Insurers Spin Data to Fight Public Plan

Washington Post: Insurance Industry Argues Drastic Changes Unnecessary, Americans Happy with Current Plans

(Washington Post)  This story was written by David S. Hilzenrath.

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The industry that helped scuttle health reform 15 years ago with its "Harry and Louise" ads is back, voicing support for a central element of the Obama administration's plans: making sure everyone is covered.

That does not mean the industry is backing the administration. Indeed, the leader of the insurance lobby has sent lawmakers a message: Be careful what you change, because "77 percent of Americans are satisfied with their existing health insurance coverage."

Karen Ignagni, president of America's Health Insurance Plans (AHIP), invoked the statistic to argue against the creation of a government-run insurance option. But the polls are not that simple, and her assertion reveals how the industry's effort to defend its turf has led it to cherry-pick the facts.

The poll Ignagni was citing actually undercuts her position: By 72 to 20 percent, Americans favor the creation of a public plan, the June survey by the New York Times and CBS News found. People also said that they thought government would do a better job than private insurers of holding down health-care costs and providing coverage.

In addition, data from a Kaiser Family Foundation poll last year, compiled at the request of The Washington Post, suggest that the people who like their health plans the most are the people who use them the least.

Those who described their health as "excellent" - people who presumably had relatively little experience pursuing medical care or submitting claims - were almost twice as likely as those in good, fair or poor health to rate their private health insurance as excellent.

The level of satisfaction expressed with private insurance was essentially the same as that with Medicare, the government program for the elderly and disabled.

The industry's stance against a public health plan revives shades of 1994, when it was instrumental in blocking President Bill Clinton's health-care proposals.

"A government-run plan would turn back the clock on efforts to improve the quality and safety of patient care," AHIP has argued. Such a plan "will ultimately limit choices and access," the big insurer WellPoint contends.

But systemic problems have persisted for 15 years, and it is not clear how much private insurers have done, or can do, to solve them.

"Insurers promise choice, they promise innovation, they promise a lot of things, but I think they've delivered very little," said Alan Sager, professor of health policy and management at Boston University. "I think net they give us very bad value for the 10 to 20 percent share of the health dollar they skim off the top."

Instead of choice, they offer "the illusion of choice," he said.

Health-care costs have continued to rise faster than personal incomes and economic growth. Even the industry agrees that much of the spending is wasted, exposing patients to unnecessary risk.

Insurers argue that a government plan could dominate the market, reducing consumers' options. But in the private market, options are limited by employers who restrict employees' choice of insurers and by insurers who restrict their choice of doctors.

Cigna, one of the nation's largest insurers, took away its own employees' alternatives in 2006 and left them with only high-deductible coverage.

"There were a lot of unhappy people," said Wendell Potter, who until last year was Cigna's head of corporate communications. For many people enrolled in such plans, "the deductibles are so high that they forgo care," he said.

Long a defender of the industry, Potter has become an outspoken critic of what he calls its "duplicitous" public relations and lobbying campaigns.

Few people have a better vantage point on the industry's efforts to improve quality and efficiency than Joseph P. Newhouse, professor of health policy and management at Harvard University, editor of the Journal of Health Economics and member of the board of insurance giant Aetna. Asked what results the industry's innovations have yielded, Newhouse said: "It's just very difficult to give much of an evidence-based answer to those questions . . . in either direction."

With respect to the disease-management programs the industry touts - efforts to make sure people with chronic illnesses get the care they need - "by and large, the literature suggests it works in some cases, but those cases are fairly limited," he said.

AHIP has produced a stack of glossy reports describing health insurers' efforts to improve care. In recent testimony, Ignagni said private health plans serving the elderly have been highly successful in reducing hospital admissions and readmissions for patients with diabetes and heart disease.

Yet one of the AHIP reports says that in an Aetna Pathways to Excellence hospital incentive program, "readmission rates did not improve significantly."

Opponents of a public option argue that it could put government bureaucrats between patients and doctors. Today, for people with commercial or employer-sponsored coverage, care is overseen by private bureaucracies. Where government bureaucracies answer to the body politic, the corporate versions answer to Wall Street.

