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The S-Word and Dr. Kevorkian's Accountant

by: Greg Palast, t r u t h o u t | Op-Ed

Wendell Potter tells Greg Palast health insurers' dirty secret.
Wendell Potter tells Greg Palast health insurers' dirty secret. (Photo: Fighting Bob Fest)



    Special Feature: Listen to Greg Palast's exclusive interview with health insurance company whistleblower Wendell Potter. Press play below to hear the clip.




    Health care Rx from my socialist fire department.

    Tell me where it hurts, Mr. President.

    What's killing you, Barack, is what's killing us all: an evil germ called "Medical Loss Ratio."

    "Medical Loss Ratio" [MLR] is the fancy term used by health insurance companies for their slice, their take-out, their pound of flesh, their gross - very gross - profit.

    The "MLR" is the difference between what you pay an insurance company and what that insurer pays out to doctors, hospitals and pharmacists for your medical care.

    I've totted it up from the raw stats: The "MLR," insurance companies' margins, is about to top - holy mama! - a quarter trillion dollars a year. That's $2.7 trillion over the next decade.

    Until the 1990's, insurers skimmed only about a nickel on the dollar for their "service," Wendell Potter told me. Potter is the CIGNA insurance company PR man who came in from the cold to tell us about what goes down inside the health insurance gold mine. Today, Potter notes (and I've checked his accuracy), porky operators like AIG have kicked up their Loss Ratio by nearly 500 percent.

    The industries' slice is growing to nearly a quarter of your insurance bill. All of it just paperwork and profiteering.

    President Obama is never going to pull the insurance company piggies from a trough this big, especially when the industry has made room for Congressional snouts.

    So what's the Rx? Easy: Kill the pigs and call the fire department.

    The only solution to Loss Ratio piggery is to kill the pigs: eliminate health insurers from the health industry entirely.

    We can't cure our ills, as our president has attempted, by attacking the problem ass-backwards. No, Mr. Obama, we don't need HEALTH INSURANCE for everyone, we need HEALTH CARE for everyone. There's a giant difference. Instead of concentrating on PAYMENT, we need to focus solely on providing the health SERVICE.

    From my London days writing for The Guardian, I can tell you the British do NOT have national health insurance. They have a National Health Service.

    The government builds hospitals, hires doctors and, when you need the service, you just go and get it. It's kind of like the fire department. When your house is on fire, you don't call your fire insurance company, you call THE FIRE DEPARTMENT. We care first about the service, not the payment.

    The British government hires the doctors, like firemen, and Brits use them, like firemen, as they need them.

    It works. My mother-in-law, a nurse, on a visit to England, was stunned at the speed, quality and absence of mad paperwork to fix her broken arm.

    But, you might say, that's, that's SOCIALISM! Well, yes, it is. And I'm not afraid to use the S-word: Socialized Medicine. Just like America's Socialized Fire Departments. (Fun fact: socialized, i.e. publicly funded, fire departments were 'invented' by the revolutionary Ben Franklin.)

    And Yes We Can get socialized medicine passed into law.

    Really. It's simple: we sneak it in with the kids.

    We can learn from Lyndon Johnson's sale of Socialist Medicare. Johnson knew that no one could argue that Granny do without a doctor. Can the "Pro-Life" Republicans now tell us that pregnant moms and children ages 0 to 3 should be denied care? Therefore, to the Medicare program for those 65-or-older, we simply add "Kiddie Care," for those from Negative 9 months through age 3.

    But instead of the wallet-busting Medicare system, in which doctors and hospitals are paid for each suture, bag of blood and pat on the head, Kiddie Care will be provided by Kiddie Care Service salaried doctors.

    How do we get doctors (who now AVERAGE $240,575 a year) to take well-paid, but not pig-paid, posts? We grab'm while they're young. We pay doctors the full cost of their medical education; and we treat them as humans during internship, not as in the current system where interns are treated as medi-slaves. In return for the public paying for their medical education, the public gets the young doctors' ten-year commitment to work for the health service at a reasonable salary.

