Profit-driven insurers are hampering access to healthcare

Date:


Fifty-two percent of registered voters said they approved of President Joe Biden’s handling of COVID-19, according to a recent Harvard CAPS-Harris Poll. I, too, approve. This is excellent news for the president. However, what is not reflected in this poll is how the COVID-19 pandemic has exposed some of the ugliest issues in America’s healthcare system.

Even as Dr. Anthony Fauci 
says
our country is “out of the pandemic phase,” the problems highlighted by the coronavirus remain prominent. Most notably, physicians’ offices, health systems, and hospitals — especially in our most vulnerable communities — that were already struggling to stay afloat are now on the brink of shuttering.  

For healthcare facilities to keep their doors open and provide quality patient care, they need adequate staffing, proper funding, and reliable resources. But even before the pandemic, the lack of nurses in hospitals was 
a nationwide crisis
. According to a 2018 
study
 by the Healthcare Financial Management Association, about 78% of hospitals reported that they faced a worsening shortage of healthcare professionals, forcing them to fill the gaps with travel nurses and other temporary hires, which cost exponentially more than routine staff. Increased demand provided an opportunity for staffing agencies to raise prices disproportionately, so the cost of travel nurses has almost 
tripled
, and in 2022, hospitals are spending almost 40% of their labor budget on travel nurses alone. So it’s no surprise that many of those staffing agencies are currently
under investigation for predatory practices
.

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As a former member of Congress and former hospital administrator, I believe a solution to protect healthcare access for Americans would be to make sure healthcare systems are appropriately funded and predatory behaviors by staffing agencies, insurance companies, pharmaceutical companies, etc., are investigated and stopped.

Through their desire to create value for their shareholders, insurance companies became richer during the pandemic. Unfortunately, hospitals and patients struggled at never before seen levels. Over the last 10 years, the average increase in coverage cost has been around 5.3%, but in 2021, the price for health insurance increased by 
10.4%
 — nearly double the overall rate of healthcare inflation. So, where is all of that money going if it is not going to help patients? I applaud the success of the CEOs of the top seven insurance companies in the United States, who made 
$283 million in 2021
, and in just the first quarter of 2022, the top five insurers made $262.8 billion. However, success should be balanced by measuring outcomes and improvement of inequalities for the patients you serve.

In other words, Big Insurance has created value for corporate leadership while creating unintended consequences for the distribution of money and resources that could have been otherwise available to patients and healthcare systems across the country.

But for some reason, the media, patients, and even healthcare workers have incorrectly blamed healthcare systems and hospitals for rising costs and insufficient staffing. This just happened in Indiana, where 
insurance advocacy groups
 tried to condemn Indiana hospitals for the rising costs of care, while Indiana insurance plans have profited 
almost twice the national average
 for the last several years, earning $300 of pure profit for every member each year, while the national average is $170 per member per year.

In the same time period, 2018 to 2020, Indiana insurance companies received 
$140 million per year
 in pharmaceutical rebates, which fulfilled 91% of their profits. According to the 
Federal Trade Commission
, these profits are “after-the-fact discounts” that offer little relief to patients.  

Needless to say, hospitals, healthcare systems, healthcare workers, and patients are tired of these issues that plague our healthcare industry. If something isn’t done about practices that focus on profit over patients, more hospitals will continue to close, staffing levels will continue to drop, and patients will lose their access to care, especially in our most vulnerable communities.

As insurance companies count their billions of dollars, hospitals serving urban and rural areas are closing and leaving huge gaps in care. One study from 2021 found that
nearly 47%
 of counties in the U.S. are considered hospital bed deserts.  

We must advocate and ensure that our corporate leaders have insights into not just healthy financial balance sheets but also healthy lives.

Former Rep. Ed Towns represented New York for 15 terms. He was the director of the Metropolitan Hospital and then assistant administrator at Beth Israel Hospital for a decade. He served in the Army and as an educator at Fordham University.





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