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They are also regulated - to varying extents - by the states in which they are licensed to operate.
All health insurance premiums are Geo rated. This was true before ACA and has remained true through 3 different iterations of replacement bills.
The premium for same plan sold by the same insurer to the same demographic with in the state will be different based upon the Geo Rating. Florida, for example, has 69 Geo Rated areas.
What matters:
Health of local population as measured by number of and type of claims, and
Ratio providers and hospital beds : local population, and
Number of networks in the region, and
Number of health insurers in the region.
A seemingly low cost of living area can easily be a high cost healthcare area due to the health of the local population and lack of competitiveness in the local healthcare market.
Insurers have been exiting the Individual Plan Market for more than 25 years.
Insurers have bee contracting through mergers and acquisistions for more than 25 years.
If one listens to Hillary's testimony before Congress 25 years ago, about the state of healthcare in the US, one would think she was talking about right now, rapidly increasing healthcare costs, unaffordable premiums, exiting of insurers in the Individual Plan markets in many states.
That is not usually possible until the bill is in collections or several months late. There is no incentive to reduce the amount of a bill otherwise. There are credit repair agencies that do just what your attorney did but the late pays still impact your credit rating...
If you don't have it, you don't have it. Yes it's a vicious circle. All put in place and designed by Wall Street. The same entity that controls BOTH parties.
Sick people, sick people, sick people! What does that have to do with anything?
We're talking cash flow here. Profitability. Quarterly results. Don't you people understand that sick people are a liability when you're trying to run a health insurance business? In fact, we could get the most amazingly healthy profit margins if you bleeding-heart do-gooders would stop all this bleating about "sick people". They are all just itching to get their big payday for their "chemotherapy" or "dialysis" or whatnot, living on for way longer than is reasonable and hurting our balance sheets every. single. day.
Plus we could harvest them for necessary organs for those who actually contribute enough to the economy to warrant medical care. WIN WIN!
The Cruz amendment — which has been inserted into the GOP Senate health plan — is smart, because it doesn’t take anything away from anyone. If you want Obamacare — you can have it. You can have the coverage for the 10 “essential benefits,?†you can have the subsidies and the exchanges that were supposed to save $2,500 per family. It’s still there for you.
The Cruz amendment creates what is called a “Consumer Freedom Option.†This essentially allows an “off-ramp†from Obamacare for the tens of millions of Americans who don’t want it. The “Consumer Freedom Option†allows insurers who offer Obamacare-compliant plans to offer a range of much less costly plans. In other words, it empowers people and families to pick and choose what they want in their own insurance package. Cruz provides billions of dollars of subsidies for people who have pre-existing conditions and high medical costs.
Essentially -- If you like your ObamaCare, you can keep it and all it's 10 required items and its high premiums/deductibles. If you don't need/want all that coverage, then you have the "Consumer Freedom Option". It's understandable that the Insurance Companies would much prefer Billions of Dollars in Bailouts every year.
People think they can scrape by with hardly any health insurance.
Last night a guy called in to the radio program, so proud that his family doesn't have any health insurance.
Said they went to Florida and his wife got in an accident. Huge hospital bills but when the hospital found out they didn't have insurance, they cut the bills way down. He still had to pay but how do the rest of the people in Florida feel, knowing that THEY really paid for this free loader who was too cheap to have health insurance for his own family.
And I wonder if he'll be that lucky when one of his kids suffers a sports injury or somebody in his family gets cancer. It's dumb to go without insurance.
They "cut the bills way down" because an Aspirin doesn't really cost $25 and a pain killer doesn't really cost $100. Insurance allows the Hospitals to radically Inflate all their prices. The man paid what the Hospital charged him (therefor is NOT a "freeloader"), and you can bet the Hospital wasn't taking a loss - they were charging what the costs should be for all of us and not the special AMA coding that Inflates prices because the Taxpayers are forced into paying the Inflated prices.
