Showing posts with label health care spending. Show all posts
Showing posts with label health care spending. Show all posts

Saturday, August 22, 2020

Reparations in the 21st century

How would reparations work?

First, it's imperative that it has to be about more than slavery, which is the mistake most white and black middle class Christians make when supporting that idea. If it were just slavery, that would leave out Barack Obama, Kamala Harris, Megan Markle, the adoptive children of movie stars and the millions like Ilhan Omar who have immigrated from Africa and the Caribbean in the past 3-4 decades. And I do mean millions. Only 350,000 blacks came during slavery days--you can see more need to be added to the roster of the downtrodden and abused.

Second, it will start with something recent that most people will remember. Maybe it will even be "affirmative action" since it failed to set things right and caused blacks undo hardship with debts they couldn't pay off. Maybe it will be "fair housing" initiatives since the concept caused so much "white flight" and pulled middle class blacks out of neighborhoods that needed them.

Third, it will include obviously bad and racist people, and we'll be asked to provide compensation for those hurt by those who consciously worked against blacks, like maybe a (Democrat) senator, former member of the KKK.

Fourth, it will include legal (at the time) business practices, either defined or redefined. Like red-lining of banks to stall mortgages. And if you've invested in that bank, or its parent company, or even if you use its savings and checking account services, you'll be part of the system, and therefore, guilty. You'll need to pay up.

Fifth, it will include local government services, like schools, parks, transportation. Did the schools in your community fail black children at higher rates than whites? Law suits coming right up. Maybe even the families of the board members and teachers will be held responsible. There goes that nice pension teachers get.

Sixth, it will include nutrition and health. We will be asked to overlook lifestyle causes of health problems, at least as far as reparations are concerned. If McDonald's is deemed to have too many stores in black neighborhoods (black because of redlining by banks) and black children have more obesity related health problems, then Mickey D will have to pay up, and if you've invested, sorry. That McDonald's has provided more top level management jobs for blacks since the early 1980s and been more environmentally responsible than most corporations will not balance the ledger.

And there will be more. There are currently national, state and local task forces for each of these. Keep your eyes and ears open. Non-profits are extremely lucrative for those at the top getting donations from foundations and gullible church mission boards. It's sort of a reparation payment all by itself.

Tuesday, August 18, 2020

Disparities

I wish every preacher, politician, prophet and prognosticator could read (or re-read) THE UNPRECEDENTED EXPANSION OF THE GLOBAL MIDDLE CLASS: AN UPDATE (2017) by the Brookings Institution,   non-profit organization devoted to independent research and policy solutions.  https://www.brookings.edu/wp-content/uploads/2017/02/global_20170228_global-middle-class.pdf   Just as an aside, some conservatives consider Brookings part of the “deep state,” i.e. certainly not a Trump supporter.

I commented on that document at my blog in May 2017. I’d forgotten the eye opening research and conclusions and re-read it today.  In light of the current pandemic and the self-flagellation I hear from educated, comfortably middle-class Christian Americans about health disparities, systemic racism, income gaps, struggling inner cities, and failures to thrive of various populations this report is truly stunning.

Here it is:   About TWO-THIRDS of the WORLD are now middle class.  Think on that a moment.  When my great grandfather (b. 1828) set out as a young man to “go west” about 95% of the world existed in overwhelming poverty and the government provided none of the social services we expect today. All that charity was left to the churches and local communities—taking care of the sick and poor and providing children (who often worked in factories or as farm labor) with an education.

In 1990, more than a third of people on Earth lived on less than $1.90 a day, adjusted for local prices (this is the line the World Bank uses as its main metric). By 2013, barely 10 percent of people did; the rate had been cut by more than two-thirds. And most of the recent growth of the last 2 decades has not been among white people (aka Europe and North America) but among Asians and Africans. Even in the U.S. the riches ethnic groups are Asians—Indians and Filipinos. https://www.worldatlas.com/articles/the-biggest-asian-origin-communities-in-the-united-states.html

Of course, the obligatory reporting on global climate change and the percent of rich households (not middle class) consumption being in the U.S. is reported in the Brookings document.  But then, think on this: “India today (2015) is already richer than Germany was when it introduced social insurance for all workers in the late 1880s. Indonesia is richer than the U.S. was in 1935, when the Social Security Act was passed. And China is richer than Britain was in 1948, when the National Health Service was introduced.”  Social programs did not building the middle class—capitalism did.  Brookings, being left of center didn’t say that, but it’s there, in print, and on-line.

