By Dr. Howard Green
Palm Beach Post, Sunday, May 15, 2011
All of the well-publicized political health care programs have one thing in common: They all seek to steer larger portions of Medicare and Medicaid through private insurance corporations. They differ only in their degrees of rationing, with President Obama’s plan restricting rationing for profit and Rep. Paul Ryan’s mandate allowing the most rationing by the health insurance industry.
What Republicans and Democrats fail to disclose is that for more than 40 years the middle man of American health care – the private insurance industry – has failed in almost every capitalistic, economic and medical measure to deliver for the American patient.
Unlike auto insurance, private medical insurance has failed to accept and spread risk, thereby preventing the delivery of quality, affordable health care .
All the private health insurers have failed to prevent personal bankruptcies due to medical illness. The administrative bureaucracy of private health insurers removes $500 billion a year from health care. Managed health care brokered by private insurance companies has failed to improve medical outcomes and lower morbidity (sickness) and mortality (death rates) for all Americans regardless of income, sex or location.
The private health insurance industry has needed massive taxpayer subsidies. It would not be profitable without a federal exemption from antitrust laws combined with a federal ban on collective bargaining by physicians. The private insurance companies would not be able to ration health care for profit without a federal law protecting the companies from malpractice lawsuits.
For over four decades private health insurance companies have decreased reimbursements to individual doctors, hospitals and therapists for care, while failing to lower the cost of care for insured citizens and business.
For 40 years, the private insurance industry has refused to invest in the development of integrated medical records and billing systems to prevent fraud and track outcomes and improve quality of care. Within the health insurance industry there is a failure to compete based on medical, surgical or preventative outcomes (the only product of health care). In addition, the health insurance industry has failed to operate profitably without massive diagnostic, treatment and reimbursement rationing of patient care by non-physician actuaries and insurance bureaucrats.
Private health insurance companies have failed to deliver to Americans low-cost medicines and drugs via competitive capitalistic bidding, even with massive federal Part D subsidies. With no real interest in our future health, the private health insurance industry has failed to contribute to meaningful medical or clinical research.
Health insurance companies can only claim success in diverting hundreds of billions of dollars of public and private money from health care providers and patients to profits and payoffs for their bondholders, shareholders, executives and political patrons.
If any other American industry failed to competitively and profitably provide a quality product for all Americans for 40 years, it would either be outsourced to an emerging nation, or shut down.
Health insurance companies ensure neither quality affordable health care nor quality insurance for most Americans. With no real product to sell, the private health insurance industry would fail to exist without hundreds of millions of dollars in direct and indirect payments to the elected officials in the Congress, state legislatures and the administration.
After 40 years of market and medical failure, America needs to cut out the middle man and move to single-payer national health insurance for all Americans with private doctors, hospitals, clinics, therapists and drug companies competing based on the quality of medical, surgical and preventive outcomes.
Dr. Howard Green is managing partner of Dermatology Associates of the Palm Beaches and director of the Dermatology Division at St. Mary’s Medical Center in West Palm Beach.