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SK in CV
ParticipantIf this is what you’ve been told, you’ve been told wrong.
The law provides that insurance sold to large group markets must have at least an 85% loss ratio, and those serving small groups and individuals must have at least an 80% medical loss ratio (MLR). The loss ratio is the percentage of premium dollar that pays for health care. If loss ratios do not meet these floors, then the shortfall must be refunded to policyholders. The remaining 15 to 20% is available for overhead and profit.
At least 15 states, already have similar regulations, or at least regulations which address MLRs.
In the late 80’s and early 90’s, when I did quite a bit of medical financing consulting, loss ratios hovered around 90% and above. Kaiser was pretty consistent in the 95% range. Over the last 20 years, those ratios have consistently fallen. Now they’re much more typically in the low 80’s and high 70’s. That extra 10 to 15% has all gone to pay exhorbitant overhead and profits, which have grown significantly faster than actual medical costs over the last 20 years.
ParticipantIf this is what you’ve been told, you’ve been told wrong.
The law provides that insurance sold to large group markets must have at least an 85% loss ratio, and those serving small groups and individuals must have at least an 80% medical loss ratio (MLR). The loss ratio is the percentage of premium dollar that pays for health care. If loss ratios do not meet these floors, then the shortfall must be refunded to policyholders. The remaining 15 to 20% is available for overhead and profit.
At least 15 states, already have similar regulations, or at least regulations which address MLRs.
In the late 80’s and early 90’s, when I did quite a bit of medical financing consulting, loss ratios hovered around 90% and above. Kaiser was pretty consistent in the 95% range. Over the last 20 years, those ratios have consistently fallen. Now they’re much more typically in the low 80’s and high 70’s. That extra 10 to 15% has all gone to pay exhorbitant overhead and profits, which have grown significantly faster than actual medical costs over the last 20 years.
ParticipantIf this is what you’ve been told, you’ve been told wrong.
The law provides that insurance sold to large group markets must have at least an 85% loss ratio, and those serving small groups and individuals must have at least an 80% medical loss ratio (MLR). The loss ratio is the percentage of premium dollar that pays for health care. If loss ratios do not meet these floors, then the shortfall must be refunded to policyholders. The remaining 15 to 20% is available for overhead and profit.
At least 15 states, already have similar regulations, or at least regulations which address MLRs.
In the late 80’s and early 90’s, when I did quite a bit of medical financing consulting, loss ratios hovered around 90% and above. Kaiser was pretty consistent in the 95% range. Over the last 20 years, those ratios have consistently fallen. Now they’re much more typically in the low 80’s and high 70’s. That extra 10 to 15% has all gone to pay exhorbitant overhead and profits, which have grown significantly faster than actual medical costs over the last 20 years.
Participant[quote=Aecetia]Everyone should go in to any health care they want to and demand free care. After all it is an entitlement. What’s good for the goose is good for the gander. Just put it on the Fed. tab. Why should anyone pay? Actually it has been happening. People are asking for free tests because it’s like Christmas now. Santobama just gave them everything the need. Isn’t this just peachy? From the insolvent Post Office, to foundering social security and medicare. Houston do we have a problem? Calling Brian to explain why this is a good thing again….[/quote]
What does any of this have to do with the HCR bill that was passed?
1. Everyone doesn’t get free health care. Some do. If your income is over roughly $88,000 for a family of 4, you pay 100% of the costs yourself. Under that amount, you get some sudsidies, down to roughly $28,000 of income. Under that, you qualify for medicaid.
2. Whats good for the goose….Non-applicable. Makes no sense.
3. According to the CBO, it will reduce the deficit over the next 10 years. It’s not adding to any tab.
4. People ask for free stuff all the time. Sometimes they get it. If you’re at or close to the poverty level, you might. Otherwise you won’t.
5. I suspect no amount of explaining will help you understand. You can’t understand what you don’t want to understand.
Participant[quote=Aecetia]Everyone should go in to any health care they want to and demand free care. After all it is an entitlement. What’s good for the goose is good for the gander. Just put it on the Fed. tab. Why should anyone pay? Actually it has been happening. People are asking for free tests because it’s like Christmas now. Santobama just gave them everything the need. Isn’t this just peachy? From the insolvent Post Office, to foundering social security and medicare. Houston do we have a problem? Calling Brian to explain why this is a good thing again….[/quote]
What does any of this have to do with the HCR bill that was passed?
1. Everyone doesn’t get free health care. Some do. If your income is over roughly $88,000 for a family of 4, you pay 100% of the costs yourself. Under that amount, you get some sudsidies, down to roughly $28,000 of income. Under that, you qualify for medicaid.
2. Whats good for the goose….Non-applicable. Makes no sense.
3. According to the CBO, it will reduce the deficit over the next 10 years. It’s not adding to any tab.
4. People ask for free stuff all the time. Sometimes they get it. If you’re at or close to the poverty level, you might. Otherwise you won’t.
5. I suspect no amount of explaining will help you understand. You can’t understand what you don’t want to understand.
Participant[quote=Aecetia]Everyone should go in to any health care they want to and demand free care. After all it is an entitlement. What’s good for the goose is good for the gander. Just put it on the Fed. tab. Why should anyone pay? Actually it has been happening. People are asking for free tests because it’s like Christmas now. Santobama just gave them everything the need. Isn’t this just peachy? From the insolvent Post Office, to foundering social security and medicare. Houston do we have a problem? Calling Brian to explain why this is a good thing again….[/quote]
What does any of this have to do with the HCR bill that was passed?
