Aetna pulling out of ACA

[timo2]

Between the behavior of big pharma and big health insurance, these people are killing the proverbial goose that laid the golden eggs. These folks could have made a decent living and provided a needed service. But they got all greedy.

 

[redduck]

As I understand it, Alicia C. Anderson was quite startled when she realized Phil Aetna was pulling out.

 

[pb4uski]

Strange.... very strange.

 

[Fermion]

Between the behavior of big pharma and big health insurance, these people are killing the proverbial goose that laid the golden eggs. These folks could have made a decent living and provided a needed service. But they got all greedy.

Add to that lawyers. The amount of law suits over drugs seems to have skyrocketed. I even saw one the other day where they were trying to get you to sue the drug company over a chemo drug because they did not adequately warn people they may lose hair!

 

[NW-Bound]

Hey, of what value is life, if one loses his/her hair, even if momentarily?

 

[Mulligan]

Hey, of what value is life, if one loses his/her hair, even if momentarily?

Well if that is the case, my life's value has been gradually decreasing yearly since about 1986...


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[MRG]

I saw some nonsense segment on the news last night about rising prices of meds. They ended the segment with "most of the costs are covered by insurance!"

 

[Mulligan]

I saw some nonsense segment on the news last night about rising prices of meds. They ended the segment with "most of the costs are covered by insurance!"

It has become sad to think we as a society are so dumb now that we think costs paid/shifted to businesses and government are free to us.


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[Freedom56]

We have individual plans directly from Anthem Blue Cross. Since we were not eligible for subsidies, we did not buy through the exchanges. Aetna did not offer any plans through the exchanges or individual plans directly in California. I was previously covered by Aetna PPO through my employer prior to retirement. The monthly premiums for myself and my wife were $2600 per month for a PPO plan of which my employer paid 75%. We are paying $991 per month for the Anthem Blue Cross silver PPO for both of us. For us the ACA kept our premiums down. We visit the doctor once a year for our annual check-ups and blood tests and take no prescription medication. Aetna's reasons for exiting the ACA and individual plans have more to do with industry consolidation than ACA losses.

 

[pb4uski]

I saw some nonsense segment on the news last night about rising prices of meds. They ended the segment with "most of the costs are covered by insurance!"

It gets worse. In our state we have property tax relief that is income sensitive to help make property taxes affordable. A few years ago we were at a meeting to vote on the school budget which proposed a significant budget increase and a gentleman got up and said how he was working hard at two jobs and could not afford the increase in property taxes that the school budget increase would result in as he was having a hard time getting by as it was. A little while later a woman known for being to the far left and was in favor of the school budget increase got up and referred to the gentleman's remarks and said that for those whose property taxes were subsidized that the increase in taxes caused by the proposed school budget would not cause their taxes to increase since what they pay in taxes is capped at a percentage of their income so they should vote for the proposal.

Talk about unintended consequences!

While I can understand that people will naturally look at things on how it affects them, I can't understand how some people can't also look past that to see how it impacts "We the People" more broadly.

 

[bUU]

I see nothing unintended by those consequences. It sounds rather like a rational balancing between conflicting priorities.

 

[pb4uski]

Perhaps you are right... perhaps the liberal extremists in our state intentionally designed the system so those who receive subsidies would be immune to the impact of budget increase and vote in favor of budget increases as a result since it would not affect those on subsidies in effect placing an increasing burden on higher income taxpayers. However, their scheme will backfire in the long run as those higher income taxpayers can more easily move to more tax friendly states and they are doing so in increasing numbers, which will exacerbate the problem and it may ultimately implode from its own weight.

 

[bUU]

Thereby necessitating a more national solution. Reactionaryism gains some footholds now and then, but the overall long-term trend is toward progress.

 

[Texas Proud]

Thereby necessitating a more national solution. Reactionaryism gains some footholds now and then, but the overall long-term trend is toward progress.

OMG.... I hope not...

 

[ShokWaveRider]

Thereby necessitating a more national solution. Reactionaryism gains some footholds now and then, but the overall long-term trend is toward progress.

+2! Absolutely what we need in the USA. It just makes sense.

 

[timo2]

Thereby necessitating a more national solution. Reactionaryism gains some footholds now and then, but the overall long-term trend is toward progress.

Absolutely that's what will happen if the current private industry solution doesn't work out (which I prefer). I can't figure out if the health insurance executives are 1) incompetent or 2) getting the money out for themselves while they can. Because there is no reason the private industry solution (ACA) wouldn't work, in theory, if people thought of the country first.

 

[samclem]

I can't figure out if the health insurance executives are 1) incompetent or 2) getting the money out for themselves while they can.

What facts lead people to believe the health insurance companies are driving higher insurance rates? The money is going to health care providers and for pharmaceuticals. And as long as an increasing amount of money is pumped into the system, costs will go up. That won't change until there is a mechanism to control costs (i.e. competition or government price/availability controls), and if the cost of providing care doesn't come down it won't matter if there is a single payer or many, and if the single payer is public or private.

. . . but the overall long-term trend is toward progress.