    That's not my invention. The free-education idea for staffing a national health service had long ago been proposed by that wily old dog Ted Kennedy. (Damn, we miss him.)

    Once the first wave of three-year-olds are about to turn four and their families face having to buy them health insurance, these millions of parents will become an unstoppable army of lobbyists screaming for the extension of Kiddie Care to age four, then to age five, then to age six and so on. Get it?

    Yes, Mr. Limbaugh, I am another bleeding heart trying to sneak socialized medicine into America. Yes, I am trying to rid us of the "free-market" insurers who are causing the bleeding. Health insurers are as useful to our health care system as a bicycle is useful to a goldfish.

    Free-Market Fantasia

    There ain't no such thing as a "free market" in medical care, as there is a free market in food. You can eat peanut butter instead of dining at Maxime's. But you can't tell the surgeon, "No thanks, I can't afford a new kidney this week - I'll just have a broken arm."

    A free-market for-profit insurance system means that, when you need a new pancreas, your fate is left to an insurance company computer programmed by Franz Kafka, Dr. Kevorkian and his accountant. It's you versus the Medical Loss Ratio. Good luck.

    In olden days, doctors would attach leeches to suck a patient's blood. Today, we have insurance companies' Medical Loss Ratio. Both can kill you. If Obama and America want to end this sickness in the body politic, start with Dr. Kennedy's sure-fire cure: a national health service for kids - and get rid of the bloodsuckers.

* * *

    I Quit: A Personal Note

    I learned of the Kiddie Care solution during my brief and ill-starred tenure at the Center for Hospital Administration Studies at the University of Chicago "Billings" Hospital. I couldn't make up that name. Years later, they hired Michelle Obama as their vice president for community affairs.

    In my time, three decades ago, "Billings" handled the affairs of that poor community by shipping the uninsured, sometimes bleeding, to poor-folks hospitals. One wounded patient died on the poverty shuttle.

    I quit, and swore that one day I'd write about it. I just did.

  

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Forensic economist Greg Palast is author of the New York Times bestseller, "The Best Democracy Money Can Buy." His investigations for BBC TV and Democracy Now! can be seen by subscribing to Palast's reports at www.GregPalast.com.

Comments

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One of the best, most

One of the best, most helpful articles I've ever read on the subject. Thank you, and thanks to Mr. Potter. :)

" In olden days, doctors

" In olden days, doctors would attach leeches to suck a patient's blood. Today, we have insurance companies' Medical Loss Ratio. " Mr. Palast strikes again, this time at the head of the snake. Forwarding his piece (in link form) to all my friends. Thanks.

Will Congress and the

Will Congress and the President throw us to the wolves? The Baucus bill, in its present form, does just that. To force Americans to purchase health insurance from a private industry is just insane. These companies are even exempt from anti-trust provisions, which means they can collude to set (high) prices without fear of prosecution. Did the millions of Americans who campaigned to put the Democrats in office know they were signing up for this?

Now that's thinking outside

Now that's thinking outside of the box!

I work for an auto insurance

I work for an auto insurance company and am well aware of the pressure on "LOWERING" the administrative cost component in order to be able to COMPETE in the marketplace. Can someone explain why the "FREE-MARKET" paradigm does not apply to this industry? Maybe this sector is already strangled by the corporate-SOCIALISM model. Unfortunately, I think we'll have revolution in the streets before that happens. I'm a Canadian, BTW, and the closest I have ever gotten to a pay-for-each-thing model was when I took my pet to the vets.

I hope the usually reliable

I hope the usually reliable Mr. Palast will take another look at what he wrote. "Medical loss ratio," as I understand it, is the proportion of premium income paid out to policyholders or on their behalf. The outrage is not that it is too high, but that it is too low.

