While trial lawyers and, ahem, the media, have long labored in the pit of public opinion, it seems health insurers have now joined us in the "Axis of Ill Repute." Welcome.
Though long in the making, the official induction to our not-so-merry club may have came as soon as Speaker of the House Nancy Pelosi (D-Calif.) publicly labeled private insurers "villains" for working to defeat a public option for health insurance. This newfound scorn is not so surprising; indeed, the large, amorphous nature of the health insurance industry seems to provide a ready-made canvas on which politicians can project blame. Quite naturally, health insurers have taken umbrage at this vilification. "Health care reform is far too important to be dragged down by divisive political rhetoric from Washington, D.C.," says America's Health Insurance Plans (AHIP) spokesman Robert Zirkelbach.
Dream on, Bob. Given the astronomical numbers involved, it was only a matter of time before health insurance profits were dragged into the debate over how to make health care more "efficient."
Never mind that one man's "inefficiency" may be another's profit or, as AHIP likes to point out, that health insurer profits constitute less than 1% of overall health care spending. Facts are indeed stubborn things, but are all too easily subsumed in a debate marked by hyperbole and discussions of "greedy insurers" and government death panels. Lest one think that this will go away soon, Reps. Henry Waxman (D-Calif.) and Bart Stupak (D-Mich.), have sent a letter to 52 health insurers asking for detailed information on executive compensation.
Unlike physicians with whom patients interact personally, even the best run health insurer remains a remote, faceless entity. While polls indicate most Americans are happy with the health insurance they receive, this support may be wide but not very deep. People may like their insurers, but are not prone to love them. Somewhat like an arranged marriage, Americans who receive health care from their employers are wedded to their health insurers due to a decision made by others.
This may explain the lingering support for the public option. The Kaiser Health Care Tracking poll for August 2009 found that 59% of respondents favor creating a "government-administered public health insurance option similar to Medicare" to compete with private plans. Despite the recent wave of disdain for a public option so apparent at recent town halls, this number was exactly the same in July.
So what can insurers do counter these negative perceptions? At a macro level, insurers could reiterate what they do well. For example, private insurers excel at weeding out fraud. These successes could be easily juxtaposed against Medicare's historical struggles in this area. Perhaps more important, they could restate their value proposition to their customers. I would gladly exchange the soft-focus treacle so endemic on my insurer's Web site for a more clearly articulated value proposition.
Public opinion is not immutable. If insurers stay focused on presenting the facts in this debate and leave the hyperbole to others, they may well avoid the level of opprobrium normally reserved for trial lawyers or journalists.
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