Here is a source for the idea that insurance companies make these 20% to 25% "profit margins:" by state regulatory laws, insurance companies are required to pay out / pay back a portion of the money they bring in. This is often around 20 - 25%. What that leaves is a clear guideline for how much of gathered money an "insurer" can use to conduct their TRUE business: just like a bank, they gather capital in order to invest this money and make money off of the money. The details about paying claims is just a side business. Profitability is based upon investment success. This is exactly what a bank does. Similarly, a bank has a rule regarding how much of gathered money the bank must hold back, versus loaning / investing. As an interstate-commerce-governed business, versus state-governed health care, a nation-wide hold-back can be regulated. **My point: most of us everyday Americans do not understand how these various components of the health care field work. And so we are generally unable to thoughtfully evaluate reform. Also, we are unable to decently think through the pros and cons of reform, versus socialism. Even though we all suffer hassles and inefficiencies with government throughout our lives. Socialism is a naively over-simplistic answer to a very big problem. We will swap one problem for a worse problem. Auto insurance is basically working. Homeowner's insurance is basically working. A range of other forms of insurance basically work. They are free-market endeavors with fairly firm govt regulation / consumer protection. So, these tell us what COULD work. What doesn't work? The post office. FEMA. Your local DMV. Your state's child / adult protective services. Etc.

According to the Center for Responsive Politics, the insurance industry (which includes health insurers) has spent $1,277,184,939 since 1998 to lobby Congress. (Remember, these are only expenses for federal lobbying.)

http://www.opensecrets.org/lobby/top.php?indexType=i

In 2008, Blue Cross/Blue Shield alone spent over $16 million.

In direct contributions to political candidates (separate from lobbying expenses), Blue Cross/Blue Shield is considered a "major political contributor" making $16,106,070 in political contributions from 1990-2010. You can find the analysis here:

http://www.opensecrets.org/orgs/summary.php?id=D000000109&lname=Blue+Cross%2FBlue+Shield

How officials within a company or industry elect to spend their revenues tempers how I evaluate their profits. Considering the spending decisions insurance officials have and are making, I'm not inclined to accept their claims of lower-than-expected profits.

And, yes, to add insult to injury, they are pains to deal with -- all of them. The insured rights have nearly evaporated in recent years while the money to Washington has flowed like an unending, raging river.

Mary Webster

Aren't auto insurance and house insurance mandatory, though? In Canada, it's illegal to drive an uninsured vehicle and every mortgage holder requires the house to be insured. So the analogy fails.

I just cannot understand opposition to universal health care.

Max Baucus, the prime author of the current "reform" received more money from the insurance industry than any other elected official, oh, and he's a democrat. The reform on the table is a bad idea because, unlike auto and house insurance which in most states are mandatory, at least until your house or car is paid for, "the health-care system is not at all like other markets, because health, for obvious reasons, is not at all like other goods. (The demand for not dying, to give just one example, is pretty much unlimited.)" quoted portion from Luke Mitchell in Harpers.

Furthermore, "This combination of guaranteed issue and individual mandates would add up to a system wherein the government requires healthy people who do not want insurance to buy it anyway, in order to subsidize unhealthy people who need insurance but can’t afford it—which sounds like what most people would call “socialized medicine.” again quoted portions are from "Sick in the head: Why America won't get the health-care system it needs" by Luke Mitchell from the February 2009 issue of Harpers. If you can't afford to subscribe, go to your library and read this important article.

Meanwhile it seems obvious to me that "we’ll never control spending so long as Americans are insulated from the true price of their medical care." http://www.nytimes.com/2009/10/19/opinion/19douthat.html?_r=1

We need a public option, it's the cheapest and best alternative and in this instance I applaud Reid for doing the right thing in insisting on it.

Sorry for the rant.

'would add up to a system wherein the government requires healthy people who do not want insurance to buy it anyway, in order to subsidize unhealthy people who need insurance but can’t afford it—which sounds like what most people would call “socialized medicine.”'

But we pay for all kinds of things through our taxes whether or not we want them. My taxes pay for our public school system even though I don't have kids. My taxes pay for our roads even though I walk everywhere. My taxes pay for our fire department even though I've never had a fire. Nobody talks about "socialized services" except for when it comes to health care.

Francesca,

I'm not against socialized medicine, I'm for it in the sense that a single payer system, a public option, is socialism.

I'm against mandatory health insurance. Health insurance is not health care. And if taxes are raised to supplement money paid to insurers for premiums, it's a sort of mandatory corporate theft from the private citizen, facism, not socialism. My reference was a response to Mvt's comment that socialism is naive and mandatory insurance somehow not socialism. In a technical sense it is socialism at it's more radical and negative, i.e. fascism, as opposed to the single payer system similar to what Canada, France and England have.

As so often happens, at least in the US, the spin is that mandatory insurance is the same as socialized medicine which it's not, it's way more expensive and draconian, providing profits for insurance at the expense of the individual, sort of like the bank bail out here benefited the banks, not the tax payers who paid for it.

Of course my taxes pay for schools and even though I don't have children, having an educated population makes the world safer and more pleasant for me. And of course I do need roads and fire protection. Here in the US I'm burned up that my taxes pay for wars which place my life in jeopardy while killing untold innocent people, instead of paying for health care under a single payer system which wouldn't just give me access to health care should I choose to access it, but would also improve the economy by providing more jobs, and a healthier public.

Sally sez: "Mandatory insurance is way more draconian and expensive." OK, Sally, please explain this one to me.