Originally Posted by Brian Rush

Health insurers don't raise premiums because they have to. They raise premiums because they can.

I've still not seen anyone tell me why health insurers are magically able to pass on price hikes to consumers when so many other for-profit industries can not. If other businesses could raise prices, they would too.

If someone can give a thoughtful, non-ideologically driven reason why this is the case, maybe we can come up with workable solutions to keep a lid on cost increases. It's not just "greed and profit" because that characterizes most large companies and yet they mostly don't have the power to keep raising prices like this.

It's not like health insurers are the only business interested in maximizing profits. Yet they are almost unique in having a seemingly endless ability to raise rates by double figures almost every year. Certainly these aren't the only greedy capitalist enterprises, are they? So why are they unusual in this regard?

Originally Posted by ziggyX65

This is a common attack on HSAs.

The truth is, many high deductible plans with HSAs (mine included) provides first-dollar 100% coverage for most annual preventative and wellness exams.

It's not perfect, but until someone comes up with a better way to control costs, I think they should remain. Over the last two years of open enrollment periods at my workplace, the traditional HMO/PPO options rose in cost by about 25% and 32%. My HSA/HDHP plan (which was actually improved in 2009 over 2008) is up only 2% over that time.

Frankly I think the primary ideological opposition to HSAs is that there is the perception that only the more affluent can afford the high deductibles and use these accounts and health plans as another way to avoid taxes on some of their earnings (i.e. it's a "tax break for the rich").

The problem with HSAs is that they segment the health insurance market. People won't sign up for HSAs unless they are healthy, with no chronic conditions. People who are less healthy will stay with the traditional insurance. However, with the healthier people leaving traditional insurance for HSAs, premiums will increase for those left behind in the traditional premium. That will drive more people to leave traditional insurance for either HSAs or for no coverage, increasing premiums further for those who stick with traditional policies. The net result is a lot of people losing insurance because they can't afford it, and they tend to be those with health needs that are not well served by an HSA.

Originally Posted by The Wonkette

The problem with HSAs is that they segment the health insurance market. People won't sign up for HSAs unless they are healthy, with no chronic conditions. People who are less healthy will stay with the traditional insurance. However, with the healthier people leaving traditional insurance for HSAs, premiums will increase for those left behind in the traditional premium. That will drive more people to leave traditional insurance for either HSAs or for no coverage, increasing premiums further for those who stick with traditional policies. The net result is a lot of people losing insurance because they can't afford it, and they tend to be those with health needs that are not well served by an HSA.

And that's a fair, non-ideological point which is probably true. Nevertheless, for the time being I appreciate having the option. It doesn't seem there's much public policy that actually *benefits* my demographic, so I'll take it.

I would contend that an even bigger problem is that healthy people who are on individual coverage (the people paying the full freight themselves) are *dropping* it in this economy. The sicker and older, knowing they could have trouble getting insurance again if they did the same, have to beg, borrow or steal to stay insured. And thus the pool of insureds in these individual plans gets sicker and sicker, and premiums rise much more than for employer-sponsored group plans where very few employees choose to "go naked" and forego the subsidized coverage because in the individual plans, the cost per insured is rising more quickly.

Originally Posted by JustPassingThrough

So they attacked the insurance companies for blaming rate increases on the health care bill, even though all of these mandates were about to go into effect. Makes sense. "Don't you dare call us out on the consequences of our crowning achievement!"

This 'HCR caused rate increases' falls squarly into the same category of 'the stimulus ddin't keep unemployment below 8%' - both, nice sound bites if you are a full-fledge memeber of Idiot America. Just keep touching those toes and maintaining that wide stance... your squealing, however, is just fine.

Originally Posted by Justin '77

Originally Posted by wtrg8

The Democrats blundered when they wrote the HCR law and did not correct it. Insurance companies should insure small children under parents plan. This loophole allowed the insurance companies to do this and its perfectly legal now.

"Blundered", my ass. They knew full well this law was written to benefit the existing power structure, and that people were going to get screwed by it, overall. They might not have known ('cared' is probably a more honest word) exactly who got screwed and in exactly which way. But not a phrase, nor word, nor even comma of the health-care abomination was in any way a 'blunder'.