The issue of whether a public plan would be more successful at bringing costs under control is harder to evaluate. As a prototype for government-run health care, Medicare has failed to control costs and makes little effort to restrict care.

Economists generally agree that if costs are to be brought under control, someone must say no to care that doctors propose and patients demand. So far, that role has fallen primarily to insurers.

"Private insurers have effectively engaged in rationing, so they're doing the dirty work for everybody else," said Jeff D. Emerson, a former health plan chief executive. "It's a thankless job . . . but somebody has to do it or health care will be even more expensive than it is now."

Private insurers might be better situated than the government to do the unpopular work of saying no, said Paul B. Ginsburg, president of the Center for Studying Health System Change, because they are less susceptible to political pressure.

[midwesterndude]

Will Congress do the right thing and pass the President's proposed Affordable Health Choice Act (AHCA) or will it be blocked by members of the GOP like Sen. DeMint of SC who are trying to play partisan politics with a very real and very troublesome health care mess brewing here in America?

Though far from perfect, the proposed health reform act will bring more accountability to how federal funds are spent on health care and will offer an affordable option to approx. 30 million Americans who have NO HEALTH INSURANCE. Treating someone's medical illness before it results in expensive hospitalizations saves the country money in the long run.

Having an "affordable option" does not threaten the Big HMOs who are crying wolf in order to keep control of the insurance industry. How can a small business owner( during these tough times) afford to pay $600/mo for an employees health insurance plan? How can the employee
(and his/her family) afford to pay the $2500 deductible on the less expesnive health plan that the business will switch him/her to in order to save money??

The federal government runs the USPS which provides affordable mail services for all Americans. Has this version of an "affordable option" led to the demise of UPS, FedEX, or DHL??? Nope and a health care version of it won't hurt Blue Cross/Blue Shield, Aetna, or Cigna as their DC lobbyists claim......America needs health reform not more of the same old Washington politics.

[karma0108]

Please do not talk about the truly disabled. I worked my whole life since 16yrs old. I am now 58. I worked for Amex for 20 yrs. I lost all my 401k money after 9/11 and the company downsized so I lost my job also. I started to work at the State and after 8 1/2 years became totally disabled. I am in shock and feel depressed, and hopeless. If I had been able to work the 10yrs I would have only had to pay $45.00 for the rest of my life for medical that covered everything, as the Empire plan is the top of the line for medical, but a steep price if you are not covered under NYS plan, or become disabled. Now I have to pay full amount of 541.00, then after that COBRA. I am under SSDI and have only that amount of money coming in. No one wants to be disabled, but please remember it can happen to you or anyone, so Please at least get some medical reform in place for the disabled, the Medicare is good, but a wait of 24 months when you are disabled and have no income, how do you pay for health insurance. For me it is giving up everything I ever worked so hard for and lost through no fault of my own.
I hope the President will take into consideration the truly disabled worker that has worked his or her whole life, and through now faul of their own are totally disabled. Please implement something like the employees of the the state of NY have, and the congress, etc that they pay under an umbrella package, for everyone. Look at the cost of medical insurance that a NYS employee pays, why can't everyone be under that kind of plan. People would pay and be covered..... Thank you for listening.

[karma0108]

Please do not talk about the truly disabled. I worked my whole life since 16yrs old. I am now 58. I worked for Amex for 20 yrs. I lost all my 401k money after 9/11 and the company downsized so I lost my job also. I started to work at the State and after 8 1/2 years became totally disabled. I am in shock and feel depressed, and hopeless. If I had been able to work the 10yrs I would have only had to pay $45.00 for the rest of my life for medical that covered everything, as the Empire plan is the top of the line for medical, but a steep price if you are not covered under NYS plan, or become disabled. Now I have to pay full amount of 541.00, then after that COBRA. I am under SSDI and have only that amount of money coming in. No one wants to be disabled, but please remember it can happen to you or anyone, so Please at least get some medical reform in place for the disabled, the Medicare is good, but a wait of 24 months when you are disabled and have no income, how do you pay for health insurance. For me it is giving up everything I ever worked so hard for and lost through no fault of my own.
I hope the President will take into consideration the truly disabled worker that has worked his or her whole life, and through now faul of their own are totally disabled. Please implement something like the employees of the the state of NY have, and the congress, etc that they pay under an umbrella package, for everyone. Look at the cost of medical insurance that a NYS employee pays, why can't everyone be under that kind of plan. People would pay and be covered..... Thank you for listening.

