Let’s pretend you’re the CEO of a for-profit health-insurance company. Here are the facts:
This could be a tough flu season with two different flus: the seasonal flu and H1N1.
Each year, 200,000 people are hospitalized with the flu and 36,000 die. That number could be double this year because we have two flus.
For a patient to spend a day in a regular hospital ward (not the Intensive Care Unit) costs about a thousand dollars a day. That does not include meals, medications, procedures, IV fluids, injections, doctors’ evaluations or physical therapy.
There are vaccines available that could stop someone from getting either flu. The vaccines cost around $20 to $30 per dose.
The Centers for Disease Control and local public-health agencies, aka the government, will handle acquiring and delivering the vaccines to local healthcare providers.
Knowing all that, what do you do? If you’re the CEO of a for-profit health-insurance company in America, the answer is: nothing.
And who takes over educating providers and patients? The Centers for Disease Control and local public-health agencies — in other words, the government.
My wife is a pediatrician. Her clinic got a call from the Public Health Department informing her that it had not received an order for H1N1 vaccines from her clinic. The boarding school where I work has its own special liaison at the Public Health Department to help with acquiring and delivering the vaccines.
How much does the government stand to make from its involvement? Close to nothing. How much do for-profit health- insurance companies stand to make from people getting vaccinated? Potentially millions.
So, why haven’t for-profit insurance companies contacted their high-risk patients more aggressively? Why do they still charge their patients a co-pay for the vaccine? Why not do a reverse co-pay, i.e., pay patients who get the vaccine? Why not offer transportation to those who need it? Where are their advertisements encouraging people to get vaccinated?
All of these efforts would cost a fraction of the CEO’s bonus, could potentially save the company millions and would dramatically improve the company’s public image at a time when they need it most.
Still, there are those who argue the merits of a for-profit system.
— Ali Javanbakht, M.D., lives in Carpinteria.
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