Dr. Steffie Woolhandler: "Private health insurance is a defective consumer product"

[Better Believe It]

What About a Single-Payer System?
By Steffie Woolhandler
New York Times
August 10, 2009

Steffie Woolhandler is an associate professor of medicine at Harvard Medical School, a primary-care doctor and co-founder of Physicians for a National Health Program.

“The Health Insurers Have Already Won” reads the cover story in Business Week’s Aug. 6 issue. That’s the short answer to why the public option option is off the table as well as to why the new bill will use an individual mandate to force the uninsured to buy private insurance. Or, more fundamentally, why Congress didn’t pursue the single-payer, Medicare-for-all approach used in other developed nations.

.... single payer would eliminate private insurance, saving nearly $400 billion annually on insurance and provider paperwork, enough to cover the uninsured and plug the gaps in coverage for those with insurance.

In 2007, 62 percent of U.S. bankruptcies occurred in the wake of medical illness, and 77 percent of those in medical bankruptcy had health insurance (usually private insurance) when they first got sick.

Private health insurance is a defective consumer product, and Congress has no business forcing uninsured Americans to buy it.

In order to get the bill out of committee, Speaker Nancy Pelosi promised single-payer supporters, led by Representative Anthony Weiner of New York a floor vote in the fall. This is a tremendous victory for single-payer supporters like my group, the 16,000-member Physicians for a National Health Program. Members of Congress, many of whom say they personally support single payer, must now go on record on the eve of the 2010 electoral cycle. Constituents take note!

http://roomfordebate.blogs.nytimes.com/2009/08/10/what-happened-to-a-public-health-plan/



Dr. Steffie Woolhandler

[TreasonousBastard]

1. Is Dr. Steffie up to doing her part and taking a pay cut to...

reduce provider expenses?

Does her plan put doctors on salary? Cut hospital costs?

Enforcing a uniform claim payment form would be one huge step forward to reducing all this paperwork everyone complains about.

(Doesn't Medicare enforce a simple payment form even though it uses private insurance companies for clainms processing? I really son't know.)

[rollingrock]

3. You assume too much.

Dr. Steffie works at a public, non-profit teaching hospital which is affiliated with Harvard Medical School. Hence, she receives the salary of a professor, not a private physician.

[TreasonousBastard]

4. I assume that when she says she is a "primary care physician"...

she sees patients.

More to the point, I haven't seen Dr. Steffie, or anyone in her group, advocate for lower costs in providing care. Perhaps someone could show me where she has a plan for that.

Our current system has interns owing a quarter million or so fighting for residencies in the high paying specialties, with primary care and internal medicine getting the leftovers. Our current system also has extraordinary hospital costs built into the bills for $10 aspirin tablets. Insurance has as little to do with this as it does with a bill for $20,000 for a normal birth.

Somewhere floating around is a program, possibly long dormant, giving scholarships to med students who promise to work primary care in underserved areas. The Army once gave scholarships to anyone agreeing to spend a few years as a military doctor. We were opening local clinics as an alternative to the ER for small things.

Lots of stuff has been done, and we can do so much more. Focusing on insurance as the fulcrum for change avoids doing the heavy lifting that will give us better and more affordable care.

[rollingrock]

5. What part of non-profit and public do you not understand?

Do you know how much she could be making working as a private physician as opposed to the work she is doing now, serving mostly low-income patients at a public hospital? She has sacrificed plenty, don't you think? Or perhaps you think she should be working for free?

And how about we start by eliminating the tremendous overhead costs required by private insurance, which makes up 1/3 of healthcare costs as opposed to just 1% taken up by Medicare?

If we did that, maybe the private physicians could then afford to take some paycuts because their sky-high administrative expenses wouldn't be so high.

[TreasonousBastard]

6. I have no idea what she does in her spare time, but nowhere...

does she address provider costs in her studies and op-eds. Perhaps she has and I've missed it.

And, once again, the ignorance is astounding-- Medicare's expenses are so low because, like TRICARE, it contracts out much of the the admnistrative costs to private insurers. But, leftwing memes and bullshit have the same staying power as rightwing memes and bullshit.

One would think that insurance companies, while so greedily denying claims, would also manage their expenses to low levels. But, that never seems to compute, for some reason. Rent, phone bills, office salaries... the government would never have any of these if it picked up ALL expenses, would it?

