HealthFirst

Dear Laura,

As the retired Director of Undrwriting for Horizon Blue Cross Blue Shield of New Jersey I have a few observations.

First, Wellness and Disease Management programs have been around for decades. These are fine concepts and they help people stay healthy and live longer, but there is little evidence that they actually save money in aggregate. Unfortunately a byproduct of greater life expectancy is higher health care costs. It is no coincidence that life insurance premiums have pummeted in recent decades.

The market system in place today is failing. A shrinking number of insurers must employ armies of doctors and nurses to oversee their provider networks. They retain cadres of actuaries, underwriters, programmers, and processors to manage a mind-numbing array of benefit configurations that drive doctors and patients crazy. Intense competition means large, highly compensated sales forces that feed a brokerage community whose clients' financial interests are often secondary to their own. Add stop-loss, risk, and profit and you have a very pricy policy. All this baggage is replicated at each insurance company.

States have tried various schemes to control health insurance costs and all have failed. That's because neither the states nor the health insurers themselves have the power to significantly reduce costs or assure an equitable distribution of care. Only the federal government can do that, and has been very sucessfull with its Medicare program. We don't have talk shows on what's wrong with Medicare. New Jersey Blue Cross Blue Shield, a large company with some economies of scale, takes twenty cents out of every premium dollar to run itself. Medicare gets by on less than three cents per dollar of income. That difference alone amounts to several hundred billion dollars annually, and Medicare enjoys significantly lower provider reimbursement costs. Unlike the Canadian system, Medicare is mostly private, with doctors and hospitals residing in the private sector - a truly American solution that was worked admirably well.

Public health is the moral equivalent of public safety. Let's not trust it to market forces.

James D. Salmon, CLU, ChFC
Director of Underwriting (Retired)
Horizon Blue Cross Blue Shield of New Jersey
Center Conway, NH

I listened to the program with an open mind as I am always a skeptic when it comes to the entire discussion on "health care." Most insurance agents, politicians, and those making policy, have never researched the connection between the western diet and preventable degenerative disease.Doctors like Neal Barnard, Dr. Gabriel Cousens,Dr. T. Colin Campbell,Dr. John McDougall, Dr. Joel Fuhrman, Dr. Caldwell Esselstyn Jr., Dr. Michael Greger, and many others, are writng books about how plant based nurition is the key to disease prevention, reduction, reversal. Why are these doctors omitted, as is the information about their books, from mainstream discussion? $$$$$- If we all got healthy and didn't need pills,procedures, and new organs,what of all the profit based medical industrial complex that continues to grow from our tragic and preventable diseases? The least we could do is become educated about how to feed children, starting in the womb, for optimal health and strong immunity. At least we could ensure trusting children were provided with real nutrient dense food that protects them from the ravages of early onset disease.

What is astounding is the USDA, marketing arm for agribusiness and global promotion of animal "products," is in charge of nutrition policy. They are the wolves guarding the hen house. The recent recall of 143 MILLION pounds of potentially hazardous, "beef" ( it was from downed dairy cows who were too sick to even stand up...imagine)that was delivered to school lunch programs, is a disgraceful commentary on how our tax dollars are used to fund the beauracrary that gives HUGE subsidies to the worst commodity products. Why are organic blueberries $5.00 for a tiny amount, while salmonella tainted, cholesterol filled poultry is $3.00 a pound or less? Why do we continue to subsidize the dairy industry when doctors from Benjamin Spock to Dr. Frank Oski warned that cow milk and dairy products are implicated in every disease from MS to Chron's to Diabetes?
Why are our federal representatives on the Senate an House agriculture committees, promoting disease and compromising childrens health using tax dollars to artificially lower the cost of the most unhealthy foods sent to schools, and other federal programs like WIC?
WELLNESS begins by understanding and caring about total health. It appears many adults rather focus on makin sure they are covered because they know they are eating themselves to death. We just can't have our "steak" and eat it too, or in the case of Americans, burgers, nuggets and cheese enchilada's. The cost to our health, the environment, children, is far too great. We need a NEW paradigm in how we think about HEALTH CARE....