Big Insurance has hauled in $500B in profits since 2014— enough to cover extending the enhanced ACA subsidies and leave $150B — yet it’s gone to shareholders and executive bonuses instead of patients.
The solution, as it has been for some time, is M4A - the ACA, as was apparent from the beginning, was/is a gift to the insurance companies and no amount of "tinkering" with it will cure that fatal defect ...
Private insurance co.s do not belong in healthcare!!! They do not provide healthcare, they are just 3rd party middlemen sucking money out of the system, standing between ,and actually interfering in, the relationship between actual providers and those needing that provision ...
This has been obvious from the start - indeed, blame the greed of the insurance companies but also the politicians who allow this to happen ...
I agree. And the longer we stay with the current system, the stronger this system becomes and the less likely that we ever transition to M4A unless it all collapses
You criticize insurance companies for spending $618 million of our dollars on lobbying, but you fail to mention the greed of the politicians who benefit from that money. Politicians should not accept money from healthcare lobbyists, as it harms patients. We need to hold our politicians who designed this system accountable!
I have a somewhat unusual take on all this. Agree that (improved) M4A is the ultimate answer, but seeing how the vested interests were able to kill/subvert prior reform efforts (Hillarycare/ACA/Healthy Americans Act) I am (oddly, I admit) finding some hope in the chaos and destruction emanating from this administration. Imagine 2028 after a Harris administration…we’d be 4 years deeper into putting bandaids on ACA and otherwise continuing the incrementalism that has crippled us, and actually put fundamental, structural reform further out of reach. But 2028 (and beyond) after the Trump wrecking ball has gone through might actually be a better place from which to effect real, structural change, including (finally!) ending employer sponsorship (probably phased). Don’t get me wrong. There is an enormous amount of suffering, death, and waste between here and there, but maybe that’s what it’s going to take in order to finally muster the political will to really address the root causes of our unconscionable “system” in a serious way. I have to hope.
In the meantime there are some things we can, and I would argue, must, do ...
1) demand that our Congresscritters pass HJR 54, the "We the People" Constit. amendment which overturns CU by saying that Corps are not People with Const. rights and Money is not Speech, and tell them no votes from us until they do, then
2) demand our Congresscritters pass laws that limit the amount that can be spent on elections
Indeed, this may take awhile, but we have wasted 15 years since CU was decided and it is way past time we got this done, the sooner the better,and if they won't do it, "throw the bums out" and elect those who will - that is the only way to "hold them accountable"
skip #1 and go straight to #2 and do a massive overhaul of campaign finance. public financing + spending limits + limited window of time for campaigning (3 months?) and add a jurisdiction stripping provision (“not reviewable by the Supreme Court”).
OK, please explain - isn't the, ostensible, reason Congress hasn't passed spending limits is because the SC, under CU, says they cannot limit $ as "speech"
Where is the authorization for the jurisdiction stripping provision that would cover this issue ...
you don’t have to point me to the absurd irony about the fact that democrats are fighting for more corporate welfare. every politician in Congress is responsible for mass manslaughter- ~200k preventable deaths each year in America bc of the corporate practice of medicine that both parties have espoused. we had the most deaths per capita from Covid here and only in America are life spans DECLINING. SCOTUS has made sure we have a very very corrupt system of government. but let’s be clear, this administration represents the culmination (not the saviors) of corruption ushered in by the Supreme Court over the last 50 years.
Insightful perspective. Although I wonder if you agree with amongst the suffering, death, and waste between now and then, that the revolution will look like millions opting out of private insurance all together? Or is this seen as too radical? To me, the way to really stick it to the "system" would be for those of us that can afford the risk to obtain catastrophic only coverage (or non at all) and then go about medical needs as a self-pay person.
Fumbling through a first comment here, but I thought I remembered that the 15% the insurance companies keep as a prize if they 👀 really m u s t spend 85% on their annoying beneficiaries and their medical losses (although I've always suspected they've tucked advertising and lobbying in as losses). My brain no longer holds what it used to, but don't the MAO contracts lay out those numbers? And maybe ACA, too? But now we're fidgeting again about incremental change possibilities as opposed to find a to get us all safety into M4A. We won't get there through incremental change.
