Mar 7, 2010

Maybe the fact that it came from Goldman will motivate some people to take a second look at where we are on health care. Goldman likes the two biggest health insurance companies because it says profits are going up due to lack of competition and lack of regulation. Like the foreclosure mess, the fact that this is further damaging what was once a healthy middle class doesn’t seem to enter the equation probably because Goldman has a proprietary interest in those companies.

The net result, if Goldman is right about the failure of health-care reform, is that premiums will continue to rise thus further reducing median income which in turn will further reduce housing prices. Fewer and fewer people will be able to afford anything close to reasonable coverage which now costs as much as $30,00 per year for a middle-aged couple. Bankruptcies resulting from medical bills — already at 50% of all bankruptcies — will continue to rise, as will defaults and foreclosures putting further pressure on housing prices. And, as we already know, a decrease in housing prices results in a failing economy. In the courtroom, we say that intent is determined by the result if it was reasonably foreseeable.

Don’t get me wrong. reasonable people can disagree on the issue. But the fact is that while companies in other countries have national health-care plans, some with private insurance companies that are strictly regulated, and some without any insurance companies, some with a mix of public and private, the U.S. has the worst of both worlds — unregulated insurance companies that do not provide a national system under which everyone is covered. The worst consequence is that we have the worst health outcomes and death rate compared to 36 other countries. So the cost factor of providing insurance keeps going up while the benefits are decreased here. Each U.S. company is subject either to lower profits because it does provide insurance to its workers or lower productivity because the good workers are going elsewhere. Only in America.

Between the insurance industry and banking flooding the state and national capitals with lobbyists there isn’t enough hotel space to put lobbyists for us ordinary folk.

March 6, 2010

Obama Wields Analysis of Insurers in Health Battle

By DAVID M. HERSZENHORN

WASHINGTON — To bolster the case for a far-reaching overhaul of the health care system, the Obama administration is seizing on a new analysis by Goldman Sachs, the New York investment bank, recommending that investors buy shares in two big insurance companies, the UnitedHealth Group and Cigna, because insurance rates are up sharply and competition is down.

White House officials on Saturday said that the Goldman Sachs analysis would be a “centerpiece” of their closing argument in the push for major health care legislation. The president and Democratic Congressional leaders are hoping to win passage of the legislation before the Easter recess. Republicans remain fiercely opposed to the bill.

The Goldman Sachs analysis shows that while insurers can be aggressive in raising prices, they also walk away from clients because competition in the industry is so weak, the White House said. And officials will point to a finding that rate increases ran as high as 50 percent, with most in “the low- to mid-teens” — far higher than overall inflation.

The analysis could be a powerful weapon for the White House because it offers evidence that an overhaul of the health care system is needed not only to help cover the millions of uninsured but to prevent soaring health care expenses from undermining the coverage that the majority of Americans already have through employers.

Republicans, however, could also point to the analysis as bolstering their contention that Democrats should be focused more on controlling costs and less on broadly expanding coverage to the uninsured.

The research brief is largely based on a recent conference call with Steve Lewis, an industry expert with Willis, a major insurance broker.

In the call, Mr. Lewis noted that “price competition is down from a year ago” and explained that his clients — mostly midsize employers seeking to buy health coverage for their employees — were facing a tough market, in which insurance carriers are increasingly willing to abandon existing customers to improve their profit margins.

“We feel this is the most challenging environment for us and our clients in my 20 years in the business,” Mr. Lewis said, according to a transcript included in the Goldman brief. “Not only is price competition down from a year ago,” he added, “but trend or (health care) inflation is also up and appears to be rising. The incumbent carriers seem more willing than ever to walk away from existing business resulting in some carrier changes.”

The report also indicated that employers are reducing benefit levels, in some cases by adding deductibles for prescription drug coverage in addition to co-payments, and raising other out-of-pocket costs for employees as a way of lowering the cost of insurance without increasing annual premiums and employee contributions to them.

Kathleen Sebelius, the secretary of health and human services, is expected to discuss the Goldman analysis on two Sunday television talk shows, “Meet the Press” on NBC and “This Week” on ABC.

In his call with Goldman, Mr. Lewis said beneficiaries were feeling the brunt of the changes to existing policies. “Visually to employees, they’re fairly significant,” he said.

But the report also sounded cautionary notes that the administration will probably not want to highlight.

Asked by Goldman analysts about the effort to pass major health care legislation, Mr. Lewis said many employers experiencing increases in their insurance costs were nonetheless apprehensive about the president’s proposal.

“They’re very mixed in their reaction, quite candidly consistent with what we’re seeing in the polling numbers by party lines,” Mr. Lewis said. “I think most people would acknowledge that there’s a need for health care reform; employers continue to be very frustrated. So when they look at what the Obama administration and the Democratic majority state as their goals to increase access and lower cost and rail at what may be termed oligopolistic behavior of carriers in certain markets, I think employers really buy in to that message and have much of that frustration and anger at our lack of solutions.”

And yet, he said, there is little enthusiastic support from employers for the Democrats’ proposals.

“Many of them still view the legislation and the partisanship coming out of Washington as possibly the medicine worse than the disease,” he said. “So many employer groups that we’re talking to feel like it would be a shame to lose an opportunity to do something with respect to health care reform. But many are starting to feel like maybe nothing is better than something in this current environment.”