THE FACTS ABOUT THE HEALTH INSURANCE INDUSTRY

[Joanne98]

Most people are unaware how similar the major health insurers are to our failed Wall Street firms.They are corporate cash cows and have virtually no fiduciary responsibility and few activities for protecting or improving health or the health care system.They will devote their vast resources to prevent any meaningful health reform. They have controlled Congress and the mainstream media. The only cure is vigorous popular support for a single payer, Medicare for All reform.

paradocs2's diary :: ::

This is a discussion about the huge and looming crisis in our nation’s health care system and the need for a radical paradigm changing reform. Because the issues discussed below necessarily involve a politically difficult restructuring of a large and well establish sector of our economy, the breadth and details of this reform have so far has been largely excluded from public policy discussions and debate. AHIP – American Health Insurance Plans - representing the private, for profit, health insurance companies and their partners had their annual national convention in San Diego, California this week. They are the association of all the major health insurers in the United States and their lobbying clout is unsurpassed. Major public political leaders of both parties, men like Jeb Bush, Dr. Howard Dean, and Tom Daschle attended.

As a practicing family physician who has been seeing patients since Medicare was started I can tell you what really ails our national health system. Making the correct diagnosis is important. Yet those in Washington – both in the White House and in Congress - both Republicans and Democrats – and the national media - are eagerly avoiding the right diagnosis and thus preventing public discussion about the necessary cures. As you all know if we don’t make the right diagnosis the disease will not be cured and the patient will not get better. Today the biggest barrier to improving our health care system in the United States is the private health insurance companies. They are the disease we suffer from. The best, and perhaps the only, public policy cure that will work is a single payer, Medicare for All, health care financing program. Yet due to financial power of the health insurance industry, their great financial lobbying clout, embarrassingly our elected officials are doing everything they can to avoid the current golden opportunity to create a single payer system.

I want to make only three main points:

1.The individual insurance companies are out for profit and must work to maximize their value on the stock market and not our friends. They treat patients like widgets or cost centers. This is not a culture of trust, caring, compassion, and fiduciary responsibility. If you were dumb enough to hope that Countrywide Mortgage would preserve your home and Lehman Brothers would preserve your retirement fund, then you will be stupid enough to expect Anthem Blue Cross and the other insurance companies to be there to protect your health. Yet it seems all Washington continues under this delusion.
2.The employer based private health insurance industry has been created by us, is hugely subsidized by public policy and public money and is expensive, inefficient, costly , and a structural barrier to a healthy America. It needs to be eliminated.
3.The only cure for our problem is a single payer, national, universal, health financing program like Medicare for All. This is not socialized medicine, but an efficient way to pool risk and share the unexpected costs of illness. Fifty percent of our population has virtually no medical expenses while five percent consume 25 percent of all personal medical care costs. This why we need the insurance principle: unexpected medical expenses are relatively rare and can be huge and should be spread across the whole population. Financial costs related to illness cause over 50 percent of personal bankruptcies in the United States. Over 46 million Americans are rationed out of the medical system (and during this economic catastrophe this number is growing by 10,000 people per day) 46 million people are subject to excess morbidity and mortality because they cannot afford financing and the insurance industry cannot profit from them. Health insurance is important and necessary. We need an efficient, national, publicaly sponsored, universal health financing system. This is the only treatment that will be a cure.
First, let me dwell on the track record of an individual insurance company, specifically United Health Plans. United Health Group is America’s largest health insurance company. According to their 2008 annual report United has 75,000 employees, insure 29.1 million Americans directly and cover up to 78 million people, contract with 650,000 doctors and 5200 hospitals. Their insurance programs include: a government subsidized Medicare Advantage program called Secure Horizons, a Medicare Part D prescription program called Prescription Solutions, and they have an exclusive arrangement with AARP to offer a Medicare supplement. The company has a subsidiary, Ingenix (remember this name) which provides "actuarial data, claims management services, and health intelligence" in 56 countries and in the USA to 6000 hospitals, 240,000 MDs, 1500 health plans, and 250 government agencies.
In 2008 United Health had total revenues of approximately $81.2 billion ($75.9 billion from health insurance and $1.6 billion from Ingenix) and their 2008 net revenue was $5.2 billion from health insurance. (This profit was in essence moneys diverted from health insurance premiums paid by government, individuals and employees to obtain medical care even after the company’s huge administrative costs are deducted.) They had an additional $229 million profit from Ingenix. According to SEC filings during our current economic and health care crisis their 2009 first quarter total revenue went up 8% to $22 billion and their net profit was $984 million. According to the company’s own report they have a medical loss ratio of about 80 per cent - that is, of collected premiums they spend only about 80 % on actual medical care, that is we loose 20 per cent of the money we pay them to their overhead and profit.

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http://www.dailykos.com/storyonly/2009/6/7/739718/-THE-FACTS-ABOUT-THE-HEALTH-INSURANCE-INDUSTRY