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Private Health Insurance Is Not the Answer

By Phil Mattera, Corporate Research Project. Posted February 23, 2007.


Why are we keeping a hopeless, for-profit health insurance system alive?
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yeah

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Healthcare reform is in the air.

Ideas for dealing with the 46 million Americans without medical insurance seem to be popping up faster than new cases of the winter flu. President Bush proposes to use tax deductions to help people buy individual plans. California Governor Arnold Schwarzenegger wants to make it mandatory for everyone in his state to obtain insurance and would force employers who don't provide coverage to pay into a fund.

Democratic Presidential candidate John Edwards would raise taxes on the affluent to pay for subsidies to help those with low incomes obtain policies. Some members of Congress are promoting insurance purchasing pools for small businesses. An odd bedfellows coalition including the Business Roundtable, AARP, the Service Employees International Union and Wal-Mart is pushing for some kind of expansion of coverage but is not saying what form it should take.

What these varied plans have in common is the assumption that, at least for the foreseeable future, most of the working population (and their dependents) will continue to receive coverage through private insurance carriers. Public officials across the political spectrum are, in effect, seeking to expand the customer base for a highly profitable industry.

Surely, it is a good thing to provide coverage to the uninsured, but it is remarkable that almost everyone assumes that coverage has to come from for-profit (or, in some cases, private non-profit) providers. Despite the overwhelming evidence from other industrial countries -- and even domestic programs such as Medicare -- that government-run health plans are much more efficient, the U.S. political class seems to be on a mission to save private insurance.

A Paternalistic Reform?

To understand the current debate, it is helpful to recall some of the tortured history of health insurance in the United States. In the late 19th Century European countries began adopting government-funded social insurance plans, but the U.S. failed to follow suit. When progressives made a push in the 1910s there was opposition not only from corporate interests but also from organized labor. AFL President Samuel Gompers denounced national health insurance as a paternalistic reform, fearing that its adoption would weaken the role of unions in improving the living conditions of workers.

Consequently, Americans both rich and poor continued to pay the vast majority of medical costs out of pocket. That began to change in the 1930s. While the Roosevelt Administration focused on retirement benefits and unemployment insurance at the expense of health coverage, physicians and hospitals struggling to survive the Depression set up private group insurance plans to bolster demand for their services. The most successful of these were the non-profit multi-hospital plans that grew under the rubric of Blue Cross. These were later followed by Blue Shield plans, which covered outpatient physician services. Once the Blues paved the way, commercial insurers also entered the field, though their coverage tended to be more restricted.

After the end of World War II, there was great momentum toward expanding the portion of the population with some form of sickness insurance. In 1945 President Harry Truman proposed a national program establishing a right to medical care and protection from the "economic fears" of illness. But once again, opposition to government involvement in healthcare emerged, this time reinforced by a Cold War hysteria about "socialized medicine" stoked by groups such as the American Medical Association.

As Truman's plan went down to defeat, what grew in its place was a system of employer-provided coverage, stimulated by aggressive bargaining on the part of unions that had come to regard improving employee benefits as a mission as important as increasing wages. This put pressure on non-union employers to follow suit, and by the mid-1950s, about two-thirds of the country was getting coverage through either their own jobs or those of spouses or parents. The Blues, which held the largest share of this booming market in the early postwar period, began to fall behind the commercial carriers by the late 1950s.

Around that same time, there was growing concern about the large number of retired workers who were left out of this workplace-oriented system. This eventually led to the 1965 creation of the federal Medicare program for seniors, along with the federal-state Medicaid program for the poor, but most of those with insurance continued to get it from the private sector.


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Philip Mattera heads the Corporate Research Project, an affiliate of Good Jobs First.

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A non-marketable commodity
Posted by: aethr on Feb 23, 2007 12:15 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
"... whose business plan depended on restricting the use of medical services."

Isn't if fairly obvious that a business that profits by refusing to provide the services it is paid for can't possibly function properly in a market-based environment? Isn't insurance, by its very nature, inherently socialistic?

