Health Insurance Premium just went way up

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dbc47
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Health Insurance Premium just went way up

Post by dbc47 »

Just got a note from Blue Cross: "We try to keep our expenses under control, blah blah blah", so beginning March 1st your premium will be going up 33.6%

Anybody else in California get this little surprise?
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Rick Ferri
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Post by Rick Ferri »

It is not just California. I live in Texas, and my health insurance went up 26% to $14,000 and we are a very health family of three. I was carrying a $5,000 deductible, which we have never met, and I am increasing that to a $15,000 deductible. This will cut my premium in half to $7,000 at least for this year.

Rick Ferri

PS. The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
retired recently
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Post by retired recently »

I think BCBS is terrible. My premiums did not go up too much (I had zero claims) but I am already charged a higher rate due to elevated cholesterol and my taking meds for acid reflux.

They give little or no weight to other factors like exercise and age...(i.e., even though I admittedly have elevated cholesterol it is extremely unlikely I will be hospitalized due to it since I am 41 and exercise strenuously regularly).

Not to mention, customer service is poor, they lost documentation, etc.

Their monopoly position in my state has made them sloppy to say the least...
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Post by gatorman »

Rick Ferri wrote:It is not just California. I live in Texas, and my health insurance went up 26% to $14,000 and we are a very health family of three. I was carrying a $5,000 deductible, which we have never met, and I am increasing that to a $15,000 deductible. This will cut my premium in half to $7,000 at least for this year.

Rick Ferri

PS. The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
I am a little older than you and our premium for a family of three was running $23,000 per year with a $5k deductible and absolutely crummy coverage. I sent my wife back to work and now we are on her insurance through work and pay $4800 per year with a $2k deductible and much better coverage. It is a nice raise!!

gatorman
neverknow
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Post by neverknow »

36 more hours, and my husband will be insured.

We were priced out of the market back in 2003. You simply can not fork over 50% of your gross income on Health Insurance (imagine what percentage of our income it would be by now!)

36 more hours.

I reminded my husband this morning to not cut off his arm with a chainsaw --- at least until Monday.

36 more hours.

Yes, I'm obsessed with this 36 more hours.

We have been paying cash --- and so far, have been very, very lucky.

36 more hours.
neverknow
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Post by richard »

Rick Ferri wrote:PS. The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
This assumes that last year doctors and hospitals could have charged a lot more, but chose not to. (Much higher than 26% or 33.6% more, considering doctors and hospitals are far from the only components of health care costs.) That seems unlikely. It also assumes an unlikely level of bargaining power.
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Post by masteraleph »

Ours also went up a lot. Apparently my employer is now big enough for "community rating," and we tend to have more useage of the plan than most similarly sized places (they won't tell you what your community rating is, but we can infer that having a higher number of pregnancies than is typical and having higher family sizes than average probably impacts on useage). Net result was that Aetna offered a 49% increase and no one else was willing to take us at all.

Thankfully, we're also now big enough to self-fund. Net result: significantly increased premium, but with a likely result of having lower than average premium increases in the future.
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Post by northend »

Mine went up 23% and the deductible went from 600 a year to $2,600 a year.

My guess it's the cost of these of some of these medications.

A individual policy with just $3,000 of prescription coverage is significantly lower then my group policy with a more generous prescription coverage.

Check out of the cost of some of the cancer medications.


http://www.usatoday.com/news/health/200 ... osts_x.htm
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Post by MWCA »

Yeah. Im seeing the realities of trying to early retire...

Not so fast...

Better to let the employer subsidize it Unfortunately I know that will end eventually. Every time I see people with individual policies I read the same thing.

HOLY COW IT WENT UP X % this year with reduced coverage.

Eventually the game will end one way or another.

There is basically no protection for individual policy holders.
We are all worms. But I believe that I am a glow-worm.
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Post by funnymoney »

Well, our insurance just went up to $1050 per month and most meds are cheaper paying cash at the local pharmacy than going through the insurance provider.

