High Health Insurance Premiums: The Lobbyist Attack

Article first published as High Health Insurance Premiums: The Lobbyist Attack on Technorati.

Throughout recent months many customers who talk to me at the register and fellow friends or co-workers complain about barely making enough money to pay their increased health insurance premiums. So what happened to the health insurance premiums and why are they so high?

I previously wrote a response to an article in the L.A. Times back in December 2008 that discussed the struggle of a primary care physician. I posted my response on my blog A Misguided Notion. 

I stated, "Working behind the scenes (HMO, major hospital, clinic, and medical equipment provider) I witnessed how both medical providers and recipients were being screwed across the board. Meanwhile, someone is making money, yes?"

Let's not waste time on the fancy language of health care, the bottom line is that money is being spent to try and make us pay more money. 

Ever since the health care bill passed in March of this year, the health care lobbyists have started to put the pressure on the U.S. public internally through high insurance premiums. 

The $267 million dollars spent in the second quarter of this year alone needed to come from someone, namely the insured. According to the Center for Responsive Politics (CRP), last year five of the top ten lobbyist spenders came from the health care industry. The five spenders are Pharmaceutical Rsrch & Mfrs of America, Pfizer, AARP, American Medical Association and Blue Cross/Blue Shield.

I spoke to a customer who told me that she had Blue Cross/Blue Shield her entire life even through her parents, but she had to change companies this year because the costs were ridiculous and they no longer covered her annual primary care check-up because she turned fifty.

The Patient Protection and Affordable Care Act or PPACA (part of the health care reform bill) will limit the amount of money the insurance companies can use as profit. Why should you care?

Say you pay $500 a month for health insurance. Out of that $500 the insurance company pays a small amount to your doctor. Primary care physicians who have a private practice might be in your health insurance network, but that doesn't mean your health insurance is paying the doctor a chunk out of your monthly payment. (See the L.A. Times article regarding struggling doctors.)

A large portion of the $6,000 does not go towards your medical costs. The insurance companies haggle down the payments to pharmaceutical companies, medical equipment suppliers, hospitals, physicians groups and any still existing private practitioners.

The PPACA has provisions that makes sure the money you spend goes towards your medical costs and not marketing ads or lobbyist functions. I'm not saying the entire bill is perfect, but the PPACA would eliminate part of the millions of dollars being spent to make us spend more money.

High insurance premiums are a direct result of insurance companies efforts to maintain their regime within the health care industry. Ads talking about hidden taxes and fees in the bill, well what about the skyrocketing costs due to lobbyist dinners or payouts?

Living check to check doesn't always allow going out to dinner, nor does it allow many of us to have a vacation other than not going to work for a week. While we sit and wonder about our premiums, there are people using our premiums to eat lavish dinners and go on lovely mini-vacations.

Just ask your health insurance company how much of your premium is going towards your medical costs? Or ask your doctor how much your insurance pays them? You might be surprised at what you learn.

Response to: "Why the Doctor Won't See You Now"

Back in December 2008 I wrote a response on my then Facebook account to an article I read in the L.A. Times that can be found here.

Nowhere in this article is there talk about how the health insurance companies are screwing medical providers left and right. Also states like Massachusetts require a mandatory health insurance coverage for every resident, while many residents suffer under a misrepresentation of the facts with regard to the health insurance offered.

When I wanted to be a doctor, I wanted to help people, find cures and contribute to the greater cause of humanity. Working behind the scenes (HMO, major hospital, clinic, and medical equipment provider) I witnessed how both medical providers and recipients were being screwed across the board. Meanwhile, someone is making money, yes?

Viewing this article is a testament to how many individual physicians are not the recipients of such wealth, and nor are their patients; thus, again where is all the money going? 

Major hospital networks and physician groups have some of the best lunches provided by pharmaceutical companies and are given loads of Vegas style "comp" items (notepads, calendars, pens etc).

Notice how the physician interviewed joined a major physician's group, which is probably on the major HMO,PPO, POP provider lists for in-network co-pays. At a major hospital in my region, the main objective of the all-hospital meeting was to discover ways to increase  the hospital bed turnover rate. 

That's jacked up, but the hospital is out to make money because it is a business. Yes, there is a pool of "free-care" money allotted by major hospitals for those who cannot afford care, but that's if you want to take a gamble  to see if you qualify.

Mind you the doctor interviewed still owes 80G's to student loans, never mind malpractice insurance. As for residents of Massachusetts who are required to have health insurance, I have friends whose hours have been reduced to a point that does not meet their company's requirements for health insurance coverage. I tell them the state's medicaid program is for "everyone" not just welfare recipients and pregnant women, but the old social stigma is hard to overcome.

There are also thousands of newly unemployed citizens across the country who cannot afford the ridiculously offered benefits of Cobra. So, what should be on America's wish list for Consumer-Mas? I believe America needs to revamp its health care system on a nation-wide level. Not possible? Yes, it is because they have no trouble with revamping Medicare (often if you consider how the Medicare guidelines have changed within ten years alone).

Do I have a plan in mind? Nope, I'm not a specialist in the field, just an observer, a participant, a recipient, a patient, and a concerned citizen. Lot of people hating on socialist systems, but I like the idea of not worrying about my health :-P