Private Health Insurers Can't Compete With the "Public Option": Medicare

| Wed May. 20, 2009 11:08 AM PDT

In case you had any doubts, here’s the real reason why insurance companies don’t want health care reform to include a so-called public option: These champions of freemarket capitalism know that they simply can’t compete with a government-run plan.

The insurance lobby is already trying to scare people off the idea of a public  option, warning that the government will leave all of us to die slowly and painfully as we try to wade through its bloated bureaucracy. (One example of the industry’s PR efforts appears at the end of this post.) But the truth is that on a level playing field, the government would probably drive private insurers out of business, because it can deliver health care more effectively and efficiently than any profit-driven corporation.

This isn’t something we need to speculate about, since we already have a government-run health plan on which to base comparisons: Medicare. For years, studies have shown a high level of satisfaction among Medicare beneficiaries. Last week, a new study released by the Commonwealth Fund revealed how Medicare measures up against private plans. It was bad news for the insurance industry.

Elderly Medicare beneficiaries are more satisfied with their health care, and experience fewer problems accessing and paying for care, than Americans with employer-sponsored insurance (ESI), according to a study by Commonwealth Fund researchers….The gap between consumers’ ratings of Medicare and ESI has widened since a similar survey in 2001….

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Thirty-seven percent of elderly Medicare beneficiaries rated their coverage as excellent, versus 20 percent of the employer group. Meanwhile, only 8 percent of elderly Medicare beneficiaries rated their insurance as “fair” or “poor,” compared with 18 percent of those with ESI.

Survey results demonstrate that Medicare beneficiaries are less likely than those with private coverage to report negative experiences with their insurance plans — including having expensive medical bills for noncovered services, being charged a lot more than insurance would pay, and physicians’ not taking their insurance….

Other study highlights include:

• Access to care. In spite of having poorer health and lower incomes than those with ESI, elderly Medicare beneficiaries were less likely (20 percent versus 37 percent) to report access problems due to cost, such as not filling a prescription or not visiting a doctor for a medical problem.

• Financial pressure. Despite their lower incomes, elderly Medicare beneficiaries reported fewer problems with medical bills, such as inability to pay or being contacted by collection agencies. Fifteen percent of them reported at least one of these problems, compared to 26 percent of those in the employer-coverage group. Furthermore, elderly Medicare beneficiaries were no more likely than those with ESI to be devoting 5-10 percent of their income or more to health care.

• Quality of care. Sixty-one percent of elderly Medicare beneficiaries said that they had received excellent or very good care, compared to just half of those with ESI. Moreover, 57 percent of elderly Medicare beneficiaries were confident that they could get high-quality, safe care in the future, versus 46 percent of those in the employer group.

So, to summarize–actual consumers of the various types of health care plans say Medicare is better, easier, cheaper, and fairer than private insurance. With results like these, you have to wonder: Why do we need a private option?

That, of course, is the question insurance companies don’t want us to ask–which is why they’re launching PR campaigns like this one, revealed on Monday in the Washington Post’s “Daily Dose” blog:

One week after the nation’s health insurance lobby pledged to President Obama to do what it can to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing touches on a public message campaign aimed at killing a key plank in Obama’s reform platform.

As part of what it calls an “informational website,” the company has hired an outside PR company to make a series of videos sounding the alarm about a government-sponsored health insurance option, known as the public plan….In three 30-second videos, the insurer paints a picture of a future system in which patients wait months for appointments and can’t choose their own doctors, according to storyboards of the videos obtained by the Washington Post.

One video titled “Waiting” shows a receptionist fielding a request from a patient enrolled in the new program. “The government plan. Okay hold on…let me see what’s available,” the woman says into the telephone. On the screen, with the caller on hold, the receptionist rearranges items on her desk, looks at a wide- open calendar and then fibs: “It looks like the first time we can fit you in is in two-and-a-half months.”

