Anthem (BCBS) likely to pull out of ACA markets in 2018

[respond2u]

Quote:

Originally Posted by Chuckanut The problem is that we are focusing on the cost of insurance rather than the root cause which is the cost of medical care. Fix the cost of medical care and the cost of insurance will come down. Good medical care will never be 'cheap', but we have one of the highest cost systems in the world. And, there are plenty of special interests that want to keep it that way.

From talking with old doctors, medical care wasn't insanely expensive until we started having more health insurance.

As one writer put it "we didn't need health insurance until we had health insurance." [From what I heard, health care costs took off big time when the fed'l govt became the health insurance provider for the old and poor and not just vets. ]

[athena53]

Quote:

The cost of malpractice insurance itself isn't that huge and fluctuates with the stock market rather than any changes in the malpractice payouts .

I am a retired Fellow of the Casualty Actuarial Society. Your statement above is wrong. Malpractice insurance premiums are a function of anticipated claims, plus a profit and expense load, with some offset for anticipated investment income on the float between when premiums are received and claims are paid- but claim costs are by far the largest component.

[pb4uski]

+1 The cost of malpractice insurance has nothing to do with the stock market.

[Chuckanut]

Maybe we need something like this:

Quote:

My great great grandfather gave some veggies, cheese, fruit and occasionally a chicken each week to the village doctor as long as everybody was well. If a person got sick, the payment was eliminated until the person was better. Death of anybody in the family (ages 4+ to 60 years) by disease or a non serious accident meant the doctor did not get paid for a many months.

[pb4uski]

Quote:

Originally Posted by respond2u From talking with old doctors, medical care wasn't insanely expensive until we started having more health insurance. As one writer put it "we didn't need health insurance until we had health insurance." [From what I heard, health care costs took off big time when the fed'l govt became the health insurance provider for the old and poor and not just vets. ]

+1 Also, college wasn't insanely expensive until we started having more student aid and student loans.

Is there a pattern developing?

[samclem]

Quote:

Originally Posted by pb4uski +1 Also, college wasn't insanely expensive until we started having more student aid and student loans. Is there a pattern developing?

A $300 textbook or $20K annual tuition is no problem when everyone is eager to throw money at you. "Making college affordable" indeed.

Not much of a housing bubble until it became a national policy to make sure everyone could buy one at subsidized interest whether they had a job or not.

Yes, maybe a pattern . . .

[pb4uski]

Those who do not learn from history are doomed to repeat it.

[NW-Bound]

<Deleted by poster>

[jesaco]

Quote:

Originally Posted by AllDone Billing services, which most practices use, generally charge about 20% of receipts.

I been involved with medical billing companies and they usually charge 3-5% of collected claims not 20%.(based on what the insurance pays NOT what the doctor charges).

[Henry Lili]

BCBS only one in my area as well. I don't get a subsidy anyway , I buy from them directly. The plan was on exchange in 2016 and is off exchange this year. With any luck, it, or similar, will be available to me next year. If not, have to see what other options are available when the time comes.


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[audreyh1]

BCBSTX is the only individual plan left in our area. They are not Anthem. We buy an off exchange plan already. I hope they remain an option.

[travelover]

Quote:

Originally Posted by athena53 I am a retired Fellow of the Casualty Actuarial Society.......... .

And here I thought you was a lady.

[athena53]

Quote:

Originally Posted by travelover And here I thought you was a lady.

Yeah, my sister is a Fellow of the American College of Obstetricians and Gynecologists. My parents are so confused.

[marko]

Quote:

Originally Posted by respond2u As one writer put it "we didn't need health insurance until we had health insurance." [From what I heard, health care costs took off big time when the fed'l govt became the health insurance provider for the old and poor and not just vets. ]

When I was a young'un 50 years ago I was in a fender bender. Took the car to the auto body shop. As the guy was doing the estimate, I told him I didn't have collision insurance. He then put his price book away and took down another one with different, lower prices. He said "I charge more for insurance claims because, well, they pay it..."

[pb4uski]

Ergo, the problem.

[travelover]

I've noticed that veterinarians are pushing pet health insurance. That can't be good for pet care costs.

[NW-Bound]

I just recall a song from decades ago.

https://www.youtube.com/watch?v=mSLXWXuch-4

[MichaelB]

"The cost of health care is high because insurance is there to pay it" and "The cost of insurance is high because healthcare is expensive" is circular reasoning. There is no attribution here, just a simple correlation.

[Chuckanut]

Quote:

Originally Posted by MichaelB "The cost of health care is high because insurance is there to pay it" and "The cost of insurance is high because healthcare is expensive" is circular reasoning. There is no attribution here, just a simple correlation.

I would argue that it is a feed back loop gone wild.

[MichaelB]

The most comprehensive study I've seen on the cost of healthcare in the US is still the McKinsey Global Institute "Accounting for the cost of US health care: A new look at why Americans spend more " (here). Even though it's dated (from '08), the only change is that US healthcare is now even more expensive. Their conclusions point to many different factors driving up the cost, such as lifestyle, defensive medicine, legal costs, overuse, but the single biggest driver of cost differential is price, after accounting for all other factors.

In other developed OECD countries, the pricing of healthcare services is regulated, there is a greater supply of practitioners, and prices are cost based. In the US, there are fewer licensed physicians and healthcare prices are not cost based, they are value based (what's it worth to you). This is brutally evident in pharmaceutical pricing.

This is a critical difference, because value based pricing has no upper limit. This is easily observed in hospital pricing, which has become almost entirely unrelated to the cost of care. For any given stay, a hospital bill is a list of everything they are able to charge for, applying prices that are entirely unrelated to the cost of the service and what they eventually expect to collect. In other words, hospitals are revenue generating machines with cost centers, instead of care centers.

In other words, the cost of healthcare in the US is likely to continue to increase at a rate higher than GDP, inflation, and OECD average.