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Health insurers near monopoly control of most markets

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Private insurance makes a lot of cents for the...
Image by Steve Rhodes via Flickr

I thought I understood why insurance companies were the main threats to a “public option.” It’s easy.  Their overhead—exec salaries, advertising, political lobbying, etc.—averages 31%.  Medicare’s overhead is 1%.  No duh they don’t want to compete.

Today, I found out there’s another reason:  they mostly don’t even compete against each other. Consumers in 94% of America’s insurance markets buy their health insurance from near-monopolies that dominate their region.  The Bigs don’t want to avoid public competition, they want to avoid any competition.

And what happens when profit-makers don’t have to compete? You know what.

Premiums have risen 87% over the last six years, while profits at the ten Bigs rose 428%.  Wait a minute: If your insurer’s profit is up 400%, why are your premiums rising so fast?

So, on with the debate:  Sen. Richard Shelby (R-AL), speaking on Fox News, defended the insurance company position, saying a public option would “destroy the marketplace for health care.”

But TPM today covered a report by Health Care for America Now, saying:

clipped from tpmmuckraker.talkingpointsmemo.com
[T]he notion that most American consumers enjoy anything like a competitive marketplace for health care is flatly false. […]
The report … uses data compiled by the American Medical Association to show that 94 percent of the country’s insurance markets are defined as “highly concentrated,” according to Justice Department guidelines. Predictably, that’s led to skyrocketing costs for patients, and monster profits for the big health insurers. Premiums have gone up over the past six years by more than 87 percent, on average, while profits at ten of the largest publicly traded health insurance companies rose 428 percent from 2000 to 2007.
HCAN describes the situation as “a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments…”
[O]ne former top Federal Trade Commission official … has sent a letter to the Justice Department’s Antitrust Division, asking for an investigation into the health insurance marketplace.
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And maybe that’s why millions of your excess insurance premium dollars are being spent on defeating a public option, rather than on reducing your premium.

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Refusing control: Jesus’ three temptations

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The 3rd Temptation - NinanA sermon for the first Sunday in Lent; February 25, 2007
Luke 4:1-13;Romans 10:8-13;Psalm 91:1-2,9-16;Deuteronomy 26:1-11

Music:
Come, Now Is The Time
You Are My All In All
This Is My Father’s World
Be Thou My Vision

Richard Swanson (in Provoking the Gospel of Luke) says if you were from another planet, dropped in, and listened to Christians, you might think they believed in two Gods – a good one and a bad one – whom they call God and Satan. With 1st century Jews, it wasn’t so – Satan was the tester, the accuser. His job was to travel the earth and look for things that weren’t true, weren’t sound, and expose them before God. “Aha! See, God? See?” Think of Job: “Here’s one, God. He isn’t true. He’s just happy because you give him lots of good stuff.”

But Luke’s first readers would never have seen the accuser as anything like God in power. “This is my Father’s world” would have been the attitude – and even “though the wrong seems oft so strong, God is the ruler, yet.”

And so this tempter comes to find what’s unsound in Jesus.

Now again, remember the last thing that happened – what’s the context here? It was Jesus’ baptism, and a voice that said, “You are my Son…” And what’s the tester’s first phrase to Jesus? “If you are the Son of God …”

Perhaps Jesus thought, “Was the voice true? Did I even really hear it? Who am I, really?” Read the rest of this entry »

Written by Monte

March 7, 2007 at 11:08 pm

Gender identification: not as simple as it seems

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BERLIN - AUGUST 16:  (L-R) Tetiana Petlyuk of ...

Image by Getty Images via Daylife

Perhaps you’ve heard of the world-class South African runner Caster Semenva (on the right in photo).  Last week, she won the gold medal in the women’s 800 meters at the world championship games in Berlin.   And then, someone—no one’s saying who—challenged her victory on the basis of gender.  In other words, “She’s not a woman, he’s a man.”

Now to we non-scientists, this seems like a simple question.  Turns out it’s difficult (not to mention humiliating for an 18 year old girl).  From the New York Times:

It requires a physical medical evaluation, and includes reports from a gynecologist, an endocrinologist, a psychologist, an internal medicine specialist and an expert on gender. The effort, coordinated by Dr. Harold Adams, a South African on the I.A.A.F. medical panel, is being conducted at hospitals in Berlin and South Africa.