On the other hand, I just had a 15 minute laser treatment to the retina which will probably come in at about $1500 and this coming week my sweetie will have surgery that will probably come in at about $50,000. Makes it hard to complain about the insurance cost....

Funnymoney
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Post by Badinvestor »

Rick Ferri wrote:The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
Where have you ever seen a profit-making business that has to be forced to charge higher prices and make more money? They love charging higher prices and making more money.
pitt76
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Post by pitt76 »

I just happened to get my notice today that my premium is going up 34.4 % with Independence Blue Cross in the Valley Forge area. I could go HMO, but refuse to.
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ualdriver
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Post by ualdriver »

Wow some of those are high- but why, especially for the high deductible plans mentioned? I must be missing something...

I went to www.ehealthinsurance.com and typed in a husband (45), wife (44), and a 16 year old kid living in Dallas (random Dallas zip code, forgot which), and there were literally tons of plans for under $500 per month.

Same when I type in plans for my family where I live in IL. What am I missing?
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southerndoc
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Post by southerndoc »

Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
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dbc47
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Post by dbc47 »

ualdriver wrote:Wow some of those are high- but why, especially for the high deductible plans mentioned? I must be missing something...

I went to www.ehealthinsurance.com and typed in a husband (45), wife (44), and a 16 year old kid living in Dallas (random Dallas zip code, forgot which), and there were literally tons of plans for under $500 per month.

Same when I type in plans for my family where I live in IL. What am I missing?

I wouldn't count on the rates quoted. I went through the ehealthinsurance thing a few years ago and turns out the rates quoted were lower than what you might end up with later. Once you tell them that you had a hang nail or you once "felt bad", then the rates go up. I tried to go with Aetna at the time. I sent them the first quarter's premium which was based on the quoted price. A few weeks later I get a bill from them for almost twice the quoted price. Guess there was something they didn't like about either my wife or myself. I called to cancel the policy, which was part of the deal, and it took almost 2 months to get our money back.
The tough part is having to send in the first quarter's premium just to "apply", then there is no guarantee that is what the premium will actually be once all is said and done. Too bad they just can't give an honest quote to begin with.
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Post by Rick_29T9W »

Several months ago I turned 55, which put me in a much more expensive age bracket. There was also an additional increase not related to my age, which also occurred just ahead of that. Due to both of those increases, the rates increased from $650 per month to $995 per month, for just myself. I have BlueCross BlueShield of Arizona with a $1250 deductible. It is a plan where I can choose any doctor that I want.

Most years, my annual medical expenses have been roughly equal to the $1250 deductible. I could increase the deductible to about $5000, to reduce the monthly premium significantly. But even, then it would still be quite expensive.

I plan to talk to independent insurance broker, to see what other plans are available for me, either through BlueCross or some other company. If I qualify for a different plan, I want to make sure that both of my doctors would still be acceptable, under the new plan.
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Post by Steelersfan »

I was very surprised when my health care plan, which is through my ex-employer until I turn 65, did not have an increase in my contribution this year. The coverage stayed essentially the same and it's through BC/BS. I'm happy, but I can't figure out how they were able to do that.
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Post by richard »

southerndoc wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
American per capita healthcare spending is in the range of 1.5x to 2.0x the spending in developed countries. Per capita costs don't change if you include more people in the insurance pool.
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Post by richard »

Rick_29T9W wrote:I plan to talk to independent insurance broker, to see what other plans are available for me, either through BlueCross or some other company. If I qualify for a different plan, I want to make sure that both of my doctors would still be acceptable, under the new plan.
If you switch, you might also want to be very careful about pre-existing condition provisions. Insurance companies can use them to deny coverage many years after you start paying premiums.
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Post by neverknow »

