Putting Profits Ahead of Patients

...insurance companies market themselves in the media as caregivers, confusing the public, but they are not. The companies are fundamentally investment vehicles, maximizing profits to boost shareholder value. Before the Blues turned into for-profit companies, they spent 95 percent of premiums on medical care. To increase profits, the Blues, along with other insurers, now spend as much as 20 percent of their premiums on marketing, lobbying, and administration. In contrast, Medicare, the federal program for seniors that enjoys widespread popularity, devotes nearly all of its funding to health care and only 1 to 2 percent to administration.
What is a feasible step to begin to remedy our costly and chaotic health care system? Many industrialized nations, including Germany, Japan, Belgium, and others, have uniform negotiated national fee schedules for hospital admissions and clinical encounters with doctors. Medicare also does this. Furthermore, Medicare markedly decreases administrative costs for both doctors and hospitals, compared to private insurance.

A public option like Medicare that provides vital services and devotes nearly all of its funds to patient care, actively competing in the marketplace with private insurance, would be a welcome step in the right direction. This could achieve a goal unmet by either Obamacare or the Trumpcare plan: to remove money as the centerpiece of our health care system and restore the essential communal relationship that sustains patients and physicians alike.