Health Insurers Aren't the Victims, But the Victimizers

The head of the health insurance lobby, Karen Ignagni, is crying fowl about being demonized by Democrats trying to complete health insurance reform in Washington.  After all, haven't the insurers been playing nice on Capitol Hill, agreeing to sell everyone a health insurance policy so long as the government forces everyone to buy it at the price insurers want?

Let's not forget health insurers have demonized themselves through tactics that would get mobsters drummed out of the mafia. Health insurers have enrolled patients and taken their premiums, then looked for innocent mistakes on their enrollment applications to cancel them and leave them high and dry after they rack up big medical bills. John Gotti would never have stood for such duplicity in his protection racket, where one's word is his bond.

Insurers deny and delay coverage for patients in critical need of treatment because they know most patients have little legal recourse to compel care. They have bludgeoned patients with the fine print in their enrollment applications to deny life saving treatment like transplants. They have changed the terms of their agreements to deny care for kids with autism.  They have confused and befuddled us all with their baffling legalese.  And they have refused to sell policies to individuals with ailments as minor as toe nail fungus, hoping to cash in on covering only the healthy.

Health insurers are not the victims, but the victimizers. The White House and Congress should not lose sight of that this August recess, but talk more about the industry abuses that have driven reform.  Health insurers are playing possum in Washington DC because they want to hijack reform and prevent competition from a government plan like Medicare that will help patients more.  Their "good will" is little more than fear that they won't be able to keep making a killing if they don't have a seat at the table in the west wing.

Comments

[redrockraven]

Here's the emerging American version of the fascist's formula: combine millions of dollars of lobbyists' money with embittered Republican troublemakers who have a small army of not terribly bright white angry people (collected over decades through pro-life mass mailing networks) at their beck and call, ever ready to believe any myth or lie circulated by the semi literate and completely and routinely misinformed right wing -- Evangelical religious underground. Then put his little mob together with the insurance companies' big bucks. That's how it works -- American Brown Shirts at the ready.

Think how this "method" worked against Dr. Tiller's abortion clinic and how that story ended. In this case a once-in-a-lifetime opportunity to save our economy from going bankrupt because of spiraling health care costs may be lost, not because of a better argument, but because of lies backed up by anti-democratic embittered thuggery. The motive? Revenge on America by the Old White Guys of the far right, and greed by the insurance industry.

It's time that this whole shabby (and insane) business be exposed, vilified and run out of town on a rail by whatever responsible Republicans -- if any -- that are still in the party and who want to see the fortunes of their party revived. Republican leaders taking insurance industry money via lobbying firms and using it to organize what amounts to roving bands of thugs not only need to be exposed but thrown out of the public debate forever.

[hsr0601]

1. 'Takeover and Rationing Cliche' lost ground, as this spoiled menu did the opposite for too long.

Like freedom of press, Public Well-being as a right, a nation took root in every free nation as a natural part of life.
The debate about it is most likely to puzzle people all around the free states. And with so many people uninsured
or underinsured, the humanitarian foreign aid ahead will confuse them, too.

2. Arbitrary Market Theory, Not Fair Market Theory, should not apply to a fundamental human right.

This last spring, due to the demand decrease, the peak fuel price came down below $40 per barrel, though, the
'Similar' insurance premiums keep on rising, accordingly the inaction could bankrupt family, business, and
government 'BEYOND this recession' , as all across the spectrum agree.

Basically, as demand diminish, the price tends to reflect it, nonetheless, the insurers that formed a cartel through
consolidation have replenished the loss by exercising inhumane malpractices involving denying, capping, rapid
premium increase and the like. And this runaway premium ended up in the collapse of middle
class ranging from finance to mental health, alongside the peak fuel price and fast-growing mortgage rate, as all of
us know.

3. The Deficit-sensitive groups have a distinctive common ground, they all have a deficit-driven background out of
question.

[DougDeWitt]

We either pay for government­-sponsored health care services up front, with Medicare and Medicaid cost-reimbursement payment methodologies to providers, or we pay for it on the back side, in the form of higher insurance premiums.

Cost Reimbursement payment methodology means simply that each carrier must pay the actual cost of providing services on a per patient basis.

High premiums are the result of cost-shifting, or what Arthur Laffer calls the "wedge" created when payers pay less than the cost of services.

