Ghost Town Reform Forum

Discussion in 'Health Care Reform Forum' started by Yagents, Jul 7, 2017.

  1. kgmom219
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    kgmom219 Well-Known Member

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    No, but I am 100% referral based, which makes a difference. If someone calls, I am going to help them. And what AC is referring to applied in 2016, not 2017. If they ask, I tell them, but I certainly don't bring it up.
     
  2. traceyemoon
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    traceyemoon Well-Known Member

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    I still actively write it. Most of my now Medicare clients started out on ACA and the rest are referrals from ACA or Medicare (so now 2nd wave of referrals from ACA).

    Yes, I have an aversion to not getting paid. On the other hand, it is generating other plans that I actually get paid for: dental, vision, disability, life, Indemnity, cancer, short-term recovery...

    So prospecting is on the back-end, what else can I help you with, your parents, friends.

    Would you like fries with that?
     
  3. kgmom219
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    kgmom219 Well-Known Member

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  4. Surancedawg
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    Surancedawg Well-Known Member

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    I have found that the one thing Obamacare enrollees get rid of faster than their Obamacare is the package of supplemental polices you load them up with in a futile attempt to make any money off of them.
     
  5. Evan
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    Evan Well-Known Member

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  6. junkman
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    junkman Well-Known Member

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    Nothing to deal with adverse selection. Allows those able to pass underwriting to bail. Allows carriers to write noncompliant plan which will allow them to write overpriced, cover-nothing plans while pretending to offer benefits. Nothing to reduce premiums by following known requirements for running a block of business. Back to the wild west of insurance.

    Repub health care fail. **** them. They should be fired but won't - yet. They should at least be forced to buy onEx paying full nondeductible premium for whatever they come up with.
     
    Last edited: Jul 15, 2017
  7. bluediamond
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    bluediamond Well-Known Member

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  8. junkman
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    junkman Well-Known Member

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    They are simply letting it crash. Anyone with other options is bailing. The healthy middle class are going without or jumping to non-insurance options.

    3-4% of enrollees on a normal group account for 40% of claims. That means we need the other 96-97% enrolled to offset the sickies. It ain't happening.
     
  9. FLM2
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    FLM2 Well-Known Member

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    If those are the real numbers (I'm not sure, it may be 10% account for 50% of the claims) the pragmatic solution is to take those 3-4% and put them in a high risk pool so it is away from everyone else and treat it like a sunk cost for the government. Finding the money from the total Federal budget is far easier than out of the pockets of a relatively small number of people and there is tons of money wasted in the Federal budget that could be moved to this.

    You can't legislate away the bad health of millions of Americans, all you can do is deal with it in the most cost effective (and fair) way possible. What isn't fair is for those in the IFP pool to pay for the claims of those people with higher premiums, it's a national issue.

    The others then have a risk pool that is 60% of the current total, that will significantly lower rates, and when someone in that pool develops conditions that moves them into the high risk range then they transition.
     
  10. Ann H
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    Ann H Well-Known Member

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    You might be right about that. There are no viable ways to fix this while staying inside the current system.

    In the meantime, there are several ways to a new system overhaul. For instance, the medical community might do it. If doctors published their fees and required payment up front, this could morph into a typical business. Right now it's a bizarre business, where they overcharge due to the under-payers, and nobody knows the fee until the service is rendered. That's not a normal business practice in any economy. During that process, people need catastrophic coverage, so hopefully there would be a combination of ancillary products and hopefully CAT plans if they are allowed. Not a perfect transition for sure, but it's a grass-roots solution. Some of the best solutions are grass-roots.

    Until someone, whether Congress or grass-roots is willing to deal with our bizarre 3rd party payer system, the costs won't go down. The best economy is where the consumer and the provider agree on the product/service and the price. Right now our "3rd party" payer system is actually 5-party, with the consumer, employer, tax system, and insurer involved in the transaction with the provider. That leaves nobody feeling that they can control it. Bizarre.

    There are other ways to fix it - employer required plans, single payer, etc., but those are still 3rd party payer systems that just delay things until we deal with the root issues. If I bought my dinner with a 3-party payer system, I would wonder why my steak costs $4,000 and I'm forced to eat scrambled eggs for $500.

    So, in the end, a crash of our bizarre system might cause a real system to arise. I hope we get there with some semblance of responsibility. Right now, I see nothing in Wash. DC that points to that goal. And, I guess that's why I visit my favorite "ghost town" just once a week at this point. Someday we will have more to talk about, but for 2018 it looks like a 2017 repeat.
     

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