Aetna pulling out of ACA

If the medicaid expansion reduced the number of ER patients who didn't pay, it could be even more lucrative for hospitals.
 
Texas Proud said:
If they are doing so bad (and I will not say all of them are doing good), then why is there a building boom going on here in Houston:confused:

I do not think they would be spending so much on construction in order to lose money...

Just sayin.....
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The hospitals that are in The Woodlands, Texas are surpassing the economic impact of the oil industry, which this area is the northern Houston hub. (and where the new 465 acre Exxon complex is built and has near 8,000 employees)

Recently, there was a piece in the local rag about how the depressed real estate market in the Woodlands, caused by the loss of thousands of local oil & gas company jobs, will be offset by the new health care jobs that will be forthcoming as a result of the two new hospitals under construction.

There are already two very large hospitals here and scores of medical center buildings. There is also another (two?) regional hospital 10 miles away.

I simply can't imagine how all of these hospitals/medical centers/clinics are all going to make money in an area with roughly 150,000 residents.
 
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Think Car & Home Insurance, they all work on the same principal, if we are going to have the current health system it should work the same way surely?
 
ShokWaveRider said:
Think Car & Home Insurance, they all work on the same principal, if we are going to have the current health system it should work the same way surely?
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I agree because if you don't have home insurance and it burns down it doesn't cost me anything, same if you wreck your car and only have liability it doesn't cost me anything. So just because someone does not have health insurance why should I have to supply it through "cost sharing" I pay enough in taxes for handouts to those that poorly planed their life.
 
Just_Steve said:
I agree because if you don't have home insurance and it burns down it doesn't cost me anything, same if you wreck your car and only have liability it doesn't cost me anything. So just because someone does not have health insurance why should I have to supply it through "cost sharing" I pay enough in taxes for handouts to those that poorly planed their life.
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BINGO! Thank you. That is the whole point of a Nationalized System, with the exception that the Very poor still do not pay. But that I OK in my books, they still get service anyway even in the current system.
 
Just_Steve said:
I agree because if you don't have home insurance and it burns down it doesn't cost me anything, same if you wreck your car and only have liability it doesn't cost me anything. So just because someone does not have health insurance why should I have to supply it through "cost sharing" I pay enough in taxes for handouts to those that poorly planed their life.
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I'll add that there is also very good capitalistic competition in the home and car insurance market....something that a nationalized health care system would not have.
 
Whisper66 said:
I'll add that there is also very good capitalistic competition in the home and car insurance market....something that a nationalized health care system would not have.
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True. But in reality, home, car and life insurance are actuarially much easier to price properly.

I don't think the health insurance problems we have are primarily a question of public or private sources of funding. They are much deeper than that, IMO.
 
ShokWaveRider said:
Think Car & Home Insurance, they all work on the same principal, if we are going to have the current health system it should work the same way surely?
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I am going to agree with you, but not in the way you intended... Yes, lets have health insurance exactly like auto and home, I agree... That way my health insurance can go back to $80 for $5000 deductible it was 19 months ago instead of $325 with $6500 deductible. Using the auto/ home owners insurance "rated" model would save me a fortune!

I do not think you really mean to compare health insurance with auto and home... Make frequent "use" of those services and see where your premium goes. :)


Sent from my iPad using Tapatalk
 
aja8888 said:
Most people paying a $10 co-pay for a med are not told what the actual retail "price" (cost?) of the med is. I also doubt if that retail price is the same from pharmacy to pharmacy.
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I just filled 2 prescriptions for my daughter at Walmart. I noticed they put the retail cost on the rx slip right next to my $10 copay cost. One was an antibiotic for $53 for a 7 day supply. The other was $102 for a tube of acne cream. Both cost me $10 but would have cost the respective retail cost if I didn't have insurance (and didn't have a freebie rx card or coupon). I see on my EOB that my insurance company paid $2 for the antibiotic (I paid $10 so total cost w/ insurance was $12). The acne cream cost the insurance company $61 plus I paid $10.

I was amazed that Walmart actually showed the retail price on the receipt. They still couldn't tell me the price when I filled the rx's, they said I had to wait till I came to pick them up.
 
Just_Steve said:
I agree because if you don't have home insurance and it burns down it doesn't cost me anything, same if you wreck your car and only have liability it doesn't cost me anything. So just because someone does not have health insurance why should I have to supply it through "cost sharing" I pay enough in taxes for handouts to those that poorly planed their life.
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But I thought we do pay for the poor. They're either covered under Medicaid or they go into ERs and leave big bills that they never pay for so the hospitals just jack up the rates for everyone else.
 
aja8888 said:
The hospitals that are in The Woodlands, Texas are surpassing the economic impact of the oil industry, which this area is the northern Houston hub. (and where the new 465 acre Exxon complex is built and has near 8,000 employees)

Recently, there was a piece in the local rag about how the depressed real estate market in the Woodlands, caused by the loss of thousands of local oil & gas company jobs, will be offset by the new health care jobs that will be forthcoming as a result of the two new hospitals under construction.

There are already two very large hospitals here and scores of medical center buildings. There is also another (two?) regional hospital 10 miles away.