The short response is that the $1,000 dollars (a number he's thrown around) Trump wants to give to regular Americans won't buy them much in individual policies, and likely won't keep folks with acute or chronic health conditions alive for long.
No argument on all the layers of legalized corruption with the private ACA insurance companies.
I thought that the ACA law required a larger percentage of the premiums to be spend on healthcare rather than enriching the executives and the stock holders. Apparently, this has not happened.
We got bamboozled once again by corporate healthcare lobbyists.
The only solution to our on going healthcare crisis is to take the profit out of healthcare.
Universal healthcare is the only solution to fixing this problem.
have to take the profit ($) out of politics first. there is only one senator (sanders) who explicitly and consistently acknowledges this. we, the voters, need to coalesce on this singular demand (campaign finance/anti-corruption reform).
what else can he do without another 59 senators on board? making a lot of noise is one of the primary things that politicians do (to build political pressure). i am at a loss as to why everyone doesn’t recognize that this is the only thing that matters right now (anti-corruption/campaign finance reform). and by everyone, i’m referring to the American people/voters.
In light of this political moment. Demand the highest quality healthcare, the lowest cost by eliminating all profit and all unnecessary administrative layers. Traditional Medicare administration cost are less than 2%, while Medicare advantage (part C) which are actually publicly funded private commercial plans, have administrative cost of about 18%. accountable care organizations and other commercial health insurance companies can have administration costs as high as 30% due to exorbitant CEO salaries and bonuses, lobbying, advertising investor profits.
This is the kind of message: Short , Direct, To the Point that will move the needle! One with Clear ,Concise Facts from reputable sources who have “the receipts “ will focus like a laser the massive outrage and disgust at the broken healthcare system that the overwhelming majority of American Voters, ( the only ones who can change this),
share and live as their real life daily experience.
The sad truth is health insurance companies are for profit and will continue to raise costs no matter how much money they are making. It's not really due to "high utilization" but rather for margin expansion. Wall Street has them in the palm of their hands.
From another blog I read - the author is pretty dependable to research information before posting:
CEO compensation makes up a tiny fraction of health insurance premiums, typically far less than 1%.
In 2023–2024, total compensation for top insurance CEOs was roughly:
UnitedHealth Group Andrew Witty~$20 million
CVS Health (Aetna) Karen Lynch~$28 million
Cigna David Cordani~$21 million
Elevance (Anthem) Gail Boudreaux~$21 million
Humana Bruce Broussard~$17 million
These companies have revenues between $100 billion and $370 billion a year.
So, for example:
UnitedHealth revenue: ~$370 billion
CEO pay: ~$20 million
Portion = 20 million / 370 billion = 0.000054%
That’s about 5 one-hundred-thousandths of one percent of revenue — and since premiums are the main revenue source, CEO pay is effectively well below 0.01% of your premium.
While CEO pay is often controversial, it does not significantly impact insurance costs. Premiums are driven mainly by:
Hospital and drug prices
Administrative costs and marketing
Medical loss ratio (claims paid out vs. premiums)
Regulatory and profit margins (~3–5%)
Considering all executive compensation, about $13.50 per year per family, or 0.05% of the premium
If I’m correct, employers can tax-deduct cost of their share of healthcare benefit. Wouldn’t that give insurers excuse to just raise premiums? Anybody clear on this?
I’m not clear on tax-deductibles for employers. For profit private commercial health insurance companies have infiltrated public schools, universities, veterans administration, state governments, Congress, retirement systems, Medicare, medicaid and many many public employers. These employers probably generally don’t fill out tax returns.
The solution, as it has been for some time, is M4A - the ACA, as was apparent from the beginning, was/is a gift to the insurance companies and no amount of "tinkering" with it will cure that fatal defect ...
Private insurance co.s do not belong in healthcare!!! They do not provide healthcare, they are just 3rd party middlemen sucking money out of the system, standing between ,and actually interfering in, the relationship between actual providers and those needing that provision ...
This has been obvious from the start - indeed, blame the greed of the insurance companies but also the politicians who allow this to happen ...
