Even A.P. ain't buying it

[DOGS THAT BARK]

<TABLE border=0 width="95%"><TBODY><TR><TD class=tdbcbst_brokeraccountmgmt_100><TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=left>Here are renewal on 2 groups I have with similar demo graphics and claim history. One renewal was this spring and one just this month--note the increases--Maybe I should tell Gumby thanks for raise- but personally would opt that neither got an increase at all--as I know what's coming down the road.</TD></TR></TBODY></TABLE><TD class=tdbcbst_brokeraccountmgmt_100></TD></TR></TBODY></TABLE><TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=tdbcbst_brokeraccountmgmt_100 width="10%"></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=left></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Individual</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Ee/Spouse</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>EE/Child(ren)</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Family</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="2%"></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="13%"></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Base Plan</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$322.09</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$676.39</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$579.76</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$966.27</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Prescription Drugs</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$78.09</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$163.99</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$140.56</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$234.27</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Mental Health</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$4.00</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$8.40</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$7.20</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$12.00</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Special Accident</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Extended Wellcare </TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$3.28</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$6.89</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$5.90</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$9.84</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Vision</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>COBRA Admin</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.37</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.78</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.67</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$1.11</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD> </TD><TD colSpan=5><HR></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=left>Total Rate</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$407.83</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$856.45</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$734.09</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$1,223.49</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100 height=7></TD></TR><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 colSpan=7 align=right>Total Monthly Premium: </TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$22,104.43</TD><TD class=tdbcbst_brokeraccountmgmt_100></TD></TR><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 vAlign=bottom colSpan=7 align=right>Total Increase: </TD><TD class=tdbcbst_brokeraccountmgmt_100 vAlign=bottom align=right>** 11.09%</TD></TR></TBODY></TABLE>
+++++++++++++++++++++++++++++++++

<TABLE border=0 width="95%"><TBODY><TR><TD class=tdbcbst_brokeraccountmgmt_100><TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=left></TD></TR></TBODY></TABLE><TD class=tdbcbst_brokeraccountmgmt_100></TD></TR></TBODY></TABLE><TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=tdbcbst_brokeraccountmgmt_100 width="10%"></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=left></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Individual</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Ee/Spouse</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>EE/Child(ren)</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="15%" align=right>Family</TD><TD class=tdbcbst_brokeraccountmgmt_100 width="2%"></TD><TD class=tdbcbst_brokeraccountmgmt_100 width="13%"></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Base Plan</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$527.87</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$1,108.53</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$950.16</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$1,583.61</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Prescription Drugs</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$115.55</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$242.66</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$207.99</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$346.65</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Mental Health</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$5.35</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$11.23</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$9.63</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$16.05</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Special Accident</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>--</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>Vision</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$3.29</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$6.91</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$5.92</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$9.87</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=tdbcbst_brokeraccountmgmt_100 align=left>COBRA Admin</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.37</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.78</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$0.67</TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$1.11</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD> </TD><TD colSpan=5><HR></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100></TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=left>Total Rate</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$652.43</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$1,370.11</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$1,174.37</TD><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 align=right>$1,957.29</TD><TD class=tdbcbst_brokeraccountmgmt_100 colSpan=3></TD></TR><TR><TD class=tdbcbst_brokeraccountmgmt_100 height=7></TD></TR><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 colSpan=7 align=right>Total Monthly Premium: </TD><TD class=tdbcbst_brokeraccountmgmt_100 align=right>$29,620.35</TD><TD class=tdbcbst_brokeraccountmgmt_100></TD></TR><TR><TD class=SubHeaderBCBST_BrokerAccountMgmt_100 vAlign=bottom colSpan=7 align=right>Total Increase: </TD><TD class=tdbcbst_brokeraccountmgmt_100 vAlign=bottom align=right>** 44.93%</TD></TR></TBODY></TABLE>

 

[Chadman]

Quick uninformed (me personally) question, Wayne, on your group's increases. Are those increases due specifically to the healthcare bill, or are they due specifically to the company raising the costs because they want to and can? Can you point to anything specific in the increases that are attributed to the recent healthcare legislation?

If so, that would help us all understand specifically what the issues are. Otherwise, it can be placed directly at the feet of the insurance company, can't it? I'm not attacking here, I just want to understand what is going on.

 

[Duff Miver]

The simple answer, which would provide health care to all, and cut costs is single payer.

