A lot of money is going into those ads and we're going to look now at just how much money health insurance companies make. Here's NPR's Joanne Silberner with the latest in our series on numbers in the health care debate.

JOANNE SILBERNER: Picture a one-dollar bill. Down the right hand side is a thin yellow line highlighting what a tiny piece one one-hundredth of the one-dollar bill really is. The caption: For every one dollar spent on health care in America, approximately one penny - just that skinny yellow line - goes to health plan profits. America's Health Insurance Plans, the insurance company trade group, features the graphic on its blog.

Dr. UWE REINHARDT (Professor of Economics, Princeton University): Whether it's fair or not depends on what it is you want to describe.

SILBERNER: That's Princeton economist Uwe Reinhardt.

Dr. REINHARDT: If you want to describe how much insurance company profits represent the total American health spending, then the one cent is a fair number.

SILBERNER: Reinhardt says the insurers are saying only one thing.

Dr. REINHARDT: All that statement says is look if you eliminated all our profits, national health spending in America would be one percent lower. That -you know, it has meaning only in that context.

SILBERNER: That's because the insurers are measuring their profits against total health care spending. That's all the money you and me and employers and insurers and the government spend for doctor's visits, hospitalizations, drugs and other things. Economists more commonly consider insurance profits based on what each company takes in, versus what it pays out, regardless of what happens in the rest of the health care universe. While insurance company cite the one cent on the dollar figure for 2006, Fortune magazine's economists figured insurance company profits at two to 10 cents per dollar.

To Richard Kirsch, even the one cent profit is too much. Kirsch heads Health Care for America Now - a grassroots group advocating, among other things, for stricter oversight of health insurance companies.

Mr. RICHARD KIRSCH (Manager, Health Care, America Now): Well, it sounds like a little but it's one percent of a huge number. We're going to spend two and a half trillion dollars - that's trillion - on health care this year. And when you're spending so much money, one percent adds up.

SILBERNER: It adds up to $20 billion a year. And, Kirsch says, there's the money that doesn't go directly to health care - administration, CEO salaries and marketing. According to the trade group America's Health Insurance Plans, administration and marketing runs around 12 cents of the revenue dollar. Robert Zirkelbach, a spokesperson for the insurers, says the profit and the administrative costs are worth it.

Mr. ROBERT ZIRKELBACH (Spokesperson for Insurance Companies): Health plans are providing value-added services to people across the country. And a vast majority of people express very high satisfaction with their health care coverage.

SILBERNER: And he says health plan profits are in line or even lower than other health care industries. But that may not be enough to give them cover, as the Obama administration searches for places to cut the nation's health care bill.

Joanne Silberner, NPR News.

Copyright © 2009 NPR. All rights reserved. Visit our website terms of use and permissions pages at for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR’s programming is the audio.



Please keep your community civil. All comments must follow the Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

NPR thanks our sponsors

Become an NPR sponsor

Support comes from