It’s amazing how much Orwellian double-speak there is out there these days. Over the past few days, while perusing the local newspaper site, I’ve noticed a site ad for Horizon Blue Cross entitled “The Bag Is Back”. It’s hard to tell what the graphics were implying, but after looking at it 10 times, I finally figured out the story: an old doctor’s bag (used back in the days when doctors still made home visits) is found during an archeological dig. Well, maybe that means that Horizon Blue, a typically nasty health insurance company, has had a religious experience and is now encouraging a kinder and gentler kind of medicine.

Sorry, not quite. Horizon Blue Cross is not suddenly encouraging doctors to bill it for their time in making home visits. No, the big blue X is just using the bag as a symbol. “The medical bag makes a universal emotional connection to a time when health care was easier”. Oh, so this is about emotions. When big corporations start talking about emotions, hold on tight; get ready for some big twists.

The Bag ad encourages you to check out a special web site, “www.thebagisback.com”, which then gives you some clues about where “the bag” is leading. After another link or two, you arrive at a plug for Horizon Blue’s new Health Savings Account plan. Ah yes, Horizon is encouraging employers to save a few nickels by sticking their employees with this lame excuse for health coverage. If you’re not familiar with it, a Health Savings Account is an insurance policy with a very high yearly deductible, combined with a “savings account” that makes up for a lot of the deductable (but still socks you with $200 or $500 yearly out-of-pocket). If you don’t use all of that savings account within the year, you can hold on to it for future medical expenses, or you can cash it out (subject to some tax penalties). The theory behind this is that when people get sick, they will act as “shrewd consumers”, nagging their MDs about every stupid test that he or she orders. Hey, doc, do you really need to do that blood test? It’s costing me money, you know. Thus, the sick person is expected to act as the agent of the insurance company in controlling health costs (which continue to skyrocket for a variety of reasons).

This is definitely Orwellian. I mean, when you’re really sick, do you want to haggle with your doctor? And when you’re not exactly sure if you’re sick, as is often the case, what then? An HSA arrangement will encourage many families NOT to seek medical care at an early stage. Sure, it may be great for people who have a lot of education and make enough money; they don’t have much to lose and can take the longer-term view. But for the struggling working class and the working poor, every day is a skirmish on the cash flow battlefield. When the credit card companies are on you night and day, you’re gonna be tempted to overlook that strange bleeding that you developed the other week, so as to cash out whatever you can from the HSA. Yea, the Health Savings Account is a wonderful idea for the professional types who thought it up. But it could well be deadly for the $8 or $10-an-hour people who it’s gonna be forced upon.

And then Horizon Blue Cross has the chutzpah to claim that it’s like a doctor’s bag, a symbol of caring and healing in the home. Orwell said in 1946 (back when doctors still used bags to make house calls) that all political language is designed “to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.” Looks as though the big corporations have learned their lessons quite well from their political friends. So well, they can use them on us even when the topic is our own health.