dbc47 wrote: I wouldn't count on the rates quoted. I went through the ehealthinsurance thing a few years ago and turns out the rates quoted were lower than what you might end up with later. Once you tell them that you had a hang nail or you once "felt bad", then the rates go up. I tried to go with Aetna at the time. I sent them the first quarter's premium which was based on the quoted price. A few weeks later I get a bill from them for almost twice the quoted price. Guess there was something they didn't like about either my wife or myself. I called to cancel the policy, which was part of the deal, and it took almost 2 months to get our money back.
The tough part is having to send in the first quarter's premium just to "apply", then there is no guarantee that is what the premium will actually be once all is said and done. Too bad they just can't give an honest quote to begin with.
We looked at this, a year ago - but never applied. 2 things were red flags to me. The price advertised was less then what it cost to buy Medicare Part A (you can buy into Medicare Part A at age 65 if you have 30 credits) not even including the extra $100 for Medicare Part B. This couldn't possibly be the price - just a teaser price. No private insurer would sell you insurance for less then Medicare. And the 2nd part - I just couldn't get past. Indeed they want you to send them a check, that they will cash - but it does not mean they will give you the service you are trying to buy. I never pay for something, before I actually get it. Who do these jokers think they are - taking our money, putting it in their bank, and then maybe giving it back to you? -- Answer; they have the most powerful marketing tool I can even think of - pay us, or risk bankruptcy - likewise the Health Care business itself - do what we say, or die.

24 more hours till my 65 year old husband with under control high blood pressure is insured. I joked with him, I might make him stay in bed all day. He said he is likely to read a book all day. 24 more hours. We have been lucky.

The worst part of this risk we took, is while our income couldn't pay the insurance premium ... my lump sum retirement money could pay a hospital bill.

24 more hours.
neverknow
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Post by VictoriaF »

neverknow wrote:
24 more hours till my 65 year old husband with under control high blood pressure is insured. I joked with him, I might make him stay in bed all day.

24 more hours.
neverknow
Just be careful there. You never know ;)

Best wishes for the next 24 hours,

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JMacDonald
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Post by JMacDonald »

Hi,
The whole heath care insurance situation is crazy. There does not seem to be the normal business competition that keeps a lid on prices. The insurance companies do not seem to have compete for our business, rather we seem to have to beg for their business.
Best Wishes, | Joe
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Post by Ron »

pitt76 wrote:I just happened to get my notice today that my premium is going up 34.4 % with Independence Blue Cross in the Valley Forge area. I could go HMO, but refuse to.
Steelersfan wrote:I was very surprised when my health care plan, which is through my ex-employer until I turn 65, did not have an increase in my contribution this year. The coverage stayed essentially the same and it's through BC/BS. I'm happy, but I can't figure out how they were able to do that.
I'm also in eastern PA (Capital BC), but my monthly combined co-contribution to my retirement medical (through PBS) for both me/wife over the last four years was:

2007 - $461/mo.
2008 - $465/mo.
2009 - $473/mo.
2010 - $473/mo. (no increase!).

True, the cost is subsidized by my former employer who gets group rates, but I'm really surprised how the rates have been limited.

- Ron
neverknow
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Re: Insurance Reform is needed.

Post by neverknow »

rcasement wrote:Until our government regulates the insurance industry through reforms, your rates and mine will go up.
I have been insured. I have had no insurance. My special needs adult brother uses Medicaid. I had only seen non profit public hospitals until my late 30's, when for the first time I saw the inside of a private hospital. I have seen rural medicine, and big city medicine. I have paid cash.

Just as this country is 2 tiered in retail - say Nordstroms and Walmart ... Healthcare is increasingly becoming all Nordstroms and there is no Walmart for Healthcare. We need an entire other tier for Healthcare. Something regular folks with regular incomes can afford. Regular folks know they will never be dripping in Diamonds and eating at Restaurants whose menu's have no prices. We need a whole other tier in medicine - something regular folks can afford. As the choice of nothing is shameful in a country as rich as ours. And raising everyone up to dripping in Diamonds and eating at restaurants whose menus have no prices - seems like a sure road to bankruptcy for everyone, to me.

