When you're trying to get something done in Washington, it's helpful to have an enemy that no one likes. When oil prices were high, it was refiners like ExxonMobil (NYSE: XOM) and Chevron (NYSE: CVX) being made out as the bandits. With health-care reform on the line, President Obama has decided that throwing the health insurance industry under the bus is the best way to get Americans on board.

But health insurers are fighting back. This week they launched an ad through their lobbying group claiming that they're not the real problem. The ad has a pie chart that shows health insurance makes up about 4% of health-care costs, a much smaller slice than the costs for doctors, hospitals, and drugs from the likes of Pfizer (NYSE: PFE) and Merck (NYSE: MRK).

The source of the numbers is the Centers for Medicare & Medicaid Services (CMS), so the numbers don't have the same bias as previous numbers promoted by the industry. But that doesn't mean they tell the full story. Insurers may contribute 4% to the cost of health care for everyone combined, but that likely includes those that pay out of pocket and people in government programs. For the individuals and companies that pay insurance premiums, the insurers cost you a lot more than 4%.


Fraction of Premiums Paid Out
for Health Costs in 2009

UnitedHealth Group (NYSE: UNH)


Aetna (NYSE: AET)


Humana (NYSE: HUM)


Source: Company press releases.

That other 15% to 18% of the premiums you and your employer paid isn't pure profit. The companies use it to pay for expenses like advertising and the salaries of everyone from the CEO to the poor sap who has to listen to your complaints when you call.

UnitedHealth's net profits have ranged between 3.7% and 6.6% over the past five years. While that net profit isn't exorbitant, health insurers could lower health insurance costs and still take in the same profit by lowering their overhead.

Rather than asking Washington to look at the whole pie, how about trimming a little fat out of your budgets, and come up with more innovative ways to reduce health-care costs? Making the pie smaller, while increasing (slightly) their share, should be the goal of the insurers.

Pfizer and UnitedHealth are Motley Fool Inside Value choices. UnitedHealth is a Stock Advisor selection. Try any of our Foolish newsletters today, free for 30 days.

Fool contributor Brian Orelli, Ph.D., doesn't own shares of any company mentioned in this article. The Fool owns shares of UnitedHealth and has a disclosure policy.