Health care vs. health industry profits

An effort to tank any attempts at health care reform under consideration in Congress was recently launched by Richard Scott, the disgraced former CEO of Columbia/HCA. Scott has been making his rounds with lawmakers, and formed a new group to oppose changes in the country’s broken health care system. The new group, Conservatives for Patients’ Rights (CPR), has hired a public relations firm known for its work with Swift Boat Veterans for Truth in the 2004 elections to help develop its strategy.

CPR has run a series of television ads attacking President Barack Obama’s health care plan, even though some of the details of that plan have not been finalized. What CPR and health industry executives are really attacking is the very concept of health care reform. The health industry does not want Congress to have a serious debate about health reform, because they know that the for-profit health insurance industry will be exposed if the issue is debated honestly. CPR is little more than an advocate for the health care industry’s reckless pursuit of profits.

Scott is a flawed messenger with a flawed message. As Columbia/HCA’s CEO in the 1990s, he built the company into the largest health industry company in the world. Scott was ousted by the company’s board of directors in 1997 following allegations that the company had intentionally overbilled state and federal health programs to pad corporate profits. Columbia/HCA pled guilty and paid $1.7 billion in fines to settle the case.

Obama’s reform plan falls short

President Obama’s plan for health care reform falls significantly short of providing universal health care for everyone living in the U.S. Obama’s nominee for health secretary, Kansas Gov. Kathleen Sebelius, unwittingly revealed volumes about the administration’s plans for health reform at her confirmation hearing.

MSNBC reported on April 2 that Sebelius stated during the hearing, “I know the president is totally committed to the proposal that every American should have health insurance.” Sebelius’ assurance that the administration is focusing on health insurance coverage is very telling.

The hearing focused on the issue of mandates in its questioning of Sebelius. Some proponents of expanded health insurance advocate an individual mandate that would require workers to purchase a private insurance plan if they are unable to obtain coverage another way. Others have maintained that a mandate financially punishes uninsured workers. Sebelius refused to take a position on mandates.

The focus on mandates evades the larger point: health insurance is not the same as health care. Expanding the pool of the privately insured, with or without mandates, does not guarantee the type of universal health care that workers need.

“Insurance companies can deny people coverage, raise premiums significantly, refuse to cover treatment for certain conditions, and even revoke the coverage of policyholders who have been paying premiums for years,” according to a 2008 study by Families USA, a nonprofit advocacy group for health care reform.

Health insurance companies frequently reexamine the medical histories of the insured and dramatically change their policies to eliminate coverage for the exact health services the individual needs, even though the patient may have paid insurance premiums for years before they required medical services. This abusive practice is known as “post-claims underwriting” and has been the subject of many investigations and court challenges.

Post-claims underwriting and rampant premium increases belie the notion that health insurance is synonymous with access to health care. Even when the insured do get the care they are entitled to receive, high co-payments can make the cost of care prohibitive and drive families into bankruptcy during times of catastrophic illness.

Health Affairs journal found in 2005 that “even universal coverage could leave many Americans vulnerable to bankruptcy.” The same article found that medical bills contribute to half of all personal bankruptcies, and three-fourths of those bankrupted had health insurance at the time they got sick or injured.

The administration’s plan to sell workers more health insurance, especially during the worst global economic crisis since the Great Depression, does not come close to providing the type of health care system that workers need and deserve.