Insurance Company 'Reform' Should Be Taken With Large Grain of Salt
By Susie Madrak Tuesday Mar 10, 2009 3:30amMichael Hiltzik in the LA Times. Go read it, it's a real eye-opener:
The genius of modern marketing is pouring old material into new packaging. Over the years this has given us yogurt in tubes, prechopped salad greens in cellophane bags and, most recently, the health insurance industry's new image as a friend of reform.
In December, the industry's trade group, AHIP (for America's Health Insurance Plans) revealed that it had experienced an epiphany and decided for the first time to support the principle of universal healthcare -- insuring everyone in America, regardless of health condition.
It described its change of heart as the product of three years of sedulous soul-searching by AHIP's board of directors, who claimed to have "traveled the country and engaged in conversations about healthcare reform with people from all walks of life."
As a connoisseur of health insurance lobbying practices, however, I withheld judgment until I could scan the fine print. What I found by reading AHIP’s 16-page policy brochure was that its position hadn't changed at all. Its version of "reform" comprises the same wish list that the industry has been pushing for decades.
Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors' and hospitals' fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.
As for universal coverage, which is the goal of many reformers (if not yet the Obama administration), the industry will accept a government mandate to take on all customers, as long as all Americans are required by law to buy coverage.
[...] The insurance industry understands that at this moment, with the political establishment thinking reform, it pays to make nice. In a speech not long ago, Sen. Ron Wyden (D-Ore.), who has sponsored a bill that would unlink health coverage from employment but leave a role for insurance companies, warned the industry against trying to scuttle reform as it did under Clinton.
"I told them, if you do what you did then, you may hold off reform for a bit, but you will hasten the day when there's a government-run healthcare system," Wyden said.
The warning may have inspired AHIP Chief Executive Karen Ignagni to tell the Obama summit: "You have our commitment to play, to contribute and to help pass healthcare reform this year." (On the coy and noncommittal scale, this statement rates a 10.0.)
Ignagni can afford to be gracious because no specific reform plan is yet on the table. But veterans of the last reform battle warn that the moment concrete proposals appear, the insurance industry will deploy in force to kill anything that threatens its profitability and freedom of movement, such as an expansion of public insurance programs or tighter federal regulations.
No one should take the summit's atmosphere of good fellowship as a harbinger of what lies ahead. "Everybody's very 'Kumbaya' right now," observes Jonathan Oberlander, a healthcare reform expert at the University of North Carolina.
The insurers think government intervention is fine if it applies to customers they don't want. The way they put it in their reform plan is that we need a system that "spreads costs for high-risk individuals across a broader base" -- the base consisting of all taxpayers, that is.
Who are these "high-risk" individuals, by the way? At an AHIP convention last year, I heard a prominent industry consultant describe the customers the industry is desperate to dump on taxpayers as those with multiple chronic diseases, like diabetes sufferers with asthma or cancer patients with heart problems. He called these people "clinical train wrecks." (Nice way for someone connected with the "caring professions" to talk, isn't it?)
AHIP's commitment to an improved healthcare system is skin-deep. It endorses the quest for lower costs, more efficiency, and the fair and impartial resolution of claims disputes. Achieving these ends always has been within the industry's power, but it never seems to make any progress toward them.
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You can not mandate 100% coverage with insurance without regulating the insurance companies. That’s a trap. Of course the insurance companies want mandated health insurance for all Americans – THOUGH THEM. Patients and doctors do not control health in this country; insurance companies do, for profit.
“Life, liberty, and the pursuit of happiness”? For me, “Life” includes “health”, and it should be one of those inalienable rights – when all men are created equal.
When greed i.e your bottom line is your sole motivation health care for the people you provide coverage for becomes an after thought a pesky problem that comes with the job...I watched the client the other day and what Ive seen personally and read about that senario isnt too far out ..you have rethugs screaming about hey dems they want the govt to tell doctors and nurses how to treat patients when right now its insurence comps that are doing that...mabey a medicare based system can work or atleast let us have the same resorces that our congresspeople have
It’s not necessary to legislatively eliminate the insurance companies. Let them rant and rave about their bottom line as they will. What needs to be done is to take away their profits by implementing a competing system that is not for-profit.
Yes, the insurance companies ARE the problem. Take away their profit, and they won’t go away quietly – but they WILL go away.
Great idea.