Expand Medicare to cover everyone. Medicare controls costs better than any State commission or any insurance company.

There is more than enough money now being collected by Insurance companies to cover everyone under Medicare with money left over. Collect that money as taxes instead of as insurance premiums. No one would have to pay more.

Our local non-profit hospital is unable to collect 1/3 of their billing because those folks simply have no way to pay. That 1/3 is recovered by charging paying patients 50% more.

If everyone were covered by Medicare, doctors and hospitals could and would, charge less per procedure. Any outliers who would not accept Medicare payments would have two options - either treat only those who can pay out-of-pocket cash, or get a shoe-shine box.

And, insurance peddlers like doggie, would have to find new jobs doing useful work. No need to pay him anymore.

 

[Trench]

Quick uninformed (me personally) question, Wayne, on your group's increases. Are those increases due specifically to the healthcare bill, or are they due specifically to the company raising the costs because they want to and can?

Well Chad, since HR 3200 doesn't kick in until 2014, I think we all know the answer to that question. DTB's just playing his usual shell game.

 

[Mags]

Well Chad, since HR 3200 doesn't kick in until 2014, I think we all know the answer to that question. DTB's just playing his usual shell game.

Given that even now, you have to get approval on rates - and states are reviewing them very closely, it is likely it is due to claim levels that they have been seeing in the recent 12 months, which is the typical baseline for the next 12 months.

So, either it is number of claims (more sick people, as healthly people have lapsed) or the dollar amount of the claims (don't you think Docs and Hospitals are raising their prices before Obama comes after them?)

Remember - there is no regulation on Doc prices - and rarely hospital prices (unlike insurers, which is the smallest part of the cost pie.

It's so easy to be cynical, when you really don't have a clue.....

 

[Trench]

It's so easy to be cynical, when you really don't have a clue.....

What did I say that was cynical? I merely pointed out the obvious.

If you and DTB are gonna claim that health insurance prices are rising rapidly due to HR 3200's implementation in 2014, you're gonna have to provide some proof.

:0corn

 

[Mags]

What did I say that was cynical? I merely pointed out the obvious.

If you and DTB are gonna claim that health insurance prices are rising rapidly due to HR 3200's implementation in 2014, you're gonna have to provide some proof.

:0corn

Re-read my post... I explained why they are rising for some insurance carriers.

Insurance companies, although they have at times in the past, are not raising prices merely to increase profit margins right now.

They don't want the bad PR - the only raise them by large amounts if they absolutely have to to break even or make a small profit. In addition, states are closely reviewing rate increases.

If there are big increases, I'm guessing that their claims experience is very poor, and they are raising them due to that.

It is also important to keep in mind that raising their rates just to provide add'l profit margin now won't work anyway - starting Jan 2011, they are being held to a 80% (85% for group) loss ratio - so if the are "overpriced" they just have to give it back anyway. So they aren't gonna raise them any higher than they absolutely have to - as there is no upside to them - they have to give back the additional profit, and they will drive away customers.

Certainly part of the rate increase is due to the additional benefits the government is mandating - which can range from 1% to 9% - depending on what coverage they currently have. The remainder - you can blame on Docs, hospitals and RX. Oh yea, Obama gave those guys a free pass with no restrictions.

How about that health care bill! :00hour

 

[Duff Miver]

Given that even now, you have to get approval on rates - and states are reviewing them very closely, it is likely it is due to claim levels that they have been seeing in the recent 12 months, which is the typical baseline for the next 12 months.

So, either it is number of claims (more sick people, as healthly people have lapsed) or the dollar amount of the claims (don't you think Docs and Hospitals are raising their prices before Obama comes after them?)

Remember - there is no regulation on Doc prices - and rarely hospital prices (unlike insurers, which is the smallest part of the cost pie.

It's so easy to be cynical, when you really don't have a clue.....

JFC, Mags, don't you ever have a clue?

The primary force driving health care costs up is cost shifting - charging those who can pay for the costs of those who cannot pay.

No regulation of doc and hospital prices? Nonsense. Medicare controls them every day.

Insurance companies have no incentive to control costs since State insurance commissions allow them rates based on their profit margins - the more thay spend, the more they are allowed to charge.

Single payer, aka Medicare for all, solves those problems just as it has in every other advanced country.

