Alex Blaze

Health care industry is scared of reforms

Filed By Alex Blaze | March 25, 2009 5:00 PM | comments

Filed in: Living
Tags: Barack Obama, health care reform, industry, insurance, mandate

From today's Wall Street Journal:

The health-insurance industry said it would be willing to stop charging sick people more for coverage if all Americans were required to buy insurance.

Tuesday's proposal, included in a letter to Senate leaders by the industry's two main trade groups, is the latest move by health insurers to position themselves as constructive participants, rather than obstacles, in the debate over how to overhaul the U.S. health-care system.

Insurers hope to prove the private sector can fix problems on its own. Most urgently, the industry wants to head off momentum for a government-run program that would compete with private carriers.

What a generous offer! They agree to stop bleeding sick people of all their money, and, in exchange, everyone in America is forced to buy their overpriced product.

Oh health care industry, how do you manage to turn a profit with such a selfless and deep commitment to improving people's lives?

The proposed compromise actually tips their hands a bit. They know that America just elected a guy who ran on a health care plan that included the creation of a public option. And they elected him with a mandate. With all the frustration and animus Americans feel towards that industry, it's no wonder why they're trying to give the people something so that the worst thing doesn't happen.

When it comes to health care reform, a few ideas keep on getting tossed around by people who actually want to improve the system (as opposed to people like John McCain who just wanted to help the industry make even more money):

  • Forcing the industry to deem everyone eligible
  • Preventing the industry from charging some people more for health care
  • Price caps
  • Creating a public option that's open to everyone
  • Implement either an individual or government mandate that requires everyone to be insured
  • Tax credits to help people afford health care
  • Various measures to reduce the price of health care, like studies to judge the cost-effectiveness of various procedures

While a few things on that list are stuff the industry wants (like tax credits that effectively subsidize that industry if there are no price controls and an individual mandate that massively increases demand for their product), there are other reforms that they are very much against. Like really against. Like "We'll make our last stand on this hill" against.

Those two things are price caps and a public option. The former they oppose for obvious reasons, and the latter they oppose because they know that they couldn't compete in terms of price and quality with a government-run program. Think about how much money Fedex, UPS, and DHL would make if the US Postal Service shut down, or how much more demand there'd be for private schools if all public schools closed their doors.

But their proposal is just awful. A mandate without price controls? No thanks, we have better plans for health care.


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this really isn't all that surprising, is it?

I mean, with the ideas in the heads of health care corps, did anyone genuinely expect different?

I actually kinda am. They appear to be much more worried about their image than I would have expected. Considering how blase the finance sector has been about accepting bloated salaries and being saddened that not everyone worships them, this is a surprising level of humility.

I know, I know, my bar is incredibly low.

Rick Elliott | March 26, 2009 1:52 AM

Being on disability since 1999 and having a partner being ill for a dozen years before that, I believe I now quite a bit about the health care industry.
--drug manufacturers and health insurance folks are "in bed" with each other. It's not incidental that drugs--whether safe or not--move swiftly to the over-the-counter status. The price doesn't go down--so the drug manufacturers aren't hurt. But the health insurance folks save a ton of money because they pay only for drugs on prescription
--the DEA doesn't read labels when inflicting its draconian obstacles on us everyday folks in an attempt to "stop drug trafficking. Witness Mucinex D. It was taken off the prescription roles. Then the DEA got itself in a dither because of Sudafed's relationship to methamphetamine production. Sales of Mucinex D are limited to one 24-tablet box per month. It's been clearly on the label and the prescription practice that one is taken every 12 hours. DEA limits folks to a 12-day supply a month. Does that make sense? Why not put it on the prescription list again. OH! I forgot insurance drug plans would have to pay for it then. It's everyday sinus sufferers who suffer over an attempt to stop the flow of ingredients for Meth. I haven't read about a shortage of methamphetamine in the illegal drug scene. Duh! I can work out the stupidity of that window dressing regulation.
--I recently underwent a test billed originally at around $3800. It was "discounted to under $1000 for Medicare. Does the poor person who doesn't have insurance pay $3800--those who can afford it the least. When you next have bloodwork done there are discounts of over 80%. Where does the original figure come from?
--I battle depression, seeing both a psychiatrist for med check and a therapist. Some arcane rule states that I can't see the two on the same day. I broke an arm and needed physical therapy. I can't see the orthopedist and have physical therapy on the same day. What mmoney does that save? I know an elderly couple who live on a ranch that's 60 miles from specialty medical care. They have to drive bck and forth for the bone doctor, then drive back and forth the next day for physical therapy. Even now when gas is less than the $4/gal. it doesn't make sense.
--If you want good hospital care, don't rate them because of all the fancy equipment they have. Check the nursing staff to see what turnover they have. Take it from me--you get better care from good nursing than all the gimcrackies a hospital has. I've learned the hard way--don't expect good care at teaching hospitals: keeping good nurses isn't a priority and you never get to see the "top gun" doctors, only their interns or residents. I take a lot of medication--I was appalled by residents vetoing specialists medications that they knew little about.
--Take it as fact: with hospitals protocols and procedures are more important than individual patients' needs.
--I got sick on a cruise and was disembarked in Madeira. My 2.5 day hospital stay in Dec. 2008 with doctors, and all special tests cost $1600. A simple ER visit with only a doctor visit and routine bloodwork--maybe 30 minutes of care--was billed at $3200. A 1.5 day hospital stay with surgery for a broken arm--no ICU--was billed at $28,000+. Something's broken here!
--I've only scratched the surface of what I know that healcare folk don't want you to know.

Not always scared. One recent "reform" :

A broad coalition of organizations, including the American Civil Liberties Union, The National Association of Social Workers, Transgender Michigan and others, are condemning a move by Blue Cross Blue Shield of Michigan to eliminate coverage for gender reassignment surgery. The new entity calls itself The Michigan Coalition for Gender Equality.

“We are concerned that BCBSM underestimates the profound impact of these medically necessary procedures,” said André Wilson of MCGE.
“Gender reassignment surgeries can be a critical part of the transition process and these new exclusions will place many transgender individuals and their families at real risk.”

The change was approved in Feb. says Jason Moon, a spokesman for the Office of Financial and Insurance Regulation. He called the change
“unfortunate,” but noted the law did not define gender reassignment surgery as a necessary medical care area. Moon said such areas were
things like breast cancer and diabetes.

Gender reassignment surgery is often used to treat gender dysphoria, the medical diagnosis given to transgender persons. The surgery is
considered medically necessary by advocates and the American Medical Association
.