MLR Makes Insurance More Expensive

[leevena]

If carriers have always been involved in the controlling of medical costs tell me why we are in a cost crisis? Tell me why all the push for new products to control costs, such as HSA's?

 

[Yagents]

Because of the 3rd party payer system, and lack of consumer involvement and transparency. Name me another market in this world that DOESN'T have consumer involvement. Plus we are living longer, better technology, drugs, paying for the uninsured, employer subsidization, tax code inefficiencies, etc.

Pick your poison

 

[leevena]

Because of the 3rd party payer system, and lack of consumer involvement and transparency. Name me another market in this world that DOESN'T have consumer involvement. Plus we are living longer, better technology, drugs, paying for the uninsured, employer subsidization, tax code inefficiencies, etc.

Pick your poison

You just made my point. The cost crisis is made by a variety of issues. But you cannot say that carriers control costs, they only finance it.

Show me where/how a carrier controls claim costs. They shift costs, not control.

 

[Yagents]

Carriers had the ability to control some aspects of the market before MLR was implemented, the point of the thread (as noted). Consumers have started to make a difference with the roll out of HSA's 8 yrs ago. Providers are now only beginning to control costs through care coordination (ACO's), which won't make a dent.

Lots of variables as we both can agree on, but the MLR eliminated the carrier side, and the law may even eliminate HSA's and take out another.

 

[leevena]

Carriers had the ability to control some aspects of the market before MLR was implemented, the point of the thread (as noted). Consumers have started to make a difference with the roll out of HSA's 8 yrs ago. Providers are now only beginning to control costs through care coordination (ACO's), which won't make a dent.

Lots of variables as we both can agree on, but the MLR eliminated the carrier side, and the law may even eliminate HSA's and take out another.

Sorry, but I need to respectfully disagree.

When a group is self-funded they have the incentive and abilities to control their costs. When a group is insured, there is no incentive or ability to control their costs. The analogy I use is my dorm room in school. Since the costs were fixed up front I could run the AC, Heat, or lights all I wanted to because it did not affect me. When a group is insured, no matter what they do, even if they are able to reduce their costs by 100% they are part of a larger pool.

As for the ACO's, your premise is flawed. To begin with the ACO's are a re-run of a movie (HMO's and Provider Capitation/Risk transfer) made years ago. I lived the original and it did not work then.

 

[Yagents]

Self funded removes the third party payer, and of course has incentives to control costs. The carrier than plays their real role by providing "catastrophic insurance". Sidenote, most of my comments are for IFP, and I don't do group. We are in agreement on ACO's

 

[somarco]

Bill, you are arguing a point by bringing a knife to a gun fight.

MLR does not make health insurance more expensive. Doesn't matter if you are talking about IFP or group.

 

[JMO Fan]

Even if HHS finds a rate increase above 10% to be unreasonable, they cannot deny it.

 

[Yagents]

Bill, you are arguing a point by bringing a knife to a gun fight.

MLR does not make health insurance more expensive. Doesn't matter if you are talking about IFP or group.

You'll never know all of the reasons why it gets more expensive. I'm saying MLR does not allow methods for the carriers to make health insurance premiums LESS expensive.
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I mis-labeled the title of the thread. Sorry for the confusion

 

[somarco]

I'm saying MLR does not allow methods for the carriers to make health insurance premiums LESS expensive.

Wrong again. 20+ yrs in medical reinsurance, studying loss reports and rate formula's might just give me an edge.

I am moving on.