Joel S. Hirschhorn

In the national debate about health care reform absolutely nothing makes less sense than the positive views of much of the public about private health insurers. There is no good reason to have positive views of private health insurers, the companies that have relentlessly increased the costs for very limited health insurance. Copays, deductibles and premiums have raped those lucky enough to have health insurance while also making it very difficult much of the time to get coverage for all kinds of health problems. The US health care system is unbelievably inefficient, providing far less effective health care for what is incredibly high costs, compared to all other industrialized countries. The main reason is the private health insurance industry.

If you need solid information to believe this view, then consider these facts.

On the cost side, what is the problem? The current private health insurance system is the most costly, wasteful, complicated, and bureaucratic in the world. Its main function is not to provide quality health care for all people but to make huge profits for companies. Private health insurance companies spend an incredible 30 percent of each health care dollar on administration and billing. Thirty cents of every dollar is not going to doctors, nurses, medicine, medical personnel; it is going to bureaucracy and administration plus exorbitant CEO compensation packages, advertising, lobbying, and campaign contributions. More efficient public programs such as Medicare, Medicaid, and the VA are administered for far less money, less than 10 percent.

From 2003 to 2007, the combined profits of the nation's major health insurance companies increased by 170 percent. William McGuire, the former head of United Health, several years ago, accumulated stock options worth an estimated $1.6 billion; CIGNA CEO Edward Hanway made more than $120 million in the last 5 years. CEO compensation for the top seven health insurance companies now averages $14.2 million. Over the last three decades, the number of insurance administrative personnel has grown by 25 times the number of physicians.

The double whammy is that we get so little for so much spending. The US spends far more per capita on health care than any other nation, and health care costs continue to soar unsustainably, now at $2.4 trillion and 18 percent of our GDP. Our per capita spending is 40 percent more than the second most costly national system. The insanity is that we get poor value for what we spend. According to the World Health Organization, the US ranks 37th in terms of health system performance; we are far behind many other countries in terms of such important indices as infant mortality, life expectancy, and preventable deaths. Even the latest federal National Health Quality Report concluded: “health care quality in America is suboptimal…the health care system is not achieving the more substantial strides needed to close the gap or ‘quality chasm’ that persists.”

If Congress and the Obama administration believed in true, necessary health reform, then they should favor a government run single payer system. But they do not because they are corrupted by the money from the private health insurance industry. If the public was not delusional and brainwashed, then they would be screaming for a single payer system, but the latest Washington Post-ABC News poll posed this question to respondents: What if having the government create a new health insurance plan made many private health insurers go out of business because they could not compete? In that case would you support or oppose creating a government-run health insurance plan? Remarkably, 33 percent were opposed and 25 percent were opposed if private health insurers could not compete. Only 37 percent support the government run option regardless of any impact on the private insurers.

Considering the predominantly negative experiences most Americans have had with their private health insurance companies, these results are depressing. The only rational explanation is that Americans have been successfully brainwashed by years of propaganda and disinformation from the health insurance industry. As I and other Medicare users can attest to, a government run plan has provided me total freedom in choosing any physician and hospital I want to use. There is no sound reason to believe that a larger version of Medicare offered to all Americans would in any way reduce the quality of health care received.

The simple fact is that a huge amount of money can be saved by shifting from private to government health insurance, $4 trillion over ten years, more than enough to pay for universal health care coverage for absolutely all Americans.

What we are now witnessing in Congress and the White House is a total, ugly capitulation to the money and power of the private health insurance industry. If the private health insurance industry maintains its stranglehold on the national system, then taxpayers will pay even more money for the worst national health care system in the world, if Congress makes that costly insurance available to more Americans by using government money.

There were some other recent poll results. The New York Times/CBS News poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector. In fact, 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt, nearly 60 percent said they would be willing to pay higher taxes to make sure that all were insured, and 72 percent supported a government-administered insurance plan — something like Medicare for those under 65 — that would compete for customers with private insurers, versus 20 percent that said they were opposed.

Part of the disinformation campaign is that people are being manipulated to think that a government insurance plan equates to government run health care itself, which is shear nonsense. Medicare users access exactly the same private health care system as those with private health insurance. Of course, private health insurers charge so much money that they pay physicians and hospitals more money than Medicare, which is primarily a tactic to keep much of those parts of the health care system supportive of maintaining the private insurance system.

Dr. David Himmelstein is a founder and spokesperson for Physicians for a National Health Program. He believes President Obama is caving to the insurance industry: “The President once acknowledged that single payer reform was the best option, but now he’s caving in to corporate healthcare interests and completely shutting out advocates of single payer reform.”

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Contact Joel S. Hirschhorn through www.delusionaldemocracy.com