The first is a December 17, 2009 internet article entitled "Medical Mutual Of Ohio's View Of Healthcare Reform, authored by George Stadtlander, its Chief Managed Care Officer. The article discusses the pros and cons of the current proposals in Congress, but this little ditty really caused me to rise out of my chair:
Another huge issue in this debate is tort reform. There have been proposals for comprehensive tort reform that would reduce the cost of delivery, but they have been widely ignored.
Really? What this article and Mr. Stadtlander did NOT mention is that we have had medical "tort reform" in Ohio now for over six years! Since 2003, there have been arbitrary caps or limits on what injured Ohioans can recover due to negligent medical mistakes. These caps range anywhere from $250,000 to $350,000 depending upon the circumstances. Essentially, your rights were sold as a way to keep healthcare costs down. In other words, limiting your rights in lawsuits was good for you and all Ohioans because you would pay less for health insurance. Sounds all well and good, right?
So, the question becomes: have these "reforms" worked to lower our insurance premuims? Interestingly, just one month before this article, The Canton Repository reported in a comprehensive piece that local businesses are being hammered with soaring healthcare costs.
Curiously, Medical Mutual has increased premuims 12-13%, according to Mr. Stadtlander, who was quoted in the Repository article:
REASONS FOR INCREASES
Employees filing a greater number of costly claims in recent years is the reason some employers are seeing massive increases in premiums, said George Stadtlander, executive vice president for Medical Mutual.
Stadtlander said Medical Mutual has raised rates by an average of 12 to 13 percent — by as little as 5 percent and as much as 30 percent.
The health insurer executive said the economy could be playing a role. Many employees who have been laid off are younger, less senior workers who are healthier and file fewer claims. Those who remain are often older Baby Boomers more likely to get medical treatment.
Also, federal stimulus spending may be playing a role. The federal government is paying 65 percent of premiums under COBRA, the mandate that permits people who have been laid off to stay on employer group health plans for at least 18 months, normally at the laid-off workers’ expense. Stadtlander says those with medical problems are the ones that tend to sign up for COBRA.
And the swine flu has driven more people to doctor’s offices and hospitals and pushed up demand for prescription drugs, resulting in a higher number of claims, Stadtlander said.
AultCare has a different explanation. The Canton insurer’s spokeswoman, Robin Clark, blames not more claims, but rather the general inflation of health care costs.
She said AultCare has kept rate increases to well below 10 percent this year for the bulk of its policyholders, especially since medical providers in its local network charge less than providers in larger communities.
But Clark said small employers are more likely to see rates rise due to an expensive claim filed by one employee, because the impact of a single worker’s claim is magnified in a smaller pool.
One final reason, according to Stadtlander, is advances in extremely costly medical technology. Its greater availability is leading to more catastrophic claims of more than $250,000, he said.
“A lung transplant is an expensive procedure,” he said.
The economy? The stimulus? Swine flu? Technology? Lung transplants? Aliens? (OK, I added that one). In other words, insurance companies can come up with any reasons they want to continue to increase premuims. And when they lobby for laws limiting the rights of Ohioans and continue to claim that these laws will bring down insurance premiums, we now have proof that it is a sham.
Yet, a majority of Americans favor "medical malpractice reform," and the paradoxical limiting of their own legal rights at rallies and town hall meetings. Perhaps someday they'll eventually wake up and realize that laws limiting their legal redress when a hospital has left a sponge or a towel inside them are potentially as noxious as limiting their Second Amendment right to carry a gun.