You're pretty quick to discount the CF effect, even though it's been in evidence from the first day this thing was "negotiated". No politician is stupid enough to do this on purpose, but they are more than capable of doing it by lack of due diligence.

I'm not a fan of HCR, so I'm not making excuses. This was a steam-roller job by every player in the game ... except the people the law is intended to help. It was eighteen months of wasted effort, in my opinion. The act that no one in favor of reform wanted to play to win guaranteed a mess ... and we have one. It will do some good, but no where near enough to justify the costs that are now emerging in force.

Originally Posted by playwrite

This 'HCR caused rate increases' falls squarly into the same category of 'the stimulus ddin't keep unemployment below 8%' - both, nice sound bites if you are a full-fledge memeber of Idiot America. Just keep touching those toes and maintaining that wide stance... your squealing, however, is just fine.

I agree with Deb C. The insurance industry reads the political polls just like we do, and they've decided that they can undo this plan now, or at least remove the few items they don't like. They need to make the voters mad, like this is hard at the moment, and get them to elect Rs who will dissect the plan with wide popular support.

We are not in sane times. You shouldn't operate on the assumption we are.

Originally Posted by Marx & Lennon

They need to make the voters mad, like this is hard at the moment, and get them to elect Rs who will dissect the plan with wide popular support.

They need to hope that sentiment rolls over into 2012. They have little to no chance to override a presidential veto of anything that repeals or rolls back some of the reforms. Of course, that assumes the president has a backbone and isn't fearing for re-election if that sentiment persists.

Originally Posted by ziggyX65

I've still not seen anyone tell me why health insurers are magically able to pass on price hikes to consumers when so many other for-profit industries can not. If other businesses could raise prices, they would too.

If someone can give a thoughtful, non-ideologically driven reason why this is the case, maybe we can come up with workable solutions to keep a lid on cost increases. It's not just "greed and profit" because that characterizes most large companies and yet they mostly don't have the power to keep raising prices like this.

It's not like health insurers are the only business interested in maximizing profits. Yet they are almost unique in having a seemingly endless ability to raise rates by double figures almost every year. Certainly these aren't the only greedy capitalist enterprises, are they? So why are they unusual in this regard?

It could have something to do with health insurance companies being exempt from the antitrust laws. I believe there was talk about dropping the exemption during the HC debate, but it didn't happen. It could also have something to do with the political power of health insurance companies.

Originally Posted by ziggyX65

I've still not seen anyone tell me why health insurers are magically able to pass on price hikes to consumers when so many other for-profit industries can not. If other businesses could raise prices, they would too.

If someone can give a thoughtful, non-ideologically driven reason why this is the case, maybe we can come up with workable solutions...

Impossible to answer, given your terms.

I mean, what price can yo put on a health-care provider's obligation to take care of somebody's pain and suffering? If the angel of health says no, due to the injured lack of ability to pay for services rendered by the angel... that simply turns the angel into a devil.

Same can be said of housing, transportation, food and energy providers. It all ought to be a human "right," based simply on Marx's dictum of "From each, according to their means..." Ergo the socialist Commie's answer.

Sad to say, but the evil, pathetic, homophobic, racist, women-hating, Bible-clinging, greedy, lazy, selfish American people simply want paid big bucks for work, services and products rendered.

Originally Posted by ziggyX65

I've still not seen anyone tell me why health insurers are magically able to pass on price hikes to consumers when so many other for-profit industries can not.

Because they have a captive market. For the same reason, they can also increase prices to consumers when there ARE no cost increases to them, and do.

Originally Posted by Brian Rush

Originally Posted by ziggyX65

I've still not seen anyone tell me why health insurers are magically able to pass on price hikes to consumers when so many other for-profit industries can not. If other businesses could raise prices, they would too...

Because they have a captive market. For the same reason, they can also increase prices to consumers when there ARE no cost increases to them, and do.

There is another even more critical reason: the sick and injured have no bargaining power. Note the disparity between the charges imposed for wellness care, typically provided by General Practitioners or by the next tier of licensed professionals: Physicians Assistants and Nurse Practitioners, and those imposed on the ill or injured, typically by specialists and healthcare facilities. It merely proves the point that healthcare, or more accurately ill-care, does not fit the business model in any way, shape or form.

