Insurers Bristle at Tough Rhetoric But Stick to Reform Path

The insurers should well bristle - they are being demonized by Democrats looking for something, anything to blame for Obama's failing socialist agenda.

There is an old saying that you should never wrestle with a pig, because you both get muddy and the pig likes it. The insurers should quit playing kissy face with Obama the Pig and launch a campaign to expose this health care fraud for what it is - the second biggest ripoff of the American taxpayer in history. Of course, the biggest ripoff of the American taxpayer occurred only two month earlier, again courtesy of the Pig.

I am not at all interested in spending generations of our grandchildren's tax dollars to insure illegal aliens. No. No way. Go away, Mr. Pig.

But the fact is, the insurance companies ARE morally bankrupt. Some are worse than others, and the ones who try to be a little better are punished with lower profits than the bad ones.

Good, moral, insurance companies will welcome regulations (like no dumping patients) because it will allow them to treat people with dignity and fairness, without losing market share for their trouble.

I'd appreciate encountering a news article that explains what the insurance industry brings to the table. That is, what benefit do they provide? If the big concern about a public option is that private insurance would be priced out of business, I wonder why I should care. That makes it sound like private insurance is a high-cost drag on medical care.

In 1965 we were told Part A of Medicare would cost 9b by 1990. We paid 66b.
Parts A-C 12b by 1990. We paid over 100b.
2003 Part D Rx drugs were to cost 500b+ over ten years. After ~2 years this has been revised to over a TRILLION.

So when the boys and girls in DC tell us that they can get the new plan done for under a trillion, hold on to your wallet.

And that is just the feds lying about health care. The private insurers have lied about their margins and the greed shows. I don't need a 20 story glass tower to house my plan which is managed by a computer and a high school grad who answers the phone to tell me how they wont pay for my endovascular aortic aneurysm repair as she asks me how to spell it.

Senate Democrats want to bypass Republicans and rush any kind of health care bill before the summer recess...I bet alot of Democrats won't be coming back in 2010.....LOL

Presently, "health care reform" is complete deception by congress, the media and insurers. Contrary to appearances, The insurance industry wants hr 3200 with the public option or co-op so these options can be used to dump the sick unprofitable policies on tax payers, while insurers keep the rest of the 50 million healthy policies for themselves.

The real insurance company fight is to deny hr 676 from even being considered by congress. The majority of Americans want single payer hr 676! But Congress and the Media denied hr 676 single payer consideration, because they are both bought by Insurance companies, This is a crime against representative government and the duty of the press to report the truth!

"This is a crime against representative government and the duty of the press to report the truth!"

The MSM (Washington Post,CNN,MSNBC) are so far up obama's colon they don't even know what day it is....having these kiss a** report any truth is laughable.

Other countries get better results at less than half the cost per patient. Clearly we can learn something from them. We do not have to invent the wheel. But Congress acts if we are the only country in the universe. The reason is never stated, but it is clear. The most important principle in health care for the House and the Senate is to preserve the income of health insurance executives and their wealthy stockholders. That is why we can't learn from other countries. That is why all of the proposals being considered are so complicated.

The goal of a well run corporation is to make money for shareholders. In the case of health insurance companies this is in conflict with providing good efficient health care to the country.

The for profit insurers have learned that the way to get a high stock price is to have a low Medical Loss Ratio which is the percentage of inflow (premiums) paid out in medical benefit to patients. Notice that they consider medical benefits as "losses."

They do this in two ways. They make the numerator smaller by making it difficult for doctors and patients to collect. They make the denominator larger by obscene executive compensation, high profits, billions spent processing complicated forms they require of physicians and patients, and still more billions spent on fighting with doctors and patients over coverage and payments. See the SEC fillings for the Medical Loss Ratios and a recent Commonwealth Fund Study for the difficulty patients and physicians have with coverage and payments.

