The bomb buried in obamacare!

[lizzie]

Care to back up what you say?
What it represents to me is the coming of FAIR priced medical care

It will do nothing of the sort. We are dealing with an increased demand, relative to the supply, and prices will go up, not down.

 

[Arbo]

One of the reasons why it must go into full effect. Sure it's not perfect, but it will help us, and the medical care in this country.

When any other country shifted to a 'similar' system, rates went up. Costs WILL go up with this plan. Quality of care will go down.

I'm not sure why so many people seem to support making the system worse for what amounts to a small percentage of the population. There are better options, better solutions.

A heartening analysis. The conservatives that continue to stand athwart the Obamacare law and SCOTUS decision drive me farther from economic conservatism with every corporate bought and paid for speech against healthcare reform. Conservatives do not represent the American people, they represent only the wishes of their corporate paymasters. It's time for the rank and file of social conservatives like myself to abandon the Republican party if we wish to remake government as being of, by and for the people, not the companies.

In my mind, a 'fiscal liberal' and 'social conservative' is the worst possible combination. Between the left wing policies of 'best for everyone', unable to understand that 'other peoples money' runs out, and the bible thumper social conservatism that shoves down equality and freedom. What a bad match.

 

[lizzie]

This year is the first year in which the MLR rule applies. The NAIC requested insurers to report MLR data for 2010. Based on those reports, the NAIC found that insurers would have had to pay rebates of nearly $2 billion had the MLR rule been in effect for 2010, with nearly half of that amount going to employer-sponsored group plans. The GAO, however, analyzing the same reports, found that the rebates were limited to a minority of insurers—most insurers would have met or exceeded the MLR requirements.

What’s Notably Not In The New Regulations: Reclassifying Agent And Broker Compensation
One of the ways in which some insurers have been cutting their administrative costs has been by cutting compensation to agents and brokers. The NAIC Report found that “a significant number of companies have reduced commissions in 2011,” although it also found that a significant number had not. For the past year, agents and brokers have heavily lobbied the NAIC to recommend that their compensation be protected from reductions under the MLR formula, and on November 22, 2011, the NAIC recommended that Congress and HHS do just that.

Implementing Health Reform: Fine-Tuning The Medical Loss Ratio Rules – Health Affairs Blog

 

[American]

Sorry but you can mandate lower prices by putting in checks and balances that insure that there is no price gauging and exploitation. As it stands now, there are no such checks and balances in the US and that is causing double+ increase over inflation in healthcare cost every year.

The problem with the healthcare industry in the US (and Chile and Switzerland) is the administrative costs are insanely high, and that is in large part due to greed. High wages, high bonuses, high "perks" for employees and "friends" are all administrative or marketing costs. It is the same reason that big pharma uses far more on marketing than it actually uses on R&D... which is frankly disgusting and should also be regulated if you ask me... especially when they claim that they need to jack prices up for everyone because they need the money to do R&D...

Now saying that, I do not mean there should be any sort of "you must do this and that", but putting in % maximums on what you can use on administrative costs or marketing.. is not a bad idea at all since it does not effect their business at all and most money goes to the actual core business. Most big companies often loose focus the bigger the get and the less control both internally and externally there are.. and especially in markets where they are totally dominant.

Is there anything that shouldn't be regulated? For a supposed centrist, you sure believe in a lot of regulation. There is so much regulation of Rx's in the US, that other countries don't even question the safety of our drugs or procedures. I had a doctor explain to me the other day that a certain European improved product, had not been FDA approved and therefore couldn't not be used, though it was proven more effective. The reason, the company could not afford to spend $3M more for trials to satisfy the FDA and had plenty of customers internationally. So they drop the application. This is one reaons why Rx are so expensive in the US, and cheaper elsewhere. The other reason is the amount of R&D conducted in the US.

INTERNATIONAL PRESCRIPTION DRUG COST CONTAINMENT STRATEGIES AND SUGGESTIONS FOR REFORM IN THE UNITED STATES

Prescription drug prices in the United States - Wikipedia, the free encyclopedia

 

[Neomalthusian]

One of the reasons why it must go into full effect. Sure it's not perfect, but it will help us, and the medical care in this country.

If this is accurate, this is a great reason why this law must be put into effect as quickly as possible. Forcing insurance companies to actually do what they're are designed to do... cover medical care, is an excellent provision of this bill.

The 80/20 rule works somewhat like a cost-plus contract. It encourages overconsumption of health care. When you can keep 20 cents of every dollar spent, it is an incentive to spend more. And spending more means turning around and raising premiums.