In the reports of the Hatti earthquake, they called it Jungle Medicine. We need some Jungle Medicine right here in this country. Something regular folks can afford. All or nothing seems like a ridiculous way to approach this problem to me.
neverknow
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Post by TheEternalVortex »

richard wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
To be fair I guess we should likewise "subsidize" the auto insurance pool with safer/older drivers.
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Post by rokid »

My Federal BC/BS went up 12.5%. Compared to everyone else, OPM must be doing a fairly good job of negotiating price.
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Post by richard »

TheEternalVortex wrote:
richard wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
To be fair I guess we should likewise "subsidize" the auto insurance pool with safer/older drivers.
You're quoting something southerndoc said, which I explicitly disagreed with.
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Post by richard »

rokid wrote:My Federal BC/BS went up 12.5%. Compared to everyone else, OPM must be doing a fairly good job of negotiating price.
Larger pools can negotiate better prices. Who would have thought :)

Consider the implications
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Post by likegarden »

When BCBS would not have been able to increase premiums they probably would have received a bailout like AIG? These are funny times. We have to keep that industry going and those people employed?

I was really surprised in the 1970s when I found out that there are many people in the US without health insurance and access to health care. I came from Europe and there everybody always had access to health care, and health insurance was never talked about and never was an issue, in the bad times and the good times.
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Post by paulob »

Rick Ferri wrote:It is not just California. I live in Texas, and my health insurance went up 26% to $14,000 and we are a very health family of three. I was carrying a $5,000 deductible, which we have never met, and I am increasing that to a $15,000 deductible. This will cut my premium in half to $7,000 at least for this year.

Rick Ferri

PS. The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
Rick,
I work for a health-care provider, so I am biased. But, the increase in Medicaid receipients would be, in your jargon, "recency" bias. Medicaid enrollment is up, but loss of income does not automatically qualify you for Medicaid. In my state, there is an asset test that also must be met.

The double digit increases in commercial insurance health premiums has been in the marketplace for many years. Medicaid increase in receipients is a variable, but I doubt its anywhere near the impact that would affect renewals at that rate (33.6%?!).

The issue that is very troubling from my perspective, is that premiums have risen much faster than medical inflation. BC/BS is private but other large insurers like UHC are public. I haven't looked at their P&L, but if you are investing premiums during the policy year, and the market goes south, then that puts pressure on the net premium earnings. That's not a justification, but I believe it is a variable in the business model.
Paul
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Rick Ferri
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Post by Rick Ferri »

It is interesting to me that all health care insurers are raising rates. At first glance this would appear to be collusion for profits, which would be an inaccurate populist reaction. I truly believe that costs really are going up for the insurers. I also believe this is a direct result of government involvement in the health care industry through more people on Medicaid combined with cuts in reimbursement for both Medicaid and Medicare. The only way the health care providers can cover the shortfall is to increase the cost to private insurers and direct payers. It seems basic to me.

Rick Ferri
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Post by rokid »

Rick Ferri wrote:The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
Per the BLS, the unadjusted increase for Dec 2008-Dec 2009 for medical care services and medical care commodities is 3.4% and 3.3%, respectively. The unadjusted increase for all CPU-U items is 2.7%. Therefore, the level of health insurance premium increases seem to be unrelated to general health care inflation and, consequently, Medicaid usage.

http://www.bls.gov/news.release/cpi.nr0.htm
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Post by paulob »

frose2 wrote:
Rick Ferri wrote:The only thing I can figure is that there has been a substantial increase in Medicaid recipients, and the low reimbursement rates of the government plan is forcing doctors and hospitals to charge private insurers a lot more money for the same care.
Where have you ever seen a profit-making business that has to be forced to charge higher prices and make more money? They love charging higher prices and making more money.
As I posted to Rick, I am in a related industry, so I am biased.

Let me add a few items: a significant amount of health-care is provided in this country by non-profit entities. I doubt seriously the non-profits "love" charging higher rates.