Because all of the current proposals try to fix health care but keep the cancer of for profit insurance, they are horrendously complicated. They run about 1,000 pages. HR676, Medicare for All, not only gives good health insurance to everyone, it solves the problems of pre-existing conditions and the situation where loss of job implies loss of health insurance. Furthermore, it costs less than any of the current proposals because it will save us $500 Billion each and every year by the elimination of the high overhead (= 1 - Medical Loss Ratio) and huge compliance costs of both physicians and patients. Also it will make it easy to crack down on the wasteful "marketing" of drug companies. In fact, studies have shown that we can get all this and it will not cost us anymore than we are already paying and probably less.

HR676 is 70 pages long.

Hurry and get it done before they find out-wait-it wont take effect till 2014. So what's the hurry?

The " Joker face Obama" posters on every corner and on bumper stickers enmasse is a loud message to the Democrats that they are done if they do not stand down the NPD sociopathic dual profile instead of shoving more on us.
Everywhere I drove I saw another one.
Democrats and Republicans are soooooo over.
Independent Party says so.

What is all this posturing about? Nonsense. Congress is in the pocket of the insurance lobby. Period. Especially Senator Max Baucus, who gets more campaign contributions from the health insurance industry than anyone else on the Hill. The insurers are getting what they want. What does anyone want? To be able to sell their wares to every single man, woman, and child in America. By forcing every single man, woman, and child in America to buy a health plan, and by scrapping any public plan for those who are too poor to buy into a profit-making health insurance company's bare-bones plan, our legislators in the Senate are giving us whatever the health insurance industry wants. The rest is posturing and rhetoric. The insurers paid for their politicians and they are getting their money's worth. It's good PR to object to being called names on the Hill. Name-calling and posturing is all it is on the Hill and the insurers know that. They'll get every point on their agenda. Why worry? So if you have stock in health insurance companies in that retirement plan you will make out well. Maybe that's what was meant by trying to sell "healthcare reform" as a stimulus measure. Health insurance company stock will skyrocket. Healthcare "reform" without controlling the cost of premiums while forcing Americans to buy these expensive health insurance plans will be ruinous to most people and very good for health insurance companies and great for the politicians who took campaign contributions from them as long as they can keep spinning their lies about how their legislation is going to do this and accomplish that and keep us from seeing the truth. The health insurance industry's money runs our polticians, not the will of the people. All the rest is posturing and political rhetoric.

lensch,

i've thought more after our conversations and i've finally realized why single payer won't work and i'd love your take on this.

We all know how much doctors make now. Most understand that if a single payer is enacted it will force doctors wages down drastically (to medicare style reimbursements).

It works in Europe because to my understanding (and correct me if i'm wrong) most everyone makes less there than the US (i'm sure i could look it up i guess to confirm). If average wages in Europe are say $40k a year and docs make $60k then people might be willing to be doctors for that much more.

Though in the US average wages may be more like $80k so if doctors make $60k like in Europe then no one would want to be a doctor. Sure you'd get some that would want to "do good" and be docs, but most wouldn't (especially when you factor in cost of schooling etc).

So unless we artifically reduce wages across the board in the US I find it hard to make it work.

I'd appreciate encountering a news article that explains what the insurance industry brings to the table. That is, what benefit do they provide? If the big concern about a public option is that private insurance would be priced out of business, I wonder why I should care. That makes it sound like private insurance is a high-cost drag on medical care.

Posted by: SonomaHills | August 3, 2009 6:08 PM | Report abuse

actually believe it or not insurers are very good at cost containment. Also they are very innovative in terms of preventative care, transparency of docs etc.

Don't laugh at the cost containment point. back in the 90's in the days of capitation costs were contained. Then everybody bashed the insurers and they started covering everything under the sun. Personally they should go back to those days because the whole world seems to bash them anyway (or at least all the people at WAPO.)

Actually, the minute insurance companies got into the picture, there was corruption. My Dad can still remember when a doctor's receptionist would ask whether you had insurance, because insured people were charged more.

