Health Care and the Mafia

Coincidentally, a couple of relevant mafia stories…

If we’re in need of a scapegoat for any health care insurance reform, Dr. Jonathan Kellerman has found the party in a biting Wall Street Journal opinion piece:

The health insurance model is closest to the parasitic relationship imposed by the Mafia and the like. Insurance companies provide nothing other than an ambiguous, shifty notion of “protection.” But even the Mafia doesn’t stick its nose into the process; once the monthly skim is set, Don Whoever stays out of the picture, but for occasional “cost of doing business” increases. When insurance companies insinuate themselves into the system, their first step is figuring out how to increase the skim by harming the people they are allegedly protecting through reduced service.

Once they affix themselves to the host – in this case dual hosts, both doctor and patient – they systematically suck the lifeblood out of the supply chain with obstructive strategies. For that reason, the consequences of any insurance-based health-care model, be it privately run, or a government entitlement, are painfully easy to predict. There will be progressively draconian rationing using denial of authorization and steadily rising co-payments on the patient end; massive paperwork and other bureaucratic hurdles, and steadily diminishing fee-recovery on the doctor end.

He actually suggests ridding ourselves completely of insurance, it’s worth a read.

The Guardian, last week, had an intriguing story on how to do (good) business like the mafia.  Despite some of the questionable tactics employed by the mafia over the years, Clare Longrigg writes there are lessons to be learned from organized crime.  My favorite (of the seven):

Rule 6: Reinvention

In case of a political scandal, or a business failure, it is vital for the new boss to be able to distance himself from the whole affair. Indeed, he may find it useful to take on a new persona altogether. When Stuart Rose returned to Arcadia after three years to rescue it, he said: “What is interesting is that people here think I haven’t changed, but I have been gone three years. I am not the same Stuart Rose, I have changed a lot.”

With Provenzano’s new directives, not only did the negative headlines cease, but he managed to dissociate himself from the scandals that had gone before. Like everyone else, he had emerged from Cosa Nostra’s most violent decade with his reputation in tatters; his advisers helped him to “get his virginity back”, in Giuffrè’s interesting phrase. With the help of his PR-savvy advisers, he made sure no one associated him with the violent years, and created his image as the peacemaker.

“When I got out of prison,” Giuffrè recalled, “I found Provenzano a changed man; from the hitman he once was, now he showed signs of saintliness.”

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