Rogermac. I have passed your

Rogermac. I have passed your comment on to Palast. Her is his response: "Yep. I described MLR in an inverted manner to make it clearer. Technically, you're correct. I should also note that Medical Loss Ratio is no longer used by the industry; they prefer HBR ("health benefits ratio"). When I was at the pro-free-market Center for Hospital Administration Studies in Chicago, the MLR was also known as "the prime cut." :)

A 500% increase from the

A 500% increase from the nickel they used to "skim" means the insurance companies now take about 30¢ of every dollar we spend as their profit. Is that correct? I just to make sure I'm understanding the numbers.

My dad was a doctor in

My dad was a doctor in Canada BEFORE "socialized" medicine. He trained as an intern making $125.00 (yes $125.00) a month and working an average 90-hour week. When socialized medicine came in, he and his friends grumbled. A few (very few) moved to USA. Most of them continued to treat the sick for 20, 30, 40 years. They never asked any committee if it was ok to treat someone - they still don't. Canadian doctors easily make $250K a year and specialists more. It is OK. We the patients like our doctors to do OK. We also like it that we can go and get CARE any time of the day or night - for free!! We like it that we can call an ambulance and not have to write a check. We like it that we can have an operation and not sell the house- or anything for that matter- to pay for it. We like it that the Government is the "insurer", because it is the mandate of the government to provide essential services. Yes critical heart surgery (for example) IS an essential service. Just like clean water out of your tap. Who would argue with that? Only deranged lunatic profiteers intent on commercializing every aspect of life.

The issue with this approach

The issue with this approach is that there are many more uncontrollable events that may occur in one's life which are not socialized. For instance, loss of property due to Hurricane Katrina. An automobile accident, an accident at home, an accident on the job. Death of a spouse (especially if sole provider) and the impact on one's family. Should these also become socialized? I actually have no problem with that.

THE OKLAHOMA OBSERVER,

THE OKLAHOMA OBSERVER, SEPTEMBER 25, 2009, PAGE 15 First Of Two Parts Although we live in Stillwater, we have for the last 27 years owned a cottage on Lake Winnipeg, Arnes, Manitoba, Canada. We have spent almost as many summers there over the years. This year was no different ... with the exception that there is raging battle going on in the U.S. in regards to healthcare reform. Wherever I went in the big city of Winnipeg or in smaller cities like Gimli or Arnes I interviewed ordinary Canadians about their thoughts about the U.S. health care controversy, a historical repeat of Canada’s health care reform some 50 years ago. Canadians, I learned, are not losing any sleep over the push for U.S. health care reform. Their attitude seems to be, “We’ve got ours, you get yours.” Gerry Cowie, a senior citizen and long-term acquaintance said, “I think they’re stupid for not having it before. I worked for doctors before Medicare [1962] and they couldn’t collect from patients who couldn’t afford to pay. After Medicare came in doctors were paid for all their patients.” My niece, Laurie Stirton, said, “Canadians laugh their heads off that Americans are so afraid of health care.” Her son Cary Stirton added, “For such a wealthy society, it’s criminal.” CANADIANS LOVE SINGLE-PAYER In the same way some Americans think they have the best care in the world most Canadians feel their single-payer system in place for 50 years puts our forprofit system in the dust bin of history. They may complain but 96% wouldn’t have it any other way. The complaints of Canadians pale beside the big time complaints of Americans, who are mostly blind to the fact that the Canadian system costs a fraction of ours and covers everybody. Andrew Schultz, a Canadian filmmaker, told me about getting sick after a heavy meal. He went to the hospital where they found a 4-mm kidney stone. He will have surgery in a few days. He will never see a bill that in the U.S. could cause bankruptcy. No Canadian goes bankrupt because of medical bills and Canadians don’t lose their health insurance because they don’t have a job. Regarding U.S. healthcare reform, he remarked, “The level of discussion is at rock bottom.” He asked, “Americans have no experience of national health care so how can they know anything about it?” He added, “The most conservative Canadian politician would never think of opposing public health care. It is not a political issue.” GIVE JACK A CALL Jack Hinchey, a retired 77-year-old and his wife Audrey live next door to our cottage and have been good neighbors for 25 years. He had a knee replacement a few years ago and is now having multiple internal problems – his gall bladder and a tumor were recently removed. He has had five colonoscopies and now has a collapsed colon. In a few days he will have surgery to remove and reconnect the colon. Over the years he and his wife have had only praise for their medical care for which they have never received a bill. I couldn’t get them to say anything negative; both are grateful for Canadian healthcare. Should you wish to contact them their number is 204.642.7739. My advice to Americans is to call individual Canadians rather than be influenced by American anti-Canadian propaganda paid for by the private, for-profit health insurance industry. Canadians at all levels are willing to talk about health care, but few think they should get involved or be telling us what to do. AMERICA NEEDS A VISIONARY LEADER Shirley Bookbinder, B.A.S., a retired social worker, believes in Canada’s medical system. She said, “America needs another Tommy Douglas [father of Canadian health care], someone with the vision to look to the ordinary person. You have to listen to what’s important for your country, not what’s good for your party.” Barry Asgeison, my brother-in-law’s son said, “For a government that provides the best health care in the world for its soldiers ... but not for its citizens is infantile thinking that will block national health care.” He added, “The U.S. worships the bottom line and is willing to sacrifice the well-being of the nation in order to line the pockets of powerful corporations.” I asked a retired family member whether a really expensive [$400,000] bone marrow transplant necessary for mylodyplasia – the cancer that killed my son – would be covered in Canada. His answer was, “It doesn’t matter ... it would be covered ... cancer care is superb.” A Winnipeg waitress said, “Americans have to pay big fees to see a doctor; here we can see a doctor any time.” FEAR-MONGERING IN AMERICA Dr. Anne Doig, president of the Canadian Medical Association, whose father took part in the strike of doctors in 1962 because they thought public health care would infringe on their basic rights, said in a CBC interview [Aug. 19], “Can- Health Insurance Reform Canadians Support Single-Payer System By Ron du Bois