(I have already been called a shill, Freeper, Republican, and several kinds of asshole for pointing these things out, but feel free to come up with more insults if you wish.)

[rollingrock]

8. Spare time? You can't be that ignorant, can you?

She works full time at a PUBLIC, NON-PROFIT TEACHING HOSPITAL.
That is her full-time JOB, not what she does in her spare time.


United Health CEO earned $124.8 million in 2005:

http://healthcare-economist.com/2006/02/14/united-health-ceo-earned-1248-million-in-2005/


The CEO of UnitedHealth Insurance makes about 200 times the average annual salary of a practicing private physician in one year, and about 250-300 times the salary of a physician working in the public sector.

So instead of demanding sacrifices of doctors, why don't you start by demanding cut backs on the extremely lavish, outrageous compensation levels of these insurance company executives?

[Oregone]

7. "Focusing on insurance as the fulcrum for change"...

Its a good start. Even single-payer nations are starting to realize its merely a start (as they explore methods to socialize aspects of health care delivery). But to look at the US's terrible condition and shun single-payer insurance reform for not doing enough is a bit too over the top, even for myself. You have to start somewhere, and the insurance end is as good as a place as any. Its instant savings, but by all means, there will be plenty of room for improvement thereafter

[rollingrock]

9. Overhead costs

"Medicare's expenses are so low because, like TRICARE, it contracts out much of the the admnistrative costs to private insurers."

No, that's not true at all. Unless you're talking about the Medicare Advantage program, which is an entirely separate program run by the private insurance companies.

Here's a GAO report comparing traditional Medicare to the for-profit Medicare ADVANTAGE program run by the private insurance companies:

'The Government Accountability Office reported that in 2006, the (Medicare Advantage) plans earned profits of 6.6 percent, had overhead (sales, etc.) of 10.1 percent, and provided 83.3 percent of the revenue dollar in medical benefits. These administrative costs are far higher than traditional fee-for-service Medicare.<20>'

http://en.wikipedia.org/wiki/Medicare_%28United_States%29#Part_C:_Medicare_Advantage_plans




Speaking if which, you ignore the overhead of profits in your evaluation of overhead costs. Profits are something private insurance companies are required to produce and maximize for their shareholders. And unlike private insurance, profits are a mammoth overhead that traditional Medicare is not burdened with.

[eridani]

12. Getting rid of insurance profiteering lowers provider costs. n/t

[ProSense]

2. " That’s the short answer to why the public option option is off the table"

The public option is in both the House and HELP bills. The Finance Committee is the one screwing around.

Still, public option is not off the table in reform.

[debbierlus]

16. The public option was reduced to a sorry political gesture

when they took out tying the rates to Medicare, limited the number of enrollees, and delayed the time frame for enrollment several years.

The devil is in the details. The public option is a toothless tiger and a HUGE distraction from the dialogue of creating real reform.

[Vinca]

10. When big insurance CEOs rake in $100,000 an hour,

defective is about the nicest thing you can say about it.

[WeCanWorkItOut]

11. Steffie W is not too reliable, but it's good that someone is talking about the unfairness

Steffie Woolhandler has hurt the quality of the health care debate in a number of respects, in my opinion. She seriously overestimated what a single payer plan could save on administration. (Savings are certainly possible, but much less than she imagined.) There's also the problem that Medicare, which she has held up as a model, has been much too easy on waste, fraud and abuse.

Steffie has also neglected the issue of overpaid doctors and their increasing monopoly power. In fact, she seems to support that.

So I can't consider her a reliable analyst. But this bill may be painful for many lower-income people. So I'm glad someone's saying it in the Times. Even if it is Steffie.

(Thanks for the link to the Business Week article in a previous posting.)

[Binka]

14. LOL!

Don't quit your clown job dear. It is pretty clear that the big shoes and red nose suit you.

[Orsino]

13. Let's say "selective consumer product."

A collection of premium offerings not intended to benefit working Americans.

[debbierlus]

15. So, why is this board so adamant in defending mandated purchase of this defective product

By supporting Obama's mandated private health insurance plan, they are advocating for the big corporations.

Point out that they need to oppose the plan and demand real reform, the pitchforks come out.

I guess as long as you don't call out the political salesman for the insurance industry, you are fine.