News In Healthcare

We cur­rently have 47 mil­lion peo­ple with­out health insur­ance.  We have an Admin­is­tra­tion work­ing really hard to come up with a plan to get health insur­ance cov­er­age for those 47 mil­lion peo­ple.  And we have an entire indus­try of health insur­ers “lick­ing their chops over the poten­tial here” — at least that is one indus­try analyst’s opin­ion.  As reported in the LA Times today, the health insur­ance indus­try is work­ing very hard to make sure that what­ever shape the health­care reform takes, that they can reap the ben­e­fits through an almost overnight surge in new mem­bers to cover.

As a small busi­ness owner, I am watch­ing what is going on with the health­care reform with great inter­est as well as great trep­i­da­tion.  As reported by Politico over the week­end, the Sen­ate Health, Edu­ca­tion, Labor and Pen­sions Com­mit­tee, chaired by Sen­a­tor Edward Kennedy, put out draft leg­is­la­tion which would man­date that busi­nesses pro­vide insur­ance to its employ­ees or pay a fee to the government.

Since when did it become cor­po­rate America’s respon­si­bil­ity to cover the health costs of the Amer­i­can pop­u­la­tion?  Now don’t get me wrong.  My com­pany does offer health insur­ance to our employ­ees and as long as we are in a solid finan­cial posi­tion, we will con­tinue to do so.  How­ever, that is my choice to pro­vide that ben­e­fit to my employ­ees.  I don’t know that I am com­fort­able with it being a man­dated cost to doing business.

With the excep­tion of cer­tain occu­pa­tions, employ­ers are not man­dated to pro­vide employ­ees with a place to live or to pro­vide food for their employ­ees.  Employ­ers aren’t required to pro­vide cloth­ing or to pro­vide edu­ca­tion for those peo­ple who choose to work for them.  Peo­ple earn a liv­ing and pro­vide for these neces­si­ties on their own.  What makes health insur­ance dif­fer­ent?  Peo­ple have to have a place to live, food to eat, clothes to wear, and a basic edu­ca­tion.  If we are going to have to have health insur­ance, which I think we should, why will this neces­sity be paid for by busi­ness own­ers as opposed to the indi­vid­u­als?  Why do we need group poli­cies and indi­vid­ual poli­cies?  Why do we need fully-funded group plans and self-funded group plans?  Why can’t we have one set of rules for all policies?

Well­point exec­u­tives are tout­ing the old say­ing, “If it ain’t broke, don’t fix it.”  With the health­care sys­tem in what is called a “cri­sis,” what exactly isn’t bro­ken?  Accord­ing to the Indi­an­napo­lis Star, its Wellpoint’s abil­ity to make a profit.  Well­point wants com­mer­cial insur­ers to extend its cov­er­age into the indi­vid­ual mar­ket­place instead of bring­ing in a pub­lic plan, sim­i­lar to Medicare, to com­pete with it.   To get its mes­sage out, Well­Point spent $1.22 mil­lion lob­by­ing the fed­eral gov­ern­ment in the first quar­ter of 2009, accord­ing to dis­clo­sure forms. That’s a 16 per­cent increase from its lob­by­ing spend­ing in the same period a year ago.

Unit­ed­Health Group, the nation’s largest insurer, released its report on the U.S. can save money on health care.  Please remem­ber that this is the same group whose Pres­i­dent and CEO, Stephen J. Hem­s­ley, was recently called to be ques­tioned by the U.S. Sen­ate Com­mit­tee on Com­merce, Sci­ence & Trans­porta­tion in hear­ings enti­tled “Decep­tive Insur­ance Indus­try Prac­tices — Are Con­sumers Get­ting What They Paid For?”

We all know that there is a grow­ing cost to med­ical providers ren­der­ing ser­vices to the unin­sured pop­u­la­tion — approx­i­mately $42.7 bil­lion went unpaid last year.  We also know that some­one has to be con­tribut­ing to pay­ing for that care.  But did you know that that cost is being cov­ered through a hid­den tax on the pre­mi­ums of peo­ple with insur­ance?  Accord­ing to today’s USA Today, the aver­age U.S. fam­ily and their employ­ers paid an extra $1,017 in health care pre­mi­ums last year to com­pen­sate for the uninsured.

What is miss­ing from the stud­ies done and the state­ments made at the con­gres­sional hear­ings is that on top of pay­ing a “hid­den tax” on our pre­mi­ums, most insureds are actu­ally “under­in­sured” and end up foot­ing most of their health­care expenses because of high deductibles or insur­ance denials.  To be pay­ing a tax on top of that for health­care ser­vices not ren­dered to those indi­vid­u­als is just one more rea­son why the cur­rent health insur­ance indus­try needs imme­di­ate reform.

As reported in the New York Times yes­ter­day, antitrust lawyers are say­ing that hos­pi­tals, physi­cians and insur­ance com­pa­nies will be run­ning huge legal risks if they agree to work together to con­trol costs — as asked to do so by Pres­i­dent Obama.  How can this be?  Accord­ing to a rep­re­sen­ta­tive of the Fed­eral Trade Com­mis­sion, while coop­er­a­tion among health care providers can ben­e­fit con­sumers, it can also increase the bar­gain­ing power of hos­pi­tals and doc­tors, mak­ing it eas­ier for them to set prices and elim­i­nate com­pe­ti­tion.  Just another hur­dle in our quest for health­care reform.