The bigger scam is the ERISA law. Search on ERISA 514a and 502i, and you'll see that plans covered under this law (mostly large company plans) are protected from ALL lawsuits, even for breach of contract. This allows insurers of these plans to deny claims, even the most legitimate, without fear. I have yet to hear any politician speak out against this scam.

visionbrkr - Thank you for your thoughtful comment, although I disagree. First of all, PPP is a measure of purchasing power which is a more accurate measure of income than merely converting dollars to pounds, francs, etc. If you look at incomes in PPP, you will see that, in general, other countries have incomes comparable to ours. It is true that physicians in some countries earn somewhat less relative to others than they do in the US, but doctors in the US get a lot more than the rest of the population. If you look up adjusted gross incomes at bls.org, you will see that family docs get about 3 times the average, OB/GYN's get over 4 times the average and many specialities get 10 times the average. If we have a national health care system, the difference between family doctors and specialities will probably lessen.

To the point, out of the 42,000 students who apply to medical school every year, 18,000 are accepted. Furthermore a lot of good students don't apply because of cost. Even if the income of physicians goes down a bit, it seems to me it will still be an enormously desirable career especially if the costs of education are addressed.

I do not feel that this is a serious problem with a well run single payer system.

Actually, the minute insurance companies got into the picture, there was corruption. My Dad can still remember when a doctor's receptionist would ask whether you had insurance, because insured people were charged more.

The bigger scam is the ERISA law. Search on ERISA 514a and 502i, and you'll see that plans covered under this law (mostly large company plans) are protected from ALL lawsuits, even for breach of contract. This allows insurers of these plans to deny claims, even the most legitimate, without fear. I have yet to hear any politician speak out against this scam.

Posted by: ProfElwood | August 4, 2009 2:01 AM | Report abuse

I'm sorry but this is absolutely not the case. Because of network discounts that average around 40% for hospitals and 60% for doctor's charges those without insurance are charged the full fee. Any doctor's office will tell you that.

lensch,

thanks. nice that we can be on opposite sides of the system when it comes to views but can still be cordial.

I don't think you can convince doctors of those figures though, especially specialists. All they'll see is their paychecks going down and they won't agree to it. They'll fight single payer i expect until they get to a breaking point when their costs in the current system are unsustainable which they aren't at yet.

Also i don't think single payer will become a reality until we have many more uninsured. Right now you have 47 million (of which many are illegals so many in the majority of the insured don't factor them in anyway). You have 170+ million insured and whether true or not many of those feel that they will lose coverage that is hanging on by a thread if they HAND OUT to the uninsured. Remember that most Americans honestly don't understand economic realities. They see just what happens to them.

You'll need to likely see close to 50% uninsured before you get the masses to move on a single payer system. At the current pace with no change that day will come unfortunately. But we're not there yet.

visionbrkr - "I don't think you can convince doctors of those figures though, especially specialists"

You may be correct here. I am a mathematician. It is a constant source of wonder to me that physicians who have at least some kind of scientific trainig can simply ignore factual evidence.

However, let me point out that a recent Pew poll showed that 59% of physicians supported single payer. You can put that along side the many polls showing that the public supports something like Medicare for All by margins of 60% - 70%.

The facts are overwhelming, but what we have is a failure of our political process where wealthy powerful special interests can overcome the facts and the will of the people.

visionbrkr - One more posting. First of all, your remark about the undocumented (they are no more illegal than someone who overparks) is not really right. Over half of the undocumented have health insurance. If you ask your hospital administrator, you will discover that an uninsured undocumentd alien is far more likely to pay his emergency room bill than an uninsured citizen because he is afraid of discovery.

