Here It Comes: Governement Health Plan

Does everyone really realize how close we are to being put out of business as brokers?

A Gov health care system for the so called un insured will crush us. Of the un insured I would guess about 1/3 of them are the ones that need a true intervention.

Right now with the new SCHIP rules a house hold of 4 earning under $63,000 a year can put their kids on the states plan.

I think the Gov. really needs to market the plans that are already available.

If there is a Gov health plan to so call keep the Private companies in check it will destroy the private market. You can kiss good bye all the small regional carriers that are renting networks. So then we will end up with 3 carriers maybe 4 for the entire county. What happens then?

I would feel a lot better if I knew what the goal of the Gov health plan is. Is it to insure the un insured? Is it eliminate the health insurance burden on doing business? Is it to eliminate all private carriers? Whatever private plan they come up with how are they going to pay for it?


As a health insurance broker I realize that there is a 50% chance I will be out of business come next year. Ten years of eating buckets of shits to get and keep clients will be flushed down the toilet.
 
End both wars and close all our foreign military bases
Cut the military budget in half.
Eliminate NASA.
Eliminate agricultural subsidies
Eliminate all pork spending
End medicare and medicaid
Eliminate the private insurance companies
Institute an SSA-like single-payor system that will set prices for medical care and drugs
Revamp the doctor training curriculum so that we can turn out docs in 4 years and not 8
Send all medical students (nurses, docs, etc.) to school for free in return for 8 years of public service at $60,000 a year tax free
Pay all doctors and nurses (after public internship) $100,000 a year state and federal TAX FREE.

Do the above and we have plenty of money in the system to give everyone FREE health care from cradle to grave. And I have no doubt that our best and brightest young people will flock to the medical professions... similar to how they flock to the service academies.

Side note - I find NASA to be extremely important to our future, as well as national security. If you look at the technologies that transpired because of our (admittedly bloated) space program it is impressive.

I agree it should be streamlined and many aspects privatized. We are still flying around 1970's shuttles and running it like the Cold War, no argument there.

Over time NASA could potentially be a revenue source based on private demand - I know pipe dream right now. It is such a SMALL amount of the Federal budget it is hardly worth talking about when you look at our debt levels that are not sustainable.
 
Al -

- Do you propose a mandate for health insurance?

I don't care one way or the other. With or without a mandate is fine with me. I want to solve the problem. I don't much care HOW it is solved. I don't have a dog in this fight... I just want the fight to be over!


- Do you want to cover illegal (or undocumented) aliens? To be specific, I'm talking people who do not have a TIN or SSN number.

Just for emergency care... once they are stable they are deported.


Al
 
. When was the last new Medical School opened in this country?


As with the British National Health Service, the new doctors wont necessarily come from this country.

Those wackos that bombed the airport in Scotland- I dont mean Lockerbie- I mean the incident a while back where the SUV's rammed into the aiport and firebombed it. The wackos were Pakastani doctors working for the National Health Serive. Real cream puffs.
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I don't care one way or the other. With or without a mandate is fine with me. I want to solve the problem. I don't much care HOW it is solved. I don't have a dog in this fight... I just want the fight to be over!

Al



Al just voted "present."
 
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Today a group including AHIP, AMA and others are meeting with Obama to present their proposal for a massive cost reduction strategy. This is part of the overall negotiaton that is going on between the players (gov and private). Will be curious to see the after-reactions from both sides.

Here is what I suspect is going to end up happening:

1 - Creation or re-creation of a univeral public health plan for those who are truly uninsurable in the private market or whose private insurance is not up to par with the public plan. For the sake of naming it, I'll call it FHIP (Fed Health Insurance Plan). FHIP might also be delegated to the states, so we'd have SHIP in each state with both state and federal funding. Also continued enhancement of Medicaid and SCHIP programs to ensure universal coverage availabililty.

2 - NO mandate. Carriers want a mandate to do GI, but this administration has backed off of it. They will use the FHIP/SHIP in place of the mandate. Mandate is a scary (should I say "scarry") proposition which would have a lot of opposition.

