In Sunday’s New York Times, Greg Mankiw, chairman of President Bush the Last’s Council of Economic Advisors, tells us that the public option is inherently unfair to corporate behemoths. He forgets to tell us how much cheaper it will be. I suspect that he didn’t examine the financial statements of any private insurance companies, like, say, Aetna. Here are the 2009 first quarter 10-Q, and the 2008 Annual Report.
Aetna is a fairly simple company, with three business segments: Health Care, Group Insurance, and Large Case Pensions, each reported separately in the 10-K. The following table shows several categories from the consolidated statements and the health care segment statements which would be different in a company set up as a public option.
| Aetna ($ in millions) | Fiscal 2008 total | Fiscal 2008 Segment | Public Option |
|---|---|---|---|
| Selling expense | 1,149.60 | 1,055.20 | 211.04 |
| Salaries and related benefits | 2,619.80 | 2,436.41 | 1,827.31 |
| Other administrative expenses | 1,982.10 | 1,843.35 | 921.68 |
| Interest expense | 236.40 | 236.40 | 0.00 |
| Amortization of acquired intangible assets | 108.20 | 101.30 | 0.00 |
| Stock-based compensation expense | 95.70 | 89.00 | 0.00 |
| Income before income taxes | 2,174.20 | 2,551.20 | 0.00 |
| Total | 8,366.00 | 8,312.86 | 2,960.02 |
| Reduction in expenses | 5,352.84 | ||
| Total revenues | 30,950.70 | 28,775.00 | ——— |
| Savings as % of revenues | 0.1860 |
The selling expense would be substantially lower. This is essentially commission income as opposed to pay to salaried workers. Let’s estimate it would drop by 80%.
Salaries and related benefits and other general and administrative costs are not separately stated in the segment data, but they are in the consolidated data. I took the general and administrative expense in the segment data and allocated it between salaries and other administrative pro rata with the data from the consolidated data to get the two numbers in the segment column. Salaries would drop, because we would be paying on a more rational basis for strictly administrative functions. Let’s guess it drops by 25%, mostly the bloated pay to executives.
We know that general and administrative expenses are lower in the public option, so let’s drop them 50%.
The stock-based compensation would disappear. There would be no interest expense. The income figure is unnecessary and can be eliminated for these purposes. I have left depreciation in the figures, which will permit replacement of existing equipment and furnishings. It will be necessary to have some profit to cover some expansion of services, but we can ignore that for this purpose.
These figures are given in the Adjusted column. It works out to a reduction of 18.6% of revenues which can cover either reduced premiums or a repayment to the government for any seed money, or necessary acquisitions.
What does Aetna do with the $5.35bn? About $1.8bn was paid to shareholders in dividends and stock repurchases. Aetna paid $924mn in federal income taxes from its profits, which will be a net loss to the Treasury. Much of the rest is still in the company and will eventually wind up with investors.
In 1996, when Aetna bought U.S. Healthcare for $8.8bn in cash and stock, the NYT did some excellent reporting:
[For] the Xerox Corporation, the amount of money involved in the Aetna purchase was worrisome. "As a purchaser I always get nervous when lots of money is shelled out by one organization that is acquiring another, say for $9 billion," said Helen Darling, manager of health care strategy at Xerox.
She added: "My worry is that the acquiring company will want to recoup their investment at a time when we are trying to control costs. I would watch them both like hawks, nervously worrying that this will fuel medical inflation, and that this might make everyone, including legislators, more cynical about managed care."
Helen Darling got that exactly right. Mr. Mankiw might want to think about her concerns. It won’t hurt: Xerox is a big company too.



40 Comments





Support this site!
Subscribe to the newsletter
Advertise on Firedoglake
Send
us your tips
Make us your homepage
About Firedoglake
“President Bush the Last” May it be so! Now to read.
Thanks for this explanation masaccio.
Thanks, Masaccio.
Check out Dylan Ratigan, host of MSNBC’s new show “Morning Meeting” blame everybody but the healthcare industry for the high costs of healthcare.