[« Reply to this comment] [Post a new comment »] [Rate this comment: 1 - 2 - 3 - 4 - 5]

» RE: A non-marketable commodity Posted by: mindcryme
» COMMODIFIED America Posted by: Cathyc
» RE: COMMODIFIED America Posted by: drricklippin
No way to go!
Posted by: Temporary on Feb 23, 2007 12:19 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Public health care for the white baby boomers is going to end up killing us all!

[« Reply to this comment] [Post a new comment »] [Rate this comment: 1 - 2 - 3 - 4 - 5]

» RE: No way to go! Posted by: mindcryme
» RE: No way to go! Posted by: Blix
» The Eagle is not that well grounded Posted by: famouspipeliner
» I have a dream Posted by: famouspipeliner
» RE: I have a dream Posted by: EagleMB
» and then I woke up Posted by: famouspipeliner
» RE: and then I woke up Posted by: dkm
» RE: and then I woke up Posted by: EagleMB
» RE: and then I woke up Posted by: EagleMB
» Schumacher Posted by: famouspipeliner
» RE: Schumacher Posted by: EagleMB
» White baby boomers?? Posted by: imntacrook
A Simple Plan
Posted by: mindcryme on Feb 23, 2007 1:09 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Look, the insurance companies own the US Senate and the House. There is no way any kind of legislation is EVER going to pass that will cut the insurers out of US healthcare system.
So the solution to this problem is simple.
What drives the insurers? Money.
How do you motivate them to go away? Money.
You want to pass healthcare reform, maybe go to a socialist universal care system managed by the government?
Simply offer the private insurance companies and HMOs cold, hard, cash; a present value of their future cash flows and they'll walk, just like any business man. They're fairly simple to understand. They don't have an ideaology, or anything so complex. They'll take fair value for their future earnings and they'll exit the business.

Once they release their grip on the Senate, health care reform will pass over night.

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» That's true Posted by: Bobsays
» RE: A Simple(r) Plan Posted by: Lincoln fan
» RE: A Simple(r) Plan Posted by: aethr
» RE: A Simple(r) Plan Posted by: Lincoln fan
» RE: A Simple Plan Posted by: Lauren
» RE: A Simple Plan Posted by: Lincoln fan
Root of the Problem
Posted by: jyongue@iag.net on Feb 23, 2007 4:11 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Finally, someone has written about the root cause of the problem--private, for profit, insurance companies. I have been told, while applying for a job, that the company can no longer afford to offer full insuance because their small employee base does not allow averaging cost over a large population. Never mind that I went for many of my younger years with no claims. I think that private insurance companys have failed as institution, they cannot perform their mission.
1. Coverage needs to be provided by the same source over the life of the individual.
2. Agents commission should be counted in the profits of insurance companies.
3. The failure of private insurance companies to provide the required product should be recognized and the federal government take over. Socialized Medicine may sound bad to some, but lables should not determing our course.
4. Recent results with property insurance and global warming modified hurricanes indicate that it may have the same problem as health insurance.

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» OK, not a flat tax: Posted by: andyc
» regulation Posted by: andyc
» RE: oot of the Problem Posted by: Lauren
Only problem is: Canada/UK become more private by the day
Posted by: Bobsays on Feb 23, 2007 4:58 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Both those countries - whose health systems are always used as an example for Americans - are rapidly going private. They have introduced open markets and outsourcing on a vast scale. You now find American, South Africa companies doing surgery in the parking lot at most UK hospitals.

Fully publicly funded is dead and it is the groaning weight of the baby boomers that is killing it. If they would only eat right, exercise, and live healthy lifestyles, they wouldn't need all this extra surgery and pills. I see it every day - and it is a HUGE waste.

Stop being so damn selfish and pull your socks up!

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» famouspipelinersays Posted by: famouspipeliner
Dennis Kucinich is saying these things
Posted by: allUneedislove on Feb 23, 2007 5:17 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
We do have a presidential candidate who is speaking out in favor of universal health care.

Even the ALTERNATE press has completely ignored this man and his message. I know Democrats who have still never heard of him, even after his prior presidential candidacy.

Shame, Shame! Once again, the people are fed what someone wants them to eat.

