Health Care for All

By Samuel Metz, MD. Samuel is a private practice anesthesiologist, HCAO representative from the Portland chapter of Physicians for a National Health Program, and founding member of Mad As Hell Doctors.

Profit is not what is destroying our health; it’s the private insurance business model.

Oregon is unusual in that our largest insurance companies are non-profit. Nonetheless, the cost of insurance in Oregon differs little from other states; our percentage of uninsured is in the middle; and we suffer the same proportion of medical bankruptcies as other states. Clearly profit-making among insurance companies cannot be held responsible for the sad state of health care in the US, or Oregon for that matter.

Many Europeans use private health insurance companies, a few of them for-profit, and Europeans enjoy better care for more people at lower cost than we do. But the European business model differs radically from ours. In fact, American insurance companies find the European model not just alien, but intolerable. Imagine an American insurance company playing by these European rules:

With this model, European companies compete with lower prices, extra benefits, and better customer service. Not a lot of that on this side of the Atlantic, is there?

Without these rules, how do American insurance companies compete?

Does profit make a difference? No. It doesn’t matter if your company is beholden to stockholders or a non-profit board of directors – you must follow the same rules. If you don’t, your company is toast.

The unfortunate consequence of these rules is the conflict between insurance companies’ financial interests and policyholder’s medical interests. Whether your company needs to show a profit or not, you cannot avoid bankruptcy if you sell comprehensive policies at affordable prices to sick people. Do not have false hopes: Removing profits, enhancing competition, and removing regulations will not correct these misaligned interests.

Our American insurance business model is the source, not the solution, of our health care problems. We must run – not walk – away from placing our health care in the hands of the private insurance industry.

Comments

  • (Show?)

    The Obama administration will be offering two national public option insurance plans when the exchanges are set up. So there are the beginnings of a choice.

    • (Show?)

      The ACA does a number of important and valuable things that advance the human right to health care in this country. But the Exchanges are the most problematic aspect of what it does.

      I have some question whether these "national public option" plans will be available in Oregon or any other state that creates its own Exchange, or only in the states that left Exchange making to the Federal gov't. It may be, ironically, that only people in the ultra conservative states will end up with a "public option."

      But in any case it doesn't really matter. The constraints of the ACA mean that any "public option" will not be allowed to use the potential cost-saving benefits of public provision (thanks Chuck Schumer!) and will be constrained by the same ridiculous system of lemon insurance "levels" and profoundly inadequate "essential benefits" as all the others in the Exchange. And of course the Exchanges do nothing for the vast majority of non-Medicare, non-Medicaid/OHP people who get insurance from employers, and who get no cost control, no choice if their employer degrades benefits and raises premiums, and no public subsidies for costs shifted to them.

  • (Show?)

    Europe, where capitalism was "invented", has preserved capitalism and yet prevented it from dominating civil society. America, which just adopted capitalism from its European roots, has allowed it to wreck our environment, destroy our communities, and establish an oligarchy whose wealth and power makes that of the old European aristocracies look like peanuts.

guest column

connect with blueoregon