Things you need to know

Knowledge is Power. So here's a bit of education for you about Health Insurance Companies.

First, from NavyBlueWife at Fire Dog Lake telling me something I didn't know:

The Sunday morning political talk programs were filled to the brim with health care reform discussions, and central to these discussions is the idea that the insurance industry needs competition. Competition, in the form of a public option or in health care cooperatives, is supposed to level the playing field and bring down premiums for all Americans while providing as close to universal coverage as we can do right now.

There's just one itty bitty, teeny weeny problem. The insurance industry has federal IMMUNITY from competition!

The federal government has not been able to attack the insurance companies through federal anti-trust laws for over 60 years. Under the McCarran-Ferguson Act passed in 1945, insurance companies (and Major League Baseball!) are specifically excluded from federal anti-trust laws as long as the state regulates in that area, and federal anti-trust laws will apply ONLY in cases of boycott, coercion, and intimidation.

Under the McCarran-Ferguson Act, Big Insurance is allowed to collect and SHARE data with each other about claims. With this information, Big Insurance can fix prices, set coverage requirements, outline conditions for coverage denials (like pre-existing conditions), and many, many more.

That's right, folks! Big Insurance can plot together to bring us all down!

This problem is one of the biggest when it comes to creating insurance industry competition, and not one single major news outlet, pundit or other talking head has covered it as of my publishing. In fact, the only time where I saw anti-trust regulation brought up was a minor squawking by Big Insurance. They claimed that they actually would be in trouble under the anti-trust laws if they were forced to work together to reduce costs to consumers. But the laws don't apply, so what's the problem, Big Insurance?? Read more at link

This is information on how Blue Cross/Blue Shield was formed and how it became a for profit company. h/t to Crank Bait at Sam Seder Show Blog:

Dr. Justin Ford Kimball, a Baylor University administrator, is generally recognized as the originator of Blue Cross. Kimball noticed that among the university hospital's unpaid bills were those of a disproportionate number of local school teachers. In 1929, he addressed this problem by organizing a plan in which teachers could be covered for a three-week hospital stay in a semi-private room by prepaying as little as 50 cents a month. The first group health plan was off the ground when 1,250 Dallas-area teachers enrolled at once.

Other groups of Dallas employees joined the program, and it began to attract attention across the United States. Similar plans sprang up in Iowa and Illinois. Like the Dallas prototype, those plans involved only one hospital. In the early 1930s, plans were created that offered customers a choice of different hospitals in their communities. California, New Jersey, and New York were among the first locations for programs of that type. The Blue Cross name and symbol were developed in 1934 by E. A. van Steenwyk, a pioneer of St. Paul, Minnesota's group health plan. By 1935, there were 15 Blue Cross plans in 11 states. The following year, the American Hospital Association (AHA) created the Committee on Hospital Services to oversee the growing batch of Blue Cross organizations nationwide. The Committee's early leader was C. Rufus Rorem, who had been involved with the AHA for several years. By 1938, there were 38 Blue Cross plans in the United States, with a total enrollment of 1.4 million. In comparison, only about 100,000 people were covered for hospitalization by private insurance companies at that time.

Meanwhile, a similar movement had begun for covering the costs of physicians' services. In the Pacific Northwest, a few lumber and mining companies had begun making arrangements to pay doctors a monthly fee for providing their employees with health care services. The first of these plans appeared in Tacoma, Washington, in 1917. The first modern Blue Shield plan was established in 1939 in California. Modeled on the earlier programs, the California Plan enabled its customers to receive physician services for $1.70 a month. Only those with income under $3,000 a year were eligible for the program. The medical societies of other states began to develop similar programs, and in 1946 the first handful of such plans banded into a national group called the Associated Medical Care Plans, overseen by the American Medical Association (AMA). This group informally adopted the Blue Shield as its symbol two years later, and it eventually became known as the Blue Shield Association.

Between 1940 and 1945, the number of Blue Cross plans operating nationwide grew from 56 to 80, and enrollment increased from 6 million to 19 million. Blue Shield's enrollment was approximately 3 million. This growth was largely due to the wartime emphasis on fringe benefits as a way to increase wages without boosting salaries. In 1946, Rorem resigned as executive director of the AHA commission overseeing Blue Cross plans, and was replaced by Richard M. Jones, whom Rorem had hired as head of public relations. The organization's name was then changed to the Blue Cross Commission.

In 1948, Blue Cross and Blue Shield agreed to merge. The move was blocked by the AMA, however, on the grounds that such cooperation between hospitals and physicians could lead to actions in restraint of trade. Nevertheless, the Blues began working together around that time on public policy issues, while remaining independent, competing entities. To facilitate their continued growth, both Blues set up nonprofit agencies to coordinate the activities of their member plans. The Blue Cross Commission established Health Services, Inc. (HSI), a stock insurance company, to coordinate national enrollment in Blue Cross plans and to act as an underwriter to make up for differences in benefits between member plans when national contracts made it necessary. The Blue Cross Association was created as a holding company for HSI stock, which was actually owned by the plans themselves. Blue Shield set up a similar structure, establishing Medical Indemnity of America (MIA) as its counterpart to HSI. Read more at link.

So the Insurance Companies have a law in place to help them take advantage of us. All of us!

And you learned how a non profit Insurance turned into a for profit.

So now you know a bit more to form a good decision about Health Care Reform.