Here is the clip.
http://progressnotcongress.org/?p=1990
This is outstanding, Masaccio. Even I can understand it! Question: What’s the likely impact of public option shift on employment/jobs in the healthcare industry? If it’s a dumb question, please pretend it’s not, okay?
So, someone explain to me exactly why we should be fair to corporate behemoths? They don’t treat us fairly, why should they expect fair treatment from us?
Health is not a commodity.
Health is not a profit center.
Single payer NOW!
That’s tough to gauge accurately. Certainly their will be lost jobs in marketing/sales, but maybe those folks just end up working life/home/vehicle insurance instead.
There will be losses on the claims adjustment side, too. Simple contracts don’t require highly trained people to figure out how to
cheatmanage reimbursement for thesuckersclients. Providers are going shed jobs in their billing departments, too.The exact level of the shakeout is entirely dependent on the structure of the bill. If we go to my preferred model (Medicare for everyone), it will be a bloodbath. If we do what massacio suggests (public health insurance adminstered through private companies, similar to France), it won’t be nearly so serious.
i don’t understand where you got the public option numbers (25% and 50%) for administrative salaries and expenses but one thing i’m pretty sure you didn’t take into account is the money private insurance companies “save” with some of those administrative costs – by denial of care, adverse selection, etc. that would affect the public option costs.
here’s an analysis of Wellpoint
Wellpoint
What you said.
But it isn’t going to happen, because cowards like Baucus and Hagan have taken it off the table. It would have been a battle without their obstructionism, with it it’s impossible. Getting to a strong public option that can bridge us to de facto single payer is going to be tough as it is.
The Hartford Courant today announced that Anthem Blue Cross would be increasing its premiums for privately held insurance by 32%. This increase will take place not in January, when they normally increase their rates, but in October.
I am a reasonably healthy 50-ish. No chronics, no pre-existings, nothing. I currently pay $ 554 a month for the privilege of insuring myself through them.
This increase will put my monthly payment at somewhere around $ 780 a month.
I can go elsewhere for my insurance, and intend to do so, but what about the folks that have issues that make them otherwise uninsureable if they try to move their coverage elsewhere?
I have written to my [worthless] senators (and actually got a response from one) as well as to my State’s Attorney General. Even the industry experts said that the increase was extreme (normal rate increase is 10 – 15%).
I’ve put the article link on my Facebook page. I’ve done everything I can do to get people to pay attention to this. This rate increase is a perfect example of the need for alternatives to this kind of crap. If Anthem goes out of business because the government gets involved, they will have brought it on themselves.
Why do they do this? Because they can. There’s nothing out there to stop them.
This is typical rent-seeking behavior on the part of Anthem, and this is precisely the kind of thing that makes a strong public option mandatory. Without it, we will continue to see rent-seeking and market-fixing behaviors. It’s economics 201, really.
another point of view:
btw, steffie woolhandler, along with david himmelstein another critic of the public option (for example, see recent bill moyers program), are coauthors with elizabeth warren on the medical bankruptcy studies and have studied and published on these cost issues for many years. see for example the nejm paper (pdf).
i’d think it would be just as tough — maybe tougher because while the insurance companies will fight just has hard, it will be more difficult to mobilize public support for a the public option in a multi payer system than it would for a single payer system like hr 676 (everyone in and no one out. no co-pays, co-insurance or deductible).
edit to add: here’s part of a comment i made recently in one of scarecrow’s threads:
if anyone can punch holes is this, i’d be very grateful to know how so i could be more enthusiastic about the public option approach. thanks.
Yeah, buddy.
I agree… a strong public option is a bridge to de facto single payer, not an end point in itself. We may not get de jure single payer, but that’s a fight for another day.
I’m on your side, I really am.
But the fact is that single-payer would be a tough fight in the House and impossible in the Senate. Baucus and Hagan have said, “No,” and no it is. Unless we can scare them — they read polls too, and they know that do-nothing isn’t an option.
If we make the choice facing them do nothing and face the wrath of the voters (eventually) or hold their noses and vote against the bill but allow it to come to a vote, maybe we can convince them to hold their noses. At least I hope so.
