“Change is inevitable in a progressive country.  Change is constant.”

— Benjamin Disraeli, 1867.

Starting 32 years ago, and lasting for a period of about 25 years, one of my duties at work was administrating the health insurance program for our company.  Business was good, and we had a good crew of workers.  In an effort to keep a stable work force, management gave the employees free health insurance.  Dependents were also covered – at no cost to the employee.  Free health insurance.

The premiums cost the company around $135.00 for an employee, his wife, and children.  For a single employee, it was less than $100 per month.  Everyone signed up for it:  why wouldn’t they?  The plan was simple:  there was a $100 per year deductible, then the insurance company paid 80 percnt of medical expenses, the employee paid 20 percent.

Each year at renewal time, agents would come around and compete for our account.  Over time, we added group disability, group term life, and a dental plan. The employees were appreciative at first, but with the passing of time, they came to view the benefits as entitlements.  And each year the cost increased, until it became prohibitive.  That company is out of business now.

Lesson learned:  don’t increase your overhead based upon the euphoria generated by the good times enjoyed in the peak of the business cycle.

Our company had become squeezed between two irresistible forces: the downward trend of the business cycle, forcing us to cut costs wherever possible, and the drastic increase in the cost of health care, and similar increases in the cost of health insurance.  We had already begun getting some of the cost shared by the employees.

I had been hearing about a new concept, from the agents who called on me, of an attempt to control costs in the health insurance field:  something called a “Health Maintenance Organization,” or HMO.  Premiums were cheaper, but there were drawbacks.  In an HMO, even if you had been using the same family doctor for several generations, if he wasn’t in your network, you had to find another Primary Care Physician.  Also, you couldn’t go to any specialist, clinic, or hospital except those in your network, and then only with a referral from your Primary Care Physician.  I vowed to resist any such plan as long as possible.  Maybe, I hoped, it was a passing fad.

Then I started hearing from agents that it was taking hold in Houston, and it was only a matter of time before it was the product of choice for companies in the Golden Triangle.  Doctors who had been originally opposed to HMOs were signing up to be in HMO networks — or take a chance on their practice shrinking, as more of their patients became members of the dreaded HMOs.

“The only constant is change.  Change is inevitable.”

Now the HMO is a fact of life in the health insurance market across the country.  Occasionally you may hear a horror story about a patient who died because an HMO refused to authorize a treatment or a drug, but those incidents seem to be less common now, as public opinion and trial lawyers have made HMO bureaucrats more sensitive to patient needs.  I belong to an HMO (a Medicare Advantage Plan), and I have found that a letter from my doctor usually results in a satisfactory resolution of a disagreement stemming from an HMO refusal.

Now there is a new monster to tame.  Once again we are faced with the prospect of change — this time, initiated by the government.  No one seems to know exactly what this plan will look like, but the experts say it will be very expensive.  Some of that cost will be recouped, it is said, by reducing the amount of money spent to support plans like the one I am in.  If the cut is drastic enough, the company offering my plan may be forced out of business.

To put it bluntly, the administration seems willing to throw seniors under the bus if that’s what it takes to achieve the goals they set for themselves. 

I do not like the idea of a government-run health care plan. Government does not have the same incentive to control costs and maximize efficiency that private industry has.  Besides, if a government bureaucrat makes a decision that results in harm to a patient, that patient can’t sue the government — unless Uncle Sam says it’s OK.

But change will come, and we will adjust and deal with it, and “like it or lump it.” I just hope our leaders can see their way clear to gradually fix the things that are wrong (and some improvements can be made), rather than proceeding like Sherman’s March to the Sea, destroying the good with the bad, and laying waste to what is now the best health care system in the world. 

Gene Dammon of Port Neches is a contributing writer to the Port Arthur News. His e-mail address is: rdammon@gt.rr.com.