Blue Cross/Blue Shield is gearing up to fight fixing Health Care – again.  Fortunately, Paul Krugman exposes their nonsense with a simple question:

“We can do a lot better than a government-run health care system,” says a voice-over in one of the ads. To which the obvious response is, if that’s true, why don’t you? Why deny Americans the chance to reject government insurance if it’s really that bad?

If that’s true, why don’t you?  Brilliant!  The truth is insurance companies have no interest in improving Health Care – only profits.  Their entire strategy is denying choice, or should I say rationing options.

When It comes to health Insurance… health insurance companies have no incentive to offer a good product at a fair price.  Not only do they see nothing wrong in peddling crap, they want us to defend and protect their right to peddle crap.  How they wrap gouging in the American Flag while screaming socialism escapes me.  Since when is it patriotic or capitalistic to pay top dollar for an inferior product?

And let’s face it, the writing has been on the health insurance wall for decades.  Not that they’ve bothered reading it, or made even the smallest attempt to change the small print – which, ultimately may have changed their fate.  Oh no, they’ve behaved as if the government option was inevitable and, therefore, justified their obscene profits with their equally obscene lack of service.  It’s as if they knew the end game and calculated how much money they could make until the inevitable happened.

The facts bear out this theory:

Today, as President Obama pushes for a sweeping reform, the system has eroded to the point that the data alone capture the urgent need not just for an overhaul of the existing system, but for the creation of a public health insurance option that will guarantee health insurance for all Americans. As the number of uninsured has risen to staggering levels – an estimated 50 million Americans will not have health insurance this year – the traditional model of employer-sponsored health insurance has been shown to be seriously flawed. Americans who once worried about losing health insurance if they lost their jobs now must entertain the possibility that their employers will not offer health insurance, or that the premiums will make it unaffordable. Minorities, children, and low-income households are at greater risk of going uninsured.

Talk about a self-fulfilling prophecy.  If health insurance companies are okay with these numbers, then they’ll get exactly what they deserve – extinction.  Go on and trot out the tired old argument about waiting for a hip replacement, but, the truth is, if taking yourself, or your child, to a doctor is something you can’t afford, hip replacements and seeing a specialist are the stuff dreams are made of.

—Although the majority of Americans under the age of 65, about 63%, have employer-sponsored health insurance, coverage has been steadily declining since 2000, even during periods when overall employment grew. Some 3 million fewer people had employment-based insurance in 2007 than in 2000. This loss of coverage was especially steep among children, where employer-sponsored health coverage dropped from 66% in 2000 to less than 60% in 2007. While still providing coverage to a majority of children, it is a slim majority that is getting smaller all the time.

—Average premiums for an employer-sponsored family plan have risen nearly 120% since 1999, three and a half times faster than workers’ earnings and more than four times faster than inflation. One of the reasons some workers do not have coverage is that they cannot afford the high premiums. This problem has hit low-income workers the hardest, although coverage levels have also fallen for college-educated workers.

—Fewer than half of all Hispanic Americans have health insurance through an employer. The rate of coverage among this group fell to 41.4% in 2002, from 45.8% last year. Among African Americans, only a slim majority have employer coverage: 51.6%, down from 56.1% in 2000.

—Workers in the service sector are highly unlikely to have health insurance through their employers. The coverage level among this group was just 29.5% in 2007. Fewer than half of all workers at small businesses with fewer than 24 employees had employer-sponsored health insurance from their own job.

Another example of greed run amuck.  Personally, I won’t shed a tear over the loss of these leeches.  They had their chance to save themselves and chose, instead, to pad their bank account.  Good riddance.

Via The Now! Blog:

Sen. Ben Nelson said Thursday that he will oppose the creation of a government-run health insurance plan as part of a health care overhaul, contrary to the position held by many of his fellow Democrats.

Nelson, D-Neb., said he may try to assemble a coalition of like-minded centrists opposed to the creation of a public plan, as a counterweight to Democrats pushing for it. He said he does not believe a majority of the Senate supports the idea.

…

But Nelson sides with opponents, who say a government-run plan would undermine the nation’s existing system of employer-sponsored health insurance.

Republicans, insurers and business groups say private insurers could not compete with a government-run plan, which presumably wouldn’t have to spend money on activities such as marketing or developing networks of participating physicians and hospitals. Eventually, opponents say, most consumers would join the public plan, either because its prices are lower or because their employers stop offering insurance.

“At the end of the day, the public plan wins the game,” Nelson said. He called the inclusion of a public plan in legislation a “deal-breaker” for him.

Never mind the reason Insurance Companies find themselves in such a predicament.  Forget about how they’ve offered a crappy product for top dollar.  Who cares that these companies chose to gouge their customers rather than read the writing on the wall of public opinion and change their ways.  Why should they alter their methods of doing business when they have people like Ben Nelson (who, as a Senator, enjoys government health care) willing to fight for their profits and lack of care.

