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| Photo by Glow Images (Getty Images) |
United-Health Group, Inc. is
demonstrating what is wrong with healthcare in America – and it is not the
Affordable Healthcare Act. The problem is our expectation of profit rather than
access to healthcare as the measure of success.
The front-page news
in last Friday’s Wall Street Journal (11/20/2015) read that UnitedHealth, the largest insurance
provider in the country, is losing money on Obamacare and may pull out of the
ACA exchanges altogether. The truth is that they are not losing money –
it is just that they are not making as much money as they would like. A
look at the New York Stock Exchange reveals that UnitedHealth has made profits for the
first three quarters of 2015, and has done better than it did in 2014. The fact
that the company would threaten to back out of its participation in the
Affordable Care Act due to less than expected profits demonstrates that quarterly
gains are more important than covering people’s healthcare needs.
Healthcare in America took a
wrong turn when someone figured out that it could be a moneymaking industry.
For-profit hospitals began to set the standard, then insurance companies and
pharmaceutical companies quickly accelerated their profit making as well. One
problem with the for-profit model is that not only is a profit expected, but
the profit also has to be greater than last quarter’s profits in order to make
shareholders happy.
There is a difference between
making money and making a profit, as Peter Ubel pointed out in an article in Forbes Magazine last year (“Is the Profit Motive Ruining American Healthcare?”). Hospitals, insurance companies, and pharmaceutical
companies have to generate enough income to pay salaries, cover expenditures,
and have some operating capital. It is certainly important that hospitals and clinics
remain solvent so healthcare workers can be paid for the work they do. It is
also important that people have access to the healthcare we provide. As Peter
Ubel put it, “No one should go bankrupt either paying for medical care or
providing it. But that doesn’t mean health care businesses, whether profit or
non-profit, should enrich themselves at the expense of society.”
If it is getting to the point
that insurance companies cannot deliver policies that will cover the healthcare
needs of the people because they think it is too risky for the company, then
perhaps it is time to look for a different model. If UnitedHealth is
representative of health insurance companies’ attitudes toward healthcare, then
it is demonstrating the need for Medicare for all, or some other version of a
single-payer healthcare system. Every other developed country has figured out
how to provide healthcare for their citizens.
Political Opposition
From the day that the
Affordable Care Act was signed into law, there has been continued opposition to
it from Republicans. Many of the
arguments have to do with costs. Companies claim that added insurance costs
hurts their ability to maintain a profitable business. Now the Republicans are
jumping on the news that UnitedHealth cannot profit from ACA exchanges. They
will look for any reason to make Obamacare not work.
The sad thing is that it is people
in need of healthcare who will suffer in the ongoing political debate of how to
make healthcare work and who will pay. One measure of a nation is how it cares
for its citizens, particularly the sick, the elderly, and the needy. While
other countries find ways to make healthcare work, the U.S. is mired down in
politics and profits.
Putting People ahead of
Profit
Steven Hill, a contributing
writer to the book, Dream of a Nation
has an article, “Tackling the Profit Problem in Healthcare: What the US
Can Learn from Europe?” Hill poses
the question, “How do the French, Germans,
British and other European countries manage to provide better healthcare than most
Americans receive for about half the per capita cost?” One big reason, he says
is one of philosophy, namely that “The various European healthcare systems put
people and their health before profits.” He goes on to point out that not every
European country has a single-payer, government-run healthcare system. “France
and Germany have figured out a third way,” he says, that “appears to perform
better than single-payer, but it also might be a better match for the American
culture.” That “third way” is a hybrid that allows for private insurance
companies as well as individual choice of doctors who are in private practice. In
France and Germany, this hybrid is apparently working, but our own hybrid
attempt with the ACA is being threatened now by corporate greed. We are missing
that ingredient of putting people and their health ahead of profit.
Businesses seem reluctant to provide
healthcare as a benefit, and insurance companies seem reluctant to accept a
reasonable profit in providing healthcare policies. Therefore, it is time for
the U.S. to make an investment in its citizens and find a way to deliver
healthcare for all. If we had a single payer universal healthcare system, for
example, it could be a boon for the economy and a shot in the arm for every
entrepreneur. I personally know of
people who would like to launch their own business, but do not want to risk
losing healthcare benefits they have in their present job. Indeed, there are
many who are working at a job they don’t particularly like just to have
insurance coverage. So not only would
big business benefit from not being saddled with healthcare costs, small
entrepreneurs would have more freedom to do what the Republicans say this
country is all about – start new businesses.
Why must we lag behind other
developed countries when it comes to providing for healthcare needs of the
people? There are some great ideas out there that put people ahead of profits
and look to the common good. With profiteering companies balking at providing
health coverage, it is the perfect opportunity to look for other models of
healthcare delivery.
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