Good Article about the future of health insurance

ABC said:
The Implications of Health-Care Reform - BusinessWeek.com - MSNBC.com

Here is a good article about health insurance. Something is going to happen in the next presidents term.

The only think I don't like is they keep referring to Mass. health plan as the model.
Click to expand...

They also mentioned Maine as a state that has come closest to achieving universal health care. This is a crock. The state implemented a state subsidized plan that went broke early on and was never able to expand significantly. They stopped taking new enrollees over a year ago. Anthem ran the program under contract with the state but abandoned it as being a money loser. Now, the state is trying to get Harvard Pilgrim to take it over even though it has frozen enrollment. The legislature has enacted a food and beverage tax to try to prop it up but the state citizens taxpayers alliance is collecting signatures for a referendum to overturn it.

Meanwhile, Maine has almost the highest rates in the nation. Guaranteed issue of course. So don't look to Massachusetts as a model but don't look to Maine either.

Winter
 
I really dont understand how politicians can use a model that has failed as the right course of action?

One thing I have learned being in this business for almost a decade is that the working poor have the worst health conditions for the most part. So to insure this class with 1st dollar benefit is going to cost a great deal. A for profit company is not going to take on this risk. So then who is going to pay?

I agree these people do need health care but at what cost to the tax payer?

I think they should be given some type of HSA plan where the preventive care is covered at 100% but the insured has to take an active roll with there health care.



Winter said:
They also mentioned Maine as a state that has come closest to achieving universal health care. This is a crock. The state implemented a state subsidized plan that went broke early on and was never able to expand significantly. They stopped taking new enrollees over a year ago. Anthem ran the program under contract with the state but abandoned it as being a money loser. Now, the state is trying to get Harvard Pilgrim to take it over even though it has frozen enrollment. The legislature has enacted a food and beverage tax to try to prop it up but the state citizens taxpayers alliance is collecting signatures for a referendum to overturn it.

Meanwhile, Maine has almost the highest rates in the nation. Guaranteed issue of course. So don't look to Massachusetts as a model but don't look to Maine either.

Winter
Click to expand...
 
Meanwhile, Maine has almost the highest rates in the nation.
Click to expand...

Post some examples - lets say a 50 year old couple.

People need to be exposed to how GI is a complete failure and unaffordable. I had a 52 year old today complain about $130/mo plan I quoted her - unbelievable!!! Get real...

As long as employers continue to receive tax benefits to subsidize health care, this will happen.

I look forward to some sample Maine rates. Also curious if there is ANY commission in Maine to agents.
 
I didn't read the entire article...I started--read a few sentences. And then skimmed and then just gave up. I don't understand why anybody would think that the Govt can handle a national healthcare program. Look at the Medicare mess, the Medicaid mess....heck look at VA! I've heard CHAMPUS was a mess and then Tricare...well, I don't know if it's improved since my husband got out of the Army in 2000 but that was a headache when we were dealing with it. Military moves are frequent..part of the deal but the hassle of moving between Tricare zones was crazy. On one move I was afraid I wouldn't have benefits because of one form that wasn't complete prior to moving to the new installation. Just stupid stuff.

Plus, I hear a lot of people say "Well, Canada has free healthcare for their citizens, why can't we?" Hello...Canadians will come down here for medical care over waiting on long waiting lists for care. I know of several cases where Canadians have come down here to have their babies because of the problems up there (I live within 100 miles of the border). Plus, their taxes are higher (it's not FREE, they're paying for it via taxes). The same goes in Europe. I don't know the tax rates in either but just from my international business college classes, I know they're higher because of these benefits. I've heard that France is having a problem with productivity because of these benefits--short work days, work weeks, etc. (Sorry, no citation, just based on remembering an article about it a few months back in BusinessWeek or something).

I'd rather see some changes with the tax credits or something. Even if it's just changing medical expenses from being an itemized deduction to an above the line deduction. The govt needs to start fixing Medicare and Social Security before they even think about taking on universal healthcare. But who am I....
 
TXINSURANCE said:
Post some examples - lets say a 50 year old couple.

People need to be exposed to how GI is a complete failure and unaffordable. I had a 52 year old today complain about $130/mo plan I quoted her - unbelievable!!! Get real...

As long as employers continue to receive tax benefits to subsidize health care, this will happen.

I look forward to some sample Maine rates. Also curious if there is ANY commission in Maine to agents.
Click to expand...

Actually, I am not much help here because I do not work with health plans other than medicare and some limited critical illness. However, there is a reason for that. In Maine there are very, very, very few agents doing health plans unless they are with Anthem/BC or Aetna, and some Mega agents sliming around. Other than that, all of the carriers have left the state in any meaningful way. Anthem really has almost all of the business and you have to be captive to be with them (or close to it, they have some process where you have to certify that you do X amount of health care business each month and that you will do X with them).

In guaranteed issue states most of the non-group business is just done by telephone or website enrollment and it is pretty well settled that Anthem is the only player so they dont even bother to advertise anywhere that I have ever seen.

As far as the rates, perhaps if you had a moment you could go to Anthem's website at www.anthem.com and select Maine and give us an opinion on how good, bad, or exagerated the comments about the rates in Maine are. I really have nothing to compare it to because as I have stated almost all agents are shut out of the market here or do not find it worth the time. With guaranteed issue, and only one carrier (Anthem with a little bit of Aetna business as well) agents are not really needed, allegedly. How much suitability analysis are you going to do if there is guaranteed issue and only one carrier in the game?

If the rates do not look as bad as has been represented to me then I will simply adjust my thinking, but they are not good, I will say that.

Side note. Couple months ago, I saw an ad on TV for Assurant health plans so I called then up to see if there was something new. They said they did not offer plans in Maine. Thanks, I think. Nice way to spend your advertising dollars. This was on cable TV where presumably they can control where their ads run by zip code or by some process.

Winter
 
But when insurance companies can't reject anyone or adjust rates based on risk, they end up charging everyone more. That's what happened in Maine after 1993, when the state passed a guaranteed-issue law. "Rates shot up dramatically because insurers could no longer cherry-pick," says Tom Wright, a health-insurance broker in Yarmouth, Maine. When prices rose, many healthy people elected to take their chances and drop their coverage, while sick people stayed on. Insurers then had to raise rates even higher. "We've entered an actuarial death spiral, and it's accelerating," says Wright.

Buying Your Own Health Insurance - Kiplinger.com

In June 2003, Maine Governor John Baldacci (D) signed the Dirigo Health Reform Act, creating a government-run, taxpayer-funded health insurance and medical care program for the state. Many have praised the initiative, which became effective in September of that year, as a bold effort to reform Maine’s health insurance market.
But the individual and small group insurance markets in Maine had been in turmoil for more than a decade because of previous “bold efforts” to reform health insurance in Maine.
In 1993, the Maine legislature imposed modified community rating (CR) and guaranteed issue (GI) mandates on the individual insurance market in an effort to increase access to health insurance for the uninsured population.

Maine Health Insurance: Out of the Frying Pan, into the Fire - by Conrad F. Meier - The Heartland Institute

For more info on Dirigo

InsureBlog: Maine Failure

InsureBlog: Dirigo on Life Support

And if you want to run your own rates for non-Dirigo plans

Maine Health Insurance
 
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