The private health industry's time is up

[RedEarth]

Obama has been supportive of a public option, but how do you solve the healthcare problem when you fail to deal with its root?
By Bernie Sanders
Opinion
Christian Science Monitor
from the June 16, 2009 edition

Washington - President Obama has indicated he wants a healthcare bill on his desk sometime around October, before we worry about timetables, however, we as a nation have to answer two very fundamental questions.

First, should all Americans be entitled to healthcare in the same way we respond to other basic needs such as education, police, and fire protection? Second, if we are to provide quality healthcare to all, how do we accomplish that in the most cost-effective way?

The answer to the first question is pretty clear, and one of the reasons that Barack Obama was elected president. Most Americans believe that all of us should have healthcare coverage, and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way.

To me, the evidence is overwhelming that we must end the private insurance company domination of healthcare in our country and move toward a publicly funded, single-payer, Medicare-for-all approach.

Our current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. But in America, the people who have to navigate that maze are the lucky ones. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home base, more than 18,000 Americans die every year from preventable illnesses. That is six times the number who died in the 9/11 terrorist attacks.

Despite the fact that we spend almost twice as much per person on healthcare as any other country, our healthcare outcomes lag behind many other nations. According to the World Health Organization, the United States ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths.

The main reason we get such bad results is that the function of private health insurance companies is not to provide quality healthcare for all, but to make huge profits for those who own the companies. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible 30 percent of each healthcare dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. Public programs like Medicare, Medicaid, and the department of Veterans Affairs are administered for far less.

In recent years, while we have experienced an acute shortage of primary healthcare doctors as well as nurses and dentists, we are paying for a huge increase in healthcare bureaucrats and bill collectors. Over the past three decades, the number of administrative personnel has grown by 25 times the number of physicians.

While healthcare costs are soaring, it should surprise no one that profits of private health insurance companies are more than keeping pace.

From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages.

It’s not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion, or Cigna CEO Edward Hanway who made more than $120 million in the past five years. The reality is that CEO compensation for the top health insurance companies now averages $14.2 million.

The president has been supportive of a public option – a plan that people could opt into if they are uninsured or don’t like their private coverage. But the situation is extremely fluid. How do you get to the root of a problem when you fail to take on the private health industry?

The time is now for our nation to address the most profound moral and economic issue we face. The time is now for our country to join the rest of the industrialized world and provide cost-effective, comprehensive, quality healthcare to every man, woman, and child in our country. The time is now to take on the powerful special interests in the insurance and pharmaceutical industries and pass a single-payer national healthcare program.



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Bernie Sanders is an independent senator for Vermont and a member of the Senate Health, Education, Labor and Pensions Committee.

http://www.pnhp.org/news/2009/june/the_private_health_i.php

[county worker]

1. I'm not going to disagree with post but I have a question.

Say we passed a single payer system this fall. Would all medical insurance companies go out of business? Would their share holders take losses in the market? Would the employees lose their jobs?
Would those who like their current coverage lose that coverage and go into the public system?
Is any of that worth thinking about?

[angstlessk]

5. thank god buggy builders did not have the lobbying force of the insurance industry

or you would still be riding a pony to town. Sorry for all those buggy whip manufacturers, their employees, and their investors to, but I do like my new mode of transportation, thanks to henry ford!

[county worker]

8. It seems to me that we are going about health care reform the way Bush went about the Iraq war.

There was no plan for what comes after the war ends.

[angstlessk]

14. well, kodachrome is being eliminated ....what about THOSE jobs??

sorry...but I prefer to do away with the insurance industry complex AND their sorry ass jobs...what we got? salesmen lying about coverage, bureaucrats denying coverage, and CEO's raking in millions...YOU GONNA MISS THEM?

[robinlynne]

6. no. They can all work for the single payer plan, but they will need to charge a decent rate and trea...

all people. They won't get to charge whatever they feel like anymore. the price of healthcare will go down. That is the point. the providers will be the same as they are now. The huge profits will be gone, not the jobs.

[ljm2002]

7. Of course those issues are worth thinking about...

...as it is inevitable that a true overhaul will have some dislocating effects on the industry and the people in it.

I am tempted to say yes, we should be just as concerned about the health care bureaucrats as we were about the auto workers...

But truly, those are jobs and some of them are even our own family and friends who, like most of us, work to get by.

