The Sopranos on Health Care

The Sopranos have taken a stand on the health insurance morass and I love it. If the rest of Hollywood were to spend more time exploring real issues instead of conducting an annoyingly arrogant vendetta against the current Administration in Washington, they might actually be performing a public service instead of self-service. Tony Soprano’s (James Gandolfini) current plight carries with it the message that not only anonymous middle class Americans but also Mafia dons have major problems with the health care system. Bada bing!

As I’ve previously opined, the infusion of Hollywood’s boring anti-administration agenda into television dramas, particularly the Law & Order series, has become enough of a pain in the ass that it has driven me away from watching most episodes. ER also has been easing over the line, albeit not as blatantly, for some time. On the other hand, The Sopranos deftly integrates slices of all of our everyday lives into the machinations of the mythical New Jersey Mafia clan without overtly crusading for a particular cause (dump Bush, dump Cheney, dump Rumsfeld, blablabla, ad nauseam).

In this, The Sopranos’ sixth and supposedly final season, the popular crime family’s patriarch, Tony, has been hospitalized with sepsis from a gunshot wound inflicted by his Uncle Junior (Dominic Chianese). Until last week’s episode, it looked pretty certain that Tony soon would be playing poker with Al Capone, Lucky Luciano, Sam Giancana, and Meyer Lansky in some smoky, Danteesque card room in the depths of hell. He pulled out of his coma because in his comatose dream he didn’t want to hand over his metaphorical brief case to Steve Buscemi, who beckoned Tony to go into a room in which everybody was waiting for him but into which he was not permitted to take his business. While this near-miss encounter with angel of death Buscemi (who in the previous season of The Sopranos played Cousin Tony, a black sheep in the family who was personally whacked by Big Tony) has evoked a certain introspection and renewed appreciation for life with a hint that his ruthlessness will be lessened, it hasn’t diminished Tony’s earthiness. Neither has it elevated him above the same sort of issues all of us must face—except the very poor—about health care.

The unnamed insurance company has denied Tony coverage for his post-op physical therapy. There has been much scrambling around in the extended Soprano family to guarantee that sufficient funds will be made available through appropriate extortion, illegal enterprise, or assorted violations of the RICO Act to fund Tony’s mushrooming hospital bill. Much of it centers on the internal workings of the Barone garbage hauling enterprise because Tony, as a silent partner, is on the Barone payroll in order to keep his health insurance. Does that sound familiar? Bound to a job in order to lock ourselves in with health insurance? “I need dat W-2!” declares Tony from his sickbed. But I digress.

The scene about which I shall comment involves a visit from the insurance company’s representative right after Tony’s most recent surgery. A hot-looking brunette enters the room in a white lab coat and is reviewing Tony’s chart. I’ll paraphrase the brief encounter from memory:

Brunette: How are you feeling, Mr. Soprano?

Tony: [eyes twinkling] I just started feeling a whole lot better, doctor! Where have they been hiding you?

Brunette: I’m not a doctor. I’m the [insert appropriate euphemism for cost controller] from your health insurance company. I’m here to see when we can send you home.

Tony: I just got outta surgery and you wanna send me home? It’s all about the money. Why don’t you people think of me once in a while?

Brunette: Actually, you’re lucky that we’re involved. If the paramedic hadn’t done the wallet biopsy in the ambulance, you would have had to go to the county receiving hospital. Instead, you were able to come here and receive much better care.

Tony: Wallet biopsy? What the hell are you talking about?

Brunette: The paramedic checked your wallet and found your insurance card. If he hadn’t found one, you would have gone straight to Martin Luther King—

Tony: Git outta my room, ya sick c*nt!

I was cheering for Tony at that point. Wallet biopsies. Jesus H. Christ! I’ve been involved in similar situations myself with our screwed-up, non-consumer-driven health care system. For example, after a couple-day stay in the hospital for pneumonia, I received a “courtesy call” from a representative of my health insurance company wanting to know if I had scheduled a follow-up with my doctor and when would that be, sir, and is there anything else we can help you with? Yeah, there is: Git offa my phone, ya sick c*nt!

I wish Tony well in his ongoing dealings with the insurance company. In a later scene, the same hot brunette insurance company representative visited the room when Tony’s wife Carmela (Edie Falco) was with him and got an earful from both of them. While reviewing Tony’s chart she patronizingly told Carmela, “Hmmm…doing well after surgery…no complications… Your husband is a lucky man. He gets to go home today!” The air of resignation and exasperation on the Sopranos’ faces told us that not even powerful crime families can surmount the tangled web of insurance company domination of our health care.

We’ve got to put an end to this crap. I haven’t rooted for anybody to get whacked since Cousin Tony became a liability to the family a couple years ago, but wouldn’t it be grand if some Sopranoesque justice could be applied to the evil health insurance machine?

The health insurance oligarchy, as it is currently structured, puts the squeeze on doctors, patients, and employers, while it drives up the cost of health care. If Congress weren’t so self-serving, we could trust them to work on returning the decisions to doctors and their patients. Rod D. Martin wrote about some possible fixes for The Conservative Voice. Other intellectuals blow wind one way or the other—either toward increased privatization and deregulation, which I favor, or toward increased socialization, which I think would be a massive error. (Observe how it hasn’t worked in Canada and England.) Alas, it is unlikely that Congress will ever do anything to solve the problems. They’ll only create new ones. The one thing that WON’T solve any of our health care problems is to merely leave it to government and its vote-buyers.

Nevertheless, there are a few in Congress who have their head screwed on properly, and they deserve your support. From The Wall Street Journal:

Congressman John Shadegg (R., Ariz.) has a bill to let Americans purchase affordable health insurance from any of the 50 states, thus bypassing state mandates that drive up insurance costs in New York and many other places. Another idea would let associations form health-care risk pools for their members, thus giving small business owners and the self-employed the same tax-preferred insurance options that big business and unions have now.

Eliminating present government mandated anti-competition measures would allow much more competition for health insurance dollars, which would drive down artifically inflated prices. The “other idea” is necessary, too. Those of us who are self-employed have very few options and they are all expensive. I fit into that category, and my health insurance tab is over $14,000 per year. Between health insurance and assorted governmental levies, I’m lucky if I can eke out a small profit at the end of the year. I know, I know—that’s my problem. But it’s also a problem with other small employers who, in turn, employ a helluva lot of people. They deserve a break, too.

Kudos and a great big BADA-BING! to The Sopranos for portraying this health care morass as the travesty it really is.