Equal treatment by equally qualified physicians and hospitals costs less everywhere on earth than it does in the USA.

 

[Trench]

JFC, Mags, don't you ever have a clue?

The primary force driving health care costs up is cost shifting - charging those who can pay for the costs of those who cannot pay.

No regulation of doc and hospital prices? Nonsense. Medicare controls them every day.

Insurance companies have no incentive to control costs since State insurance commissions allow them rates based on their profit margins - the more thay spend, the more they are allowed to charge.

Single payer, aka Medicare for all, solves those problems just as it has in every other advanced country.

Equal treatment by equally qualified physicians and hospitals costs less everywhere on earth than it does in the USA.

Psssst... Duff... we're not supposed to question Mags on the topic of health insurance. He's the "expert" and apparently we're just "clueless cynics".

I've argued for years that the only solution to skyrocketing healthcare costs is single-payer. We knew the Rebs and the Blue Dogs were a lost cause, but it's too bad Obama and (most of) the rest of the Dems didn't have the cojones to fight for single-payer.

 

[DOGS THAT BARK]

Quick uninformed (me personally) question, Wayne, on your group's increases. Are those increases due specifically to the healthcare bill, or are they due specifically to the company raising the costs because they want to and can? Can you point to anything specific in the increases that are attributed to the recent healthcare legislation?

If so, that would help us all understand specifically what the issues are. Otherwise, it can be placed directly at the feet of the insurance company, can't it? I'm not attacking here, I just want to understand what is going on.

Chad biggest part of renewal increase on 2nd group was due to passed legislation one directly on bill in general and the other indirectly due to gov paying 66% of COBRA premium. As they sold a plant and almost all employees kept ins as it only cost them 1/3 of premium and this would come under Demographics in renewal factors--other factor in consideration on renwal rates are Trend-risk adjustment-SIC (standard industry code)

The risk adjustment (claims history) was 6.91 more than 1st group so you would need subtract that from 44.93 to get more accurate comparison.

I'd say 15 to 20 % was directly related to healthcare reform and am expecting 1st group renewal rates to have 25% increase minimum next spring--they had been ave from 8 to 12 % past years.

 

[Mags]

JFC, Mags, don't you ever have a clue?

The primary force driving health care costs up is cost shifting - charging those who can pay for the costs of those who cannot pay.

That is certainly part of the overall cost of health care. But it is not the primary reason that costs are going up so quickly. Many more healthy folks are dropping their insurance today (who can blame them - they have bills to pay) which leaves a sicker pool remaining.

No regulation of doc and hospital prices? Nonsense. Medicare controls them every day.

Yep, the Gov does control that market - paying about 65-70% of the market rate. But what about the prices charged to anyone under age 65? (that's a large part of the population). Who controls that? Don't you realize that the Docs/Hospitals continue to increase prices in this market, to make up for the "low" reimbursement under the gov programs?

Insurance companies have no incentive to control costs since State insurance commissions allow them rates based on their profit margins - the more thay spend, the more they are allowed to charge.

True, to a point. Insurers do want to have costs controlled, as it by having lower claim costs, they can have a lower premium rate and greater market share.

BUT - Docs and Hospitals are the ones you should focus on here - how many people ask about how much a procedure costs before having it? That is where costs are going up and up,since the public has no idea of what it costs to go to the doctor. The insurance company just takes care of it for them.

BTW - do realize there are thousands of industries that price their product by taking cost of good sold and adding a markup? Why is it ok for any other industry to do so, by not insurance? Please don't get into the argument "everyone needs insurance". I'd counter with - everyone needs gas and groceries - and that is exactly how they operate too.

Single payer, aka Medicare for all, solves those problems just as it has in every other advanced country.

Equal treatment by equally qualified physicians and hospitals costs less everywhere on earth than it does in the USA.

It solves some problems, but creates many more. Imagine if every Doc/Hospital were forced to charge Medicare rates. Many couldn't make it. There won't be enough phyicians now - much less in 2014. Much less if there was national health care.

Government rationing on health care services (which Berwick has said he'd implement and he strongly supports) vs. rationing based on ability to pay.

If we were Europe, and a non capitalistic country, I could see it. But in America, we pride ourselves in giving people power to make their own decisions - I really don't think this bill will survive over the next few years. Ameicans won't stand for being put on waiting lists to get a doctor visit, or having to wait for surgery when they are in pain.

