To The Workers In The Health Insurance Industry

It must be disheartening if you are one of the many employees of the health insurance industry to feel the resentment of policy makers and fellow citizens. The industry you work in is being blamed for a lion's share of the cost overruns of the health care expense in this country. However you are not to blame since you are, like any other loyal citizen, trying to earn a decent living for your family. The problem is the companies you work for have not fulfilled the bargain that established them. HMOs were created in the 1970s on the idea if people were guided properly through the health care system with a primary care gatekeeper and offering inexpensive preventive care everyone would be a winner. It didn't turn out that way. Those in your management embraced a model that no longer serves your fellow Americans well. It did for a few years but when they started to be more on their own, adding bureaucracy, and making deals that were too costly and consequently cost shifting to the subcriber, an ongoing era of double digit premiums ensued. Of course I'm sure a different view was portrayed in meetings and memos but ultimately it is clear that the path chosen by company executives has added expenses that no longer can be sustained by the general population.

To cover their tracks you were told it was the government that was the source of their problems. Medicare and Medicaid were not pulling its fair share according to their view. This is not true and in fact the current drastic situation would have come sooner if Medicare hadn't balanced out the shortcomings of HMO's business plan. For years your government was paying 130% of costs to hospitals, allowing heavy discounting to corporations such as yours. The spicket dried up in the 1990s with the Balanced Budget Act. Medicare reduced its payments via a DRG system to establish payments that paid essentially for costs. Since the insurance companies were no longer pulling their load, negotiations with the hospitals resulted in higher fees for their services. So now insurance companies had to increase their enrollments or cost shift to employer clients and subscribers. This process included some very expensive deal making inflating company negotiating and marketing teams. You should know that bureaucracy in private insurance has grown 1500% over the past 20 to 30 years. An astounding number.

All this is not your fault. However it must put a scare into you that moving to a more centralized efficient sytem will mean loss of jobs in your line of work. It cannot be sugar coated, this is true. The private health industry as it now constituted is dying. However there must be an effort to value your work contributions and no reform should take place if it adds to your misery. This would be highly unfair. This will take leadership from the President and proper action from the Congress. A tall order, I know, but not inconceivable. Other countries have made this transition and, quite frankly the handwriting is on the wall, There are too many people working in the insurance business to be sustained. It is no longer serving the needs of society. HR676, the Medicare For All Bill, now in the House of Representatives sets aside $20 billion dollars recognizing that layoffs will occur and provides for training and movement to more up to date services. If those of us who want to fix health care payment neglect you, our fellow citizens, we have not fully accomplished a fair solution to this problem.

There is a silver lining. Your own health insurance will cost less and the societal savings overall will allow entrepreneurs or present businesses to hire more people, create new positions, or even raise incomes. That would certainly be nice for a change. In this entire health care debate, you are the forgotten people and as a fellow countryman, your very survival should be part of the picture. We can not substitute one kind of suffering for another if it can be helped. Please join us in the Single Payer movement for the sake of your future, your family's future, and the future of your nation. We need your voices also to make sure you are not left out or mistreated for the work ethic you have shown. However there is also a caveat. Without changes the problem will grow and you will be left in a high and dry situtation. This must not happen.