Originally Posted by Brian Rush

For the same reason, they can also increase prices to consumers when there ARE no cost increases to them, and do.

If this is true, it's a failure of regulation and lack of enforcement of anti-trust laws. If there is no truly competitive market and the insurers are in cahoots to all increase premiums in unison, then there's a regulatory problem.

Having said that, I strongly doubt your statement about having no cost increases from providers imposed on them.

Originally Posted by ziggyX65

If this is true, it's a failure of regulation and lack of enforcement of anti-trust laws. If there is no truly competitive market and the insurers are in cahoots to all increase premiums in unison, then there's a regulatory problem.

Having said that, I strongly doubt your statement about having no cost increases from providers imposed on them.

Please look carefully at what I said: not that they have no cost increases from providers imposed on them, but that there is no real relation between such cost increases and insurance premium hikes. The latter happen with or without the former, whenever the companies see an opportunity.

The question is whether regulation and anti-trust laws, which work reasonably well where producers do not have a captive market, can suffice for the insurance industry. I don't think they can. In the end, I believe we're going to need to move to a single-payer system such as most advanced democracies employ. I consider the French system just about ideal.

Originally Posted by Brian Rush

The question is whether regulation and anti-trust laws, which work reasonably well where producers do not have a captive market, can suffice for the insurance industry. I don't think they can. In the end, I believe we're going to need to move to a single-payer system such as most advanced democracies employ. I consider the French system just about ideal.

I agree that a single payer system would be better than what we have now. But I think that a system with a single insurance pool for the USA with the companies and other organizations( eg Unions) then competing for our business would also work.

Originally Posted by radind

I agree that a single payer system would be better than what we have now. But I think that a system with a single insurance pool for the USA with the companies and other organizations( eg Unions) then competing for our business would also work.

Uh, a "single insurance pool" would quickly become a cesspool of corruption and graft, lowering the level of competition to a battle of who could payoff the political party protecting the ever degrading pool.

Good grief, you liberals are dumb.

Originally Posted by Publius

Uh, a "single insurance pool" would quickly become a cesspool of corruption and graft, lowering the level of competition to a battle of who could payoff the political party protecting the ever degrading pool.

I agree. Better to get the for-profit sector out of health insurance altogether, or perhaps reserve them for optional plans available in addition to what's provided publicly (as in France).

Good grief, you liberals are dumb.

Well, at least they're proposing to do something to clean up this mess, instead of pretending fatuously that we have "the best health-care system in the world."

Dumbness is relative.

Originally Posted by Brian Rush

I agree. Better to get the for-profit sector out of health insurance altogether, or perhaps reserve them for optional plans available in addition to what's provided publicly (as in France).



Well, at least they're proposing to do something to clean up this mess, instead of pretending fatuously that we have "the best health-care system in the world."

Dumbness is relative.

http://en.wikipedia.org/wiki/List_of...ife_expectancy

We're number 38!

Now a graph of our ranking over time would be interesting. I seem to remember when I was in college (mid 80's) we were more like 15th or 20th. Not the right direction to be heading!

Sure it is. Get the old, poor, disabled, and sick off the health plans, off welfare, and out of everyone's hair and be rid of the useless wretches. I believe such a thing was once proposed in all seriousness by a Dickens character confronted with homeless children.

There is no such thing as a stupid suggestion. "Do not examine a folly ... just ask what it accomplishes." And if it's that old, old business mantra of "get rid of the deadwood," well, that's what it was meant to accomplish.

Though throwing the deadwood on the fire to provide the rest with heat and light was ... no, not mid-19th Century. A hundred years later, I believe. But that was in another country, and besides, the boogieman is dead/

Originally Posted by Bill66

http://en.wikipedia.org/wiki/List_of...ife_expectancy

We're number 38!

Now a graph of our ranking over time would be interesting. I seem to remember when I was in college (mid 80's) we were more like 15th or 20th. Not the right direction to be heading!

Life expectancy by itself is not a good indicator because of massive differences in how various nations calculate infant mortality, and what counts as a "stillborn" versus a life birth that adds to "infant mortality" statistics.

