Why Sicko is Only the Tip of the Iceberg

Some final points about the health insurance industry — a few steps beyond Michael Moore….

Private — even not-for-profit — health insurance companies exist in this country for only one reason — to make a profit and to line the pockets of their employees.

Hear me out…

They are businesses FIRST, many with investors to please, and as such, that is their requirement — to make money. No matter what the business is, no matter how they do it, their number one vision, mission, goal, is to make money for themselves and their investors. It’s no different than a pizza vendor or the power company or the state lottery. Making money is their only reason to exist.

What that means is that the amount of money coming IN, must at least exceed, and at best FAR exceed the amount of money going out. Even for the so-called not-for-profit health insurance organizations, they must bring in much more money than they spend, because their executives are making six figures — and sometimes more. It could be the organization is considered not-for-profit, but that doesn’t mean they have paychecks that are anything less than those of their colleagues across the industry.

The only way they make money is by charging their customers — we patients and our employers — more money.

They want us to believe that their costs are skyrocketing because the hospitals and doctors and pharmacists and other providers are charging them more — BUT — that is only partially true. In fact, they tell the providers what they will pay — not the other way around! Are we patients getting any sicker? As a group — no.

And don’t forget — on top of all that profit, they must continually pay out the expenses of lobbying state and federal legislators, not to mention donating to their campaigns…. and yes, that gets more expensive, too.

So think about it this way, taking a stab at the healthcare dollar you and your employer are giving the health insurers:

• a percentage is being paid for executive salaries, bonuses and perks
• a percentage is being paid for administrative costs
• a percentage is being paid for lobbyists and campaign contributions
• a percentage must be kept to make investors happy
• and then, whatever little is left over actually covers a PORTION of your health care.

Frustrating, isn’t it? What’s wrong with this picture?

Here’s another way of looking at it: in the health insurer’s perfect scenario, we pay in and pay in and pay in for as long as we stay healthy — then as soon as we get sick, they would just as soon we die. Once we die, then they don’t have to pay out for our care! Especially for those with chronic diseases, or something that needs newly developed treatments or surgeries — either we are uninsurable, or if they are already stuck with us, then we are denied care. I suppose denying us service might be the only better scenario than letting us die. At least then they don’t feel like our blood is on their hands.

Is it any wonder they employ people (like the guy in Sicko) who do everything they can to uncover reasons not to pay out? Is it any wonder why they refuse to pay for “experimental” treatments?

This is not about the human thing to do. In fact, allowing these health insurance companies to make decisions about what care they will — or will not — allow to their insurance customers is simply providing them with a license to kill. The more of us who die early, the more money they will make.

Does all this sound a bit extreme? Well, OK. Then tell me what I’ve missed?

Now do you understand why being a sharp patient is so important?

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Read two more posts about Sicko:

A Patient Advocate’s Reaction to Sicko
What Sicko Doesn’t Tell Us

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