In the early 80s I worked for a health insurance company in Madison, Wisconsin, processing problem insurance claims. It was a shitty, low-paying job. If someone had a question about denied benefits, if something went wrong with a claim, they came to us. We answered questions on the phone, via mail, or, occassionally, in person. We had a script.
We also had, on our desks, each day, a checklist on which to indicate how many times we performed each of our tasks. The list was called Reasonable Expectations, or “REs,” renamed by staff as Ridiculous Expectations. An efficiency expert had figured out how many times hourly we should be able to perform each of our tasks. We were expected to reach at least 80% of our REs each day. We were evaluated according to our REs. Every meeting centered on our performance as illustrated by our REs. They became, for some of us, the point of our work.
One of the employees could be found regularly riftling through the jobs, choosing those claims which would be quickest to resolve, in order to keep her REs high. And what did it mean to resolve claims? It generally meant, as far as I could see, confusing or stonewalling the client, checking the task off the list, and then moving on to the next thing.
The workplace was designed to dehumanize. When one of my co-workers took three, instead of two, bereavement days, after the death of her husband, she was fired. Without doctor’s orders, we could not have a glass of water on our desk. Nor could we display a photograph of a husband or child. We could not have a plant or flowers, or anything at all to remind us of our personal lives outside of work, or our humanity. I suspect that this environment helped us forget, also, the humanity of our clients. Women called and wept on the phone, but we didn’t have time to figure out what went wrong with their claims. We had our REs to think about.
I was in my 20s, a former bartendar. I had never worked in an office, and I couldn’t understand the purpose for the way in which things were done. Why did the girl who picked out the easiest claims get promoted? Why did the woman who bullied her clients move ahead? Why was it that the most conscientous employees were the least valued? It took a while for me to understand that our purpose was not to find out why a client’s insurance claims were denied, but rather to respond to their complaints in such a way as to convince them of the futility of their efforts.
Why was incompetence rewarded? Why was the workplace designed in a way that guaranteed high staff turnover? Because the better we were at our jobs, the more money it cost the insurance company.
I was constantly struck by the contrast between the environment in which we worked— sterile, stark, stripped of humanity, driven by a whipped-up concern for meeting arbirtary quotas— and the very real human anguish we confronted each day.
I knew I wasn’t long for the job when I found myself whispering into the phone: don’t pay the bill. Send $5 a month. What can they do? But I was naïve. The fact is they can, and will, do a great deal to people who are unable to pay their bills.
A man came to meet with me one day. We sat downstairs, near the lobby, in leather chairs, across from each other. He was about my father’s age. He didn’t look at me while he spoke. His wife had been sick, he said, and, even though they had insurance, her illness had taken all their savings. They had lost their house, and she had died. He had worked all his life, but now his wife was dead, he had spent all their money, and he had lost his home.
When I hear the phony arguments against health care reform, I remember how easy it was for my employers to strip us of our humanity and make us forget what was at stake. They are just trying to protect their profits, which is the point of corporations. It’s what they do. But the men and women at town hall meetings screaming that Obama is a Nazi because he wants to give them health insurance? What is wrong with people?
The man I met in the lobby that day said he knew I couldn’t do anything, but he needed to tell someone. Even if it was just a young woman with a shitty job, thinking about her REs. I'd never heard anything like it, but now we all know this story. It’s happened to us, or it’s happened to someone in our family, or to a friend, or a neighbor. Stories like this are a dime a dozen. His wife died because she got sick, and sometimes you can’t do anything about that. We get sick and sometimes we die. But his life was destroyed because of decisions made by people. His life was destroyed because we stood by passively allowing corporations to create a medical system shaped and driven by profit.