 

[Arbo]

One of the reasons why it must go into full effect. Sure it's not perfect, but it will help us, and the medical care in this country.

The 80/20 rule works somewhat like a cost-plus contract. It encourages overconsumption of health care. When you can keep 20 cents of every dollar spent, it is an incentive to spend more. And spending more means turning around and raising premiums.

And overconsumption is probably one of the main problems we have, that has caused cost increases WRT insurance. Normal checkups and small stuff, should never go to insurance, but society is lazy, and for some reason thinks they are 'making out' using it for even the small stuff..

 

[tecoyah]

Bush Sr. was the last Republican to believe the Democrats were telling the truth when they made a promise.

Gimme a freakin' break...he knew as well as any that they all lie and pander, I think it's called politics.

"WASHINGTON — The failure of the so-called "supercommittee" to meet its spending-cut target set off an automatic trigger that in January would slice federal spending, divided evenly between domestic and defense.

At $1.2 trillion over a decade, it was meant to be so painful that the select bipartisan group of 12 lawmakers, including U.S. Sen. Pat Toomey, R-Pa., would be pressured into a consensus. Most Democrats would want to avoid cutting domestic programs, the thinking went, and most Republicans would want to protect military spending.

Instead, the Republican-majority House voted Thursday to cancel the automatic cuts, and replace them with targeted reductions that included decreasing benefits and eligibility for food stamps, reducing or eliminating programs created in the 2010 health care law and requiring federal employees to pay an additional 5 percent of their salary toward pensions."
House Republicans replace defense cuts - Morning Call

You....have completely made my point (though you likely cannot see it). You personify what the Republican Party has morphed into...and you can have it.

 

[Mycroft]

It's called forced ethics.

I support it.

Health Insurance is a broken backwards business model--I support trashing it and regulating it as much as possible.

"Forced Ethics"???

Then you are no better than the Religious Right who want to force THEIR ethics.

Forget it.

 

[iguanaman]

Oh and to be a stick in the mud, the large insurers already spend 83% of premiums on medical care.
So this is much to do about nothing.

If only that were so.....

More than 550,000 people in Missouri will be getting a total of more than $60 million in health care premium rebates this summer.

In Illinois, more than 299,000 people will be getting more than $61 million back.

Those rebates could come in the form of a rebate check in the mail, a reimbursement on a credit card or debit card if you used one to pay your premium, a reduction in a future premium or your employer could reinvest it in the company health plan.

The reason for the refunds is because the health reform law makes insurance companies reimburse you if they used your premiums to boost company profits instead of paying for medical care.

Health care premium rebates for Missouri, Illinois residents | ksdk.com

 

[iguanaman]

"Forced Ethics"???

Then you are no better than the Religious Right who want to force THEIR ethics.

Forget it.

It is nothing of the sort. We are being gouged by the insurers and it is wrong. There is no free market when it comes to medical care and they shouldn't be allowed to charge whatever they want for it. The electric companies have always been regulated for the same reason.

 

[iguanaman]

And overconsumption is probably one of the main problems we have, that has caused cost increases WRT insurance. Normal checkups and small stuff, should never go to insurance, but society is lazy, and for some reason thinks they are 'making out' using it for even the small stuff..

Let me get this straight. Before this constraint, the insurers didn't make more money when they spent and charged more? How is that possible? Rates have been rising 10% a year for the last 10 at least. I believe the insurers profits have been rising at a similar rate.

 

[ChuckBerry]

a 'fiscal liberal' and 'social conservative' is the worst possible combination. Between the left wing policies of 'best for everyone', unable to understand that 'other peoples money' runs out, and the bible thumper social conservatism that shoves down equality and freedom. What a bad match.

Good thing I'm not fiscally liberal then. I am not for or against any particular economic model, I am for what works to provide reasonable cost healthcare for everyone, and I am for government of, by and for the people, not companies. You can keep your class warfare rhetoric. And I too bemoan those that try to shove social change down my throat.

 

[Neomalthusian]

Let me get this straight. Before this constraint, the insurers didn't make more money when they spent and charged more? How is that possible? Rates have been rising 10% a year for the last 10 at least. I believe the insurers profits have been rising at a similar rate.

Why couldn't they continue to? Or accelerate? With 80/20, the more money they can find a way to spend, the more they will make.

 

[Neomalthusian]

It is nothing of the sort. We are being gouged by the insurers and it is wrong. There is no free market when it comes to medical care and they shouldn't be allowed to charge whatever they want for it.

Then you must be vehemently anti-mandate then.

 

[ChuckBerry]

"Forced Ethics"???

