Driving through downtown Albuquerque last weekend, many of us were startled to see scenes of near-total devastation. Entire blocks of our city streets had apparently suffered a catastrophe of immense proportions. Dozens of burned-out cars, trucks and city buses were strewn around like toys in a sandbox amid overturned chunks of concrete pavement blown apart by some great force.I would have called 911 except there were already many police present and the affected areas were ringed with yellow crime scene tape and … scores of movie production trailers, vans and tents.I’d been fooled briefly by the skill of sophisticated illusionists. In the final version of Game , the film whose shooting has tied up much of Albuquerque’s core for almost 10 weekends now, we may have a hard time even recognizing our own hometown. That’s how good these guys are; that’s how real their phony production looks. But even Hollywood’s magicians could pick up a trick or two from the health insurance industry in New Mexico. For the past year they’ve been busy kidnapping our governor’s honest desire to reform health care in the state. It appears they succeeded in fooling him into believing that “Health Care Solutions” is something more than a fake.They enlisted him in selling the illusion to the rest of us. Let’s take a moment to look at their techniques. Let’s learn how to fake health care reform. In other words, let’s examine how insurers have been able to take the public’s hunger for real improvement in the current system and co-opt it—while making a big-time profit.“Co-opt” means stealing the passion for change and detouring it; figuring out how to keep everything the same as before, while pretending to do something different. Here’s a few of the ways the passion for health care system change can be fooled, using Hollywood terms. Create a Monster Nothing keeps your eyes occupied while your pocket is being picked like a bogeyman stalking you from the big screen. Or Godzilla. Or space invaders. So one way to sell fake health care reform is to put your energy into fabricating monsters, like, “socialized medicine” or “do you want the government telling you which doctor you can see?” Or “the only alternative to what we’re selling you is for you to go without any coverage yourself.” None of those Darth Vaders are on the table, of course. But spend enough energy painting horns and a tail on your opposition and you may never have to explain away the weaknesses in your own version of “change.” Spread a Lot of Blood Around When the scenes of devastation are startling enough, they can paralyze our critical judgment, our mind’s ability to carefully analyze a situation and reject the absurd. So fake health care reform peddled by the insurance industry lays on the blood real thick: “Either you do it our way or all the doctors will flee New Mexico and you’ll die alone!”Alternatively, there’s lots of talk about fiscal hemorrhages: “You think you spend a lot on health care now? Just wait ’til those single-payer folks get ahold of your wallets.”When painted by the masters of deception, these gory scenarios prevent realistic cost/benefit analysis, something critical to suppress if the insurance industry is ever going to sell us “Health Care Solutions.” Don’t Forget the Sound Effects Even patently artificial simulations can be made to seem more natural by adding on a dramatic soundtrack. The crash of cymbals, the insistent sawing of a violin that builds to a crescendo, the echo chamber enhancement of a deep voice—there are a million ways to sell us an illusion, and no one understands how to use Madison Avenue artifice better than the insurance industry.Notice how the governor, in his State of the State talk last week, dismissively handled the alternative to “Health Care Solutions,” a statewide insurance cooperative plan its backers call “Health Security”: “We don’t need government to run the health care system for us.”That’s all he said about it. But you could practically hear the trapdoor slamming shut, the “swish, swish, swish” of his hands wiping away that dusty notion once and for all, the trumpet sounding “Taps” in farewell.And, finally: Sign Up a Big Star In New Mexico, they don’t come any bigger than Bill Richardson. His name on the marquee is practically a guarantee your production will be a hit. Your script may be weak, your premise wobbly, your director’s reputation tainted—but if you’ve got New Mexico’s No. 1 box office magnet mouthing your words for you, you’ve got a chance to make money.Notice I didn’t waste your time with actuarial pool talk, didn’t glaze your vision over with medical loss ratio figures, the cost of electronic record systems or Medicaid matching rates, or bore you with arguments about why 400,000 New Mexicans don’t have insurance coverage now. Don’t worry about them, those are only issues for wonks.For the rest of us, the true audience for Health Care Reform: The Movie , the insurance industry is betting its special effects will be enough. If only we don’t look behind the curtain.
The opinions expressed are solely those of the author. E-mail jerry@alibi.com.
