For-profit insurers hinder access to health care

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Fifty-two percent of registered voters said they approved of President Joe Biden’s handling of COVID-19, according to a recent Harvard CAPS-Harris poll. I too approve. This is great news for the president. However, what is not reflected in this poll is how the COVID-19 pandemic has exposed some of the ugliest problems in America’s healthcare system.

Even though Dr. Anthony Fauci says our country is “out of the pandemic phase,” the issues highlighted by the coronavirus remain significant. Most notably, doctors’ offices, health systems and hospitals – especially in our most vulnerable communities – that were already struggling to stay afloat are now on the verge of closure.

For healthcare facilities to keep their doors open and provide quality patient care, they need adequate staff, adequate funding, and reliable resources. But even before the pandemic, the shortage of nurses in hospitals was a national crisis. According to a 2018 study by the Healthcare Financial Management Association, about 78% of hospitals reported facing a growing shortage of healthcare professionals, forcing them to fill gaps with traveling nurses and other temporary hires, which cost exponentially more than routine staff. Rising demand has allowed staffing agencies to raise prices disproportionately, so the cost of traveling nurses has nearly tripled, and by 2022 hospitals are spending almost 40% of their labor budget of work to traveling nurses only. It is therefore not surprising that many of these recruitment agencies are currently being investigated for predatory practices.

As a former congressman and former hospital administrator, I believe that one solution to protecting access to health care for Americans would be to ensure that health care systems are funded appropriately and that predatory behavior by recruitment agencies, insurance companies, pharmaceutical companies, etc., is investigated and stopped.

By their desire to create value for their shareholders, insurance companies have enriched themselves during the pandemic. Unfortunately, hospitals and patients have struggled to levels never seen before. Over the past 10 years, the average increase in the cost of coverage has been around 5.3%, but in 2021 the price of health insurance has increased by 10.4%, almost double the overall health care inflation rate. So where is all this money going if it’s not going to help patients? I applaud the success of the CEOs of the seven major insurance companies in the United States, who earned $283 million in 2021, and in the first quarter of 2022 alone, the five major insurers earned $262.8 billion. dollars. However, success must be balanced by measuring outcomes and improving inequities for the patients you serve.

In other words, Big Insurance created value for corporate leadership while creating unintended consequences for the distribution of money and resources that might otherwise have been available to patients and healthcare systems at across the country.

But for some reason, the media, patients and even healthcare workers have wrongly blamed healthcare systems and hospitals for rising costs and understaffing. It just happened in Indiana, where insurance advocacy groups tried to condemn Indiana hospitals for rising healthcare costs, while Indiana insurance plans profited from nearly twice the national average in recent years, earning $300 pure profit for each member each year, while the national average is $170 per member per year.

During the same period, from 2018 to 2020, Indiana insurance companies received $140 million a year in pharmaceutical rebates, which earned 91% of their profits. According to the Federal Trade Commission, these profits are “afterthought rebates” that offer little relief to patients.

Needless to say, hospitals, healthcare systems, healthcare workers and patients are fed up with these issues plaguing our healthcare industry. If nothing is done about practices that focus on profit rather than patients, more hospitals will continue to close, staffing levels will continue to drop, and patients will lose access to care, especially in our most vulnerable communities.

As insurance companies count their billions, hospitals serving urban and rural areas are closing and leaving huge gaps in care. A 2021 study found that nearly 47% of counties in the United States are considered hospital bed deserts.

We must champion and ensure that our corporate leaders have insight into not only healthy balance sheets, but also healthy lives.

Former Rep. Ed Towns represented New York for 15 terms. He served as director of the Metropolitan Hospital and then deputy administrator of Beth Israel Hospital for a decade. He served in the military and as an educator at Fordham University.

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