Posted on November 6, 2009

The reform that's missing


By Rhonda Swan
Palm Beach Post
Thursday, November 05, 2009

Perhaps “death panels” weren’t such a bad idea.

For private health insurance companies.

If ever there was a useless entity, it’s a business that earns profits for doing nothing.

Wait. I take that back. They do something. They decide who lives and who dies. Paper-pushers with no medical training choose what is and isn’t medically necessary for millions of people on whom they’ve never laid eyes. And for that, their employers rake it in.

United Health Group reported net income of nearly $3 billion in 2008; Aetna Inc. reported $1.3 billion, Humana Inc. came in at $647 million. Their CEOs had total compensation of $3.2 million, $24.3 million and $4.7 million, respectively. Their profits were down sharply compared with 2007 because of the recession. Still, it’s not a bad haul for being nothing more than middlemen.

“What product does this industry sell?” Dr. Howard A. Green, director of the dermatology division at St. Mary’s Medical Center in West Palm Beach, asked in an interview. “They don’t do health care, they don’t do access to health care because we have so many uninsured and underinsured. They remove too much money from health care, and therefore make it inefficient and ineffective.”

In an article for On Call: The Journal of Palm Beach County Medical Society, Dr. Green maintains that shutting down private health insurance corporations is the first step to creating comprehensive quality health care. “Without the inefficiencies and burden to productivity of private insurance corporations,” he wrote, “we can deliver efficient and effective comprehensive health care with great savings and no sacrifice of jobs.”

The U.S. House is expected today to take up the 2,032-page health reform bill proposed by Democrats. A national insurance plan is a key element, though this version is far from the single-payer Medicare for All program that Dr. Green and Physicians for a National Health Program endorse.

Such a plan, which eliminates private profits, would be real reform. Yet it hasn’t even come up for discussion, not this year or in 1994 under President Clinton, the last administration to attempt reform. No one in the White House or Congress has had the guts to take on private insurers, even though they clearly are the problem.

The major reform proposals focus more on private insurers than actual health care delivery. Forcing insurers to cover sick people. Getting insurers to compete and lower costs. Doling out subsidies to insurers so we can afford their high prices.

Why not just get rid of them? All they do is take our money and then show us the hand when we expect something in return like … medical treatment.

Opponents of the so-called public option say they fear a “government takeover” of health care that would put private insurers out of business. So what!

The fact that we are the very government that would “take over” our health care system under which doctors and hospitals would remain private gets lost.

As does the fact that we are a capitalist society where businesses that can’t compete go out of business every day. And for-profit insurers just can’t compete.

A Harvard Medical School and Public Citizen study found that health insurance bureaucracy - billing, sales and marketing, profits and executive pay, which have nothing to do with health care - costs $399.4 billion a year. Money that could insure every American.

Insurers also spend millions legally bribing Congress and the White House to protect their profits. But who is protecting us from them? Harvard researchers found that medical problems caused 62 percent of all personal bankruptcies in 2007. Of those, 60 percent had private medical insurance. “It’s unethical,” said Dr. Green. “It’s a crime to bankrupt someone because they’re sick.”

It should be. Private insurance companies are too big, too inefficient and too heartless not to fail.

Rhonda Swan is an editorial writer for The Palm Beach Post. Her e-mail address is