I agree. And the longer we stay with the current system, the stronger this system becomes and the less likely that we ever transition to M4A unless it all collapses
You criticize insurance companies for spending $618 million of our dollars on lobbying, but you fail to mention the greed of the politicians who benefit from that money. Politicians should not accept money from healthcare lobbyists, as it harms patients. We need to hold our politicians who designed this system accountable!
Dean Baker has a great article on this prospect
https://deanbaker22.substack.com/p/rip-van-winkle-comes-to-the-white
I have a somewhat unusual take on all this. Agree that (improved) M4A is the ultimate answer, but seeing how the vested interests were able to kill/subvert prior reform efforts (Hillarycare/ACA/Healthy Americans Act) I am (oddly, I admit) finding some hope in the chaos and destruction emanating from this administration. Imagine 2028 after a Harris administration…we’d be 4 years deeper into putting bandaids on ACA and otherwise continuing the incrementalism that has crippled us, and actually put fundamental, structural reform further out of reach. But 2028 (and beyond) after the Trump wrecking ball has gone through might actually be a better place from which to effect real, structural change, including (finally!) ending employer sponsorship (probably phased). Don’t get me wrong. There is an enormous amount of suffering, death, and waste between here and there, but maybe that’s what it’s going to take in order to finally muster the political will to really address the root causes of our unconscionable “system” in a serious way. I have to hope.
In the meantime there are some things we can, and I would argue, must, do ...
1) demand that our Congresscritters pass HJR 54, the "We the People" Constit. amendment which overturns CU by saying that Corps are not People with Const. rights and Money is not Speech, and tell them no votes from us until they do, then
2) demand our Congresscritters pass laws that limit the amount that can be spent on elections
Indeed, this may take awhile, but we have wasted 15 years since CU was decided and it is way past time we got this done, the sooner the better,and if they won't do it, "throw the bums out" and elect those who will - that is the only way to "hold them accountable"
3) apply the same approach to getting M4A ...
skip #1 and go straight to #2 and do a massive overhaul of campaign finance. public financing + spending limits + limited window of time for campaigning (3 months?) and add a jurisdiction stripping provision (“not reviewable by the Supreme Court”).
OK, please explain - isn't the, ostensible, reason Congress hasn't passed spending limits is because the SC, under CU, says they cannot limit $ as "speech"
Where is the authorization for the jurisdiction stripping provision that would cover this issue ...
see Article III, Section 2, Clause 2 (exceptions clause).
Please explain how this would work
1) where is the Gov't going to get the money to put into this Health Savings Account?
2) do health care providers submit their bills to the account or do they submit their bills to the patient who then submits them to the Account?
3) are there any "insurance companies" in the loop at all?
if not, why wouldn't they be just as opposed to this as they are to M4A?
if so, what's the difference between that and what we have now?
Dean Baker has a great article on this prospect
https://deanbaker22.substack.com/p/rip-van-winkle-comes-to-the-white
you don’t have to point me to the absurd irony about the fact that democrats are fighting for more corporate welfare. every politician in Congress is responsible for mass manslaughter- ~200k preventable deaths each year in America bc of the corporate practice of medicine that both parties have espoused. we had the most deaths per capita from Covid here and only in America are life spans DECLINING. SCOTUS has made sure we have a very very corrupt system of government. but let’s be clear, this administration represents the culmination (not the saviors) of corruption ushered in by the Supreme Court over the last 50 years.
Insightful perspective. Although I wonder if you agree with amongst the suffering, death, and waste between now and then, that the revolution will look like millions opting out of private insurance all together? Or is this seen as too radical? To me, the way to really stick it to the "system" would be for those of us that can afford the risk to obtain catastrophic only coverage (or non at all) and then go about medical needs as a self-pay person.
Let’s hope this is the crisis to bring an end to the for profit health insurance ripoff of the American citizen.
Fumbling through a first comment here, but I thought I remembered that the 15% the insurance companies keep as a prize if they 👀 really m u s t spend 85% on their annoying beneficiaries and their medical losses (although I've always suspected they've tucked advertising and lobbying in as losses). My brain no longer holds what it used to, but don't the MAO contracts lay out those numbers? And maybe ACA, too? But now we're fidgeting again about incremental change possibilities as opposed to find a to get us all safety into M4A. We won't get there through incremental change.
