Is it really true that health insurers are to blame for inflating the cost of health insurance, for making "record" profits, for dropping coverage when members get sick and for everything that's wrong with our health care system?

In defense of an industry that employs thousands of Missourians, pays millions of state and federal taxes, helps contain the rising cost of care and ensures that millions of people can afford to pay their medical bills, consider these facts:

Insurers aren't driving up the cost of health insurance. Medical costs are.

According to a Rand Corp. study, "Medical costs explain nearly 89 percent of health plan increases." Increases in medical costs — doctors, hospitals, technology and pharmaceuticals — drive increases in health insurance premiums, not the other way around. Data from the Centers for Medicare and Medicaid Services show that health benefits cost increases have averaged 8.7 percent annually. At the same time, premium increases have averaged 8.7 percent annually.

Health insurers' profits are 3 percent to 5 percent. The average profit margin for Standard & Poor's 500 is 12 percent.

Health insurers' profits are far lower than those of hospitals, pharmaceutical companies, beverage companies, cleaning product makers, banks and restaurants. According to Kaiser Health News, "Even the elimination of insurers' profits would lower health care spending by just 0.5 percent."

Competition is alive and well in the insurance industry. Non-profit and for-profit insurers compete every day in Missouri and nationally. This status makes minimal differences in premium costs or benefits covered. While Missourians can choose non-profit insurers, Anthem, a for-profit insurer, covers more Missourians than any other. Contrary to the argument that private insurers' "have a monopoly," Missouri has more than 20 licensed insurers, and the competition is intense.

Insurance companies want to end the need to deny coverage for people with pre-existing medical conditions — and support an enforceable mandate that brings everyone into the insured pool. To reduce the cost of health insurance, all Americans need to be insured; if not, only those needing health care services would choose to be insured. The bill passed by the Senate Finance Committee includes a fairly weak penalty that would, in effect, allow healthy individuals to wait to purchase health coverage until they were faced with paying medical bills. This would be the same as allowing people to obtain auto insurance after they have had an accident or secure homeowner's insurance after their house has burned down. As a recent PricewaterhouseCoopers study found, this will result in higher health costs for all Americans.

Insurers cannot drop coverage for sick members. Federal law prohibits insurers from dropping sick members. Missouri law guarantees ongoing coverage for anyone covered through their employer. The National Association of Insurance Commissioners reports only 56 complaints nationwide regarding rescissions in 2007.

Insured Americans are highly satisfied with their own personal health plan. About 160 million Americans are covered through their employers. And, poll after poll shows they're very satisfied with their insurance coverage. For example, a 2008 Employee Benefits Research Institute survey found that 93 percent of people enrolled in a traditional health care plan were satisfied with the quality of coverage they received through their health plans.

Health care costs are increasing for several reasons:

— Rising prices and the increased use of medical services — including hospital stays, prescription drugs, new technologies and doctor visits.

— Cost-shifting to the privately insured from providers who must cover their financial losses from treating the uninsured and those using government programs.

— Government regulations and new coverage mandates.

— Lifestyle choices — including smoking, overeating and inactivity — that cause health problems.

As Congress works to reform America's health care system, we must demand that they do more than falsely vilify insurers. They must engage in an honest, fact-based debate that tackles the real health care cost drivers. This is the only way to create legislation that results in a sustainable, affordable and high-quality system of health care for our country.

Dennis Matheis is president of Anthem Blue Cross and Blue Shield in Missouri.