The Corporate Profit Motive & Questionable Public Relations Practices during the Lead-Up to the Affordable Care Act

By Maher, John N. | Journal of Law and Health, Spring 2012 | Go to article overview

The Corporate Profit Motive & Questionable Public Relations Practices during the Lead-Up to the Affordable Care Act


Maher, John N., Journal of Law and Health


I. INTRODUCTION

II. SKY-ROCKETING COST, LOSS OF COVERAGE, &
BANKRUPTCY

 A. Extremely High and Rising Costs Overall
 B. Rising Insurance Premiums, Deductibles, and
    Out-of-Pocket Expenses
 C. Rising Costs Hurt the Economy
 D. Personal Financial Ruin

III. HEALTH CARE FINANCING IN THE UNITED STATES

 A. Signing the Affordable Care Act
 B. Government Health Care Financing Programs
 C. Privately-Funded Medical Coverage
 D. The Underinsured & The Uninsured
 E. Financing Friction
 F. Corporate Interests Protected Through Public
    Relations Tactics
 G. Unsavory & Apparently Unlawful Public Relations
    Tactics
 H. The Challenges A head

IV. INSURANCE COMPANY RISK REDUCTION AND RISK
    AVOIDANCE TACTICS

 A. Dropping Beneficiaries Who Get Sick
 B. Padding Profit Through Coverage Denial
 C. Dr. Linda Peeno 's Testimony Before the House of
    Representatives

V. WIN-AT-ALL-COSTS PUBLIC RELATIONS TACTICS

 A. What Is Public Relations?
 B. Misleading Public Relations Tactics
 C. Specious Third-Party Front Groups
 D. Contrived Self-Serving Studies
 E. The Result of the Public Relations Gamesmanship

VI. POTENTIAL SOLUTIONS

 A. Congressional Hearings to Build a Record
 B. State-Based Licensing of Public Relations
    Professionals
 C. There Must Be Disclosure
 D. Existing Laws

VII. CONCLUSION

"IT IS A FACT THAT HEALTHY NATIONS ARE WEALTHY NATIONS. ... "(1)

Excerpt-1:

   ... This is the fatal flaw. Many of those charged to fund medical
   care are incentivized, by corporate and fiscal law, to find ways to
   deny coverage.

   This enticement has led each of the larger private health insurance
   companies to implement various morally unsettling, but often licit
   ways to deny payment based on technicalities and fine print. So
   doing positions the company to maintain a medical loss ratio in
   keeping with shareholder and investor expectations, not to mention
   mammoth executive compensation linked to stock performance.

   Meanwhile, somewhere else in America, a patient goes untreated even
   though the technology and the medical resources may be available.
   Attending physicians are embarrassed, even frustrated or outraged.
   The patient feels the despair of abandonment. The anxiety and pain
   family and friends already feel is worsened by the idea that their
   loved one has been devalued by an anonymous, aloof, and apparently
   disinterested medical director ensconced in a distant office
   building overlooking the green fields of Connecticut.

   Given the importance Americans place on individual rights, freedom,
   and the inherent value of each life, one would think that those
   charged to fund medical care would be incentivized by benevolence
   and good will rather than the bottom line, especially when those in
   need of care are at their most vulnerable in body and spirit. (2)

Excerpt--2:

   The time is now to clearly identify the extent of these two
   material problems: the elevation of profit over the financing of
   care on the one hand, and unchecked corporate duplicity guised as
   legitimate public relations on the other hand. Solutions must
   contemplate recalibration of the payment system so that those
   responsible for payment are motivated to fund medically necessary
   care rather than deny payment to increase profits. Solutions must
   equally embrace measures to require public relations firms to
   disclose the identity of their clients and certify the good faith
   basis of public claims so that debate about significant issues such
   as the health of America's citizens is free from disguise and
   unseemly manipulation. A problem identified is a problem half
   solved. (3) Until these two problems are taken up, each remains
   poised to produce high-stakes problems in the future. (4)

I.INTRODUCTION

The purpose of this Article is two-fold: first, to highlight two problems which threaten the effectiveness of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), (5) and second, to invite civic and governmental dialogue to implement solutions to those problems. …

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