Destroying the Trump economy (which actually came after this amazing report) and attempting to make us more dependent on government rather than the values that built our country and those of the countries rising today are critical for those who want global power. Whether you think that means Soros or a global cabal of capitalists, or “woke” international corporations, we seem to be in the battle for our lives.

We need to get back to work and to stop listening to those who are trying to defeat us.

Tuesday, April 14, 2020

Covid19—when I realized we’d turned the corner

A week or so ago there was a sign covid19 was coming under control. What did I see? The task force noted it was time to start throwing more time and energy at racial disparities. So much of our medical research dollars have been spent the last 30-40 years looking at poverty, obesity, sexual promiscuity of gays, family dynamics, educational achievement, smoking, drugs, and now transgenderism, it's no wonder CDC and NIH don't get the viruses and bacteria under control.

Today I saw: "Columbus Mayor Andrew Ginther and Columbus Public Health Director Dr. Mysheika Roberts have opened the Center for Public Health Innovation to address racism as a public health issue. The new center seeks to reduce health inequities to increase life expectancy and improve quality of life. The center will also address racial disparities related to COVID-19 in Columbus and around the country." This is regurgitating epidemiology, social sciences and public health research that has been going on since the 1960s, and some earlier pieces are classics, still true. Behavior affects health, whether white, Asian, Hispanic or black. More money to advance careers and enhance resumes.

We don't prevent or cure AIDS by studying how gay men think about the size of their penises, yet that research has been on going for years. You don't solve diabetes by measuring the girth of Filipino Americans compared to Swedish Americans. You can't end nicotine addiction by more funding of support groups on-line paid for by Medicare. And concluding that LaTisha and LaToya had too many "daddies" in their home growing up, isn't going to make them want to exercise when they are 50 and overweight. Bridget and Bonnie are also overweight and their parents were married and faithful.

There are thousands, maybe millions of these articles stuck deep in data bases now--we don't need more to tell us behavior matters in keeping us healthy and happy. If anyone, of any race or culture, eats too much, smokes and drinks too much, sleeps around, and only exercises long enough to change the channel, he or she is not going to be healthy based on statistical studies and grandma's advice.

There. I could have saved the tax payers billions, although no one will take my advice because it's too lucrative for academics and politicians.

Tuesday, January 15, 2019

What exactly are the Democrats’ policies?

The Democrat policies you say you care about are:  “Most are in the area of social issues: common-sense gun control, affordable health care for all (can't wrap my head around the fact that gun ownership is a right, but healthcare is a privilege), increase in federal minimum wage so it at least matches the poverty level minimum, pro-choice.”

They all sound rather vague, but that’s not what the Democrat party means with those words.

1.  We all know the issue isn’t “gun control,” because some of the worst disasters have happened in cities that have that.  The goal is confiscation for all except the government and private security guards to protect entertainers and politicians.  It’s never been anything else.  Democrats are almost as patient as terrorists—and it is always incremental.

2.  Healthcare—we already had 5 federal/state medical plans before Obama decided to make NOT having it a crime punishable with a fine or jail time. Native Americans have had cradle to grave health care for many years, and they are the least healthy and poorest of American minorities—at least if they live on the reservation. My brother-in-law was a full blood Indian who grew up in Huntington Beach, CA, and used all the rights and privileges the rest of us have, plus a few from his tribe. He had a public employee pension, but died at 73, not for lack of health care, but lack of agreeing to a colonoscopy.  I think it was the take over of one of the largest industries that Republicans objected to.  If he had begun without the mandate, or not forcing religious groups to buy contraception/abortion, he would have had no problem growing it to single payer. But it was never about healthcare, it was always about power.  Also, the government no matter who is in the White House is eyeing the deductions or credits for medical care by employers and employees—they (it) believe that is rightfully their money.

