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Do insurance companies earn their income on the claims they pay out?

How close is claims payout to sales commission? If you've wondered why health insurance companies don't cover non-prescription, over-the counter nutritional supplements or healthy, organic vegan and vegetarian foods, in a campaign for "letting food become your medicine," could it be because, as the Wall Street Journal put it in a series of articles, that insurance companies earn their income on the claims they pay out? You can find a whole section written on this subject in Sherry A. Rogers, MD's book (on pages 41-46), How to Cure Diabetes.

Do insurance companies earn their income on the claims they pay out?
Anne Hart, photography.

Why do some common prescription drugs raise the risk of mortality? Check out the March 31, 2014 article, "New Study: Common Prescription Drugs Could Increase Risk of Death." A new study from Mayo Clinic researchers reveals that seven out of ten Americans take at least one prescription drug. And one of the side effects from the meds might be more dangerous than just dry mouth. Chain pharmacies are starting to sell health insurance nowadays.

One issue is the way claims payout happens, more like a sales commission. And if there's motivation to earn something like a sales commission, why would any business want to cut down their income by seeing you get healthy and stop needing to take prescription drugs on a daily basis for the rest of your life? After all, the claims payout is something like a sales commission. The income keeps arriving. If insurance companies were interested in helping patients save money by using foods for health instead of prescription drugs for chronic diseases that last a lifetime, they'd lose a lot of their income.

And if you didn't have to keep seeing your health care professional, the person also would lose income. But of course, your teeth need cleaning to prevent gum disease. It's not like your diet could help...or could it? And what about the soda and candy all around you? What if you drank clean water with meals instead of the sugary beverages? Or what if fresh fruit were served instead of birthday cake or salty chips deep fried and loaded with trans fats, bleached wheat flour, and sweeteners? Would the drug companies want to see you eating that beet burger instead of the processed cold cuts or bacon? No, they'd lose the income they need from you after health-related conditions develop and remain chronic.

“Let food be thy medicine and medicine be thy food”― Hippocrates

Sure, people with certain chronic and genetic diseases need specific drugs, such as insulin to keep them alive, or antibiotics when sick with infections that would kill them without the prescription drugs. And during surgery, certain drugs are keeping people alive in acute situations to dissolve blood clots or stop bleeding. But what about those chronic, long term diseases that are not getting cured by prescription or over-the-counter drugs?

If someone has osteoarthritis, insurance isn't paying for that spoon of fish oil, not unless it's a prescription to be filled rather than something bought from a health food store or online. If the excuse is the supplement industry isn't standardized or controlled, what about food as medicine, such as special diets designed to reverse certain chronic conditions, at least for the time the food is being eaten?

Who's doing what's best for the patient?

If the drugs aren't curing anyone, and just putting a cover on the symptoms, or another drug on top of still another drug is prescribed to soften the side effects of the first drug, who's interested in looking at what happens when side effects become a waterfall flooding the patient with other health conditions?

If you take a look at the Wall Street Journal articles, you can see how insurance companies make money on the claims paid out. If insurance income methods work somewhat like sales commissions for insurance companies, making a patient healthy might stop that stream of income, especially if more people start to let food be their medicine as the saying goes.

The Wall Street Journal articles discuss the lack of an incentive to cure chronic diseases and get people off any prescription or over-the-counter drug in the case of the type of chronic disease that lasts a lifetime but is not an acute situation where a certain drug is needed for a very short time to cure an infection or stop a bleeding situation or dissolve a clot immediately to save lives. The point is where is the profit in prevention?

If there's little incentive to cure, that must mean insurers earn a profit by charging a premium on the claims paid out, explain the Wall Street Journal articles.

Do insurers spend too much and as a result are not in such a hurry to take drugs off the market that aren't helping or aren't effective? If insurance companies make money on handling the claims they pay for, similar to businesses that earn their incomes by earning a sales commission, who pays the price, the patient? If everyone became healthy, health care professionals, scientists, pharmaceutical corporations, and insurance firms wouldn't have money coming in from patients with symptoms.