3 - Group would remain relatively untouched. This administration is on record as wanting to increase employer-sponsored health coverage. Likely a tax incentive will be created to encourage more employers to offer health benefits to their employees. At the same time, employers who push to FHIP/SHIP instead would pay a penalty as percentage of payroll to help cover the costs. Expect to see a slight reduction in commissions on group business (see bloat reduction below).

4 - IFP. Private health plans continue to be available for those who can pass underwriting. Underwriting will be both standardized and more "relaxed" to allow more people onto private plans. Absent a mandate, there will still be declines. Plans themselves may become more standardized across the states with more similarities in coverage. The ability to decline high risk will expose the carriers to a requirement to help fund the FHIP/SHIP plan, which will in part come from agent commissions.

Now the hard part, trimming the "bloat".

Private carriers are going to have to reduce non-medical care expenses and will probably be forced to move up to the 85% level. That will mean a reduction in both administrative bloat and agent commissions.

I would expect to see a drop in group commissions by a couple of points with IFP being hit harder. 20/10 will be a thing of the past and most likely plans will pay something like 5% flat with an enhanced FYC of maybe 7-8% something like that. A portion of the reduction on commissions would be provided to FHIP/SHIP to help fund that program.

Also, I would expect to see a small agent enrollment fee paid out, something like $50 per person to help enroll in FHIP/SHIP.
 
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Dave -

As usually, I think you are pretty much right on the money with what my crystal ball says. I'd like to see group at 8% and IFP at 10% across the board (new, renewal, everything), but this is likely a pipe dream. I think higher first year commissions are out the window.

The solution, as you outlined it, provides political cover for almost everyone (despite everything, this is important to politicians), addresses what I think most people want to do with health insurance (not necessarily health care though).

It leaves cost containment of health care for a future generation, which is really the toughest problem to fix. This is unfortunate, but hopefully, they will address a few things.

My test case for any plan is a family of 4 making $60K a year with a health problem. They currently have little opportunities in the market (SCHIP for the kids, maybe). Perhaps a high deductible plan, but they can't afford the deductible. It sounds like FHIP should help this situation, so it works for me.

Dan
 
The gov't can address supply all it wants but until they address demand costs will continue to soar and anything established will be broke within 10 to 20 years.

Addressing demand simply means living a healthier lifestyle.
 
Speaking of cost containment, here is a summary (sort of) of today's meeting with Obama:

Health care groups propose cost controls - May. 11, 2009


For IFP, maybe 10% FYC 5% renewals something like that. The carriers are still going to want to provide and enhanced FYC to promote new sales. But for certain agent commissions, at least on IFP, will be cut.

Also, I could see group going to a per head flat amount instead of % commission (like Kaiser used to do).
 
Today a group including AHIP, AMA and others are meeting with Obama to present their proposal for a massive cost reduction strategy. This is part of the overall negotiaton that is going on between the players (gov and private). Will be curious to see the after-reactions from both sides.

Here is what I suspect is going to end up happening:

1 - Creation or re-creation of a univeral public health plan for those who are truly uninsurable in the private market or whose private insurance is not up to par with the public plan. For the sake of naming it, I'll call it FHIP (Fed Health Insurance Plan). FHIP might also be delegated to the states, so we'd have SHIP in each state with both state and federal funding. Also continued enhancement of Medicaid and SCHIP programs to ensure universal coverage availabililty.

2 - NO mandate. Carriers want a mandate to do GI, but this administration has backed off of it. They will use the FHIP/SHIP in place of the mandate. Mandate is a scary (should I say "scarry") proposition which would have a lot of opposition.

3 - Group would remain relatively untouched. This administration is on record as wanting to increase employer-sponsored health coverage. Likely a tax incentive will be created to encourage more employers to offer health benefits to their employees. At the same time, employers who push to FHIP/SHIP instead would pay a penalty as percentage of payroll to help cover the costs. Expect to see a slight reduction in commissions on group business (see bloat reduction below).

4 - IFP. Private health plans continue to be available for those who can pass underwriting. Underwriting will be both standardized and more "relaxed" to allow more people onto private plans. Absent a mandate, there will still be declines. Plans themselves may become more standardized across the states with more similarities in coverage. The ability to decline high risk will expose the carriers to a requirement to help fund the FHIP/SHIP plan, which will in part come from agent commissions.