But time will tell - and it will be fun to watch!

 

[Duff Miver]

That is certainly part of the overall cost of health care. But it is not the primary reason that costs are going up so quickly. Many more healthy folks are dropping their insurance today (who can blame them - they have bills to pay) which leaves a sicker pool remaining.]

And ever more cost shifting

[Yep, the Gov does control that market - paying about 65-70% of the market rate. But what about the prices charged to anyone under age 65? (that's a large part of the population). Who controls that? Don't you realize that the Docs/Hospitals continue to increase prices in this market, to make up for the "low" reimbursement under the gov programs?]

According to our local non-profit hospital, Medicare pays them 93% of cost. they could easily find the other 7% if medicare paid them for every patient - BINGO! Hospital and doc costs reduced by 1/3



[True, to a point. Insurers do want to have costs controlled, as it by having lower claim costs, they can have a lower premium rate and greater market share.

BUT - Docs and Hospitals are the ones you should focus on here - how many people ask about how much a procedure costs before having it? That is where costs are going up and up,since the public has no idea of what it costs to go to the doctor. The insurance company just takes care of it for them.]

True, few people ask, but it's understandable. Try asking any hospital for a quote on, say setting a broken arm. You'll get a blank stare. The sickest patients have no time to ask, and in a good many communities there is only one hospital.

[BTW - do realize there are thousands of industries that price their product by taking cost of good sold and adding a markup? Why is it ok for any other industry to do so, by not insurance? Please don't get into the argument "everyone needs insurance". I'd counter with - everyone needs gas and groceries - and that is exactly how they operate too.]

You're not following me, Mags. I want to eliminate for-profit medical insurance altogether. BC/BS can open a grocery store.



[It solves some problems, but creates many more. Imagine if every Doc/Hospital were forced to charge Medicare rates. Many couldn't make it. There won't be enough phyicians now - much less in 2014. Much less if there was national health care.]

Bullshit. Suppose a thoracic surgeon has to take a cut from $500K to $400K. He's going to shine shoes?

[Government rationing on health care services (which Berwick has said he'd implement and he strongly supports) vs. rationing based on ability to pay.

If we were Europe, and a non capitalistic country, I could see it. But in America, we pride ourselves in giving people power to make their own decisions - I really don't think this bill will survive over the next few years. Ameicans won't stand for being put on waiting lists to get a doctor visit, or having to wait for surgery when they are in pain.]

There are no non-capitalist developed countries. All of them, including ours, are blends of capitalism and socialism. In most areas you'll damned well wait for most treatment except emergencies now. Around here joint replacements a 3-6 month wait today.

But time will tell - and it will be fun to watch!

...

 

[Mags]

Originally Posted by Mags
That is certainly part of the overall cost of health care. But it is not the primary reason that costs are going up so quickly. Many more healthy folks are dropping their insurance today (who can blame them - they have bills to pay) which leaves a sicker pool remaining.]

And ever more cost shifting

???? How does that produce more cost shifting? Having the people who use the services pay more for their insurance? That sounds like sound economic principles to me

[Yep, the Gov does control that market - paying about 65-70% of the market rate. But what about the prices charged to anyone under age 65? (that's a large part of the population). Who controls that? Don't you realize that the Docs/Hospitals continue to increase prices in this market, to make up for the "low" reimbursement under the gov programs?]

According to our local non-profit hospital, Medicare pays them 93% of cost. they could easily find the other 7% if medicare paid them for every patient - BINGO! Hospital and doc costs reduced by 1/3

Ah, there's the rub - 93% of the COST - you are forgetting about the 30% profit margin that they must charge on private patients to get a 15% overall..... (compare to 3-4% for the insurance industry)......and most hospitals are not at 93%

[True, to a point. Insurers do want to have costs controlled, as it by having lower claim costs, they can have a lower premium rate and greater market share.

BUT - Docs and Hospitals are the ones you should focus on here - how many people ask about how much a procedure costs before having it? That is where costs are going up and up,since the public has no idea of what it costs to go to the doctor. The insurance company just takes care of it for them.]

True, few people ask, but it's understandable. Try asking any hospital for a quote on, say setting a broken arm. You'll get a blank stare. The sickest patients have no time to ask, and in a good many communities there is only one hospital.

