Why will health insurance coverage cost more under reform???

[Chadman]

Mags, I can agree that this does seem to be one-dimensional against insurance companies. I agree it's an easy villain, as people usually only deal more with their insurance company, and not so much with the cost creators (of which insurance also is, but). I wish they went after the other players in this, as well, probably more so. But I'm happy to see some action against one of them, at least. I honestly feel that if it were up to Republicans, nothing would EVER get done about this issue. Or not for a long time, or whatever. It's certainly not in the spirit of what conservative values aspire to, IMO, and I think some of that thinking hurts the consumer, in some ways.

I'd prefer we broke things down, and it wasn't so monstrous. I wish all of these legislative efforts weren't so convoluted, and hard to understand. I wish for a lot of things, but I probably won't get them. I'm not naive enough to think I know what's best when it comes to this. But I DO know things aren't working out well for me, and costs are killing people and companies across the country. A focus on this is good. And if this passes and doesn't work out, I'd guess we'll eventually try to fix that, too, or parts of it.

Doing nothing is not alright with me. And that's what one side of the fence seems to think is best for ALL of us. And that is shortsighted, selfish, and self-serving. It's easy to attack ideas and bills that are put forth. It's not so easy to put something up, and be on the record for it.

Your point about elective healthcare is well taken with me. And deciding when to go, and all of that. But the prescription drug thing - I don't think most people really WANT to be on the drugs they are on. I think their doctor tells them they should, and they do it, because, well, the doctor tells them they should. And they are inundated by ads that tell them how much better off they'll be by taking these meds. And people who don't have to pay for them themselves (their employers do) could care less if it costs them $5 or $10 per bottle or dose. But leaving all of it, or a large part of it to private healthcare accounts - putting all of our private money into institutions that we all have seen are not necessarily trustworthy or reliable when we need them, isn't necessarily the be-all concept either. And why would there be more people protecting themselves with these accounts when they are elective, and are limited to what people put in them? People make choices all the time with their budgets, and many would not use these, either. Or not put enough in them to protect themselves.

I will defer to you on the area of cost competition, because I honestly don't know. No sense in arguing something I am not that knowledgeable about. But I do still feel that most of the market is controlled by large interests, private business, that don't care at the end of the day about my well-being, but about their bottom line. This is not that different from other sectors as you point out - but I think health is a much more serious area for people than most other ones.

I want to address your other issues, but have some other things to attend to at the moment. Going to post this now, and come back later. Thanks for the discussion. I appreciate the opportunity to learn from someone with solid perspective.

 

[Mags]

Mags, I can agree that this does seem to be one-dimensional against insurance companies. I agree it's an easy villain, as people usually only deal more with their insurance company, and not so much with the cost creators (of which insurance also is, but). I wish they went after the other players in this, as well, probably more so. But I'm happy to see some action against one of them, at least. I honestly feel that if it were up to Republicans, nothing would EVER get done about this issue. Or not for a long time, or whatever. It's certainly not in the spirit of what conservative values aspire to, IMO, and I think some of that thinking hurts the consumer, in some ways.

I'd prefer we broke things down, and it wasn't so monstrous. I wish all of these legislative efforts weren't so convoluted, and hard to understand. I wish for a lot of things, but I probably won't get them. I'm not naive enough to think I know what's best when it comes to this. But I DO know things aren't working out well for me, and costs are killing people and companies across the country. A focus on this is good. And if this passes and doesn't work out, I'd guess we'll eventually try to fix that, too, or parts of it.

Doing nothing is not alright with me. And that's what one side of the fence seems to think is best for ALL of us. And that is shortsighted, selfish, and self-serving. It's easy to attack ideas and bills that are put forth. It's not so easy to put something up, and be on the record for it.

Your point about elective healthcare is well taken with me. And deciding when to go, and all of that. But the prescription drug thing - I don't think most people really WANT to be on the drugs they are on. I think their doctor tells them they should, and they do it, because, well, the doctor tells them they should. And they are inundated by ads that tell them how much better off they'll be by taking these meds. And people who don't have to pay for them themselves (their employers do) could care less if it costs them $5 or $10 per bottle or dose. But leaving all of it, or a large part of it to private healthcare accounts - putting all of our private money into institutions that we all have seen are not necessarily trustworthy or reliable when we need them, isn't necessarily the be-all concept either. And why would there be more people protecting themselves with these accounts when they are elective, and are limited to what people put in them? People make choices all the time with their budgets, and many would not use these, either. Or not put enough in them to protect themselves.

I will defer to you on the area of cost competition, because I honestly don't know. No sense in arguing something I am not that knowledgeable about. But I do still feel that most of the market is controlled by large interests, private business, that don't care at the end of the day about my well-being, but about their bottom line. This is not that different from other sectors as you point out - but I think health is a much more serious area for people than most other ones.

