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Cross posted at Blue Indiana

I woke up a little groggier, and a little later than normal and flipped immediately to the Opinion Page, and then to Business. I then begun to read the headline of the Sunday Indy Star, "Wellpoint Going on the Offensive" and was delighted for a moment that a full page article was dedicated to the health care reform with a public option debate. Instead, it's a hit piece and quotes Wellpoint lobbyist's at length.

It begins with, "'What our goal is, is to make sure we fix what's broken but leave in place what works,' WellPoint Chief Executive Officer Angela Braly told Indianapolis Star journalists during a recent meeting on health-care reform."

"Braly sees the innovations and efficiencies spurred on by the private market, which includes the $61 billion company she heads, as a big part of what works in U.S. health care."

I am sure she thinks that. Angry doesn't even begin to describe my reaction.

Much more stewing and aggressive finger waving after the jump.

The company opposes a public plan, such as Medicare, that would be open to all Americans and would compete with private insurers such as WellPoint. It's an approach that was backed by Obama during last year's campaign.

To get out its message:

WellPoint spent $1.22 million lobbying the federal government in the first quarter of 2009 to see its position on health reform and other issues was heard, according to disclosure forms. That's a 16 percent increase from its lobbying spending in the same period a year ago.

Last week, the WellPoint Institute of Health Care Knowledge, a unit of the company launched about a year ago, released a report "dispelling the notion that insurer profits are fueling spiking costs." Instead, the report points to factors including advances in medical technology, price inflation for services and lifestyle factors such as obesity.

When it comes to reforms in health- care coverage, WellPoint is touting the idea of expanding the individual insurance market as the way to provide coverage to the estimated 46 million Americans who are uninsured.

WellPoint, with about 35 million members, and other insurers would drop their longstanding practice of excluding people with pre-existing conditions. In return, the government would require that everyone buy insurance and provide subsidies for those below certain income levels.

I find it extremely rich that Wellpoint, a company that last year had 59 billion dollars worth of revenue, with 3 billion profit, is telling the government that if they accept people with preexisting conditions than they should be forced to buy that insurance, and that subsidies should be utilized to ensure that it's affordable for all.

Here's a question: in terms of cost controls, efficiencies and other factors that can be used to bring down the total costs of health care, what incentive would Well Point have to bring down their overhead? In many instances, companies have monopolies on certain states, including in Indiana. Wellpoint, according to a new study released by Health Care for America NOW! entitled "Indiana Health Plan Premiums Soar as Insurers Face Less Competition" Indiana's market is saturated by Wellpoint at 60%. That's right, 2/3 of everyone with health insurance by a private insurer in the State of Indiana are serviced by Wellpoint.

In the last 8 years, premiums have increased for Hoosier families by 83%. But according to Wellpoint, this can be attributed to more expensive tests and people being obese. This is on it's face ridiculous. The Department of Justice, once a company rises above 42% of a market, it is considered highly concentrated where an "...insurer could raise premiums and/or reduce the variety of plans or quality of services offered to customers with impunity."

Wellpoint also has the highest rate of stock repurchases, and its profitability in the last eight years has skyrocketed disproportionately to the rest of the market, all while denying life saving treatment to its customers. The median earned income of an Indiana worker as of 2007 was $27,330, while the cost of a family health care package went from $6,600 to over $12,000 a year from 2000-2007.

The possibility of a public-plan option is of particular concern to commercial health insurers such as WellPoint.

"We think there are some real concerns there with trying to have a level playing field when government comes in and competes with you," said Braly. She said that up to 130 million people could migrate into such a plan if offered.

That, she said, would prompt commercial plans to pass on higher costs to members to make up for what tend to be lower reimbursement rates paid by government programs.

Now, for the CEO of Wellpoint to make the argument that government coming in would be an unfair 'leveling of the playing field' while they control over 60% of the market in Indiana, and 68% of it in Indianapolis proper, it's important to note that she knows and understands that this is a line. Furthermore, I don't know how they came to the conclusion that 130 million people would migrate to the government plan, but if that is the case, doesn't that prove that it would be a more affordable alternative, and that the private insurance market cannot reasonably compete with the economies of scale that a government plan can provide?

A new study by the WellPoint Institute of Health Care Knowledge, the lobbying research arm of Wellpoint, comes to these conclusions that the main drivers of cost in health care are:

Advances in medical technology and subsequent increases in utilization.
Well this is fantastic for people who have coverage, but at the same time the initial cost of medical advances if you are going to attribute it to that has pushed people off the roles.

Price inflation for medical services that exceeds inflation in other sectors of the economy.
Huh? Why would this happen? Someone explain to me why the price inflation of goods in the medical field would be higher than elsewhere? Because the availability of funds from the health care industry is higher and thus increases prices? Is it because the companies providing the goods purposefully keep down production to increase costs?

Cost-shifting from people who are uninsured and those receiving Medicare and Medicaid to the private sector.
Cost-shifting per the uninsured is the fault of the insurers, and thus can't be attributed formally to the increase in costs; and furthermore, I can't understand why shifting from medicaid and medicare, which tend to pay out lower than private insurers, shifting to the private sector would be a reason for the INCREASE in costs.

High cost of regulatory compliance.
Are insurance companies experiencing higher rates of regulatory measures now than they were five years ago? Eight years ago? If not, why would this be attributed as being one of the costs.

Patient lifestyles, such as physical inactivity and increases in obesity.
This is certainly true, and many companies have picked up on how Wellness programs can help fight this. Also, part of the reason why there is so much physical inactivity is because people are working such long hours to be able to afford health care. Obesity is a problem that can be attributed to diet, which tends to be on the cheaper, high fructose corn variety

Well point's CEO understands that it's "...unclear where support is in the Senate."

Please call Senator Evan Bayh if you live in Indiana: (202) 224-5623

And if you don't live in Indiana, there is a handy 1-800 patch through number provided by AFSCME at: 1-888-460-0813. Ask your Senator to support the public option.

I'm not going to provide a script because I think most if not all of you know what to say. It's affordable, and will increase competition that isn't happening.

And let's be honest about what this is about. It's corporate welfare v. life saving treatments. I have good friends who had cancer who couldn't get treatment, and aren't with us anymore. I know diabetic family members who couldn't get their insulin.

This is the fight for our country's citizens basic human rights and the future fiscal solvency of America. Let's act like it.

And to further enrage the senses...

Commercial insurers such as WellPoint, he said, have overhead rates running from 5 percent of premiums for self-insured large companies to 40 percent for individual insurance.

Dr. Samuel Nussbaum, WellPoint's chief medical officer, has a response for such criticism.

WellPoint's administrative costs, he said, include services for patients to improve care such as 24-hour nurse lines, and care coordination for those with chronic diseases.

"If you talk to seniors (on Medicare) who have multiple chronic illnesses, they're on their own," Nussbaum said.

He echoed Braly's message on reform: "The private sector has solutions today."

24-hour nurse lines really are worth it. Otherwise, I might have to go the hospital because I, you know, have insurance.

A Note: I support Kennedy's proposal in its spirit. Let's hope we get there, but it's awfully promising that Baucus and him are 'working together', if the press reports are to be believed.

Originally posted to WorkingClassHero on Sun May 31, 2009 at 10:19 AM PDT.


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