Now the hard part, trimming the "bloat".

Private carriers are going to have to reduce non-medical care expenses and will probably be forced to move up to the 85% level. That will mean a reduction in both administrative bloat and agent commissions.

I would expect to see a drop in group commissions by a couple of points with IFP being hit harder. 20/10 will be a thing of the past and most likely plans will pay something like 5% flat with an enhanced FYC of maybe 7-8% something like that. A portion of the reduction on commissions would be provided to FHIP/SHIP to help fund that program.

Also, I would expect to see a small agent enrollment fee paid out, something like $50 per person to help enroll in FHIP/SHIP.


The mandate issue is a hard one to analyze because it is one of those area where politics makes for strange bedfellows. True, the carriers want the mandate because they want the volume to make up for narrow margins that are coming. However, Hillary, and the Clintonistas also argued for a mandate for different reasons while Obama opposed it. So the lack of a mandate would not just be a matter of Obama beating the carriers back. Obama never wanted it. Ironically, Obama agreed with McCain that the problem was just one of affordability. Which leads to the issue of tax incentives for IFP plans in addition to group plans. Such as a substantial tax credit and subsidy where no taxes are paid anyway. This would put Obama and McCain in sync in some areas and he and the Hillary wing of the party apart in others. Strange bedfellows.


I continue to project that we are going to end out with guaranteed issue rather than a federal risk pool and that is where the gamechanger will or will not be. I don't know of course. I am just saying that is where I would place my money. It, of course, is not necessarily a black and white scenario anyway. We could end out with an arrangement where, for example, we have guaranteed issue with the exception of a long list of conditions such that one could argue that it really is or is not guaranteed issue in the end.
Probably that could very well happen. Thus the carrier would be able to decline for certain reasons but would still end out having to take many that they would otherwise decline.

As usual, with the government their attempt to simplify will end out with so many rules, regulations, and exceptions that it will end out being more complicated. We will have guaranteed issue with the exception of conditions A-Z that must go to the pool. Or the other way around, it is not guaranteed issue except that you have to take people with conditions A-Z.

Oy!
 
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Speaking of cost containment, here is a summary (sort of) of today's meeting with Obama:

Health care groups propose cost controls - May. 11, 2009


For IFP, maybe 10% FYC 5% renewals something like that. The carriers are still going to want to provide and enhanced FYC to promote new sales. But for certain agent commissions, at least on IFP, will be cut.

Also, I could see group going to a per head flat amount instead of % commission (like Kaiser used to do).

The meeting today says several things

1) There will be no public option

2) There will be no federal health exchange

3) There will be a nation risk pool that will be administered by each state. (it will be similar to the state risk pools available now- there will be subsidies for said applicants)

4) Since there will be no GI due to no workable mandate the agent's commissions will not be as cut as much as you think as agents commission make up a very small % of overall admin and they are front loaded. They need us to drive business and if too many agents quits due to low compensation they cant meet their growth goals. In house and the resultant adverising that would be necessar for anyone but the blues wwold be cost prohibited. Keep in mind most insurers are far less than household names except BCBS

5) We will make additional moneys as enrollers from the sale of risk pool (we are inexpensive promotion for it versus advertising)

I fel better about the prospects for our industry than I have in a while. Obama sold out to the insurers today. He has settled for a symbolic victory rather than real systemic change. The USA thankfully is run still by the corporations and not by the whiners on the left.

Better than that many liberals will vote NO because it isnt single payer. This will further fragment the left and show to all the shrillness of their ideas. These idealogues want single payer and health insurance company dissolution and they will not get it because the Senate still has enough members with a brain and an understanding of the cost of this venture.

Most important polling shows that 85% of americans overall are happy with their healthcare. They would like to pay less however. Health care reform was merely a stick weilded by the OBama admin to get the insurers to control costs, nothing more and once again just like The Iraq withdrawl the liberal left has been lied to and followed the pied piper that is Barack off the cliff and have their leftist dreams dashed on the rocks below. Bait and Switch is the order of the day.
 
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