And if what most anti-government health care advocates claim is true – that the government plan will stink and we’ll all die sitting in a hospital waiting room – why would they say “At the end of the day, the public plan wins the game.”   Wins what game?  The game of competition?  Why would they lose against a voluntary program?  Given the nightmare scenarios they like to trot out in relation to government run heath care it seems to me that health insurance companies would hold onto their existing customers, cherry-picking would become a-okay, and they wouldn’t have to worry (not that they ever did) about the millions of uninsured Americans.  But they are worried… with good reason.

Luckily, health insurance companies have politicians like Ben Nelson in their pockets corner.

With the writing on the wall concerning Health Care, suddenly Insurers are willing to talk.

WASHINGTON —The health insurance industry said Tuesday that it was willing to end the practice of charging higher premiums to sick people if Congress adopted a comprehensive plan that provided coverage to all Americans.

The industry’s flexible position on the issue came as a surprise to lawmakers, and could make it easier to reach an agreement in Congress because it narrows the issues on which insurers are ready to fight the Democrats who control Congress and the White House.

Insurers said they were still staunchly opposed to creation of a new government-run health insurance plan, which, under many Democratic proposals, would compete directly with private insurers.

Ah… they are staunchly opposed to a government-run plan because it would create competition.  But, how could this be?  We’ve been told for years about the horrors of  government-run health care, so, it goes to reason, that only those losers with pre-existing conditions and people too dense to get a job with benefits will take advantage of a government health care program.  Everyone else will stay with their private insurer.  Right?

Wrong.  This won’t happen, and health insurance companies know it.  They know that they’ve been offering a crappy product at exorbitant prices.  And for all the nightmarish stories thrown out concerning a government plan, the truth is that the health insurance industry has its own little shop of horrors.  And it’s this truth that has them in a panic.  It’s also funny to note how quickly they abandon their competitive, free market principles when faced with competition.

In effect, insurers said they were willing to discard an element of their longstanding business model, under which insurance policies are priced, in part, on the basis of a person’s medical condition or history.

In the past, insurers have warned that if they could not consider a person’s health in setting premiums, the rates charged to young, healthy people would soar, making coverage unaffordable.

But Karen M. Ignagni, president of America’s Health Insurance Plans, a major trade group, told lawmakers on Tuesday that insurers were exploring ideas to prevent such increases by spreading the risks and costs across a larger population of both healthy and unhealthy people.

Insurers said that they could accept more aggressive regulation of not just their premiums but also their benefits, underwriting practices and other activities. Such strict regulation, they said, would make a new public program unnecessary.

Yep, they are in a panic, and their goal is clear: Stop government health care.  The truth is they can’t compete, and the only reason they’re still in existence is because they’ve all agreed to be as bad as the next guy.  Seriously, if one buys into all the insurance companies’ propaganda then no one with private insurance would ever consider a government plan.  Which would maintain the status quo – meaning that only those people currently uninsured would take advantage of government health care because they had no other option.  The rest of us would stay with our awesome private insurance.  Life goes on, same as before.

But that’s not what will happen, and insurance companies realize that they’re in trouble and quite possibly facing extinction.  For far too long they have been gouging the American people, offering only two choices:  Pay up or be uninsured (small print: even if you pay up don’t count on having your health bills paid).  And, when it comes to greed, private health insurers give Wall Street a run for their money.  It’s another example of a rigged system, one in which profits are built not by offering a sought after, superior product, but by denying care.

So spare me the dire warnings and horror stories about government-run health care.  I don’t believe it can be any worse than what most of us are dealing with now.  And that’s the problem.  Private Health Insurance companies have very little to do with health… unless health refers to company profits.

UPDATE: Action Item – Stand With Dean.  Sign the petition!

“Give America a choice. We support healthcare reform that allows individual Americans to choose either a universally available public healthcare option like Medicare or for-profit private insurance. A public option is the only way to guarantee healthcare for all Americans and its inclusion is non- negotiable.

Any legislation without the choice of a public option is only insurance reform and not the healthcare reform America needs.”

I’ve been saying this for years, but maybe hearing it from Business Roundtable will add credibility to my liberal opinion.  Let’s look at the findings (emphasis mine).

Lead Health Care Messages

In many important respects, the American health care system is among the best in the world. When it comes to scientific advances, medical technology and the quality of our doctors and medical institutions, the United States is without peer.  But our country’s health care system also is becoming increasingly expensive, which is having a direct negative impact on American competitiveness.  Rising health care costs are one of the top cost pressures facing U.S. businesses today, inhibiting job creation and hurting America’s ability to compete in global markets. This study helps demonstrate the relationship between spending, quality and competitiveness while enabling us to track progress as we push forward with health care reform.

Direct negative impact on American competitiveness.  Inhibiting job creation and hurting America’s ability to compete in global markets.  Houston, we have a problem, and it doesn’t get any clearer than this.  We also have health issues, which given the money we spend on Health Insurance should make all of us realize we aren’t getting what we’re paying for.

Let’s look at the study’s results which “combines internationally reported measures covering both spending on, and the performance of, national health care systems to assign a value to the U.S. health care system compared with important global competitors.”

