Could greed and a sentence in a law lead us to single payer? It's a bit convoluted, but here goes...
A little bit of economics. Business is in business to make money for itself, and often stockholders. If a business cannot make a profit, it goes out of business. How much money does a business have to make to be viable? It depends on the business, but it generally relates to the amount of net income divided by the revenue. "How much" a company needs depends on its greed levels. Supermarkets, for example, generally run on very low profit margins, of under 5%. What that means is that for every dollar you spend on food, after subtracting out salaries, rents, taxes, food and transportation costs, etc., the market earns less than 5 cents. Some businesses, like Wall Street investment banks, feast on much fatter margins.
In the medical field, profit margins are very slim, with two major exceptions. Doctors, hospitals and other providers have slim margins, drug companies and insurance companies tend to have large profit margins.
Remember the Affordable Health Care Act? From the government:
Today, many insurance companies spend a substantial portion of consumers’ premium dollars on administrative costs and profits, including executive salaries, overhead, and marketing. Thanks to the Affordable Care Act, consumers will receive more value for their premium dollar because insurance companies will be required to spend 80 to 85 percent of premium dollars on medical care and health care quality improvement, rather than on administrative costs, starting in 2011. If they don’t, the insurance companies will be required to provide a rebate to their customers starting in 2012.
Most people would think 15 - 20% profit was acceptable. And remember, "profit" comes out of those "administrative costs". It appears that it's not enough for a lot of insurance companies. Note that the reason there are two different numbers are that it's 85/15 for large group policies, and 80/20 for the smaller and individual policies because it costs less to insure a large group than a small one. So what are the insurance companies doing? Some are banding together to reduce costs, and others are leaving the market all together. A right wing group put all the data together about which companies are leaving, and I posted it after the jump. Ignore their pandering, and look at the sheer number of companies that are leaving the business on a state-by-state business.
The right wing group views the movement of private insurers away from the market as a bad thing. In fact they subtitle the article "Millions to lose the health coverage they have now." But I see it as something quite different. First off, in a free market, it you can't make a profit earning 15 to 20 cents on every dollar of revenue, you deserve to be branded "idiot" and leave the business. The only companies that can't survive on that are just plain greedy....and well, who do we know who can provide the same services for administrative costs (or, um, what private industry calls "profit") of 2 to 4%????? MEDICARE!
So kids, here we have a case of government being able to provide a service at, basically, a profit (or at least breaking even since government is not private industry) for many more people than private insurance ever covered, with high satisfaction scores.....hhhmmm....what's Medicare for all? Single payer. Go figure.
And think about it: a lot of people are opposed to changes in the insurance structure because they HAVE insurance and it works fine for them. Normally, these are people who work for large companies and have never faced a major illness or chronic condition. But as prices go up and up and up at those companies, and the exchanges come on line, these folks may well feel differently if they can get the same (or better) insurance for less money. This will drive public opinion, which we know often influences lawmakers. Add to that the Vermont Single Payer system currently under development, and we may well have Single Payer before the end of the decade across the land. To the benefit of all.