The idea that there's a "right side of history" or some type of "arc of history" is a belly laugh to historians. There may be some remaining Soviet-era bitter-enders who believe in Karl Marx's view of a one-way arrow of history, but events on the ground have pretty much left that idea in tatters. Caracas.

 

[timo2]

What facts lead people to believe the health insurance companies are driving higher insurance rates?

but events on the ground have pretty much left that idea in tatters. Caracas.

The fact that, according to Forbes, CEO Heather Bresch had a 671% salary increase company recently Forbes Welcome

 

[samclem]

The fact that, according to Forbes, CEO Heather Bresch had a 671% salary increase company recently Forbes Welcome

Your argument is based on the pay of a single person? Did any of the CEOs of health care providers make any more money last year?

 

[timo2]

Your argument is based on the pay of a single person? Did any of the CEOs of health care providers make any more money last year?

every little bit helps. like the proverbial 'straw that broke the camels back'. I personally feel that our corporations have dumped our country. Mylan moved to the Netherlands, for instance. These people have to have accountability, just like everyone else. They just took the easy way out. Not very patriotic.

 

[explanade]

Heather Bresch is head of a pharmaceutical, which has no restrictions on pricing like the health insurers.

She offered $300 coupons to help pay for the $600 EpiPens, which is the big moneymaker for Mylan, rather than offer to cut the price. By using coupons, Mylan still gets full price from the insurers and a lot of consumers may go away satisfied that their out-of-pocket has been reduced.

But increasing drug prices leads to higher premiums and eventually, higher health care costs.

The top executives at Mylan have huge incentives to increase the earnings and stock price of the company by the end of 2018, so they're going to try to continue increasing prices.

 

[samclem]

Heather Bresch is head of a pharmaceutical, which has no restrictions on pricing like the health insurers.

She offered $300 coupons to help pay for the $600 EpiPens, which is the big moneymaker for Mylan, rather than offer to cut the price.

Hey, she explained everything in her* letter to EpiPen customers:

And yet the essential matter is not complicated. It can be explained in a sentence: Six hundred dollars is the price we want insurers to pay.
Insurers are not spending your money. They are spending everybody’s money. Look at it from the perspective of health-care providers, drugmakers or medical-device suppliers. All of us are competing for a common pot of loot. Naturally, each wants to maximize his share. That’s human nature.
. . . .
Now you know why we offer coupons and rebates to individual consumers. This is our way of trying to re-desensitize customers to the price of EpiPen in order to counter the efforts of insurers to re-sensitize them by hitting them with copays and deductibles.

*WSJ editorial, actually penned by Holman Jenkins

 

[bUU]

The idea that there's a "right side of history" or some type of "arc of history" is a belly laugh to historians.

It's a good thing, therefore, that no one said that.

As I said, there is a roughly 350 year trend within history.

The current micro-trends could be the harbinger of a regression back to barbary, within which healthcare will again become reserved to the few. Heck we could theoretically be seeing the beginnings of a regression in the status of women in society, a move toward a more formal and legalized two-class structure (with lords replaced by CEOs, no doubt, as timo2 would perhaps posit), and so forth. I hope not. I hope the next step is a national solution for healthcare, where yet-even-more people can set aside especial worries about receiving basic care due to the economic straights they find themselves within.

 

[pb4uski]

What facts lead people to believe the health insurance companies are driving higher insurance rates? .....

The fact that, according to Forbes, CEO Heather Bresch had a 671% salary increase company recently Forbes Welcome

Timo.... you obviously do NOT get it. Heather Bresch is CEO of a pharmaceutical company, NOT a health insurance company. As samclem points out, the problem with health insurance affordability is really a problem with health care costs since insurers are required by law to pay at least 80% of what they collect in premiums in claim costs... if in a given year their claim costs are less than 80% of premiums then they are required by law to refund the difference to their customers.... so at most they can keep the remaining 20% for overhead, taxes and shareholder return.

So say you run an insurer and your estimated claim costs are $50 million so you set rates to collect $62.5 million... you collect $62.5 million and pay our $50 million in claims. The next year, the medical providers have increased their prices and the projected claim costs are $60 million so you set rates to collect $75 million...you have just increased premiums by 20%... because your claim costs increased 20% (from $50 million to $60 million). So if all that plays out then the medical providers and pharmaceutical companies get $10 million more and the health insurer gets $2.5 million more.

So at the end of the day, Heather's increase in reflected in the prices that the pharma charges to health insurers and that the health insurers pass along to their customers so I can see where you can legitimately see that Heather is part of the problem but what did the insurance company do wrong that causes you to think they are the problem?

 

[athena53]

She offered $300 coupons to help pay for the $600 EpiPens, which is the big moneymaker for Mylan, rather than offer to cut the price. By using coupons, Mylan still gets full price from the insurers and a lot of consumers may go away satisfied that their out-of-pocket has been reduced.

It's interesting, though, that the cost-shifting to the consumer (mostly in the form of very high deductibles) is having the anticipated effect. Few people notice the cost of an expensive med when the co-pay is $10. The backlash occurred when so many ordinary people for whom the EpiPen was a matter of life and death screamed about the steep cost increases. IMO, this is a very good development.