It can be unfair to lump health-care in with all "profit-making business".
If I was indigent, I could walk into a restaurant and come away with a free meal. But if I walked into a car dealership, I'm not going to drive away in car, new or used, if I can't qualify to pay for the vehicle. However, I walk into an urgent care center with an emergent situation, I would be able to be transported to the hospital ER via ambulance.

That is a fundamental difference between health care and other for profit business. It is much more an issue of cost-shifting than it is an a desire to "love" to up prices.

Unless Congress acts, in a few months the physician payment schedule from Medicare will be reduced by 21%. Congress has been bandaiding this issue for several years now. So, the issue could receive another temporary fix. The industry trend has been for physicians to no longer accept Medicare patients. Medicaid has traditionally paid less than Medicare. But the service provided is not cheaper based on the patients payment source. So, it is an issue of Medicaid not being fully funded to provide for an equivalent benefit. Medicaid payment rates for most providers (e.g. not just physicians, but nursing homes, etc.) in my state declined this fiscal year due to the state budget deficit. FYI, Medicaid is a Federal program, but is also subject to state by state delivery, administration and regulation.

So, if this rate decrease were to happen, then Medicaid is not an offset. That leaves commercial insurance for the source of offset. Not just for the lost of revenue and margin, but a potential reduction to far below the cost of the service.

So, when I see a general statement about "loving to charge higher prices", I wonder, if your own industry faced this kind of revenue decrease for a large segment, how would it react?

Should the hospitals decrease the nurse and aide wages? Since there are shortages in these fields today, will the hospitals be able to meet patient demands in the future?
Paul
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Post by bc3x »

Rick Ferri is almost correct in his diagnosis.

In 2008, 202 million Americans had private insurance, 45 million with Medicare, 43.5 million with Medicaid, 44 million with no coverage and 25 million who are underinsured. Medicare pays about 60% of the cost while Medicaid pays about 17%, resulting in cost shifting from the 158 million to that of the 202 million.

In New York State we have price control on physicians' fees. Even if a medical office does not accept Medicare, the amount charged cannot exceed 10% of what Medicare will allow. To compound the problem, on March 1, 2010; the reimbursement for the most common ophthalmic surgery is scheduled for reduction to 26.9% of the 1980's levels. Try living on 1/4 of your salary from 30 years ago and not indexed for inflation, either. The commercial carriers take their lead from Medicare to reduce reimbursement.

The sentence, "They love charging higher prices and making more money" is too facile and shows a want of understanding of the economic dynamics at work. Precisely because there is price control, perhaps less severe outside of New York, it's not "higher" but "more" which has been the unintended consequence of all the government underfunding. Physician services constitute about 13% of all Medicare expenditures in 2008. Medicare will reimburse at higher rates for new pharmaceutical drugs and new technologies. To recoup the losses, more services and exorbitant services are rendered. Very perverse incentives indeed.

You may gasp, but Avastin is the cheapest in that group of drugs, for ophthalmic use. Anyone who has had a MRI or robotic surgery would also gasp when they are billed. Hospitals and physicians don't set these sky high prices, but it's very difficult to forego the perverse incentives given the low public funding. The alternative is to go into another line of work, hence hospital closings and physicians retiring at an ever younger age.

The Blue Cross/Blue Shields companies have in the past been non-profit and had the insured's interests at heart. When Empire Blue Cross/Blue Shield applied and received permission from New York State to become for-profit, it was obvious that they had become shareholder-centric rather than patient-centric. The fact that they are part of Wellpoint resulted in them behaving more like Wall Street than Main Street.

It would be good if we have the French model (WHO ranks them #1 in health systems) where the government sets the rules and the private sector executes the policies and delivers the care. This is not likely to happen anytime soon. The French also have underfunding problems.
Last edited by bc3x on Sun Jan 31, 2010 9:12 am, edited 1 time in total.
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Post by snowbound »

My provider never sends a notice regarding healthcare rates for the next year, so when the bill comes in towards the end of December you get a little nervous when opening.