Not sure what communities you are talking about - you have to weight by population - most of the population have access to 2-3 hospitals at a minimum - and even more outpatient clinics - don't use a small town in ND as the norm

[BTW - do realize there are thousands of industries that price their product by taking cost of good sold and adding a markup? Why is it ok for any other industry to do so, by not insurance? Please don't get into the argument "everyone needs insurance". I'd counter with - everyone needs gas and groceries - and that is exactly how they operate too.]

You're not following me, Mags. I want to eliminate for-profit medical insurance altogether. BC/BS can open a grocery store.

[I understand that. You can make that argument for any industry. In fact, food and shelter are way more important to being able to survive than healthcare. I view health care to be an economic good, just like housing, food, shelter, and electronics. I'd love to pay a reasonable price for a car, instead of the bloated costs due to the union wages and benefits. Same with grocery costs - with all the added advertising, middle men, union benefits, etc. I enjoy capitalism - you clearly enjoy having the government own all business in America. Healthcare can't be a right, as long as people have such control over their own healthcare costs and are not good stewards of their own bodies (obesity is great example). Did you realize that 70% of healthcare costs are directly related to a person's habits and how they take care of themselves?


[It solves some problems, but creates many more. Imagine if every Doc/Hospital were forced to charge Medicare rates. Many couldn't make it. There won't be enough phyicians now - much less in 2014. Much less if there was national health care.]

Bullshit. Suppose a thoracic surgeon has to take a cut from $500K to $400K. He's going to shine shoes?

Ha, again, the exception, not the rule. Most GP's make between $100 and $200K.

[Government rationing on health care services (which Berwick has said he'd implement and he strongly supports) vs. rationing based on ability to pay.

If we were Europe, and a non capitalistic country, I could see it. But in America, we pride ourselves in giving people power to make their own decisions - I really don't think this bill will survive over the next few years. Ameicans won't stand for being put on waiting lists to get a doctor visit, or having to wait for surgery when they are in pain.]

There are no non-capitalist developed countries. All of them, including ours, are blends of capitalism and socialism. In most areas you'll damned well wait for most treatment except emergencies now. Around here joint replacements a 3-6 month wait today.

[And THAT is what is great about the US (and why people come here for treatment all the time) - we don't have to wait, nor should we.

I have to admit, you seem to have such strong socialistic tendencies. Wouldn't you be much happier in a cradle to grave environment, as most European countries are? Have you thought about moving there?

But time will tell - and it will be fun to watch!

 

[Duff Miver]

Originally Posted by Mags
That is certainly part of the overall cost of health care. But it is not the primary reason that costs are going up so quickly. Many more healthy folks are dropping their insurance today (who can blame them - they have bills to pay) which leaves a sicker pool remaining.]

And ever more cost shifting

???? How does that produce more cost shifting? Having the people who use the services pay more for their insurance? That sounds like sound economic principles to me

[Yep, the Gov does control that market - paying about 65-70% of the market rate. But what about the prices charged to anyone under age 65? (that's a large part of the population). Who controls that? Don't you realize that the Docs/Hospitals continue to increase prices in this market, to make up for the "low" reimbursement under the gov programs?]

According to our local non-profit hospital, Medicare pays them 93% of cost. they could easily find the other 7% if medicare paid them for every patient - BINGO! Hospital and doc costs reduced by 1/3

Ah, there's the rub - 93% of the COST - you are forgetting about the 30% profit margin that they must charge on private patients to get a 15% overall..... (compare to 3-4% for the insurance industry)......and most hospitals are not at 93%

Fuck, Mags, could you just pay attention for once? NON-PROFIT

[True, to a point. Insurers do want to have costs controlled, as it by having lower claim costs, they can have a lower premium rate and greater market share.

BUT - Docs and Hospitals are the ones you should focus on here - how many people ask about how much a procedure costs before having it? That is where costs are going up and up,since the public has no idea of what it costs to go to the doctor. The insurance company just takes care of it for them.]

True, few people ask, but it's understandable. Try asking any hospital for a quote on, say setting a broken arm. You'll get a blank stare. The sickest patients have no time to ask, and in a good many communities there is only one hospital.