3.  We already have 123 federal wealth transfer programs, and many started out to help the sick, poor, elderly, etc., (those who tug at our heart strings), but as time goes on more people are added as they expand, until now we’re at the point that 62% of the people who receive entitlements or assistance are well above the poverty line. Nonpoor households received 48% of the $2.4 TRILLION distributed in 2015.  And about 31% were in the upper half. There’s just something about a government entitlement plan that is like our waist sizes (at least mine) and expands as we age.  These programs don’t necessarily reduce poverty, but they certainly employ a lot of middle class bureaucrats in state and federal government.  If poverty were to disappear tomorrow, on Thursday we’d have a new class of poor—all those folks who work upstream from the poor. (figures from “The high cost of good intentions” by John F. Cogan, 2017)

4.  As far as minimum wage goes, that’s another feel-good, guilt trip.  A tiny fraction of wage earners are at minimum—I think  it’s 2.9% of all workers.  And even at the old $7.50/hr figure, if a 2 adult earner household was working 40 hours a week at $7.50, that household has gone beyond the level for qualifying for most important benefits like SNAP, Medicaid, Section 8, WIC, etc. Low income doesn’t mean stupid, so if it were me at that job, I’d cut my hours or refuse a promotion so I could continue qualifying for about $22,000 a year in benefits. It’s quite possible for EITC for a man with a family to have a stay at home wife and 3-4 kids who is better off than the man earning $60,000/year because the government pays him to earn below $50,000 and it’s non-taxable. The average family income of a minimum wage earner is $53,113 and they are more likely to have some college than the average American worker. Why?  They are not the primary earner of the family!

5.  And pro-choice.? Well, there goes your concern for the weakest and most vulnerable in society. Again this is incremental.  All the talk these days from the left is that abortion is OK right through the full 9 months—it’s legal to poke a hole in the skull to make sure the baby’s dead on arrival, and the more radical Democrats have moved that to 2 years out from birth. It will come.  Soon the Democrats’ drive for euthanasia of the elderly and severely ill will meet up in the middle with their desire to end the lives of children who are not perfect or who come at an inconvenient time.  At the age of my readers and family, it might be wise to have your EOL documents stated clearly, because the Democrat party is coming for you.

https://www.cathmed.org/assets/files/LNQ59%20FINAL.pdf 

A response:

Norma;

I really like the point that you are making about the slow incremental loss of freedoms, rights and government intrusion in every facet of our lives.

And I share your concerns that will be happening to the old folks and agree that you need to work on a plan.

There is always this argument about being reasonable and accepting of progress and small changes but when you look at it over time the impact on the American Way of Life is significant.

While not directly germane to the border security discussion, it is relevant to the issue of slowly stripping law abiding citizens of their rights and putting government in control over every aspect of our lives, whether it is healthcare, education, physical movement, gun ownership, property ownership, etc. etc.

I see this with my two youngest kids in elementary school. We live in Maryland.   The school supplies that we buy become community property – property ownership is one of the hallmarks of capitalism and freedom (and communism the opposite).  The result is that the kids go through 100 pencils, 10 erasers, … a head per year and the teachers beg for more before the school year is over because they have run out.   Sounds like the Kolkhoz (State owned Farm) in the Sowjet Union that could never succeed of making a fraction of their crop plan and had to import most their grain from the USA.       

The kids and parents are highly discouraged to pay for lunch with cash out of their wallet – learning the use of money is fundamental to a capitalistic society.  Result, the kids have a lunch account and have no concept of what stuff costs and how to make choices. Sounds like Obamacare for the low income people.

  A month ago, I learned that the children are no longer taught cursive writing. I was told that WE ONLY TEACH PRINTED LETTERS for the last 5 years now.  When I raised the issue that they would never be able to attain a decent speed of writing, I was told, that the direction is that at some point the kids would only be typing.

DOES ANYBODY UNDERSTAND THAT THIS SETS UP A TOTAL SURVEILLANCE STATE?

  The children are undergoing mandatory behavioral testing annually which was part of common core legislation under Obama.   What does this look like. It’s frightening. It reminds of how the Communists identified those who were potential dangers for the dictatorship regime.

The kids read a story about some animal pet that will be put to death UNLESS a child is willing to say some lies. Only with these lies could the pet animal be saved.  The testing involves asking the children various questions about their opinions on this story.

