Mergers bad for health
Decision to block insurers good for the rest of us
Nothing sparks greater frustration for patients, doctors or health administrators than a call to a health insurance company.
Patients trying to sort out bills can spend hours on hold. Doctors become infuriated by claims specialists questioning their medical judgment, and hospital administrators complain executives will not return their calls when they want to join a network.
All of these people should rejoice in the Justice Department’s decision to block four of the five largest health insurance companies in America from merging.
Health insurance companies, by definition, seek to make money by managing health insurance costs. They collect premiums from hundreds of millions to pay the bills of tens of millions. To make that work, they need to suppress use of the health care system and minimize prices paid to health care providers.
Health insurers have discovered the best way to do this is to become so large, and so powerful, that they don’t have to care what their consumers (you and me) or their subcontractors (health care providers) think about them.
All they need to do is save money for the people
who choose them (employers).
This is the great lie about America’s health care system. Private insurance doesn’t give consumers any choice, since our employers pick what plans we can join. The insurance company picks the doctors and hospitals that are “within network.” And in an emergency, we are at the mercy of whatever safety net a community has created.
Most senior citizens love Medicare because they have more choices and less fuss.
Most doctors and hospitals take Medicare, and the government guarantees the same level of care for everyone. The basic costs are paid from taxes they paid during their working years.
But Republicans have pushed for privatizing Medicare, and that’s led to Medicare Advantage, which allows senior to pay a little more and get a few more benefits if they allow a private insurance company to manage their Medicare benefits. That means limiting themselves to the private insurer’s network, or pay even more.
The proposed mergers of Anthem with Cigna, and Aetna with Humana, would not only have limited options in the private insurance market, but they would have combined the biggest providers of Medicare Advantage plans. That would mean these companies would have even more power over the largest share of the health care market: senior citizens.
There are many problems with the U.S. health care system, and I write about those problems on a regular basis.
Whenever I suggest a single-payer system like those used in other industrialized countries, inevitably someone objects to big government bureaucrats controlling their health care.
I would argue big business bureaucrats are already controlling our health care.
And thankfully, the Justice Department is trying to keep them from becoming even more powerful.