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Where Do We Go from Here? POLL
- Thread starter Yagents
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Trump only managed to help screw up 2018 rates with the increased uncertainty. Perhaps he intended to cause more carriers to leave so Oscar would have an easier time.
The prior year increases were mostly adverse selection. Carriers had no good data on those who would be covered under ACA when this started. The 1st or 2nd renewal would normally have been enough information to get close on year 3. Instead we've had 20 to 100% increases which is much higher than medical trend. Insure the sickies without the healthy, let people get away without paying premium for 1 to 3 months at year end and you have a pretty good explanation for the rate increases.
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As of Jan 26, 2018, there are still some HHS and Trump-initiated items in the hopper awaiting approval, but HHS put out a report today that highlighted its 2017 accomplishments. Even with a Secretary (Tom Price) who quit in September, and did relatively nothing before then, the agency feels that it accomplished quite a bit.
HHS 2017 Accomplishments: https://www.hhs.gov/sites/default/files/hhs-end-of-year-accomplishments-2017.pdf
GI and adverse selection are hands down the two primary drivers behind premiums.
Reinsurance, premium subsidies, etc should never have been part of the "overhaul to make health care (a misnomer) affordable". They were political plays funded by taxpayer dollars.
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Reinsurance is used all over in the insurance world. Saying it should never have been part of the overhaul is asking the health insurance system to play by a different set of rules. If we don't subsidize by income how are lower income families supposed to afford the rates? Is it just the system of tax credits you disagree with or the idea of subsidizing the cost for lower income families in general?
Before ACA, we paid for the lower income people with higher procedure costs which were paid with premiums of the insured.
Retail medical charges have become meaningless. I just looked at an EOB from Quest Labs. submitted charge was $215. Allowed charge was less than $30. Friend who was a lab technology says very basic equipment and low skilled employee cab run the test in less than 5 minutes including setup, clean up and data logging.
We have runaway greed and opposing regulation distorting what is supposed to be subject to capitalistic market regulation. We will never have market regulation as long as healthcare isn't paid for directly by consumers.
Regardless, ACA premium increases are adverse selection. All you need to confirm this is to look at calculations on a large group renewal. All of the components art there in one form or another. It doesn't change.
Retail medical charges have become meaningless. I just looked at an EOB from Quest Labs. submitted charge was $215. Allowed charge was less than $30. Friend who was a lab technology says very basic equipment and low skilled employee cab run the test in less than 5 minutes including setup, clean up and data logging.
We have runaway greed and opposing regulation distorting what is supposed to be subject to capitalistic market regulation. We will never have market regulation as long as healthcare isn't paid for directly by consumers.
Regardless, ACA premium increases are adverse selection. All you need to confirm this is to look at calculations on a large group renewal. All of the components art there in one form or another. It doesn't change.
Junkman - "There is no competition at the carrier level since carriers are looking at the same data."
If that were true wouldn't every med sup carrier have the same rates? Obviously, they don't. Different carriers focus on different sups and they have different criteria for underwritten business. So their data is not all the same and there is competition as evidenced by different rates, different rate increases, different commission structures, different approaches to sales and marketing.
If that were true wouldn't every med sup carrier have the same rates? Obviously, they don't. Different carriers focus on different sups and they have different criteria for underwritten business. So their data is not all the same and there is competition as evidenced by different rates, different rate increases, different commission structures, different approaches to sales and marketing.
Junkman - "Before ACA, we paid for the lower income people with higher procedure costs which were paid with premiums of the insured."
Actually, before the ACA a lot of hospitals received direct payments from the government for indigent care.
Junkman - "Retail medical charges have become meaningless. I just looked at an EOB from Quest Labs. submitted charge was $215. Allowed charge was less than $30. Friend who was a lab technology says very basic equipment and low skilled employee cab run the test in less than 5 minutes including setup, clean up and data logging."
I agree with you...Retail charges are meaningless. I tell people negotiated rates are kind of like buying something at JCPenney's. Monday through Thursday the shirt is $50, but no one buys it because everyone knows there is a sale Friday, Saturday, and Sunday where it will be $17. Negotiated rates, whether through Medicare or a carrier, just gets you a fair prices all the time (kind of).
Junkman - "We have runaway greed and opposing regulation distorting what is supposed to be subject to capitalistic market regulation. We will never have market regulation as long as healthcare isn't paid for directly by consumers."
I agree with have runaway greed and some opposing regulations, but the idea that we will never have market regulation as long as healthcare isn't paid for directly by consumers is nonsensical. Obviously, many people just don't have the income to pay for healthcare. We have to have some sort of insurance system with pooled risk. That is NOT "health care being paid for directly by consumers."
Actually, before the ACA a lot of hospitals received direct payments from the government for indigent care.
Junkman - "Retail medical charges have become meaningless. I just looked at an EOB from Quest Labs. submitted charge was $215. Allowed charge was less than $30. Friend who was a lab technology says very basic equipment and low skilled employee cab run the test in less than 5 minutes including setup, clean up and data logging."
I agree with you...Retail charges are meaningless. I tell people negotiated rates are kind of like buying something at JCPenney's. Monday through Thursday the shirt is $50, but no one buys it because everyone knows there is a sale Friday, Saturday, and Sunday where it will be $17. Negotiated rates, whether through Medicare or a carrier, just gets you a fair prices all the time (kind of).
Junkman - "We have runaway greed and opposing regulation distorting what is supposed to be subject to capitalistic market regulation. We will never have market regulation as long as healthcare isn't paid for directly by consumers."
I agree with have runaway greed and some opposing regulations, but the idea that we will never have market regulation as long as healthcare isn't paid for directly by consumers is nonsensical. Obviously, many people just don't have the income to pay for healthcare. We have to have some sort of insurance system with pooled risk. That is NOT "health care being paid for directly by consumers."
I'd say we won't have fair regulations while lobbyists, PAC's (Political Action Committees) and SuperPACs are allowed. Their influence on our political system and thus our regulations overpower good intentions of those running for office and/or the working and middle class.
