Among the most important issues facing the American body politic is the extent to which insurance companies and other corporate entitites are allowed to use their financial and political muscle to dominate the delivery of health care. For those who do not believe that corporations should have unlimited powers, yesterday’s Maine Supreme Court decision limiting the premium increases by Anthem Health Plans marks a step in the right direction.
One of the many moving parts of the Patient Protection and Affordable Care Act (aka Obamacare) is the power it grants the Secretary of Health and Human Services to limit unreasonable premium increases by insurers. This Maine decision is based on state rather than federal law, but it tracks well with the issues in play at the federal level:
In its ruling, the Supreme Judicial Court said that Maine’s insurance superintendent had “properly balanced the competing interests” in arriving at an approved rate increase of 5.2 percent. The insurer, a unit of Wellpoint, the nation’s largest insurer, had sought a 3 percent profit margin as part of an overall 9.2 percent increase in health insurance rates for policies sold to individuals in 2011. It argued that state regulators’ decision to grant a 1 percent profit margin violated state law and the U.S. Constitution by depriving the company of a “fair and reasonable return.”
The Maine Supreme Court is essentially affirming that “reasonable return” is not an area where corporations have the final say. This case, or one like it, may well reach the U.S. Supreme Court. Perhaps one day we will have a Supreme Court that does not consider corporations to be people and remembers that corporations are permitted to exist under law in order to serve a public purpose.
It is not widely appreciated in this country that while many nations allow private companies to provide insurance services, all but the United States limit these to the nonprofit sector. Allowing life-and-death health matters to be influenced by the constant urge to maximize shareholder profits is only permitted here.
That is unlikely to change anytime soon. For now, passing and enforcing laws limiting the more rapacious instincts of corporate CEOs is a necessary step in defense of the public.