1. Everyone doesn’t get free health care. Some do. If your income is over roughly $88,000 for a family of 4, you pay 100% of the costs yourself. Under that amount, you get some sudsidies, down to roughly $28,000 of income. Under that, you qualify for medicaid.
2. Whats good for the goose….Non-applicable. Makes no sense.
3. According to the CBO, it will reduce the deficit over the next 10 years. It’s not adding to any tab.
4. People ask for free stuff all the time. Sometimes they get it. If you’re at or close to the poverty level, you might. Otherwise you won’t.
5. I suspect no amount of explaining will help you understand. You can’t understand what you don’t want to understand.
Participant[quote=Aecetia]Everyone should go in to any health care they want to and demand free care. After all it is an entitlement. What’s good for the goose is good for the gander. Just put it on the Fed. tab. Why should anyone pay? Actually it has been happening. People are asking for free tests because it’s like Christmas now. Santobama just gave them everything the need. Isn’t this just peachy? From the insolvent Post Office, to foundering social security and medicare. Houston do we have a problem? Calling Brian to explain why this is a good thing again….[/quote]
What does any of this have to do with the HCR bill that was passed?
1. Everyone doesn’t get free health care. Some do. If your income is over roughly $88,000 for a family of 4, you pay 100% of the costs yourself. Under that amount, you get some sudsidies, down to roughly $28,000 of income. Under that, you qualify for medicaid.
2. Whats good for the goose….Non-applicable. Makes no sense.
3. According to the CBO, it will reduce the deficit over the next 10 years. It’s not adding to any tab.
4. People ask for free stuff all the time. Sometimes they get it. If you’re at or close to the poverty level, you might. Otherwise you won’t.
5. I suspect no amount of explaining will help you understand. You can’t understand what you don’t want to understand.
Participant[quote=Aecetia]Everyone should go in to any health care they want to and demand free care. After all it is an entitlement. What’s good for the goose is good for the gander. Just put it on the Fed. tab. Why should anyone pay? Actually it has been happening. People are asking for free tests because it’s like Christmas now. Santobama just gave them everything the need. Isn’t this just peachy? From the insolvent Post Office, to foundering social security and medicare. Houston do we have a problem? Calling Brian to explain why this is a good thing again….[/quote]
What does any of this have to do with the HCR bill that was passed?
1. Everyone doesn’t get free health care. Some do. If your income is over roughly $88,000 for a family of 4, you pay 100% of the costs yourself. Under that amount, you get some sudsidies, down to roughly $28,000 of income. Under that, you qualify for medicaid.
2. Whats good for the goose….Non-applicable. Makes no sense.
3. According to the CBO, it will reduce the deficit over the next 10 years. It’s not adding to any tab.
4. People ask for free stuff all the time. Sometimes they get it. If you’re at or close to the poverty level, you might. Otherwise you won’t.
5. I suspect no amount of explaining will help you understand. You can’t understand what you don’t want to understand.
Participant[quote=Hobie] Less regulations helps all.[/quote]
Yes, it worked wonders in the mortgage market.
Participant[quote=Hobie] Less regulations helps all.[/quote]
Yes, it worked wonders in the mortgage market.
Participant[quote=Hobie] Less regulations helps all.[/quote]
Yes, it worked wonders in the mortgage market.
Participant[quote=Hobie] Less regulations helps all.[/quote]
Yes, it worked wonders in the mortgage market.
Participant[quote=Hobie] Less regulations helps all.[/quote]
Yes, it worked wonders in the mortgage market.
Participant[quote=meadandale]Another take on the “Medicine Cabinet Tax”:
And this tax change will almost certainly cost the health care system billions more dollars in unnecessary spending both to the government and private insurance plans. The Joint Committee on Taxation estimates that the tax hike will bring in $5 billion in revenues over ten years – itself a drop in the bucket when compared to the bill’s new trillion-dollar entitlement – but that estimate doesn’t take into account behavioral changes as a direct result of this provision.
OTC drugs are much cheaper those available for prescription, but they could now be more expensive to individual consumers given that prescription drugs would still be eligible for favored treatment in the tax plans, and that insurance companies would be mandated to cover many of them. Consequently, any time a consumer has the slightest headache, the financial incentive would often be to see a doctor and get a prescription rather than go to the store and get medicine off the shelf.
This could mean that billions will be wasted on the additional costs for prescription drugs in instances when OTC medicines could be just as safe and effective at treating the illness. A 2005 study in the American Journal of Managed Care found that the Food and Drug Administration’s clearing of antihistamines such as loratadine (Claritin) for over-the-counter sale saves about $4 billion a year in health care costs. Ironically, the liberals and Democrats who normally rail against big pharmaceutical companies are now creating a huge windfall the firms that make expensive prescription drugs by penalizing users of OTC medicines.
[/quote]
You know, I’ve read both the original senate bill and the reconciliation bills, and I don’t know where this claim comes from. Exchange plans must include (in general) the same kind of benefits that group plans currently have. Most group plans currently provide that where generic drugs are available, there will be no coverage for name brand drugs without meeting specific protocol. Same goes for OTC v. prescription drugs. Medicare Part D currently has similar coverage.
The claim that the “change will almost certainly cost the health care system billions more dollars in unnecessary spending both to the government and private insurance plans” is speculative at best. Not surprising, given the origin of the claim.
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