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Health CARE does not exist in the U.S.
Posted by: disenfranchised on Feb 23, 2007 5:19 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
The best we can do now is to purchase medical service contracts, modeled after copier and computer service contracts. The corporatization of the old individual doctor and fee for service system resulted in the insertion of somewhere around 25-30% profit margin for insurance companies in the 1979s. Since then, we have seen copays and exclusions that have taken form in multiple "plans" offered that do nothing but limit the insurance company (HMO, etc) liabilities and put the cost back on the patient. The complexity is daunting and more than the average person can deal with, especially when ill. The current system is simply immoral and represents the worst of all possibilities for abuse of the vulnerable. Anything short of single payer not for profit health-care is not acceptable. To profit from human suffering is not acceptable.

Does anyone really think that the Insurance corporations will treat your health any differently from the way that they have dealt with storm and flood damage srought by natural disasters? Just look at what they have done to the Hurricane victims.

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Insurance middle men are ghouls
Posted by: bomec on Feb 23, 2007 5:25 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I have spent a good part of my life in Europe and own property in France. It is a source of disbelief in those countries that the US has allowed ghoulish middle men to intepose themselves between a sick person and the physician who treats him or her. By what logic or right does a profit-grubbing insurance company middle man with no medical training determine what treatment is appropriate, what price is appropriate, what follow-up care is appropriate, what medication is appropriate? And all with his and his company's profit margin as his sole concern. This US system of providing health care is truly nuts at it core, and hugely expensive, but also hugely profitable for the insurance companies, obviously. Insurance companies are truly ghoulish enterprises which profit from the misfortunes and anxieties of the public. They are in the business of collecting premiums and serving their bottom line, and not in the business of paying out benefits and serving the public.

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FEAR OF "RAPID-RADICAL" CHANGE IS SCARING POLITICIANS
Posted by: drricklippin on Feb 23, 2007 5:37 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Phil- Thanks for excellent historical summary and correct conclusion.

IT IS FEAR OF "RAPID-RADICAL" CHANGE THAT IS SCARING POLITICIANS. Putting aside very hefty campaign contributions by our "disease care" industry the pols fear severe US economic dislocations if they try to change a $2 trillion dollar plus system too quickly.

Hence, regrettably. incrementalism rules the present day

I am for H.R.676 (Conyers/Kucinich etc-"Medicare for All") but the bill needs to be modified to include individual and institutional prevention.

Because I do agree our "disesase care system" is not economically sustainable long term

Dr. Rick Lippin
http://medicalcrises.blogspot.com

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» I read your blog, Dr. Posted by: henderson
Market Fundamentalism
Posted by: spencerh on Feb 23, 2007 5:44 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Until the left can successfully challenge the very entrenched myth put forth by the Market Fundamentalist Right that:

- markets don't solve everything

- "every person for themselves" has no place in a modern country. We're not an anarcho-capitalist country.

- government needs to be made small enough to drown in a bathtub

- government involvement equals socialism/communism

we're just going to continue to run into the same exact barriers, the same exact arguments, and the same exact inertia for every single issue involving government management. Completely free public higher education? Universal, single-payer healthcare? A real social safety net so that people don't feel like losing a job means that they're going to be out on the street? These arguments run counter to the fundamental ideas the MFR has:

- Good social safety nets makes people lazy, and that means people won't work.

- Nature is a "dog-eat-dog world", so too should human society.

- Helping people equals weakness.

- Government is bad. It just is (the Bush administration is making this argument easier for them to make every day).

Social Democracies in Europe haven't imploded. Look at happiness indexes and human rights records of countries like the Netherlands, (modern) Spain, and the Nordic countries.

Shift the Overton Window not on various specific issues, but on the fundamental ideas of the MFR, and progress will be so much easier. Until then, we'll continue to beat our heads against these entrenched ideas, which they don't have to do *any work to defend*, because they're so widely accepted.

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» Free Marketeers Posted by: eddie torres
Leading Democratic candidates lack courage on this issue
Posted by: Moonray on Feb 23, 2007 5:49 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Neither Hillary, Obama nor Edwards has come out in favor of a single-payer system. That shows you how strong the insurance lobby is --- and how unlikely we are to get those blood-suckers out of our health care system.