[sjc_1]

If you were siphoning off part of the $200 billion in profits from exploiting the sick, you would fight tooth and nail to keep it going too. If you want to help people, join the Peace Corp. If you want to get rich in America exploit those in no position to defend themselves.

[cydygitt1]

Many economists say insurers face very little competition now across large swaths of the U.S.

Various studies have found that health insurance is one of the most concentrated markets in the U.S., and that the lack of competition may be one factor behind sharply rising premiums. Each year, the American Medical Association surveys the competitive landscape for commercial health insurers; the latest report found that out of 314 metropolitan areas across the nation, 94 percent can be defined as highly concentrated, with two companies or even a single provider dominating the market. In 15 states, one insurer has half or more of the entire market, and in seven states, a single insurer has 75 percent or more.

This concentration has become a potent argument for supporters of a public plan, President Obama among them. Such a plan would theoretically lower administration costs. And with no need to generate profits for shareholders, it could offer lower premiums ? thus applying precisely the kinds of pressures that are most needed.

[noloyalisti]

The medical insurance companies are the epitomy of the aristocratic corporate elite who own and run our government. They want us to take all the risk while they reap all the reward. They want us give their corporate CEOs billions in bonuses and then bail them out when they get in trouble. They want to ration health care and stand between us and quality health care. They are bad actors, do we really want them here in America?

[ncapps0924]

I have health insurance and NO I do not like it. I always have thousands of dollars in out-of-pocket costs after the insurance company pays. Just had a $700 test done and I'm stuck paying $300. I'm an insurance broker and deal with folks daily that want insurance but can't afford it or are sick so the insurance companies don't want them. It's broke. Fix it. Meanwhile, think of healthcare reform as a three-legged stool with insurance only one of the broken parts...there's also the high cost of medical care (ever see a physician in a hospital come by and just scan your patient barcode but not do anything for you... talk about scamming!)with malpractice/legal abuse as the third component.

[cydygitt1]

"Instead of choice, they offer "the illusion of choice," he said.

Health-care costs have continued to rise faster than personal incomes and economic growth. Even the industry agrees that much of the spending is wasted, exposing patients to unnecessary risk.

Insurers argue that a government plan could dominate the market, reducing consumers' options. But in the private market, options are limited by employers who restrict employees' choice of insurers and by insurers who restrict their choice of doctors."
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The for-profit insurance companies have been limiting care, denying care and dropping those with insurance for years when they need health care the most, just to improve their bottom line.

"The illusion of choice" by the for-profit insurance companies is NO CHOICE, and even the health care industry agrees that it is a cesspool of waste and abuse with a 37th in the world ranking!

Insurers have already restricted the patient's choice of doctors while raising premiums 130% over the past 10 years -- and there is no reason for them not to continue to squeeze the American populace in the future while their profits continue to soar!

We need true health care reform now, before the 80 million baby boomers retire over the next 2 decades, and some type of single-payer system would be the best for covering all Americans and keeping costs from bankrupting America.

[tazmjam]

