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RANT FROM JANUARY 1999
"Secure or Insecure"
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     My wife and I recently attended a "town meeting" for Secure
Horizons, so-called -- the HMO that bought FHP.  We really didn't
want to go, and almost didn't, but then did, feeling that we
needed to find out how the system is supposed to work.
     The first snag was when the people up front repeatedly
thanked us for joining "Secure Horizons: Presbyterian's Health
Plan for Seniors."  We didn't join.  We were sold, like cattle. 
Or more like when Jim Konstanty was sold by the Phillies to the
Yankees.  
     Lots of blather ensued, and a growing awareness on my part
that this was a very large room filled with angry, disbelieving,
suspicious people.  Apologies for computer-blamed delays in
getting membership cards into the hands of members did not
mollify anyone.
     Usually the question-and-answer period of a meeting is the
worst part, but in this case it was not so.  Questions were quite
pointed.  "How long will this arrangement last, before it is sold
to someone else, like a bank?  Who gets the profit?"
     "Presbyterian is not a corporation.  There is no stock, to
buy or sell.  It is community owned," the answerer stated.  "All
profit is plowed back in."
     The purpose of the recent buy-out was to widen the choice of
health care deliverers, they told us.  Yet the plan clearly
limits choice, especially after the choosing of one's "primary
care physician."  It felt more like the all-pervasive notion that
bigger is in every case better, and we didn't believe it.
     I went to the rest room, and when I came back, I was accosted 
at the door in the hall, by two young agents who wanted to know if
all my questions had been answered.  So I asked my question,
which I had submitted but had not yet heard the answer to from up
front.  "If there is no stock, who owns Presbyterian?  Who gets
the profit?"
     Answer:  Presbyterian is community owned.  But I still
didn't understand that.  "What community?  Who in the community?"
I insisted.
     "There is a foundation."
     Aha!  "Well, I didn't know that.  So no one is clipping
coupons and taking money out of the system as profit?"
     "No," they assured me, "All profit is plowed back in to
provide better health care."
     I told them I was glad to hear it.  I knew that Presbyterian
started as a TB sanitarium and at one time was owned by the
Presbyterian Church, but then I assumed that some corporation
bought it and made it into a profit-making organization.  But,
no, they said, no corporation.  No profit, really.
     "Well, I think you need to tell that to more people.  It
might reduce the tension and hostility," I said.  They stared at
me, as if they hadn't noticed how much of that there was.
     "Of course," I went on, "what I really think we need is the
single-payer plan, such as they have in Canada and Cuba and
Denmark and Norway and the United Kingdom."
     "Oh, we think most people don't want that," the young men
said, quite vociferously.
     "The people who don't want that have never traveled," I told
them.  "They're believing what they're told, and believing things
that aren't true.  When people come here from those places I
mentioned, they can't believe our system.  For one-third of our
population it's no better here than in Bangladesh.  Visitors
really are simply astounded."
     [Later I realized that when they said "most people" -- the
ones they think do not want the single-payer system -- they meant
"most of the people we associate with," who would be insurance-
persons like themselves and who indeed do not want the single-
payer system, because they would then have to join the ranks of
the unemployed, along with steel-workers and auto-workers who
have been downsized.  The fact that one-third of all our "health
care dollars" would be freed from insurance parasites and made
available for the delivery of health care would not be convincing
to the people who stand to lose their "jobs."]
     I didn't get to say all that, even though it is true.  What
I did say was this:  "When I became eligible for Medicare, it
provided a great relief from tension, but it also became clear to
me that the government needs to provide that for all citizens,
not just the elderly.  It is a crime and a shame that so many are
going without health care."  The young men stared at me, in what 
looked like disbelief. I realized once again how few really do 
believe in equality.
  And," I added, "I think there is a public health danger in all 
this.  The microbes don't give a damn if you're a member of a plan 
like this one or not."
     "Well, Sir, you're right about that," one said with a weak 
grin, but when we all shook hands and parted, I thought I saw a 
glimmer of fear in their eyes.
* * *
Copyright © 1999 Harry Willson

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