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Ethan Rome

Ethan Rome

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The Truth About Health Insurance Company Profits: They're Excessive

Posted: 05/18/11 12:36 PM ET

The health insurance industry's mouthpiece doesn't want the rest of us to know what Wall Street knows well -- the record-breaking profits of the health insurance companies are, in fact, excessive.

In response to astonishingly high first-quarter profit reports from health insurance companies, the industry trade group America's Health Insurance Plans (AHIP), claims it is among the least profitable health care industries. AHIP says the health insurance industry profit margin is only 4.4%, and that this "low margin" represents less than one penny out of every dollar spent on all health care in the U.S. These are simplistic and misleading statistics.

Last week the New York Times reported that the health insurance industry is enjoying record earnings while millions of Americans get less medical care. Wall Street investors are delighted with the industry's profits, and to health insurance executives, that's all that counts. Insurance CEOs want investors to buy their stock and keep share prices marching higher, and that's exactly what has happened. To achieve excessive profits, insurers are happy to gouge consumers and small businesses, do little to rein in medical costs and spend billions of our premium dollars on lobbying, secret political activities, bloated executive pay and stock buybacks.

AHIP's focus on profit margins is misleading and designed to protect their massive income by shifting attention away from their return on equity -- a key measure of profits as a percentage of the amount invested. That return is a phenomenal 16.1% as of today. By that measure, health insurers are ranked fourth highest of the 16 industries in the health care sector. They also deliver a higher return for investors than cellphone companies, beer companies, mortgage companies, life insurance companies, TV broadcasters, drug store companies or grocery stores.

AHIP likes to talk about how insurance profits are a small share of national health spending -- less then one penny of every dollar spent on health care in the U.S. -- but that is an absurd, deceptive and self-serving statistic. Yet even their own chart of this data shows that the share of the health care economy sucked up by health insurance profits has more than tripled over the past decade.

One penny of the health care dollar is worth $347 billion over 10 years ending in 2019. That one penny would pay for more than one-third of the entire cost of the health reform program.

In response to a memo that Health Care for America Now (HCAN) sent to news outlets yesterday, AHIP attacked HCAN for pointing out the insurance industry's misleading use of statistics. Yet AHIP did not challenge the validity of HCAN's critique. That makes sense, because they are wrong on this issue.

The health insurance industry is also wrong to oppose the Affordable Care Act (ACA) by bankrolling the Republican repeal effort. The ACA expands coverage, ends the worst insurance company abuses, reduces health care costs, and reduces the federal deficit while building on the private insurance system.

The Republicans' relentless opposition to the law is a naked appeal to their extreme right-wing base and an attack on people already benefiting from it -- millions of seniors, children, young adults, families and small businesses. It's time for AHIP to turn away from Republican politics and vigorously support implementation of the law.

Cross-posted on the NOW!Blog here.

 

Follow Ethan Rome on Twitter: www.twitter.com/@HCAN

 
 
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02:39 PM on 06/06/2011
For the last two years when I receive my new Medicare payment rate I am notified that "due to increased healthcare costs" my premium will be going up by about 22.5%. Oh really? Healthcare is costing 22.5% per year more each year? Also my carrier is posting healthy quarterly profits. Whose health are we looking after? If costs really are rising like this I think we are demonstrating clearly that private enterprise is a failure. Let's eliminate all private insurance proviers, a great savings right there, and let the Feds run everything. Even they can't run the price up at 22.5 % each year.
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Rixar13
U.S. Coast Guard Veteran and University
04:51 PM on 05/25/2011
For Profit Health Insurance companies have no business in Health Care for Americans...
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AcademicFreedom
Often banned; always factual
11:01 AM on 05/20/2011
Health care profits are excessive - a nice amount of that money goes for health care company advertising on HP. It is curious how HP accepts money from United Healthcare.
05:23 PM on 05/19/2011
Health Care Insurance profits are excessive.
Health Care costs are excessive.

