David Lubar is the author of a funny Q&A piece about HMOs that has made the rounds on the Internet. It begins: "Q. What Does HMO stand for? A. It is really an abbreviation of 'Hey, Moe!,' and it comes from Dr. Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough in the eyes."
Today's health care system does seem like a Three Stooges schtick, and it has certainly delivered a poke in the eye to both us patients and our doctors, benefitting no one but the handful of corporate executives whom we suddenly find in charge of health care for a nation of 270 million people (well, 225 million if you subtract the 45 million of us have no health coverage at all). Barely a decade ago, the insurance giants and their puppets in Washington were direly warning us about the grotesque evils of "Socialized Medicine"—bureaucrats would make medical decisions rather than doctors, they would not let us choose our own doctors, patients would be denied treatments they needed, health care money would be siphoned off to feed the bureaucracy, and the costs of the whole system would go through the roof.
Hello? Ten years later, this is the reality of health care in America. While the insurance companies had us watching in fear for any sign of socialized medicine, they snuck around behind us and created Corporatized Medicine.
In the last few years, what is now referred to as the health care industry has fallen into fewer and fewer hands. Met Life, Prudential, New York Life, Travelers, and John Hancock are among the major HMO competitors that were there a moment ago, but are now gone, gulped down whole, like a boa constrictor eats a pig, by the likes of Aetna, Cigna and UnitedHealth Group. Not only are these three already the dominant national players, but they divide up the country, city by city, which gives them near-monopoly power because most people don't leave town to go to the doctor.
Aetna, which is notorious for squeezing the care out of health care, has captured 40% of the Philadelphia market, nearly 60% in several New Jersey cities, and a third in Atlanta, Orlando, and San Antonio. As Consumers for Quality Care points out, "With greater market share in key cities and states, Aetna [has] put itself in a higher position to offer more patients less coverage for ever higher premiums." Two-thirds of the entire market is now in the hands of the 10 biggest companies.
Already, the consolidated HMO industry is acting not in competition, but in concert — in 1998, the biggest national firms decided virtually on the same day to dump their Medicare service for rural seniors, and in 1999 every one of them uniformly hiked premiums for all of their patients.
Spending on everything but healing
Not only are premiums up dramatically, and going higher again this year, but more and more of the money we spend is going, not to our health needs, but to corporate bureaucracies and CEO paychecks. The growth in the number of beancounters has far outstripped growth in nurses and doctors—there are now four times more clerks and managers than there are doctors. ... [ read more ]
What the hell's happening here? Why is my bank in the tank? And my house and job? And my retirement money? Even my state's teetering on the brink of broke! Who did this to us? Fair questions, but we're not getting honest answers. 
