorist is like a suicide bomber who goes into a crowd indiscriminately.
Unlike a terrorist, Luigi is alleged to have gone after a single individual in the break of dawn in a nearly empty Manhattan street.
To attach terrorism to the charges is really more a reaction to the public response and intended to put a chill in the air, especially when Luigi is being made into some folk hero in social media.
Luigi is no folk hero, but it’s a First Amendment right to call him one
What he’s done is force people to understand and explain health care insurance like no one has before. And that’s no small thing.
Emil Guillermo is a journalist, commentator, and humorist, who has also studied and worked in the insurance industry. See his micro-talk show on www.patreon.com/emilamok