Not sure what communities you are talking about - you have to weight by population - most of the population have access to 2-3 hospitals at a minimum - and even more outpatient clinics - don't use a small town in ND as the norm

Go ahead. Mags, call a hospital, any hospital, and ask for a price to set an arm, or do a triple bypass. Go ahead, compare prices between hospitals.:00hour

[BTW - do realize there are thousands of industries that price their product by taking cost of good sold and adding a markup? Why is it ok for any other industry to do so, by not insurance? Please don't get into the argument "everyone needs insurance". I'd counter with - everyone needs gas and groceries - and that is exactly how they operate too.]

You're not following me, Mags. I want to eliminate for-profit medical insurance altogether. BC/BS can open a grocery store.

[I understand that. You can make that argument for any industry. In fact, food and shelter are way more important to being able to survive than healthcare. I view health care to be an economic good, just like housing, food, shelter, and electronics. I'd love to pay a reasonable price for a car, instead of the bloated costs due to the union wages and benefits. Same with grocery costs - with all the added advertising, middle men, union benefits, etc. I enjoy capitalism - you clearly enjoy having the government own all business in America. Healthcare can't be a right, as long as people have such control over their own healthcare costs and are not good stewards of their own bodies (obesity is great example). Did you realize that 70% of healthcare costs are directly related to a person's habits and how they take care of themselves?

Why the fuck can't health care be a right? Education is, on spite of the fact some students are indolent, police protection is, in spite of the fact that some choose to be criminals, clean air and water are, in spite of the fact that some smoke and drink. So, tell us, Mags, why can't health care be a right? :shrug:


[It solves some problems, but creates many more. Imagine if every Doc/Hospital were forced to charge Medicare rates. Many couldn't make it. There won't be enough phyicians now - much less in 2014. Much less if there was national health care.]

Bullshit. Suppose a thoracic surgeon has to take a cut from $500K to $400K. He's going to shine shoes?

Ha, again, the exception, not the rule. Most GP's make between $100 and $200K.


So what? A GP takes a cut from $200K to $160? What is he going to do, flip burgers? Here's a better idea. He can work a half day on Saturday, earn just as much as before, and alleviate the Dr shortage.

[Government rationing on health care services (which Berwick has said he'd implement and he strongly supports) vs. rationing based on ability to pay.

If we were Europe, and a non capitalistic country, I could see it. But in America, we pride ourselves in giving people power to make their own decisions - I really don't think this bill will survive over the next few years. Ameicans won't stand for being put on waiting lists to get a doctor visit, or having to wait for surgery when they are in pain.]

There are no non-capitalist developed countries. All of them, including ours, are blends of capitalism and socialism. In most areas you'll damned well wait for most treatment except emergencies now. Around here joint replacements a 3-6 month wait today.

[And THAT is what is great about the US (and why people come here for treatment all the time) - we don't have to wait, nor should we.

Come here for treatment all the time? Wake up, Mags. Americans are flocking to Mexico, Thailand, India and elsewhere to get reasonably priced good quality health care. More Americans seek healthcare elsewhere than come here for it.

I have to admit, you seem to have such strong socialistic tendencies. Wouldn't you be much happier in a cradle to grave environment, as most European countries are? Have you thought about moving there?

Wrong again Mags. Please try a little harder to pay attention, or get an adult to check your work. I am not a socialist. I am a progressive populist. Do you even know what that is? You're just an example of what is wrong with our education system. You can't follow a train of thought, or comprehend words of more than two syllables.



But time will tell - and it will be fun to watch!

....

 

[rusty]

Single payer, aka Medicare for all, solves those problems just as it has in every other advanced country.

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[Mags]

.
Fuck, Mags, could you just pay attention for once? NON-PROFIT

Where does that stop? Shouldn't every business that people use on a day to day basis be non-profit? Why should we pay markup on food? Why pay markup on cars? Why should we even pay for homes, since everyone needs a place to live? Because are the USA - this is the system we are based on, and we love it!



Go ahead. Mags, call a hospital, any hospital, and ask for a price to set an arm, or do a triple bypass. Go ahead, compare prices between hospitals.

You are concentrating on ER. You could call around, or go to the web and force docs to put their prices out there, and list prices for Doc visits, immunizations, etc. But nobody wants to mess with the Docs - they are protected.



Why the fuck can't health care be a right? Education is, on spite of the fact some students are indolent, police protection is, in spite of the fact that some choose to be criminals, clean air and water are, in spite of the fact that some smoke and drink. So, tell us, Mags, why can't health care be a right?

