How for-profit insurers hijacked the health care system

In summary, Wendell Potter describes the problems with for-profit insurance companies and how they have stood in the way of health care reform. He also has strong opinions about how people should treat money and people.
  • #1
Ivan Seeking
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With almost 20 years inside the health insurance industry, Wendell Potter saw for-profit insurers hijack our health care system and put profits before patients. Now, he speaks with Bill Moyers about how those companies are standing in the way of health care reform.
http://www.pbs.org/moyers/journal/07312009/watch.html
 
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  • #2
@health care:

Just today, I heard from someone who had to make a quick trip to US from Canada so forgot about the insurance. Due to sudden appendix, had to stay at hospital for 4 days and bill totaled to like 50K. They got an option of paying 10K then and if they pay remaining in two weeks they will get 40% discount. And the surgeon doctor also said that her fee is like 2000 but paying it within few days and they can get 40% discount.

I am not sure how US citizens react to those kind of offers but that's certainly not how I think health care should be.
 
  • #3
I'm not sure how one forgets about the US health insurance situation when leaving Canada. I'm so over-insured before I set foot out into the States it's goofy.

But, so, truly, rootx? You can negotiate your fees if you pay more quickly? Like a traffic ticket?

I'll have to watch the Moyers link. His programmes are always lucid and reliable.
 
  • #4
GeorginaS said:
But, so, truly, rootx? You can negotiate your fees if you pay more quickly? Like a traffic ticket?

I think that if you don't have insurance and tell them you are unsure you will be able to pay they will come up with some alternative payment plan and possibly reduce the cost for you depending.
 
  • #5
GeorginaS said:
But, so, truly, rootx? You can negotiate your fees if you pay more quickly? Like a traffic ticket?

That's what I heard but I would like ask here if that is true.
 
  • #6
"for-profit insurers"

I don't suppose many of them are nonprofit.

Anyway, you seem quite passionate on the subject during this political broo ha ha.

Ivan Seeking, or should I say President Bar...wait, that doesn't make much sense.
 
  • #7
TheStatutoryApe said:
I think that if you don't have insurance and tell them you are unsure you will be able to pay they will come up with some alternative payment plan and possibly reduce the cost for you depending.

This is correct. If you get a 50,000 dollar bill you can't pay you won't pay any of it. So they try to get however much money they can out of you, and preferably sooner rather than later
 
  • #8
Office_Shredder said:
This is correct. If you get a 50,000 dollar bill you can't pay you won't pay any of it. So they try to get however much money they can out of you, and preferably sooner rather than later
I can't claim to know any specifics but as far as I understand you are able to do this with just about any debt you have. If there is a real possibility that you could file for bankruptcy and leave your debt holders with nothing they will likely be willing to negotiate. In the case of Root's Canadian friend it may have been more a matter of them not being able to do much to him after he left the country. I'm not sure how debters issues work out across national borders.
 
  • #9
Pinu7 said:
Anyway, you seem quite passionate on the subject during this political broo ha ha.

I am always passionate about my country. :smile:

Due to a ~ thirty-year inside view of the medical industry and some recent catastophic health issues in my family, I have some particularly strong opinions about health care. I don't claim to have all of the answers, but no one can tell me that we don't have serious problems. I know better.
 
  • #10
I'm watching the interview, and the sensation is a combination of feeling slightly ill to my stomach and outrage.

I'm passionate about people, and I've believed that people were more important than money. Always.

I will say, though, that the propaganda put out by the insurance companies (that's talked about in the interview) is very, very effective. I see their words parroted on message boards constantly by Americans, and there's no amount of saying, "I live somewhere else, and, no, our health care system doesn't work like that, yes, I have health coverage whenever I need it, and no, what you've been told about my health care system isn't true."

Anyway, I recommend people watch the linked interview.
 
  • #11
Pinu7 said:
"for-profit insurers".

The key word was "hijacked". And yes we do have insurers that are not for-profit.

There was a rather amusing moment yesterday when one Republican was touting the wonders of healt care for veterans, and almost in the same breath, said that the government can't run a health care system.
 
  • #12
GeorginaS said:
I'm watching the interview, and the sensation is a combination of feeling slightly ill to my stomach and outrage.

I'm passionate about people, and I've believed that people were more important than money. Always.

