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Health Insurers Now Have To Take Their Medicine

A

Ausm

Lifer
W00t finally some of the Affordable Healthcare act is being implemented! It is one of the major components that the Republicans and Big Insurance hated the most called the PPCA limits. In layman terms to reduce the amount of padding between actually claims and their profit margins.

Who would of thunk that the American Health insurance cartels would have to actually insure people!!

American people can start rejoicing!

http://crooksandliars.com/karoli/health-insurers-now-have-take-their-medicin
 
Ausm said:
W00t finally some of the Affordable Healthcare act is being implemented! It is one of the major components that the Republicans and Big Insurance hated the most called the PPCA limits. In layman terms to reduce the amount of padding between actually claims and their profit margins.

Who would of thunk that the American Health insurance cartels would have to actually insure people!!

American people can start rejoicing!

http://crooksandliars.com/karoli/health-insurers-now-have-take-their-medicin
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Lol you're really showing them. That's why the stock of every major health insurer has dramatically outperformed the S&P 500 since Obama was elected.

http://finance.yahoo.com/echarts?s=...pe=line;crosshair=on;ohlcvalues=0;logscale=on

(change the start date on the chart to Nov 2008)

Why do you think that this?
 
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When does the "affordable" part kick in? I can barley afford it now and it goes up 10% every year like clockwork maybe not soon.
 
the DRIZZLE said:
Lol you're really showing them. That's why the stock of every major health insurer has dramatically outperformed the S&P 500 since Obama was elected.

http://finance.yahoo.com/echarts?s=...pe=line;crosshair=on;ohlcvalues=0;logscale=on

(change the start date on the chart to Nov 2008)

Why do you think that this?
Click to expand...

Do you know why? Is there some loophole we don't know about?

Also, is out-performing the market in the past few years really an accomplishment? Markets have been stagnant since 2008...
 
Zebo said:
When does the "affordable" part kick in? I can barley afford it now and it goes up 10% every year like clockwork maybe not soon.
Click to expand...


Never, the insurance companies have both parties in their pockets and always will reap the rewards of their lobbying dollars.
 
Dman8777 said:
Do you know why? Is there some loophole we don't know about?

Also, is out-performing the market in the past few years really an accomplishment? Markets have been stagnant since 2008...
Click to expand...

Outperforming the market on a risk adjusted basis is always an accomplishment, and if you look at the chart their performance has been exceptional.

The reason they are doing so well is that Obamacare is the best thing to ever happen to them. They have 20million + new customers, many of whom come with government subsidies. The had the adopt some policies that will increase their costs such as covering preexisting conditions, but those costs will be passed on to the other customers who didn't have these preexisting conditions and must buy the product by law.

The policy described by the OP requires them to spend a certain percentage of the premiums on healthcare costs which would seem like a negative but they were spending about that percentage on health care before anyway so it won't have much effect.
 
Yeah who's to say they werent only running at 8% margin and Obama gave them cover of law /legal collusion to see it through at 15%.
 
Zebo said:
Yeah who's to say they werent only running at 8% margin and Obama gave them cover of law /legal collusion to see it through at 15%.
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Here's an article from 2009 about the loss ratios back then. http://www.nytimes.com/2009/11/03/business/03insure.html

It was 84% for large customers 80% for small business, and 74% for individuals according to the Senate report. Considering that the majority of people work for large companies and almost no one buys individual policies this will have very little effect and is dominated by the flood of new customers.
 
So basically, the article in the OP is exagerating reality...

Is their claim with respect to Medicare correct? ie 92 - 93% MLR?

It's kind of sad that they call it that though, medical loss ratio. Their product is medical care for people. In normal business, it's just called a profit margin. Imagine if GM referred to their cars as PWBP: profit waste by-products.
 
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the DRIZZLE said:
Here's an article from 2009 about the loss ratios back then. http://www.nytimes.com/2009/11/03/business/03insure.html

It was 84% for large customers 80% for small business, and 74% for individuals according to the Senate report. Considering that the majority of people work for large companies and almost no one buys individual policies this will have very little effect and is dominated by the flood of new customers.
Click to expand...

