Stanley Feld M.D.,FACP,MACE
Of course the CEO of Aetna would want mandatory healthcare coverage with the government providing a subsidy to consumers to buy healthcare insurance. The more lives insured the more profit his healthcare insurance company would make.
“Americans should be required to buy health insurance, bringing healthier people into plans that will help bring down costs, the chairman of one of the nation's largest private insurance companies told a Detroit audience Tuesday.”
This is obviously self serving. Massachusetts bought into this concept only to see the premiums and state subsidies go up. As long as the healthcare insurance industry’s administrative costs are opaque and not transparent the healthcare premium costs will not go down.
A mandatory system misses the point of the dysfunction in the healthcare system. The healthcare insurance industry would become more powerful. The healthcare insurance industry’s increased control over the healthcare system would add to the dysfunction.
The incentives of all stakeholders must be aligned and consumers must be in control of their healthcare dollar and not the healthcare insurance industry. The insurance company should be in control of the dollars spent after $6000 dollars.
“A mandatory system would help bring down costs and end a problem known in the industry as cherry-picking -- enrolling healthy applicants and rejecting those with prior medical problems -- because costs and risks would be spread over a larger group of people, Williams said.”
The cherry pickers are the healthcare industry. The healthcare industry is required to insure people in an employer group. However, if sick people are in the group the group premium is increased. Cherry picking occurs when an individual tries to buy insurance. If the consumer is 55 years old and recently unemployed he is unable to get insurance if he has hypertension and diabetes. If he could get insurance the premium would be high and he would be paying with after tax dollars. The healthcare insurance industry would love every healthy 20 year old to be insured.
Mr. Williams has produced a smoke screen to give states the idea that they should make health insurance mandatory. He has no interest in repairing the system because that would decrease Aetna’s profit.
Williams is also in favor of:
“• Selling health insurance across state lines, a proposal favored by Republican presidential candidate John McCain.”
The healthcare insurance industry has lobbied John McCain to take this position. This form of deregulation would have adverse effects on the healthcare system. State Boards of Insurance can eliminate insurance abuse by refusing to grant a health insurance carrier a permit to sell insurance in its state because of abuse. So far state boards of insurance have not imposed this penalty. Healthcare insurance company abuse has only been punished by weak and insignificant monetary fines. John McCain would eliminate this potential protection for consumers.
“• Expanding access of those now eligible for Medicare and Medicaid programs.”
John McCain would also like to eliminate the Medicare entitlement. He would like to move all Medicare patients to private sector run Medicare Advantage program. The Bush Administration has increased the subsidy to the healthcare industry for Medicare Advantage $3,600 per patients. The healthcare insurance industry has increased profit last year by over 5 billion dollars from the Medicare Advantage program with only 20% of the potential patients being enrolled. .
"No candidate has the right answer," Williams said.
Neither candidate's program suits Mr. Williams’ goal of increasing his massive profits.
John McCain essentially has no program. Mr. Williams and Aetna would have to continue to build up it power slowly.
President-elect Barack Obama has a program that will fail because it is outsourced to the healthcare industry. In my next post I will explain how he can convert his healthcare plan to a healthcare plan that will succeed.