Alarmingly, now some states are making health insurance mandatory, like automobile insurance. This will only drive insurance rates -- and profits -- through the roof.

Insurance is largely an extortion scheme and we should put a stop to 90 percent of it. We need a single-payer health system and we need to get rid of state-required auto insurance, which is just a gravy train for the insurance companies. States should establish their own insurance systems and cap pain-and-suffering awards.

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» Insurance is Extortion Posted by: Cathyc
The Problems with Our Health Care System
Posted by: ProgressiveManiac on Feb 23, 2007 6:23 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
The primary problems with our health care system are that it costs too much and delivers much too little.

The root of both of these problems lies with the system that depends on private, for profit insurance to pay for our health care. Nearly a third of every dollar that is paid for health care in this country goes instead to paperwork and profits of these private health insurance companies.

The best solution to this problem is to remove these insurance companies from the picture and the experience of the rest of the world seems to indicate that the best way to do this is by replacing the insurance companies with a single payer in which the government steps in to play the role of a non-profit insurance company.

Unfortunately, in this country this solution has been difficult to achieve. Many people seem to feel that this is a step towards Socialism that has to be avoided no matter what it costs in lives.

The point I want to raise for discussion is that there may be another solution. Suppose a non-profit insurance company could somehow be established that is separate from the government. Then the non-profit company would have to cover costs but would not need to show profits. This could allow that foundation to offer health insurance at a cost that would be much lower than the profit-making firms.

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The Cure will have to be drastic
Posted by: lb on Feb 23, 2007 6:34 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I see no way to fix our healthcare system without going to single payor, universal coverage. I am a physician and have practiced in both the public and private sector for over 25 years. The public sector, funded by Medicare and Medicaid, provided better preventative care and maintenance care, at least until the government started slashing the funding. The private, for-profit sector, has created a system where the majority of people ONLY see a doctor when they are sick. In order to make a profit, costs are increasingly passed to the the insured. Providers reimbursements keep being reduced to inflate the insurers profits, so I can no longer afford to provide "free care" to people without insurance, or I have to see more patients per hour to make a living. And I'm not talking about a lavish living, either. I make 60% of what I made 5 years ago.
The insurance companies have to go. Medicare has shown time and again that they are the most cost effective health care delivery system in our country. Medicare could be "state of the art" if they had the money that now goes to the insurance companies.
And then we can go after Big Pharma.

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» RE:Nice web site. Posted by: Lincoln fan
There's an easy answer for your question, but you aren't going to like it.
Posted by: ABetterFuture on Feb 23, 2007 6:55 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
Why are we keeping a hopeless, for-profit health insurance system alive?

Because 85% of the people in the country are covered under some form of health care in this country, and because we are inherently distrustful of our policymakers.

Let's let our Congresscritters figure out something easy, like balancing the national checkbook which only involves adding and subtracting, before we turn them loose on heart valves, HIV drugs, and emerging diseases. I mean, have you heard some of the intelligent things these folks have been saying lately? And you want them in charge of rationing your burn therapy?

In the meantime, I certainly wouldn't be opposed to expanding matching medicaid dollars to all the states to cover children and those who are not able to provide for themselves. Finding a way to extend health coverage to the portion 15% of the populace who can't get it on their own should not involve completely scrapping the excellent health care that the majority of us enjoy.

We don't need a 100% different direction to fix a 15% problem.

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» Coverage and Cost Posted by: eddie torres
» You've fairly described a problem. Posted by: ABetterFuture
» All good points. Posted by: ABetterFuture
» Back to the Future Posted by: eddie torres
» You could be a Fox News anal... Posted by: ABetterFuture
why do we even have a government?
Posted by: antiapathy on Feb 23, 2007 6:58 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
seriously, why do we have a federal government? The primary task of our government seems to be to transfer wealth to the already wealthy. At the expense of the health and lives of the poor, as exhibited in our modern health care crisis, as well as the slaughterhouse that is Iraq.

what ever happened to providing positive rights? health care, education, the right to unionize? all of these are under attack by the government. there are precious few members of Congress who have the backbone to stand up for our rights, and I continue to be amazed that the majority of corrupt politicians are rewarded for their betrayal with reelection.

