Corporations USA: Healthcare Insurance industry's structure, allegedly makes inevitable a single-payer health system

 Part I -- Healthcare Insurance Businesses have Achilles Heal

"The inevitability of an American single-payer health system," by Rick Ungar. Ungar's article, vital to understanding the capitalism oi American healthcare appeared on the Policy Page, True/Slant (Sep20,2k9). This article, tho not from my own viewpoint, I recommend strongly as vital reading in these days.

Virtually all large health insurance companies are publicly held; and public companies have a life force that is unlike any other. They are driven by the desire of current management to show improved profits of about 10% each year so as to sustain share price increases for the shareholders and compensation increases for management. Also understand that while public companies like to talk about the “long term”, the phrase has no true meaning to them.

Management and shareholders worry about this year’s numbers with an eye towards next year’s – and that is as far as it goes. Most shareholders and managers have no expectation of being around in the ‘long term.’ [Especially at the scale of coporations that are "too large too fail."]

Thus, while current management [personnel] of the large health insurance companies may very well realize that they cannot sustain their business model for the longer term, this is not something they can afford to worry about.

Interspersed commentary by economics reporter / opinionater /ranter, EconoMix,  and Albert Gedraitis (rW publisher):

Here at last we found a clear, concise ins+t into the American economy -- such that the specific healthcare-insurance industry and its permissible corporate forms instance a valid exception to the general rule presumably established for enterprises otherwise ("free enterprises generally but not specifically in regard to healthcare-industry free enterprises").

Ungar:

Their shareholders want returns on their investment as management wants boosts to their compensation and they are looking for it now. The future will be someone else’s problem.

Take virtually any failed industry in America and you will see that the dynamic set forth above is inevitably true. Whoever ran General Motors before the CEO in charge when the industry fell apart probably knew what was down the road for the company. But it wasn’t his problem. An adept shareholder in GM who got out five years ago, really didn’t care where the industry was headed, nor did a CEO who had no plans to be around when the balls in the air crashed to the ground.

So, when the price of health insurance reaches the point where most Americans truly cannot afford it – and the numbers make it more than clear that the point will be reached and reasonably soon – what then?

Will ‘free marketers’ be out there arguing that we should just let the health insurers fail? After all,that’s how a pure, capitalist system is designed to work, right?

So severely distinguishing, Ungar has laid bare how the general capitalist investment ethos in North America, is deadly to the specific corporate interface between healthcare itself and insurance tailored to the task of the separate and sovereign sphere of providing that medical professional care (a signficicant part of "healthcare") in regard to the role of specifically medical healthcare insurance.

Unstated presupposition of the Ungar article: the only options for reform of American healthcare insurance are

either the single-payer system (a socialist conception in origin -- but not necessarily socialist when advocated today, lest we fall prey to the genetistic fallacy [Albert Wolters] which often crops up in theoretical thawt and policy decision-making and -advocating)

or an unalleviated, unameliorated, unregulated free-market system, free to the point of madness, the apocalyptic madhouse being a favored metaphor of today's arts and society, a metaphor frawt with ambiguity, semantic slipperiness

(on behalf of which metaphor many "conservative" public thinkers and rhetoricians are making extreme authoritarian reverse-totalitarian claims today).

A digression on social conservatism

To the strident woud-be TV definers of conservatism, just compare the social conservative duo of Russell Kirk and Hadley Arkes, cited recently as beyond the scope of David Koyzis in his piece "Why I am not a Social Conservative." Koyzis apparently aims at rebuking advocates of the moralistic "pet" issues of what I call "TV conservatism" in America.

Koyzis also registers his objection to prioritizing the "consistent ethics of life" (Roman Catholic moral doctrine). He does not elevate this theory of morality to be, while distinctvely Catholic, a more broadly Christian political program, regarding all of which Koyzis and rW share a point of agreement. In the exchange following upon his blog-entry, the Koyzis duo of social conservatives of another kind is supplemented by Francis Beckwith who additionally lists George Gilder, Francis Canavan, Robert P. George). To this list of non-individualist societally-conservative American philosophers, some woud want to add the name of a Brit historian of the American national experience, Paul M. Johnson, especially for his book, A History of the American People (1999). More recemtly, there's the new work by Patrick Allitt, The Conservatives: Ideas and Personalities throughout American History (2009).

"Allitt understands the Civil War as a 'clash of rival conservatisms,' the conservatism of Clay, Webster, and Lincoln, who wished to conserve the Union, and the conservatism of the Confederacy, which wished to conserve the South’s traditional way of life. Both conservatisms abounded in paradox." -- Peter Berkowitz

An unalleviated Capitalism,  a system that generates human misery as a byproduct of its many good achievements otherwise, such a Capitalism ossified now into an absolutist ideology brayed aloud by some of the oxen on FoxNews -- regarding healthcare insurance, of all things!

Part II -- Dooyeweerd-style critique of healthcare-insurance  businesses

The necessity of disclosing the internal structural principle of an exceptional phenotype of a particular societal sphere, the sphere of business in its phenotype devoted to healthcare insurance by means of stockmarket-traded corporations; that phenotype will here be referred to simply as "American healthcare insurance companies" (but referring chiefly to megacorporations like Cigna, Aetna, Humana and similar entities traded on the stockmarket), this necessity presses upon all who are concerned with viable solutions in the present wave of interest in healthcare reform in the USA.

... The internal structural principle that typifies those business enterprises that have come to dominate the economics of healthcare as an industry, with spiralling costs to premium-payers in the USA is an important consideration when we are beset these days thawtless Conservatives and Liberals obfuscating the analysis that Protestant philosopher Herman Dooyeweerd has suggested.  Practically, we all must face "the rising spiral of healthcare insurance costs."

But healthcare insurance is surely built around what Dooyeweerd woud call a typically hybrided entity -- where, in this case, the aspect of medicalcare costs (optimatic-economic aspect of medicalcare) are enkaptically intertwined with the general socioeconomic climate and, precisely, a specialty profit-driven finance industry, the healthcare-insurance speciality of the finance industry.

Not that all the enterprises in healthcare insurance are profit-driven. There are some splendid examples of non-profit healthcare insurance companies. A few authentic "mutuals," like Northwest Mutual Insurance (as advertized on FoxNews channels) and some successful other forms of co-op structures in this industrial sector and speciality.

But the greedy metacorps that interlope into what shoud be rather the zone of a type that is carefully regulated to balance the intertwined symbiotic enkapses that constitute it in its uniqueness of type (displaying a duality at its core, its internal structural principle [Dooyeweerd], a zone with legislated incentives to balance that intra-industrial contrast and tension, just as in D's celebrated citation of the hybrided phenotype of the family farm (a business enterprise hybrided with a specific family community and structure).   Of course, sometimes a family farm proves itself dysfunctional as a family as a result of its particular configuration, but often family farms are quite functional as both family and as farm business, as one, aside from the rapidly changing economic climate and situation in which it is located, both  societally and ecologically.




Awareness that the healthcare insurance company can be organized differently from the firms that Ungar puts his finger on, in regard to the current mis-structration and antinormativity of the main greedy capitalist corporations dominating the industrial sector for some time.  These two moments of greed-capitalism today are keys to why the whole healthcare-insurance industry is unusually vulnerable to the determinants of stockmarket-traded corporations conceived more largely across all American industries.

I think Ungar locates two precise structuring principles that dominate the dominant type of megacorps in the health insurance industry; he shows what I mean by antinormative so-called "free enterprise" businesses gone amuck in the healthcare insurance field.

-- EconoMix