Americans Hate Insurance Companies and Really Like Medicare
This outfit called Morning Consult has done some polling to gauge American attitudes towards some aspects of our health care system and then created a word cloud of the responses. Interestingly, “expensive” and “greedy” are associated with insurance companies, pharmaceutical companies, medical device companies and hospitals. Americans are more positive about nurses and Medicare. I’m posting the two word clouds for Insurance Companies and Medicare (thinking that the idea of being able to buy into Medicare as a Public Option was really a missed opportunity by Congress), but you should go over and see all of their word clouds — it is an interesting narrative:
In a word or two, could you please tell me what comes to mind when you think of health insurance companies?
In a word or two, could you please tell me what comes to mind when you think of Medicare?
This is most interesting to me as this is pretty much the reverse of how Congress prioritizes dealing with these items. In the main, the portions of the system that consumers like and value are the bits that Congress is least likely to support. And the portions of the system that consumers are least happy with are the portions that the government is most interested in supporting and funding– and those portions are also the parts of the system with the most money to spend on campaign contributions and lobbying.
Tags: Health Care
I’m among those who view the ACA as a step in the right direction. To be competitive with the rest of the world we’ll need single payer at some point, but it will be an arduous transition. Mainly because safeguarding the profitability of private insurance companies has taken on some kind of holy purpose.
Good post, Cassandra.
I am in total agreement with Jason330 about the ACA being a good start and that single payer is the logical place we go. However, waiting until we can figure out how to safeguard health insurance companies means that safeguarding will be more and more difficult as time passes. Health Insurance companies are consolidating and we are ending up with huge corporations that have near monopolies in the majority of states. If that continues the power of their corporate contributions will influence elections at the federal and state levels much more than they already do.
@jason
I’m curious how you think we’re going from here to there. In Delaware just over 50% of the population is covered by some form of government-paid insurance (Medicare, Medicaid, CHIPs, military). Of the remainder, Highmark Blue Cross Blue Shield has a 93% lock on the market, including 97% of the new sign-ups on the ACA website.
Highmark has successfully purchased interests in a major chain of urgent care clinics (MedExpress) and used its muscle as monopoly private insurer to start running locally owned clinics out of business. Highmark owns the second largest vision care chain in the country, owns three of the six most used dental plans in Delaware, and serves as a major Medicaid processor. In PA Highmark has bought entire hospital chains and is now using the ability to deny benefits and payments to try to bankrupt its competitors.
How does Highmark (whose non-profit mother company owns 35 corporations, most of which are for-profit entities, and which made an “incidental” $4 Billion profit in 2012) get into this–dare I say it?–monopolistic position?
Simple. Highmark paid its way in. Insurance Commissioner KWS and Senator Patti Blevins engineered the legislation that allowed Highmark to buy BCBS Delaware, and in so doing removed 90% of the Attorney General’s oversight over private health insurance and relieved Highmark of the responsibility of maintaining a $175 million fund for underwriting indigent care not at the expense of policyholders. And, of course, Highmark and other private insurers are major individual, PAC, and sector contributors to Delaware politicians on the State and Federal level.
You could say, “That’s why change will have to come from the Federal level” except that what the ACA did for insurers like Highmark was allow them to carve the country up into non-competitive regions, where each mega-insurance company now holds an 89%+ share of the market and buys its own politicians.
Final note: it sure isn’t a “free market” failure. Health insurance is one of the most highly regulated markets in the nation. The problem, of course, is that the health insurance corporations write the regulations.
So (since even I have lost the thread of my initial question): how do you expect to get there from here? In a process sense I believe that the private insurance companies allowed reformers to believe that ACA was one step closer to single-payer. It isn’t. It’s one step toward the enhanced profitability of corporations like Highmark.
One of the things hat I keep pointing out is that “single payer” isn’t the same animal all over the world. In Germany, for instance, it *is* insurance companies who are financed by citizens and employers. The difference is that these insurance companies are no-profit and they are regulated something like a utility. You can buy additional insurance (for stuff like cosmetic surgery) if you want. I can see the ACA eventually transforming to this model — with insurance companies basically administering a Medicare for All model. The biggest obstacle to this reform is Congress, of course. At some point they need to be more invested in good quality health care at a reasonable price than they are in the profits of insurance companies.
Cassandra is right about Germany. There are other countries with similar single-payer plans. This remonds me of a conversation on the subject of single payer that I had around 2010 with an executive with Blue Cross Blue Shield of Delaware. He said “we are in favor of single-payer health insurance, as long as we are the single payer”.
Steve Newton is correct about the rough percentages in Delaware and that is why a successful plan may have to be federal. My intention in 2012 was that, if elected, I would see how the roll out in Vermont worked.
A quick sidebar. The above helps also explain the concurrent controversy over educational issues. When trying to sort through it, remember the same graphic applies… Ironically in the News Journal’s freeped poll, teacher’s unions are getting the blame… That is so 1980. That may seem logical to old people until one figures it is the exact same 5 financial houses investing in these medical fields as well as bankrolling insurance companies, are the very ones behind bankrolling all the educational reforms and moving in on the monopolization of the entire nation’s teaching materials….
You should mention why health insurance premiums are now higher in Delaware than just about anywhere else. That smells just as bad as the Highmark-BCBS deal the crooked insurance commissioner and Sen. Blevins “engineered”.
Steve, Well Stated. I propose the VA Hospital expand into the US National Health System. 85% of Vets like their care at the VA Hospital and it is the most efficient health care system in the world. Th VA beats out some of the best private hospitals in quality indicators for managing Vets w/ chronic diseases. The VA can also negotiate & set the price for durable medical equipment and medication which helps lowers costs overall. They cut out the middle man and “pharmaceutical companies.” This proposal might seem far fetched but we need “out of the box” solutions on the table.
I would also agree w/ Cassandra that private insurance companies should NOT be for profit. Speaking w/ a colleague who is German, there are also CAPS on Insurance Company’s CEO pay as well. He is German who lives in the US and will not carry or purchase a US insurance policy. Anyone know the CEO’s compensation package at Hymark? The real winners of Obama care are the Insurance and Pharmaceutical companies and those who qualify for Medicaid (income 130% over the “poverty line.”). Middle-Class gets screwed again.