Another spot in the series, being developed by Capstrat media in Raleigh, shows a woman and child wandering down a darkened hospital doorway “as if they’re starting to realize that they’ve lost their way,” according to sketches of the video. “We can do a lot better than a government-run health care system,” the narrator concludes.

Apparently, America's old folks disagree.

This post also appears on Unsilent Generation, James Ridgeway's blog on the politics of aging.

James Ridgeway is a senior correspondent at Mother Jones. For more of his stories, click here.

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Comments

Although it may be true, as

Although it may be true, as the ad states, that “We can do a lot better than a government-run health care system,”, it should be pretty clear by now that the private insurance companies are highly unlikely to do so since their prime motivator is increasing profits.

So, how much do doctors prefer dealing with the government?

Let's see if this 2008 survey of doctors sheds any light:
An overwhelming majority – 78 percent – of physicians believe that there is an existing shortage of primary care doctors in the United States today. Additionally, nearly half of them – 49 percent, or more than 150,000 practicing doctors– say that over the next three years they plan to reduce the number of patients they see or stop practicing entirely. ... The reported reasons for the widespread frustration among physicians include increased time dealing with non-clinical paperwork, difficulty receiving reimbursement and burdensome government regulations. Physicians say these issues keep them from the most satisfying aspect of their job: patient relationships. ... “Tens of thousands of primary care doctors face the same problems as millions of ordinary citizens: frustrations in dealing with HMOs and government red tape,” said Sandra Johnson, Board Member
Source: The Physicians Foundation

they didn't differentiate

they didn't differentiate between the bureaucracy of the HMOs or the government. That was your emphasis. Most people with private insurance HMO plans I know at the last three employers I worked for will tell you that the red tape of the private companies is just as arbitrary and unresponsive a labyrinth as the worst of government programs... And as a former HR manager who saw the declining services, smaller physician networks, and stricter regulations of reimbursement and deductible submissions and how it affected my employee's willingness to go see a doctor, I am ready for some discussion of substance on what this option could look like. I would prefer to see more pieces from MJ about structural proposals that are emerging in policy circles rather than a rehashing of PR points that discuss how this won't be replicated in a government option...

Exactly!!

they didn't differentiate between the bureaucracy of the HMOs or the government. Yes.., Exactly!! They're saying government is driving them away from practice as surely as any other factors. They obviously see the government as no improvement over what they're dealing with now, and they're apparently not eager for the government to "kiss it and make it all better". Many doctors are already refusing to take new medicaid and medicare patients. Here are some of the survey's Key Findings, regarding the doctors' opinions about government:
Government * - “Declining reimbursement” rated highest on list of issues physicians identify as impediments to the delivery of patient care in their practices, followed by “demands on physician time” [63% of doctors said non-clinical paperwork has caused them to spend less time with their patients 94% said time they devote to non-clinical paperwork in the last three years has increased] * - 82% said their practices would be “unsustainable” if proposed cuts to Medicare reimbursement were made * - 65% said Medicaid reimbursement is less than their cost of providing care and 36% said Medicare provides reimbursement that is less than their cost of providing care * - Over 33% of physicians have closed their practices to Medicaid patients and 12% have closed their practices to Medicare patients
Links to this and more info are available here: Physicians Foundation Survey of Doctors

UK health care is horrible

My daughter lives in London for school and has had a terrible time getting proper health care. The physicians don't really care, they don't really help, and she has to wait until she comes home for visits to have medical needs taken care of. If you like a public health care option so much, then you fly to Canada or the UK and try their system out first, before taking my hard earned dollars and trying it here.

The UK probably didn't have Medicare as a prototype

tagged as: 
The UK is the UK. Canada is Canada. You can take your hard-earned dollars to a private insurer. Your tax dollars, however, are subject to the democratic process. Besides, a gov't health plan would lower YOUR insurance premiums as well. More than negating any paltry health taxes. You should get behind it, its a win-win.

