Public Enemy No. 1: Health Insurers

Philip Betbeze, for HealthLeaders Media , August 14, 2009

I'm not defending health insurers. To a large extent, they are sleeping in a bed that they've made. Retrospective denials of coverage, dropping patients when they become too expensive, and other high-profile, borderline unethical activities that seem to put profit well ahead of patient welfare haven't helped. Not to mention that insurance company chief executives have enriched themselves grossly, to the apparent detriment of some patients. These activities have left health insurers more hated than just about any group besides perhaps lawyers. Did I mention most members of Congress are lawyers? But I digress.

In tarring one industry though, often the nuances get lost. Health insurers for years have only been responding to demands by employers—the ultimate payers in healthcare—to cut costs. Many hospitals and health systems, until recently, haven't done much to demonstrate that they're providing value in the equation either.

But this is what happens when you start playing to the lowest common denominator in the face of complicated problems. Health insurers = bad. Other segments appear to have gotten lucky—this time.

I'm simply suggesting that demonizing one segment of an industry and smacking it down with a public option isn't going to solve the problem. Drug companies got a cheap way out this time.

But watch out hospitals. You might be next. The opening bid, apparently, is $155 billion over 10 years.

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Philip Betbeze is senior leadership editor with HealthLeaders Media.

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