I will say, though, that the propaganda put out by the insurance companies (that's talked about in the interview) is very, very effective. I see their words parroted on message boards constantly by Americans, and there's no amount of saying, "I live somewhere else, and, no, our health care system doesn't work like that, yes, I have health coverage whenever I need it, and no, what you've been told about my health care system isn't true."

Anyway, I recommend people watch the linked interview.

I liked how they showed the Republican Congressman following the talking points; one by one.

The Republican party line - brought to you by the for-profit insurers protecting their profits.
 
  • #13
Ivan Seeking said:
There was a rather amusing moment yesterday when one Republican was touting the wonders of healt care for veterans, and almost in the same breath, said that government can't run a health care system.

The Daily Show with Jon Stewart ran a clip just a few days ago of a Republican government (not sure if it was a congressman or a senator) rep saying precisely that.
 
  • #14
Ivan Seeking said:
I liked how they showed the Republican Congressman following the talking points; one by one.

The Republican party line - brought to you by the for-profit insurers protecting their profits.

I never cease being aghast when I watch that in action. A memo telling politicians what to say, and then footage of politicians saying precisely what they've been told by whoever is paying them to say it. I am absolutely blown away every time I see it. Maybe one day I'll get over it, but for now, it's still beyond frightening. Here's the hunk transcript for that portion:

[Just as a point of interest, each one of the politicians quoted here have an R before their name.]

BILL MOYERS: I have a memo, from Frank Luntz. I have a memo written by Frank Luntz. He's the Republican strategist who we discovered, in the spring, has written the script for opponents of health care reform. "First," he says, "you have to pretend to support it. Then use phrases like, "government takeover," "delayed care is denied care," "consequences of rationing," "bureaucrats, not doctors prescribing medicine." That was a memo, by Frank Luntz, to the opponents of health care reform in this debate. Now watch this clip.

REP. JOHN BOEHNER: The forthcoming plan from Democratic leaders will make health care more expensive, limit treatments, ration care, and put bureaucrats in charge of medical decisions rather than patients and doctors.

SEN. MITCH MCCONNELL: Americans need to realize that when someone says "government option," what could really occur is a government takeover that soon could lead to government bureaucrats denying and delaying care, and telling Americans what kind of care they can have.

SEN. JON KYL: Washington run healthcare would diminish Americans' access to quality care, leading to denials, shortages and long delays for treatment.

REP. JOE WILSON: How will a government run health plan not lead to the same rationing of care that we have seen in other countries?

REP. TOM PRICE:
We don‘t want to put the government, we don't want to put bureaucrats between a doctor and a patient.

BILL MOYERS: Why do politicians puppet messages like that?

WENDELL POTTER: Well, they are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don't understand from an insider's perspective like I have, what that actually means, and the consequences of that to Americans.

They parrot those comments, without really realizing what the real situation is.

I was watching MSNBC one afternoon. And I saw Congressman Zach Wamp from Tennessee. He's just down the road from where I grew up, in Chattanooga. And he was talking-- he was asked a question about health care reform. I think it was just a day or two after the president's first-- health care reform summit. And he was one of the ones Republicans put on the tube.

And he was saying that, you know, the health care problem is not necessarily as bad as we think. That of the uninsured people, half of them are that way because they want to "go naked."

REP. ZACH WAMP: Half the people that are uninsured today choose to remain uninsured. Half of them don't have any choice but half of them choose to, what's called, go naked, and just take the risk of getting sick. They end up in the emergency room costing you and me a whole lot more money.

WENDELL POTTER:
He used the word naked. It's an industry term for those who, presumably, choose not to buy insurance, because they don't want to. They don't want to pay the premiums. So he was saying that half... Well, first of all, it's nothing like that. It was an absolutely ridiculous comment. But it's an example of a member of Congress buying what the insurance industry is peddling.
 
  • #15
Don't you guys have Blue Cross down in the States?
Ah, just checked: they're all independent of one another, with some non-profit, some are for-profit, and at least one is prepping a campaign against the upcoming health plan. I guess the non-profit ones are the ones that administer MediCare/Caid?
http://en.wikipedia.org/wiki/Blue_Cross_and_Blue_Shield_Association

Still, no coop-type insurance schemes?
 
  • #16
MATLABdude said:
Don't you guys have Blue Cross down in the States?
Ah, just checked: they're all independent of one another, with some non-profit, some are for-profit, and at least one is prepping a campaign against the upcoming health plan. I guess the non-profit ones are the ones that administer MediCare/Caid?
http://en.wikipedia.org/wiki/Blue_Cross_and_Blue_Shield_Association

Still, no coop-type insurance schemes?