Uk Healthcare

I've lived in the UK for the past 30 years and by comparison to the USA I can see my doctor (one I've chosen) anytime, without any great wait and for free- so I DO go and use the service when I feel I need it, rather than when I can afford it- unlike when I was in the USA and un-insured. And I feel that my health is a LOT better as a result. Medical needs that are pressing or urgent are taken care of quickly and effectively. My doctor is helpful and the treatment is well considered and effective. My daughter had UK orthodontic treatment over a 2 1/2 year period and was well attended to, despite the common view that UK dental care is poor. Since then, she worked in the USA and went to a dentist there that "found" she needed treatment costing thousands of dollars- just revenue generation since it wasn't really needed at all. Why is American medicine so expensive- because the doctors can make it so. Here in the UK there's more emphasize on preventative medicine and less on "defensive" tests and procedures that are not needed. Thing is, lots of people in the UK CAN have private insurance and use private medicine... but few choose to so waste their money. And its interesting that you don't look to those countires such as France, Germany and the Scandanavian ones as exemplars of the BEST of socialized medicine, rather than the UK or Canada. Seems that the American model would look to the best of foreign systems as its guide. Americans pay the most for the worst outcomes... just look at any comparative statistics instead of anecdotal stories....

Health Care for ALL Americans is Simple!

tagged as: 
Hmmm… Health Care for ALL Americans is Simple! 1) Merge Medicare with Medicaide into one single "Income Based" system for elderly and poor citizens. 2) Require insurance companies to provide the same basic coverage for all Non-Medicare/Medicaide citizens, regardless of health status, at affordable rates. 3) Allow insurance companies to profit by offering additional benefits and options to those who qualify and are willing to pay the difference. As for Funding… 1) Changing from an "Emergency Treatment" to a "Preventive Care" system will save local communities billions, maybe even trillions of taxpayer dollars! 2) Small business will be able to compete globally and hire additional taxpaying employees! 3) Wealthy seniors will pay their fair share! 4) The tremendous burden on future generations will be greatly reduced! Hmmm... www.jpinsatx.newsvine.com/

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Private companies administer Medicare

that's why people like it so much. Blue Cross takes care of the medicare claims processing on behalf of the government in many states. Medicare is not government run.

Health care

My high deductible plan has more than doubled in the last four years.
Lots of hard earned money shelled out for mediocre results in my opinion.
$17,000 per year is hardly free - that's what we pay after funding our HSA.
Impossible to shop for health care - the true market of costs is never really established because of that. Beauracrats and the government are deciding the market, not you an me ,and affordability.
Health care needs a quick dose of reality - they have priced their product beyond average affordability.
Glen Beck said it costs $600.00 per month, per person - that's $24,000 per year for a family of four. By the old standards of 10% for health care spending, the average income in America should be $240,000 for a family of four.
Maybe a doctor can't make it on medicare rates, maybe he or she should think again. If we had a true free market based on real consumer affordibility I think they would find those rates are about right on for the average incomes.
My son's last level one doctor visit was $120 list, reduced to $59 by my insurance company. On his last visit our bottom line price was $42.00 - that's a 40% increase in this "down" economy. Of course, the only way to find the price is to have the service performed.
The actual time with the doctor was at best 5 minutes - that's about $1440/hour at list, $708/hour with insurance discount, and $384/hour at Canada's $32 doc visit rate.
By the way - after a clean bill of health from his doctor, my son developed a few days later a rash at night from his pesky virus that we visited the doctor about. Went to emergency room - he actually had walking pneumonia. Diagnosed, treated, and totally wiped out by this outstanding doctor.
Very happy to pay that $1500 list, $750 discounted bill. Livid about the 40% increase $59.00 office visit.

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online

The Center for Media Research has released a study by Vertical Response that shows just where many of these ‘Main Street’ players are going with their online dollars. The big winners: e-mail and social media. With only 3.8% of small business folks NOT planning on using e-mail marketing and with social media carrying the perception of being free (which they so rudely discover it is far from free) this should make some in the banner and search crowd a little wary.

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