Anyway exact same plan, exact same co pay ($17.00) and guess what? My cost this year is $9.88 per month less. Go figure!
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Post by richard »

From our own Austin Frakt (aka sewall), an actual health economist:
There is a pervasive notion that providers of health care can make up for lower payments received from one set of payers (e.g. Medicare, Medicaid, uncompensated care) by increasing prices charged to other payers (e.g. private insurance companies).
...
Claims that reductions in public payments for health care will necessarily show up as commensurate increases in private payments are unfounded.
http://www.thehealthcareblog.com/the_he ... -myth.html
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Post by paulob »

Rick Ferri wrote:It is interesting to me that all health care insurers are raising rates. At first glance this would appear to be collusion for profits, which would be an inaccurate populist reaction. I truly believe that costs really are going up for the insurers. I also believe this is a direct result of government involvement in the health care industry through more people on Medicaid combined with cuts in reimbursement for both Medicaid and Medicare. The only way the health care providers can cover the shortfall is to increase the cost to private insurers and direct payers. It seems basic to me.

Rick Ferri
This is from Zack's review of Tenet's last quarter results. Tenet is the largest publically held hospital chain in the country.
Same-Hospital Data

Revenues increased 5.2 %to $2.24 billion on a same-hospital basis. Same-hospital data does not include Sierra Providence East Medical Center in El Paso, TX, which opened on May 21, 2008. Currently, there are 48 hospitals in same-hospital operations.

Total admissions in the reported quarter recorded a marginal increase of 0.1% as compared to the third quarter of 2008. Commercial managed care admissions decreased 4.5% compared to the year-ago quarter.
Revenue was up 5.2%, yet managed-care admissions were down and, more importantly, overall admissions were almost flat. So revenue per admission is higher, so not a lot of justification for placing blame at the government's doorstep.

However, the bottom line profit is that earnings (overall, not per same hospital) were $4 million vs $120 million in the year ago quarter. Appears to be cost issues in this most recent quarter, not payor mix.
E.G. bad debt ratio increased from 7.6% to 8.5%. Applying the 0.9% increase in bad debts, this would be in the range of $20 million of the $116 million decline in profit.

Since the latter info is not same-hospital data, then the costs could be acquisition related. But I'm too lazy to look at the 10Q.
Paul
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Post by paulob »

bc3x wrote: The Blue Cross/Blue Shields companies have in the past been non-profit and had the insured's interests at heart. When Empire Blue Cross/Blue Shield applied and received permission from New York State to become for-profit, it was obvious that they had become shareholder-centric rather than patient-centric. The fact that they are part of Wellpoint resulted in them behaving more like Wall Street than Main Street.

It would be good if we have the French model (WHO ranks them #1 in health systems) where the government sets the rules and the private sector executes the policies and delivers the care. This is not likely to happen anytime soon. The French also have underfunding problems.
I can certainly sympathize with a perception of shareholder-centric vs patient-centric. But that outcome is not predicated merely by profit, but increases in cost are a huge component.

In my employer's small industry in health-care, the non-profits are less efficient based on government required cost reports. So, the shareholder-centric insurers are paying higher costs of the patient-centric providers.

I'm not familiar with the French model. However, I think our country should forgo our "USA is the best" mantra, and consider other health-care delivery models as our model appears to be (one of?) the highest in terms of GDP%.

I'm not sure the answer is turnover "all the rules" to the government, but I think our system would be more efficient if there were less administrative regulation and more consistency (e.g. fewer) rules among the various payors.
Paul
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Post by bc3x »

sewall: "Another instance in which cost shifting could occur is in a more competitive market in which all providers have roughly the same level of undercompensated care." The exact raison d'etre for the Sustainable Growth Rates and the Resource-Based Relative Value Scale payment system.

