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GOP Rep. Admits That Health Insurance Companies Control The Market And Dictate Medical Decisions

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"GOP Rep. Admits That Health Insurance Companies Control The Market And Dictate Medical Decisions"

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Today on C-Span’s Washington Journal, a caller told a story of how he was forced to see numerous doctors at different hospitals in the area in where he lives, some as far as 100 miles away, to get a diagnosis. The caller then faulted health insurance companies for preventing the practice of having “diagnostic tests done under one roof.” “So in essence,” the caller noted, “the insurance companies are the ones controlling what tests you can get, when you get them, how you get them and if they’re accepted or not.”

In a remarkable moment of candor, C-Span’s guest — Republican Congressman Tim Murphy (PA) — agreed:

MURPHY: Yeah and that brings up the point here that with regard to one of our big frustrations with insurance companies is they control the market place, they control what’s done, a lot of times doctors not making the decisions here. And you recognize the frustration.

Watch it:

Murphy is right: Insurance companies control markets and are the ones making medical decisions. Insurance companies have consolidated in local markets which has resulted in limited choice and higher profits. In fact, “1 in 6 metropolitan areas in a 2008 study of more than 300 U.S. markets is dominated by a single health insurer that controls at least 70% of consumers.” And as The Wonk Room’s Igor Volsky has noted, insurance companies try to cover only the healthy because offering care to sicker Americans puts them at a competitive disadvantage in the marketplace.

In order to preserve the status quo of keeping health insurance in the private sector,
the GOP’s strategy has been to repeat the dubious claim that a public option “rations” care. But by making that argument, as Murphy pointed out, rationing care is just what these very same conservatives are supporting. Indeed, during her confirmation hearing in March, Health and Human Services Secretary Kathleen Sebelius said, “as insurance commissioner where I served for eight years saw it on a regular basis by private insures, who often made decisions overruling suggestions that doctors would make for their patients that they weren’t going to be covered.”

Transcript:

CALLER: Ah yes good morning representative. And I’m calling from Georgia and I had a short statement I wanted to give to you and then ask you a question about it.

MURPHY: OK

CALLER: And my question is based on, well now I’m not insured but I had been insured, I’m a teacher that was outsourced I guess you would say. I was diagnosed with post-polio last year but I had to bounce from one doctor in one hospital to another doctor in another hospital all of them within 60 to 100 miles of where I live in order to go through the procedures to get enough information so that I could finally go to a doctor, a PMNR, who could then diagnose that I had post-polio.

But there used to be clinics where you could actually go and get all the diagnostic tests done under one roof and there would be the variety of medical expertise there that would be able to also follow through and say this patient because of this test and this test has this illness. But because of the insurance companies, they are no longer able to do that and so in essence, the insurance companies are the ones controlling what tests you can get, when you get them, how you get them and if they’re accepted or not.

MURPHY: Yeah and that brings up the point here that with regard to one of our big frustrations with insurance companies is they control the market place, they control what’s done, a lot of times doctors not making the decisions here. And you recognize the frustration.

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