These results show the U.S. is suffering from a significant health care value gap.
o U.S. workers and employers receive 23% less value from our health care system than the
average of five leading economic competitors – Canada, Japan, Germany, the United
Kingdom and France (the “G-5 group”).
o U.S. workers and employers receive 46% less value than the average of emerging
competitors Brazil, India and China (the “BIC group”).

Let’s be honest.  The only people benefiting from the US Health Care system are the insurance companies and those rich enough to go outside of their network and pay for care.  And given what we pay for Health Care as a nation there is no excuse for us not to be number one.  These figures are a national embarrassment, and all the flag waving and free market talk won’t change the fact that we are paying top dollar for an inferior product.

The study also shows:
o As a group, G-5 countries spend about 63 cents for every dollar the U.S. spends on health
care – yet the health of the U.S. workforce lags by 10% in a composite measure.
o The gap is even wider in relation to rising economic powers: the three BIC countries
spend just 15% of what we spend on health care, yet the health of the U.S. workforce
trails that of BIC countries by 5%.
o In terms of per capita spending, the United States spends $828 more per person than G-5
countries and $1,654 more per person than BIC countries.
o When you look just at employer spending, in 2006, American businesses paid 73 cents
more per hour more for health benefits than those in the G-5 group – a disparity that grew
by nearly 50% between 2004 and 2006.

Pro-Business groups… are you listening?  This is a problem that’s effecting our economy and our health.  We, as a nation, can no longer afford to separate the two.  The connection between our Economy and Health Care is indisputable, with Health Care having the upper hand… because it’s Health Care that’s bringing business to its knees.

I sincerely hope so.

According to The Plum Line.

President Obama may make health care a theme of the big prime-time speech he’s making next Tuesday about the major challenges facing this country, Obama aides confirm to me.

This could be a big deal, particularly if Obama uses the high-visibility speech (which will be made before Congress) to press the case that health care reform is essential to righting our economy.

The news comes amid other signs that Obama is moving on health care. Today’s New York Timesreports that Kathleen Sebelius has emerged as the front-runner for the post of Health and Human Services secretary, a choice that would cheer reform advocates.

It’s not yet clear how central health care would be to Obama’s speech, but if it’s a major component of Obama’s message, it could signal a renewed determination to prioritize reform.

I have always thought that fixing healthcare is one of the major keys to fixing our economy.  And, let’s face it, healthcare/insurance in this country is definitely broken.  It’s expensive, unresponsive, and more focused on denying claims than providing good-faith service.

How many of us have struggled to have a claim paid?  How many of us have submitted a claim only to be told that it’s not, or it’s no longer, covered – and I’m not talking about some over the top procedure, unless you consider a child’s yearly check-up excessive.  

It seems to me that the first course of action for Health Insurance companies is to deny.  That also appears to be their second and third choice as well.  And when they do pay there’s nothing to stop them from changing their mind.  RSmitty, from Delaware Politics, is living this nightmare. 

From the “When it rains…” file.  Today, just a smidgen under six-months-to-the-day of receiving settlement, we received a subrogation request from my wife’s old health insurance to recover over $1200 worth of claims from the accident they paid for the first handful of hours…due to the settlement we received…you know, the one that didn’t cover total costs, after the fees, etc were worked in.  Oh yeah, this is good times here

Read the entire post.  One accident changed Smitty’s life.  And it can happen to all of us, because the truth is… no one knows how good or bad their Health Insurance is until they need to use it.

So I hope Obama does put Healthcare front and center in his speech next week.  The country is more than receptive.

Oh, and those of you tempted to regale us with horror stories from France and Canada.  Save your breath, because for every one of your Nationalized Healthcare horror stories I’ll raise you two American privatized health insurance nightmares. I’ll start the ball rolling here, here and here.

From a recent CBS/NYT poll:

Are Democrats listening? This represents a 37% swing in opinion on an item that Americans routinely put at the top of the list of priorities for the government to fix. National health insurance has multiple faces, so it is a mistake to think that this question indicates support for any one idea — but it is pretty safe to say that people no longer think that private insurance is doing what it should.

Another interesting item from this poll:
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After “Am I going to die?”, and sometimes even before, “Is this procedure covered?” has to be one of the most asked question of Doctors.  And, frankly, I resent it.  I resent the fact that Insurance companies have forced their way into my Doctor/Patient relationship.  I resent that they have the ultimate veto power over my health.

But, most importantly, I resent that I even have to think about Healthcare insurance.

Go ask anyone with a health condition how they are doing.  I guarantee that their answer will veer towards their health insurance.  They’ll tell you about their hassles with the insurance company, the number of bills they received marked as “not covered”, the number of phone calls they made trying to rectify the matter, and/or the amount they ended up paying out-of-pocket.  Along the way you’ll meet a couple of people who boast of how they didn’t have to pay a cent – their ecstatic tone far more suited to winning a lottery than receiving an MRI.

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