Health economists do excellent work; but the the reality is a bit different in the trenches, where the struggle for reimbursement becomes more trying by the day.
Gratitude and Rudyard Kipling's "If"
duhmel1
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Post by duhmel1 »

Why is there such venom only directed towards the insurance companies? A very large portion of the companies' expense is doctors' fees. As long as Obama Care is taking over healthcare and making insurance companies wards of the state, why not regulate physicians?
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paulob
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Post by paulob »

duhmel1 wrote:Why is there such venom only directed towards the insurance companies? A very large portion of the companies' expense is doctors' fees. As long as Obama Care is taking over healthcare and making insurance companies wards of the state, why not regulate physicians?
From my perspective, its already been posted by more than one individual on this thread. Full disclosure again, I am employed in the industry by a service provider. Our industry has been receiving rate increases less than general inflation and certainly less than medical related inflation. But we have for many years received double digit premium increases from the commercial health insurance market for our employees. The net impact on the workforce is both much higher premium increase than wage increase, and a transfer of paying for benefits to the employee. That in itself is not necessarily a bad outcome, but you want it be a fair increase in costs. 10, 20, 30 percent increase in premiums, year after year, that is not sustainable. First employees drop coverage, and ultimately employers stop offering plans. Individuals result to individual coverage and lose the benifit of pooled risk.

Regarding your statement on Obama Care, physicians are already heavily regulated today. Existing regulation is terrible (e.g. google bc3x's reference to "Sustainable Growth Rate" for an example), more regulation of physcians is scary. P.S. I'm not clinical, I'm a finance guy.
Paul
mark500
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Post by mark500 »

I work at a non-profit hospital. 25% of the work we now do is for "self pay" patients...which means no pay.
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paulob
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Post by paulob »

I don't recommend reading anything issued by CMS, but if you want to read the non-media or any non-biased interpretation of "Sustainable Growth Rate", then here is the latest on the government's website:

http://www.cms.hhs.gov/SustainableGRate ... r2010f.pdf

Here is an excerpt where physicians are scheduled for a 21% rate reduction this year:
Table 5. CY 2010 Physician Fee Schedule Conversion Factor
CY 2006 Conversion Factor
$37.8975
CY 2007 Pre-legislation Conversion Factor Update
−5.0% (0.94953)
CY 2007 Pre-legislation Conversion Factor
$35.9848
CY 2008 Pre-legislation Conversion Factor Update
−5.3% (0.94674)
CY 2008 Pre-legislation Conversion Factor
$34.0682
CY 2009 Pre-legislation Total
−11.5% (0.88502)
CY 2009 Pre-legislation Conversion Factor
$30.1510
CY 2010 MEI
1.2% (1.01200)
CY 2010 Update Adjustment Factor
−7.0% (0.93000)
CY 2010 Budget Neutrality Adjustment
0.0% (1.00045)
CY 2010 Total
−5.8% (0.94158)
CY 2010 Conversion Factor
$28.3895
CY 2009 Conversion Factor
$36.0666
CY 2010 Conversion Factor Update
−21.3% (0.78714)
The large schedule decrease is due, in part, to prior year legislature overrides (see negative years in the table). If "ObamaCare" means regulating physicians to you, then I'm glad I didn't go to medical school.
Paul
JordanIB
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Post by JordanIB »

High-deductible Cigna HSA plan in New York. Premiums remained the same this year, as did the deductible.
retcaveman
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Post by retcaveman »

IMO, healthcare costs took off in 1965 with the start of Medicare. (Iam talking economics - not politics!) With the government artificially increasing demand and not increasing supply, costs went up. Also, when a third party (government and/or insurance) is paying, most people don't concern themselves with cost...it's "free." This demand push is also working with prescription drugs and will definitely be a factor if 30 million more people end up getting healthcare (not that they shouldn't have it).

A couple of quotes:
"When you rob Peter to pay Paul, you can always count on the support of Paul." Also, "if you think healthcare is expensive now, wait until it's "free."

Utilities have rate commissions because everyone needs water, gas, electric and it would be bad if companies made excessive profits off of something people need. Couldn't healthcare also be considered a need? There is something like a 4% administrative fee target (cap) for health insurance companies that administer Medicare. Private healthcare companies don't have this.

