Blue Cross Blue Shield Execs Profited From Bogus Bonuses

http://www.huffingtonpost.com/2009/09/09/blue-cross-blue-shield-ex_n_281282.html
You mean they used premium payments to cover bonuses and pay for a $35,000 retirement party? No wonder my Dad couldn't get the therapy he needed. Blue Cross used the money for other things...

Astonishing, but not really.

Health care insurers often dominate market - Health care- msnbc.com

http://www.msnbc.msn.com/id/32524528/ns/health-health_care
of course

WASHINGTON - One of the most widely accepted arguments against a government medical plan for the middle class is that it would quash competition — just what private insurers seem to be doing themselves in many parts of the U.S.

Several studies show that in lots of places, one or two companies dominate the market. Critics say monopolistic conditions drive up premiums paid by employers and individuals.

For Democrats, the answer is a public plan that would compete with private insurers. Republicans see that as a government power grab. President Barack Obama looks to be trapped in the middle of an argument that could sink his effort to overhaul the health care system.

Even lawmakers opposed to a government plan have problems with the growing clout of the big private companies.

"There is a serious problem with the lack of competition among insurers," said Republican Sen. Olympia Snowe of Maine, one of the highest-cost states. "The impact on the consumer is significant."

Wellpoint Inc. accounted for 71 percent of the Maine market, while runner-up Aetna had a 12 percent share, according to a 2008 report by the American Medical Association.

Overhaul supporters tout savings
Proponents of a government plan say it could restore a competitive balance and lead to lower costs. For one thing, it wouldn't have to turn a profit.

A study by the Urban Institute public policy center estimated that a public plan could save taxpayers from $224 billion to $400 billion over 10 years by lowering the cost of proposed subsidies for the uninsured, while preserving private coverage for most people.

"Right now, there's no incentive for insurers or big hospital groups to negotiate with each other, because they can pass higher payments on through premiums," said economist Linda Blumberg, co-author of the report. "A public plan would have the leverage to set lower payment rates and get providers to participate at those rates."

"The private plans would come back to the providers and say, 'If you don't negotiate with me, you're going to be left with only the public plan,'" Blumberg continued. "Suddenly, you have a very strong economic incentive for them to negotiate."

Insurers contend their industry is extremely competitive, and a public plan is unnecessary. About 1,300 carriers operate across the country, although many only have a small share of the market in their states.

"You can have a very competitive market and still have companies with a high market share," said Alissa Fox, a top Washington lobbyist for the Blue Cross Blue Shield Association.

Fox points to the federal employee health program, which also covers members of Congress. It offers a total of more than 260 options and 10 nationwide plans. Despite all the choices, about 60 percent of federal workers pick a Blue Cross plan.

"Insurers need to be of a significant size to best serve their customers and make sure that people get the best value," Fox said.

Nonetheless, lawmakers are concerned. Big insurers are getting bigger. Small businesses in particular have fewer and fewer options for getting coverage.

Congressional investigators this year looked at insurers catering to small employers around the country. The Government Accountability Office found that the median — or midpoint — market share of the largest carrier increased to 47 percent in 2008 from 33 percent in 2002.

The basic framework lawmakers are looking at for a health care overhaul would encourage competition, even without a government plan. It calls for setting up a big insurance purchasing pool called an exchange. It would be open, at least initially, to individuals and small businesses. The government would offer subsidies to make premiums more affordable.

Consumers would find it much easier to shop for a plan through the exchange. For one thing, they would be able to readily compare benefits and premiums in different plans. Also, participating insurers would have to take all applicants and not charge higher premiums to those in poor health.

Offering the option of a public plan would supercharge the competition, supporters say.

Plan could rival giants
Blumberg envisions a plan that pays medical providers more than Medicare, but less than private insurance. Her study estimated it could grow to 47 million members, leaving 161 million with private insurance. Even so, that would make the new public plan one of the largest insurers in the country, rivaling Medicare, Medicaid and big private companies such as Wellpoint and UnitedHealthcare.