Does anyone see a connection here?
03:06 PM on 05/19/2011
Here are some good tips on how to save money on Car insurance

i) Raise your Deductible - This is the amount you pay out of your own pocket before the car insurance company pays anything. As an example, raising your deductible from $100 to $500 will reduce your monthly car insurance premiums by 10% to 20%. This will also make you a more responsible driver knowing a lot of your own money is at stake; and over the long term, you will maintain a better driving record versus if you have no responsibility.

ii) Drop Collision & Comprehensive Coverage - If you have an older car, this makes sense. If your car is old & not worth much, why pay high premiums if you are going to replace it anyways if it gets in to an accident.

iii) Comparison Shop - Do not assume that all insurance companies charge the same rate. Search for the best insurance rates from multiple companies. Be sure to check out the rates at Tesco Car Insurance.
Source: http://www.tesco-car-insurance-quote.com/

iv) Drive Safely - Do not speed, take unnecessary risks when driving & always maintain a safe driving distance from other cars. Accidents can greatly increase your car insurance premiums so be careful.

vii) Shop for Insurance before you buy - If you plan to buy a sports car, be prepared to pay a higher car insurance premiums than regular cars. Cars that are expensive to repair or heavy targets for thieves have higher insurance
05:27 PM on 05/19/2011
vii works. I shopped for my car insurance two years ago and dropped my premiums in half. I'm a great driver who hasn't been in an accident ever and got my last moving violation when I was 18. That was over 40 years ago. When I decided to go shopping my record gave me leverage to get a great deal.

Your present insurance provider will keep inching up your premiums each year even if you have a great record. A new insurance company will create a new baseline that is often lower than your current provider. Start over and then in a few years, go shopping again.
11:33 AM on 05/19/2011
Exactly why are there health insurance companies? What good do they serve? Why can't I go to the doctor and pay for the service myself? I'll tell you why. Insurance companies mask the obscene costs and cost increases that medicine has undergone in the last couple of decades. Do away with health insurance companies, put cost controls on all medical/dental procedures, and let old people die without spending 99% of their health care costs in the last 1% of their life. The arguments taking place is a red herring.
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spriddler
11:15 AM on 05/19/2011
Mr. Rome a profit margin below 5% is not excessive in any business, and the fact remains that if you elminated profit all together prices would be right back to where they were within 30-60 days (profit=0.5% of spending, healthcare cost inflation is somehwere between 8-12% per year). And if health insuarnce companies were as uncaring and malicious as you paint them to be they would lose their customers in an awfully big hurry. Customer retention has orders of magnitude more importance then recissions for a company's share price.

And the PPACA only exacerbated the cost problem. The biggest driver of healthcare cost inflation has been a medical industry divorced from the normal market price constraints. This has been facilitated for decades by companies bearing nearly the full cost of very rich benefit plans. They were able to hide premium increases with lost wage increases. It is only recently that companies have started to shift the burden to consumers which has for the first time created loud calls for pricing discipline in the healthcare industry. If they had done that decades ago we would not have the cost problem we have today. But the PPACA only fursthers the problem with hefty premium subsidies and mandated rich benefit plans.

And the PPACA will assuredly add to the defecit. The $500 billion in Medicare cuts will never happen and for good reason. It would drive a great many rural and inner city hospitals to bankruptcy.
04:23 PM on 05/19/2011
LOL, are you trying out for standup? Don't quit your day job.
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Jack Daniels Esq
Hold the ice
12:39 PM on 05/20/2011
How come nobody in DC told Obama this ....?
05:28 PM on 05/19/2011
You must be joking. Most health insurance companies are a monopoly and in my neck of the woods you only have one choice. The new health care reform is trying to bring competition into the system but we know where Republicans want to take that.
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spriddler
12:14 PM on 05/20/2011
The PPACA has in fact limited competition. Its required premiums to claims ratio for insurers have been tough for most companies to meet, but they have been especially tough for the smaller players. We have already seen a marked increase of consolidation in the industry. Principle, Guardian, and American Community were all significant regional players that have since left the health insurance business. Many of the smaller companies are now much more vulnreable, and nobody expects the consolidation to slow down let alone end any time soon.

