In last month's column, I cited opinions from other nations about our health-care system. This month, I'm going out on a limb with a saw. After recently speaking with some high school graduates who are going on to college, I found that their almost universal choice of major was either finance or computer science. The really smart ones occasionally mentioned some high-paying medical specialty — never family medicine because that doesn't pay the college loans — or that they wanted to become lawyers. None were even slightly interested in fields like nursing, social work, or teaching. There's no money in that. So, do J. P. Morgan, Donald Trump, and Bill Gates really need these kids to make them another billion bucks?
Not one was interested in a career in the P&C industry either, unless it was in some phase of marketing or investments. No one considered a career in claim adjusting. But then, why should they? They've probably never heard of it. Our end of the industry is not very big on PR, and most high school grads would probably consider handling claims as a dead-end job. Few know how exciting the claim profession can be. When you were graduating from high school, did you say, “Gosh, I can hardly wait to become an insurance adjuster”? Most of us stumbled into our careers by accident.
Last month, this column cited criticisms from British journalists who think our “capitalistic” approach to medical care is based on greed. Well, of course it is. Haven't we all bought into Ayn Rand's utopist ideals, where we're all rich and famous? We're surely not going to get there teaching high school or working for the welfare department, or as a nurse or other non-physician medical technician. Those jobs are for losers. Today's Generation X or Y wants the big bonuses customarily paid to bankers and Wall Street investors.
Consider what one banker suggests when he speaks to young people, according to an article by Andrew Martin of The New York Times. In Martin's article titled, “Give BB&T Liberty, but Not a Bailout,” John Allison, chairman of North Carolina's BB&T Bank, opens a speech by telling a story about a boy playing in a sandbox. Another child steals the boy's toy truck, and “a fight ensues, and the boy's mother tells him to stop being selfish and to share.” This, Allison asserts, is “a horrible lesson.” Selfishness is not a vice. Rather, Allison suggests, it is the highest virtue.
The Idea of Sharing
Perhaps this is why P&C adjusting is not a profession that many young people think about, because the whole concept of insurance is sharing. We share the risks. We spread the risk of loss among all those homogeneous exposure units so that when a catastrophe does arise, resources are in place to assist. That's the basic role of the P&C sector or health insurance. Selfish people would not give up their homes and families for a month or two to live in a disaster zone, as many adjusters worldwide will do each typhoon or hurricane season. Self-centered beings wouldn't climb out of their beds in the middle of the night to assist some insured trucker who has just been involved in a bad wreck, or help a family with a burned-out home find temporary living arrangements. There are simply no million-dollar bonuses associated with doing that.
But let's get back to the little boy in the sandbox. In some ways, Allison is right. When someone steals our toys, we should have a right to be angry. He goes on to suggest that big government is stealing our “toys,” as in the bank and auto bailouts, which he opposes. But isn't that an “I say 'po-tay-to' you say 'po-tah-to'” game? Is the government “we,” or “they”? Do we work for the government, or do they work for us? Greedy bankers made bad loans because they saw big bucks in the deals. Then deals went sour, and all of us — we, the government — had to bail them out. They were stealing our toy trucks.
Those of us in the casualty claim business should be familiar with the cost of medical care. What type of medical insurance reform might Congress pass this year? Will it pertain only to “medical and hospital care for illnesses,” or will it also apply to accidental injuries or occupational diseases? That is doubtful. That is what “universal medical care” systems do. The health insurance problem is not just the life and health insurance industry. It is also the casualty insurance industry, including auto accidents, workers' compensation, dog bites, and fall-down claims.
Lack of Family Physicians
One reason medical costs are so high is that there are so few “first-level” physicians. Medical students can't afford to go into family practice even if they want to, because a family physician doesn't receive enough from insurance reimbursements to pay for both the administrative staff needed or the high cost of a medical education. That is part of America's health-care dilemma. So how many Botox-injecting plastic surgeons, chiropractors, or sports-medicine specialists do we really need? How many MRIs and CAT scans are absolutely necessary? How many TV ads instructing the masses to ask their doctors if prescription BlahBlah is right for them (even though the side effects might kill a person) do we need?
In the U.S., the serious shortage of nurses, teachers, and professional technicians is growing. We have to import them to keep our schools and hospitals running. Men and women smart enough to be a nurse or teacher are also smart enough to realize that these are low-paying jobs of drudgery.
Congress, if it is going to do anything about the medical insurance problems, must also address the high cost of a medical education for both physicians and nurses. One thought is to waive the tuition loan repayments for any nurse or physician agreeing to work in rural or inner-city family medicine, military medicine or public health service, a Native American Indian reservation, or a migrant worker camp for five years.
A Possible Panacea
Add to the lack of family physicians a lack of professional medical support staff. In virtually every field of public employment, there are not enough social workers, teachers, nurses' aids, personal care personnel, teachers, firemen, prison guards, or garbage collectors. Unless the job pays $150,000 or more a year, nobody wants it. Instead, we allow thousands of immigrants annually to do work in personal care or agriculture, while at the same time unemployed, teenaged high-school dropouts are mugging little old ladies on the street for drug money.
