Louisville Medicine Volume 67, Issue 9 - Page 31

DOCTORS' LOUNGE Deductibles, copayments, surprise medical bills, uncovered ser- vices and denying coverage for expensive services are the bread and butter of the for-profit health insurance companies. The for-profit health insurance companies prioritize their investors and sharehold- ers, not the people paying premiums, with expectation of getting actual health care coverage. In the business model of the for-profit health insurance industry, actually paying for the costs of health care, the product that they are selling, is identified as the Medical Loss Ratio and is considered a business loss. The single-quarter profits of the top 85 publically traded (for-profit) health insurance companies was $47 billion (6) . Multi- plied times four, that represents a huge amount of money paid in as premiums which will not be used to pay for health care. Instead, it will be used for an assortment of other purposes including advertis- ing, political contributions (very important), outrageous executive compensation and investors. Before Blue Cross Blue Shield became for-profit, in 1994, 95% of the revenue was spent on health care costs and 5% on admin- istrative costs (7) . When Blue Cross Blue Shield became for-profit, the “administrative costs” exploded to 20-35% depending on what they could get away with in any specific market. Medicare admin- istrative costs are 2%. UnitedHealthcare has a short-term plan with a Medical Loss Ratio of 37.3% (3) . Thirty-seven cents of every dollar are spent on paying health care costs while 63 cents are kept by the company as profit. exploitation will continue. Almost every other first-world or devel- oped country considers health care an essential public service and a government responsibility. This list includes Saudi Arabia, Dubai and the United Arab Emirates—not exactly examples of raging so- cialism. Fortunately, there appears to be an increasing recognition of the benefits of some form of single payor system in this country. Beth Johnson, MSLS, MSET is the Medical Librarian at Norton Downtown. Ms. Johnson’s investigative research skills provided much of the background information for this article. 1. https://scopeblog.stanford.edu/2009/11/17/no_one_goes_ban/ 2. Am J Med 2009:122:741-8 3. Getting Sick and Going Broke – Boston Globe, December 16, 2019 4. CNBC June 25, 2013, www.cnbc.com/id/100840148 5. Maine Law Review, 67:1 (2014) 1-23 6. New York Times, Sunday Review, November 14, 2019 7. penguinrandomhouse.com/books/319776/an-american-sickness-by-elis- abeth-rosenthal/97815942067571 Dr. Flynn is a retired surgical oncologist. Sadly, the current political ruling class is complicit in allowing this form of modern piracy to exist. Until that is addressed, this FEBRUARY 2020 29