Originally Posted by Publius

Uh, a "single insurance pool" would quickly become a cesspool of corruption and graft, lowering the level of competition to a battle of who could payoff the political party protecting the ever degrading pool.

Good grief, you liberals are dumb.

You are quite mistaken, I am not a liberal. We do need a real health care insurance system , not the patchwork we now have.
If you look at the Federal employees health insurance system, you will find that it works reaonably well. There is no basis for your assertion.

Is the Affordable Care Act unpopular? If so, exactly why? Here's a poll that clarifies:

http://news.yahoo.com/s/ap/20100925/...BvbGxyZXBlYWw-

A new AP poll finds that Americans who think the law should have done more outnumber those who think the government should stay out of health care by 2-to-1.

...

The poll found that about four in 10 adults think the new law did not go far enough to change the health care system, regardless of whether they support the law, oppose it or remain neutral. On the other side, about one in five say they oppose the law because they think the federal government should not be involved in health care at all.

...

Those numbers are no endorsement for Obama's plan, but the survey also found a deep-seated desire for change that could pose a problem for Republicans. Only 25 percent in the poll said minimal tinkering would suffice for the health care system.

It may well satisfy people who share Braley's outlook if Republicans succeed in tearing out what they dismiss as "Obamacare" by the roots. But GOP leaders would still find themselves in a quandary.
Republicans "are going to have to contend with the 75 percent who want substantial changes in the system," said Stanford political science professor Jon Krosnick, who directed the university's participation.

"Republican legislators' passion to repeal the legislation is understandable if they are paying attention to members of their own party," Krosnick added. "But if they want to be responsive to all Americans, there are more Democrats and independents than there are Republicans."

So, next time you hear that business about HCR being "against the will of the American people," stop a minute and consider the details. The reality is not what you're being told.

Originally Posted by Brian Rush

Is the Affordable Care Act unpopular? If so, exactly why? Here's a poll that clarifies:

http://news.yahoo.com/s/ap/20100925/...BvbGxyZXBlYWw-


So, next time you hear that business about HCR being "against the will of the American people," stop a minute and consider the details. The reality is not what you're being told.

Maybe, maybe not. But if this is indeed an accurate reading of the nation's pulse on the matter, people who say "it didn't go far enough" are idiots if they stay home in protest of that belief.

Originally Posted by ziggyX65

Life expectancy by itself is not a good indicator because of massive differences in how various nations calculate infant mortality, and what counts as a "stillborn" versus a life birth that adds to "infant mortality" statistics.

The US is listed #33 in infant mortality:

http://en.wikipedia.org/wiki/List_of...mortality_rate

So that is operating in the opposite direction, pulling our "life expectancy at age 1 day" even further down the list...

Also, your explanation doesn't explain the dramatic drop in the US ranking over time...

Seems to me US health care overall is overpriced and underperforming dramatically relative to other developed nations.

Originally Posted by Bill66

Seems to me US health care overall is overpriced and underperforming dramatically relative to other developed nations.

Hey, all I want is exactly the kind of healthcare that John Boehner has.

Anyone who examines the healthcare system of the US up close cannot possibly believe that it has any of our best interests at heart. It's as if we went out of our way to manufacture a care system that is virtually guaranteed to malfunction, eventually even pulling the quality of care for the richest people down.

I think I would burst into tears of gratitude if I heard a civil conversation that actually tried to assess our needs and our current system and then tried to define a transition from our current insanity to something that made a little sense.

For all of you who think Obama's health care reform was at least a start, you may not have realized that it would contribute to a huge monopoly in the industry. Monopolies have extreme power over people. Is that really a start or the end of quality health care for the masses?

Insurer Cuts Health Plans as New Law Takes Hold - By REED ABELSON
Published: September 30, 2010

The Principal Financial Group announced on Thursday that it planned to stop selling health insurance, another sign of upheaval emerging among insurers as the new federal health law starts to take effect.

The company, based in Iowa, provides coverage to about 840,000 people who receive their insurance through an employer.

Principal’s decision closely tracks moves by other insurers that have indicated in recent weeks that they plan to drop out of certain segments of the market, like the business of selling child-only policies. State regulators say some insurance companies are already threatening to leave particular markets because of the new law. And some regulators in states like Maine and Iowa have asked the Obama administration to give insurers more time to comply with some of the new rules.

