For-profit Medical Insurance Industry Supports Bottom Lines, Not Patients

By Jay Brock
GUEST WRITER

Photo by Levi Meir Clancy on Unsplash

While stuck in traffic the other day, I turned on a news channel on my radio, where the young hostess was discussing with a couple of guests the recent shooting of a health insurance industry CEO, and the subsequent outpouring of rage across the nation on social media aimed directly at a health insurance system that most Americans clearly find unsatisfactory.

She lamented the current state of our health insurance system. And with good reason—we pay more, get less, and still leave tens of millions uninsured or underinsured. Three of four Americans worry they won’t be able to afford to pay their medical bills. Tens of thousands of Americans will delay costly care—and will die prematurely as a result.

And what really enrages many Americans is when they learn at one of the most vulnerable times of their life—during their illness or that of a loved one—that the person really in charge of their healthcare is not their physician or physician-extender, but an insurance company representative who makes the final determination about whether the care their physician thinks is essential is really needed.

How’s that?

It’s because the business model of the for-profit health insurance industry—the industry in question here—is to make a profit, not deliver healthcare. (Delivering healthcare is something healthcare providers, not health insurance CEO’s, do.) We give the industry our dollars, and the industry tries to keep as many of those dollars as it possibly can—to increase profits, even if it means denying healthcare to patients who will suffer or even die without it.

So in order to enhance profits, the for-profit health insurance industry sets up mechanisms to delay and deny care. This outrages patients who must await anxiously for their care to be covered, or must deal with the shock and disappointment of being denied care ordered by their physician.

This is apparently a major reason behind the CEO’s shooting—and it certainly registered with a huge number of Americans, at least according to the explosion of outrage on social media against the health insurance industry and the executives most accountable for those decisions.

But the news channel hostess went on to lament that because other countries with universal coverage have their share of problems, including rationing of care and long waiting times to get it, perhaps such a system would not work here.

That conclusion is regrettable.

It is a stretch to imply that because another nation has a health insurance problem we’d automatically have the same problem here. And blaming another nation’s health insurance system for those problems would be wrong as well.

Let’s look further at this, taking as our example the single payer system Canadians enjoy (even Canadian critics of their system acknowledge it’s even more popular than hockey).

The Canadians have a great system. Unlike our system based on the for-profit health insurance industry, the Canadian model is a public good, which emphasizes patient health rather than health insurance company profit.

But Canada suffers from a problem we don’t have: a lack of dollars. They simply don’t throw as many dollars per person into their system as we do. So there are waits for elective care (emergency care is handled expeditiously, however).

Of course, we have waits here as well, especially when it comes to getting appointments with physicians both primary and specialty. But we don’t blame our health insurance system for those delays. So it’s inaccurate to blame the Canadian single payer system for the delays.

Bottom line: it’s not the single payer system that accounts for the wait times—the real problem in Canada is the lack of money.

We don’t have that problem here. Quite the opposite: We already throw more than enough money at our healthcare system to enact our own single payer health insurance system here: Medicare for All. According to the nonpartisan Congressional Budget Office, we could cover everyone, have all necessary medical care 100% paid for (ie, no need for copays or deductibles) and still spend less than we do now.

And without many of the waits for and rationing of care that other nations might contend with.

I’ve personally seen the vast benefits of the Canadian single payer system as both patient and provider. It’s affordable: contributions are based on income. Healthcare decisions are made with the patient in mind, while understanding that dollars are limited and need to be spent in a way that is most beneficial to patients and society rather than to health insurance industry profit.

I hope the next time the young lady opines on health insurance, she keeps in mind not the imaginary deficits but how beneficial a single payer system would be here.

We’re the only advanced nation without universal affordable healthcare. Let’s fix that now.

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