Get rid of insurance companies?
Gee, thanks for getting rid of my job. Please tell me what industry you work for and I will propose getting rid of it, just to be fair.
People generally do not like insurance companies. I’m well aware of that. The insurance company I work for raised premiums, eliminated a lower-cost group health plan and laid off employees. We are likely to have a record profit this year.
The problems with the cost of health care are numerous, but only the insurance companies - and, at times, the pharmecutical companies - are blamed.
Americans are fatter than ever, leading to more utilization of services for problems like heart disease and diabetes. While cigarette smoking has decreased, the cost of treating smoking related illnesses, almost always serious, continues to increase. An aging population, especially where I live, along with stagnant economic growth, causes young people to leave. Community rating - the practice of taking all the members of a community and assessing risk - pushed up the cost for everyone.
Auto insurance is experience rated. If you are a good risk, you pay lower rates. If you are a high risk, you pay more. This is often not permitted for health insurers because the elderly would be hit with the highest rates.
Blues plans are the “insurers of last resort”. They provide coverage (at a cost) to people who cannot buy it from anyone else. This line of business loses money. As a result, other customers pay more to help defray this cost.
Hospitals in many regions have formed cartels, designed to push up reimbursement rates from insurers. This pays for exorbitant salaries and excessive advertising. Hospitals tend not to be well run administratively and in some cases, a management company is hired to manage the hospital system. This practice allows hospital management to hide their salaries from public review.
I know more about this than most people. I worked in a hospital for more than eight years, starting when I was in high school and putting myself through college in the same job. I have worked in health insurance for 15 of the past 16 years. Neither has been my definition of “fun”. I have prepared the financial statements that are filed with the state insurance department. I know what goes into it.
Health care inflation has been a problem for decades. People receive a card from their employer and think everything should be covered. It isn’t. For anyone.
Health care inflation would be kept in check if:
- Americans must take better care of their own health. Eat right. Stop smoking. Exercise. Do this and major problems can be delayed or avoided altogether.
- Caps must be put on punitive damage awards for malpractice and bad doctors are removed from practice. Several malpractice insurance companies have been forced to close and certain physicians have had to close their practices and relocate because of the cost of malpractice insurance - which is factored into the cost of physician care.
- Hospitals must be subjected to quality and financial audits.
- Excess use of emergency rooms. My mother was an emergency room nurse for nearly 30 years. Unionized car factory employees often brought their children into the emergency room for things such as a cold, then pulled out the insurance card expecting it to be paid for. This is not the purpose of emergency room care.
Virtually every state closely monitors the surplus level of insurers of all types to ensure adequate surplus level to pay claims and to guard against excess premiums. While some insurers gouge, the high cost of health care is reflected by, not determined by, health insurers.
Everyone shares the blame. Everyone has to accept responsibility for the cost.