I want to address your other issues, but have some other things to attend to at the moment. Going to post this now, and come back later. Thanks for the discussion. I appreciate the opportunity to learn from someone with solid perspective.

Chadman - and I too enjoy discussing/debating this with you. I do understand "my side" is a difficult one to defend - not unlike the gas station operator when gas goes to $4.50 a gallon. To consumers, it doesn't matter that costs have gone up for the company selling the product - they only understand what it means to them individually. And I do understand that.

Funny thing is - if there were more Reps/Dems that would discuss and debate this openly, as we do on this forum, they could probably come to a compromise that would be good for the country.

The whole process has really made me ill (no pun intended). Between the Reps basically not allowing anything to get through, and the Dem's and Obama arm twisting (or worse) to get votes - it just has been a terrible process.

It will be interesting to see what Massa has to say - he claims he was threatened by Rahm and blackballed. I guess he will be interviewed on Glenn Beck. This could get really bad if what he says, and what a few others have said (a representative in PA said he was promised a job in Obama's admin if he voted for the bill, and of course the UT situation).

I hate Chicago style politics - although I do realize that they work well for the party in power.

FYI - from your response, it doesn't seem that you understand how health savings accounts, and the type of health policy that goes with it, work. It may be worth reading up on it - these have been proven (and I've seen it time and time again) to slow down the growth of health care costs - and typically get the smallest rate increases among health care plans. They do incent people to be better health care consumers - and that helps with part of the problem.

 

[Chadman]

Chadman - and I too enjoy discussing/debating this with you. I do understand "my side" is a difficult one to defend - not unlike the gas station operator when gas goes to $4.50 a gallon. To consumers, it doesn't matter that costs have gone up for the company selling the product - they only understand what it means to them individually. And I do understand that.

Funny thing is - if there were more Reps/Dems that would discuss and debate this openly, as we do on this forum, they could probably come to a compromise that would be good for the country.

The whole process has really made me ill (no pun intended). Between the Reps basically not allowing anything to get through, and the Dem's and Obama arm twisting (or worse) to get votes - it just has been a terrible process.

It will be interesting to see what Massa has to say - he claims he was threatened by Rahm and blackballed. I guess he will be interviewed on Glenn Beck. This could get really bad if what he says, and what a few others have said (a representative in PA said he was promised a job in Obama's admin if he voted for the bill, and of course the UT situation).

I hate Chicago style politics - although I do realize that they work well for the party in power.

FYI - from your response, it doesn't seem that you understand how health savings accounts, and the type of health policy that goes with it, work. It may be worth reading up on it - these have been proven (and I've seen it time and time again) to slow down the growth of health care costs - and typically get the smallest rate increases among health care plans. They do incent people to be better health care consumers - and that helps with part of the problem.

Interesting you mention the gas station operator. My father was a gas station operator, and I worked for him for many years when younger. We took a beating from people on a daily basis when gas prices were high - and our prices were set by our "jobber" who called us and told us what to set the price at. Even today, gas stations don't make money off gas, they make it off the other things they offer and sell. All that being said, don't get me started on oil companies...

I agree on the open discussion. One political thing I will toss in here: I think it's cool that Obama spoke in front of Republicans a while back, head to head. That impressed me greatly, and was unique. And the recent summit, televised, with both sides visible and on the record - that was good theater. Both things reaffirmed my contention that Obama is clearly different and impressive as a President. He is comfortable in public, and directly with his political opposites.

After a couple of days of the Massa thing, I personally think this guy is flaming out - literally. This is one of the most liberal legislators, and now he's attacking democrats when found out. Clearly, IMO, he's going to say anything he can to make himself look better. I don't discount Chicago politics, but on this level, I think it's more than that.

On the HSA front, I awould agree with most of what you say. I agree with it in principle, for those who can have them. Two obvious problems with them after what we've seen of late - they are private, essentially, and people are putting their health in the interest of private for profit interests. If these companies develop trouble, people are in real trouble. We've seen this all too often lately.

I had a cafeteria plan in the past few years and had to appropriate funds to it at the start of every year, and I had to spend the money in it every year, or I lost it. Maybe there are others out there.

And, many people can't afford to put a decent amount of money into HSA's, so this won't help many people that aren't already being helped today.

You talk about insurance companies eating price increases. They don't. Why don't they talk at all about rising costs, and pinpoint what they are and who is raising them? I don't think I've seen anything specific along these lines. Why? Because they don't really care, they don't have to. They merely pass along the costs to the consumer, and the consumer in most areas really don't have a viable option for the same insurance. DEFINITELY they don't in more rural areas. There's no doubt that certain insurance companies CONTROL the market in many areas. And the big companies can control the markets they are prominent in, and cut payments to doctors and care givers. I doubt that direct cut gets passed on to consumers to any degree.

