Health Care for America by Wes Davenport
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Health Care for America
One person’s opinion
Wes Davenport
Here comes the “Swift Boating” of Universal Health Care for all Americans:
- Health care is the first step in trading in our democratic form of government for SOCIALISM.
- Government bureaucracy will only increase costs and decrease treatment if there is a public
plan.
- Single payer health insurance is SOCIALISM.
- You won’t be able to choose your own doctor, treatment, medical facilities, medical equipment.
- Some bureaucrat will decide whether you get treatment or not, whether you live or die.
These are just some to the lies Americans are being told as this fight heats up.
Based on over 25 years experience in the Private Insurance Industry, I assure you that the Insurance
companies do not have your best interests at heart. Private insurance companies come in two
varieties: Stockholder owned and Mutual Companies (owned by the policyholders.) Stock
companies are interested in stock price and maximum profits, Mutual companies are interested in
competitiveness (read maximum profits). Neither company is interested in paying your claims
legitimate or not. Every claim that they pay reduces their profits and reduces either stockholder
earnings or policyholder earnings. It is their duty to minimize the number of claims paid and to
explore every avenue to avoid or delay paying claims. Oh, and they do like their generous salaries,
perks, fancy offices, expense accounts, private jets, business meetings held at luxury resorts, etc.
etc. ad nauseum.
Current administrative costs for private insurance companies run over 34% of total health insurance
spending. Researchers at the Institute for Health Policy Studies at the University of California, San
Francisco determined that about 10 % of premiums went for billing, marketing, financial activities and
profit. Physicians offices spend 14 % of their income on insurance paperwork, and hospitals spend 9
% on insurance paperwork. This financial cost to physicians for insurance paperwork is especially
high.
Of the total insurance premiums used to cover hospital and physician care, this research showed
that 21% is spent on insurance administration. Another 13 % is used to cover other administrative
tasks. Only 66 % is used for patient care.
Much of the problem is created by multiple types of claim forms and computer payment systems.
Each company pretty much has their own ideas of how to do it and our physicians and hospitals have
to fill things out their way to get paid. Additionally, each company decides what evidence will be
necessary to allow authorization of treatment for specific problems and huge amounts of time are
wasted by doctors trying to justify treatments for their patients.
So, what are the components of a workable system?
A single payer system with administrative and profit margins accounting for no more that 5% of
premiums achieved by tight regulation of basic health insurance markets with requirements for open
enrollment and community rating. Single payer means that there would be one source of funds for
paying all health care providers, one claim form, one set of administrative procedures, one computer
system for all physicians, hospitals and other health care providers. Single-payer health care does
not mean that the government or some government agency delivers or controls health care services.
It pays for health professionals and services that are delivered in either private or public sector
settings according to the needs and wishes of the patient and his or her doctor. Medical decisions
must be made by medical professionals, not by insurance industry administrative personnel or
government bureaucrats. What are the immediate potential savings? In 2008, the US spent 2.8
trillion dollars on health care. 34% of 2.8 trillion is $952 billion dollars. 5% of 2.8 trillion is $140
billion dollars. Savings of $812 billion dollars. Seems like a good value to me.
A public health insurance option encouraging the private insurance industry to stay competitive or
get out of the business with risk equalization systems to help reduce incentives for insurers to seek
only the healthiest enrollees,
Establish rigorous national standards for basic coverage for private insurance to ensure that benefits
are comprehensive for acute care services.
Provide mandatory universal coverage for all citizens. Mandatory universal coverage insures that
everyone is covered and that healthy peoples premiums help offset the costs associated with less
healthy participants. Insurance is the sharing of risk after all.
Now just in case you don’t believe that this is possible in our modern world check for yourself. Works
fine in the Canadian, Swiss and Dutch systems just to name a few.
So, blow off the baloney, look to your own and your families welfare and best interests and let us
move forward together to create a system that works and is affordable.
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