It's a scenario that gives pause even to traditional adversaries of the insurance companies.

"The fear and concern is that the public plan could become the market-dominant plan," said Dr. James Rohack, president of the American Medical Association. "When you've got the federal government involved, it can infuse money into a plan to keep it solvent even if the premiums are lower than its actual costs."

Snowe, among the few Republican senators still trying to come up with a bipartisan compromise, wants to hold back on creating a public plan for now and give insurers one last chance to show if they can keep costs in check.

That's doesn't go far enough for liberals, who are loath to give the insurance industry tens of millions of new customers supported by taxpayer subsidies.

"It would give the industry a windfall without any countervailing force to require them to lower their costs," said Richard Kirsch, national campaign manager for the advocacy group Health Care for America Now. "The insurance companies could continue to jack up premiums while getting a whole new market."

one last chance, Snowe? that $1M a day in lobbying fees should have been their last chance

What Value do Health Insurance Companies Bring?

http://rawstory.com/08/news/2009/08/20/whistleblower-insurance-profits-resemble-casinos/

Olbermann sees similarities between insurance, casino profits

Today, insured Americans will ultimately pay up to 20 cents on every dollar they spend for health care. However, according to MSNBC host Keith Olbermann on Wednesday night, in its “reform” talks the U.S. Senate is debating if it should allow insurers to increase that figure to as much as 35 cents for every dollar.

“In Vegas, they used to call casinos that made more than 20 percent profit a ‘flat store,’” said Olbermann. “The flat store reputation was the kiss of death, because gamblers knew they could get a better deal elsewhere. Today, Nevada laws restrict casino profits to a max of 25 percent. New Jersey casinos take no more than 17 percent profit by law.”

The difference now is, insurance companies may have a real shot at taking much more.

He continued: “So, why is the Senate Finance Committee, run by Democrat Max Baucus [of Minnesota] considering making even Americans who have insurance pay 35 percent of their medical bills?”

The iconoclastic host was joined by Wendell Potter, the former communications director for health insurance giant Cigna. Potter has since become a Senior Fellow on health care at the Center for Media and Democracy.

Potter, speaking to PBS host Bill Moyers in July, appraised the U.S. health insurance industry as being exactly like what filmmaker Michael Moore depicted in his documentary Sicko.

Olbermann called him “one of the heroes in the current drama being played out.”

Potter explained that what the insurance providers are after is nothing short of a “vast shift” of costs onto U.S. consumers.

“It is a reason why you already have a lot of people filing for bankruptcy or losing their homes,” he said. “Right now, if you consider the average median income in this country is $50,000, if yo’re asking people to pay that much out of pocket for medical claims, you’re going to have a much worse crisis of bankruptcies and foreclosures in the near future.”

“Are we, the American consumer, under attack by these insurance companies?” asked Olbermann.

Potter claimed that insurers had enlisted an unwitting mob through the use of misinformation.

“The insurance companies are very, very savvy at manipulating public opinion,” he said. “They do this through big PR firms that they hire to feed talking points to politicians to talk show hosts, editorial writers and people that these people trust, so that they think they’re hearing it from people who are telling them the truth, but not realizing it’s coming straight from a special interest that wants them to think a certain way.”

This video is from MSNBC’s Countdown, broadcast Aug. 19, 2009.

Chris Hayes Healthcare Flowchart from nn09

http://www.donkeylicious.com/2009/08/flowchart.html


larger version

Billionaires for Wealthcare: It's On!

H/T Cyd

I wondered where health care supporters were.

U.S. Insurance Companies: Friends or foes?

http://www.economist.com/world/unitedstates/displayStory.cfm?story_id=14248420&source=features_box_main
The health insurance lobby may prove to be President Obama’s most important friend this year.

Can Obama continue to bash the insurers one day and rely on them the next?