By , Brave New Films
Posted on August 21, 2009, Printed on August 24, 2009
http://www.alternet.org/bloggers/http://bravenewfilms.org/142137/
by David Dayen
(This is part of my blogger fellowship for Brave New Films and its Sick For Profitcampaign)
Bernie Sanders discussed health care today as part of his "Senator Sanders Unfiltered" series.
http://www.youtube.com/watch?v=NB3_K20qk-s
He brings up a very good point about what could happen in the absence of a strong public option or single payer system. You would generally have the federal government subsidizing private insurance companies without any cost containment. Individuals forced to buy insurance would only have the options among private companies, and they could raise their premium rates as much as they want every year, without being forced to compete with a more efficient alternative like a public option.
This is exactly what we're seeing in the market right now. And you don't have to believe me. Just believe none other than Glenn Beck.
Before leaving for his "vacation" this week, Beck taped a show about small businesses and the struggles they're having staying ahead. The show, aired August 17, got around to Beck asking some small businessmen about their health care costs. This extraordinary passage followed.
BECK: I just had a meeting with my staff, because I'm a small business owner, my company's called Mercury, and we're an entertainment company, we do all kinds of stuff. And I cover 100% health care. And we have the best that we could get for New York. This year, I think our health care went up 40% and then the next year it was up like 47%. And they keep taking away options. This year when we renewed, the health care provider came into my office and he said, "Are you really going to pick that?" And I said, "Well, yes, as long as I can." And he said, "You are the last person in the state of New York that is covering your employees like this." And I said, "Well, I just had a meeting with my employees and I said, 'I don't know how long I can do that, but we'll do it as long as we possibly can.'" But they're making it impossible. Does anybody else find it impossible? They make it impossible for you to do the right thing for your employees!
Beck doesn't want to fill in the "they" there, and I'm sure he figures his viewers will just substitute "government". But of course, the unnamed "they" is, clearly, the private insurance market and the health care industry in general. There has been no limit on their growth, no effort to control costs, and in fact the incentives go in the opposite direction. And it's crushing small businesses. Even GLENN BECK understands that. Without any need for competition, with regional monopolies across the country, with no meaningful checks on their power at the federal level, insurance companies can charge more and more for premiums and deny enough care to enough people to make exorbitant profits that allow them to pay CEOs hundreds of millions of dollars in compensation, stock options and perks.
And it's worse for the individual, who has no leverage, and often, no insurance. The health care market sees these people coming a mile away, and their eyes light up.
For example, one doctor billed $4,500 for an office visit when Medicare would have paid just $134. Another doctor billed $14,400 for removal of a gallbladder when Medicare would have paid $656. And a hip replacement cost $40,000 when Medicare would have paid $1,558.
....[Jeffrey] Rice said people should know they have a choice even when their insurance company is paying the bill. "Everyone knows you don't buy a car without knowing what the Blue Book value is. Well the same should be true in health care," he said.
....Previous research published in 2007 in the journal Health Affairs showed the "uninsured and other 'self-pay' patients for hospital services were often charged 2.5 times what most health insurers actually paid and more than three times the hospital's Medicare-allowable costs." The study by Gerard Anderson also found the "gaps between rates charged to self-pay patients and those charged to other payers are much wider than they were in the mid-1980s."
The lack of leverage in health care feeds the skyrocketing costs. Nobody should have to go broke because they get sick. Individuals empowered through collective action and purchasing power should be able to drive down those costs, without bankrupting health care providers. But the insurance companies would rather funnel that savings, the difference between what providers charge for the uninsured and the insured, into their own bank accounts. Without an incentive to make the product cheaper, the system will limp along and lots of people will get rich at the expense of tens of millions, who either have no insurance, or who find themselves denied coverage when they need it.
For all the talk of the insurance industry being a "constructive partner" in health care, theyhave not banned their own shameful practices of denying coverage and care, because even though they claim to support those changes, they will wait until the last possible moment to shut down their racket.
And things are going great for them at the moment. According to the Kaiser Family Foundation, the average premium for a family plan in 1999 was $5,791. By 2008, the average premium was $12,680. So over a decade in which inflation increased prices by 29 percent, the price of family health insurance went up 119 percent. UnitedHealth, probably the most despicable of America's health insurers (look at any health-insurance industry scandal, and UnitedHealth is likely leading the way) just announced that in the second quarter of 2009, they made a profit of $859 million, every dollar squeezed from patient premiums and through the avoidance of what the industry calls "medical losses," meaning when they reluctantly pay for care [...]
So if the insurance industry really wants to demonstrate its good faith on health-care reform, here's what it could do: End these practices now. Don't wait to see what's in the final bill. Do it now. Stop denying coverage for pre-existing conditions. Stop rescinding the policies of people who get sick. Let people keep their coverage when they leave a job if they keep paying the premiums. Stop discriminating against pregnant women. You want to atone for your sins? Changing these policies would be a good place to start.
But they won't do that, most surely. They'd rather continue to profit off the pain and suffering of their customers. And until the politicians step in and change things, it will continue.
David Dayen is a blogger fellow with Brave New Films. He writes at D-Day (d-day.blogspot.com) and Digby's Hullabaloo (digbysblog.blogspot.com). His work has appeared in the Washington Post, Los Angeles Times, Huffington Post and Capitol Weekly. He has appeared on NPR, Pacifica and Air America Radio.
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