Could also have a "Kick an AHIP agent day".
They say that medical decisions should be made by a patient and their doctor, why sould a government bureaucrat be involved? Well, the way the system works right now, the decisions are being made by insurance representitives with profits on their mind. The spin wins the weaker minds... get out there and educate the masses!
and thought it sounded too good to be true.
yes and the mantra of "choice" when effectively one cannot choose a doctor or hospital outside their "plan" and besides, who wants to make such complex choices when faced with an illness? Insurance companies can not solve the problem they ARE the problem.
My Congress person A Schwartz said at the summit no mandates without a public option. But you know AHIP will fight tooth and nail against this
I'm for Conyers bill..
we most definitely let insurance companies assist in writing any type of insurance reform legislation. Letting the wolf guard the henhouse is a basic fiscally conservative principle, and it has worked so wonderfully in other industries.
Now...excuse me...I need to gather my nerve as I sit down to eat this peanut butter snack.
it may be time to have a national strike. We should pick a day and all stay home until they pass universal health care. Show them the power of mass resistance. That's how Gandhi brought the mighty British empire to its knees. It's either that or the Haitian model which defeated Napoleons' armies in combat. Of course we could continue to sit on our asses and hope for the best. That's what the oligarchs are counting on.
but baby boomers are pampered pansies.
They don't put their asses on the line. They sit home and watch old war movies about their fathers and grandfathers and fool themselves into thinking they have the same qualities.
or show up all over the country in emergency rooms
we will get nothing this time unless we are protesting.emails and phone calls ain't cutting it
Doesn't salt raise blood pressure?
Then we would all need medical insurance.
Insurance companies raise my blood pressure higher than one grain of salt ever would.
Yes, this is necessary and essential. A brief definition of "insurance,"--everyone takes a small loss (their premium) so no one takes a large loss. For health insurance we need people at all ages and all stages of health & sickness, not just sick people. Fire insurance on your home is affordable because just about everyone has it. You would not expect to buy fire insurance after the fire started; why would anyone expect to be able to wait to buy health insurance until they've become sick?
You are correct. As long as everyone is equally covered by traditional insurance, and all pay in equally and receive fairly, insurance works.
When the insurance companies dictate to which pool you are assigned, and arbitrarily change the coverage to benefit the least profitable pools, the fairness is removed.
When insurance companies dictate what treatment is available and what ailment is covered based on the profitability of the disease, receipt of medical care is perverted.
When pre-existing conditions are post-facto assigned, payments are stolen.
Existing medical coverage in the US looks nothing like traditional insurance.
And why shouldn't we just accept the insurance companies' word for it?
It makes sense when ridiculously oversimplified and brought down to a junior high level. In the real world? Not so much.
Insured: Why won't you pay for these treatments? I'm supposed to be covered.
Carrier: No. We've determined that it's a pre-existing condition.
Insured: But I just switched insurance companies last year! In fact, your brand new company is just the old company with a new name! [or]
Insured: But my previous carrier dumped me as soon as they heard about this condition! [or]
Insured: But I was born with this condition! [or]
Insured: But it's not a pre-existing condition; it's a major complication that just developed! [or]
Insured: But it's not a pre-existing condition! Not in any possible way! Every one of my doctors says so!
Carrier: Now let's bring this down to a child's level so we can totally screw you. You wouldn't expect to have fire coverage if you bought the policy after the fire started would you? We've had a laws written based on this version of reality and they have been extremely profitable for us. So go ahead, sue us. We'll pick the most naive jury we can; we'll use the "fire" analogy (as we have for many decades); and we'll probably win. So screw you.
Carrier: Oh! And thanks so much for buying into that bull$%&# definition of insurance. We love when people do that. It completely leaves out the profit and third party investment part of our business and makes it seem that we're just doing this for the benefit of everyone. Sucker!
Seeing how American taxpayers are shoveling billions of $$ into Wall St. and big American bank holding corporations how about doing the same thing with top 3-5 American healthcare insurance providers?
Find out what the market price is and buy them out. The current owners get their coveted "profits" for a final round of pig at the trough and then they are gone.
The new owners? Gosh--that would be the American public. All Americans would own these healthcare insurance providers.
First decision to make and take? Run them as public corporations with the "profits" coming right back to us,the American public.
Next decision? Set up one rational,coherent universal healthcare plan all these American publicly owned healthcare providers would manage and maintain.
