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Donald Cohen

Donald Cohen

Posted March 26, 2009 | 12:17 AM (EST)

Why are Health Insurance Companies Afraid of Competition


The Health Insurance industry is already gearing up, once again, to fight Obama's health care plans. This time it's not Harry and Louise, but rather cries of unfair competition with a successful model of government organized health insurance.

Insurance companies, along with other vested health care interests, have successfully thwarted every serious attempt at universal health insurance since the New Deal and are taking no chances to keep a solid streak. The standard line of attack is to raise the specter of government-run health care, long lines and losing our choice of doctor. They back it up with endless repetition of ideological arguments that free, unregulated markets are the only way to meet America's needs.

Now, the insurers are crying foul about President Obama's plan to create a public Medicare-like insurance product that Americans could choose to purchase. In a letter to Obama, five senior senators including Mitch McConnell and Charles Grassley said that "forcing free market plans to compete with government-run plans would create an unlevel playing field and inevitably doom true competition." The term "free market plan" is a clever choice of words intended to obscure that these are actually just normal private, for-profit insurance plans.

What makes this ideological about-face so remarkable is that insurers and industry funded think tanks have been arguing for years that competition is the best mechanism to keep costs down and quality high. The message is clear -- competition works, but not when it works against us!

For years, former Indianapolis Mayor Steven Goldsmith and a gaggle of conservative think tanks like the Reason Foundation, Heritage Foundation and others have often argued the benefits of competition between the public and private sector for taxpayers.

The libertarian Reason Foundation is an intellectual leader of a national pro-privatization policy and message machine. In their own words, "The added incentives provided by competition will lead to lower costs and higher quality services. When government competes, the taxpayer wins every time."

Reason's push for government to compete with the private sector to deliver services often results in reducing costs by cutting wages and health and retirement benefits of middle class public sector workers. By contrast, Public-Private Competition in health insurance will squeeze overhead and profits from the middlemen in the system so we can put more money into actual health care.

Since health insurance costs are rising at nearly twice the inflation rate, there couldn't be a more important time to eliminate non-essential overhead through healthy competition. Families and employers are being crushed under the burden of increased health care costs. Since the year 2000, employer-sponsored health coverage premiums have increased by 87 percent.

It's no wonder, though, that the Health Insurers are frantically trying to head off competing with a public plan. Private insurance overhead and profits eat up 20% and more of health care premiums while Medicare overhead (and no profit) is closer to 3%. There is big money to be made in health insurance. The top 7 "for profit" health insurers made a combined $12.6 billion in 2007-- an increase of 170.2% from 2003. The same year, the average CEO compensation package for these health insurance companies was $14.3 million. Pay packages ranged from $3.7 million to $25.8 million.

All of that money could have gone to paying for health care for children, cancer treatments or diabetes screening -- in other words, health care.

By contrast, top Medicare administrators' salaries don't come close to these "free market" CEO salaries even though they are responsible for insuring millions more people than any of these private insurers.

In 2003, the "free market" Congress overhauled Medicare so that private insurers who enrolled the elderly were paid about 14% more than the government typically spent under traditional Medicare for service that was nearly the same. It was the same kind of wasteful spending as when we pushed student loans into private banks and increased the cost of a college education and the debt load of college graduates. Thankfully, Obama wants to take the banks out of the picture and provide direct government lower cost student loans.

Despite fear mongering about government run health care, seniors aren't asking for their Medicare to be taken away. Quite the contrary. People with Medicare can choose between public and private plans that contract with Medicare and an overwhelming 80 percent choose Medicare's public plan over the privately contracted plans.

The debate about whether to offer American consumers a public insurance plan couldn't come at a better time. In the wake of deregulation disasters on Wall Street and in our food supplies, consumer products and workplaces, American's now see the value and importance of a government role in creating vital public goods. In a recent report by the Center for American Progress on the State of American Political Ideology, 65% believe the federal government should guarantee affordable health coverage for all Americans. A CBS/NYT poll in January showed only 32% believes health insurance should be left only to the private sector.

A Single Payer system makes the most financial sense if we are really committed to universal insurance. In 2009, though, Public-Private Competition offers the way ahead for an American public that doesn't trust the free market to do it on its own but is still susceptible to insurance company anti-government campaigns.

The Health Insurance industry is already gearing up, once again, to fight Obama's health care plans. This time it's not Harry and Louise, but rather cries of unfair competition with a successful mode...
The Health Insurance industry is already gearing up, once again, to fight Obama's health care plans. This time it's not Harry and Louise, but rather cries of unfair competition with a successful mode...
 
 
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05:09 PM on 04/05/2009
Don’t worry for the moment about single payer. Don’t worry either about whether embracing subsidies for a grossly inefficient industry with an unsatisfactory product is a good way to cut health care costs. Forget our wallets—what will happen to US if a health care bill emerges that mandates private insurance for all citizens?

Private insurance companies would get millions of new customers. But they are constrained to accept everyone and offer government-mandated services. What can they do to ensure that the board of directors and stockholders continue to see a profit? Restrictions, endless restrictions, higher copays, higher deductibles, higher premiums.

We are required to buy a policy. Seeking relief, we shop around for insurance. What kind of car insurance would you buy if you had a Lexus? You probably have the money to buy bumper-to-bumper insurance to keep your ride pristine. The rest of us buy the policies that exact the lowest out-of-pocket.

