You can consider this the post that Ezra didn't write, I suppose, since it's taken from a cute and interesting post of his about cell phone companies and extending it to the health care reform debate. The twinkly Ezra post is this interesting one about one of those mild irritants that turns out not to be the result of incompetence but malice---the 15 seconds after someone's voicemail message telling you how to leave a voicemail, as if you didn't know. It's as if they think everyone on the planet is leaving those cutesy messages where they play a clip from a TV show into the phone instead of alert you to the fact that this is voicemail. But even those of us with tendencies to be cutesy are usually all business on the cell phone, and so our loved ones and colleagues who the misfortune to call while we're playing Rock Band get to suffer this:

Voice Mail: Hi, you've reached Amanda Marcotte's cell phone. Leave a message and I'll get back to you.

Irritating mandatory message: If you'd like to leave a message, press one now. Or wait for the tone.

(Actually, not, because I have an iPhone, which means that Apple---who hasn't yet gone 100% to the dark side, apparently---was able to muscle it off my phone, as they did for all their iPhone customers.) Pressing one doesn't work, I've decided. Incompetence? No. Corporate malice, as David Pogue found out.

In 2007, I spoke at an international cellular conference in Italy. The big buzzword was ARPU–Average Revenue Per User. The seminars all had titles like, “Maximizing ARPU In a Digital Age.” And yes, several attendees (cell executives) admitted to me, point-blank, that the voicemail instructions exist primarily to make you use up airtime, thereby maximizing ARPU.

I'd like you to remember this story next time a conservative is wailing about government bureaucracy, because it's not the government that's sliced your life into 15-second intervals where it can hold you hostage and take your money. People hate that the government is occasionally indifferent with your time, such as at the DMV, but hey, they're not actually trying to steal it from you. But corporate America's vicious attitude towards the public, where they actually appear to enjoy seeking ways to screw you, is much darker even than reducing your life to 15 second intervals that can be snatched from you (to the tune of 3 hours of your life a year, meaning that you lose a day of your life to unnecessary cell phone messages every 8 years.) Which brings us to private insurance, where there's a lot of money in looking at the customer as an enemy that you should try to screw every chance you get.

"This American Life" recently had a great segment on the practice of rescission, which is where an insurance company that doesn't want to pay for your treatment scours your medical history in order to find an excuse to kick you off. This has already happened to me once---apparently, I was supposed to just know that I was going to get a bad Pap smear, and they kicked me off the second my doctor billed them for a colposcopy, probably because if I had cancer they sure as shit weren't going to let me live, because cancer is expensive. (Don't worry---I don't have cancer.) Insurance companies claim the practice is rare, but it's obvious from this report* that it's incredibly common, and if you have to pay for your own insurance, consider yourself a very rare lucky one if you actually get coverage if you get really sick. Because they will comb through your medical history and use anything as an excuse to say you weren't healthy when you signed up, and are trying to commit fraud. One woman they interview, for instance, faced rescission when she got a particularly aggressive form of breast cancer that required an immediate double mastectomy. Instead of letting her get this, the insurance company put her policy on hold to investigate the fact that she had been treated in the past for.....acne. Yes, she had gone to a dermatologist who probably gave her a topical antibiotic to reduce her acne. Because of this, she should have known she was going to get breast cancer.

Of course, non-Americans probably have the same reaction that I did when listening to the congressmen who were outraged about this talk: Well, we're starting from the fucked-up assumption that the only people who "deserve" health care are people who have a completely clean bill of health and only get sick down the road. Over and over, the congress critters defended the people who'd been kicked off their insurance by saying that they didn't intentionally lie about their health---they usually didn't lie at all---but never once did any of them suggest that it's fucked up that insurance companies are allowed to require people to have a perfect bill of health, or they'll keep them off with denial or charging premiums no normal person can afford. At the end of the day, the system is based on a false premise, which is that insurance companies are betting that you won't get sick, which means they reserve the right to act betrayed and indignant when you demonstrate that you're a flesh and blood human being whose body is susceptible to illness.

At one point, one congressman did get an insurance company representative to flinch and admit he didn't enjoy killing innocent people for money.

All the insurance representatives basically had the same line---they'd abuse and kill people as far as the law would allow. That's the logical end of the mentality that drives corporations to see customers as the enemy of profit, and to do things like steal 15 seconds of your time over and over again while putting on a smiley face and pretending to be there to serve. Basically, they were saying right there that the government needs to ban rescission. There's no "free market" solution, because the so-called "free market" isn't competition between companies for your dollars, it's a competition between you and the corporations. With the 15 second thing, there's enough play in the market that one carrier can charge you more and simply break the mold of trying to steal it, but with insurance companies, they're all going to act exactly the same on this issue, because it's always going to be more profitable to take your money and refuse to cover your bills. Every single time.

By the way, after I listened to that podcast, I got a press release from Janet Trautwein, CEO of the National Association of Health Underwriters, scolding Nancy Pelosi for her "outburst" against insurance companies, because Pelosi apparently called them "villains". Quote:

"It's unfortunate that Speaker Pelosi has resorted to petty name-calling in the debate over health care reform. We all have a stake in achieving meaningful reform that both preserves Americans' freedom to choose their doctors and lowers long-term health care costs. A public option will accomplish neither."

It's unfortunate that the sheer level of choadery of this press release made me throw up on my shoes because I didn't have Trautwein around to throw up on. You want "petty" name-calling, assholes? How about you just go fuck yourselves instead?

Of course, during the hearings, the representatives for the insurance companies denied everything, even when their denials contradicted themselves, and basically lied about how many people face rescission when they get sick.

*I just want to say that Michael Moore was demonized for doing an entire movie about this practice, and now it's being covered by public radio and hearings are being held in Congress.