I think we do have medical coops, but I have never participated in one.
 
  • #17
rootX said:
That's what I heard but I would like ask here if that is true.
Hospitals advertise that if you don't have insurance, they will find alternatives to pay your bills. They actually hand you a brochure about the alternative options to paying your bills. I know, having been hospitalized twice in the last year. I have one brochure right here (I had major surgery a few weeks ago). Luckily my insurance paid for all of it.
 
  • #18
Thanks for posting that link, Ivan. It's very informative. The current system is definitely not working. Let's hope things can change in our country -- for the better.
 
  • #19
It's not fair to lump all insurers into the same category. My health insurance is excellent. I do nothing, no forms to fill out, no hassles, my doctor orders something and it's done, no questions asked. I just had major surgery. My expenses? $20 for my regular doctor, the cat scan, ultrasounds and all other tests and biopsies...free, all done within 3 days, no pre certification needed, had to do nothing. The specialist that did my surgery - $40, and my follow up appointments are free. My copay for the hospital - $150.

With the proposed health care reform, I will lose this. Under the proposed healtcare reform, I would have to pay ~ $12,000 annually for what I get for free. There has to be a way to help out the unemployed without hurting the employed. When you consider that 258 million insured Americans could be hurt by the proposed healthcare reform, to some extent, something is wrong with the proposed plan.
 
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  • #20
Why shouldn't insurance companies try to cut the amount of money they pay out? The only way any company makes a profit is to bring in more money than you pay out.

I agree that the idea of having my health care decisions made by someone who benefits by giving me less health care makes me nervous. Is it that much worse than having your medical decisions made by someone who makes a profit by giving you too much health care?

SELF-REFERRING PHYSICIANS - Doctors Reap Benefits By Doing Own Tests - There's laws against doctors' offices selling prescription medications to prevent prescribing medications purely for profit. Only Maryland has any laws against doctors self-referring for medical tests.

Health Reform's Taboo Topic - Or is requesting unnecessary tests a natural reaction to the threat of malpractice suits if any disease is missed? (This is the side of the story that most doctors would give you.)

By the way, uninsured patients are usually given fewer medical screenings than insured patients, so the uninsured at least can't be blamed for this part of medical costs.
 
  • #21
BobG said:
Why shouldn't insurance companies try to cut the amount of money they pay out? The only way any company makes a profit is to bring in more money than you pay out.

You don't see a problem with having your insurance canceled if you have a major health problem; or being denied coverage due to a prexisting conditions?
 
  • #22
Evo said:
Hospitals advertise that if you don't have insurance, they will find alternatives to pay your bills. They actually hand you a brochure about the alternative options to paying your bills. I know, having been hospitalized twice in the last year. I have one brochure right here (I had major surgery a few weeks ago). Luckily my insurance paid for all of it.

It is interesting that medical bills are a major cause of bankruptcy.

Who pays for your medical care if you have no insurance? Please provide some examples of these brochures.
 
  • #23
Evo said:
With the proposed health care reform, I will lose this. Under the proposed healtcare reform, I would have to pay ~ $12,000 annually for what I get for free.

Please provide the evidence supporting this. I have seen nothing to support such a claim. First of all, one is supposed to be able to keep their current health care insurance if desired. The point is to get people covered who have no insurance and to reduce the cost of medical care.

What's more, I can get coverage now for less than that by paying for it outright. This is not a program that increases the cost of health care. $12,000 is about what it cost to insure a family of four. Do you still have three kids at home?
 
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  • #24
http://www.forbes.com/feeds/ap/2009/08/05/ap6743391.html"
By RYAN KOST , 08.05.09, 10:41 AM EDT
Associated Press


PORTLAND, Ore. -- Gov. Ted Kulongoski signed into law a bill that expands state health care access to nearly every child in Oregon.

...and 35,000 low-income adults. To pay for the expansion, the state is relying on a combination of taxes on hospitals and insurers.

...

The measure makes Oregon one of just 12 states that has universal health care for children.

I wasn't aware that so many states had such coverage. But it's nice to know that local governments are ahead of the game, as usual. Perhaps the hijacking insurer's can't keep up with 50 rogue states, and find it easier and more economical to target just the federal governments plan.
 
