WorkShop Talks

HMO scams cost jobs and lives

by Htun Lin

A high-level computer software project manager at Kaiser HMO recently wrote a bombshell memo accusing Kaiser's CEO and CIO of Halliburton-style cronyism in awarding a multi-billion dollar contract to Epic Systems, whose software product has a track record of failure. This boondoggle is projected to lose $7 billion for Kaiser over the next two years.

They kept us employees in the dark. The only official acknowledgement that there is a problem came to us indirectly through hearing about its ramifications in the media--the necessity for massive cuts and layoffs to stave off financial disaster. The ultimate impact will undoubtedly endanger patients' lives.

Patients and health workers are being asked to make a new round of sacrifices as financial shenanigans are plundering the resources of the company. Ironically this comes in the midst of another spree of hiring business office employees to "enhance revenue" through increased co-payments and deductibles.

We are a nation that spends more than any other on earth on health care, and we are less healthy for it. It is foolhardy to measure health care primarily by dollar expenditure.

The current price of health care reflects financial imperatives coming from the needs of capital, whether in the form of companies that pay for health care for their employees or companies that produce health care products like pharmaceuticals.  Far from any actual scarcity of resources, the crisis reflects a contradiction between capital's concerns and workers' concerns over actual delivery of health care.

Workers who look to the future have stopped asking "how much?" and instead ask "what kind?"--be it labor, health care or education. Why would we workers only want more of the same? Why would we want to limit ourselves to taking over what presently exists?

We are constantly seduced by capital's imperatives to think that way instead of reflecting on the meaning of our labor. Why focus just on reclaiming the full value of our labor without questioning the very production of, say, depleted uranium, chemical-weapons, or cigarettes? We health workers ask, what about Viagra, Vioxx, or a thousand other poisonous products currently passed off as health care under an inhuman system at its core? As one RN who left the profession said, "I got tired of being paid so highly for killing people."

Counting the dollars spent does not signify a real standard for health care. From capital's perspective there is a debt to be paid, which patients pay through a chronic deficit of care.

Some advocate a single-payer system to cover all people.  But the significance of single-payer is not who pays, it's that it needs to be worker-controlled. We already have a kind of "single-payer" system for health care, Medicare. Except, we're paying to help capital expand, much in the same way the U.S. military budget is a "single-payer" which makes every man, woman, and child, virtual "share owners" through the public debt in the military-industrial complex.

This perversion existed long before the Bush/Frist Medicare Prescription Plan, designed to help the pharmaceutical giants and HMOs rob seniors by milking Medicare for more dollars.

While individual whistle-blowers uncover corporate abuses, our union officials, under the labor-management partnership, are seduced by technology, by automation, and specifically, the fetish of hi-tech. Our own union leaders tell us that "we can't stop progress."

Through the labor-management partnership they aim to help the company compete, even to the point of helping the company outsource our own jobs! Then they try to seduce us with the promise that high-tech will deliver the "better jobs of tomorrow," in order to get us to accept the sacrifices demanded today, such as speed-up and lay-offs, and deep cuts in health care and pensions.

Could it be that we are lured into thinking that way because we subscribe to some form of "there is no alternative"? Because when we look out our window, "capitalism is everywhere," as far as the eyes can see? Whatever happened to our mind's eye? A new movie about Jim Jones reminded me that he too told his People's Temple congregation before the Jonestown Massacre in 1978, "There is no way out." We workers helped prepare the Kool-Aid. But we don't have to drink it.

Without a doubt, there are going to be plenty of specific tasks to be accomplished concretely in order to reach the new society. But none of those tasks will signify "progress" unless they are preceded by the concrete and specific task of organizing our own minds.