This is the first part of a multi-part series considering the new PR campaign by the lobby of American Health Insurance Plans (AHIP). The homey sound of a town hall meeting. The promise that insurance companies are working with Americans to "solve" the health services crisis. The petition for signing. Going on the road to "listen" to consumers.
Sorry, we all want it, it sounds great, we share your concerns, we're working on it, but it's not true.
We knew it was coming after the passage of recent legislation protecting doctor pay under Medicare and it's of course here, the Insurance Company response to protect and increase health insurance company profits.
The first thing to remember is that AHIP is an insurance company lobby. As stakeholders, we know that insurance companies have the goal of MAKING MONEY BY REDUCING THEIR LIABILITY FOR ACTUALLY COVERING EXPENSES FROM PAYING OUT ON INSURANCE. Not rocket science, the more they take in and the less they pay out the more money they make.
If you don't believe that premise, I hope I can further illustrate that examining your stakeholder and what its (his/her) primary goal is pulls together all the blah blah blah that we have overlooked in the past. In this industry, the devil is in the details.
So I read with curiosity the use of our AAQT standards (affordability, access, quality tactics) in its "evil twin" format put forth by the new Health Insurance Company Campaign, CAMPAIGN FOR AN AMERICAN SOLUTION PUT FORTH BY HEALTH INSURANCE COMPANIES.
In the very first page of marketing we read: Insurance companies support Coverage Affordability Quality Value Choice Portablility as their key goals and that the Campaign for an American solution will seek support and feedback from coast to coast .
1)Public relations rather than "listening" is the goal of AHIP campaign: The first issue is, what's the point of the town meetings, really? I mean, go to the website, AHIP proposals are already written, compiled, documented and available for the public. So make no mistake, rather than seeking citizen opinion, AHIP will be doing one of those: "This is the plan, it's great, don't you agree?" campaigns, in other words, Public relations, not seeking your input.
2) Nothing "NEW" in the AHIP "plan": Because the AHIP "plan" is already available for our reading, I went to the Health Insurance Plan section: "A Strategy to Make Health Care More Affordable." Notice the absence of the word "NEW", because it is not. In that publication are the five key points AHIP will be selling: a) overuse, underuse, and misuse of health care services inconsistent with medical evidence b) new technologies without a NATIONAL (for those anti-government types, emphasis added) entity to compare clinical and cost-effectiveness 3)Prevalence of defensive medicine 4) Personal health habits 5) cost-shifting to private payers to make up for insufficient payments from PUBLIC (again you anti-big government types should note).
3) WHAT IS OMITTED: While the Health Insurance Companies and their lobby created this "plan", is it not amazing that there is nothing but self-congratulation by the industry regarding their efforts to REDUCE costs? Not one of the above five "strategies" addresses FRAUD in the health insurance industry. Fraud accounts for BILLIONS of dollars wasted by insurance companies. Instead of strengthening their fraud detection, insurance companies just whine that insurance fraud costs us all money. A "strategy" that omits the expansion of fraud detection within and outside insurance companies that cost CONSUMERS dollars omits one of the key issues for consumers...someone's getting rich and it's off our backs.
CONTROLLING COSTS THROUGH MONITORING HEALTH INSURANCE COMPANY EMPLOYEE SALARIES: Throughout the year we read or hear about health insurance companies, but what about THEIR salaries. http://www.forbes.com/lists/2008/12/lead_bestbosses08_Daniel-P-Amos_A2OR.html is an April 2008 report about CEO salaries. Read it and weep for the salaries our health insurance premiums help pay. Included are the CEO of AFLAC, Daniel P. Amos coming in at $75.16 million, CEO of AIG, Martin J. Sullivan coming in at $10.93 million, CEO of Metlife, Robert Henrikson coming in at $8.03 million.
INSURANCE COMPANY EXPENSES FOR THEIR OWN BAD PRACTICES paying too little for out of network care, wrongfully withholding cancer treatment coverage, denial of payments for eating disorders, Federal securities class action lawsuit regarding health insurers' stock options. And then there are those lawsuits. Not the lawsuits by patients who are victims of malpractice. Lawsuits against and won against health insurance companies. For instance, Health Net agreed to a $255 million settlement of a class action lawsuit. Touchpoint Health Plan was required after a lawsuit to reinstate cancer treatment coverage. Aetna was required to settle a lawsuit regarding denial of coverage for eating disorders. United Health Group will pay $895 million to settle a federal securities class action lawsuit. Amerigroup just agreed to pay $234 million for discriminating against pregnant women and other high risk patients. In breaking down the costs, consider the Amerigroup breakdown, $225 million to be paid to the federal government and the state of Illinois plus $9 million in legal fees.
Health insurance companies are only useful as a means of a person partnering with a company that will share the cost of treating medical conditions. Everything else is not meaningful to consumers. If a company cannot provide such a financial partnership, then a new solution is necessary for consumers. And if health insurance companies cannot afford to provide their products? Who cares. The most frightened people are those who boldly pronounce the virtues of capitalism. Put your money where your mouth is, if they can't make it without taking away meaningful coverage for consumers then the market place should be allowed to vote them out, without them running for protection through lobbies such as AHIP seeking more government dollars.
Tomorrow, more on the AHIP "Strategy" for selling the American people.