The Cruz amendment — which has been inserted into the GOP Senate health plan — is smart, because it doesn’t take anything away from anyone. If you want Obamacare — you can have it. You can have the coverage for the 10 “essential benefits,?†you can have the subsidies and the exchanges that were supposed to save $2,500 per family. It’s still there for you.
The Cruz amendment creates what is called a “Consumer Freedom Option.†This essentially allows an “off-ramp†from Obamacare for the tens of millions of Americans who don’t want it. The “Consumer Freedom Option†allows insurers who offer Obamacare-compliant plans to offer a range of much less costly plans. In other words, it empowers people and families to pick and choose what they want in their own insurance package. Cruz provides billions of dollars of subsidies for people who have pre-existing conditions and high medical costs.
Essentially -- If you like your ObamaCare, you can keep it and all it's 10 required items and its high premiums/deductibles. If you don't need/want all that coverage, then you have the "Consumer Freedom Option". It's understandable that the Insurance Companies would much prefer Billions of Dollars in Bailouts every year.
It cuts out much of the more generally younger and healthy people and families from Obamacare, where those with pre-existing and chronically ill will remain. So their premiums will rise.
IMO this pushes us closer to a public option, which I continue to support.
We have the generally younger, healthier working people and families, who can do well with a cheaper, less inclusive private sector policy. Freer markets can do well here.
And then we have the poor, elderly and high risk people and families who could do well enough with a public option. Where free markets don't do well. A Medicare or Medicaid type option.
They "cut the bills way down" because an Aspirin doesn't really cost $25 and a pain killer doesn't really cost $100. Insurance allows the Hospitals to radically Inflate all their prices.
Except that insurance never pays what the hospital charges.
Hospitals pull their charges straight out of their rear ends. Insurance companies know what an aspirin really costs, and have the industry weight to pay what is closer to the real cost than an individual has.
While my mother was in a coma, I received a constant flood of "not-a-bills" from BC/BS (her primary insurer) and Medicare (her secondary insurer). Even between the two of them, they rarely paid the entire bill. There was always a "You may be charged" amount...which I never was.
So if medical providers never get what they charge and yet stay in business at all, that indicates to me they are always overcharging. Substantially.
They "cut the bills way down" because an Aspirin doesn't really cost $25 and a pain killer doesn't really cost $100. Insurance allows the Hospitals to radically Inflate all their prices. The man paid what the Hospital charged him (therefor is NOT a "freeloader"), and you can bet the Hospital wasn't taking a loss - they were charging what the costs should be for all of us and not the special AMA coding that Inflates prices because the Taxpayers are forced into paying the Inflated prices.
Hospitals can price anything they want. But they rarely get paid that price. Insurance typically does not pay that price, but at a pre-negotiated lower one. What special AMA coding do you refer to?
Except that insurance never pays what the hospital charges.
Hospitals pull their charges straight out of their rear ends. Insurance companies know what an aspirin really costs, and have the industry weight to pay what is closer to the real cost than an individual has.
While my mother was in a coma, I received a constant flood of "not-a-bills" from BC/BS (her primary insurer) and Medicare (her secondary insurer). Even between the two of them, they rarely paid the entire bill. There was always a "You may be charged" amount...which I never was.
So if medical providers never get what they charge and yet stay in business at all, that indicates to me they are always overcharging. Substantially.
Guess what my wife's AZ Obamacare policy paid for her 1/1/17 out of state auto accident injuries?
The charges for the month of Jan. were over $1M.
They paid $168K. Vastly underpaid IMO, but there you go.
I'm a doc. And a patient, so I understand and agree with you.
A simple cough. No blood, high fever, shortness of breath, chest pain, or other serious concomitant disease or predisposing factors.
A simple office visit.
A possible x-ray and Rx and that is about it 90+% of the time.
Do people really go to the Doctor for a "simple cough, no blood-high fever-shortness of breath- chest pain or other concomitant disease or predisposing factors"? They really do that?
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