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THE FACTS ABOUT THE HEALTH INSURANCE INDUSTRY

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Joanne98 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 06:24 AM
Original message
THE FACTS ABOUT THE HEALTH INSURANCE INDUSTRY

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.

continued>>>
http://www.dailykos.com/storyonly/2009/6/7/739718/-THE-FACTS-ABOUT-THE-HEALTH-INSURANCE-INDUSTRY
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Cleita Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 06:26 AM
Response to Original message
1. K&R
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laborinvain Donating Member (16 posts) Send PM | Profile | Ignore Tue Jun-09-09 02:01 AM
Response to Reply #1
16. Just so you know
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Cleita Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 02:44 AM
Response to Reply #16
17. Thank you. That's nice of you to post that link.
Welcome to DU. :hi:
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laborinvain Donating Member (16 posts) Send PM | Profile | Ignore Tue Jun-09-09 03:12 AM
Response to Reply #17
19. Thanks Cleita
I've been a lurker for a long time. Finally got around to contributing a bit. Thanks for the warm welcome.

As for Sicko, I saw it only reluctantly as I figured I'd seen enough of the death by spreadsheet scam that is our health care system. I was wrong. Moore does a great job of bringing to light a lot of information that is under played by even prominent health care activists.

But the big shocker was the juxtaposition of American health care and that of all these other countries.

It's funny. Whoever posted the movie to Google Video added the comment "USA Sucks". That was my exact sentiment after watching this film. We've allowed our country to be taken over by monsters. And it is nothing less than a disgrace what we allow these insurance companies and HMOs to do to people every day.

A sad disgrace.

Oh, and the movie's pretty funny too.
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Soylent Brice Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 07:04 AM
Response to Reply #16
23. welcome to DU.
:hi:

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annabanana Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 06:36 AM
Response to Original message
2. The diagnosis is clear.
Surgery is required. Excising the dead tissue will be painful to a small but noisy section of the organism.
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snot Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 07:54 AM
Response to Original message
3. k&r'd.
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snot Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:08 AM
Response to Reply #3
4. this is great. but one thing i don't get:
"Universal coverage will also shrink the need for . . . medical malpractice insurance."
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Dragonfli Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:42 AM
Response to Original message
5. K&R n/t
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havocmom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:44 AM
Response to Original message
6. .
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Orwellian_Ghost Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 08:58 AM
Response to Original message
7. K&R n/t
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cslinger59 Donating Member (124 posts) Send PM | Profile | Ignore Mon Jun-08-09 09:06 AM
Response to Original message
8. Explain how you think Universal Health Care Should work.
I don't mean that to sound like an attack, I really want to get an understanding of how potential universal health care should work.

In theory I am all for providing at least the bare minimum health care and life saving services to ALL and I really don't necessarily have a problem paying for it.

That being said my fear is that by nationalizing or socializing or whatever you want to call it, you drive out the capitalism / drive to create new treatments, drugs etc. since there is no profit in it. I think in the long run this will hurt society.

I think there needs to be some kind of balance and frankly I do not have the education/knowledge on the subject to say what it is. So educate me.

A little background, my wife is from a socialist/communist country and the current direction we are taking scares the bejezzus out of her as she has no good memories from this type of governing/market etc.
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area51 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 10:35 AM
Response to Reply #8
10. I think you'll find your concerns addressed ...
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Gormy Cuss Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 10:56 AM
Response to Reply #8
11. area51 provided an excellent link with FAQs
Here's the section addressing your concern on development of new treatments and drugs.

What about medical research?

Much current medical research is publicly financed through the National Institutes of Health. Under a universal health care system this would continue. For example, a great deal of basic drug research, for example, is funded by the government. Drug companies are invited in for the later stages of “product development,” the formulation and marketing of new drugs. AZT for HIV patients is one example. The early, expensive research was conducted with government money. After the drug was found to be effective, marketing rights went to the drug company.

Medical research does not disappear under universal health care system. Many famous discoveries have been made in countries with national health care systems. Laparoscopic gallbladder removal was pioneered in Canada. The CT scan was invented in England. The treatment for juvenile diabetes by transplanting pancreatic cells was developed in Canada.

It is also important to note that studies show that, in the U.S., the number of clinical research grants declines in areas of high HMO penetration. This suggests that managed care increasingly threatens clinical research. Another study surveyed medical school faculty and found that it was more difficult to do research in areas where high HMO penetration has enforced a more business-oriented approach to health care.

Finally, it appears that the increasing commercialization of research is beginning to slow innovation. Drug firms’ increasing reliance on contract research organizations (and for-profit ethical-review boards) has coincided with a sharp drop in innovative new drugs and a spate of “me-too” drugs - minor variations on old drugs that offer little benefit other than extended patent life.
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Junkdrawer Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 11:12 AM
Response to Reply #8
12. See also: Canada, England, France, Sweden, Germany.....
The opponents of Single Payer wish everyone to believe that it's never been tried before and it's fraught with risks.

In fact, we're one of the few industrialized democracies that HASN'T nationalized health care. And our infant mortality rates, for example, are now in the Third World category.

http://www.webmd.com/parenting/baby/news/20081015/infant-mortality-us-ranks-29th
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Enthusiast Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 04:43 AM
Response to Reply #8
20. No one suggested we emulate
the healthcare system of a communist country. And what country would your wife happen to be from, if you don't mind my asking? Seems to me there is only China and Cuba that could still carry the 'commie' label. Why would national healthcare advocates wish to create a system with deficiencies? Do you think we are out of our fucking minds? We want the best, most efficient system we can make. I have to say, I'm very suspicious of you and your post as you have expressed right wing talking points.
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OhioChick Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 10:20 AM
Response to Original message
9. K&R n/t
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Wednesdays Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Jun-08-09 03:33 PM
Response to Original message
13. K&R
:kick:
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Baby Snooks Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 01:41 AM
Response to Original message
14. But "Medicare for All" would put the health insurance industry out of business!
Which of course is the point of all the various proposed plans - even Kennedy's ensures that the insurers will still be guaranteed a profit.

We will be told it will lower costs. We heard that once before with energy deregulation. You can look at your utility bills this summer and see how much deregulation lowered our utility costs.

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Cleita Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 02:44 AM
Response to Reply #14
18. Oh wouldn't that be a happy day! n/t
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Enthusiast Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 04:47 AM
Response to Reply #14
21. Baby Snooks, we are being played.
In both energy and healthcare. You know this, of course.
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democrat2thecore Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 01:54 AM
Response to Original message
15. Answer: ELIMINATE them with Single-Payer. PERIOD!.......-nt
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Enthusiast Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Jun-09-09 04:48 AM
Response to Reply #15
22. Yes, maybe someone outside
of manufacturing can lose their jobs so they will understand what industrial America has been going through.
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