Gee, The NY Times Finally Noticed: The Fox Is Guarding the Hen House

Our U.S.government is not expert in the "insurance risk" business, but health insurers and HMOs, which may not have corporate competence in health care but do understand their respective financial bottom lines, understand the concept of risk very well. And corporate health insurers and HMOs lobby for laws which explicitly limit their risk or allow them to limit their risk by defining that risk away and influencing their friends at the states' level to help them.

As Reed Abelson of the Times describes in his 7/24/10  "For Insurers Fight Is Now Over Details" article, insurers are trying to define away their risk under the health reform provision which requires that 80 cents of each premium dollar be spent on the welfare of patients. Instead of the 80 cents purchasing actual health goods and services, the health care industry is attempting is use that 80 cents to pay for the paperwork and clerical functions involved in credentialing doctors in its networks, for commissions to those who sell insurance, for taxes on investment income and other items which will improve its bottom line (such as policing health care billing fraud), but not the health care bottom line of those insured under the health reform package.

Insurers are already showing their willingness to dump sick kids who are under individual (not group) health insurance policies as they manipulate their exposures to risk. Our health care premiums will buy less health care, more bureaucratic services, and we will not have the true reform promised by the Obama administration.  The health insurance and HMO industry, guarding the hen house like foxes, will take care of their needs first and provide only left-overs for Americans who will dig deep into their pockets for health insurane coverage.