I wrote a letter to the school that I am opting my kids out and they don’t have permission to be testing. They told me there is no ‘opt out’ allowed.  I met with the principal and was redirected to the assistant principal who is in charge of testing.  To my surprise, he confided to me that he as 4 children that will be tested soon and he has been thinking about how he gets around this because knowing what he knows he thinks it’s very dangerous too.  After he explained all of the rules to me we found a loophole around it and it has worked now for the last 3 years. Although I would not be surprised if the authorities will show up at my door step one day.  If you look at the parent group websites in protest of this testing, they have been largely unsuccessful protecting their children.

We had hoped that with a Republican governor this nonsense would stop, but it hasn’t.

So while I don’t own guns, don’t shoot, I have to completely sympathize with the people who want to uphold their constitutional gun rights.

But those rights have been slowly eroding piece by piece and have been converted to hunting rights and gun ownership. The Constitution was not about guns for hunting. It was about safeguards against an oppressive regime.

So it is important to recognize that there are consequences when you allow the forfeiture of citizens rights and you are not paying attention.

Tuesday, October 16, 2018

Who determines that healthcare is too high?

According to the Bureau of Labor Statistics, the average American family earned $74,664 (before taxes) and spent $57,311 across various expense categories in 2016.  [not sure what is “family”—probably means household—doesn’t give number of people] 

1. Taxes 2. housing 3. transportation 4. food 5. pensions and insurance 6. Entertainment and contributions 7.  health care

Taxes are the biggest chunk. $18,900 each year, and then housing, $18,886. “Following housing costs, transportation ($9,049), food ($7,203), and pensions and personal insurance ($6,831) topped the list for the biggest ticketed items on most Americans' budgets. For the majority of people who prefer not to cook, the cost of dining out could add up big. The occasional luxury experience may not seem like a big drain on the average budget, but entertainment, cash contributions, and apparel and services accounted for nearly $7,000 (over 10 percent) of most Americans' annual expenses.”  Health care was $4,612. That said, health care increased almost 67% between 2006 and 2016, 8 years of which Obama was taking over our health insurance choices.

https://www.creditloan.com/blog/how-the-average-us-consumer-spends-their-paycheck/

Tuesday, August 07, 2018

What socialized medicine looks like

What you have to look forward to if the socialists like Ocasio-Cortez and Sanders win in 2018: "Native Americans have received federally funded health care for decades. A series of treaties, court cases and acts passed by Congress requires that the government provide low-cost and, in many cases, free care to American Indians. The Indian Health Service (IHS) is charged with delivering that care." [IHS web site quote].

The per person cost is about 1/3 of what the other Americans spend, but is in line with Europe. Also, native Americans have a life expectancy 5.5 years less than all other Americans.

https://www.ihs.gov/newsroom/factsheets/disparities/

Thursday, October 16, 2014

What has NIH done with funding specifically for preparedness and biosurveillance?

The NIH has already been given massive amounts of money beginning with post Katrina funding to handle the situation we have now with Ebola.  Where has the money gone?

Here’s what’s covered in the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013

“The 2013 law builds on work the U.S. Department of Health and Human Services has undertaken to advance national health security. These include authorizing funding for public health and medical preparedness programs, such as the Hospital Preparedness Program and the Public Health Emergency Preparedness Cooperative Agreement. These programs build the capabilities of communities’ health care and public health systems to support people in need during and after disasters.

Thousands of hospitals and communities across the country participate in these programs, and because of this participation they now have stronger capabilities and better planning to respond to disasters. They regularly exercise and conduct drills. They are building partnerships across their communities so that if parts of the infrastructure are overwhelmed by disaster, the system can still provide care. Using these programs over the past seven years to strengthen health systems and build coalitions, states have been able to handle in a number of disasters on their own without federal responders.”

http://www.hhs.gov/news/press/2013pres/03/20130313a.html

https://www.govtrack.us/congress/bills/113/hr307/text

Tuesday, October 14, 2014

HIV, Ebola, and spending

This is government speak to absolve individuals who spread this disease of all responsibility.

"Creating an AIDS-free generation will require shared responsibility, including that of partner governments, multilateral organizations, the private sector, civil society, and faith-based organizations, among others."

Yet when a nurse who gave her best to help a dying Ebola patient comes down with the disease, SHE violated protocol.

