What value does the insurance industry add to our healthcare?

[Little Star]

I know the employ people but why couldn't most of those workers work in a government run program doing much the same type of jobs? Why do we need them at all? Am I missing something?

[BrklynLiberal]

1. Nope. the insurance companies serve no purpose except to perpetuate their own existence and make a

profit from the ills and misfortunes of other people.

There has to be a better way to earn a living for those who are employed by insurance companies.

[Snarkoleptic]

40. Right...they add as much value to healthcare as a leach adds to a river crossing.

[sharesunited]

2. It is nothing more than a premium collecting, claims denying racket.

[Land Shark]

41. +1

[ixion]

3. The add nothing but heartache, in my opinion

and are largely responsible for driving healthcare costs through the roof.

They are the anti-health care.

[lefthandedlefty]

4. No value whatsoever

That is one business that needs and deserves to be run out of business.

[MNDemNY]

5. Compassion?

[Cleita]

6. Absolutely zero.

There is no need for them to step between a doctor and a patient to administer health care and siphon off profits for themselves. Nowadays, they seem to even have forgotten that they are supposed to pay for health care as part of the risk pool. Instead most of the plans seem to be a high deductible scheme where the deductible for the year is seldom met with the result that the insured must also for pay health care out of pocket along with premiums. Then to add insult to injury they can deny claims and coverage for pre-existing conditions. Supposedly the new legislation changes that, however, there is one big loophole, the insurers can charge whatever they want for coverage. There are no price controls that I can discern from what it being offered so far.

[Dragonfli]

7. Denial of care and exorbitant costs? /nt

[Little Star]

8. I figured I must be missing something if...

Our Democratic Senators, Representatives and President have not noticed that we don't need the insurance industry.

[Kansas Wyatt]

9. They give money to the DLC Pom Pom Squad.

So they can come here to cheer for Republican Ideals...
'Corporate America above the American People!'

Other than that, they are fucking parasites sucking the life out of sick and injured people.

[dwilso40641]

15. Leeches

parasites on the ass of society.

[gateley]

10. Profits for their shareholders, which is what a publicly traded

company is charged to do. It's their raison d'etre. That's why we need to get for-profit companies OUT of the "health care" field. :grr:

[Little Star]

13. Thats what I was thinking. I think we need to start asking

our representatives this question.

[Sebastian Doyle]

11. Not a goddamned thing.

Unless you're talking stock prices.

[snagglepuss]

12. It benefits shareholders not patients. Get with the program.

(btw last remark is sarcasm). Insurance is a profitmaking industry whose main goal is to increase share value. That is it. There is no other reality. For PR purposes insurance companies spin themselves as caring but that is meaningless crap.

In all businesses customers are simply the means to an end which is money. This is why socialists in countries like Canada fought to have socialized health care. Socialists say that there are things like health care that shouldn't be subject to the profit motive which puts money before people.

[highplainsdem]

14. None at all.

And trying to use them to improve healthcare is equivalent to turning our entire military over to companies like Blackwater.

Yes, you can try to control the worst abuses and profiteering with regulations, but they'll try to get around the regulations. And in the meantime you've just set up a system that inevitably diverts a lot of the money from the intended purpose to the profit of companies who will profit even more by evading those regulations.

[bvar22]

16. The Health Insurance Cartel manufactures NOTHING,

produces ZERO "Wealth" (value added), and is a complete PARASITE on our national resources.

I can NOT fathom WHY a supposed "Democrat" would want to permanently enshrine this "parasitic" Cartel as the Gateway to Health Care in the USA.

At least the "Oil Cartel" produces oil.

[autorank]

17. Unlike other forms of insurance, health insurers offer no value added

Thank you for making this so succinctly. They offer nothing.

If you're insured and: your car is trashed, you get paid; and you have a clear cut disaiblity, you get paid; and you die, somebody gets paid.

How often do we hear about any other insurance company quibbling about paying a claim (it happens but "often" is the operative term here).

But with health insurance, how often do people hear

-- we never go the claim;
-- this box wasn't filled in;
-- it wasn't coded properly; and
-- we're paying it now.

These are just a few of the routine denial excuses. There are many more.

Even when they say that the claim will be paid, it often takes several calls to get it done.

That's just what you see as the insured. There are all sorts of back and forth arguments between providers and insurance companies that you never see, unless you've already paid and are submitting for reimbursement.