I am totally disgusted with the scare tactics being used by insurers and other groups opposed to healthcare reform. All these commercials about rationing, and Canada and the UK?s terrible healthcare systems which makes you wait months to be treated for life threatening conditions. Why all the concern now...is it because they care about the average American getting the best care in the world? I don?t think so. I think it has more to do with profit, namely their own. Our healthcare system has been broken for years for many people and it is unwise to assume because it is working for you now that it will continue to do so. Think about how premiums and out of pocket expenses seem to increase every year. One lost job, one major illness, can change your situation in a heartbeat. Money can be save if everyone is covered under some type of health insurance, a lot of these pre-existing conditions that insurance companies refuse to cover can be controlled with proper medication and treatment at minimal cost. These same conditions left untreated because of lack of insurance can cause people who could live a normal life to become disabled. Why should you care...because once their disease progresses to the point they can no longer work they will cost you money through SS disability and Medicare or Medicaid. So not only has someone?s quality of life been lowered but now they must be taken care of. This country used to be known for its innovations...surely we can do better with healthcare than other countries. A reminder to congress...you work for us not the insurance lobbies. If you oppose the bill offer feasible alternatives, because very few people will say healthcare in this country does not need fixed. As for the dingbat leadership in the House of Reps. Nancy Pelosi please...shut up. If a fund is established to pay for healthcare you people need to keep your grubby little hands off it, if there is savings that?s what it should be savings, we may need it in the future for Healthcare. Your stupid remark that if there is enough healthcare savings we can spend what is left over to pay down the debt is fueling the fire for people to yell about rationed care and Washington wasting more of our money. Don?t you people learn from the past? Social Security would be on much firmer ground right now if congress had not treated the money left over like their personal piggy bank...if the money hadn?t been touched Social Security would be fine for at least the next 40 years, instead we will have to pay the money back and include it as part of the budget. Can you people in Washington at least try to get something right?

[noloyalisti]

Yes, the Republicans, those who have NO plan except to obstruct and keep the status quo for their corporate masters< are just doing what they do best: LYING.

Canada and most of the European countries have much better health care systems and ALL PAY LESS. Here we all pay for the rich to have good health care. America, the land of socialism and welfare. For the rich.

[cydygitt1]

tazmjam with total logic says:
"This country used to be known for its innovations...surely we can do better with healthcare than other countries. A reminder to congress...you work for us not the insurance lobbies. If you oppose the bill offer feasible alternatives, because very few people will say healthcare in this country does not need fixed."

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Excellent post with excellent points, proving that those still in DENIAL about our cesspool of waste and abuse known as for-profit health care in America, are just water carriers for the American health care debacle and really need to offer remedies for this outrage and not more LIES and INUENDO in the form of FEARmongering!

America CAN do better, but first everyone needs to at least admit the failings of the current for-profit health care debacle, and stop placating the GREEDY lobbyists with their FEARmongering advertisements!

[stillwaters6]

77 percent of those who still have a job are HAPPY. what's that 77/100


what about the 6.8 MILLION AMERICAN people who do not have a job and the company was not able to ask??? What about the 23 Million underemployed Americans that are priced out of the system??? Do their thoughts count??? NO

BUT GUESS WHAT...THEIR VOTE DOES...at least for now...

[speakinup22]

A small percentage of US citizens will use this budget buster.

See this article, curtosy of Alpha10000, a liberal:
http://online.wsj.com/article/SB124580516633344953.html

[noloyalisti]

Great article speakinup22! Of course the insurers are spinning facts, that's what they stand for. Do we really want to continue to put up with inefficient, greedy insurance and drug companies rationing our health care? Do we really want to continue to pay for the rich to have good health care while the rest of us suffer?

Public option and then universal single payer is the only way to go. Why should there only be socialism for the rich?

[noloyalisti]

We are like barbarian in this country. Health care is a basic human right. Here, where the big corporations own and run the government, we all want to pay for the rich to have health care. And 20% of the country's wealth for the top 1%. What the heck is wrong with us?

[elliesamericana]

The reality is we need a single payer system designed to do one thing, pay the bill. I'm a health care professional and I do not work for free. Sadly, with our current system of private insurance some 52 million Americans cannot pay the bill and most others are simply a job loss away from losing their health care. The insurance companies like their huge profit margins. Back when Clinton tried this the insurance companies creamed off about 5% of each premium dollar, now it's more like 23%. These are their profit dollars that they get from denying claims and dropping their insured who suddenly need care. With our hodgepodge system America ranks around 25th in rank of world healthcare. The 24 nations that beat us all have one thing in common, some form of national health care. As a nation, we already spend the money to fund health care for all Americans. The money is there, it just needs to be allocated to health care coverage, not private insurance company profit. I'm glad to be a "have" when it comes to health care. I got America's government health care during my 28 years of military service, now I have both military retiree & VA healthcare. Plus, as a state employee, I'm covered by their government plan. Most Americans are not that lucky, through no fault of their own. I still have Sen Grassley's idiot comment in my head "if you want health care like mine, go to work for the Federal Government." Great advice for 52 million uninsured. Respectfully, retired US Army Medical Officer.

