Physicians Losing Financial Control Over Health Care — How Very Sad??

People interpret and process information in many different ways, for
example, the article below from the SF Gate -  “Calif. HMOs raked in $4B in
profits”. To some, this is good news and a notice to buy more HMO stock, to
others this is bad news and demonstrates the hypocrisy in our health care
financing system  – insurers making billions while 47 million people remain
uninsured.

However, to me this article means something completely different – it describes a major health care financial wealth shift away from Physicians and patient care to Health Insurer Shareholder ROI’s. To me this is a very disturbing event – to take limited dollars from a financially distressed health care delivery system and convert these dollars into pure financial profit is unconscionable.

I do not begrudge Insurers from making a profit. However, the society must understand that for every health care dollar that is converted to profit a simultaneous decrease occurs in available health care dollars for patient care. Do you ever ask yourself – How many thousands of lives could have been saved if CA HMOs only had a $2 Billion dollar profit?

This article demonstrates to me that Physicians and Consumers/Patients have
lost FOUR (4) Billion Dollars in health care services and these dollars have been converted into Health Insurer Shareholder ROI’s. It is very, very sad to see a proud profession like the Medical Profession (Physicians): 1) slowly lose control over their revenue streams and thereby lose control over the quality of care they practice and their patient management decisions.

When are the Physicians in this country going to wake up and smell the Roses and take back health care control? Tom!

Study: Calif. HMOs raked in $4B in profits
By SHAYA TAYEFE MOHAJER, Associated Press Writer
Monday, June 23, 2008

(06-23) 22:42 PDT Los Angeles, CA (AP) –

Some executives at California health insurance providers paid themselves
handsomely while their companies were raking in more than $4.3 billion in
profits in the last year.

In addition, HMOs spent $6 billion on administrative costs, which include
hefty CEO salaries, according to a report by the California Medical
Association, which said the money could have gone toward driving down
premiums or better protecting the insured.
The annual report, which draws on expenditures reported to the state
Department of Managed Health Care, will be released Tuesday.
It found that annual salaries topped $1 million for chief executive officers
at providers like Aetna, Inc., CIGNA Corp., Health Net, Inc., UnitedHealth
Group and WellPoint Health Networks, Inc.
The medical association is sponsoring a bill to require health plans to
spend at least 85 percent of their annual income from the insured on health
care.
“This report really underscores what we have been saying all along, which is
there’s massive waste in the insurance industry,” said Sen. Sheila Kuehl,
D-Santa Monica, who authored the bill.
“Californians are literally going into bankruptcy because of rising
insurance premiums and having their benefits gutted simultaneously,” she
said.
The report found that if the bill were already in place, nearly $1.1 billion
dollars would have gone back to providing health care.
Of major providers, Indianapolis-based Anthem Blue Cross’ 4.1 million
members see the smallest proportion of their premiums returned, with 79
percent of revenue used toward medical care.
“One of the worst ratios is Anthem Blue Cross,” said CMA President Richard
Frankenstein. “They sent more than $1 billion back to Indiana last year and
I don’t think that’s where Californians want to see their premium dollars
go.”
Anthem Blue Cross said in a statement that as a for-profit business, it also
pays more taxes than the nonprofit HMOs included in the study, which
accounts for some of the difference in administrative costs.
“Anthem Blue Cross continually strives to reduce its administrative costs
while also delivering innovative products to its members,” the statement
said.
The report highlighted four major providers who already put more than 90
percent of revenue directly toward medical care: L.A. Care Health Plan (97.1
percent), CIGNA HealthCare of California (94.3 percent), Inland Empire
Health Plan (93.1 percent) and Kaiser Foundation Health Plan (90.6 percent).
“We’re a not-for-profit so there aren’t any shareholders who get dividends
or bonuses, so any net revenue is invested right back into facilities,
services, and keeping our rates affordable,” Kaiser spokeswoman Kathleen
McKenna said.

http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2008/06/23/state/n221615D33
.DTL&hw=health+care&sn=007&sc=935