Why Does Everyone Bow Down to the Health Insurance Industry?

[babylonsister]

http://alternet.org/healthwellness/63352/

Why Does Everyone Bow Down to the Health Insurance Industry?

By Barbara Ehrenreich, Barbaraehrenreich.com. Posted September 24, 2007.


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 evil-doers. 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?

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: We can’t just leap to a single payer system, he said in so many words, because it would be too disruptive, given the size of the private health insurance industry. Then I heard it yesterday from a Chicago woman who leads a nonprofit agency serving the poor: 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 for 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 what economist Paul Krugman has estimated two to three million people just turn down claims.

This in turn generates ever more employment in doctors’ offices to battle the insurance companies. 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.

more...

http://alternet.org/healthwellness/63352/

[rpannier]

1. What seems to get lost in the discussion (and I wish someone with more influence would pick it up)

is that in the 1980's we went with mandatory auto insurance. We were assured that with everyone having to have auto insurance, premiums would actually go down because everyone would be insured.

Well...surprise, surprise, surprise...premiums went way up because the insurance could charge whatever they wanted and you HAD to have insurance. I bought a car in California in 1993 and I couldn't drive it off the lot until I could show them proof of insurance.

My rate was 137 dollars a month for a 29 year old with no blemishes on his record.

I had a 27 year old friend who was paying about 150 a month

[madmom]

23. yes, you have to have it, but they can still turn you down, that's bullshit!!!!!!!!

[leftchick]

2. this is key...

<snip>

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 happily take your money. Not Aetna. If you have a prior conviction -- excuse me, a pre-existing condition -- it doesn’t want your business. Private health insurance is only for people who aren’t likely to ever get sick. In fact, why call it “insurance,” which normally embodies the notion of risk-sharing? This is extortion.

Think of the damage. An estimated 18,000 Americans die every year because they can’t afford or can’t qualify for health insurance. That’s the 9/11 carnage multiplied by three -- every year. Not to mention all the people who are stuck in jobs they hate because they don’t dare lose their current insurance.

[babylonsister]

3. And disgusting imo. They are killing people and don't care. nt

[Forrest Greene]

14. "People Who Are Stuck In Jobs They Hate..."

"...because they don’t dare lose their current insurance."

It seems to me that this assistance to human resources departments all across the land is one the biggest & most important services the health insurance mob offers.

[bemildred]

4. I cancelled my insurance five years ago.

I rarely see any "health care provider". It's great. You save great big wads of time AND money. It is true that I could die one of these days, but that is true anyway. You have to decide how much extortion you are willing to put up with.

[Stuckinthebush]

5. If it was just me, then I might do it too

But I have three children and I won't make that bet with their health.

[bemildred]

6. I understand your point, but a lot of people don't have that choice.

And it is that fear that the "insurance" companies rely on to protect them. The main thing I worry about is being bankrupted by some "catastrophic" illness. The way things are arranged now almost everybody has a "catastrophic" illness before they die. I'm thinking I will "short-circuit" that process when the time comes.

[Stuckinthebush]

7. Let's hope that doesn't happen

and hope that a Democratic president and congress will do something about health care. I understand that it could be false hope, but hope nonetheless.

[bemildred]

10. Unfortunately, it almost certainly will happen. The only question is when.

Doctors like to talk about "saving lives", but what they really do is postpone death, for while.

The other thing they can sometimes do is improve the quality of life, which is a very good thing if you need it. But in the current health care regime that is a "pre-existing" condition, and you will be kicked out of the system if there is any way to do so.

The thing I want to know, the thing you should want to know, is: If YOU are obligated to provide health care for your family as a parent, why is the government not obligated to provide health care to it's citizens as a government? Does the government bear no responsibility to it's citizens? What is the relation of the people to a government that owes them nothing?

[Stuckinthebush]

13. Damn good question

What is the role of government? That is the fundamental question that seperates liberals and conservatives. Liberals believe that the government is there to help people. I agree with that.

Too bad our Democratic representatives don't believe it enough to fight like hell for us. Of course, they are covered by socialized health care. We should demand that they give up their health care and purchase from BC/BS or an HMO like the rest of us.

[Lydia Leftcoast]

21. My deductible is so high that just about any illness would bankrupt me

:-(

[Nothing Without Hope]

8. money, money, money - and not a shred of conscience n/t

[Froward69]

9. All politicians lie...

this issue was the main reason I got behind Biden. he was at least saying someone needs to stand up to the insurance industry. however I hope that his modification to his health care plan is just a lie to get elected. as I hope the rest of them are also pandering to insurance. once Democrats take control i hope that they in fact do repair the system effectively. WITHOUT the insurance industry. After all it is HMO's that created this current health crisis. It is a shame that it seems inevitable, things will continue as they are.