Clunker insurance doesn’t cover the fender benders (regular doctor and dentist appointments, gym memberships, physical therapy) and only part of the big crashes (catastrophic illness or injury). To save money, we don’t buy collision insurance that would cover our own damage (we cope on our own with little problems like diabetes and high blood pressure), but we’re required to buy liability insurance (the hospital will be paid for our cancer surgery, but we’ll still owe 20 percent of the total bill).

No relief for us.
02:47 PM on 03/28/2009
I know a lot of American people will simply dismiss the following because of who it is (Michael Moore), but watch the whole YouTube clip taken from his movie Sicko...

http://www.youtube.com/watch?v=0DacChr5MRo

See all the scaremongering, the "oh-no! Socialised healthcare will turn us into a poverty-stricken third-world country nonsense", then look at the scene were all the politicians are labelled with how much they've been paid off by these for-profit insurance companies. I didn't see anyone get less than six figures, and all money that could have been spent on *real* healthcare - not buying politicians to look the other way while you make obscene profits.

What is at stake here is the quality of life of every single person in the USA. To someone like me living in Europe your system of healthcare is a privately administered tax. A tax for the already excessively wealthy to skip a percentage off to fund their holiday home in the Bahamas. Healthcare is a basic human right; you should not walk into a hospital seeking emergency treatment and get told where the ATMs are for you to draw the money to cover care. You should not be discharged from hospital and presented with a bill for hundreds of thousands of dollars. Face it, when the latter happens because some jobsworth at the insurance company denies your claim, they probably get a bonus for saving the insurance company from doing their job - ensuring you get healthcare.
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kd1s
I.T. Geek!
12:20 PM on 03/28/2009
You touch on a very good point in this article, that of regulation. I want to see regulation return to the food and drug market, but more importantly the energy and telecommunication markets.

When you think about it, who has benefited most from de-regulation of anything? It most certainly is not the consumer, it is the shareholder that benefits most.

Do I need to hold out National Grid as a clear example?
09:57 AM on 03/28/2009
I don't think they're going to have much choice in the matter ... if the politicians decide to create laws which nationalize health insurance for the purposes of Universal Healthcare for all citizens, a practice widely adapted by every other industrialized nation except the United States, the existing health insurance companies will be either out of business or in the business of providing secondary coverage ... considering the horrible job the H.M.O. have done in prioritizing profits over peoples health, and that the primary reason that people go into debt is to cover medical expenses for unanticipated ailments, I'd say this change would be greatly welcomed ...
09:20 AM on 03/28/2009
It bothers me that the author chooses to use quotes that are taken out of context to support his point and make it appear that groups that are apposed to government healthcare actually support it. When the Reason foundation talks about the government fostering competition they are talking about allowing market competition to lower the prices on services that have typically been provided by government monopolies. This reform is designed to do the exact opposite. It's designed to create a government monopoly by first creating a competing healthcare program that will undercut private insurance companies because it's paid for by the tax payers. Eventually as the government program grows in size it will kill off competition allowing for a complete government take over of the healthcare industry. The designers of this program have admitted this but it tends to get very little coverage in the media. It's time for the American people to educate themselves. The Obama administration is very smart to bring reform through the backdoor in a way that appears to be bringing competition but will actually destroy is and allow for the total nationalization of our healthcare system.
07:50 PM on 03/30/2009
"..they are talking about allowing market competition to lower the prices on services that have typically been provided by government monopolies."

Except it never seems to work out that way - The FreeMarketeers always seem to find a way to get the government (taxpayers) to finance their projects and pay for their losses.
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acacia72
03:24 AM on 03/28/2009
I'm paying 1252.00 per month on COBRA thru my former company plus deductibles for meds and drs office visits; I'm out of work with a monthly income of about 1100.00, as my wife works part time. We have some savings, but do the math feeding, clothing, housing, etc for a family of three. Screw the insurance companies! GO OBAMA!
08:39 PM on 03/27/2009
Its not socialized healthcare, but public insurance, in other words, an insurance company run by the government so that profit margins are non-existent and they can provide lower health care costs than any greedy provider. I'm pretty sure that the private insurance companies will loose out big.....
08:07 PM on 03/27/2009
Our own take on our nation's healthcare:

http://www.funnyordie.com/videos/2d18bcf57c/code-blue
06:43 PM on 03/27/2009
I have worked at billing health-care for 10+ years, have to say that I don't have a problem with private insurance providers existing and not even with them being able to turn a reasonable profit. My problem, like Mr. Cohen's, is with companies making an obscene profit margin, TRULY, at the expense of the insured. And that expense is not just monetary, it's usually at the cost of the their health / well-being, which cannot be refunded, recouped, or reimbursed.
Why can we, as a country, see the need for socialised education, but not socialised health-care?
Think about it -
You pay to support the public school system, regardless of how many kids you do or don't have.
You pay for the public schools, even if you choose to send your kids to a private school.
There are good and bad teachers / administrators / staff regardless of how affluent the school.
All schools (theoretically) provide a comparable basic education, with some 'extras' like sports, music, art, etc. and you always have the option of providing more of those things yourself.
School districts are expected to provide these services with a degree of cost-effectiveness and financial responsibility, but turning a profit is not the motive.
Why can we see that that is a necessary and appropriate expectation for educating our children, but not for ensuring the basic health and well-being of our citizenry?
03:49 PM on 03/27/2009
I put this on Digg! It's a great find:
http://digg.com/world_news/Health_Insurance_Giants_to_Block_Obama_s_Health_Care_Agenda
07:55 AM on 03/27/2009
I guess the best part of competition between the public and private insurance will be that it can bring down the excessive costs and raise the quality of service to survive particularly in private sector , therefore there is no need to worry about the expensive medical costs over time, as EUROPE tells it.