Here’s a fundamental fact, maybe the fundamental fact, that has been obscured in the debate over health insurance reform: We wouldn’t need a government option if the private sector had a plan for covering everyone, and the only reason the plans don’t cover everyone is greed.
Think about it. The health companies have had since they killed the Clinton plan in 1993 to get their collective act together. Instead, premiums are up, fewer people are covered and the public’s collective health and well-being is in decline.
Conservatives assert that only the private sector can solve the insurance crisis — an assertion that ignores the fact that the military, veterans, federal workers and members of Congress, including even Republican congressmen — are covered by government-run plans that perform comparatively well.
Still, let’s assume for a moment that what conservatives say is true — that only the private sector can fix the problem — then here is a question:
What is stopping it?
By its inaction as the crisis has worsened, the industry has demonstrated that it is unwilling to reform itself. The reason for this is simple: From a financial perspective, the industry is not have a crisis. In fact, things are going quite well.
As evidence of this, here’s a table showing revenue and profits of the top 10 private health insurers, from the 2008 Fortune 500:
| Company | Revenue | Profit |
| UnitedHealth Group | $75.4 billion | $4.6 billion |
| WellPoint | $61 billion | $3.3 billion |
| Aetna | $27.6 billion | $1.8 billion |
| Humana | $25.2 billion | $883.7 million |
| Cigna | $17.6 billion | $1.115 billion |
| Health Net | $14.1 billion | $193 million |
| Coventry Health Care | $9.879 billion | $626.1 million |
| Amerigroup | $3.945.5 billion | $116.5 million |
| Universal American | $3.034 billion | $84 million |
| Centene | $2.926 billion | $73.4 million |
| Total: | $240 billion | $14 billion |
The bottom line for the industry is that it is cheaper to kill reform than it is to solve the crisis. In its current campaign, the industry is spending $1.4 million per day on lobbyists and advertising and buying the votes of Republican pols and Blue Dog Dems. That’s $42 million a month and $504 million if the campaign takes 12 months — a pittance when compared with its $14 billion in profits last year. In fact, it’s a steal.
The rightwing will tell you that things are the way they are because of lawsuits, and that doctors aren’t free to perform medicine as they see fit because they fear being sued. Tort reform (i.e., not allowing legitimate malpractice claims) is all we need to control costs, they say, not health insurance reform.
The high price of malpractice premiums contributes to rising costs, but my take here is that the consumer plans’ over-the-top revenue is de-motivating them from addressing the crisis within. If they don’t want regulation, they should quit asking for it.
Well, we KNOW that the gov’t won’t stop malpractive lawsuits (like in Europe) since that would cost the lawyers, and what are most pols? LAWYERS. WHEN, oh WHEN(?!) will the day come when the U.S. looks at what has worked and IS working in older, more established societies, and emulate what works and toss what doesn’t?
Remember there are four powerful interest groups opposing true health care reform and lobbying congress to prevent it.
1. Health Insurance Industry – already discussed would loose their big paying jobs.
2. Lawyers – many would loose considerable income if tort reform occurred.
3. Drug Companies – wouldn’t be able to charge what ever the market will bear.
4. American Medical Association – high priced specialist who are overrepresented in this association would loose there $500,000+ annual income.
Billions of dollars have been and are being paid congress to maintain the status quo. These interest groups killed Clinton reform efforts in the early 90’s. They are at it again!
Part of the trouble getting the national debate on health-care reform on track is that there are many moving parts. What I’m addressing here is insurance reform. Issues like tort reform, drug pricing and the role of doctors in the system are not really in play in this piece of the debate.
This is about an industry that produces a lousy product that it delivers inefficiently while still making enormous profits. They make these profits because they have bought sufficient political influence so that they, in effect, own the casino. This has allowed them to game the system — for example, by refusing to insure people with preexisting conditions, a trick that exists in no other medical system on the planet — in order to eliminate risk for their shareholders.
The insurance industry has done this at the expense of the public health and well-being of the United States. It works to their advantage to turn this into a political debate, when it should be a policy debate.