Why all the fuss?  Either she is or she isn’t, right? Read on:

clipped from www.nytimes.com
To be fair, the biology of sex is a lot more complicated than the average fan believes […] f the person has XY chromosomes, you declare him a man. If XX, she’s a woman. Right?
Wrong. A little biology: On the Y chromosome, a gene called SRY usually makes a fetus grow as a male. It turns out, though, that SRY can show up on an X, turning an XX fetus essentially male. And if the SRY gene does not work on the Y, the fetus develops essentially female.[…] Even an XY fetus with a functioning SRY can essentially develop female […]
In the case of Androgen Insensitivity Syndrome […] the genitals and the rest of the external body look female-typical, except that these women lack body hair […]
Moreover, a person can look male-typical on the outside but be female-typical on the inside, or vice versa […]
Matthew, a 19-year-old who was born looking obviously male, was raised a boy, and had a girlfriend and a male-typical life. Then he found out […] that he had ovaries and a uterus […] he had XX chromosomes […] his body developed[…] male-typical […]
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In the end, it’s a judgment call.

Which brings to mind the subject of sexual orientation (though, far as I know, it’s not a question Semenva has raised). Many of my good friends are convinced that gay men and lesbian women should remain celibate, for (they say) homosexual sex is “un-natural.”

But if an individual has both male and female characteristics, with which gender, my friends,  is he or she to be prohibited from marriage? What is natural?

Even more, what dozens of unknown psychological aspects of sexual identity and behavior might this combined physical identity bring about?  What aspects of it might never appear physically but influence sexual preference?

So I wonder.  How can we, who understand all this so very little, legitimately insist upon legal or theological control over the sexual destiny of people who are personally—perhaps even unknowingly—involved in these mysteries?  If scientists can’t conclusively say whether an athlete should race as a male or a female, how could we amateur theologians possibly know enough to judge who should be attracted to whom?

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Iowa State Senators: “Grassley Should Start Listening to Iowans”

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The State Capitol of Iowa, featuring its golde...
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The Des Moines Register:

“The will of Iowans and the rest of America is marching steadily toward reform.”

The following is a guest opinion on health care reform by State Senators Jack Hatch and Joe Bolkcom that appeared in Saturday’s Des Moines Register. [I encountered it as a reprint at Blog for Iowa – Monte]

As we head into August, a few Washington lawmakers are standing in the way of health-care reform that America desperately needs. While patients are denied crucial treatment and families go bankrupt from medical bills, Sen. Charles Grassley and a cadre of his Senate colleagues have provoked a stir by steadfastly refusing to support the most essential piece of President Barack Obama’s proposal: a public health-insurance option. We think it’s time for Grassley to start listening to Iowans and work with the president for real health-care reform.

A public health-insurance option would introduce much needed competition into the health-insurance market, extending quality care to as many as 300,000 Iowans, while providing incentives to insurance companies to offer their current customers a better deal. Unfortunately, in a July 30 Des Moines Register editorial, Grassley said he opposes giving Americans the choice of a public option “because it is a pathway to a completely government-run system.” Read the rest of this entry »

Protecting private profits: the reason the healthcare debate goes on

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And the reason it is so hard to understand: politicians are trying to craft a plan that preserves the problem while fixing it. It’s been that way since Harry Truman.
clipped from www.truthout.org
“Absent from the debate are not only single-payer systems like the ones in England and Canada, but other systems with multiple payers, like ones in Germany and Japan – or, for that matter, any discussion of why a system that relies on competition among private insurers in The Netherlands hasn’t resulted in lower prices for consumers, as advocates claimed.”

    The variety of health care delivery systems abroad, in industrialized countries, spans a common assumption – health care as a human right – an assumption that doesn’t cut the mass-media mustard in the United States. “What’s common to all these systems,” Lieberman points out, “is that everyone is entitled to health care and pays taxes to support the system, and medical costs are controlled by limits on spending. The specter of a system that takes a significant bite out of stakeholder profits in the US is the real reason the debate is so restricted.”

“Reform efforts have danced around this impasse for decades.”
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Written by Monte

July 24, 2009 at 11:17 am

Posted in Politics