Health Care Premiums Also Used for Lavish Salaries, Luxury Items, Underwriters

Health Care Premiums Also Used for Lavish Salaries, Luxury Items, Underwriters
West Virginia Democrat Wants Transparency in Insurer Health Care Spending
By Kate Snow, Elizabeth Tribolet and Suzan Clarke | ABC News

A significant portion of health insurance premiums go not for actual medical care but for private jets, generous CEO salaries and underwriters who decide when to drop patients who become too expensive, according to a Senate committee report.

Sen. John D. Rockefeller, D-W.Va., chairman of the Senate Committee on Commerce, Science and Transportation, wrote to 15 of the biggest health insurance companies in August, asking them to provide information on how much of policyholders' monthly premiums was spent on medical care versus the amount that went to administrative costs and company earnings.

Such figures are known in insurance industry-speak as "medical loss ratios." But when insurance companies balked, saying the information was confidential and proprietary, Rockefeller's investigators went digging through public documents and found that much of policyholder premiums was going to nonmedical costs.

The insurance industry has long pointed to federal data that says about 87 percent of every dollar that people spend on premiums goes toward actual medical care, but Rockefeller's investigators found the average for the top six insurance companies is closer to 82 cents on the dollar for medical care.

That five-point difference represents billions of dollars.

And when investigators broke down the information by insurance type, they found that people who buy individual insurance from those companies rather than being part of a small or large business, get the least bang for their buck.

On average just 74 cents of every premium dollar for individual coverage goes to medical care. Read more.