A few years ago, a Morningstar analyst report said this about a major health insurer:

- "We are worried about the alarming confiscation of shareholder wealth for the enrichment of management"

- "We think executives are egregiously overpaid."

- "We would like to see a separation of the chairman and CEO roles, and a sharp curtailment of executive pay."

Clearly, the rate of increase in healthcare costs is unsustainable. Some retirees from my former employer spend all of their pensions and more just to pay their health premiums. At some point, (for an increasing number of people that point has already arrived), healthcare will be unaffordable. Who will the health insurance companies have to sell it to??? Who will be able to afford it? Government? unions? What will hospitals and doctors do? Charge still more to members of the shrinking group who can pay in order to make up for their lost income/profit? Unsustainable!

IMO, this is the greatest DOMESTIC ISSUE facing this country.
"The wants of mortals are containers that can never be filled." (Socrates)
Fear and Loathing
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Post by Fear and Loathing »

TheEternalVortex wrote:
richard wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
To be fair I guess we should likewise "subsidize" the auto insurance pool with safer/older drivers.
Since health insurance is so expensive and companies are eliminating coverage wholesale - the old will die off quickly, and you will get your wish.

The only solution is a mandatory retirement home for the aged - like any one in a high insurance bracket - where they are allowed to die. Not unlike the "home" in the old movie "Wild in the Streets".....
richard
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Post by richard »

kb0fhp wrote:
TheEternalVortex wrote:
richard wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
To be fair I guess we should likewise "subsidize" the auto insurance pool with safer/older drivers.
Since health insurance is so expensive and companies are eliminating coverage wholesale - the old will die off quickly, and you will get your wish.

The only solution is a mandatory retirement home for the aged - like any one in a high insurance bracket - where they are allowed to die. Not unlike the "home" in the old movie "Wild in the Streets".....
It would be nice if people stopped attributing things to me that I explicitly disagreed with.

It would also be nice if we didn't have political posts in this thread, often with made up facts, but that's another issue.
Fear and Loathing
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Post by Fear and Loathing »

richard wrote:
kb0fhp wrote:
TheEternalVortex wrote:
richard wrote:Insurance rates will always be high until we "subsidize" the insurance pool with healthier/younger individuals.
To be fair I guess we should likewise "subsidize" the auto insurance pool with safer/older drivers.
Since health insurance is so expensive and companies are eliminating coverage wholesale - the old will die off quickly, and you will get your wish.

The only solution is a mandatory retirement home for the aged - like any one in a high insurance bracket - where they are allowed to die. Not unlike the "home" in the old movie "Wild in the Streets".....
It would be nice if people stopped attributing things to me that I explicitly disagreed with.

It would also be nice if we didn't have political posts in this thread, often with made up facts, but that's another issue.
It was not specifically directed at you - if you took it that way I apologize. More like the "royal you"... :D

That said, I have heard many people indicate in conversations, that the reason that health insurance is so high is that there are so many sick people. Since some sources indicate, that most health insurance expense is used in the last years of life, then a simple elimination of old people from coverage would substantially reduce costs. If the old want insurance - then special risk pools should be set up - not unlike the SR8 pools for high risk auto insurance - why should the young and healthy pay for the sick and infirm?.

In addition, genetic pre-screening at birth to determine if coverage should be extended to genetic tendencies - like obesity, diabetes, heart disease, breast cancer, prostate cancer, MS, or a whole myriad of other genetic based diseases or precursors.

People need to be careful what they wish for.....
richard
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Post by richard »

kb0fhp wrote:It was not specifically directed at you - if you took it that way I apologize.
I was objecting to you including a quote attributed to me that I did not say. In fact, I disagreed with the language you quoted.

I realize you were just including language from someone else, but I don't like people claiming I said things that I never said.
bc3x
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Post by bc3x »

kb0fhp,

You seem to relish playing the role of Jonathan Swift (he "advocated" the notion of raising children to supply meat for consumption in Gulliver's Travels).
Gratitude and Rudyard Kipling's "If"
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