TruthToTell June 11: HEALTH INSURANCE COMEUPPANCE: Companies Make the Case for Their Replacement – PODCAST HERE

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Every time I think we may be returning too often and concentrating on the health care issue on this program, I’m upended by the plethora of stories coming from every quarter of the health care universe – most of them unearthing fraudulent or deceptive practices by a healthcare system run amok. To wit:

1. Locally, the Health Care for All Minnesota group, which under its former banner, Minnesota Universal Health Care Coalition, is peopled by a mix of physicians, former healthcare providers and health insurer types, not to mention citizen advocates of extraordinary dedication to the idea that the medical and insurance system in the USA and Minnesota is riddled with uncaring incompetence and a focus on the money to be made or saved by providing the absolute minimum levels of care to everyone – or no care to many while their bottom lines bloat and their collection tactics smell (see Accretive Health and Fairview Medical). Attorney General Lori Swanson’s report has blown up Fairview’s management.
2. From a Stateline (Pew) report on Medicaid fraud: “Nationwide, the federal government estimates it lost $22 billion of its share of Medicaid funding last year to what it calls “improper payments,” according to its payment accuracy survey. This suggests that the loss to state treasuries was also in the tens of billions.”

   Improper payments refers to Medicaid paying out those billions to fraudulent providers. Do these stories hit the mainstream media? Rarely. How does the public generally view Medicaid (and welfare) fraud? As perpetrated by the legendary “welfare queens” so often heard about in drunken bar conversations and on Fox News. The tiniest percentage of assistance recipients may game the system – but it’s a flea on a pinhead compared to the blanket billions of taxpayer dollars vacuumed up by thousands of doctors, dentists and other providers, each of whom can hit on the Medicaid Fund to the tune of millions per month, compared with a few thousand over a full year for an unscrupulous recipient.

3. And not so finally, the health insurance industry whose sole purpose for being appears to be in denying, not supplying, health benefits. In fact, an assessment by one of Minnesota best-known health insurance analysts, Kip Sullivan, talks about the new wrinkle in what we used to call HMOs (health maintenance organizations) and are now called ACOs – accountable care organizations – although there are, indeed, some distinctions, namely the size of the risk, the number of enrollees (that’s us) and the provider pool (the medical-dental-hospital community). Beyond this, this will involve Medicare and Medicaid recipients under the new Affordable Healthcare Act (Obamacare?). We’ll learn more about these Monday, we trust.

   But, the health insurance industry is a study unto itself. We’ve heard for years that any notion of a single-payer or healthcare for all system smacks of socialism or that it would be too costly and that “the Best Health Care System on the Planet” would be fatally compromised. The fact is, the insurance industry has claimed millions of lives and ruined others through its coordinated denial of health care services and exploded costs to the tune of 16% – or nearly ten times the overall national inflation rate – per year. This, from the former CIGNA executive, Wendell Potter, author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, whom Barack Obama cited as an authority in his quest for health care reform legislation. Potter, now a senior analyst at the The Center for Public Integrity, among other positions, was CIGNA’s spinmeister, if you will.

Mr. Potter joins our discussion along with local insurance whistleblower, David Feinwachs and Dr. Ann Settgast of Physicians for a National Health Plan (PNHP). As usual so much to cover, but important in its own right and as a set up for the following Monday’s show on a report – Beyond the Affordable Care Act Web.pdf – issued by our local progressive policy group, Growth & Justice on which we’ll feature G&J’s president, Dane Smith and the report’s author, Amy Lange, RN, MS, CNM and Growth & Justice Policy Fellow on Health Care, and Dr. Elizabeth Frost, also of the PNHP and HCAMn.

TTT’s ANDY DRISCOLL and MICHELLE ALIMORADI start this week with the status of state and national health insurers as we work our way toward full implementation of the Affordable Health Care Act – unless it’s thrown out in the middle of our conversations with our reform advocates.