[cydygitt1]

"As a nation, we already spend the money to fund health care for all Americans. The money is there, it just needs to be allocated to health care coverage, not private insurance company profit."
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Exactly! The money is already there to the tune of 18% of GDP or $2.5 Trillion in 2008, and just needs to be allocated for health care and not PROFITS in the cesspool of waste and abuse by insurance companies!

[SomeGuy_9128]

I have to agree with AHIP here; "A government-run plan would turn back the clock on efforts to improve the quality and safety of patient care." The government has a long history of being inefficient. I just don't see a government option being an improvement. While the insurance industry is part of the problem, the lion's share of the blame rests with the health care industry. Costs rising faster than personal incomes and economic growth. Unnecessary tests and procedures being ordered by providers trying to protect themselves from liability suits. There are a lot of factors behind the health care crisis but the simple fact is the cost of medical care is where the problem needs to be attacked first. I am deeply worried about what is on Obama's agenda right now.

[endurorob]

O.K. Most agree there are problems with the health care system. My question is how how do you fix something that is excessively expensive by throwing more than a trillion dollars at it? That is just feeding the beast.

[proud_churchgoer]

There is nothing wrong with our healthcare system. Service is great and prices are reasonable. Liberals hate it because it isnt free. Well there is nothing free liberals.

[dmwj2]

A "Proud Churchgoer" should know of the suffering that our current system causes... What would Jesus do? Let people die in the streets? Or try to find a way to help? What say you?

[speakinup22]

Christians aren't perfect, dmwj2. Only Christ was. They do get forgiven.

Somehow, I kind of doubt your concern for prou_churchgoer is related to their ecumenical well being. Rather, it is but another thoughful slam from an unbeliever that wants something for nothing.

Well, you got it from me... free advice - get God, get rid of Obama.

[cydygitt1]

You rabid evangelicals should really stop the delusional support of the for-profit health care debacle, and completely understand that it is nothing more than a cesspool of waste and abuse and needs immediate reform. The water carriers for the insurance ripoff companies truly need huge mental health care!

[endurorob]

i have no doubt the insurance industry spins data toit's own benefit. Now how about a story on how Obama and the dems spin data to there own benefit.

[jsd330]

Agreed, why aren't Obama and the DEMS giving the American people the true facts of their plan? They aren't giving you any facts on how they are going to fix health care or how much it's going to cost each person, and what it's going to cover or what new government beauracracy is going to oversee it. A lot of information they being tight lipped on.
So we'll watch the POTUS tonight give his spin with his pre screened question from the audience. Cleveland Clinc is a high end for profit hospital. it's where all the oil rich Arabs go for treatment,that is Obams back drop. If you aren't rich or don't have good health insurance for get about getting treatment there. Can't wait to hear Obamas spin on the Cleveland clinc.

[speakinup22]

I don't have that for you endurorob, but I do have something where alpha100000 tried to spin by using sources:

kenwood171 said, "daffy64: Please tell us what information (fact) you are aware of that confirms "THE VAST MAJORITY OF AMERICANS WANT A GOVERNMENT HEALTH CARE OPTION"."
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1. CBS/NYTimes, June 20, 2009
http://www.cbsnews.com/stories/2009/06/19/opinion/polls/main5098517.shtml

aplha - please note that this article was 72% according to a CBS poll. CBS's poll results are not usually the most accurate. In the election results they were way down the list (I think 16th) when compared to say Rasmussen. Source: http://www.fordham.edu/images/academics/graduate_schools/gsas/elections_and_campaign_/poll%20accuracy%20in%20the%202008%20presidential%20election.pdf

2. Quinnipiac, July 1, 2009
http://www.quinnipiac.edu/x1295.xml?ReleaseID=1344


Alpha - in this article, while 69% did like the idea of a government health care plan, most would not use it; AND, most were happy with their current plan. From what I'm hearing, those plans would be devastated. BTW, who is Quinnipiac University anyway - how do I know where their polling sample was taken ?

From the article:

"Although 69 percent of voters nationwide say Americans should have the option of government- run health insurance, only 28 percent would choose to be covered by it, according to a Quinnipiac University national poll released today. Voters say 49 - 45 percent they would pay more to reform health care, but a total of 72 percent DON'T WANT TO PAY MORE THAN $500 A YEAR (something for nothing!)

