Health Insurers' Wish Lists

Like children, hoping for a rewarding visit from Santa Claus in December, Health Insurers have their own wishes, waiting to be granted. While kids want Santa to come with a full sack of goodies, the insurers might want (and have already negotiated for) an empty sack from Congress and President Obama. Read on -

1. No weakening of anti-trust protection of insurers for the their activities constituting the "business of insurance."

2. No meddling by the federal government in the salaries and bonuses of health insurance company executives and their key staff.

3. No action by the federal government which might draw major employers away from traditional health care insurers to an insurance pool or public plan.

4. No interference by the federal government with health insurers' drug distributing subsidiaries ability to extract rebates, discounts and other incentives from pharmaceutical companies, as well as providers of other health care goods and services, and not pass them on to patients and employers.

5. No entry by the federal government into administration of health plan enrollments and premium collection and distribution which would cut into health insurers' profitable administrative overhead revenues.

6. No extension of federal fraud and abuse laws to the products, services and arrangements provided by insurers, their subsidiaries and contracting parties.

7. No national standard uniform contract for health care insurers with patients, employers and other similarly interested parties.

8. No single payer system.

9. No federal requirement of freedom of access by all health insurers to all physicians, nurses, hospitals and other organization which provide health care services (see #11).

11. No American standard of enforceable performance by health insurers for the services and products they sell to employers and patients, and no weakening of the ERISA protection of insurers against private lawsuits by injured patients and their families.

12. No restriction on the ability of health care insurers to purchase networks of providers and facilities who will then provide services only to each owner-insurers' clientele.

13. No unionization of health care professionals, such as physicians.

14. No interference with the system by which 50 states regulate insurers.

15. No restriction on commercial "free speech" by health insurers.

10. (Inadvert. omitted - added 8/17/09) - No requirement that the insurance companies be required to provide high-technology prostheses.

Kafka Couldn't Have Done Better

The New York Times, Monday May 11, 2009, page A1: Stephen Labaton's "Administration Will Strengthen Antitrust Rules." Page A11: Robert Pear's "Health Care Industry Is Said to Promise to Hold Down Costs Voluntarily." Page A21: Paul Krugman's "Harry, Louise and Barack."

The administration has made a grandiose threat to enforce antitrust rules "against corporations that use their market dominance to elbow out competitors, or to keep them from gaining market share." And then, with apparent administration encouragement representing a full-blown schizophrenic break, the big financial interests in healthcare ("doctors, hospitals, drug makers and insurance companies") have joined forces, out of the public eye (in Senator Kennedy's offices?), to exert their market dominance on the citizenry without any administrative recognition that this is insane. When the big players put their heads together, will they be more interested in diverting dollars to their corporate treasuries or in saving health care dollars while providing quantitatively higher quality health care? Were these the country club buddies of the bankers and financial people who just wrecked our economy, chanting "greed is good"?

Krugman describes his cynicism about the motives of these big money operatives. I'm not cynical, I just think the whole situation is sick.

Yesterday's blog illustrates how the money will be saved. And it bodes poorly for our families' health.

By the way, who is protecting the public?