Payer denials of claims on a routine basis are the result of an inadequate insurance regulation system ~ corporate insurance company profits must be capped at a set percentage of the total claims paid by the company in a given fiscal period.

When it generates corporate profits, insurance companies will suddenly have a million reasons why pre-existing conditions SHOULD be covered. Baby economics: let greed drive the machine, make that greed serve the public good by tying profits to desired behaviors.

[hsr0601]

All of the excellent health systems seem to have one thing in common, a well-organized preventative program.

I think prevention system works as a 'levee' built against flood by the government, similarly, it also needs non-profit aid from the government on a large scale.

This might offer us the clue of why all of the free states have public insurance policy in place.

It won't be easy to draw some specific numbers on the economic effect of the 'levee' , but the flood measure without a stable 'levee' would be a house on the sand, as all of us agree.

Thank You !

[hsr0601]

All of the excellent health systems seem to have one thing in common, a well-organized preventative program.

I think prevention system works as a 'levee' built against flood by the government, similarly, it also needs non-profit aid from the government on a large scale.

This might offer us the clue of why all of the free states have public insurance policy in place.

It won't be easy to draw some specific numbers on the economic effect of the 'levee' , but the flood measure without a stable 'levee' would be a house on the sand, as all of us agree.

[DougDeWitt]

Admittedly there is abuse within the health insurance industry. I contend that this is the result of how insurance company profits are maximized. They are permitted to base rates on retail pricing in the market, profits being equal to total premiums less what they had to pay out in claims. The incentive, obviously is to maximize premiums and minimize the payment of claims.

By changing the structure of insurance profits through legislation empowering the state insurance departments and commissions to limit profits to 10% of the total claims paid out by the company in a give fiscal period, the incentive could be reversed. Suddenly, pre-existing conditions would all be covered, and at provider usual customary and reasonable rates billed, because those policies would then maximize profits.

Tough to blame the insurance industry, a corporate entity for greed. Instead, put their greed to work for us, and we'll all have coverage that makes us smile.

[Chaimirija]

they also make money by investing.

[hsr0601]

-Some say we don't have faith in government, others say, we will be forced out.-
-No Tax, No Saving, That means No Way To Reform.-
What kind of music should this reform dance to ?

U.S. health care consumers are usually one step removed from the cost because they are covered by employer-provided insurance, which might operate as a formula for a slow pace of transfer, along with the code of mandate.

And I share the opinion that unlike the insurer-friendly, baseless senate plan by 'some' members, only a 'strong' public option by this new administration will be capable of getting the premium inflation under control and saving the U.S in turbulence.

To my knowledge, a dual system tends to deliver better results than a pure single payer system. Supposedly, to be or not to be might be up to the innovations like a pay for value program, otherwise, the forthcoming start-ups may fill the void with competitive deals. The competition based on 'fair' market value would be a beauty of true capitalism, not monopoly, an objective for anti-trust.

All free states as a nation / one body, and a fundamental human right, cover all their people. The debate about a human right, or public policy
in America is puzzling them now.

[DougDeWitt]

The public option will control premium inflation only if it provides cost-based reimbursement. Any further shifting of costs to the uninsured and commercial insurance policies will exacerbate the problem further.

There is no denial that everyone should have coverage. The only real question ultimately, is how we're going to pay for it.

[unitron]

"The head of the health insurance lobby, Karen Ignani, is crying fowl..."

Shouldn't she be crying "foul" instead?

Unless she's talking "turkey".

Or is she too "chicken" for that?

Unless crying "fowl" means yelling "Duck!"

Maybe she got "goosed".

[alisonv]

It is about 1:00 a.m. where I am and maybe that has something to do with the fact that I cannot stop laughing at your post! Thanks. Now I'd better get to bed!

[usna73]

Excellent post. Yes, the analogy with the mob is totally appropriate. Health insurance companies moved in on a vulnerable populus with the tactics of fear and extortion to profit from their misery.

It is a racket, with government protection, replete with the same bribery and cronyism.

The only way top deal with them is to break them up and bludgeon them to extinction.

[sail]

Absolutely! In fact, it's nearly impossible to believe that anyone could claim otherwise (with a straight face). They should not only be outlawed, but should be forced to pay public compensation (through the nose!) and then the ring leaders should be hauled off to prison along with the banksters and Cheneyites.