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  • #25
And as everyone knows, politicians are far less dangerous than insurance companies for the simple reason that we have to obey everything the insurance companies say but we can ignore what the politicians tell us to do. So that's why we should set the precedent to give the politicians sweeping power over our industry. Especially considering how all the nations throughout history that ever gave sweeping economic control to their politicians always did so well. Oh wait... never mind.
 
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  • #26
fleem said:
And as everyone knows, politicians are far less dangerous than insurance companies for the simple reason that we have to obey everything the insurance companies say but we can ignore what the politicians tell us to do.

So that's why we should set the precedent to give the politicians sweeping power over our industry.

Especially considering how all the nations throughout history that ever gave sweeping economic control to their politicians always did so well. Oh wait... never mind.

Nonsense.
 
  • #27
GeorginaS said:
REP. TOM PRICE: We don‘t want to put the government, we don't want to put bureaucrats between a doctor and a patient.
I never understand why American politicians think this way. I live in UK and I don't have to see a bureaucrat every time I wan't to see a doctor or get drugs. The cost of medicine is very low here (around £7 I think) and seeing an NHS doctor is free.

I dred to imagine living in a country where my health is in the hands of privately owned companies. I would rather pay the extra money and be in the comfort of knowing me or anyone else will get treatment when they need it. After all isn't the role of the government looking out for the wellfare of its citizens?
 
  • #28
Focus said:
I never understand why American politicians think this way. I live in UK and I don't have to see a bureaucrat every time I wan't to see a doctor or get drugs. The cost of medicine is very low here (around £7 I think) and seeing an NHS doctor is free.

I dred to imagine living in a country where my health is in the hands of privately owned companies. I would rather pay the extra money and be in the comfort of knowing me or anyone else will get treatment when they need it. After all isn't the role of the government looking out for the wellfare of its citizens?

Precisely, Focus, but if you watch the interview posted by Ivan, and read about the escalating scare tactics, lies, and propaganda currently being spread by the health insurance companies in the States, it puts into focus people's fears. Or, the fears of people who don't stop and question the words of the people shouting the loudest.

Witness Ms. Palin's most recent press release

http://www.salon.com/politics/war_room/2009/08/07/palin/"

Someone is feeding these people these words to say, and other people are actually listening.
 
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  • #29
Focus said:
I would rather pay the extra money and be in the comfort of knowing me or anyone else will get treatment when they need it.
The NHS costs much less to run, overheads are about 6% compared to 24-30% in the US.
After all isn't the role of the government looking out for the wellfare of its citizens?
You only think like that because you have been brainwashed by the fluoride that the communists put in the water to make you support the Queen.
 
  • #30
mgb_phys said:
You only think like that because you have been brainwashed by the fluoride that the communists put in the water to make you support the Queen.

Why would the communists make people support the Queen?
 
  • #31
Focus said:
Why would the communists make people support the Queen?

Because that's what the makers of fluoride want you to think.
 

1. How did for-profit insurers gain control of the health care system?

For-profit insurers gained control of the health care system through a combination of factors, including lobbying efforts, mergers and acquisitions, and the implementation of policies that prioritize profits over patient care. They have also taken advantage of the complex and confusing nature of the health care industry to increase their control and influence.

2. What impact has for-profit insurance had on the cost of healthcare?

For-profit insurers have significantly contributed to the rising cost of healthcare. By prioritizing profits over patient care, they have implemented policies that increase premiums, deductibles, and out-of-pocket expenses for patients. They have also negotiated lower reimbursement rates with healthcare providers, leading to higher costs for patients who are not covered by their insurance.

3. How have for-profit insurers affected the quality of healthcare?

The focus on profits has led for-profit insurers to prioritize cost-cutting measures, such as denying coverage for necessary treatments and medications, and limiting access to certain providers or services. This has resulted in a decline in the quality of healthcare, as patients may not receive the necessary care they need due to cost constraints imposed by for-profit insurers.

4. What alternatives exist to for-profit insurance in the healthcare system?

There are several alternatives to for-profit insurance in the healthcare system, including government-run programs such as Medicare and Medicaid, as well as non-profit health insurance companies. These alternatives prioritize patient care over profits and may offer more affordable and comprehensive coverage options.

5. What can be done to address the issue of for-profit insurers hijacking the healthcare system?

To address this issue, there needs to be significant changes in the healthcare industry, including stricter regulations on for-profit insurers, increased transparency in pricing and policies, and a shift towards a more patient-centered approach to healthcare. Additionally, promoting and supporting alternative options to for-profit insurance can help reduce their control and influence in the healthcare system.

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