There is progress and Tuesday gave us Mikie, Abigail, Zohran, prop 50 & Pennsylvania high court wins.
The short response is that the $1,000 dollars (a number he's thrown around) Trump wants to give to regular Americans won't buy them much in individual policies, and likely won't keep folks with acute or chronic health conditions alive for long.
No argument on all the layers of legalized corruption with the private ACA insurance companies.
I thought that the ACA law required a larger percentage of the premiums to be spend on healthcare rather than enriching the executives and the stock holders. Apparently, this has not happened.
We got bamboozled once again by corporate healthcare lobbyists.
The only solution to our on going healthcare crisis is to take the profit out of healthcare.
Universal healthcare is the only solution to fixing this problem.
have to take the profit ($) out of politics first. there is only one senator (sanders) who explicitly and consistently acknowledges this. we, the voters, need to coalesce on this singular demand (campaign finance/anti-corruption reform).
And what is he doing, other than making a lot of noise about it?
what else can he do without another 59 senators on board? making a lot of noise is one of the primary things that politicians do (to build political pressure). i am at a loss as to why everyone doesn’t recognize that this is the only thing that matters right now (anti-corruption/campaign finance reform). and by everyone, i’m referring to the American people/voters.
See today's Healthcare Uncovered post about Anthem.
Hello and thanks for this succinct report.
In light of this political moment. Demand the highest quality healthcare, the lowest cost by eliminating all profit and all unnecessary administrative layers. Traditional Medicare administration cost are less than 2%, while Medicare advantage (part C) which are actually publicly funded private commercial plans, have administrative cost of about 18%. accountable care organizations and other commercial health insurance companies can have administration costs as high as 30% due to exorbitant CEO salaries and bonuses, lobbying, advertising investor profits.
My wife and I just joined an alternative to all this mess called CrowdHealth.
It was a scary decision to become uninsured, but here’s a post about how we came to that decision!
https://nicholaswestfall.substack.com/p/why-i-got-rid-of-health-insurance?r=61w2ip&utm_campaign=post-expanded-share&utm_medium=web
This is the kind of message: Short , Direct, To the Point that will move the needle! One with Clear ,Concise Facts from reputable sources who have “the receipts “ will focus like a laser the massive outrage and disgust at the broken healthcare system that the overwhelming majority of American Voters, ( the only ones who can change this),
share and live as their real life daily experience.
The sad truth is health insurance companies are for profit and will continue to raise costs no matter how much money they are making. It's not really due to "high utilization" but rather for margin expansion. Wall Street has them in the palm of their hands.
From another blog I read - the author is pretty dependable to research information before posting:
CEO compensation makes up a tiny fraction of health insurance premiums, typically far less than 1%.
In 2023–2024, total compensation for top insurance CEOs was roughly:
UnitedHealth Group Andrew Witty~$20 million
CVS Health (Aetna) Karen Lynch~$28 million
Cigna David Cordani~$21 million
Elevance (Anthem) Gail Boudreaux~$21 million
Humana Bruce Broussard~$17 million
These companies have revenues between $100 billion and $370 billion a year.
So, for example:
UnitedHealth revenue: ~$370 billion
CEO pay: ~$20 million
Portion = 20 million / 370 billion = 0.000054%
That’s about 5 one-hundred-thousandths of one percent of revenue — and since premiums are the main revenue source, CEO pay is effectively well below 0.01% of your premium.
While CEO pay is often controversial, it does not significantly impact insurance costs. Premiums are driven mainly by:
Hospital and drug prices
Administrative costs and marketing
Medical loss ratio (claims paid out vs. premiums)
Regulatory and profit margins (~3–5%)
Considering all executive compensation, about $13.50 per year per family, or 0.05% of the premium
If I’m correct, employers can tax-deduct cost of their share of healthcare benefit. Wouldn’t that give insurers excuse to just raise premiums? Anybody clear on this?
I’m not clear on tax-deductibles for employers. For profit private commercial health insurance companies have infiltrated public schools, universities, veterans administration, state governments, Congress, retirement systems, Medicare, medicaid and many many public employers. These employers probably generally don’t fill out tax returns.