If you have not seen Michael

If you have not seen Michael Moore's Sicko, you owe it to yourself to watch it at least once... Our 9/11 "heroes" were treated in CUBA....

Huzzah to truthout for

Huzzah to truthout for adding Greg Palast to the roster of writers. His stuff is superb, and he gets his facts straight as an arrow!! Thanks Mr. Palast, for this piece. While I'd rather see Medicare for All, with the docs hired under your and Ted Kennedy's formula, along with nurses, techs, lab and medical technologists, et al, and a truly NATIONAL health SERVICE, I'd settle for your incrementalism. Now, let's get these corporate vampires OUT of our government (with public financing of elections and a bar against corporate and/or private money) so we can get this done!

Mr. Palast has it right.

Mr. Palast has it right. But as he says, who's going to get rid of the pigs? Doesn't seem to be anyone in office who's got the guts to do s, at least, not in my lifetime. If I could, I'd leave the US, emigrate to Canada, the UK, Austria, France, somewhere they have some better form of health care for everyone instead of just fewer & fewer people, some of whom get everything possible paid for, most of whom get less & less covered. I am tired of living in a country that thinks bailing out investment banks & keeping up ridiculous levels of military spending is more important then providing a reasonable level of health care for all at a reasonable cost. Every other "advanced" nation finds it possible & useful to do so.

We put in the middle of our

We put in the middle of our healthcare system an industry that's essentially a bet against our health... and expect it to be reasonable? Health insurance has no place in a civilized society.

A good limousine service

A good limousine service will help you do just that: by providing the best transportation available to you, you can make sure that such life-changing events will be made as memorable as possible. Limousine@service

Capitalism, as it turns out

Capitalism, as it turns out in the US, is socialism for the rich capitalist. They get get all the government bailouts, tax breaks, tax incentives, free research and exploration money, etc. Almost all the laws are written for them like business deductions. Regulations against businesses are getting less and less enforced. Capitalists get most of the socialism. Regular people get to pay huge medical bills.

as long as there is slop in

as long as there is slop in the trough you'll nsever get rid of the pigs.