“What you’re seeing is the beginning of some serious math and some posturing,” said Len Nichols, a health economist and policy expert at George Mason University. While some insurers, like Principal, are choosing to leave the business rather than make the necessary investments to stay, others may be simply trying to delay some of the new rules or overturn them, he said.

McDonald’s recently asked federal officials for an exemption to rules that would ban the kind of health plans many of its restaurant workers have, because the existing policies sharply limit coverage. The McDonald’s push was first reported by The Wall Street Journal on Wednesday night. A McDonald’s spokeswoman declined to comment on that report, and the company has denied any intention of dropping coverage for its employees.

So far, the administration has signaled at least some willingness to listen. In the case of McDonald’s, federal health officials told the insurer responsible for providing these plans that it would not be affected by new rules prohibiting annual limits on coverage. The new waiver will allow McDonald’s and other companies to continue offering such plans, which cap benefits, to their workers.

The administration has already issued dozens of such waivers, as insurers and companies try to influence proposals for regulations to put the law in place. As far as giving insurers continued leeway to sell more restrictive coverage than the legislation intended, administration officials say they are trying to ensure that people do not lose their benefits before 2014, when the law is fully in effect.

“It’s the best some people can do right now, and we don’t want to disrupt it,” said Nancy-Ann DeParle, who heads the Office of Health Reform at the White House. She emphasized that the administration had been working closely with insurers and employers to deal with their concerns and objections to some of the rules. “I think we’re working together very constructively,” she said.

McDonald’s, which confirmed that its insurance carrier received a waiver from the government on annual limits, says it is negotiating with federal officials and others to determine how best to maintain employee coverage. Many of its restaurant workers are covered under plans that do not provide broad protections and limit individual insurance coverage to a few thousand dollars a year. Such plans are known as mini-med or limited benefit policies. Medical bills beyond those limits have to be paid out of pocket by employees.

The company and its franchises “are committed to finding a solution whereby we can continue to provide health care options,” said Danya Proud, McDonald’s spokeswoman.

At the Principal Financial Group, the company’s decision reflected its assessment of its ability to compete in the environment created by the new law. “Now scale really matters,” said Daniel J. Houston, a senior executive at Principal, which is headquartered in Des Moines. “We don’t have a significant concentration in any one market.”

Because Principal Financial is primarily in the business of asset management, it decided not to make the investments needed to remain competitive as a health insurer, Mr. Houston said. The company, which focused on plans sold to small businesses for their employees, does not participate in other markets, like selling policies to individuals or for people enrolled in Medicare or Medicaid.

Other aspects of the health care regulations are worrying some state insurance commissioners, who fear that insurers are going to stop selling policies in some areas of coverage. For example, in the case of child-only policies, the new rules require insurers to offer coverage to even those children who are seriously ill, leading some insurers to balk at the idea that they will be forced to cover too many sick children. Aetna, Cigna and WellPoint, among others, have said they will stop selling new policies in some states.

“Disruption in our marketplaces is a concern for insurance commissioners,” said Jane L. Cline, the president of the National Association of Insurance Commissioners, who is also a West Virginia regulator.

In the case of Principal Financial, UnitedHealth Group’s insurance plans have agreed to offer coverage to Principal’s customers. “They are clearly going to be a long-term player in this market,” Mr. Houston said.

More insurers are likely to follow Principal’s lead, especially as they try to meet the new rules that require plans to spend at least 80 cents of every dollar they collect in premiums on the welfare of their customers. Many of the big insurers have been lobbying federal officials to forestall or drastically alter those rules.

“It’s just going to drive the little guys out,” said Robert Laszewski, a health policy consultant in Alexandria, Va. Smaller players like Principal in states like Iowa, Missouri and elsewhere will not be able to compete because they do not have the resources and economies of scale of players like UnitedHealth, which is among the nation’s largest health insurers.

Mr. Laszewski is worried that the ensuing concentration is likely to lead to higher prices because large players will no longer face the competition from the smaller plans. “It’s just the UnitedHealthcare full employment act,” he said.