Mags, can you show me when the large health insurance companies have shown a yearly loss over, say, the past 10 years? Is there a chart somewhere that shows a great differential in profit margins for these companies? Because the sheer amount of money made in a constant 4% (or so) profit margin when controlling a market is a pretty good deal, when the companies can completely determine where the money goes before claiming profits. I think we all know that an insurance company can spend money in many different ways.

 

[Mags]

I agree on the open discussion. One political thing I will toss in here: I think it's cool that Obama spoke in front of Republicans a while back, head to head. That impressed me greatly, and was unique. And the recent summit, televised, with both sides visible and on the record - that was good theater. Both things reaffirmed my contention that Obama is clearly different and impressive as a President. He is comfortable in public, and directly with his political opposites.

I saw this debate quite differently - it was orchestrated by Obama, to pull in a few minor Republican ideas, as a way of building more consensus within his party.... it really didn't work. Polling today shows the Public is still strongly against this bill - which has Scott Rasmussen said (Rasmussen polling - the most "trusted" one out there) - this hasn't changed since November, and likely won't change in the future. The majority of the public has made up it's mind at this point.

After a couple of days of the Massa thing, I personally think this guy is flaming out - literally. This is one of the most liberal legislators, and now he's attacking democrats when found out. Clearly, IMO, he's going to say anything he can to make himself look better.

I agree - he is a flake, and it is hard to take anything this guy says all that seriously.

On the HSA front, I awould agree with most of what you say. I agree with it in principle, for those who can have them. Two obvious problems with them after what we've seen of late - they are private, essentially, and people are putting their health in the interest of private for profit interests. If these companies develop trouble, people are in real trouble. We've seen this all too often lately.

Well, I see private as a good thing. The HSA accounts are held by a bank, not the insurance company and are completely at the insured's discretion. These have been very effective, for both the insured and the companies at controlling health care costs.

I had a cafeteria plan in the past few years and had to appropriate funds to it at the start of every year, and I had to spend the money in it every year, or I lost it. Maybe there are others out there.

HSA's are much different than Flex spending accounts - HSA money is yours forever and rolls over from year to year, gaining interest. Flex accounts at an employer are "use it or lose it" - and the excess goes back to the employer. HSA's alllow people to actually save towards retirement, if they don't use it for health care costs.

And, many people can't afford to put a decent amount of money into HSA's, so this won't help many people that aren't already being helped today.

FALSE - people are undisciplined. Instead of buying a $500 deductible policy, buy a $2500 deductible policy and put the rest in an HSA - it will be much cheaper in the long run. Problem is, people buy the $2500 HSA and use the "extra" money for other things. People don't understand what savings means anymore - it is all about instant gratification. It is sad.

You talk about insurance companies eating price increases. They don't. Why don't they talk at all about rising costs, and pinpoint what they are and who is raising them? I don't think I've seen anything specific along these lines. Why? Because they don't really care, they don't have to. They merely pass along the costs to the consumer, and the consumer in most areas really don't have a viable option for the same insurance. DEFINITELY they don't in more rural areas. There's no doubt that certain insurance companies CONTROL the market in many areas. And the big companies can control the markets they are prominent in, and cut payments to doctors and care givers. I doubt that direct cut gets passed on to consumers to any degree.

Of course, insurance companies don't eat price increases - and they shouldn't. I don't think a 4% profit margin (2.2% in 2008) is excessive - hell, railroads make a higher margin. And they have less control on Doc/Hospital/Rx costs than you think. Thank the Fed entitlement programs for that - private payers (i.e. anybody without Medicare and Medicaid) pay WAY more than they should because the Gov prices fixes those 2 programs. I think any company (gas, electric, phone, cable, insurance, grocery stores, etc) have the right (and the need) to make a reasonable profit margin.

A study came out today that said 4% of the overall costs of the medical system are due to insurance company overhead and profits. We are wasting our time spending 100% of our time on 4% of the costs - wouldn't we be better at spending time debating the 96% of the costs????

Mags, can you show me when the large health insurance companies have shown a yearly loss over, say, the past 10 years? Is there a chart somewhere that shows a great differential in profit margins for these companies? Because the sheer amount of money made in a constant 4% (or so) profit margin when controlling a market is a pretty good deal, when the companies can completely determine where the money goes before claiming profits. I think we all know that an insurance company can spend money in many different ways.

