Democratic presidential candidates paint insurers as the health-care bogeymen, letting providers off the hook.

By Olga Khazan @ TheAtlantic.com, July 31

[....] It’s true that high-deductible plans are one reason people get high medical bills in the first place. And it’s also fair to say that insurers don’t always negotiate for the lowest prices they can, and that they make healthy profits.

But in fact, the types of medical bills that lead to medical bankruptcy most commonly stem from out-of-network emergency-room visits and planned surgeries, not co-pays and premiums, experts told me earlier this year. Insurance companies do have networks, and services that are out of network are billed a higher rate. But doctors and hospitals decide whether to participate in certain insurers’ networks, and whether to bill patients for the balance of their bills (and, later, whether to sue patients for that balance).

The sentiment behind the anti-insurance talk is understandable. The most frustrating part of many Americans’ interactions with the health-care system is trying to get their insurance claims paid. No one enjoys hearing that something isn’t covered or will cost more than anticipated, and insurers are often the bearers of that news. And certainly, insurers also have money-saving tricks up their sleeves.

But the profits of health insurers are not that exorbitant compared with other parts of the health-care system. And in fact, many scholars suggest that American health care is so dysfunctional because it simply costs too much. That’s the fault of doctors, drugmakers, and hospitals, too, not just insurers.

Why are Democrats so focused on insurers, rather than providers and hospitals? Perhaps it’s because America’s Health Insurance Plans, the health insurers’ trade group, is not as big of a lobbying spender as the American Hospital Association. In a less cynical interpretation [....]