Medscape
February 26, 2002
Book Reviews
By J.D. Kleinke
Quotes from the review by Peter Frishauf:
“Noted health economist J.D. Kleinke once saw managed care as the solution to America’s healthcare problems… In 1998, he declared victory for the managed care solution in a controversial book, Bleeding Edge: The Business of Health Care in the New Century. Kleinke was wrong, as he acknowledges in his interesting new book, Oxymorons: The Myth of the U.S. Health Care System.”
One reason cited in Frishauf’s review:
“Parasitic middlemen, pointless regulation, and waste suck billions of dollars from premiums that could be redeployed to pay for care. Kleinke identifies 2 intertwined constituencies as prime culprits: the 5000 state insurance bureaucrats who preside over a ‘mess of state-based benefit mandate laws,’ and 50,000 health insurance brokers ‘in bed with them.’ The brokers, I was astounded to learn, collect commissions ranging from 3% to as much as 20% of the total cost of plans — a ‘shadow tax’ of some $300 billion per year on premiums, more than twice what the nation spends on all prescription drugs! Insurance companies, it seems, have been unable to break the stranglehold of brokers, and those that attempt to offer plans without brokers face massive retaliation.”