Kaiser Insurance Quotes

HMOs have been so successful that they now occupy a dominant position in the market for health care in the United States. Approximately forty-five million Americans are uninsured. Of the remainder, about half are enrolled in some type of HMO. Most others receive some sort of managed care plan. Less than 10 per cent of Americans still have classic fee-for-service private health insurance (down from more than 70 per cent in the late ’80s). So even though many people equate HMOs with private health care, these sorts of corporations exist only because of the failure of private markets to supply appropriate health care. HMOs succeed precisely because they are more efficient than insurance markets. There should be no illusions about the character of these organizations—they are giant bureaucracies. The largest of them, Kaiser Permanente, employs over eleven thousand physicians and has more than six million subscribers in the state of California alone. This makes Kaiser larger than most of the government-run health care systems in Canada. And while the Canadian system is extremely decentralized, Kaiser Permanente is a single, vertically integrated corporation.

In Original Medicare, according to an example provided by Kaiser, a $100 doctor’s bill involving a participating provider would cost you a 20 percent copayment, or $20, after Medicare’s 80 percent payment under Part B insurance rules. If you were, instead, seeing a nonparticipating provider, Medicare would first reduce its allowable fee for the service by 5 percent, from $100 to $95. If your doctor agreed to assignment here, Medicare would cover $76 of the $95 bill (its 80 percent payment) and you would pay the remaining $19. But if the doctor did not accept assignment, he or she would be able to charge you up to 115 percent of the reduced charge. In our example, this would total up to $109.25 (115 percent of $95). Medicare would still pay $76. But now you would pay not $19 but as much as $33.25. In the real world, of course, especially if the doctor involved was performing surgery, you would be multiplying this $100 many, many times over. And balance billing could definitely unbalance your budget.

Finally, as I’ve emphasized, there is the level of conscious public policy. A Soviet official issuing a planning document, or an American politician calling for job creation, might not be entirely aware of the likely effects of their action. Still, once a situation is created, even as an unintended side effect, politicians can be expected to size up the larger political implications of that situation when they make up their minds what—if anything—to do about it. Does this mean that members of the political class might actually collude in the maintenance of useless employment? If that seems a daring claim, even conspiracy talk, consider the following quote, from an interview with then US president Barack Obama about some of the reasons why he bucked the preferences of the electorate and insisted on maintaining a private, for-profit health insurance system in America: “I don’t think in ideological terms. I never have,” Obama said, continuing on the health care theme. “Everybody who supports single-payer health care says, ‘Look at all this money we would be saving from insurance and paperwork.’ That represents one million, two million, three million jobs [filled by] people who are working at Blue Cross Blue Shield or Kaiser or other places. What are we doing with them? Where are we employing them?”9 I would encourage the reader to reflect on this passage because it might be considered a smoking gun. What is the president saying here? He acknowledges that millions of jobs in medical insurance companies like Kaiser or Blue Cross are unnecessary. He even acknowledges that a socialized health system would be more efficient than the current market-based system, since it would reduce unnecessary paperwork and reduplication of effort by dozens of competing private firms. But he’s also saying it would be undesirable for that very reason. One motive, he insists, for maintaining the existing market-based system is precisely its inefficiency, since it is better to maintain those millions of basically useless office jobs than to cast about trying to find something else for the paper pushers to do.10 So here is the most powerful man in the world at the time publicly reflecting on his signature legislative achievement—and he is insisting that a major factor in the form that legislature took is the preservation of bullshit jobs.

In 2018 the Kaiser Family Foundation produced an international study of loneliness and isolation. The organization found that 20 percent of Americans “always or often feel lonely or socially isolated, including many whose health, relationships, and work suffers as a result.” Health. Relationships. Work. Can we agree that those are foundational to living happy, successful lives? A majority of Americans surveyed (58%) see the increased use of technology as a major reason why people are lonely or socially isolated. In the U.K., 50% said technology and social media are to blame for the spike in loneliness. Around the same time, the health insurance company Cigna surveyed 20,000 American adults and found that more than half — 54% of them — feel like no one knows them well. The survey also revealed that 56% said the people they surround themselves with “are not necessarily with them,” and about 40% said they lack companionship, meaningful relationships and that they feel isolated.