Insurance Companies

The plot twist storytelling technique, which relies on introducing a radical change in the direction of a plot to shock the reader, is difficult to execute in a satisfying manner. More often than not, readers are disengaged by the technique for a variety of reasons ranging from introducing too little change to ruining an already interesting story. When done right, however, it is a different story, For instance, the Portal game franchise by Valve corporation is consistently ranked among the best games of all time by experts like IGN for “undoubtedly coming out of nowhere and shattering the mold”(1). In the second installment of the franchise, the player’s ally is revealed to be the main antagonist of the game after the player assists his rise to power. Similarly, the big baddy of single-payer healthcare prefers to stay in the shadows and manipulate the outcome to their favor. Out of all the issues preventing the implementation of single-payer healthcare discussed on this website, the biggest opposers are health insurance companies. Regardless, the time when insurance companies could hide in the shadows draws to a close as the public slowly realize that their opinions were controlled by insurance companies for the sake of profit.

Health insurence profits

In order to expose health insurance companies, it is important to first estimate their profits after the implementation of the Affordable Care Act (ACA). According to data presented to The Council of Economic Advisers in an article titled “The Profitability of Health Insurance Companies.” in March 2018, insurance companies suffered significant financial losses in the individual market. To make up these losses, insurance companies used government tax credits to pay for rising premiums. Another indicator that insurers leeched taxpayers, is that enrollment levels remained consistent as premiums rose. Meanwhile, the Medicaid expansion, which provides federal financed care through private insurers, opened room for large insurers failing to cope with the new individual market to profit in the Medicaid market. In other words, as the ACA Medicaid expanded so did the opportunities for insurers to profit. As a result, health insurance stocks outperformed the S&P 500 by a stunning 106 percent! The report ends on a ‘high note’ by stating that “all health insurers can expect to become more profitable this coming year due to the recent tax reform”(2). As shocking as this data is on its own, any dedicated researcher must consult a variety of sources. Therefore, I will include the data of two additional sources. Similar to the data presented to The Council of Economic Advisers, the 113th Congress received a report that “the total taxpayer bailout [to insurers] could, in fact, well exceed $1 billion this year alone”(3). This more evidence that health insurers used taxes to pay for premium raises. Another scholarly article written by Professor Claudia Chaufan and released in the International Journal of Health Services informed readers that the ACA increases health spending by about $1.1 trillion. In this case, health insurance companies are not solely responsible for the $1.1 trillion raise, but they definitely played a part. In essence, even though it is impossible to get a set number, data from various sources indicate that the profits of health insurers skyrocketed after the ACA without any improvements in care quality.

This cartoon draws attention to the ever-narrowing ‘coverage options’ and ‘recommended services’ that health insurers provide. In the cartoon, the doctor informs the patient that even laughter as medicine is not covered under his health insurance policies. https://standupforamerica.wordpress.com/2009/08/20/mess-with-the-bull-get-the-horns/health-insurance-cartoon-giggles/

Influence of health insurers

Due to the incredible profitability of healthcare, insurers resorted to protecting their profits at all costs and they are fully aware that the implementation of single-payer healthcare would mean the end. Unfortunately for health insurers, Professor Claudia Chaufan concludes that “polls show strong support for government-guaranteed health insurance when the questions are adequately asked”. Moreover, a study for The Commonwealth Fund, The New York Times, and Harvard T.H. Chan School of Public Health calculated that the Medicare-for-all plan drew more support than the other plans offered. Health insurers quickly realized that without intervention, the implementation of single-payer healthcare, or any other financing system, would be imminent. In order to prevent this, health insurers started to dedicate some of their profits to public relations (PR). While PR campaigns are not necessarily harmful, health insurers do not always promote accurate information with their campaigns. One example of health insurance PR was analyzed on the introduction page under the Issues tab of this website. In that case, an expensive graphic was designed with poorly researched facts and then placed at the top of google image search results for single-payer healthcare. This image was strategically placed by health insurers to dishearten individuals researching single-payer healthcare with loosely based statements. Another strategy that Health insurers employ is supplying handsome political donations in the hopes of shifting the scales to their favor. Professor Claudia Chaufan states in her article that “as talk about health care gained traction in the run-up to the presidential elections, insurance and pharmaceutical corporations rushed to increase their political donations. The drug and health products sector alone gave Barack Obama $2,436,836 for his campaign.” Of course, these monetary gifts are not bribes, but they are not goodwill donations either. The goal of these donations was to promote legislation that, at the very least, only shifts the healthcare market slightly like the ACA. Moreover, some of the politicians that write the health care legislation implemented have deep connections with health insurance companies. For instance, Liz Fowler, a former insurance company executive of WellPoint, wrote a considerable amount of the proposal on which the ACA was based and he was hired by the U.S. Department of Health and Human Services to implement those policies. Nowadays Liz Fowler works for a pharmaceutical giant. These connections also help health insurers influence legislation being passed (4). Altogether, health insurers managed to sink their claws deep influential sites and politicians solely through money in a desperate attempt to secure their profits from single-payer healthcare.

This picture was released by Roper Insurance and is an excellent example of insurance companies trying to sway public opinion in their favor. No statistical evidence is given on the website where this image was posted to back up these claims.

Conclusion/Summary:

In brief, passing legislation at the federal level is a continual struggle in the United States. Change can be slow with the three branches of the government fighting over passing laws, the two main political parties competing for representation, the big businesses resisting the public, and many more hindrances. Out of the six challenges discussed on this website, the health insurance monopoly is the largest obstacle on the road to single-payer. Motivated by the astonishing profits of healthcare, health insurers try to prevent the passage of new healthcare financing systems like single-payer healthcare. Using poorly research statements in attractive packaging, they convince individuals that single-payer is unfeasible. Moreover, health insurers are persuasive with their generous political donations. However, change is inevitable and when something as essential as healthcare is put on the line people willingly face these challenges.

In this cartoon, an individual is being ‘persuaded’ by insurance companies that single-payer healthcare will dig into his pockets. Meanwhile, cash tumbles out of his pockets for insurance companies to collect.

Footnotes:

1.“Top 100 Video Games of All Time – IGN.com.” Accessed May 16, 2020. https://www.ign.com/lists/top-100-games.

2.“The Profitability of Health Insurance Companies.” The Council of Economic Advisers, March 2018. https://www.whitehouse.gov/wp-content/uploads/2018/03/The-Profitability-of-Health-Insurance-Companies.pdf.

3.“House Hearing, 113th Congress – POISED TO PROFIT: HOW OBAMACARE HELPS INSURANCE COMPANIES EVEN IF IT FAILS PATIENTS.” Govinfo, 18 June 2014, www.govinfo.gov/app/details/CHRG-113hhrg88826/CHRG-113hhrg88826/summary.

4.Chaufan, Claudia. (2015). WHY DO AMERICANS STILL NEED SINGLE-PAYER HEALTH CARE AFTER MAJOR HEALTH REFORM?. International journal of health services: planning, administration, evaluation. 45. 149-60. 10.2190/HS.45.1.l.