Opinion: Whistleblower Diagnoses Unhealthy Healthcare System
Potter spent 20 years working for the health insurance industry as a public relations whiz before leaving in protest of its policy to put profits before policyholder health. His job was to fool the public into opposing reform that favors the public.
According to Potter, the industry was well aware that public opinion opposed the private health care system and favored national health care. Potter says the industry used two tactics to change this: the “charm offensive,” which deceptively depicted the industry as advocates for reform, and “fear mongering,” where the industry spread lies through front groups, think tanks, pundits and politicians.
Potter found that between 2007 and 2009, insurance companies spent $586 million on lobbying, sometimes spending $700,000 a day of customers’ money.
Potter knows that 47 million people are uninsured in the United States and that 20,000 die every year as a result. He also knows half of the people who file for bankruptcy do so because of medical bills and that three-fourths of those people had health insurance. Potter blames consumer-driven plans, which shift costs from companies to their customers.
He discusses a device called the “medical loss ratio,” which helps companies determine how much of a policyholder’s payments pay for actual health care. If a company has to pay a customer’s medical bills, it’s considered a “loss” because it dents profits.
Accordingly, companies found ways to avoid paying their policyholders’ medical bills. Companies use policyholder money to fund efforts to find sly methods of skirting their responsibility to policyholders.
The difference between government bureaucrats and corporate bureaucrats is that corporate bureaucrats must obey the profit motive and reduce company costs. Therefore, they deny coverage to policyholders and purge sick customers from the company’s rolls.
Insurance companies require healthy customers to pay high premiums and then dump those customers when they get sick. After all, sick customers are unprofitable customers. So those who need health care the most are the most likely to be denied. Insurers will gladly take your money, but they’ll resist paying your medical bills.
Corporate bureaucracies are far less efficient than government bureaucracies. Medicare and Medicaid have three percent administrative costs. But private industry’s costs are 20 percent, which amounts to $400 billion a year, all paid by policyholders. US citizens pay twice as much per capita for health care as Canadians, Germans and the French- and those countries provide comprehensive care for everyone.
However, people fear public health care will lead to totalitarian “socialism” – just as it hasn’t in every other western, industrialized country with public health care. A public plan doesn’t socialize medical care; it socializes the payment of medical bills.
With the public plan, doctors decide what kind of care patients receive, not the profit-driven insurance companies. Also, people choose their hospital and doctor. Poor folks can visit the same hospitals as wealthy people. Women wouldn’t pay higher fees than men, as happens with private plans. If people get laid off, and were covered by their employer, they’d no longer lose their job and health care at once.
When the final health care reform bill passed, Potter was dismayed, claiming that “it might as well be called the ‘Health Insurance Industry Profit Protection and Enhancement Act’ [since] insurers will get billions of dollars in new revenues from people required by law to buy their products.”
People can’t afford to get sick under the current “pay or die” system in which health care is considered a luxury rather than a need shared by all. Private plans are a pox on the public. The insurance industry is beyond reform. A system of health care should replace a system of profit care. But for now, the anti-public healthcare system will continue being a boon for corporations and grave diggers.Share