Monday, August 16, 2010

BREAKING THE BANK CEOs From 10 Health Insurers Took Nearly $1 Billion in Compensation

BREAKING THE BANK

CEOs From 10 Health Insurers Took Nearly $1 Billion in

Compensation, Stock From 2000 to 2009

Health Care For America Now

August 2010

http://hcfan.3cdn.net/684f3fa81c1e757518_01m6bxg6s.pdf

 

If you want to read the entire report, including

tables and notes, go to the PDF file.  

 

 

IN 2009, WHILE AMERICA'S FAMILIES and employers

struggled with skyrocketing health insurance costs and

the worst economy since the Great Depression, the chief

executives of the 10 largest for-profit health insurance

companies collected pay of $228.1 million, up from $85.5

million in 2008.

 

It was one of the best years ever for health insurance

bosses. CEOs collectively gave themselves a 167 percent

raise (not counting tens of millions more dollars in

exercised stock options), while Americans saw their

average wages increase by about 2 percent. In fact, 2009

capped a decade of extraordinary paydays for health

insurance industry leaders. Including exercised stock

options and pension packages, the CEOs of the 10

companies raked in nearly $1 billion in total

compensation from 2000 to 2009 (Table 1). Over the full

10 years, the average reported pay for each of these

CEOs has soared to nearly $10 million a year. This

report graphically illustrates the status quo that the

leaders of the health insurance industry are fighting to

preserve. The jaw-dropping compensation for 2009 set new

standards for the industry and for what CEOs will pay

themselves in the future. Last year's CEO pay could have

paid for stress tests to check heart health for up to

776,000 patients or covered medical office visits for

every resident of Philadelphia, Dallas and Minneapolis

combined (3.2 million people).

 

Each year, health insurance companies charge their

customers higher premiums and provide less coverage.

They blame the hikes on rising costs charged by health

care providers, but the facts say otherwise. Meanwhile,

health insurers set new profit records (the five largest

for-profit health insurers reported net earnings of

$12.2 billion in 2009) while compensating their top

executives with exorbitant salaries and stock options.

Unsatisfied by the excessive pay and stock options he

arranged for his last year at CIGNA, CEO Edward Hanway

also gave himself a $111 million pension package as a

retirement gift. Combined with pay received by his

successor, David Cordani, the company devoted $136

million to CEO compensation in 2009. CEO Stephen Hemsley

of UnitedHealth Group banked $107.5 million in 2009,

including $98.6 million from exercising stock options.

CEO Ron Williams of Aetna collected $18.1 million in

total compensation, enough to pay for 4,853 people to

undergo arthroscopic knee surgery.

 

CEO Angela Braly of Wellpoint Inc. got a 51 percent

raise to $13.1 million in 2009. This came as WellPoint

subsidiary Anthem filed inaccurate actuarial data in an

attempt to increase 2010 premiums in the California

individual market by as much as 39 percent. The company

blamed the massive rate hike on the weak economy and the

soaring cost of medical care. Anthem Blue Cross

President Leslie Margolin urged WellPoint not to pursue

the politically explosive rate hikes, but the CEO and

her lieutenants rejected the recommendation, according

to the Los Angeles Times. Margolin also "privately

pressed WellPoint to abandon the company's gettough

approach to longtime adversaries-doctors and hospitals-

and instead collaborate as part of a new `healthcare

transformation strategy' to cut costs and improve

patient safety and the quality of care," the Times

reported. That was rejected too. In July 2010, Braly

orchestrated Margolin's resignation and ordered security

guards to escort her without warning out of the Anthem

offices. WellPoint posted a record profit of $4.75

billion in 2009.

 

Health insurance moguls don't collect big paychecks for

providing consumers with the best possible health plans.

It's the opposite. They focus on keeping the amount they

spend on the delivery of health care as low as possible.

These costs are known by Wall Street analysts and

insurance executives as "medical losses.

 

That business practice is thriving this year (Table 2).

CEOs haven't made needed health care more accessible for

consumers. In fact, they have cut back on benefits and

created more plans that provide fewer benefits. They are

doing whatever they can to avoid paying claims,

including selecting their customers by discriminating

against people who are sick.

 

CIGNA put profit above all else by offering health plans

with extremely limited benefits to companies with large,

low-wage workforces. The underwriting criteria

established by such plans essentially guarantee big

profits. Pre-existing conditions are not covered during

the first six months, and the company must have an

annual employee turnover rate of 70 percent or more, so

most of the workers don't even stay on the payroll long

enough to use whatever benefits they might become

entitled to. The average age of employees must not be

higher than 40, and no more than 65 percent of the

workforce can be female, thus limiting maternity claims.

Employers don't pay any premiums-the employees pay for

everything. Many people who buy limited-benefit

policies, which often provide little or no

hospitalization coverage, are misled by marketing

materials into thinking they are getting more

comprehensive care. In many cases it is not until they

actually try to use the policies that they find out they

will get little help from the insurer in paying the bills.