I simply can't imagine how all of these hospitals/medical centers/clinics are all going to make money in an area with roughly 150,000 residents.
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Maybe they planned those facilities years ago before the oil price drop.

Or maybe those oil companies have generous retiree health care benefits.
 
FUEGO said:
I just filled 2 prescriptions for my daughter at Walmart. I noticed they put the retail cost on the rx slip right next to my $10 copay cost. One was an antibiotic for $53 for a 7 day supply. The other was $102 for a tube of acne cream. Both cost me $10 but would have cost the respective retail cost if I didn't have insurance (and didn't have a freebie rx card or coupon). I see on my EOB that my insurance company paid $2 for the antibiotic (I paid $10 so total cost w/ insurance was $12). The acne cream cost the insurance company $61 plus I paid $10.

I was amazed that Walmart actually showed the retail price on the receipt. They still couldn't tell me the price when I filled the rx's, they said I had to wait till I came to pick them up.
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Walmart has been doing that for a long time. On the prescription slip you see cash price and patient pays.
BTW if some one on this forum has bought an epipen with insurance recently what does the EOB say the insurance company paid?
 
aja8888 said:
The hospitals that are in The Woodlands, Texas are surpassing the economic impact of the oil industry, which this area is the northern Houston hub. (and where the new 465 acre Exxon complex is built and has near 8,000 employees)

Recently, there was a piece in the local rag about how the depressed real estate market in the Woodlands, caused by the loss of thousands of local oil & gas company jobs, will be offset by the new health care jobs that will be forthcoming as a result of the two new hospitals under construction.

There are already two very large hospitals here and scores of medical center buildings. There is also another (two?) regional hospital 10 miles away.

I simply can't imagine how all of these hospitals/medical centers/clinics are all going to make money in an area with roughly 150,000 residents.
Click to expand...


And it is not just those up in the Woodlands.... there are a few smaller ones down in the 249 area and in between... not all are the big ones....

Also, the whole 1960 area is chock full of hospitals and health care facilities... not to mention the Medical Center where there are more hospitals concentrated together than any other place on Earth.... they are building down there also... I have no idea about any other areas, but would think building is going on all around the city....
 
meierlde said:
Walmart has been doing that for a long time. On the prescription slip you see cash price and patient pays.
BTW if some one on this forum has bought an epipen with insurance recently what does the EOB say the insurance company paid?
Click to expand...

I didn't know that. Guess it's been a few years since we've needed any prescription meds other than the $4 or $9 generics they sell.

FYI I checked the epi-pen in my insurance with unitedhealthcare with optumrx pharmacy benefits and it said insurance pays $561 and I pay $40 for a 2 pack. That's the estimate so I think it's the retail rate. I'm also curious what the negotiated rate is.
 
Texas Proud said:
And it is not just those up in the Woodlands.... there are a few smaller ones down in the 249 area and in between... not all are the big ones....

Also, the whole 1960 area is chock full of hospitals and health care facilities... not to mention the Medical Center where there are more hospitals concentrated together than any other place on Earth.... they are building down there also... I have no idea about any other areas, but would think building is going on all around the city....
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We are seeing the same thing in Colorado, new hospitals, and lots and lots of urgent care centers, sometimes within a few blocks of each other.
 
MichaelB said:
The issue we have is not only how to prevent costs from rising, it is also how to deal with costs that are now unaffordable for so many. And how to reconcile a system where insurers demand that the population be subject to a "must insure" regulation but won't accept to the same extent a "must insure" requirement.
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The latter is at the heart of the problem - if people accept that everyone should be able to get insurance (I think this is the consensus now) then there must be some system that ensures that all, or most all, have insurance. Without a wide risk pool the market fails.

And there's been no serious ACA replacement proposal that I've seen that addresses this.
 
My guess is that they were highly 'encouraged' to stay in the market with some sort of quid pro quo. BCBS in particular is one of the big government employee/retiree HC insurers, don't know if they handle AZ or not.
 
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GTFan said:
My guess is that they were highly 'encouraged' to stay in the market with some sort of quid pro quo. BCBS in particular is one of the big government employee/retiree HC insurers, don't know if they handle AZ or not.
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51% increase is quite a lot of quid in itself! :D
 
RockyMtn said:
BCBS is still dumping out of the rest of Az other than Pinal County!
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Source?

These say otherwise for 2017 and are consistent with notices from the Blue Cross Association.
Cigna: Sole carrier in Maricopa only
Blue Cross Blue Shield of Arizona: Sole carrier in all remaining Arizona counties, except Pima, where it competes with HealthNet.

https://www.thehertelreport.com/phoenix-health-plan-latest-to-quit-the-2017-him/

Adding Pinal County means BCBSAZ will sell plans in 14 Arizona counties, and be the sole carrier in 13 of them. "We are committed to serving these areas in 2017," said Rich Boals, president and CEO.

Blue Cross Blue Shield of Arizona to Offer ACA Individual and Family Plans in Pinal County in 2017
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I got my official letter from Coventry today. I hope I can find a plan on the exchange that has my wife's specialist. Now, I have to wait until November 1.
 
A year ago when companies started to drop out, this was called letting the market work, and thinning the weak competitors from the herd.
 
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