[Marxism] "We're going to get rid of insurance companies?

[andrew pollack <acpollack2@xxxxxxxx>]

"We're going to get rid of insurance companies.?

So says the head of one of the country?s leading healthcare software
firms.  He then adds the qualifier ?at least insurance companies as we
know them."  But the article from today?s New York Times in which this
quote appears is proof positive of what the Labor Party, Physicians for a
National Health Program -- and even the GAO -- have been saying for
years: that the administrative savings from automating and centralizing
billing and clinical information make for-profit insurance and
pharmaceutical companies totally unnecessary.

The Times article reports on a recent national conference held to discuss
plans for a national electronic healthcare record.  Not surprisingly the
Times? business reporter, Steve Lohr, frames the news inside a pro-market
argument which makes nonsense of his facts.  He tries to twist the
technological advances touted to show how computers would enable a
restructured, more rational ?free market? for healthcare ? and even ends
with an approving quote from Newt Gingrich to that effect.

But let?s look at those facts.

For instance, Lohr reports that ?Big insurers like UnitedHealthcare,
Aetna and Cigna insist that they have moved beyond being insurers to
become experts in managing health care. But in large part they still
operate as the middlemen, tussling with doctors and hospitals over
reimbursements for visits, tests and operations. In a digital network,
the rules for approval and nearly all transactions could be automated,
drastically reducing the middleman's role.  ?We're going to get rid of
insurance companies, at least insurance companies as we know them,? said
Neal Patterson, chief executive of Cerner, which produces software for
health care automation.

?The pharmaceutical business could also be in for a shock. Doctors often
get most of their information about drugs from the drug makers. Obtaining
genuinely objective information about the effectiveness of drugs requires
close tracking of academic studies, particularly those not funded by the
drug industry. Kaiser Permanente, a health maintenance organization, is
big enough to field its own drug information team to review the available
research and study the treatment results of its 8.3 million members.?
Lohr then cites a Kaiser study using this data which saved tens of
millions by switching to a generic drug.  ?The company's drug information
unit, said Dr. Sharon Levine, a director in Kaiser's medical group, is
intended to combat ?the total failure of the market for information in
pharmaceuticals.?"

Lohr continues: ?A digital medical network like the one envisioned by the
National Institutes of Health would make studies such as Kaiser's, though
with even larger data sets, available to doctors and patients across the
nation. An open system for information on drugs and their effectiveness
might just make obsolete the sales visits to physicians' offices and the
television pitches for drugs.?

Lohr concludes by noting the role the government will have to play in
setting up data standards which all healthcare providers and institutions
could agree on.  For Lohr ? and Gingrich and Bush (and for the Democrats
as well) ? this would be solely to enable a more integrated, ?freer?
market (maybe they?ll call it ?HAFTA?).

But as the LP and PNHP have argued, the savings from wiping out the
administrative, profit-seeking middlemen ? the insurance and
pharmaceutical companies ? should go not to other market vultures but to
providing more healthcare (including retraining and reemploying displaced
insurance company staff as healthcare providers).  In fact those savings
alone are enough to guarantee insurance for every person in the country.

Coincidentally the same day the Times ran an editorial in favor of using
Radio Frequency Identification Devices (RFID) tags on pharmaceuticals and
notes the tremendous savings ? and centralization of information -- there
too.  RFID is the technology Walmart and others are introducing to
further centralize and plan already huge stores of information on
billions of products.  Should all medications have RFID tags, the data
available would complement the electronic patient record to further
integrate all aspects of the patient care experience.

And in another strange coincidence ? strange not primarily for the timing
but for what it says about the irrationality of our high-tech, low
morality economy ? the Times ran yet another healthcare article today
(without drawing the connection), reporting that the rate of increase in
health care costs for the bosses will slow down for the first time in
five years.  And the reason is almost entirely that bosses are succeeding
in pushing healthcare costs onto the backs of workers.  So in the midst
of these technological advances we have a barbaric economy forcing
already hard-pressed families to cut back on even essential healthcare
for themselves and their loved ones.

Every union contract negotiation and strike these days involves a fight
over such healthcare costs.  Once workers start forging solidarity with
each other around these healthcare-related contract battles, they?ll soon
pick up the demand for a single-payer plan to take healthcare out of the
realm of bargaining.  And when they, do they?ll find, because of the
technological advances mentioned above, a healthcare system ready to leap
overnight into a cheap and efficient state no market can match.

(full Times articles at):
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