Health Care Conundrum

Dylan Ratigan of Morning Meeting, asked health insurance lobbyist and guest, James Klein of the American Benefits Council ---"Are you in favor of perpetuating the monopoly for health insurance, [i.e.,] the anti-trust exemption?"

Ratigan asked Klein the same question over and over and Klein avoided answering, insisting it was a "charged question."

This is not a charged question.

The reason this question is important, is because most people in this country would have never known or suspected that Health Care Insurance Companies were exempt from the Sherman anti-trust laws. People who go to manufacturing plants, schools, hospitals, and a thousand different types of business offices to work every day, and then go home to meals, cleaning, bathing, homework, lawncare, and another thousand different types of chores, have no time to sit at home and enjoy a leisure browse through the Internet on the latest government fiasco, or news scoop on how they are being ripped off.

There is so much dishonesty now, that it fails to raise the interest of most---except for those who can find a small market niche in working for corporations who want them to put on a public face in town hall meetings.

Wikipedia adds this explanation: the U.S. Supreme Court in Spectrum Sports, Inc. v. McQuillan: outlined that, "The purpose of the [Sherman] Act is not to protect businesses from the working of the market; it is to protect the public from the failure of the market. The law directs itself not against conduct which is competitive, even severely so, but against conduct which unfairly tends to destroy competition itself."

So finally, it has come to the attention of some people that Health Care Insurance Companies are exempt from anti-trust laws --- the only corporate group as a whole, as far as the public knows right now.

You might ask why. I did. But there is no answer except somewhere, somehow, elected representatives heard one side of a story and bought into it---or were bought.

This is not good for you if you are a Republican, because if you are a sincere believer in your own principles, you would tout open and free competition. You might have enough money to become a budding Health Care provider, but in most states, your aspirations wouldn’t have a chance. This has to be very bad news for you because you believe!

You are sold on your theories and want to be able to jump into any market and prove your are better---that is, you believe that Adam Smith was right and that your principles produce the best economic wealth for all people in all nations. This is a solid and concrete precept to you and there are no mitigating factors. You don’t believe in coersive monopolies. You believe in natural monopolies and you think you have the know-it-all to get into the business and provide the best, most efficient Health Care on the market.

If you are a Democrat and are in favor of torte reform, this becomes a huge issue that has developed over the years and makes the anti-trust laws extremely important. You see as soon as it became widely known that Health Care Insurance Companies were defrauding good people with honest insurance claims, the courts filled up with new law suits. That is that dishonest people delighted in a new-found way to become professional litigators and collect millions based on a pyramid of new frauds at the expense of all payers into their insurance programs. The spillover loss to those keeping up with their health care costs has since then skyrocketed.

If you are a Republican or a Democrat, you have to be really scared if tort is reformed and the exemption to the Sherman Anti Trust laws is not dropped. You can’t imagine what it would be like if Health Care Insurance Companies could do what they want on the market and there was absolutely no recourse for you. Can you imagine, wanting to drive from North Carolina to Georgia to receive special heart transplant services and you were suddenly not allowed to get those services? That is not out-of-service, just plain not allowed at all---or at any price. You would have to be fairly certain that there was no chance that you might actually get sick and need medical care.

So somewhere along the line, the Health Care Insurance Companies saw a light at the end of their tort problem tunnel. It was exemption from Trust laws. Think about it. If you were the owner of a big provider, and you were paying out part of your profit to litigants, you would have to stop, or your stock holders would be angry. And where would your millions in compensation come from? It is only you and the stockholders who are the ones making a profit on your medical reimbursements.

If you are exempt from the Trust laws, you are exempt from price fixing. That means if it’s you, the Republican, who wants to jump into the business, you must meet with your competitor and agree to hold all your public customers to a fixed price for a specific service. You might also pass that same type of agreement onto the doctors---you will hold them to a reimbursement ceiling, or set a limit on what they can charge for a service because you must maintain a certain profit margin. Of course, this is already the case.

You must then hold all your suppliers to the same agreement. You can make fifty percent above your costs but you have to make sure we are reimbursed fifty percent as well. The more you charge our providers the more you will have to pay us. If you can’t provide our supplies at the price we want, we will have to go elsewhere . . . to some other supplier like China or Japan. They will give us the price we need to make our profits.

If you are the consumer, you can expect one thing. Less service at a higher cost---all the economic principles that maintain a free market are lost and the market spins out of control. It serves one master---the profit master. So if you need cancer treatments, and the provider doesn’t want to pay for them, many thousand excuses can be brought to the table to bear witness against your need. You can’t have it both ways --- profit and necessary health care. It doesn’t matter what you believe in. You’re screwed!

If you are a Republican or a Democrat, you have to be really scared if tort laws are reformed and the exemption to the Sherman Anti Trust laws is not dropped first. You can’t imagine what it would be like if Health Care Insurance Companies could do what they want on the market and there was absolutely no recourse for you. It could happen!