Thursday, August 6, 2009

My take on the medical care debate.

In a video being shown on You Tube, Stephen Hemsley, CEO of United Health Group is quoting as saying, “The mission at United Health Group is to help people live healthier lives.” In a word, this is bullshit. The mission at United Health Group is to buy risk at a price that they calculate will be lower than then risk calculated by person who is selling it. What do I mean by that? Let me put it this way. We, as consumers, pay insurance companies to assume our risk. We give them, say, $10,000 each year in our assumption that someday, our medical costs will be well in excess of the 10K we’ve been giving to our insurance company – and if we have to collect, we’ll be ahead, financially. Of course, it’s not quite that simple, but the principle remains. Insurance companies make a living by buying risk at a price that ultimately returns a profit. If any of us thought that we had more than enough money to pay for any medical care – or that the price of the insurance was far more than we would normally expect to have to pay over the course of our lives, we would no more buy medical insurance than we would buy plumbing insurance or lost sock insurance.
The real mission at United Health Group is to buy risk, and make a profit on that purchase. The real mission at United Health Group is to take in more capital in the way of premiums than it pays out in terms of benefits. Anything else is a bold face lie. Mother Theresa’s mission was to help people live healthier lives. The mission of our local food pantry is to help people live healthier lives. My mission with my sons is to help them live healthier lives. Our mission in all these examples is lacking the fundamental ingredient that separates our mission from that of United Health Group and that ingredient is profit.
Insurance companies and gambling companies both employ statisticians who calculate risk and the companies use that knowledge to run their business with a profit. Insurance companies call these people actuaries. Actuaries carefully calculate the probable medical costs of an individual for a specific term, and then insurance company offers to assume the cost of that for a price that is larger. The difference between the policy price and the payout is profit for the insurance company. Sometimes the insurance company loses, just as sometimes people leave Las Vegas with more money than they came with. But we all know that the money of losers built the new hotels in Vegas, just as the money of losers paid the $3.2 million dollar salary of Stephen Hemsley.
United Health Group and all other medical insurance corporations in America have one mission and that is to turn a profit for their investors. Don’t think for a minute that Mr. Hemsley conducts his quarterly reviews with his department heads and asks them, “How many people have you helped live healthier lives this quarter?” Do not assume that the way up the corporate ladder at United Health Group is to be the employee who has helped the largest number of people live healthier lives. United Health Group is no different than any other corporation as it rewards employees who rake in the biggest pile of cash.
Now don’t get me wrong. I am not against insurance, profit, corporations, CEOs or Las Vegas. I just do not think that gambling and profits should play that prominent role in a nation’s medical care.
Medical care is not like most things that we buy, and buying insurance to cover those possible costs it not the same as buying insurance to cover a replaceable house or car. Our children are not replaceable, nor are our own lives, but yet we are somehow asked to deal with these as one would insure a 2003 Toyota Corolla.
We do not shop for a good value in setting broken bones, or clip coupons for half off an MRI treatment. Medical care is more like the police officer that we call in the middle of the night when our car is stolen – or the fire department that responds to our 911 call when our home is on fire. Can you imagine having our police or fire services operate on the principle that they need to return a profit to their investors? “We’re sorry; the co-pay to assist you in finding your lost daughter is now $150. Please pay the cashier” Can you imagine a world where one calls for the fire department and is told “Sorry, your application states that you live in a two story home and not a split level. Your policy is therefore void and we cannot serve you.”
But in fact, these things happen in the medical care sector of our nation every day. Men like Stephen Hemsley make decisions as to who will get medical service and who will not – and what drives that decision is not “Will this help someone lead a healthy life”. No, what drives that decision is, “Will this adversely affect our quarterly profits. Will this be seen as bad news to the Wall Street investors?”
Those opposed to any meaningful reform or government system try to scare me with the idea that some bureaucrat in the government will be standing between me and my doctor. I'll tell you this, I'll take that bureaucrat over men like Stephen Hemsley - men who place corporate profits ahead of my well being, and then lie about it in public.
There must be an awful amount of money at stake here because men like Stephen Hemsley are spending more than a million dollars a day, every day, to protect their position and maintain a medical care model that is based on the profit motive. Now that we know that this money is not being spent to “help people lead healthier lives”, why aren’t more of us upset?