Profits come before patients for insurers

Mark Mikowski, North Las Vegas

Saturday, June 27, 2009 | 2:01 a.m.

In response to a Tuesday letter to the editor by Richard McCord headlined “President’s plan will kill competition”: Mr. McCord says a government-run option for health care will not increase competition in the health care industry, but will kill it. He writes, “Americans trust the profit motive when it comes to buying just about everything else, so why not their health care?”

Here is an example of the profit motive in the health care industry in action. Last week in testimony before Congress, a parade of witnesses told stories of how they were denied coverage, after pre-certification had been given, for treatments of various ailments. That is called rescission.

Rescission is when a health insurance provider denies coverage to an individual based on something in that person’s previous medical records. It was originally intended to protect health insurance providers from fraud. However, its use has been expanded to increase the profitability of companies at patients’ expense. In one case, a gentleman lost his insurance right before he was to begin a stem-cell transplant to treat lymphoma because doctors had discovered gall stones during a CT scan.

Documents were produced at the hearing that showed insurance companies rewarding employees for pulling people’s coverage, thus driving up profits. When three health insurance executives called to testify were asked by subcommittee Chairman Bart Stupak, D-Mich., if they would end the practice of rescission except in cases of intentional fraud, all three replied “no.”

According to the group Health Care for America Now, from 2001 to 2007 the profits of the 10 largest publicly traded insurers increased by 428 percent, and health insurance premiums have increased 87 percent over the same period.

Why exactly was it I am supposed to trust the profit motive in the health care industry?