 

Coventry Health CEO Allen Wise acknowledged that his

company's health plans are good enough to be marketed

now but no longer will be acceptable under the higher

quality care standards enacted by Congress in the

Affordable Care Act (ACA) in March 2010. "We think that

the product that we have today is not at all competitive

for tomorrow," Wise told insurance industry analysts.

The new law aims to induce Coventry and other companies

to reduce administrative, lobbying, profit and

executive-pay costs and create health plans with

quality, affordable benefits.

 

Because executive compensation is based on performance

evaluated by companies' boards of directors, CEOs lack

the incentive to deliver quality, affordable health care

to people who desperately need it. Instead they use

their unchecked power to enrich themselves by abusing

consumers and manipulating share prices.

 

One key method they use to achieve excessive profits and

CEO pay is to deploy their vast corporate capital to

repurchase company stock on the open market. This

technique drives up share prices and increases the value

of personal holdings acquired through stock options

granted by the companies. From 2003 to 2009, the seven

largest for-profit health insurers spent an astonishing

$57.6 billion of their capital, some of it borrowed, to

buy back stock and propel share prices upward (Table 3).

 

In determining how to spend their capital, the companies

decided it was more important to enrich their CEOs and

top investors than to reduce premiums, improve benefits,

reward providers for raising the quality of care, or

bring efficiency to claims-processing and customer-

service operations. Share buybacks benefit a tiny elite

of CEOs and other company officers with bonuses and

shares that increase in value if they can manipulate the

share price upward. The enrichment of the CEOs goes

unnoticed in some cases. They may not exercise their

stock options until after they have left their jobs,

when they are no longer company insiders required to

publicly report the transactions. This camouflages the

enormous transfer of wealth from hard-pressed employers

and consumers to CEOs.

 

William Lazonick, a University of Massachusetts

economist who has concluded that exploding executive pay

and excessive use of share repurchasing are eroding

American prosperity, says health insurance industry

executives are among the biggest users of this

technique. "Profits are used solely to manipulate stock

prices and enrich a small number of people at the top,"

Lazonick said. "The top executives of these [health

insurance] companies typically reaped millions of

dollars, and in many years tens of millions of dollars,

in gains from exercising stock options.

 

Beyond the fact that stock buybacks allow executives to

divert capital resources provided by insurance premiums

to their own pockets, this practice also strips

companies of resources that otherwise could be used to

create jobs and bring innovation to the business of

health insurance. "The persistence of unregulated stock

buybacks and unindexed stock options will ensure that

the corporate executives who control the largest health

insurers will remain part of our health care problem,"

Lazonick said.

 

Wall Street assesses health insurance companies in

exactly the opposite way consumers would. Wendell

Potter, a former insurance industry executive, said he

became fed up "with the industry's practices-especially

those of the for-profit insurers that are under constant

pressure from Wall Street to meet their profit

expectations." This has "contributed to the tragedy of

nearly 50 million people being uninsured as well as to

the growing number of Americans who, because insurers

now require them to pay thousands of dollars out of

their own pockets before their coverage kicks in, are

underinsured," he said. "An estimated 25 million of us

now fall into that category.

 

Premiums have skyrocketed in recent years, often without

justification. Strong standards for insurance company

spending are needed to ensure that premiums are not

jacked up merely to perpetuate bloated executive

compensation. The largest forprofit health insurers

reported spectacular profit growth in the second quarter

of 2010 compared with the same period a year earlier.

While profits grew, the companies spent a smaller

portion of premium revenue on actual health services

(Table 2). This closely-watched indicator is known to

Wall Street investors as the medical-loss ratio (MLR).

 

One provision of the ACA creates standards that make

sure health plans spend a minimum amount of premium

revenue on medical care. The law requires insurers to

spend on patient care at least 80 percent of health plan

premiums collected from individuals and small employers

and 85 percent of premiums paid by large employers.

 

The health insurance industry wants to expand the

definition of allowable medical expenses to include

costs that are not directly related to the delivery of

care and have not historically been classified as

medical. Instead of reducing costs and improving the

efficiency of their operations, they simply want to

change how certain expenses are classified. This would

encourage CEOs to gouge consumers even more than they

already do in order to jack up profits and share prices,

increase bonuses and grants of stock and stock options,

and augment the value of their personal holdings-all

while spending a smaller share of premium dollars on

medical care. With little competition in 99 percent of

metropolitan areas,14 insurers lack the incentive to

drive down costs, and the absence of transparency about

their behavior drives up costs.

 

The MLR standards in the ACA are critical to curbing the

worst of the health insurance industry's consumer

abuses, controlling rising premium costs, increasing the

value of premiums paid by private and public customers,

and reining in the profiteering of health insurance

companies. To enforce the MLR standards and fulfill the

promise of quality, affordable health care for all, the

U.S. Department of Health and Human Services must reject

the insurance industry's sophisticated efforts to

undercut the law. If the rules governing medical-loss

ratios, rate review and other consumer protections are

implemented as intended, the ACA will hold accountable

an industry that abuses millions of customers when they

need health benefits the most.

 

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