Insurance companies control over the health care system

Blue Cross offers a concession

Lack of choice is part of the current problem

By Will Collette

Recently, I wrote about the impact insurance company pay rates have on our two South County hospitals – Westerly and South County – whose rates for providing the same services are generally much lower than, for example, Rhode Island Hospital, even though patients rate the services of Westerly, and in particular, South County much higher.

In response to adverse publicity, Blue Cross/Blue Shield said it would begin being more transparent about its payment rates by no longer writing a clause into future contracts that forbids health care providers from disclosing how much they get paid by Blue Cross.

This change would take effect as new contracts are signed. State Insurance Commissioner Christopher Koller had planned to require insurance contracts to include price transparency. And our local state Senator Dennis Algiere, the Senate Republican minority leader, had introduced legislation to require transparency.

It’s a baby step in the right direction, but there’s still a long way to go before the public can find fair deals in health care in the marketplace.

How's that socialized medicine thingy workin' out for ya, Sarah?

Because, despite all the rhetoric about “socialized medicine” and Obamacare, the health insurance industry remains the most powerful player in the health care industry. The irony – one that most conservatives just don’t get – is that Obamacare actually institutionalizes the role, and increases the power, of private insurance industry.

In the usual back-and-forth both in comments, conversations and e-mails, the overwhelming power of insurance companies in the health care system became more and more apparent. They control the purse strings, and by so doing, they can control which health care providers thrive and which fail, as well as who lives and who dies. And they often times do it with little justification.

Some of you may remember that last year, Rep. Donna Walsh took on one of the more outrageous aspects of health insurance conduct through legislation that would have banned the common insurer practice of charging women who buy individual insurance coverage more than men for no other reason than they are women. Donna plans to reintroduce that bill.

The insurance lobby actually testified that their reason for this was so they could keep rates low for young men. They said they need to offer an enticement, since young men are notorious for being uninsured unless they get coverage through their employment.

I received one comment recently which was not the first one very sore spot in Rhode Island’s medical system. Rhode Island has chosen what seems to me to be the worst way to finance medical care. The state severely limits the choices offered to Rhode Island employers and group buyers to a very small number of insurers – Blue Cross, UnitedHealthCare and Tufts.

The lack of choice hampers competition, which is the one saving grace the free market approach to health care offers to consumers. By state mandate, just three private companies corner the market.

Personally, I believe we can work around the edges and tweak the system a bit to reduce a few of the worst aspects of the system, but will not catch up with the rest of the industrialized world until we go to a single-care system, perhaps like a Medicare-for-all arrangement.

Let the private insurers sell supplemental insurance, as they do now to Medicare members, but let’s use the tried and true basic coverage system that Medicare offers to provide basic universal coverage.

The US scores so poorly when compared to the rest of the First World nations because we do not have a universal health care system. That is, until Americans turn 65 and go on Medicare, whereupon their life expectancy is as good as or better than the other nations on the list.