I am skeptical about bumper stickers as an effective form of communication. Can any important social issue be reduced to a message that fits on a 5" x 12" sign with type large enough to be read from a distance at highway speeds? It seems as though it is a medium that begs for reductionist thinking and pandering to stereotypes. You can't really even fit a haiku comfortably on a bumper sticker.
Granted, some bumper stickers can provide momentary amusement or even provoke some thought, as this parody I saw recently on a subcompact car in Midtown: on the left side, a blurry-edged vignette of an American flag flying in the breeze. To the right, in chancery script, "These colors don't run..." Beneath that, "...the world." But face it: I wouldn't have appreciated that sticker if it didn't express a sentiment I was already pretty in tune with. While it was humorous, it really didn't profoundly affect my thinking.
There is an exception, of course, lest this would be a pretty short and pointless essay. Last year I was driving to my office, frustrated at some of the problems common to being a health care provider these days. An insurance company was refusing to pay for a patient's medication because they hadn't been promised a kickback from the manufacturer to place that particular medication on their formulary
. Their persistent delay in paying for this medically necessary treatment was leading inexorably to a worsening of the patient's condition. Soon, the patient would require hospitalization. The insurer stood to save, perhaps, $1200 by refusing to pay for the medication. Instead, the patient ended up in the hospital at a cost of tens of thousands of dollars and disruption in the life of the patient and his family. The insurance company was blaming their pharmacy benefit management company. The pharmacy benefit management company was blaming the mental health "carve-out" company. What nobody
was doing was expressing a desire to help a fellow human being and valued customer by providing the services they had promised him when he paid his premium. I was mulling over the injustice of the situation when I noticed a car parked in front of a transitional housing agency with a bumper sticker that read "Abolish Corporate Personhood
." Those three words succeeded in channeling my frustration in an entirely new direction.
There is a scene in The Incredibles
where Bob Parr is being confronted by his boss. Parr, who is a former superhero working as a customer service representative at an insurance company, asks his boss something like "aren't we supposed to be helping people?" to which the boss replies "we're supposed to help our
people, Bob, starting with our stockholders!"
There is tremendous power and richness in face-to-face interactions among human beings, and all too often the effect of corporatization is to move the decision makers completely away the people whose lives are affected by corporate policy. Even though, ultimately, it is people who make the decisions, the humanity of the process is buried under layers of corporate bureaucracy. This inhumanity is not limited to health care organizations, either, nor is the frustration limited to patients. The phrase "faceless corporation" gets almost 9,000 hits on Google
I am far too cynical to think that a three-word slogan and a conceptually simple (albeit dramatic) change in law would eliminate the frustration we all experience when dealing with corporations that are compelled to focus on quarterly earnings above human dignity. Still, anyone who has had the experience of trying to correct a mistake made by an institution where no individual is available to take responsibility should be able to see the appeal of the idea. From childhood obesity to war profiteering, from Enron to WorldCom, health care to defense contracting, corporate personhood is certainly contributing to the misery in our world.
A Word About Formularies
You might have heard it from your doctor, your pharmacist, or your insurance company: "sorry, that drug is not on the formulary." So what is a formulary? Basically, it is a catalog of medications for which the insurance company is given a kickback
. Shouldn't that be unlawful, you're thinking? Keep in mind that, here in California, the biggest purchaser of prescription medications is the state government, mostly through Medi-Cal (California's rebranded Medicaid program). That also makes the state the largest recipient of kickbacks for listing medications on their formulary. I doubt seriously that we'll see any big push by the state to outlaw or regulate pharmaceutical kickbacks any time soon.
- 09 Apr 2005