When the buck is passed, it ends up on the desk of the patient who keeps asking why one drug is prescribed to quell the side effects of another drug instead of the first drug being changed or stopped and nutrition being used in cases of certain chronic conditions. Outside of acute procedures such as stopping late-stage cancer with chemotherapy or dissolving blood clots in the emergency room, the drugs making a lot of money also include those that are not doing what they were supposed to do.

The population often looks for a drug for a fast solution rather than the slower solution, a change of diet or lifestyle

Get a mild headache or anxiety, take a pill instead of finding out whether the headache is caused by a food allergy or a low magnesium level or any other cause that might be traced back to the wrong diet, exhaustion, anxiety, allergy, hormone imbalances, or sedentary living. Could the person be sensitive to carbon dioxide in a room and suffer a panic attack as a result? Often the person is prescribed drug instead of finding what else can help the imbalance, allergy, or other cause of the symptom.

When the fast solution is prescribed medications, sometimes the outcome is not changed. For example, the rate developing new diseases may not be changed. The big picture is that if you look at the most frequently prescribed drugs, then you can ask why didn't all those drugs result in fewer chronic illnesses, fewer strokes or heart attacks?

Are most drugs useless for certain chronic conditions?

If a lot of the chronic illnesses are caused by inflammation, couldn't the inflammation be cooled down to normal with foods that heal inflammation? Just take a look at the drugs used that didn't reduce the mortality rate for the illness for which they were intended. What the prescription drugs might do is just temporarily stabilize the patient.

If you work in the health care industry, you know doctors and nurses look for blood test results that look better. But what if the blood tests only look better for a short time? What if the patient's chronic illness is stabilized only for a while? What drug has ever prolonged life compared to a diet that can reverse the clogged arteries filled with soft plaque? Or what if a combination of nutrition and exercise can work for a longer time than certain drugs?

With all those clubs on letting food be medicine to help health in the long-term, each individual usually asks whether he or she deserves better than what's out there now? Meantime, you still can't get insurance to cover non-prescription supplements or organic vegan foods, for example.

Most people might say they deserve better solutions. You might take a look at the following Wall Street Journal articles, "Scientists Make First Embryo Clones From Adults." Or see, "Search for Better Diabetes Therapy Falls Short -"

Do numerous current treatments fail to prevent major health problems?

You might look up the article, "Current treatments, while effective, fail to also help prevent heart attacks and stroke, in blow to researchers, patients," by Winslow R, Wall Street Journal, A5, March 15, 2010. Or see, "A Simple Health-Care Fix Fizzles Out - Wall Street Journal," by Winslow, KJ., February 11, 2010, A1, A18. There's another article that discusses the KJ Winslow article. Check out, "COURAGE" Not Enough: A Million Stents A Year," posted by Gary Schwitzer in Evidence-based medicine.

Or see, "New Cholesterol Drugs Shown Effective in Studies." You also may wish to check out the article, "New Medicines Emerge, but Few Blockbusters -" Then there's the article, "Panel Unveils Shake-up in Strategy to Cut Heart Risk -"

What diseases might be invented?

You also may wish to check out, "Study Questions Evidence Behind Heart Therapies -," Wall Street Journal, D1, February 25, 2009," by Winslow, R. Or see the book, Drug-Induced Nutrient Depletion Handbook: 2nd Edition, 2001, by Pelton R, et al.

Other noteworthy articles in the Wall Street Journal include, "Study on Stroke in Women Focuses on Risks From Pregnancy" and "Guidelines Say Lower Blood Pressure Not Always Better." A noteworthy article is "Genes Point to Best Diets - Wall Street Journal."

Also noteworthy is the article, "Dangers of Statin Drugs: What You Haven't Been Told About." High LDL cholesterol levels also known as hypercholesterolemia is the health issue of the 21st century, that article explains. But the article goes on to note that it's actually an invented disease, a 'problem' that emerged when health professionals learned how to measure cholesterol levels in the blood. The Wall Street Journal has some eye-opening articles on health worthy of reading.

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