Wanna know how it works - SEE The Rain Maker

[depakid]

18. They detract value in almost every way

Each dollar spent on denying care, cherry picking, marketing and administration (not to mention the mountains of red tape hoisted on providers) is one less dollar used to "produce health."

The inefficiency, waste and drag on the system is enormous- which makes these entities little more than parasites.

[Little Star]

21. Why the heck do we have them?????? Why aren't our

representatives fighting to get rid of them? Do they think we are stupid? I've never heard of any senator, rep, president saying enough is enough of these leeches. Why not? Why are we not demanding justification for their existance?

[depakid]

25. Their predominace is an historical artifact

During World War II, The War Labor Board ruled in 1943 that certain work benefits, including health insurance coverage, should be excluded from the period’s wage and price controls. Using generous health benefits then to draw workers, employers began to bolster group health insurance plans.

The economy expanded greatly following WW II, building and responding to the needs of growing families, in an era when American capitalism flourished. Large American businesses (e.g., U.S. Steel, GM, AT&T) faced little competition and were sufficiently profitable that unions could successfully negotiate for greater fringe benefits, including health insurance.

More on all of that here:

http://www.kff.org/healthreform/upload/7871.pdf

[Way2go]

19. Gov. should supply ALL forms of insurance.

Insurance-for-profit co's should have to compete with not-for-profit GOV. insurance.

[postulater]

20. None

They're simply a toll booth operator that collects a fee for the use of the service.

[Warren Stupidity]

22. They are in the rent extraction business, by definition: less than nothing.

[Little Star]

23. Our mantra should be Get Insurance Companies out of My Healthcare.

The Repubs sure like to shout Government out of Healthcare.

[fascisthunter]

24. We Don't Need Them, They Need Us.... They are Parasites Who Live off the SIck and Dying

and too many parasites who do not work in that industry have invested in it, so they too need us...

Lots of people for this Bill are investors with money invested in Big Pharma and the Health Insurance Racket.

[roamer65]

26. Zero.

France, the UK and Canada get along without them, so can we.

[hayu_lol]

27. I noticed in a couple of threads the other day...

that the former CEO of Cigna had resigned.

He left with a 79 million dollar bonus.

Wonder how many unpaid claims it took to provide that Golden Parachute?

[izquierdista]

28. Insurance is for losers

Actually for people who are afraid of being losers. Winners and rich people don't buy insurance, they self-insure. If they suffer some kind of a loss, they have adequate reserves to pay for it to be replaced. Being rich means that you have extra money someplace that is not dedicated to meeting current wants and needs (well, maybe scratch wants, for every billionaire wants another billion).

The only value of insurance is to be there when someone who has suffered a loss doesn't want to be a loser. Unfortunately, if an individual who is in jeopardy of losing his health comes forward and asks for the health insurance company to restore his health, all the insurers do is stamp "denied" on his claim and make him a loser.

[MerryBlooms]

29. I don't really know

what I do know is in the last 3+ years, my total health bills are over 3.3 million (car accident related) 7 months total in the hospital, mostly spent in ICU. Out of my pocket, it's been 300,000+ (I've had to cash out everything) and still under 3 docs' care, monthly meds, regularly scheduled x-rays, etc... I have a lien on my home for 35,000 and then owe another 10,000 to my microneurosurgeon. Without insurance, my doc visit is $80 - with insurance, the doc bills for $121. wtf is up with that? Anyway, the only thing I do know is our health care system is totally f'd up.

[Joe Chi Minh]

30. Freedoms. All sorts of freedoms. I actually, wrote, 'Freedooms', first!

[Uncle Joe]

31. They contribute no value to health care but as a nationally sanctioned and soon to be mandatory

game of chance profiting from the American People's illness and injury, they do contribute value to three other entities.

1. The casino workers, shareholders, owners and upper management of the "health" insurance industry, salary, bonuses, dividends, perks etc.

2. The corporate media via the purchasing of commercials and advertising.

3. The Congress via lobbying; aka; bribery with blood money generated from the profits made gambling on the American Peoples' illness and injury.

The game of chance aspect is in fact an illusion in so far as those entities are concerned, the game is clearly rigged in their favor; this is why in spite of all logic, reason, efficiency, functionality, morality and public support, Medicare covering everyone from the cradle to the grave was all but abandoned from the start.