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Facebook founder Mark Zuckerberg and his wife announced Tuesday they are donating $25 million to the U.S. Centers for Disease Control foundation to fight the Ebola crisis. Wow. That's spitting into the wind. Why not give it to a church or charity who actually do something like building hospitals and training local medical staff, or to pharmaceutical R & D companies developing a vaccine or cure? WHO estimates that between 40% and 70% of African health facilities are the property of or managed by Catholic churches. I'm sure they could use some help now that treating Ebola is interfering with other health concerns like malaria, TB and AIDS. Or, since so many Liberian doctors and nurses have died from Ebola, perhaps he could fund their replacements. $25 million for CDC is chump change.

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Think we spend too much on other countries' health problems? When asked, many Americans guess 28% of our budget goes to foreign aid, but it's actually less than 1%. G.W. Bush really pushed the envelop increasing U.S. global health funding from $1.7 billion to $8.2 billion; Obama? Not so much. It's at $8.7 billion. But let's say it's roughly $9 billion. Sounds like a lot on my pension, but that's out of $4 TRILLION, or less than 1%. The largest amounts go to Africa, and most is for HIV ($4.9 billion); very little for "neglected tropical diseases" like Ebola. Also, since the Democrats came into power, some foreign aid is dependent on those countries accepting our anti-family, birth control programs. So don't believe all the hate ads you're seeing from the Democrats that stingy Republicans are to blame for Ebola. The CDC share of the health budget actually went up. (Statistics from Kaiser Family Foundation, published in JAMA, April 23/30, 2014; editorial comments are my own)

http://kff.org/infographic/visualizing-health-policy-a-snapshot-of-us-global-health-funding/

http://www.nbcnews.com/storyline/ebola-virus-outbreak/facebook-founder-mark-zuckerberg-kicks-25-million-ebola-n225381

http://www.who.int/mediacentre/news/notes/2007/np05/en/

Saturday, September 21, 2013

Health care costs—the lie

Spiraling health care costs.  We've heard it so often it's burned in our national soul.  But 100 years ago, health care was 5% of consumer income, and today it is 6%.  Entertainment has soared as a percent of income, as has transportation.  Where's the outrage? Food has dropped from 40% of consumer income to 15%, and if you cut eating out, it would drop even more. If a pill costs $100/week instead of pennies like an aspirin (which won't keep us alive), we are outraged, but don't consider the 10 years of research and FDA approvals and the recovery costs.  We want the best when we go to the hospital for surgery or illness, but we want someone else to pay the bill and seem to want the RNs and doctors, cooks and janitors to work for free.

What has increased is the amount of government in our health care, not just in research, but in expensive, ever growing regulation of the insurance industry (they are now same species partners), plus creating a new bureaucracy and red tape that steps between us and our doctors.  And now despite the soaring graft, payola and crime in Medicare, Medicaid, VA, S-CHIP, state programs and insurance companies, Obama wants an even fatter layer of government, plus he wants the IRS which is embroiled in its own scandal supervising it. (Can't wait for the IRS, NSA, our electronic medical record and the i-phone fingerprint to all be linked.) Whether or not the ACA was designed it to crash the economy is no longer the issue; that is what has resulted as we’re still struggling with Obama’s recovery.

Thursday, May 30, 2013

Telephone surveys on health care

I know why Americans sound so stupid on these surveys. I got one last night, and because of the complexity of the questions finally had to interrupt the woman and tell her to call the next person on her list. She wasn't a very good reader, had difficulty pronouncing the words and I doubt she understood the questions either. It was about Comparative Effectiveness Research which preceded Obamacare (never used this word in the survey), but is now incorporated in it. http://www.heritage.org/research/reports/2012/04/comparative-effectiveness-research-under-obamacare-a-slippery-slope-to-health-care-rationing

Sunday, February 10, 2013

An inspiring speech by Dr. Carson

Dr. Benjamin Carson spoke at the 61st National Prayer Breakfast  in Washington DC at the Hilton Washington International Ballroom. Many Conservatives cheered and thought he really told the administration about health care (advocates for Health Savings Accounts), but really, it’s just a rousing patriotic speech with his own rags to riches story and is mostly about the important of education, reading, and a mother who refused to be a victim.  He and his wife established a foundation to help children and have awarded over 5,000 scholarships.  Watch the whole thing—you won’t be sorry. Every school age child should see this speech and stop looking to NFL players with 8 baby mamas for inspiration.

“Jesus is my role model. . . “  Benjamin Carson.