So I would say this: first of all, since health care still needs to be provided and records still need to be kept, many of these people will be able to find jobs in the same professional area. Second, for those whose primary job was to deny claims, and who gloried in their displays of literal life-or-death power over policy holders, well you know what? sometimes karma bites. Third, the best benefit of all from the dismantling of the monopoly of the private health sector will be to see those overpaid executives go begging for other jobs that will pay them as well -- fat chance. Fourth, there will still be a place for private health insurance, a la France, for premium coverage or for elective surgery (cosmetic surgery would fall into this area where the public plan would not pay unless it was a result of some disfigurement -- i.e., I'm thinking the public plan would not pay for breast augmentation for Vegas showgirls).

These things can be worked out. It will be painful for some. In my opinion, a true single payer plan would benefit businesses greatly. IMO we should take that burden off businesses and we would find that existing businesses become more competitive internationally, and that new businesses could start up more easily. Thus, it could act as a stimulus that would help expand the job market and thus, would help address the issue of those people who will be put out of work by such a plan -- that of course is in the long run, and there would still be some pain during the transition. But we seem willing to absorb pain for so many sectors of the working population, why not this one? And the great thing is, those people who are thrown out of work would still have access to health care -- which is a lot better than you can say right now for so many.

[Uncle Joe]

9. It's an immoral business; not only having nothing to do with health care but

actually impeding it, profiting as a result while simultaneously corrupting the government to not represent the American Peoples' best interests.

1. The medical insurance corporations can go the way of the snake oil salesmen of the Old West.

2. The shareholders have been given notice, quit investing in the destruction of the American Peoples' health and finances, if they continue to so, they have no one else to blame but them selves, when it all comes to an end.

3. Many of the employees should have an inside shot at going to work for the government in the same line of work. While some may not be able to land employment with the government, you must compare the numbers of people being damaged by the current dysfunctional system as versus a uniform, universal, single payer system across the nation. I believe there is no comparison, the numbers aren't even close, 18,000 Americans are dying every year simply because the current corrupt system excludes them either by decree or by cost.

4. I believe those people liking their coverage now, will love it afterwards.

[GeorgeGist]

10. Optimum healthcare requires the elimination

of all jobs necessary to profit from bad healthcare.

[county worker]

11. Sort of like the Russian revolution is a small way.

[eridani]

15. Most of the people who "like" their coverage don't know shit about it

That's because 85% of the population will never get expensively sick. The people who don't like their insurance are disproportionally composed of those who have actually had to use it.

As far as what we do with insurance workers, don't you think it's odd that people haven't displayed the same concern as they have for people who spend their days adding negative value to health care instead of actually producing something?

Still, there ae plenty of options for them.

1. If the financing of health care is a public good, then public oversight can insure that the claims processing jobs that remain will never be sent out of the country. This is true whether we hire existing insurance companies to do this work or build a separate institutional structure from scratch. This policy alone may save as many jobs as single payer eliminates.

2. Once the burden of being robbed by expensive middlemen is removed from all other private and public employers, they will be able to afford to hire many more employees. The CA Nurses Study estimates that single payer could provide 2.6 million new jobs this way.

3. There is a growing shortage of nurses, and we should be funding more training in this field.

4. Private insurance will not disappear. All countries with universal health care have regulated private insurers who provide plans to fund extras not provided by the basic system. Introducing Social Security survivors' benefits didn't make private life insurance go away, did it?

5. With health care not tied to a job, people will be free to start their own businesses, or to retire early and take on second careers or community work. This is particularly true of the 55-65 age demographic, and this trend will free up quite a few spaces on their former employers' career ladders.

[madaboutharry]

2. Bernie Sanders is a true hero of the people.

The health care system in the United States does not exist to heal the sick. It exists for the purpose of profit.

[DJ13]

3. how do you solve the healthcare problem when you fail to deal with its root?

Obama has been dealing with the financial crisis the same way, so Im expecting any health care "reform" we get (bent over with) this year will end up being a massive welfare program for those who have created the crisis in the first place.

[snappyturtle]

4. Yep. nt

[MISSDem]

13. I'm afraid you are 100% correct. I know people who don't have

health insurance and futhermore, auto insurance because they don't want to pay for it. They are living an "affluent" type life otherwise.

[The Wizard]

12. This is it in a nutshell

"The time is now for our nation to address the most profound moral and economic issue we face."
Our health care system is Byzantine and immoral. The insurance lobby bribery of our Congress has to end.
It is incumbent on the netroots to find out who is taking bribes to act as agents for the insurance lobby and remove them from office, either in a primary or (hoping lightning doesn't strike my keyboard) voting Republican.