If we have mandatory health insurance without a public option will I be allowed to deduct 30% (the amount of waste, fraud, and excess CEO compensation) from my monthly health insurance bill?
You really think Ratigan is going to dump on his corporate master? GE is big in health care. Do you really think they want a public option?
i absolutely know we’re on the same side. i just want to have more optimism that, even with a public option, this isn’t going to be a massive fail: with the public plan getting the people who are sickest (i’m sure private insurance companies would love that), a mandate the public hates, etc. iow, an expensive big government program that people hate so much that all gov intervention, including single payer will be tainted as well.
woolhandler, himmelstein and others have made a case that i haven’t see refuted by public plan advocates. i keep bringing this stuff up in the hopes that i will be shot down.
The only way this system is going to change is if the CEO and the bought and paid for flunkies like Ben Nelson and Kay Hagan feel the pain.
I have relatives who sell health plans for Aetna. They make six-digit salaries plus commission. The company holds “retreats” in Hawaii or on cruise ships to the Caribbean. It is astounding.
My family has an Aetna health plan. IMO it’s barely a step up from Medical. We had a situation with my sons medication that an administrator at Aetna over ruled the opinion of our Neurologist and Pharmacist. After a lengthy battle with them involving attorney’s Aetna finally relented.
Barbara, I think there will be job losses over time. I expect that the losses will be spread over the entire range of employees, top to bottom. The public option company will need people in clerical, and in the routine side of the business, so I think there will be new jobs for them. For the rest, it’s a problem.
That’s a good point. It means that the benefits paid will increase, which will eat up some of the savings. I’ll remember that.
I am assuming that the public option company will operate a lot like the current company in this analysis.
Nice piece, masaccio! I don’t think it could be laid out much better, therefore, I intend to poach your table & use it freely & often. Thanks in advance!
increased benefits paid = very good thing. but it does come with a cost.
adverse selection and similar is a more difficult problem though, and one i’m not sure there is a practical solution for. as far as i can tell, the whole business model is
fucked upbuilt on perverse incentives.The NYT agrees with you. This article describes one of their policies and explains that it didn’t cover enough to keep the insured out of bankruptcy.
Nice. Wellpoint is an HMO, isn’t it? Do you think they will be affected differently?
Couple things. Insurance costs are one thing but they cover costs that hospitals charge. Hospitals charge $15 for an advil because in our country we treat everyone who walks through the door regardless of ability to pay because it is law. (most hospitals at least) This means that the costs must be placed on those who can pay which causes the price to inflate. that needs to be worked on too. money coming into insurance companies and going out is one thing but that doesn’t affect anything with costs of services…
Your interest expense at 0% for the government I find a little off…. We are in massive debt. The government runs social security pay-as-you-go. all the money we spend is borrowed and shuffled around. I see your logic in shifting to a more efficient business model but also find it hard to believe that the government could be a model of efficiency for it never in it’s history has
Actually, because most of the insurance plans negotiate rates, very few people pay anywhere near the “full price” on things like Advil through their coverage.
The only folks that pay the “going rate” are those without insurance, i.e., those who can least afford.
that nyt article is about one of the medical bankruptcy papers i mentioned above (where himmelstein and woolhandler collaborate with warren):
here’s the pdf
Prices are inflated all around though I believe. I recently got a piece of metal in my eye and had to go get it taken out. The bill was $1200. My insurance covered all but $175. I was there 45 minutes total. They gave me maybe 10 eye numbing drops through out, 2 drops of marking solution and looked at my eye through a microscope-like device, then took an engraver-like tool ground out the metal. They then took a IV bag filled with cleaning solution and flushed it all through my eye and I was done. $10 a drop =$120… 1 minute of looking device use $100… Grinding out with tool 3-5 minutes $100. Bag of cleaning solution $100. 15 minutes of nurse time $100. Doctors 15 minutes $250. That a total of $870 that I can bullshit and I don’t think I was lowballing too much but I am truly no expert. That $400 less than what was paid. The payments and what insurers cover and don’t cover are not out of line in my mind. It is the costs that hospitals and doctors charge that need adjusting. That is where reform needs to take place not in pushing numbers around and making stuff look better and class warfare.