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I know why. Do you?
Posted by: Lincoln fan on Feb 23, 2007 7:01 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
the U.S. political class seems to be on a mission to save private insurance

If you will click on open secrets you will see the answer. The 2004 campaign contributions of the Finance, Insurance, and Real Estate industries totalled $338 million. Roughly 60% to the Republicans and 40% to the Democrats. How's that for hedging your bets.

No matter who loses the election the corporate establishment wins. No matter who wins the election the voters lose.

Bob Reichenbach,
Director, The Lincoln Initiative.

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» Correction - Sorry Posted by: Lincoln fan
» RE: Correction - Sorry THANKS BOB! Posted by: drricklippin
» RE: I know why. Do you? Posted by: Lincoln fan
» RE: I know why. Do you? Posted by: drricklippin
US Socialized Care and Problematic Partial Solutions
Posted by: sofla100 on Feb 23, 2007 7:02 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
It is worth pointing out that Medicare's overhead is a meager 3% while in the private insurance sector, your overhead can easily be 20% or more. This is a good argument right off the bat for a single payor system. Now, you are going to see arguments for some sort of "partial" solution or compromised solution such as non-profit entities and such that could run American health care. But, here is the big problem, almost universally, under "so-called" government-private "partnerships" and the like, it is the government that has often been taken advantage of. Many examples abound, but just look at the problems now in government contracting. The defense budget, for example, is going out of control and due in part to escalating costs from companies that have learned well how to manipulate and control the system to their advantage. Woe to us to ever forget that companies; profit, non-profit, however they are set-up, are going to want to make a profit, and the more the better. As for so-called "non-profits," take a look right away at how they often manipulate the "bottom-line" and hide profits with accounting techniques or high salaries. Once again, the business of any and all companies is to make money! Therefore, the "partial solution" of using private insurance companies as some sort of mechanism to insure everyone has insurance is problematic. The companies will always be looking for a way to dump the sickest and the oldest, as they cost the most money. And, the companies will always be looking for a way to "stick" the government with more charges and "more money under contract." No, the best solution really is a single provider one. Service delivery can be in the private sector, sure, but not how things are ultimately paid for. Not, if we really want this to work.

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» Right On! Posted by: Lincoln fan
"Personal responsibility"+"free market"=a bunch of BS
Posted by: sausage on Feb 23, 2007 8:13 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
The bloated parasite on the body politic that is the American medical insurance/pharmaceutical-industrial complex, is slowly killing its host. But before that host is completely bled dry our "liberal" Democratic politicians are attempting to squeeze out a last few drops through the legerdemain of state mandated health insurance plans.

As I understand these corporate-giveaway programs, every citizen of any given state is required under law to have health insurance provided either by his employer or through a private, out-of-pocket, plan. Now, again as I understand it, if an individual does not have recourse to either of the above options, then the state, at taxpayer expense, will subsidize the cost of her health care insurance premiums.

Of course these wonderful plans always are couched the in language of "personal responsibility" and the "free market;" the premise being that the individual citizen will always make the "right" decission in choosing his or her health care provider. Of course from the fiasco that is the Medicare Prescription Drug Benefit Plan, a major sop to the nation's insurance and pharmaceutical companies, we can see that letting the individual choose his own plan is confusing, often contradictory and just plain doesn't work. (Yes, yes, a Google search yeilds glowing reports, but from conversations I've had with folks on Medicare D, it ain't so.)

When given nothing but bad choices, one will only end up with bad results. If health insurance company A's plan is horse shit, company B's chicken shit, company C's bull shit, they may all look and smell differently but they are all, at the basest level, still just plain shit.

