I read an excellent series of articles published by M. Smith, beginning with, “Profits… What are they and what do they do?” I highly recommend this article as it provoked me to think about the current “Health Care Crisis” in a very different light.
I too, at least in part, attributed too much blame for the current “Health Care Crisis” to the insurance companies. After reading Mr. Smith’s article, I began to question, what exactly should we expect from our medical insurance. Should the insurance companies be held responsible for our medical treatment? Is it right and moral that insurers turn our health concerns into a commodity by which they can turn profits? Should we limit the profits they can make?
Let’s face it, insurance providers are involved in a screwy game. By purchasing insurance, we are literally betting against ourselves by wagering that we are going to get injured or sick. In the process, we force the insurance company to take the opposite position, betting that we will not get injured or sick. Anyone with just a little common sense can see who is going to lose that wager. The question is not if I am going to need medical treatment, everyone is injured or gets sick, rather the questions are when, and how serious.
As much as President Obama and the Congressional Democrats would like to vilify the insurance companies, in an effort to promote Nationalized Health Care, the fact is, these private sector companies provide a very important service.
Paying for medical treatment can be overwhelming. We often joke that if the trip to the hospital does not kill you, the bill will. Therefore, we purchase insurance to hedge our losses. Think about how self-defeating the idea of insurance is; we purchase insurance for peace of mind, and then hope we never need it.
Honestly, it reminds me of “Emergency Preparedness”. This country spends a lot of time, energy, and money on planning and training for emergencies, all the while hoping we never need to implement these plans. However, in the event of an emergency, think of how devastating an incident (i.e. natural disasters such as hurricanes, tornadoes, earthquakes, wild fires, and floods, or events of the manmade variety such as terrorism, riots, or even mass gatherings for concerts) would be without the advanced planning and training.
How much profit is acceptable? Other than maintaining the ability to operate within the regulations foisted upon insurance companies by the Government, the answer depends entirely on whether you own any of insurance stocks. After all, like several retailers, manufacturers, and utilities, most insurance companies are publicly traded on the stock market, and therefore have a responsibility to shareholders to remain profitable.
Oh, I know! We do not hear those in favor of “Health Care Reform” discussing this aspect of the issue. Those who are attempting to control your health care decisions from some smoke filled, hidden, back office of a Washingtonian basement do not mention the legislative obstacles that Congress has inflicted on the insurance companies. Have you ever thought about the financial and legal criteria that must be met before an insurance company can sign their first client?
Other than meeting the litany of requirements of the Securities and Exchange Commission, as a prerequisite for Wall Street, the legislation requires insurance companies to maintain significant financial holdings as proof of ability to pay for your coverage. The issue becomes even more complex when licensing is taken into consideration, and licensing becomes even more convoluted as each State commissions their own sets of regulations for the insurance providers.
Ironically, on one hand, we demand the services of the insurance companies, and that they earn profits to satisfy the shareholders that provide the capital to fund the services. On the other hand, we accuse them of wrongfully profiteering from the health care needs of the people.
As Obama and his Congressional Cronies continue their vilification of the insurance industry and their investors, bear in mind the role of the insurance companies, and the service they provide; simply stated, Health Insurers provide a means of managing health care expenses.
Insurance providers manage health care expenses by;
- Contracting coverage to groups or individuals, who pay premiums to protect against unexpected health care costs.
- Contracting with health care providers, and facilities, to render medical services.
- Estimating the annual costs of health care services to determine premiums.
- Ensure funds are available to pay for contracted services.
Notice, I did not include “providing treatment” in the list. Providing medical treatment is not the responsibility of the insurance companies; but rather, providing assistance in managing the expenses of the medical treatment.
As a side note, I have not heard of an insurance company denying treatment to a patient, only denying coverage of treatment not included in the contracted services. Although they will have to pay for it, patients can still receive the treatment not covered under the insurance contract.
America is a “Free Market, Capitalist” country, and insurance companies are earning profits while remaining within the scope of the “Laws of the Land” and the rules and regulations of their industry.
Lest we forget, when considering Government Health Care Reform, we already suffer from the effects of previous dabbling from Congress. Remember, Congress federally mandated that no person be denied medical treatment, regardless of the person’s ability to pay. This forces hospitals render unreimbursable services, negatively impacting the efficiency of our Health Care System and significantly driving up the cost of expenses.
America cannot afford more unconstitutional acts of irresponsibility from more “Congressional Malpractice”. We can ill afford to destroy the benefits of the majority, who enjoy the health care they pay for, by catering to a very small minority and transforming marketable benefits into entitlements.