I justify cutting interest because to the extent there are start-up costs loaned by the government, there is plenty of money to repay them quickly.
I did not try to estimate savings because a large public plan will be able to rationalize pricing by the medical people, too hard. There will be savings on that side as well. And, the public option will probably try to teach people to make better use of the system.
I flatly disagree with your suggestion that government can’t do anything right. If you want to see real waste, try Merrill Lynch with the $85,000 wastebasket for its CEO who led them into disaster; or any huge corporation, wasting money left and right at the expense of investors.
People aren’t as economically rational as the Chicago School of economics said they were. Even the Ayn Rand worshipper Alan Greenspan realizes that.
Government does not manage money well. That is hard to argue that they do. People who work in government rarely take personal responsibility because they are ultimately not responsible for the future consequences. Look at FDR and his statements regarding Social security. He knew or at least was shown how it could not endure down the road but said no politician would dare try to stop it because it is an entitlement. The government wastes huge sums of money from all places. The military (any arguments on that one), grants and subsidy programs that cost multiples more to administer than the funds that they put out. The post office (a government run company, $2 billion in the red last year, but still gave a bonus to the Post Master General (read: CEO)). Yes there are many cases of corporate waste and fraud and manipulation but there are also many great business stories that far outweigh the bad. Government has a horid history of running programs and businesses. I believe people with a vested interest will always do better on the whole.
What is the price of one pain pill?
I’ve heard it said for years that costs within a hospital are redistributed. The hugely expensive machine and surgeries and other large expensive things and the costs of uninsured unpaid-for care are distributed, to the cost of a pain pill so many of us require and to all other services.
But then, I’ve also heard recently that uninsured and unpaid-for care is paid for by the government. Millions!
Okay, which is it?
Do they collect twice by redistributing the costs to other patients AND to the government?
I think a public option which is uncomplicated will suddenly show up a lot of garbage that has been going on. Who knows, maybe they will begin to undo some of that stuff before the gov’t reform goes into action.
I don’t think you can punch holes in it. The only public option plan that makes any sense to me would be an option to sign on to a plan negotiated by your state, and giving states the power and including to jointly offer a health care plan with other states. For example, the six New England states jointly offering a health insurance plan to all New England residents.
But you will not see dramatic savings unless you can substantially reduce the administrative dead wood in the system in addition to eliminating the profit motive, which is what drives all the shenanigans with respect to denying coverage to sick/costly patients and denying claims due to pre-existing illnesses and all the other bullshit.
Single payer is the only system that will deliver big savings to the consumer while maintaining a high level of quality care.
I keep reading unsupported claims that a public option is “a bridge to single-payer.”
It seems to me that the public option would be a bridge to nowhere, unless the final bill included a viable solution to the adverse-selection problem, about which selise has repeatedly quoted Himmelstein and Woodhandler.
the congress is outrageous.
i read these comments and ask, do any of you pay for employee health care?
i do.
and have for decades.
and beyond health care, i pay for long-term disability care[in other words, incapacitated by a stroke, i furnish coverage that will provide a stricken employee a monthly amount to pay for some percentage of their care requirements].
and if you purchase my products, you pay for that.
but, in a funny sense, this system makes my employees my slaves. though i think that i run a great ship, whether i do or don’t, the current system mandates that my employees cannot leave my employ. they are health care-indentured servants in a very real sense.
and that is why i think that the gangsters in bentonville do not want a health care system that eliminates their employees being chained to their largesse[sic].
you know, if a citizen has a health care contract with an entity other than the citizen’s employer, which grants the citizen some independence, then an employer cannot be a simon legree[sic]. and workers can be free to move elsewhere. indebted to no one for their health care.
when you listen to any senator, congresscritter,dems/reps, trying to tell you how health care cannot be provided without the instrumentality of the insurance industry, know that you are listening to an individual on the take.
and understanding that, i think that you have to recognize that to change this is to implement a revolution. build the tumbrils.
the congress IS TELLING us to “EAT CAKE”.