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Posts Tagged ‘HCR’

Wellpoint: You Will Never Find a More Wretched Hive of Scum and Villainy

March 21st, 2010 No comments

Let’s start with the basics. Wellpoint is the largest US health insurer, and its CEO is a charming woman named Angela Braly. From the Wall Street Journal:

Mrs. Braly is the CEO and president of WellPoint, the largest U.S. commercial health insurer by membership. Her company’s affiliated health plans in 14 states cover 34 million people—or roughly one out of nine Americans. It contracts with 82% of the nation’s primary-care physicians, 84% of specialists, and 94% of hospitals. That scale lands her on the most-wanted list in President Obama’s Washington, though it’s tough to imagine a less likely villain than the very Midwestern Mrs. Braly.

(Ah yes. She must be a good person if she’s from the Midwest, right, right. That’s some quality WSJournamalism.)

Times are pretty good at Wellpoint, and even better for Mrs. Braly. In 2008 the company took in 61.2 billion, yes, billion dollars. Mrs. Braly took in almost 10 million herself in total compensation.

Keep that figure in mind when you read this next bit:

In 2007, just as Democrats took control of Congress, WellPoint pledged that its charitable foundation would spend $30 million over three years as part of a “comprehensive plan to help address the growing ranks of the uninsured.”

However, WellPoint’s public records indicate that from 2007 to 2009 the foundation gave less than $6.2 million in grants targeted specifically at helping uninsured Americans get access to coverage and care — barely one-fifth of what was promised and just 11% of the charity’s total giving over the last three years.

To simplify: Wellpoint pledged, out of the goodness of their black corporate hearts, to spend 30 million dollars to help the uninsured. Keep in mind that much of this money could have landed right back in their pockets if the uninsured in question were ‘helped’ to buy Wellpoint products. However, they didn’t *feel* like keeping their word, so they broke it. C’est la vie.

Meanwhile Braly, who found the time to to take her measly ten million even as her company couldn’t scrape together the money they promised to charity, has been making the rounds in the business press.

Who’s to blame for the current woes? Why, everyone but the insurers, of course.

It’s hard to see how WellPoint could be to blame for surging health spending, Mrs. Braly says, when 85 cents out of every premium dollar or more “is paid out in the actual cost of care, doctors, hospitals, suppliers, drugs, devices.”

Yes, it’s so hard to see how setting 15 cents of every healthcare dollar on fire and flushing it down the Wellpoint toilet would drive up costs.

Oh, speaking of driving up costs:

Details: Braly, like Williams, earned more money in 2008 ($9,844,212) than in 2007 (9,094,271), increasing her option rewards by nearly $1.5 million, and also receiving a $200,000-plus bump in base salary, from $922,269 to $1,135,538. Braly’s stock awards dropped from $2,160,159 to $1,750,015 because, according to the SEC, “performance-based restricted stock units awarded in 2008 were cancelled because our ROE target for 2008 was not met.”

Braly’s “other compensation” comprised use of a private jet for her and her family on business trips, just under $10,000 for legal services relating to her employment agreement and cash credits.

Yeah, I’m having trouble identifying any waste in Wellpoint’s corporate structure.

Since it’s not Wellpoint’s fault that costs are soaring, whose fault is it, Angela? Why, it’s those dastardly government types and the hospitals that are to blame.

Depending on the plan, WellPoint’s monthly premium for a 20-year-old in Indianapolis, where the company is based, ranges from $53 to $202. But the same young adult looking for similar coverage in Albany would face costs anywhere between $832 and $1,047. Obviously health costs vary across the country, Mrs. Braly says, but these disparities are almost entirely due to New York’s regulatory mandates. In a state with 19 million people, 88 New Yorkers between the ages of 18 and 24—88!—have bought WellPoint’s best-selling individual insurance product because insurance laws make it perfectly rational not to acquire costly coverage until people need it.

This scheme would have been, and might still be, imposed on the rest of the country. At the request of several congressmen last year, including some Democrats, WellPoint mined its own actuarial data to model ObamaCare and found that it would as much as triple premiums for the small businesses and individuals who are most of the company’s customers. The White House political shop promptly compared WellPoint to a tobacco company.

Which is completely unfair. Tobacco companies would never triple prices in such a short time period; it’d drive them out of business. After all, Obama isn’t going to compel people to purchase THEIR products.

Meanwhile, the dastardly hospitals are forcing Wellpoint to jack up prices:

Mrs. Braly suggests that the industry gambled politically in part because the cost problem seems so insoluble, and that the hand of the industry was forced because the market clout of doctors and hospitals is making it increasingly difficult to contain health costs. “Is there competition in the underlying delivery system,” she asks, “and is that lack of competition potentially driving up costs? . . . People have been talking about competition among insurers, and what they really need to be talking about is competition in the delivery of health care as well.”

Realistically, it’s not as if there’s a market that sets health prices. Instead, they’re negotiated between providers and health plans. Perhaps the doctors and hospitals who were largely exempted from the tepid cost-control provisions in ObamaCare shouldn’t have been.