You are right though. Too often there are only one or two carriers in an area with competitive contracts with the local docs and facilities. That is a complicated problem with no easy solutions. Allowing insurers to sell across state lines would be the biggest single thing that could be done, but there are plenty of problems that come with that as well.
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Carol Gebert
10:05 AM on 05/19/2011
Want to save a bundle? For those over 75 years of age with a terminal illness and less than 1 year forecast to live, deny extraordinary life saving measures. I do not have the numbers, but I suspect the nation will save many multiples of the 1% the author is so eager to recover from financially responsible insurance companies.
05:29 PM on 05/19/2011
You're talking death panels again.
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Carol Gebert
09:45 AM on 05/20/2011
You call them 'death panels.' I call it sensible end of life care. Rationing extraordinary care is the best way to reduce total costs. About 50% of a person's lifetime cost of care occurs in the last year of life. About 25% is incurred in the last month. Follow the money.

Personally, I do not want to wait for a terminal illness. Sometime after I turn 80, I want to pick a good time to die. Before I am bed-bound, before I am lonely, while I can still wipe my own ass. Before I give the taxpayer a bill for $100k. Switzerland, here I come.
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heron77
Drive on the right
09:37 AM on 05/19/2011
Most health insurance companies are non profit. That means the excess revenues are called just that and are invested in safe securities in case of a health calamity. Wouldn't want our health insurer to run out of money.

Some insurers are mutual companies and may declare dividends to the policy holders. And some for profit companies may declare dividends to the shareholders and your 401 K may be enhanced.

Quit whining with the wealth envy syndrome. The public benefits when insurers are rock solid.
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Carol Gebert
09:52 AM on 05/19/2011
well said.
itolduso
lateral thinker
11:34 AM on 05/19/2011
"The public benefits when insurers are rock solid" - heron77 ************* ahhhh....those "public benefits" become clearer everday......in tens of millions of Americans who have no health insurance, the many millions more, who do, but cannot afford the co-pays, or whose coverage doesn't quite 'cover' what is needed.......the bankruptcies and homelessness of those who are unfortunate enough to get ill or need surgery.......the daily stress and midnight panic of thousands of workers who know they risk the same at any moment..... even as 12.....15....or 20% of gross pay is withheld 'upfront' for policies that never quite live up to their promise, for protection that fails to protect. An entire nation held hostage to the threat of pandemic & death because too many who grow our food, who pick it, pack it, ship it, and stock & sell it....cannot afford to see a doctor or take a day off when they are ill....."public benefits"...that's a very funny thing to call it.
09:21 AM on 05/19/2011
Greed, that's all I see. Since the public option failed, the industry is left unchecked. The health care industry should be nationalized. Public health care should be a right, not just reserved for the old. As with any industry, they are bleeding us dry. Controls have been removed by our elected officals. They don't work for the people any longer.
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Skeptical Patriot
08:55 AM on 05/19/2011
The misleading part is your article. If you eliminated that entire profits of the health insurance industry by your numbers it would impact health costs by less than 1%. This total cost of healthcare in the US is $2.3 Trillion - that is Trillion dollars. The complete elimination of health insurance profits is approximately $50/person out of the roughly $7,500/person we spend each year on healthcare.

Want to save between 1 to 10 times the amount in profits by insurance companies. Medical Malpractice reform is estimated to save between 1 to 10 times the amount. A Stanford study in the mid-90's estimated it at 6%. Other groups at between 10-15% and as little as 1%. Why no ruckus of this item. Hmmm Plaintiffs Lawyers are one of the most potent (read: $$$) for Congress

