The highest-grossing films in America in February 2002 included a war drama about American soldiers in Somalia (“Black Hawk Down”), an action film with Arnold Schwarzenegger (“Collateral Damage”) and a future Oscar winner about a brilliant mathematician struggling with schizophrenia (” A Beautiful Mind”
But none of these movies topped the box office this month. This title went to the film “John Q.” about health insurance.
More specifically, the story of a desperate father – played by Denzel Washington – who takes a hospital emergency room hostage at gunpoint when his HMO refuses to cover the cost of his son’s heart transplant.
John Q.’s brutal pursuit of justice was, of course, fictional. And even in the movie, no one dies.
Unfortunately, that was not the case on the streets of New York City on December 4, when a gunman fatally shot Brian Thompson, CEO of health insurance giant UnitedHealthcare.
But there was nothing up-to-date in the anger at health insurers that Thompson’s shooting sparked online and that suspect Luigi Mangione expressed in the documentary he allegedly wrote.
In fact, outbursts of public outrage have cast a shadow over the American health care system for decades.
In the delayed 1990s and early 2000s as “John Q.” hit theaters, Americans rebelled against HMOs, whose practice of denying members planning in order to make a profit made them public enemy No. 1.
Just a few years later, health insurers drew renewed ire cancellation of insurance after people are diagnosed with costly diseases such as cancer. Recently, insurers’ increased employ of burdensome prior authorization procedures that leisurely patients’ access to health care has sparked another wave of outrage.
The cycle of outrage periodically affects others in the health care industry as well. Exorbitant bills aggressive debt collection tactics, such as misappropriating patient wages, are here to stay undermining public trust in hospitals and other medical facilities.
And pharmaceutical companies – perennial poster children of greed and profiteering – have enraged Americans since at least the 1950s, when up-to-date “wonder drugs” like steroids fueled the burgeoning industry.
When Senator Estes Kefauver, a Democrat from Tennessee who was investigating the Mafia, hearings convened in 1959, to investigate high prescription drug prices, his committee received mountains of mail from Americans who reported that they had been defrauded by drug manufacturers. One retired railroad worker told how he had to spend more than a third of his retirement income on medicines for himself and his wife.
All this public outrage sometimes sparked change. President Barack Obama and Democrats in Congress have capitalized on anger at increases in insurance premiums in California to complete the Affordable Care Act in 2010, a landmark achievement that expanded health care coverage to millions of Americans.
More often, however, the cycles of rage were hearty and furious, producing only modest reforms. In some cases, public anger caused patients to suffer from more headaches.
For example, the HMO response in the delayed 1990s and early 2000s led employers—from whom about half of Americans receive health insurance—to take advantage of high-deductible health plans. Many employers viewed these plans as a way to reduce costs if they could not limit patients’ choices of health care providers through HMOs. These deductions, which can amount to thousands of dollars a year, put tens of millions of Americans in debt.
For many leftists who have long advocated for a single-payer, government-run health care system, the obstacle to more significant relief is the political power of the very industries — health insurers, drug companies, hospitals — that stoke patient anger.
These industries actually proved effective in resisting changes that threatened their financial performance. They also benefited from a paradox about how Americans think about their health care.
Patients may become enraged. They may even lose faith in the system. This year public opinion about health care quality dropped to its lowest level since Gallup began asking about it in 2001, with 44% of Americans rating quality as excellent or good, down from a high of 62%.
However, more than 70% said their health care was excellent or good.
There is much debate about the causes of this paradox. Are Americans just grateful for the health care they have? Are they content because most do not need to employ health care regularly? Do they simply like their doctor in the way that voters routinely say they like their own member of Congress but hate Washington politicians? Or do they fear that no matter how frustrating the current system may be, any change could make things worse?
The answer is probably a little bit of all of this. Collectively, such sentiments pose a major challenge to those who hope the current wave of anger at health insurers will lead to significant improvement.
Could this change? Maybe. These are unstable and unpredictable political times. And the pressure of vast medical bills is real. Medical debt in particular is taking a horrific toll on millions of Americans, KFF Health News– reporting showed.
But to effect change, advocates seeking to tame public anger at the health care industry will likely have to rethink their preferred solutions. Old ideas like “Medicare for All,” long nurtured by the left, and a deregulated health care market, long promoted by the right, have yet to sway Americans, no matter how enraged they are.
KFF Health News is a nationwide newsroom dealing with broadly understood journalism about health issues and is one of the main operational programs of KFF – an independent source of research, surveys and journalism in the field of health policy. Find out more about KFF.
This article appeared for the first time KFF Health News and is republished here under a Creative Commons license.