"Of the 88 percent of American voters who have some form of health insurance, 49 percent are "very satisfied" with their plan and 36 percent are "somewhat satisfied."


3. Campaign for America's Future
http://www.ourfuture.org/blog-entry/2009062515/new-poll-shows-tremendous-support-public-health-care-option

This is a "Progressive" (read Democratic) blog site, which eliminates all possibility of unbias results. So you flat out LIED to us in the below statement.

* this poll was funded by a conservative research organization, heavily corporate-funded

4. FiveThirtyEight
http://www.fivethirtyeight.com/2009/06/public-support-for-public-option.html

On this site Rasmussen is shown as saying only 40% of the population supports the Health care issue. Rasmussen tied for first place in the election poll accuracy. the other 5 were spread between 60 and 80 (2 from kaiser, Lake Research, Consumer's Union & EBRI) weren't big enough polling companies to be in the research in the source I gave.

BTW - according to your source Consumer's Union, "They take a somewhat unabashedly liberal view on health care reform and the poll was released in conjunction with Democratic Senator Chuck Schumer. The Consumers Union' generally spends several hundred thousand dollars on lobbying activities each year."

According to your source: "Lake Research Partners is a Democratic polling firm. Their poll was conducted on behalf of Health Care for America Now! (HCAN), an advocacy group that wants comprehensive health care reform and strongly favors the public option.

Slightly bias towards your opinion isn't it ?

5. Wall Street Journal
http://online.wsj.com/article/SB124580516633344953.html

Alph - while this article is good, the author quotes nbc/wallstreet and CBS polls to make his point of the percentage that want healthcare. Both rated low in the source I gave.

It does have an unbias point, which the President has not answered, and will not allow us to hear about athough he said he'd be transparent on all issues, especially this one, the COST of this Health care.

From your source, "So why the stall? Mainly because Congress can't decide how to pay for it. The hardest blow came last week when the Congressional Budget Office (CBO) estimated that the trial-balloon bill emerging from the Senate Health Committee would cost a whopping $1 trillion over 10 years and would cover only a fraction of Americans currently without health care."

I find your sources marginally support your argument, and prove "reform" will cause inflation in spite of not many using it.

The below was supportive of your point of view, but you excluded the cost issue, which came in the paragraph immediately preceding the one below. (of course the WSJ didn't call Republicans "bozos" That was your editorization after you plagerzied the article.

"Interestingly, GOP bozos went completely silent while Bush doubled the national debt to $10.7 trillion, and then became fiscal budget hawks on something so critical as national healthcare....


Note to conservatives - ALWAYS check the liberal's sources, usually they are looking for facts to support their opinions, instead of formulating their opinions after reading the facts.

[Petepilot62]

The USA needs a publicly funded health care scheme, how can it be the only major western power where you can be bankrupted by health care costs. You get so much crap from the spin doctors i.e Foxes expose on Cdn care...as a 62 year old man who has worked hard for 43 years and recently become disabled I have nothing but praise for our system, minor stuff can take a while to be looked at BUT ANY TIME I OR MY PARENTS OR FRIENDS HAVE HAD ANY SERIOUS ISSUES THEY HAVE BEEN ATTENDED TO QUICKLY WITH COMPASSION & STATE OF THE ART MEDICINE & DIAGNOSTICS. You can even go one step further to France or England & they put us to shame. WAKE UP AMERICA BIG CORPORATIONS ARE DOING IT TO YOU AGAIN.

[differnet]

Tootoofunny, try getting your mother, before her death, ANY health care under a commercial policy. I'm going to assume your mom was over 65. Do you have any idea what it would have cost your family to idemnify her? I'll type this slowly so you can understand. We developed MEDICARE because the cost of health insurance for the elderly was astronomical and most were dying because they couldn't afford even the basics. You really should take the time to read say some history of health insurance in this country before you comment.

[cydygitt1]

texassanna.....you really need to stop the "COMMIE" rants!

[trillion1]

We are happy to have insurance. Are we happy with the quality. Not even close.