Then you are no better than the Religious Right who want to force THEIR ethics.

Forget it.

...which is worse, the religious right and their insistence on social change at the ballot box (not really different from liberals, but I digress), or pro-business right that insist that corporate profits supersede all other considerations?

 

[lizzie]

And overconsumption is probably one of the main problems we have, that has caused cost increases WRT insurance. Normal checkups and small stuff, should never go to insurance, but society is lazy, and for some reason thinks they are 'making out' using it for even the small stuff..

Overconsumption is THE main problem we have. Making healthcare coverage comprehensive, as was done by congress in the 70's via mandate, has led to overutilization, thus soaring costs. It has increased the demand of a commodity with finite resources.

 

[Arbo]

Good thing I'm not fiscally liberal then. I am not for or against any particular economic model, I am for what works to provide reasonable cost healthcare for everyone, and I am for government of, by and for the people, not companies. You can keep your class warfare rhetoric. And I too bemoan those that try to shove social change down my throat.

So you didn't know what you were talking about when you called yourself a social conservative?

 

[Arbo]

Overconsumption is THE main problem we have. Making healthcare coverage comprehensive, as was done by congress in the 70's via mandate, has led to overutilization, thus soaring costs. It has increased the demand of a commodity with finite resources.

Well, you and I seem to get that.

 

[Mycroft]

It is nothing of the sort. We are being gouged by the insurers and it is wrong. There is no free market when it comes to medical care and they shouldn't be allowed to charge whatever they want for it. The electric companies have always been regulated for the same reason.

In other words...YOUR ethics are good...the other's ethics are bad.

Uh-huh...

 

[Mycroft]

...which is worse, the religious right and their insistence on social change at the ballot box (not really different from liberals, but I digress), or pro-business right that insist that corporate profits supersede all other considerations?

False comparison because the pro-business right insist on allowing the market to determine success...not the characterization you express.

 

[Simon W. Moon]

Interesting read........
The Bomb Buried In Obamacare Explodes Today-Hallelujah! - Forbes

Wasn't this roundly debunked a while back?
Iirc, insurance companies make most of their profit from their investments, not their premiums.

 

[Simon W. Moon]

Ah here we go, the same site:

What Bomb Buried in Obamacare? - Forbes

What confuses me here is that in a competitive market it’s entirely normal for an insurer to have a loss ratio higher than 80%. There are plenty of entirely profitable and growing insurance companies that have loss ratios over 100%. So I cannot really understand why the law insisting on an MLR of 80% (or 85% in the large group market) is going to cause all for profit insurance companies to fall over.

This idea of a loss ratio over 100% is a little odd, of course, but allow me to explain it. There are two entirely different income streams for an insurance company. One is the premiums that are paid in: we can all see that one and understand it. The second is the hidden one that most don’t understand is there: that’s the investment income gained from having those premiums in between their collection and the need to pay them out again on a claim.​

 

[digsbe]

I fear that this has potential to be widely abused. What is stopping them from creating pharmacies and physician offices that are owned and operated under the insurance company? Many are requiring patients do to mail order pharmacy because they can keep the profits (due to owning or partially owning the mail order pharmacy). Good in theory, but there needs to be some oversight to prevent abuse.

 

[Slartibartfast]

I fear that this has potential to be widely abused. What is stopping them from creating pharmacies and physician offices that are owned and operated under the insurance company? Many are requiring patients do to mail order pharmacy because they can keep the profits (due to owning or partially owning the mail order pharmacy). Good in theory, but there needs to be some oversight to prevent abuse.

Thats what happening in Mass now. vertical integration.

 

[Phoenix]

Sorry but you can mandate lower prices by putting in checks and balances that insure that there is no price gauging and exploitation. As it stands now, there are no such checks and balances in the US and that is causing double+ increase over inflation in healthcare cost every year.

The problem with the healthcare industry in the US (and Chile and Switzerland) is the administrative costs are insanely high, and that is in large part due to greed. High wages, high bonuses, high "perks" for employees and "friends" are all administrative or marketing costs. It is the same reason that big pharma uses far more on marketing than it actually uses on R&D... which is frankly disgusting and should also be regulated if you ask me... especially when they claim that they need to jack prices up for everyone because they need the money to do R&D...

Now saying that, I do not mean there should be any sort of "you must do this and that", but putting in % maximums on what you can use on administrative costs or marketing.. is not a bad idea at all since it does not effect their business at all and most money goes to the actual core business. Most big companies often loose focus the bigger the get and the less control both internally and externally there are.. and especially in markets where they are totally dominant.

How DARE workers in the healthcare industry demand good wages (without a union)