Health insurance companies are con artists

By James Binder, M.D.
The Charleston (W.Va.) Gazette, Dec. 20, 2014

Private insurance companies have conned us once again. It wasn’t long ago that many folks were pleased with a new insurance regulation that required private insurers to cover pre-existing medical conditions. People said it was the moral thing to do. It was also self-protective, since almost all of us will develop a chronic medical condition at some point in our lives.

It is no surprise to many of us that private insurers have found a way to avoid paying for sick people with pre-existing conditions. The private insurers are very clever! They have created a way to sidestep the intent of the pre-existing regulation. How did they con us this time?

First, it is important to realize that Obamacare not only allowed private insurers to remain as middleman in the delivery of health care, it actually increased their income and power. From their position of power, they have begun to collect huge copayments for certain specialty drugs. Don McCanne, MD, a top healthcare analyst, explains:

“Specialty drugs are a problem for private insurers for two reasons. They are very expensive and they are taken by individuals with serious disorders, such as cancer, rheumatoid arthritis, and multiple sclerosis. By assigning high coinsurance payments for specialty drugs, patients who were on them would go elsewhere for their insurance coverage when they found out the coinsurance was unaffordable.”

This deceptive strategy allows them to get rid of the sicker, more expensive patients and hold onto healthier patients. In other words, we have a heath care system shunning the sickest and most needy patients.

It is well past the time to rid the health care system of these middlemen, who deny necessary care to the sickest patients and increase the cost of health care at the same time. This a double hit. We would save over $300 billion annually in administrative costs if we eliminated this unnecessary bureaucracy.

It would not be wise or moral to simply repeal Obamacare, as some politicians are proposing. Many people do benefit from Obamacare.

A logical and compassionate response would be to replace with it a better system — single-payer national health insurance. Everyone would be covered for all necessary care with the amount of money already in the system. National health insurance is much more efficient than marketplace care. Patients learning to live with chronic medical conditions would not have the additional emotional burden of dealing with a health system trying to deny them care. What a good idea!

James Binder, M.D., is co-leader of the West Virginia Chapter of Physicians for a National Health Program.