Insurance is a type of risk management, and the idea seems reasonable enough. Catastrophes are bound to happen and major ones can so financially damage someone that dealing with it is impossible. But if a group of people pooled their resources, when catastrophe struck one of them, she might be able to survive. It is a collective, collaborative, cooperative social/financial arrangement.
This was Ben Franklin’s idea when he started the first insurance company in America, before the United States existed. But when the idea became the basis of a private company, the actuarial capital (calculating the statistics of risk and adjusting contributions accordingly) separated from the managerial capital (incorporation and selling shares), and we entered the era of private profit. Today, with the enormous expansion of finance arrangements, buy-outs, commodifications of contracts, etc., insurance is a different world entirely, and health insurance sits comfortably at the front of this new age.
UnitedHealth Group is the largest health care company in the world by revenue, ranked eighth among Fortune Global 500 companies, worth around $475 billion. Its annual revenues are roughly 10 times the revenues of New Mexico and roughly 1/10th of the United States. UnitedHealth Group has two independent subsidiaries, UnitedHealthCare, selling insurance, and Optum, engaged in health care. Much of its activities are regulated by states, which all have less money than it. In this world which we all happily worked so hard to create, that seems to mean it is not regulated at all.
ProPublica has published another of its deep examinations of health care problems. This time on how UnitedHealth uses its statistical data to find mental health patients to whom it can deny care, sometimes forcing therapists and doctors to withdraw care. It’s all part of “saving money” and “efficiency,” responsible sounding synonyms in the corporate world for “profit” and “greed.”
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