Interesting so he gave them margins they were operating under. Course I'm sure some were higher and some insurers lower. They are going to pad this now as to not run into accounting problems at years end and hit 15-20% exactly. So that's billions they will collect interest on before sending it back to consumers. I guarantee even this provision will account for a rate increase. (although rebated but you still have to pay it initially)
 
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Ausm said:
Um if you look at the overall stock market the Dow alone has gained 7000 points since President Obama has gotten into office.
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How much of that gain was realized through printing money and inflation since President Obama took office? Perhaps you have taken note of the price of food lately?
 
Ausm said:
Um if you look at the overall stock market the Dow alone has gained 7000 points since President Obama has gotten into office.
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The red line is the S&P500 which is a better proxy for the overall market then the Dow. The insurance companies have all significantly outperformed the market. Obama has been incredibly good for them.
 
Zebo said:
Interesting so he gave them margins they were operating under. Course I'm sure some were higher and some insurers lower. They are going to pad this now as to not run into accounting problems at years end and hit 15-20% exactly. So that's billions they will collect interest on before sending it back to consumers. I guarantee even this provision will account for a rate increase. (although rebated but you still have to pay it initially)
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Um, no. If you read the article, it states

The current MLR, just for perspective, is about 40-45%. That means for every dollar paid toward health coverage, only 60 cents or so goes to actual health costs.
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And since Medicare has an MLR of about 8%, it's clear that insurance companies can still make a good profit with an MLR of 15 (for large groups) and 20% for other customers.

There was also this interesting tidbit in the article:

The only reason for insurers' efforts to deny benefits was simply to boost up the bottom line, and in many cases, the only reason for big premium hikes was also to boost that bottom line and the profits distributed to shareholders. Now insurers will find themselves in the business of actually paying for medical benefits. The regulations, by the way, do not allow them to include agents' commissions in their "medical expense" column.
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So here we see an alternative explanation for the big rate hikes that righties have been blaming on Obamacare. And we can also see that - if anything - this new MLR requirement will force rates to go DOWN, not up.
 
shira said:
Um, no. If you read the article, it states



And since Medicare has an MLR of about 8%, it's clear that insurance companies can still make a good profit with an MLR of 15 (for large groups) and 20% for other customers.

There was also this interesting tidbit in the article:



So here we see an alternative explanation for the big rate hikes that righties have been blaming on Obamacare. And we can also see that - if anything - this new MLR requirement will force rates to go DOWN, not up.
Click to expand...

You can trust the number from some random blog or you trust the numbers that I posted from the Senate report published in the ultraconservative New York Times.
 
This plot tells you just about everything you need to know about what's wrong with health care in America:

cost_longlife75.gif


In case you're wondering, that spike for the United States isn't due to "malpractice abuse" (we know that malpractice-related costs - including defensive medicine - are less than 1/2 of 1% of total health care costs in America). No, a BIG portion of that spike is profit. And the insurance companies and their right-wing politicians are desperately trying to scare the American public about Obamacare so that they can keep theit current system and continue to pocket their unconscionable profits.
 
shira said:
This plot tells you just about everything you need to know about what's wrong with health care in America:


In case you're wondering, that spike for the United States isn't due to "malpractice abuse" (we know that malpractice-related costs - including defensive medicine - are less than 1/2 of 1% of total health care costs in America). No, a BIG portion of that spike is profit. And the insurance companies and their right-wing politicians are desperately trying to scare the American public about Obamacare so that they can keep the obscene profits.
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Read the damn thread. I've pretty conclusively shown that Obamacare has been a boon to the health care insurers.
 
And this excerpt from the article really tells it like it is:

If you believe that the end of private, for-profit health insurance is some type of nefarious step towards a socialist society, then you might want to attend church this Sunday to mourn the loss of health insurers being able to worm out of covering the bills of a cancer patient because she forgot to write down on her application that she had skin acne for three months when she was a teenager.

Of course, those of you who fear the inevitable arrival of universal health care really shouldn’t be too fretful. There will always be a for-profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need

Everyone wins-except the for-profit health insurers.
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I'm still waiting for the affordable part. I don't take all my prescribed drugs now because I can't afford them. Funny, I could afford them before all this healthcare BS started and my insurance company implemented changes.
 
This won't be as easy a goal for insurers to meet as you may think. The problem is that the 85% medical loss ratio mandated isn't really a medical loss ratio. It includes many non-medical and non-administrative costs, like agents' commissions, which have historically not been part of the MLR calculation into the equation. So, if you compare the "new" MLR to the "old" MLR it's really about an 89-92% MLR which will be more difficult.
 
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