Private Insurance vs. Public Life

by Michael Foley

The Grange Hall in my little community is one of two venues where community groups can rent a room or a ballroom for their activities.  There’s a commercial-grade kitchen under construction, with high hopes that it will serve as an incubator for locally based small food businesses.  But the insurance industry has its claws even into these eminently civic purposes.  Non-profits, small businesses, wedding parties, even little groups of friends have to prove they have a million dollars in liability insurance just to walk in the door.  Why?  Because a single serious accident could cost the Grange its building.  And it’s insurer wants to see, every year, the insurance certificates of every entity that rented Grange facilities.

We tolerate this situation because it is the way we pay for medical care.  Yes, it is primarily a matter of how we cover the inevitable expenses of an accident or serious case of food poisoning or, God forbid, another outbreak of Legionnaires Disease.  Liability insurance, of course, also covers loss of livelihood resulting from such injuries, the pain and suffering experienced by the victim and his or her family, and penalties for gross negligence.  It represents, in short, the complete privatization of public welfare and even basic police functions.

It has become progressive doctrine that tort reform is a tool of self-interested big business and greedy incompetents in the medical profession to roll back basic consumer protections.  And no doubt such motives are not badly represented among conservative advocates.  But anyone who has tried to set up an alternative medical practice, a community health clinic, a home-birthing center, knows the price liability insurance exacts on our medical system.

And the damage extends much further, as our little Grange Hall suggests.  The insurance industry collects on every event, every homeowner, every organization, every business in the country.  And the pretext is a medical system that demands cash on the barrel head for everything from preventive care to emergency resuscitation.  Take away the system of privatized health insurance, guarantee health care as a right, to be paid for out of public funds, and the trammels of mandatory insurance coverage would be severely weakened.  Add a decent system of social security – what the social security and worker’s compensation systems could have been – along with real enforcement of medical practice and basic safety regulations, and the insurance industry’s throttle-hold on American civic and business life would be broken.

The conservative ideologues who lead the rejectionist response to universal coverage simultaneously advocate tort reform.  The progressive ideologues who reject tort reform out of hand simultaneously advocate a single-payer health care system.  In fact, the two measures go hand in hand, but a single-payer system would accomplish what mere tort “reform” could never do, break the hold of the insurance industry on our pocketbooks.  And while the ideologues at the head of the conservative movement openly advocate a dog-eat-dog world, most Americans retain enough of a sense of solidarity to recognize that universal coverage should be a basic right.

We won’t get a single-payer system, or anything like it, from our corrupted Congress and Presidency.  But we can build support for real change out of a recognition of the multiple ways in which the insurance industry profits not just off misery but off the vulnerability of us all in a system makes each and every one of us liable for every mis-step, every accident, every trick of fate.

Michael Foley

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