Last I looked at the constitution, health care was not listed as a right. But, in some ways, it is - you go to an ER and you are covered. Again, if you are wanting us to be a cradle to grave society, you need to start with other "rights", such as housing, food, transportation, etc.

Rights are freedoms - the right to the pursuit of happiness, for example. "Rights" are not free giveaways of economic goods. Just because someone is born, or crawl over a fence to get into our country, doesn't mean we should give economic goods to people. But we SHOULD give them every opportunity to succeed.


Ha, again, the exception, not the rule. Most GP's make between $100 and $200K.

So what? A GP takes a cut from $200K to $160? What is he going to do, flip burgers? Here's a better idea. He can work a half day on Saturday, earn just as much as before, and alleviate the Dr shortage.

It's called free market - the government should not manage salaries or profits. It's called the free market, which is what makes America great. Who is to decide how much a doc should make? Or a pro athlete? Or a fisherman? Should the government dictate pay schedules for every profession and every industry? Who are they going to manage next?

There are no non-capitalist developed countries. All of them, including ours, are blends of capitalism and socialism. In most areas you'll damned well wait for most treatment except emergencies now. Around here joint replacements a 3-6 month wait today.

You must live in a very rural area. The vast majority of the population would not have that wait. Of course, in Canada, I understand the wait would be much longer. Then again, with your socialistic views, you very well may be Canadian

Come here for treatment all the time? Wake up, Mags. Americans are flocking to Mexico, Thailand, India and elsewhere to get reasonably priced good quality health care. More Americans seek healthcare elsewhere than come here for it.

Surely - Americans have more money - due to our system of CAPITALISM. Our standard of living is higher than many countries. You see a lot of Canadians coming here for healthcare - due to our quality and the fact that they don't want to wait for care in Canada. I don't think too many folks are flying to Thailand for a knee replacement.

If we become single payer, where will Americans go for healthcare? It surely won't be Canada or Europe...... their systems are all screwed up already - in fact, some of the European countries are backing away from single payer and are starting to develop a public/private blend

Wrong again Mags. Please try a little harder to pay attention, or get an adult to check your work. I am not a socialist. I am a progressive populist. Do you even know what that is? You're just an example of what is wrong with our education system. You can't follow a train of thought, or comprehend words of more than two syllables.

OK, a progressive populist. Popularism is viewed as a building block of facism. Great, that's much better. :facepalm:

I've always found that those who despise capitalism are ones that are not capable of creating wealth for themselves. Or they are an idealistic college student - and the latter category usually changes their tune once they get to the real world and hold down a job and have to pay taxes.

...

 

[Chadman]

Chad biggest part of renewal increase on 2nd group was due to passed legislation one directly on bill in general and the other indirectly due to gov paying 66% of COBRA premium.

I'd say 15 to 20 % was directly related to healthcare reform and am expecting 1st group renewal rates to have 25% increase minimum next spring--they had been ave from 8 to 12 % past years.

Thanks for taking the time to explain this. I certainly don't pretend to understand insurance scenarios that well, but am trying. Specifically, can you help explain these parts further?

"biggest part of renewal increase on 2nd group was due to passed legislation one directly on bill in general"

What does this refer to? What part of passed legislation? What part of the bill in general?

the other indirectly due to gov paying 66% of COBRA premium.

How does this mean an increase for the company or policyholder? I know with my layoff, my company is paying the 66% of COBRA premium, not the government. And if the government is paying for it moving forward, how is this a direct cost increase for the individual with this particular policy? It's certainly nowhere near what the cost would be TO the individual, or TO the company, if the government is paying for it.

You mention your guesstimate raises the costs of the renewal policy 15 to 20% due to the healthcare reform. I haven't seen anything specific you've mentioned due to the healthcare reform that this can be attributed to. Unless, of course, the insurance company is simply raising rates on their own, which is status quo. I'm not saying it's not true, I'm just asking you to show me, not tell me.

 

[DOGS THAT BARK]

Thanks for taking the time to explain this. I certainly don't pretend to understand insurance scenarios that well, but am trying. Specifically, can you help explain these parts further?

"biggest part of renewal increase on 2nd group was due to passed legislation one directly on bill in general"

What does this refer to? What part of passed legislation? What part of the bill in general?

the other indirectly due to gov paying 66% of COBRA premium.

