Gapers Block has ceased publication.

Gapers Block published from April 22, 2003 to Jan. 1, 2016. The site will remain up in archive form. Please visit Third Coast Review, a new site by several GB alumni.
 Thank you for your readership and contributions. 


Sunday, July 21

Gapers Block

Gapers Block on Facebook Gapers Block on Flickr Gapers Block on Twitter The Gapers Block Tumblr


When you hear, over the coming years, those arguments that the free market will ultimately deliver the best services and the most efficient systems, remember this story: that the market shrugged towards pregnant women and the soon-to-be-born, live or die.

The outrageous headline of the Chicago Sun-Times told of an insurance contractor Amerigroup's response for finding uninsured individuals and providing them with some sort of coverage. The insurer allegedly avoided covering pregnant women in order to maximize their profit.

Amerigroup was contracted by the Department of Public Aid to provide health coverage to the poor. A pretty plum gig when you consider that they were allegedly electing to only cover the healthy (or "healthies," as internal documents referred to them).

So here we go: more evidence that because the market is controlled by self-interested (not necessarily rational) actors, it cannot be expected to perform in a rational way.

Reading the article, which detailed emails from the company's senior management encouraging its salespeople to continue the "good" work of actively avoiding providing coverage to pregnant women, I thought about a scene in David Mamet's play Glengarry Glen Ross, when Moss says to Aaronow:

"What did I learn as a kid on Western? You don't sell a guy one car. You sell him five cars over 15 years. The guys come in, 'Oh, the blah blah blah, I know what I'll do — I'll go out and rob everybody blind and go to Argentina, cuz nobody ever thought of this before.' So they kill the goose..."

In business — like in all types of organized human activity — most people are of the "rob everybody blind and go to Argentina" variety. Their goal is one thing: to enrich themselves to the best of their ability, hopefully with minimal repercussions (to themselves).

There is no denying this simple fact. Blah blah blah: the market will root out irresponsible firms. Blah blah blah — at what cost?

How many miscarriages until the Market makes this correction? What is the acceptable number of stillborn corpses? How many dead pregnant women does the Market need to detect before it undergoes a "self-correction?" That's the part often left out — in matters like health care, and retirement to a certain extent, what causes the Market to "self-correct," are typically catastrophic events (Enron). Would free market enthusiasts and Ayn Rand acolytes be so eager to allow the Market to provide essential services like health care if it meant their wives or daughters or sisters or themselves to die in childbirth? Or give birth to a sickly child, if it could have been preventable?

The Market, these morons forget, is ultimately composed of individuals who don't necessarily care even about the long-term success of their own corporations.

The best part of this story, naturally, is that this was a contracted company, getting taxpayer dollars to make themselves richer. Be absolutely clear: this is yet another example of what happens when what should be a publicly controlled services is removed into the private sector.

Meanwhile, who knows what goes on in the big insurance firms, free to deny coverage to whomever they choose, to gouge the needy to serve the greedy?

And yet again, we see how this most disproportionately affects women, who are already less likely than men to be insured. It is wildly expensive to be pregnant. And do you realize how expensive it is to give birth? Most estimates put the costs to insurers — who get a considerable discount — at about $5,000-$6,000. Which means it would cost an individual closer to $11,000. Women with little or no insurance can end up mired in debt for the act of perpetuating our wretched species.

Why? Who benefits? Why disincentivize birth itself? Of course, as always, the rich get richer, that's why. They get richer and our elected officials and half-witted intellectuals will circle the wagons and pray for a "free-market solution." Never mind that the growing trend of business supping at government's table — Cf., the Iraq war, see also "war profiteering" — is almost exactly the opposite of true enterprising, yet it has always been the true goal of economic conservatives.

No, the right wing doesn't want government to help anybody that isn't already rich. Especially uninsured pregnant women.

GB store


clomp / October 15, 2006 12:38 AM

i really enjoyed reading this piece. thank you for pointing this example out. the right wing's class dividing agenda hurts our society in the most intimate and personal ways. these individuals need to be corrected. regulations are necessary and appropriate. i got a Republican flyer in the mail today, i am looking forward to telling them to remove me from their mailing list. i don't even know how i got on it

yikes / October 16, 2006 7:23 PM

I am outraged that healthcare does not seem to be on the table for these mid term elections.
How are we morally accepting what is happening with our uninsured in this country.
My family buys our insurance independently and it mostly works out, however guess what they do not cover...pregnancy, and guess how far along I am...twelve weeks. I am unsure how we are going to pay for the whole thing.
How can we let our elected leaders know that this is important to us!


About the Author(s)

Richard F. Carnahan is a true South Side Sox fan who's played a bit part in Chicago politics more than once over the years. Contact him at

GB store

GB Store

GB Buttons $1.50

GB T-Shirt $12

I ✶ Chi T-Shirts $15