The State of Our Healthcare Industry is Weak

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Bush said tonight that when it comes to our health care, private insurance is the way to go. As you take that in, consider this: Americans spend $5,000 more per capita on health care, fully 50% more than any other country.

What’s Bush’s solution? According to the Washington Post, Bush wants to redirect federal money away from hospitals that serve the poor and uninsured, and away from Medicare and Medicaid. Redirect it where, you ask? To private insurance companies, of course.

Now consider this: Private insurers take a dollar for every five dollars in the health care industry. It’s a super-duper rip-off. How? Well, have a look at the “medical loss ratios” of major insurers—that is, how much insurers pay in doctors bills, hospital bills, tests and drugs, divided by their revenue in insurance premiums.

  • 76.9% – Aetna
  • 82.3% – Cigna
  • 83.9% – Health Net
  • 83.2% – Humana
  • 78.6% – UnitedHealth Group
  • 80.6% – WellPoint

Get it? You pay Aetna $100 a month? They spend $76.90 percent on your health and $23.10 on corporate overhead, administration, and their own healthy profit margin. That list was compiled by Jonathan G. Bethely of American Medical News, but it’s quite easy to find in insurers’ SEC 10 filings, though insurers prefer to call it “benefit cost ratio” and “benefit expense ratio.” (Whatever they call it, it’s no perfect measure, argues James Robinson, a UC Berkeley professor of public health. But it’s what we have to work with.)

And it’s not all. How many staff at doctors’ offices and hospitals devote their time to billing, negotiating, and haggling with insurance companies? In order to get private insurance companies to pay up, doctors’ offices spend 14 percent on “billing and insurance-related functions” and hospitals spend another 7 to 11 percent, according to the journal Health Affairs.

Add that up and you see that one in three dollars in the healthcare industry is spent on neither health nor care. That’s how efficient the market is! The state proposals to force people to buy private insurance — and Bush’s proposal tonight to divert money from government caregivers to private insurance — just send more money down the drain. The answer is single-payer health care. But in the meantime we have patchwork plans like Arnold’s, though at least his would cut what insurance companies skim down to 15 percent.

— April Rabkin

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

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