Maine Supreme Court: Anthem's Profit Can Be Limited

[Crabcake Johnny]

Anthem is the sole reason we have health care reform.... all was quiet after the first round back in late 2009 early 2010 then anthem slamed the california market with some god awful over the top increase... pissed off the RIC obama man and rekindled the fire.... boom, health care reform

I remember that - issued like a 39% rate increase in CA which they might as well have lit everyone on fire.

The DOI stepped in...but ONLY after the DOI stepped in did Anthem say "oooops, wrong math."

Yeah...whatever.

So just how stupid is the Anthem CEO?

"We figured out the California rate increase and it's 39!"

Anthem CEO; "Sure, nothing seems wrong there, send out the notices."

 

[taterpeeler]

I remember that - issued like a 39% rate increase in CA which they might as well have lit everyone on fire.

The DOI stepped in...but ONLY after the DOI stepped in did Anthem say "oooops, wrong math."

Yeah...whatever.

So just how stupid is the Anthem CEO?

"We figured out the California rate increase and it's 39!"

Anthem CEO; "Sure, nothing seems wrong there, send out the notices."

yep and obama took the hand off and ran the ball up the middle. he was saying something like "this has to stop" and for a brief moment he had community support... right up until the point it appeared he was playing hide the wennie with the process

 

[djs]

I don't think the premium change 'guaranteed' a profit, it created a projected profit of 3%. Compare that to most service industry profit models of 50+% or retail models of 20+%.

I haven't read the article, but in general sense, the only things that are usually capped on profit are monopolies or price setting entities. Basically, water, electric, phone, cable type of stuff.

Of course, I'm glad for this ruling, it is very timely. I'm going to Maine next week to buy my IPAD3, where I figure it should cost about $250. After all, Apple shouldn't be guaranteed a profit on these.

In fact, Apple has enough cash, they can (and should) buy everyone in America an IPAD3. Think of how this would help the economy! If Apple spends all of their cash buying their own product, obviously, they will make a fortune, have more cash and a tremendous sales year!!!!

Dan

 

[Crabcake Johnny]

That's not a great analogy.

Almost every company had to set prices for their products that consumers are willing to pay. If not, they go under. Apple's actually a bad example since their prices are subsidized by carriers like AT&T and Verizon. Without those subsidy agreement, you'd never have seen the first iPhone.

But in all other markets there's true competition. If I don't like Wendy's prices or products, I can go to Burger King.

Where this analogy fails for health insurance is many people cannot simply cancel Anthem. First of all, if your employer stays but continues to pass the cost onto you, there's no choice.

If you have an individual plan, due to pre-ex conditions, you can't simply cancel and go with their competitor.

If Anthem can't survive "on their own" which means offering sustainable rates people are willing to pay, then they can go out of business.

And then this country can enter into a REAL and honest debate about health care.

 

[djs]

Actually, its a perfect analogy.
The Apple subsidy agreements (which don't apply to most IPADS) are part of a way to make it work for a consumer. The consumer still has to agree to the terms, just its a bundle deal.

Besides, I still want my IPAD3 for $250 and think Apple should pay that cost. Anything more than that is pure profit, which is evil and isn't justified.

Dan

 

[Crabcake Johnny]

I'll stick to my guns here:-)

Let's say you have the first iPad and want the new one. But Apple has decided to raise the price. You can choose not to buy their new one or go buy a competitor's product.

But if my family has an individual plan with Blue Cross and they want to jack my rates 20%, I can only go with their competitor if I'm healthy. If not then my only two choices are go without insurance or pay their higher rate.

Everyone's had enough of that cr*p.

 

[djs]

But you don't understand....
My current tablet is full (its made of paper even) and is therefore broken. I can't switch. Heck, my granddaughter glued the pages together, so I can't even switch pages anymore on my paper tablet.

The evil corporate empire has determined that I must actually pay to get my Ipad. I think this is just so they can make a profit. Therefore it should be illegal and I should get a new Ipad, paid for by Apple.

My only point really is I want an Ipad 3. Beyond that, its silly to limit the profit of health insurers in the same way its silly to limit the profit of Apple. Unless you are saying health insurers are a monopoly.

I understand your point. There is a lot broken in health insurance world. Thats a different discussion than my Ipad though.

Dan

 

[Crabcake Johnny]

Ok, here's your analogy. You have your iPad with the data plan and let's just keep the math easy and say you're paying $30 per month.

You get a notice from your provider; your data plan is going up to $45 per month effective next month.

You say "screw that" and call a competitor. But those competitors say this:

"Have you used your current data plan?"
"Ummm, yes, of course I use it"
"Then you don't qualify for ours."

Now you have two choices - pay the $45 per month or cancel and have the world's most expensive table weight.

 

[Norwayguy]

That's not a great analogy.

Almost every company had to set prices for their products that consumers are willing to pay. If not, they go under. Apple's actually a bad example since their prices are subsidized by carriers like AT&T and Verizon. Without those subsidy agreement, you'd never have seen the first iPhone.

But in all other markets there's true competition. If I don't like Wendy's prices or products, I can go to Burger King.

Where this analogy fails for health insurance is many people cannot simply cancel Anthem. First of all, if your employer stays but continues to pass the cost onto you, there's no choice.

If you have an individual plan, due to pre-ex conditions, you can't simply cancel and go with their competitor.

If Anthem can't survive "on their own" which means offering sustainable rates people are willing to pay, then they can go out of business.

And then this country can enter into a REAL and honest debate about health care.

Pre-ex is a non-issue in this real life example as Maine is GI. You have said that Anthem is making money, which is true, they are making money on certain blocks of thier business. Why must 1 block of business subsidize the other?

 

[Ann H]

Profits drive stock prices. If they are "for profit", why not just allocate stock to every citizen, and they'll get their money back through stock appreciation. Or, put the stock in a pool, and sell appreciated shares periodically to pay for indigent care, reducing pressure on that cost of care. Don't try to beat em', join em'

OMG, Yagents, what a great point! If citizens felt they had a personal interest in proper management, they might view utilization and fraud differently. The problem becomes the "small fish in a big pond" concept. An economist once said that a person who belongs to a group of more than 100 people loses a sense that personal sacrifice will benefit the whole group and/or that personal sacrifice will benefit oneself instead of just benefiting the group. Nonetheless, I love the stock option idea.