How does this mean an increase for the company or policyholder? I know with my layoff, my company is paying the 66% of COBRA premium, not the government. And if the government is paying for it moving forward, how is this a direct cost increase for the individual with this particular policy? It's certainly nowhere near what the cost would be TO the individual, or TO the company, if the government is paying for it.

You mention your guesstimate raises the costs of the renewal policy 15 to 20% due to the healthcare reform. I haven't seen anything specific you've mentioned due to the healthcare reform that this can be attributed to. Unless, of course, the insurance company is simply raising rates on their own, which is status quo. I'm not saying it's not true, I'm just asking you to show me, not tell me.

1st Chad -while your company is paying 2/3 of premium initially they are being reimbursed by gov for all it--so it cost company nothing. The gov is footing the tab at tax payors expense.

There was abnormal increase on trending and factors considered future expectants and not related to past 12 month history. Only reason I see for this is ins co look at uncertainly of what will happen--unknown at this time--and trying to A soften the landing or hedge against possible rate freeze in future or having adverse selection (forced to take unhealthy people at rate as healthy) which would be same as charging drunk drivers same rate safe drivers--or charging same premium on building in watts as in in suburb.

Bottom line all insurance is based on risk--when you have gov trying to dictate equal risk to all--you have serious problem

 

[Chadman]

1st Chad -while your company is paying 2/3 of premium initially they are being reimbursed by gov for all it--so it cost company nothing. The gov is footing the tab at tax payors expense.

There was abnormal increase on trending and factors considered future expectants and not related to past 12 month history. Only reason I see for this is ins co look at uncertainly of what will happen--unknown at this time--and trying to A soften the landing or hedge against possible rate freeze in future or having adverse selection (forced to take unhealthy people at rate as healthy) which would be same as charging drunk drivers same rate safe drivers--or charging same premium on building in watts as in in suburb.

Bottom line all insurance is based on risk--when you have gov trying to dictate equal risk to all--you have serious problem

Okay, so why is there an increase by the insurance company at all because the government is paying the COBRA payment? What sense does that make? Are they trying to take advantage of the government, and make all the money they can make, when they can make it? Are you sure that the companies are being reimbursed for all of that money? Are they this year, or is that only next year?

And the second part, the insurance company is raising the rates that much next year, and will do so in the next two years, in advance of something unknown? Hypothetical scenarios that do not exist yet? No real risk factors in play, so they will increase rates dramatically now, and in the next three years before anything becomes known? You yourself are dealing with hypotheticals in your assessment. How is the general public afforded any kind of cost protections with that scenario? Rates were skyrocketing with nothing being done leading up to this. And now, it's another excuse to raise them even more? I guess these companies can always find someone else to blame, right?

I agree something should be done to control costs in areas of pharma, doctors, hospitals, etc. But I'm glad to see something being done in SOME area, which might make it possible to make changes later in those other areas. If insurance companies are making less, perhaps they'll put pressure on the other areas to avoid paying out so much. As it is now, they have no reason to care at all, being able to raise their rates indefinitely, without recourse.

And we know, without the current initiative, nothing would ever have been done from the right. At least that's how I see it. But I'm mainly interested in my first question, on COBRA. Why would the insurance companies raise rates on policies because the government is paying the bill and not the consumer or individual? Makes no sense to me, unless they are gouging the government, hoping they won't be discovered.

 

[Duff Miver]

Well, Mags, there's no point in reposting all your bullshit and responding to it point-by-point, since you aren't able to follow logical progression.

Here, I'll try to ask you a really simple question and see whether you can answer.

Start with this fact, which, in this day of internet information, even you can verify -

Now you will notice that all of these countries are more "socialistic" or, if you prefer "egalitarian" or "progressive" or "populist" than the USA.

So, Mags, let's hear your explanation as to how rank capitalism is a superior system. You know, explain your theory and how it fits the above facts. That's FACTS, Mags, FACTS, not Fox News talking points or Sarah Palin platitudes or misspelled slogans on a teabagger poster. The Gadsen flag is not a fact.

Oh...don't forget to let us know what your local hospital quotes for a knee replacement, and when they can get to it. You will give them a jingle and report back, right? But, hey if you can't get that, just tell us what your local pediatrician quotes as a firm price, all costs included, to deliver a baby. Or how much your local clinic of GPs charges to treat a simple case of influenza, bottom line.

I am laughing my ass off at you....but you already knew that, right?