The "average salary" of a

The "average salary" of a doctor is really skewed because it doesn't take into account that primary care doctors are paid well under this "average. My husband is a Primary Care Doc and one of the many "gatekeepers required by the HMO system. We live in one of the most expensive cities in the nation and he makes only $105K per year. There is a huge inequity in physicians pay which needs to be corrected. This article assumes that doctors are overpaid, but that is not always the case. Dozens of doctors in our city are going out of business because they cannot make enough money to compete with the huge clinic that dominates the patient pool here. I get a little tired of hearing that physicians are over paid. The problem is the "for profit" insurance companies, not the doctors pay!

10/15/2009 - 22:51 —

10/15/2009 - 22:51 — Doogie writes; "The issue with this approach is that there are many more uncontrollable events that may occur in one's life which are not socialized. For instance, loss of property due to Hurricane Katrina." Has Doogie not heard of such a devestated area being declared a Natural disaster with help available from the Federal Government?? "An automobile accident, an accident at home, an accident on the job.": Auto accident? are we not required to have auto insurance so if we hurt someone, medical costs are covered? Companies are required to cover the cost of industrial accidents. "Death of a spouse (especially if sole provider) and the impact on one's family'. My brother in law died at 45 leaving four children and a wife with no skills. Thanks to SS survivors asssistance, she was able to see her children educated. so when the question is asked "Should these also become socialized? I actually have no problem with that." I think they are already to a large degree

Greg Palast, still my hero!

Greg Palast, still my hero!

I appreciate Mr. Palast's

I appreciate Mr. Palast's efforts to bring forth more of the truth about insurance companies, however a large portion of truth about health in general has still not reached the mainstream or not so mainstream media that I've seen. Our medical system, which has not kept up with the new science, is based on Newtonian physics which sees the body as a biochemical machine to diagnose and treat. When DNA was discovered about 50 years ago, science thought they had more keys to use to determine what chemicals to use to treat the body. In Dr. Bruce Lipton's book "The Biology of Belief" (the 2006 Science Book of the Year), he radically alters how health and healing should be viewed. He shows how it's your beliefs, perceptions and the environment that control how your cells respond and that genes cannot turn themselves on and off on their own. By being 100% responsible for our own health, dealing with the emotions that get stuck in our bodies and changing our view about how things really work, there are many, many ways to cut health care costs dramatically in this country. Of course this will cause Big Pharma, hospitals and doctors to have a lot less business and make a lot less money since chronic disease is a major profit center. I encourage everyone to pick up a copy of Dr. Lipton's book. He's being awarded Japan's Goi Peace Award in November. If you're intrigued and would like to learn more about quantum physics and healing, check out the dvd "What the Bleep Do We Know". A new movie just out about healing is "The Living Matrix".

Greg Palast and WENDELL

Greg Palast and WENDELL POTTER are my heroes!! FORWARD THIS WIDELY. Don't sit back and do nothing, make healthcare reform with at least a public option your cause until it passes. ATTEND EVENTS AND CALL YOUR REPS!!

I'm still stuck on the

I'm still stuck on the question of how we kill the pigs. In fact, we know they are everywhere, not just in the health insurance industry, but actually running frothing and frenzied through the halls of our government, devouring everyone else share, and crapping all over our country. So what are we going to do about it? Obama is clearly not a transformational figure, anymore than Clinton was (except maybe for the worse). He has made an ironic absurdity of his campaign claim "change we can believe in" and betrayed his own principle from day one. So if not from Obama, from whence will come this change? When do we, as a people and a nation of empowered citizen, kills all the pigs and take back the troughs? I'm ready now.

AIG DOESN'T SELL HEALTH

AIG DOESN'T SELL HEALTH INSURANCE. THE INTRO IS DELIBERATELY MISLEADING.

No, AIG didn't sell Health

No, AIG didn't sell Health Insurance PER SE, but let's definitely force them to disclose any Dead Peasants policies they might have, and how they might STILL be gambling with "derivatives". Full disclosure, Sargam, and take off the stupid CAPS LOCK. Real geniuses know size doesn't matter; it's grammar.