Chad, actually I don't have the data readily available. I'm sure you can find it if you look via the net. You say "insurance companies can spend money in many different ways". Is that ANY different than any other companies? Basically, at an insurance company, 80% of the revenue is spent on cost of good sold - with 20% being used for marketing, salaries of all workers, and profit margin. Do you really think that is out of line compared to other industries? How much do you think the true cost of groceries are? How much do they "waste" on employees salaries and marketing?

What makes it a lot more difficult for the private insurance industry is their prices are automatically increased (I'm estimating 15-20%) due to the government entitlements of Medicare and Medicaid. Without that transfer of costs, our goverment could not support those programs.

I'd love to see the government mandate that the Medicare/Medicaid fee schedules would be applicable nationwide for all health care, as that would result in a substantial price decrease of heath care - which the current biill doesn't even come close to touching. Buy why go after 96% of the costs, when you can spend 100% of your time villifying an industry that accounts for 4% of the overall costs?

Again, insurers are an easy target. People bitch when they pay $3000 in premiums and have no claims. But those that pay $3000 in premiums and have $100,000 in claims - well, you don't hear those folks bitch too much - they got a good "deal".

Check out Pharma's profits by year, and compare them to the insurance industry. Check out what hospital systems profits margins are per year, and again compare.

Obama picked insurance as a villain, as he pre-cut deals with the docs and hospitals. He knew they were too big and too tough to take on, so he choose a smaller and easier foe to defeat. And he may still win. Even if the bill passes, it won't slow the growth in health care costs - he didn't do anything towards cost containment unfortunately.

It's a tough nut to crack - I certainly don't have all the answers. Getting at the true cost drivers is really hard - there are so many of them, and the ones that really matter (Pharma, hospitals, docs) are basically untouchable.

 

[rusty]

Baker's salary soared as CEO of Harvard Pilgrim while premiums did as well.

Baker's salary soared as CEO of Harvard Pilgrim while premiums did as well.

Critic: ?He?s part of the problem?
Baker?s $ soared as premiums spiked
Jessica Van Sack By Jessica Van Sack
Monday, March 15, 2010 - Updated 43m ago

As Republican Charles Baker seeks to capture the independent vote that bolstered U.S. Sen. Scott Brown?s win, a Herald review shows Harvard Pilgrim tripled the former CEO?s annual salary as it hit consumers with a 150 percent increase in premiums.

Brown rode to victory as an independent voice on health care, a position critics say Baker will have a tough time following with those numbers.

Baker defends his record and argues that Gov. Deval Patrick is late to the health-care discussion. He said he?s been ?shouting from the rooftops? about the need for hospitals and medical providers to make the cost of health care more transparent, and pushing for legislation that would control costs.

?My salary?s been a matter of public record for 20 years, and I?m probably the only candidate,? for whom that?s the case, Baker said. Baker?s salary as CEO of Harvard Pilgrim surged from $548,351 in 1999 to a high of $1.7 million in 2008. He earned $1.3 million in seven months in 2009 before he resigned to run for governor last summer, filings with the state Attorney General show.

Over the same period, premiums at Harvard Pilgrim went up by 100 to 200 percent.

When Baker took the reins in 1999, rates on Harvard Pilgrim?s most popular plans ranged from about $166 to $187 a month per member. Those rates soared to $425 to $483 a month, as of April, according to filings with the Massachusetts Division of Insurance.

?You have to look at him as the incumbent in terms of health-care costs,? said Democratic operative Michael P. Shea. ?If you look at his salary and the increases that people are paying now, how can he say he did a good job? It?s absolutely fair to pin this on him. He hasn?t shown he?s part of the solution, he?s part of the problem.?

Patrick is expected to keep the focus on health care - and keep the heat on Baker - as he proposes a so-called soft cap on premium increases. His plan pits him squarely against health insurers in an intensifying three-way race that also features unenrolled candidate Tim Cahill, the state treasurer.

Baker said Patrick is trying to shift the focus.

?This probably beats talking about spending and taxes and unemployment if you?re him,? Baker said. ?I?ve supported a lot of things that would put my organization and my industry at risk. I have no idea if it?s going to be good or bad for my company or my industry, but it?s the right thing to do for the people of Massachusetts. I got a lot of grief from people for doing that.?

Baker, a former secretary of Health and Human Services under then-Gov. William Weld and financial czar under Gov. Paul Cellucci, is credited with pulling Harvard Pilgrim from the brink of ruin to become a top-rated health plan.

But a leading consumer advocate said that doesn?t necessarily bode well for a campaign.

?The health-insurance industry has driven our problems,? said Robert Weissman, president of Washington, D.C., watchdog Public Citizen, which advocates a ?Medicare for all? system. ?Their business model is to deny care and obtain high profits or executive pay.?
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