Any American can get in/on this plan. Price of admission? Dependent on nothing more than being able to fill out the plan admission paperwork,establish your yearly base income and get your Plan Card.
Make less than $50,000 a year? You pay from nothing to set amount based on your projected income amount per year.
Make more than $50,000 a year? You pay from nothing to set amount based on your projected income amount per year.
You have a fantastic money is falling from the sky year? Great!! Your membership fees are based on that.Month to month.
You have a terrible year of lost wages,no job or other disaster? Your membership fees are based on that. Month to month.
Once you have your Plan Card you are set. Go where you want. See who you want. It works in all cases and places. The plan provides full access no matter where you live or work or are retired or move to or move from.
Americans own it. Americans fund it. Any "profits" come back to us.
Since we are buying up the losses and debts of Wall St. and the banks now is good time to buy some healthcare insurance corporations,group them into one national universal healthcare plan provider.
Owned by all Americans.
Hundreds of billions of $$ are being thrown around these days to "rescue" the reckless and robber class who let greed rule prudence.
Lets take a few billion more $$ and buy Universal Healthcare System.
Doing so will clean up the rotten politics and profits motivation of the current hopeless system of multiple healthcare insurance gamers/providers. Buy them out. We all are owners then. Just like we all own the current Social Security System. Or Medicare System.
Show private healthcare profiteers the door. Good riddance.
All Americans will be owners and all will get same access and levels of possible care.
Take the greed politics out. Take the private profits out.
Frankly I'll take my chances with a government bureaucrat "making" decisions about my treatments over an insurance company bureaucrat any day. At least the government bureaucrat isn't trying to make a profit off my illness.
Insurance companies offer NOTHING but a parasitic profit layer to all health "transactions". There's no reason their function couldn't be done by a non-profit organization at a much cheaper rate. If anybody could tell me a single thing that insurance companies add to health care I'm all ears...
It's dry, period. Making Health Insurance mandatory isn't going to make me go out and buy insurance just because it may be a bit cheaper. Most people's bills are directly related to their income without a lot of wiggle room. I always laugh when I hear legislators crow about "tax credits". I have needs today, not months down the line. The fact is that the Federal government has access to more money than I do. Giving me something else to budget in is pointless.
It's shameful that this country has coddled the few over the majority and we have yet to develop a single-payer national healthcare plan. Unfortunately, politicians will keep putting this on a back burner indefinitely. After all, they've got full healthcare. The rest of us don't matter.
How large does a grain have to be until it's a rock?
I'm one of the "untouchables". I had the misfortune of getting lymphoma at the age of 25. Several years later I needed a bone marrow transplant, and since then have required extensive treatments to stem anti-rejection symptoms. When I started out, I had great insurance. After my transplant, I hit my insurance cap ($1 million), and that was that. I was dropped at the snap of a finger; they had spent all they were going to spend on me. "Oh, you're still alive and need post-transplant treatment? Too bad. Good luck with that."
Luckily, I was able to get on my wife's insurance plan. But what would happen if she were ever laid off? Absolutely no insurance company would ever cover me. You get into these debates about how much a human life is worth, and, my old insurance company actually put a price on it: $1 million. I don't know if I'm worth all that, but I think I'm an OK guy, and maybe deserve to live.
Universal health care is the only way to go, I think. Private health insurance is a racket; you can't put a price on a human life.
Well that's a really touching sentiment from the greedy insurance fuckers, eh?
I'm one of the train wrecks, I guess. I've kind of mentioned this before, but I've been recovering from a breakdown due to PTSD and depression, so in the insurance people's eyes, I'm a suicide risk, and they don't cover that. It's a catch 22 for me. In a way, I'm almost afraid of being in sort of a twilight zone where I've recovered enough to have a full time job but not enough to not need care (and really, I've been told I'll probably need some sort of medication or care for the rest of my life), and therefore not have Medi-cal and not be able to get insurance leaving me without the much needed medication and care...
We do need some sort of Universal Health Care!
I feel that the Dems use health care the way Cons use abortion as a device to get elected and then do nothing about it.
They'll give the issue lip service but at the end of the day they have no plans to change a damn thing.
I have no coverage now and in 10 years time exect I'll have none then.
let's get rid of the insurance middlemen and put cost caps on health care and make drugs affordable.
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