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Single payer universal health care a Socialist program(?)
Posted by: willymack on Feb 23, 2007 8:14 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
We STILL seem to be hung up on the idea that Socialism is inherently evil and freedom threatening. Just take a look at the evil bastards currently in office. They DEFINE evil, and are on the opposite pole from Socialism. Do you feel secure that your Constitutional guarentees are being assiduously looked after by the bushies? If you do, you need a brain transplant. Programs such as Social Security and Medicare are, by their nature, Socialistic, and have greatly benefited our elderly population. The countries which have the best life expectency, health, education, and quality of life are Socialist, and their freedoms, rather than being taken away, have been enhanced. Even Cuba has a better health care system than us in terms of availibility and overall quality, dictatorship that it is. Their literacy rate is better than ours, by the way. We sorely need to institute a health care system along the lines of Canada, Scandinavia, Italy, etc. We can make it our own and make it the best in the world. After all, we're Americans, and that STILL means something.

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Health Care is FREE in the USA!
Posted by: imntacrook on Feb 23, 2007 9:01 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
I personally know 5 people who have been given FREE health care - operations, hospital stays (one for over a year), wheelchair vans, bypasses etc. None of them had insurance!! This together with stories of illegals being treated, and having babies delivered etc. So, my conclusion is insurance is not necessary. Prove me wrong.

Naturally no one can afford health insurance with people like John Edwards suing doctors. Hell the doctors can't even afford it.

My advice - don't buy insurance and when you need to call 911. - ITS FREE!!

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» You are so wrong Posted by: sausage
The Least For The Most
Posted by: NoPCZone on Feb 23, 2007 9:09 AM   
Current rating: Not yet rated    [1 = poor; 5 = excellent]
In the US, we spend the equivalent of over $16k/per citizen for healthcare, more than any other country in the world. The next highest country spends half as much, despite the fact that many countries do a much better job of delivering quality care to all while paying a living wage to all the healthcare providers/extenders. That cannot be said for many working in US healthcare today.

Many of the jobs that require significant education, continuing education and certification in the US pay scandalously low wages relative to the education and skills that they require. The result is that many working in healthcare cannot afford to use the very services that they provide to others. In the meantime, drug and equipment reps that never touch a patient and hold minimal to no education beyond a business degree commonly make 6-figure incomes loaded with perks.

If nations that provide quality care AND pay their staffs proper wages while covering all people do so at HALF the US expenditure rate, the symptoms say that our system is terribly corrupted, inefficient and ineffective. What the US is getting could be likened to buying a luxury car that doesn't run 1/5th- 1/6th of the time to a mainstream car that costs half as much with all of the same features and runs reliably every day. Otherwise, an intolerable mess.

Let me bust a myth for you. FOR ALMOST EVERYONE, THERE IS NO FREE MARKET FOR HEALTHCARE INSURANCE OR DELIVERY IN THE UNITED STATES. Let that soak in and commit it to memory the next time some pundit or politician starts spouting free market bullsh*t concerning healthcare. Your employer picks what insurance is available (no choice). Your insurer has negotiated a PPO arrangement without your input or consent (no choice) and has determined what will be covered and how it will be offered- all or nothing (no choice). In most of the US, the insurer has little choice but to arrange for a PPO with the only hospital (or system) that is the only or dominant provider in your local market (no choice). Most hospitals have been driven be economics into supplier lock-ins for equipment and supply purchases (no choice). More of the same goes on throughout the chain of supply , delivery and accounting. Your only 'choice' is to take it or leave it. Not even the slightest similarity to the open and competitive markets described by Adam Smith.

There is little to no competition on the provider side. States regulate the establishment of clinics, care facilities an hospitals with certificates of need. Needless to say, the process is a lawyer feast full of politics, money and influence peddling. The bottom line- those already in the business do not want anyone else in and fight among themselves for pie slices like an oligarchy.

In the end you are offered a crappy product that is overpriced, provides little choice and has been designed from the bottom up to maximize the profits of the insurers, employers, hospital chains, pharmacy and medical equipment companies and executives at the expense of everyone else. What regulation exists is fractive and has largely ben 'captured' by representatives of the very people and institutions it was designed to regulate. You are told what you will pay, under what terms, who you can see, when you can see them, and at what facility-- all subject to pre-approval, second guessing and hindsight by the insurance company.

That's not a free market or even a regulated free market. The terms CARTEL and OLIGARCHY come to mind.