C-SPAN video of speech

Wednesday, July 07, 2010

A tax on pale (white) Americans

I have little sympathy for people who go to tanning salons to ruin their skin for a later date (on my dime), but I do feel badly for the salon owners who were doing nothing illegal and will have to pay this additional (no new taxes except for the uber rich--B.O.). Although like any business, they will pass this cost along to the customer. If customers decide to give up this unhealthy practice, the owner will need to find a new business.

People--just look at the splotches, brown spots, wrinkles and scars from surgery that your grandparents have. Whether they were addicted to indoor tanning, the beach or the garden, sun is only good for you in little doses and moderation.

Speaking of addictions, Archives of Dermatology (2010; 146(4):412-417) has reported on addiction to indoor tanning among college students. They found that those addicted to tanning also have a greater problem with alcohol, marijuana and anxiety, but were not necessarily more depressed. Bad news, good news, I guess. Maybe the anxiety stems from comparing tan lines or bikini waxing.

Federal tax on tanning salons takes effect today - Healthy Living : The Orange County Register

Wednesday, April 07, 2010

Why health care costs so much

"American health care is an accidental system. Private coverage - the type most Americans have - has its origins in the wage controls of the Second World War as employers offered rich health-insurance benefits in pre-tax dollars. Public coverage like Medicaid and Medicare, on the other hand, takes its inspiration from the Beveridge report in Britain, drafted in the early 1940s; Lord William Beveridge believed in zero-dollar health care - that people ought to pay nothing at the point of use. Today's American health care fuses these two systems, but with a common economic flaw: people are overinsured, paying pennies directly on every dollar of health service they receive.

The end result: for every dollar spent on health care in the United States, just 12 cents comes out of the individuals' pockets. Imagine what food costs might be if your employer paid 88% of your grocery bill or what a trip to Saks might be like if your company covered the vast majority of the costs of the shopping spree."

RealClearMarkets

Thursday, February 25, 2010

Petulent, rude, whiny, dismissive and sneering

And that was just their leader. Who cares about the color of his skin, it sure is thin. He shouldn't have skipped so many sessions when he was a Senator. Would've learned the rules. As Democrats droned on and on and on with stories of teeth, cousins and phone messages, McCain was rudely told to stop campaigning. Really, I was shocked. I'll take a cowboy's manners and presidential decorum any day over this stumbling grand stander. Clown in chief Reid claimed no one considered reconciliation! And Dick Durbin. Did he really say we should all just have the health care plan that federal employees have. Has he noticed how they get to pick and choose their "Cadillac" coverage from private insurers? The ones other Dems are calling rapacious crooks and want to destroy? Has he noticed their club is already a select group in wealth, education, race, and gender? There was really no reason for Republicans to show up. . . except they showed up the President and his party. And that they did.

Scrap the bill. Start over.

Thursday, November 12, 2009

Media starts to report on health care costs

Maybe it's just because Fox is cleaning their clocks, or perhaps there are just too many lies to ignore it any longer.
    "Could it be that the press is finally catching on to the fact that the Democrats’ health care reform bills don’t decrease costs? New York Times columnist David Leonhardt rips up the House bill in a column today. He writes, “Making the medical system more efficient is, in short, about saving lives and giving Americans a long overdue raise. It is arguably the single most important step that the federal government could take to improve people’s lives. And the bill that the House of Representatives passed last weekend simply does not get it done.”

    The Politico also gets in on the act, writing “Barack Obama ran for president on a promise of saving the typical family $2,500 a year in lower health care premiums. But that was then. No one in the White House is making such a pledge now. It’s one of the most basic, kitchen-table questions of the entire reform debate: Would the sweeping $900 billion overhaul actually lower spiraling insurance premiums for everyone? No one really knows. …. [MIT health economist Jonathan] Gruber, the favorite economist of the White House, said the bill “really doesn’t bend the cost curve.” … Reminded that Obama demanded a bill that lowers health care spending, Gruber said: “That is what he would like to do. But he’s not doing it.””

    And ABC News corrects the Democrats’ claim that insurance company profits are responsible for increasing health insurance costs. ABC News reports, [T]he companies’ profits still represent a miniscule percentage of the $2.5 trillion Americans spend every year on health care. “Insurance company profits in the large picture have very little to do with the overall rising cost of health care,” said health care expert Henry Aaron, a senior fellow at the Brookings Institution.” Link