Friday, June 22, 2007

A brief history of US health insurance

I've cherry-picked another quote for you:
At the forefront of these service (non)providers was U.S. Healthcare, which grew out of the first for-profit HMOs in the 1970s. By the early 1990s, it was the largest publicly traded HMO, with annual revenues of more than $1 billion. The company -- a notorious proponent of gag clauses in physician contracts that prevented doctors from giving patients a thorough description of their treatment options -- took on the mission of revolutionizing the insurance industry. In a 1992 interview with Business Week , U.S. Healthcare founder and chairman Leonard Abramson expressed scorn for traditional carriers, calling them "dinosaurs" and saying they operated in "a dying world." [emphasis mine]

We should be giving tax dollars to this industry? One that prevents your doctor from telling you about all possible treatment options for whatever ails you? No.

It's a readable and not overly techincal review of the industry's morphing from social insurance [premiums are the same for everyone, and risks are spread over as large a pool as possible] to actuarial insurance [individual premiums are based on individual risk, and high-risk members are "encouraged" to drop out of the pool].

Those "dinosaurs" mentioned in the quote above were of the social insurance persuasion, whether they were for-profit or non-profit, and they predominated until about the 1970s. There were flaws, and health care costs were rising*, but our present-day system is almost entirely actuarial now, and things are just worse. Much worse.

* Just thought I'd point out this sentence fragment [top of page 2 of the article]: "... escalating health costs -- a problem that was greatly exacerbated by the growth of for-profit hospital chains."


Steve Bates said...

Before Bush came along, predatory medical insurance practices were the only thing that ever made me think of emigrating. Almost 30 years ago, I experienced the Austrian medical system firsthand, and realized that all the horrors we are told about are baldfaced lies, or at least gross exaggerations. Humane healthcare (humane, not to be confused with Humana!) is possible and affordable, but it's going to take a systemic change that will meet with a lot of resistance.

Each month that I open my private insurance bill, I realize how ready I am to fight that battle. If a political party (especially my own) wants to prove to me that they have my interests at heart, they can pursue, seriously, affordable healthcare for every American, no exceptions.

Anonymous said...

At some point I'm going to write a post on this, as I have looked at it from every angle, and the current "system" is insane.

I had "socialized" medicine in the military, single-payer in Rochester, NY [short explanation - major corporations negotiated one contract that covered everyone who wanted it in the county, and almost everyone opted in], the HMO mess.

Single payer works, is cheaper, and provides better service.

hipparchia said...

predatory and insane are both good descriptors of what we have now. i believed all those half-truths, mischaracterizations, and bald-faced lies about "socialized" medicine until recently.

i look forward to your post, bryan.

daveto said...

pour vous ..
In Search of the Health Care Candidate
By Tobin Harshaw

Tags: worth a click

The coastal elites may all be talking about Michael Moore’s “Sicko,” but what do average folks think of America’s health care system? Joseph Paduda at Managed Care Matters has the scoop on the latest Kaiser Family Foundation poll, where health care is the top domestic concern, but ranks a distant second to the war on Iraq. “Among health care ’sub-topics,’ ” Paduda notes, “voters most wanted to hear candidates talk about covering the uninsured (36 percent) followed by health care costs (21 percent). Alas, quality barely registered, with only 2 percent of respondents naming quality as one of their top two interests.”

And according to the poll, there doesn’t appear to be a health care savior among the 2008 presidential crowd. “The poll also asked respondents which candidate’s views on health care best reflected their’s; 59 percent of respondents could not name one,” Paduda writes. “Democrats preferred Clinton while Republicans liked Giuliani — BUT no candidate from either party has much traction, and the Mayor led with a mere 9 percent.”

For his part, Barack Obama seems to be seeking healing of a spiritual kind, telling an audience that faith got “hijacked” by the religious right. But Ann Althouse isn’t buying it:

It’s entirely distracting to use the word ‘hijack,’ especially if the problem you’re talking about has nothing to do with what we saw on September 11th but is simply the way some Christians take the conservative side on various issues and, failing to content themselves with mere belief, participate in politics. According to Obama, Christianity should move a person to political action — Obama himself was speaking to a church congregation — but only on the progressive side. Yet he said that in traveling around the country he had sensed an “awakening” of an interfaith movement of “progressives.” ... Obama’s famous rhetoric looks entirely self-contradictory. If he’s trying to stimulate liberal Christians to political action, he too is using faith to “drive us apart.”

It may not have any cute kitties or dancing dorks, but a video recently posted on YouTube is creating quite a fuss in the blogosphere. According to Walter Olson at Overlawyered, the clip shows “ attorneys for Cohen & Grigsby, one of the largest law firms in Pittsburgh, explaining at a conference on immigration how to obey laws that require Americans be given top priority for jobs while still ensuring foreigners are hired.”

hipparchia said...