Crush this enemy.

• Author: Ehrenreich, Barbara
• Position: Flip Side - Health insurance

Bow your heads and raise the white flags. After facing down the Third Reich, the Japanese empire, the U.S.S.R., Manuel Noriega, and Saddam Hussein, the United States has met an enemy it dares not confront--the American private health insurance industry.

With the courageous exception of Dennis Kucinich, the Democratic candidates have all rolled out health "reform" plans that represent total, Chamberlain-like appeasement. Edwards and Obama propose universal health insurance plans that would in no way ease the death grip of Aetna, Unicare, MetLife, and the rest of the evildoers. Clinton--why are we not surprised?--has gone even further, borrowing the Republican idea of actually feeding the private insurers by making it mandatory to buy their product. Will I be arrested if I resist paying $10,000 a year for a private policy laden with killer co-pays and deductibles?

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It's not only the Democratic candidates who are capitulating. The surrender-buzz is everywhere. I heard it from a notable liberal political scientist on a panel in August, and in September from the leader of a Chicago nonprofit agency serving the poor, with both asking, How can we go to a Canadian-style system when the private industry has gotten so "big"?

Yes, it is big. Leighton Ku, at the Center on Budget and Policy Priorities, gave me the figure of $776 billion in expenditures on private health insurance for this year. It's also a big-time employer, paying more than 400,000 people just to turn down claims, according to economist Paul Krugman.

Dr. Atul Gawande, a practicing physician, wrote in The New Yorker that "a well-run office can get the insurer's rejection rate down from 30 percent to, say, 15 percent. That's how a doctor makes money. It's a war with insurance, every step of the way." And that's another thing your insurance premium has to pay for: the ongoing "war" between doctors and insurers.

Note: The private health insurance industry is not big because it relentlessly seeks out new customers. Unlike any other industry, this one grows by rejecting customers. No matter how shabby you look, Cartier, Lexus, or Nordstrom's will...