I was the doctor on duty one night in August when the ambulance rushed a man into our Midwestern hospital ER. As I walked into the room, the scene was right out of TV. A nurse was trying to start an IV. Someone was running an EKG. A student had just put oxygen in the patient’s nose. The room seemed crowded. The paramedics were sweating and slightly out of breath.

But my attention was on a pale, thin, 55-year-old man sitting bolt upright on a gurney, clutching his chest and straining to breathe. Cold sweat dripped off his nose. I asked a couple of quick questions as I leaned him forward to listen to his lungs. Someone handed me his EKG showing an acute heart attack.

On May 17, 2011, the traffic in downtown Indianapolis moved slower than an insurance company clerk preparing a reimbursement check, backed up for blocks, and if we were one second late the doors to the WellPoint annual shareholders meeting would be sealed, protected by armed guards. We jumped out of the car, leaving it our friend Donna Smith to find a parking spot, and started running up the street, dodging traffic, past the phalanx of police cars and into the Hilton.

Breathlessly rushing through the lobby we asked which floor for the WellPoint meeting and luckily didn't wait long for an elevator. When we reached the ninth floor with minutes to spare, the WellPoint staff at the registration desk greeted us like old friends, "Dr. Stone, we were afraid you weren't going to make it."

"The new health care legislation is a step toward elimination, by slow strangulation, of private health insurance and establishment of government as the 'single payer.'" - George Will, in his weekly newspaper column, Sunday, July 11, 2010

***
Everyone loves to pick on the Affordable Care Act, and well they should. This 2,000-page contraption, this heap of handouts to the special interest lobbyists with a few shiny baubles thrown in to placate the common folk, was not only written by the for-profit health insurance industry but now will be implemented by former WellPoint/Anthem Vice President Liz Fowler, who actually penned much of the law in her role as Max Baucus' chief healthcare staff person for the Senate Finance Committee.

The WellPoint Inc. annual meeting on May 18 in Indianapolis was contentious and dramatic. The first story out was about the collapse of Board member William "Bucky" Bush, followed later by CEO Angela Braly's sudden adjournment of the meeting, while a line of concerned shareholders waited to have their questions answered.

That story went 'round the world, picked up by even the Singapore Straits Times, given legs by the irony of Mr. Bush getting assistance from the very doctor who had been regaling the board minutes before. That physician, of course, was me.

This was the fourth annual meeting of WellPoint that I have attended in my role as "a cheery thorn in [their] side," as the Indianapolis Business Journal called me in a May 29 article, "ER doc is affable WellPoint activist."

The modern era of fire as a weapon of war came with jellied gasoline, or napalm, dropped from bombers in the latter days of World War II. The bombing of Tokyo created a firestorm that incinerated more people than the nuclear bombing of Hiroshima.

The modern era of corporate shareholder activism was born during the Vietnam War when the Medical Committee for Human Rights and its leader, Dr. Quentin Young, were given shares in Dow Chemical Company, infamous for manufacturing the napalm used in Vietnam. In 1968, Young submitted a resolution to Dow saying "napalm shall not be sold to any buyer unless that buyer gives reasonable assurances that the substance will not be used on or against human beings."

Dow fought inclusion of the proposal in its proxy statement, and the Securities and Exchange Commission (SEC) initially sided with the company. Young appealed, and the U.S. District Court in Washington, D.C., ruled that part of the original intent of Congress in creating the SEC was "to give true vitality to the concept of corporate democracy," and the resolution made it onto the proxy.

Wasichu is the Lakota (Sioux) word for "those who take the fat," the greedy ones. WellPoint/Anthem, the health insurance behemoth born of Blue Cross, is a wasichu corporation.

As the Blue Cross movement grew in the 1930s, one of the foundational standards established in 1937 was "No private investors should provide money as stockholders or owners." There was no concept of pre-existing condition. Excluding someone from health insurance because they might be likely to become ill (and need to actually use the policy) was felt to be immoral. Their mission was essentially charitable.

Over the following 50 years the Blues grew dominant, but in the late 1980s the marketplace began to change, and many state Blue plans found themselves in trouble. Blue Cross of California established a for-profit subsidiary in 1994, and that summer the national Blue Cross Blue Shield Association changed its policies so that its licensees could convert to for-profit status and distribute their earnings to those who controlled the company. Enter WellPoint, under the guidance of Leonard Schaeffer.

I had some face time with Rahm Emmanuel two weeks ago at my friend Owen's. (Owen's brother-in-law is the former chair of the Democratic National Committee.) Rahm said nothing surprising but made his points. He had just finished David Kennedy's 1999 book Freedom from Fear, about WW II, the Depression and, germane to this conversation, the tremendous compromises involved in forging the New Deal.

Politically, he asserted, if you want to make big changes, you have to choose your battles and win the big ones. If health reform goes down, then energy, global warming, financial reform and labor's legislative agenda are all at risk. He stayed right on message.

I posed this to him: "Many Democratic politicians, including our Blue Dog Rep. Baron Hill, tell us in private conversations that they believe we have to get to single payer eventually. What advice would you give on how to get there?" Without a blink, he replied it's "going to be a long haul," and if we don't pass this bill it's going to be even longer. He asserted that this bill begins building the required infrastructure for any future progress.

On a cold and rainy Dec. 2, while the Senate in Washington was slogging along debating health reform, a remnant troupe of public-option-supporting Organizing for America stalwarts stood outside the corporate headquarters of WellPoint, Inc. in the center of downtown Indianapolis. Minutes before their demonstration started, three single payer activists slipped in and out of the WellPoint office dropping off a shareholder resolution for next May's annual meeting.

WellPoint, also known as Anthem or Blue Cross, is the perverted spawn of what was once a charitable venture known as Blue Cross/Blue Shield of Indiana. From the '40s up into the '90s Blue Cross of Indiana was like all the other Blues around the country, non-profit with a charitable mission. Its board of directors included physicians, hospital administrators and labor and community leaders, and it existed to serve the needs of patients.

One of my professors years ago was a round, little man who liked to warn us, with a twinkle in his eye, "Making predictions is very difficult, especially predictions about the future." Will a bill pass, in what form, and then what will the long-term implications be? It's hard to predict.

Dr. John Geyman, former president of Physicians for a National Health Plan, makes the case in a Tikkun magazine article, "The Affordable Health Care for America Act (HR 3962): Enough Reform to Succeed?" He argues that whatever bill this Congress is able to pass will probably set the cause of single payer health care back because it "would leave in place an inefficient, exploitive insurance industry that is dying by its own hand, even as [the bill] props [the industry] up with enormous future profits through subsidized mandates."

His argument backs up Dr. Marcia Angell, who asks in the Huffington Post, "Is the House Health Care Bill Better than Nothing?"