Want to save another $300B? Congress passed a law that requires a gradual reduction in doctor reimbursement for Medicare about 7 years ago. Every year, they have deferred putting this requirement into effect. BTW - the OMB assumes that it WILL go into effect under the healthcare law. Congress has once again deferred this cost reduction for another 6 months. Total effect over 10 years = $300B.
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edva
Capitalism vs Humanity
08:15 AM on 05/19/2011
Stuffing their pockets as fast as they can. Even the greediest of the greedy know it's wrong.
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Kevin Zeese
08:06 AM on 05/19/2011
Health Care for America Now sold out to Obama and supported the "reform" that entrenched the insurance industry further in their control of health care. The result will be more expensive insurance, less coverage and more health-related bankruptcies. The only solution is to rid health care of the unnecessary insurance middleman rather than support laws, as HCAN did, that will force people to buy their defective products and give hundreds of millions in annual tax payer subsidies to them. Next time fight for what is right, not a compromise that makes things worse as the Obama law will do.
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ETexOpinion
01:46 AM on 05/19/2011
I absolutely hate the health insurance industry. It WILL bankrupt itself and we will be starting at ground zero. I am looking forward to it. I would rather pay my doctor directly for services rendered than an insurance company that has the power to decline payment on anything they may deem "experimental" or "unnecessary" even though my doctor and I know it's what's best for my health.
T-Haight
What was wrong with federalism?
10:19 AM on 05/19/2011
Paying your doctor directly for service sounds great - until you get cancer or need a $100k CAT scan. Unless you're loaded, you're hosed.
01:30 PM on 05/19/2011
A CAT scanner machine costs $1.6 million, so based on your number ... 16 scans pays for it...after that ... all profit.
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moAb
"when bad men combine, the good must associate”
06:38 PM on 05/19/2011
No such thing as a $100k CAT scan.
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spriddler
11:21 AM on 05/19/2011
You must be incredibly wealthy. You do realize that your doctor charges over $100 just to see you for a few minutes before anything is done. And that lipitor you pay $20 a month for actually costs $380. And for those "experimental and unnecessary" treatments you better have hundreds of thousands of dollars saved up.
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ETexOpinion
11:45 PM on 05/19/2011
Doctors charge so much because of a middle man they've got to pay (insurance). General practitioners who offer fee based practices and will not take patients with insurance are already in 22 states and growing. I just found out there is one 90 miles from me. I won't be driving there (because I have insurance), but it won't be long before the idea catches on here.
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Kai-HK
Don't Share My Wealth! Share My Work Ethic!
12:30 AM on 05/19/2011
Mr. Rome:

Isn’t a bit disingenuous to point out an industries ROE, without putting it in perspective of what other industries make. Assuming 16.1%, that really is not anything to write back about, especially when one takes into account the additional risk that they assume on that equity, that say other industries do not, and the fact that they are subjected to more regulation and, in some cases more taxes, on the gains from equity. In short, your analysis is incomplete and not really that rigorous. Fourth in health care industry really does not say much considering the risk they incur. But lest look at a few full-year rankings from Value Line:

http://pages.stern.nyu.edu/~adamodar/New_Home_Page/datafile/roe.html

Insurance (Prop/Casualty), 11.48%
Insurance Life, 9.09%
Medical supplies, 18.54%
Medical Services, 13.47%

Other

Aerospace, 23.91%.
Education Services, 22.74%
Publishing, 55.74%
Restaurants, 27.13%

Mr. Rome looking at the ROE on insurance compared to, say, starting a school or selling medical supplies or even opening a restaurant seems almost not worth it. If what you really seek is parity compared to risk-reward, they should be allowed to at least double the ROE to be on par with the less risky education services industry…Agreed?

In short, it looks like they are not making enough.

Kai
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mudman
01:10 AM on 05/19/2011
That may be true, but you forget that health insurance companies (which I differentiate from real insurance companies that are in the business to spread risk among a pool of people) don't actually make anything or provide a useful service. They create a maze of rules designed to ration care and in the process skim a lot money off the top. They also make life miserable for physicians and interfere with the patient/doctor relationship. What is it that a health insurance company does that makes them deserving of making a profit by denying medical care to people?
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Kai-HK
Don't Share My Wealth! Share My Work Ethic!
01:46 AM on 05/19/2011
So you claim. My insurance provider has never not paid in accordance with the policy, ever... patient/doctor relationship? I don't need a romance. I get sick, I go to the doctor, I file paperwork, and my doctor gets paid or I get reimbursed. What more could I ask for in that relationship? Flowers and a movie?

So maybe the problem isn't with the insurance industry but with your specific provider.

Regardless, they are not responsible for the cost increases of medical care and being wrongly targeted as is their profit model, which was the point of the erroneous article by Mr Rome above.

Kai