Employers say they have to employ immigrants because the illegal ones especially don't have to be paid a minimum wage or benefits. If immigrants weren't available, then the price of food and construction and a lot of other things would increase. Absent fathers and foreclosures have left hundreds of thousands of poor people homeless. Urban streets and shelters are full of the mentally ill who ought to be institutionalized. They are also brimming with winos and narcos who have blown their brains on dope or booze. Hundreds of thousands of ex-cons have been released from jail, but they can't be employed because employee dishonesty insurance doesn't apply to anyone who has a record of dishonesty.
Finally, there are the truly unemployed who have lost their jobs and their homes, perhaps in some industrial city up North, and who migrate from place to place looking for work. Many have abandoned their wives and children to “the system.” Their kids, living on the street, may be unable or unwilling to go to school, but they may be willing to make the big bucks dealing crack and joining gangs.
What's the solution? Bring back the draft.
Universal Service Requirements
A new draft system would not be like the former Selective Service, whereby all 18-year-old males had to register, and numbers were drawn for military service. The new draft would be universal (applicable to men and women) not only for military service, but also for any area of public service where there is a need, including working in schools, inner-city welfare centers, child care, hospitals, AIDS clinics, farms, public housing construction, road and bridge building, and every other field where enough workers can't be found.
Sure, this may sound like a horrible idea, but let's think it through. Every person, regardless of intelligence or mental handicap, would be required to serve a minimum of two years starting at age 16, not 18. If that person is in high school and making passing grades, then he or she would be exempt until graduation. If they are smart enough to qualify for college (and a good many who are in college are not qualified), then they would be exempt until they graduated. There would be one caveat: every college would have an Officer Training Corps. The college student, regardless of major, would be trained to be an officer in the new Universal Service program. The student would have a three- (not two) year commitment. By then, if there is some sort of government medical insurance program, some of these officers could serve as medical claim adjusters, and perhaps be trained to ferret out medical insurance fraud, which, according to some studies, more than exceeds the $1.2 trillion that the current health insurance proposals might cost.
As in the old Selective Service draft, some draftees might choose military service, and others might be assigned military service rather than some other service area such as teaching or social work in urban slums or rural areas. They could be assigned to flood control projects, building levees, or to disaster relief work. However, (and this is the reason it would work) all of the draftees or OTCs would be bound to the Military Code of Conduct. They would undergo a minimum of two months of “basic training,” or regular two-week summer camps for the OTCs. There, something lacking in many youth of today — discipline and loyalty — would be instilled. There would be no “he yelled at me and my feelings are hurt and I'm going to sue” nonsense. In the military, when sergeants say “jump!” the answer is not “why?” but rather “how high?” What would be in store for those who refuse? When caught, they would help build the prisons to hold themselves.
Positive Results
Universal Service would eliminate most unemployment, which is a major cost to the government. It would eliminate the need for foreign workers in any field, whether it is a lettuce field or a technology field. As things stand now, we have to import people from Europe or Asia to work as nurses or teachers or technicians because we don't have enough of these trained Americans to fill vacancies. Universal Service would teach them.
Our urban areas are junkyards for dope heads and gun-toting gangs; citizens are not safe on the street. We taxpayers — the government — spend millions on drug enforcement, and yet still the dope gets in. Look what that costs in taxes and insurance premiums every year. Elimination of that factor alone could more than pay for the program, as draftees are not going to be earning anything near the minimum wage during their first year of service, unless they are astute and advance quickly in rank.
For those high school grads who look forward to a career in finance or marketing or computing, they may find nursing, medical assistance, or social work to their liking and continue their education in those fields. If they graduate from college and are smart enough to advance to graduate or medical school, then their Universal Service rank upon graduation would be much higher, perhaps the equivalent of colonels or commanders in the military. All draftees would have uniforms, room and board, and both health and dental care. The illiterate would be educated, and thousands of 14-year-old single mothers could receive special training related to child care and home economics.
Would it work? The draft was abolished in 1973 because it got a bad name due to the Vietnam war. Kids were snatched up from everywhere, including school, because our politicians and military believed in war, and American youth made good cannon fodder. I was among them, assigned to the First Infantry Division.
A Universal Service plan would solve problems, not create them. The cost would be no greater than the cost society pays now to deal with unemployment, illegal immigration, and drug-related gang wars. It would take many teen-aged drivers off the road, reducing the highway auto accidents. Such a plan could also instill insight to preventive medicine so that, upon completion of service, these men and women would be healthier adults. It might even influence a few to realize that those “big bucks” jobs are simply not for everyone. I think that it would only work if it is universal. When I was drafted for my two years active and two active reserves, classmates whose numbers did not get drawn got a two-year jump on the good jobs. The system was unfair.
A little bit of service work never hurt anyone, unless they are killed in combat. Today those perishing in combat are all volunteers, including reservists who are desperately needed at home. That, too, is unfair. If our nation really wants and needs to go to war, then it should be an equal opportunity employer.
Ken Brownlee, CPCU, is a former adjuster and risk manager based in Atlanta, Ga. He now authors and edits claim-adjusting textbooks.
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