As for your 50% figure, there are millions who are underinsured, who cannot afford the co-pays or deductibles required if they get a serious illness. I don't know this for a fact, but I wouldn't be surprised to discover that almost 50% od the US population is one serious illness away from unecessary death or bankruptcy.

lensch,

agreed but remember most physicans are far removed from their scientific training. many are on the "front lines" of healthcare and don't have the time or inclination to think rationally about it. they're too engrained in the process.

yes the problem is all the special interests (of which i am admittedly a part of). you have so many people, industries groups, wanting their share of this ever growing pie and they're all pulling in diffrent directions. its been cordial to this point but its about to get ugly I fear and I hope that if nothing else we get some reforms that are absolutely necessary including but not limited to insurance reform. There needs to be more competition and I've warmed to the idea of a national or regional co-ops as long as they are given a limited amount of federal support (to the extent that BCBS was given when it was first started) and in such a way that it competes fairly. Also private insurance should be made to compete fairly too. ALso as I've said before I don't know why they don't put on the table (maybe they will) a national requirement of an 85% medical loss ratio. That will quell fears of insurers profiteering.

lensch,

the undocumented aliens will pay insurance like that, you are correct but only up until the point in which they can. If they have much more than an ER visit they won't pay because they can't afford to pay.

as far as underinsured you are right as well. the problem is that the human psyche isn't built to tell us that we're going to die, get sick or rack up major medical bills we can't afford.

The savings rate is now finally with this serious recession going up but American's won't let that go for long i fear. The old theory was that you need to have 3 months of salary saved in case of illness, etc. I'd expect about 5% of the population has that and that is sad. I'm saving more now than I ever have (tough when you're taxed on everything) and I plan to continue saving even when the economy turns around. This cars for clunkers thing is a good picture too. How many people are getting these new cars that truly can't afford it. Are they the same people that bought homes they couldn't afford? How many of those cars will end up being reposessed when people don't have jobs and can't afford to make the monthly payments? Will they ever learn. Realization of the American dream is NOT a right of every American, IMO. that's not the politically correct thing to say but its the truth. That thought by most is what caused the housing bubble to burst very recently and people just don't learn.

The need to erase the blemish of illegal immigration prompted Congress to enact the Immigration Reform and Control Act (IRCA) of 1986. The IRCA toughened criminal sanctions for employers who hired illegal aliens, denied illegal aliens federally funded welfare benefits, and legitimized some aliens through an amnesty program–EXCEPT THESE LAWS NEVER WERE ENFORCED? Neither the federal government, nor state county have denied most benefits to illegal immigrants. That is why one state–California–is involved in a monstrous budget deficit? California--THE SANCTUARY STATE-- has been overrun with millions of illegal entrants, as with Arizona and other border states. An the ingredients of federal law has been a breeding ground for entitlements that have been gravely compromised by pandering to minority caucuses REMEMBER THERE ARE MANY SPECIAL INTEREST GROUPS, WHO WANT ABSOLUTELY NO RESTRICTIONS ON HOW MANY PEOPLE CAN BE ALLOWED INTO THE US?.

It would be untrue to accuse just the Democrats for this, because all politicians have been involved in distracting–THE PEOPLE–from the real issues that cost them billions of dollars. The population falls for these distractions every time, so they can hit you with either higher taxes or give huge tax reimbursements to their corporate comrades. Illegal immigration is a major depletion of every tax treasury, throughout this land. Giving any kind of AMNESTY will enhance the predictable–OVERPOPULATION. The complete neglect of our interstate highway system, tunnels and bridges is just the slow eroding of our infrastructure. In the near future the population growth will explode, to over another hundred million people. IT would be an unmentionable catastrophe to open the doors wide at the border, giving millions of illegal immigrant’s expressway to a path to citizenship. Already our Senate has voted to give illegal immigrants and families a right to access the new health care provisions--WHICH THE TAXPAYER WILL PAY FOR?
THEREFORE THIS IS A FREE WELFARE FOR ALL PARIAH BUSINESSES THAT STILL HIRE ILLEGAL LABORERS.