“We know there’s a lot of redundancy, a lot of waste,” she says. “If we have a contentious discussion with a major hospital system that people want to have access to,” Mrs. Braly explains, and WellPoint doesn’t meet its asking price, “then the question is what do you do about that access?”

Aside from the hilarity of the WSJ admitting that there’s no free market in healthcare, think about Braly’s disjointed illogic here. Waste and redundancy in the medical system drives up costs. The solution is more competition in hospitals, doctors, device makers, etc. So if you have an area served by one large, wasteful hospital full of redudancy, your solution is.. to build another large, wasteful hospital full of redundancy to compete with it? And this will drive down costs?

We’ve heard this refrain before, as Jon Walker pointed out. Insurance companies, whose sole job is to set up efficient systems for reimbursement of medical care, admitting in public that they are completely unable to do so. Their manifest failure somehow demonstrates the need to hand them 30 million new compulsory customers. Rather than instituting some proven system that would actually reduce costs, like single payer with a central reimbursement negotiator. Someone who could, say, set the prices hospitals can charge for procedures, the prices that pharmaceutical companies can charge for drugs, etc, in order to control health care inflation.

Oh wait, I forgot. Obama bargained away a government insurance option and drug price negotiation in secret months ago. Silly me.

Not to fear, though. Braly recognizes there is a problem with health insurance in America:

Mrs. Braly concedes that some people with pre-existing conditions can find it difficult to find affordable coverage, especially if they lose their job, get divorced, move, etc. “It’s when people have no option that we’re really in trouble and need to find a solution,” she says.

That solution of course won’t involve cutting her sky-high pay, or honoring their pledges to charity.

With such a trustworthy and honorable ally, I’m sure Obama’s HCR will go far.

Categories: Politics Tags: ,

The Handmaid’s Tale by Bart Stupak and “Pro-Choice” Democrats?

March 19th, 2010 No comments

In order to get my undergrad degree the university required me to take some general BA coursework to fill some generic requirement or other, prove I was functionally literate, you know the drill. So one semester I signed up for a ‘Women of Science-Fiction’ class from the English lit department.

It was about what you’d expect. Well, worse, since it was a women of sci-fi class that barely touched on Ursula K. LeGuin or any decent authors, taught by an aging hippy professor who picked some of the worst books I’ve ever had to read. (Including this little pro-eugenics piece of trash)

When we came to The Handmaid’s Tale, I was exasperated. The book opens with a brief description of the United States succumbing more or less overnight to theocratic military despotism. In our classroom discussion, I tried to explain what I thought was the political impossibility of a the world’s most powerful democracy made up of slightly under 50% women quickly and willingly becoming such a place. The majority of women, I said, would have had to support such a change, not just the majority of men. And that, surely, would never happen. Why would women, let alone women in positions of power, willingly throw themselves under the bus to become second-class citizens?

I suppose we’ll find out if I owe Margaret Atwood an apology in a couple of days.

Categories: Politics Tags: ,

My Premiums Only Went Up 15% This Year, So Obama Says I’m Doing Great

March 16th, 2010 No comments

Well, we got ours today, so to speak. Our health insurance plan is coming up for renewal and we got our rate increase notification.

It’s only a 15% hike. Only 15%. Only about five times consumer inflation.

Sigh.

A lot of people have gotten it a lot worse, obviously, as the private health insurers that we may shortly be forced to patronize gouge the end consumer to line their pockets.

Still, as we all know by now, under the Obama-Senate health plan, costs aren’t going down. No matter how much free market economagic Ezra Klein believes in, or how many chickens Jonathon Gruber sacrifices to the great Gods of Capitalism, hard data tells us the truth: they’re only going up.

The Exchange will not bring down costs, nor your premiums, at least not for long. They will continue to go up. Period.

Oh, and that plan that Obama rolled out for an Insurance Rate Overseer? The Devil’s definitely in the details on that one:

The legislation would call on the secretary of health and human services to work with state regulators to develop an annual review of rate increases, and if increases are deemed “unjustified” the secretary or the state could block the increase, order the insurer to change it, or even issue a rebate to beneficiaries.

The new rate board would be composed of seven members, including consumer representatives, an insurance industry representative, a physician and other experts like health economists and actuaries, the White House said. The board’s annual report would offer guidance to the public and states on whether rate increases should be approved.

That’s right. An unelected board composed of people like Jonathon Gruber, insurance execs and actuaries, along with some token ‘consumer representatives’, will be charged with overseeing future rate increases.

Their carefully considered advice can then be summarily ignored by the Secretary, but hey. I’m sure everything will just work out. Unelected and unaccountable boards always do such a good job; I’m just overflowing with confidence.

It’s not like our government is in the business of cutting secret backroom deals with powerful players in the health industry. Surely they will be good partners, err, stewards, of the insurance industry.

Categories: Politics Tags: ,