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» See also: Monopsony Posted by: eddie torres
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» Neocon talking points Posted by: dkm
» RE: Neocon talking points Posted by: EagleMB
» RE: See also: Monopsony Posted by: mjabele
» RE: See also: Monopsony Posted by: EagleMB
Sure, the insurance companies are greedy and heartless, but
Posted by: earthwater on Feb 23, 2007 9:59 AM   
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several commenters are right that no health reform will get started without them. If you look a little closer at John Edwards' plan, he would have private insurance companies competing with a much more efficient public health plan, so private insurance would have to get more efficient and be content with lower profits. At some point down the road, Edwards would have the people vote on whether they want to keep it like that or go over completely to public health. To me, this sounds like the only plan that will eventually work to the benefit of the people instead of the profiteers. Anybody see a better way that's practical and politically viable?

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Two Levels of healthcare needed
Posted by: dayahka on Feb 23, 2007 10:57 AM   
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The health insurance system in this country needs to have two levels: (1) Level one is a universal, government sponsored accident and sudden illness insurance program; (2) Level 2 is private insurance for all preventable illnesses (like lung cancer from smoking; cirrhosis of the liver from drinking) that is paid for by the individual and sponsored by the private insurance companies.

This is the only workable system, with a role for government and the market.

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Health Insuranceis not about Health
Posted by: djnoll on Feb 23, 2007 12:00 PM   
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Ihave paid for insurance and I have been the recipient of state health care services over the course of my life. I have noticed several things over the decades of needing medical care that are directly caused by insurance and/or state systems.

1) Did you know that the determination of how long a person needs to recover from any illness in a hospital facility is based on how long it takes a normally healthy 35-year old man in good physical condition to recover? God help you if you are an 83 year old man in poor health or a small child weakened by high fever!

2) Decisions are no longer made on the course of treatment or care by your personal physicians who have an acute knowledge of your medical history or care. They are made by nurses and paraprofessionals thousands of miles away who have not even seen you or have any personal knowledge of your situation. They use doctors in consultation on insurance company payrolls to help them make their decisions, and not necessarily even doctors who specialize in your particular problems.

3) Medicare and Medicaid are some of the worst managed health care systems in the world. They often pay far below the charges, leaving clients with huge medical bills unless they carry supplemental insurance, and they often pay very late. Most reputable doctors will not longer treat patients on Medicare or Medicaid, or if they do, you may have to wait as long as 6 months to a year for an appointment.

4) The quality of care provided to patients by doctors and hospitals is so abysmal that it is dangerous to even enter their care for fear of your life. Death due to doctor or hospital error has been rising steadily, the last I read, for over 20 years now and could be considered of epidemic proportions, if it were ever made public.

5) When you discuss insurance, do not forget the AMA and its desire to protect itself and its members from complicity in this debacle. Doctors will work for insurance companies, Medicare, Worker's Comp carriers and corporations well before they will work for the public at large. The idea of the Hypocratic Oath is a thing of the past. The first line "I will do no harm..." is long since forgotten by the medical profession that has more interest in artwork and Porsches than in helping sick people.

6) The premium we pay for insurance are far in excess of what you will ever pay out in medical bills for the average American. If every American would set up a a no-strings savings account for health expenses, not the HSA of IRS fame, and place in it what an employer would deduct for a policy payment or some portion of each paycheck around 10% maybe, they should be able to cover their average medical needs and expenses very well. This account grows with each year.

I have been uninsured for over 6 years now, and I have only been forced to run up medical bills as the result of an accident until I said stop. I have not seen a doctor for regular medical care in nearly three years, and I have found healthy alternatives to caring for my many aches and pains that are inexpensive and work. So tell your employers thanks, but no thanks, and open the health savings account for you and your family. If you do not need it, then just let it continue to grow. If people did this, then insurance companies would soon find themselves needing to reduce premiums, and change their practices or go out of business. Doctors would have to start adjusting their charges to ones that people can afford, just as many of them do now for cash customers.

Forget universal health-care and forget insurance companies. Take personal responsibility for your own health expenses, and allow the state to set up a fund to be billed for indigent care as needed. It is called sustanability, and it starts with personal responsibility.

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