In short the answer to your question is we don't need them, in fact the American People are damaged by them but the rule-makers and the corporate media propaganda machine profit from the blood money.

After Katrina hit when Cheney/Bush were in power the priority was placed on rebuilding the casinos, this is no different.

Thanks for the thread, Little Star.

[defendandprotect]

32. Nothing . . . you need to ask?

Agree . . . a single payer system or Medicare for all would have created 2.3 million

jobs providing health care rather than destroying it!!

[TheWebHead]

33. if you're saying government should be solely responsible for providing health insurance

you'd likely see more money being spent in healthcare or poorer outcomes. I don't see how a government run system employing all union employees with generous benefits and pensions operated as a largely political operation without any direct accountability and an ability to operate with massive losses thanks to an implicit guarantee by the government vs private insurers averaging 3% after tax profits, competing ferociously with each other and reporting to unforgiving shareholders every 90 days would be the savings windfall many on DU project.

[Edweird]

35. You can't be serious.

[Little Star]

37. I think Medicare works pretty good. Why not something like that?

[eridani]

43. Government run systems now operate at half the cost of ours

If all this fucking competition is so good for us, why do 45,000 a year die and 500,000 become bankrupt from health care expenses. Why do we pay twice as much to get a lot less?

[treestar]

34. They spread the risk

They are to cover the risk of expenses one might never have, but could, so they are not part of ordinary expenses.

That's why you buy insurance for auto accidents but not for fuel.

Malpractice insurance - fortunately professionals do not make so many mistakes they'd expect to pay for the consequences. Without it, it might be too risky to practice, in case one thing went wrong.

[Little Star]

38. Medicare works fine without the Ins. Industry.

[treestar]

39. Isn't it a form of insurance?

You pay into it while you aren't sick.

It spreads the risk.

[amborin]

36. they provide lucrative jobs for lobbyists:

....An early version of national health care legislation contained a $40 billion tax aimed squarely at members of the medical device trade association he represents.

Nexon.....marshaled 14 people like himself -- lobbyists who were once congressional aides, many of them from staffs of congressional leaders or committees that had a hand in crafting the health care overhaul.

When Senate Democrats unveiled their bill in mid-November, Nexon's handiwork was evident. The tax on device-makers was still large -- $20 billion -- but only half what it might have been without the efforts of Nexon and his fellow lobbyists.

snip

Their health care clients spent $635 million on lobbying over the past two years, the study shows.

The total of insider lobbyists jumps to 278 when non-health-care firms that reported lobbying on health issues are added in, the analysis found.

snip

Lobbyists' earnings can dwarf congressional salaries, which currently top out at $174,000 annually for lawmakers and $156,000 for aides, though committee staff members can earn slightly more.

The lineup of insiders working for clients with health care interests includes at least 14 former aides to House Majority Leader Steny Hoyer and at least 13 former aides to Montana Democratic Sen. Max Baucus, the chairman of the Finance Committee and a key overseer of the health care overhaul.

snip

The largest insider lobbying cadre belongs to the Pharmaceutical Research and Manufacturers of America, or PhRMA, which employs at least 26 former congressional members and staffers, according to Medill/CRP research.

Two other drug interests, biotech firm Amgen Inc. and the Biotechnology Industry Organization trade group, with at least 24 and 16 insiders respectively, ranked second and fourth among reported hiring over the past two years of lawmakers' former staffers and members of committees considered in the analysis.

snip

"We'll get a bill. And the president will sign it. But it'll be less than the country deserves," said Edgar, a former six-term member of the House.

Health care lobbyists increase their effectiveness by strategically targeting their campaign contributions or the donations of the interests they represent, Edgar said.

Health industry contributions to congressional candidates have more than doubled so far this decade, rising to $127 million in the 2008 election cycle from $56 million in the 2000 election, with disproportionate sums going to the party in power and to members of committees that oversee health care, according to the Center for Responsive Politics.

But lobbyist and former Kennedy staffer Andrew Rosenberg said political conditions, not big money or the predispositions of lobbyists sidelined a public option.

http://www.chicagotribune.com/health/chi-health-lobbyists_bddec20,0,4912184,full.story

[eridani]

42. Other than claims processing, they subtract value

[JoeyT]

44. Didn't you get the memo?

Apparently we're supposed to be talking about how great the insurance industry is.
The same industry that made reform an absolute necessity.

