‘America’s Bitter Pill’ Makes Case For Why Health Care Law ‘Won’t Work’
1st February 2015
This is NPR, so you have to take all this with a grain of salt. Still, he seems to be asking the right questions.
It’s hard to understand why you get 36 different first-class envelopes with 36 different pieces of paper from the same insurance company on the same day. That tells you something about the efficiency of the health care industry right there. But then, as you open each envelope, they’re as completely unintelligible to me as they are to you, as they are to everyone listening. But better yet, they’re also as unintelligible, apparently, to the people who write them.
I got to do what is probably a reporter’s dream … which is I took one of those explanations of benefits, which said, “Amount billed: zero. Amount insurance company paid: zero.” And the third column said, “Amount you owe: $154.” So it makes no sense.
I’ve had the same experience.
But here’s what I got to do: I had scheduled, as part of the reporting for my book, an interview with the CEO of United Healthcare, the largest health insurance company in the United States — and my health insurance company, as it turns out. I went out to Minnesota to interview him and asked him all kinds of questions about what he thought the impact of the Obama health reform was likely to be. And at the end, I took that explanation of benefits out of my suit pocket and said, “I’m wondering if you could do me a favor, could you explain this to me?” … “How can I owe $154 if nothing was billed?” He looks at it … and looks up at me and says, “I could sit here all day and I couldn’t explain that to you. I have no idea why they sent this to you.”
And that tells you everything that there is to know about American health insurance — although not even close to being what you want to know and perhaps need to know.
The insurance companies are not really the bad actors in this movie. The insurance companies are in many ways like us: They pay health care bills. The culprit here — and the reason that the Affordable Care Act doesn’t work is, is not going to work — is that nothing has been done to curb the marketplace of exorbitant bills and exorbitant profiteering on the part of hospitals, medical device makers and obviously the drug companies. The insurance companies are as much the victim of that as we are. Now, they’re terribly managed; again, the CEO of the largest company can’t even explain what his bill means. They’re incompetently managed; they’re not very nice people when you get them on the phone. But they’re sort of stuck in the same ditch we’re in, which is being forced — unlike the payers for health care in any other developed country on the planet — being forced to pay uncontrolled, exorbitant prices and high profits that are generated by nonprofit hospitals and by drug companies and medical device makers. In that sense, I kind of feel sorry for them.
As do I — your tax dollars at work.
In the sense that if you step back the way I did as a reporter and look at the economics of health care in the United States, it’s absurd. That nonprofit hospital makes a lot of profit. The executives are highly compensated. The people who sell all of the equipment that is in operating room have humongous profit margins. The [prescription] drugs that I was given … have humongous profit margins and we have done nothing in this country, unlike every other country in the free world, to control that because we have lived with the illusion that health care can be a free market.
Note the pervasive ‘progressive’ delusion that ‘free market’ means ‘small profit’. In fact, the whole hostility to profit — the larger the profit, the more the hostility — is one of the signature obsessions of the modern Left. The high profit margins for health care is quite simply explained by the fact that there is not, and never has been, a ‘free market’ in health care (or health insurance); it’s one of those ‘basic rights’ (like roads and schools) that people insist government subsidize and the costs of which are therefore grossly inflated.