You must decide the future of future generations, because just my ranting will have very little influence on the power brokers in Washington. Call your Senator or Congressman at 202-224-3121 and impress on the people you vote into office that you want an alternative to the predatory health care insurers. You want the right to choose? That includes the Universal government run system that certainly isn’t any worse than the profiteering insurers. That you also want your political representative to sever any path to citizenship, but to enforce a firm, permanent--ALL ENCOMPASSING-- E-Verify, police 287(g) enforcement and not to rescind the no-match letter or weaken ICE raids. Tell them you are a voter and convey to them, as you voted them into office as you can remove them, just as easy? Read the naked true facts by GOOGLING--NUMBERSUSA

It's all crocodile tear bristling. The insurers recognize the boogie-manning of them as just pig fat that greases their way to 47 million new subscribers. And, most of those subscribers will be subsidized by $90 to 100 billion. This is permanent corporate welfare on steroids.

It's easy to demonize paper shuffling or should I say keyboard pounding parasitic insurance middle people than it to recognize that the real sources of health premium inflation are hospitals, doctors, drug companies and other providers. Poxes on all their houses.

These insurers try to act as though they are not parasites on our health care, but look at what they do with a practice they call "recission":

"The House hearings on rescission – the retroactive cancellation of individual health insurance policies – were over a month ago, but after its initial run through Daily Kos it seems to have waited a bit before popping up on Baseline and Slate. James Kwak at Baseline described the practice as rare, affecting only 0.5% of the population. The faint light bulb above my head began to flicker: could that be true…that’s not rare – that is amazingly common."
Read the rest here:
http://tauntermedia.com/2009/07/28/unconscionable-math/

It's a real eye-opener for those with health insurance that they think will cover them if they REALLY get sick. Dream on. If you come down with something that costs more than they want to pay, you are almost always booted out, with nothing but their refund of what you have paid in, if you are lucky.

I just wanted to respond briefly to visionbrkr's post which basically said that perhaps wages must be lower in Europe, and that's why doctors are paid less than they are here and are willing to work for that. The truth is that in most of the EU, (and in the UK which is the country I know the most about...) their wages--not to mention their benefits--are MUCH HIGHER than what we get in the USA.

The current minimum wage, for example, in the UK, for everyone over age 22, translates today to $9.73 US Dollars per hour. Of course in the US, the current minimum wage is $7.25 an hour.

Still, I do appreciate that you are trying to think this stuff through and all that... which is what we NEED to do as a society.

I think the major difference between the US and the EU is that they have figured out the reality that we are all in this life together... and the USA hasn't quite gotten there yet.

mssanity,

thanks for your reply on the topic.

I wasn't as much looking at wages for lower income earners as much as i was at doctors. I'd be interested in finding out what wages doctors make (across all specialities) in Europe and socialized countries as opposed to what they average in the US.

I think we need to get everyone, docs, insurance company execs as well as all executives off of their pedastols of income but going from $500k a year to $50k a year to me is too drastic a step to make all at once. We'll get to more equality, but we'd better not bite off more than we can chew or we'll end up with too much of a backlash from the other side.

To all you scum bag democrats that want to tell me what to do.

I DON'T WANT SINGLE PAYER. f u.

And you sleeze bags. Want to know why???? Because I LIKE MY HEALTH INSURANCE THAT I PAY FOR.

But you idiots will generalize anyone that disagree's with you as being in the pockets of insurance companies.

If you scum bags wern't so stupid and actually had a skill set that allowed you to have a job which offered paid insurance, you wouldn't be the meek sheep that you are.

YOU WILL TAKE MY INSURANCE THAT I PAY FOR MYSELF AWAY FROM ME AT THE END OF A GUN. And you pricks, I will take you with me.

I'm done with you pricks. You refuse to answer anyones concerns that has insurance. You label us obstructionists. f.u. How hope you all DIE in the hospitol waiting on the illegals to be served first as you thank jesus for your goverment health plan.