They add nothing. In theory they spread the risk over a larger pool. In reality, the only way they spread the risk is by putting everyone at risk.

[Vinca]

45. Zero value. All they do is move money around - usually in their direction.

[Hidden Stillness]

46. When Health Insurance was Real, "Traditional," It Did Have a Value; Now as Profit-Maker, None

This is such an interesting question to think about, now, so I decided to try to read a little about the situation, to get an explanation (but not being knowledgeable on the topic, by any stretch). If you want to know what insurance was really good for, you have to go back, to the time before it was all deregulated, which yet again, was not during a Republican Admin., (although they all did and do), but during the 1970s and Jimmy Carter, again.

Back when insurance was actually good for something, when it worked, was regulated, paid claims, did not add fees unless agreed to and necessary, etc., when it was real insurance, it made sense to have it. This was what was called "traditional," fee-for-service, "indemnity" ("regular") insurance. You paid a reasonable premium into a large pool with other members, went wherever you wanted (doctor of your choice, etc.), it covered whatever further tests or procedures were ordered, surgery, rehabilitation, etc. It covered costs you could not possibly have paid for on your own, but that the large money-pool of the group can support, as others who are healthy do not need to use it. They paid claims, as they were made and submitted, and were essentially non-profit, as almost all of the money taken in went back out to the members. That was "tradtional" health coverage; I remember it from my parents--who warned me about the scam of Hillary Clinton's forced HMO "plan" during the 1990s--and it handled everything. I don't remember any denials for anything. This old style set-up, is why people needed insurance: there wasn't a Government program for it, so you had to do something, and, it worked. (It was run the way Medicare still is. It paid things.)

Then came the 1970s and deregulation. (I can't really remember, but I'm sure this was dressed up as another "health costs are too high," so let's not control commercial costs, let's let corporations run wild by making the system lawless, after it already has no anti-trust provisions. Every time.) This was when you started to have huge costs for advertising, which used to be illegal, and more and more, premiums went to executives and stockholders, also once illegal. There were more and more complicated "plans," covering less and less, money was now spent on legal teams to work ways to deny coverage, on the pretext of "controlling costs," also once illegal. Plans were so broken up and fractured, that covered groups were now smaller, increasing individual costs. Deregulation meant they started shifting costs to the individual--increased premiums, co-pays, things not covered or denied, high deductibles, penalties.

With "managed" care, everything had to be done on their schedule: their doctors, their covered clinics, prescriptions, treatments (or, usually, not), or there were penalties and the individual had to pay for all costs. Limits, restrictions, time-schedules, lists of "members," penalties, fees, increased share of costs. All this explosion of fragments was called "choice" and "competition," and painted as "good" every time, and more profit went to advertising, denial of care, and executives and shareholders.

I found a PDF at a "Government" site (believe it or not--it reads like a corporate hack; but then, that is what they are now), I think from the Dept. of Health and Human Services, "led" by Sebelius. The agency is called Agency for Healthcare Research and Quality, and reads like a corporate lobbyist. They lie that costs are higher on tradtional coverage--they are not--etc. www.ahrq.gov/consumer/insuranceqa/insuranceqa.pdf "Health maintenence accounts" and "savings accounts" and the like are hyped, but this is the outrageous way "government" website pages are written since the corporate takeover.

Interestingly, it mentions that 30 States have "high risk" health insurance pools already, for poor people who cannot get any type of insurance because of already existing medical problems, programs paid by taxes for the most part--this was one of the phony hypes of the recent forced-commercial-insurance-buy propaganda; that they would now be covered. They already were. Just like the pharmaceutical-industry-written "Medicare" Part D, for prescription price-gouged revolving coverage-non-coverage: they claimed this would help the poorest, who could not afford prescriptions; but of course they already had a truly great plan under Medicaid, which actually did pay for all. That was killed by Part D. This also is like that. Whenever they tell you they are going to make a huge, complex bill to solve one small problem for one small group--investigate. Usually, it means they are going to kill something that now exists.

When it was regulated and treated as if a non-profit, for a service, health insurance ("traditional") had a real value. Now that it is basically only a stockholder's or investor's profit-maker, it has no value at all. They killed it by deregulation, as with so many other things.