[tomreedtoon]

11. You always bow down...if you have no spine.

It's traditional for Democrats now. Even Hillary, whose big plan will put more wealth into the insurance companies. (Anyone check her stock purchases?)

[Maribelle]

12. Yet another lie about Hillary's plan being mandatory.

Even though I have repeatedly asked for facts to back up the lies, all I ever receive is a totally false interpretation of what Hillary "envisioned" for the future regarding portability, and another misinterpretation on the subject merely indicating that folks will need to enroll in their plan of choice.


It's sad that on this vital issue some have to lie, preventing an honest debate that is truly needed.

[rpannier]

16. I've gleaned over their (Democratic and republikkan candidates) proposals

The thing that bothers me is, there is not one mention of preventing these companies fromcuttingyou off if you get really sick.
In the end analysis it's just more of the same until the government changes the rules for how 'insurance companies' are allowed to do business.

[Maribelle]

18. I agree, it does not seem to be discussed in the candidates plans.

However perhaps the following is applicable"

The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996

- - prohibits any group health plan from creating eligibility rules or assessing premiums for individuals in the plan based on health status, medical history, genetic information, or disability

- -limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. However, individuals may reduce this exclusion period if they had health insurance prior to enrolling in the plan

Sec. 101) Provides for increased portability through limitation on preexisting condition exclusions. Limits the preexisting condition exclusion period. Sets forth rules relating to crediting for periods of previous coverage. Makes preexisting condition exclusions inapplicable to certain newborns, adopted children, and pregnancy. Requires special enrollment periods for certain individuals losing other coverage and for dependent beneficiaries. Allows group health plans that offer health maintenance organization (HMO) coverage to provide for an affiliation period with respect to such coverage only if there is no previous condition exclusion and if such affiliation is applied uniformly and for a specified limited period.

Prohibits discrimination against individual participants and beneficiaries based on health status, both in eligibility to enroll and in premium contributions.

http://www.hipaadvisory.com/REGS/law/summary.htm

[depakid]

17. Mandatory or not- Hilary's "plan" doesn't address the fundamental problems

Then again, neither do Edwards' and Obama's.

[Maribelle]

19. And what do you consider the fundamental problems?

There surely are in fact many fundamental problems, which affect families differently.

[depakid]

20. The obvious ones are costs

The current plans are destined to fail because they do NOTHING to address the inefficiencies in the system- parasites, if you will. Every single dollar that's diverted from the treasury (and your pockets) to pay for administrative costs, claims denials, marketing etc. is one less dollar that could otherwise "produce health."

The second, less obvious problem is adverse selection, by which for profit companies will cherry pick the healthy folks, leaving the government plan(s) to cover a much more expensive risk pool.

There's also the matter of keeping health care on the backs of American employers- which is a huge drain at a time when we have a HUGE and growing current account deficit.

Another deal I haven't seen is whether or not it repeals ERISA preemption. My bet is no, which leaves one of the biggest injustices in American civil justice in place.

[OneBlueSky]

15. because they are owned by that and other industries . . .

the influence on Congress of huge mega-corps is abominable . . . they answer to no one but their shareholders, and their bottom line in all things is, well, the bottom line . . . not a good way to run a country . . .

[AdHocSolver]

22. One has to consider the interlocking relationships between hospitals, insurance, and drug companies.

These three industries are "owned" and controlled by the same financial institutions. They work together to keep prices and profits high. Most hospitals are run by "bean counters", not medical types. They "compete" by duplicating services and charging exhorbitant rates for these services.

For example, to save money, a group of hospitals in a geographical area should share an MRI scanner so as to keep it busy and avoid costly duplication of services. Instead, they each have their own scanner, and then have to find patients to use it on to recover the costs of this expensive machine.

It is estimated that hospitals "cause" as many as 80,000 deaths a year among patients. Many are due to drug-resistant infections developed by patients. This problem, and other problems, are due to cost-cutting measures by hospitals to increase profits. Hospitals are not immune from criticism in this overpriced, underperforming medical system we have in the U.S.

We have to eliminate the system in the U.S. where people get their health care through their employer (assuming they have employment.) Employers have used health insurance as a carrot and a stick to keep employees in line and reluctant to change jobs for fear of losing health benefits. This is a "sick" system. What we need is a system that guarantees ACCESS to health CARE, NOT health INSURANCE.

When will this system be fixed? When we get rid of the corruption both in Washington and in many state capitals, or when businesses lose so much money on health insurance that they support national health care, or when pigs fly.