Sunday, August 2, 2009

So, About That Private Insurance...

Those of us who practice medicine realize that the system is broken, and badly so. We realize that the current structure of public insurance is in bad shape and is losing money badly (though, as I've posted before, this is at least in part because public insurance insures high-risk, high-use patients that private insurance can avoid).

For these reasons, many conservative and/or free-market supporters are pushing for expansion of the private insurance market. Apparently, that would fix all the current problems we're dealing with.

Or would it lead to more of this?. In this extensive interview, Bill Moyers discusses the failings of the private insurance market with Wendell Potter. Mr. Potter was previously a top executive for CIGNA, and he lays out the tricks and underhanded tactics used by private insurers to make money by denying care to patients who need it. Mr. Potter is also interviewed by Amy Goodman on Democracy Now!

So, this is how private insurers think. Even though the private plans are already dealing with the healthier (read: less expensive) patients, they find ways to deny care or cancel policies in order to make even more money. This underlines a key failing of private insurance: how much will a for-profit company pay for your healthcare when they are trying to make as much money as possible? Corporations always claim that they have responsibilities to their shareholders. If so, how much responsibility will they have for providing healthcare?

How are we supposed to trust private insurers? At least a public insurance plan would be PUBLIC and would have public oversight, with more liklihood of transparency and accountability to those who enroll and for those who pay for the coverage.

To date, I have not heard how private insurance markets are planning to address these issues. Something tells me that we probably won't be hearing much any time soon.

(PS--the Bill Moyers transcript can be read here).

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