Business & Finance Business Insurance

Reforming The Healthcare Industry

When President Obama stepped into office, he was a known quantity on health care. He wanted reform. Two years later, we have it. It says something interesting about how politics works when the guy who gets his signature policy into law finds himself so unpopular. OK, so the real problem is unemployment and the state of the economy but, with more affordable health coverage on the way, you'd think people would still be supporting him. Well, judging by the swell of public opinion and the pile of lawsuits working their way through the courts, the Patient Protection and Affordable Care Act is not winning him many friends. Why is this? It sounds good that no one can be refused cover because they already have something wrong with them or that, with everyone required to have a policy, it will costs less for everyone. Well, make no mistake. One group is really pleased - the insurance industry!

Yes, that's right. The insurance industry likes Obamacare because it suddenly gives them 50 million more people to insure. And the good news? Well, a high percentage of these 50 million don't bother to insure themselves because they are young, fit and healthy. Most of them will not make a claim in the immediate future. That's a lot of premium income to subsidize all the other people with poor health. In fact, the premiums for everyone should fall except, of course, the insurers want more profit so the rates will only come down a little. We might actually see something remarkable as and when this gets up to the Supreme Court. The insurance industry might declare itself in favor of Obamacare. In fact, until Judge Henry Hudson ruled against the law, it was all looking rosy for the President and the insurers. Now with the GOP back in control of the House, there's going to be more pressure for repeal.

A better place to look for reform would be the actual amount of fraud in the current system. It's estimated that about $60 billion a year disappears out of Medicare and Medicaid. In other words, the programs designed to protect the poor and old are targeted by companies as a gold mine. At present, the US spends about 5% of its GDP on these programs. Every week there's a news report of yet another company caught overcharging by $10 million or more. Have a look at Massachusetts. It has recovered $4 billion in civil and criminal fraud settlements over the last two years. Just think how many people could be treated if that $60 billion was available.

Health insurance is not rocket science. It's a simple business to collect money in as premiums and pay for people to get the health care they need. Yet, because of the politics and profits involved, it's become a battleground. When so much benefit is due to come to individuals like yourself, it's hard to understand why it does not enjoy mass support. Yet, for now, everything remains uncertain except for the fact that health insurance companies are likely to continue one of the most profitable businesses no matter who wins the debate.
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