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Calif. insurer's rate increases draw attention of federal government
WaPo ^ | February 8, 2010 | Alec MacGillis

Posted on 02/08/2010 4:43:38 PM PST by UAConservative

President Obama's secretary of health and human services fired off a sharply worded letter to a California insurer Monday, demanding to know why it is raising rates for individual policyholders by as much as 39 percent.

The unusual salvo offers a reminder that, even as health-care legislation lies in limbo in Washington, the battle over surging health care costs continues in other venues.

Anthem Blue Cross of California sent out notices earlier this month to many of its roughly 800,000 holders of individual policies, informing them that the costs of their plans would sharply increase to cover rising health-care costs. The increases do not affect employer-provided plans in the state.

The letters set off a furor among many Anthem policyholders, prompting California insurance commissioner Steve Poizner, who is running for the Republican gubernatorial nomination, to say that his department was investigating the increases.

On Monday, HHS Secretary Kathleen Sebelius joined the fray, writing Anthem President Leslie Margolin to impress on Anthem its "responsibility to provide a detailed justification for these rate increases to the public." In particular, she said, Anthem should disclose to policyholders what share of their premiums is going toward profits, administrative overhead and advertising, as opposed to covering medical claims. In its initial defense of the increases, Anthem has said only that its so-called "loss ratio" (the proportion of premiums spent on care) is above the state's required minimum of 70 percent.

(Excerpt) Read more at washingtonpost.com ...


TOPICS: Business/Economy; Culture/Society; Government; US: California
KEYWORDS: bho44; healthcare; hhs; sebelius
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To: votemout
I'm not a real big fan of tax breaks for particular expenses such as medical, educational, home buying, etc.

So even if it would work out that people would spend less overall, I believe the tax system needs to be simplified and aimed at providing sufficient income to run the government rather than encouraging/discouraging particular behaviors.

The only reason why I advocate having the government be lender of last resort is that I do believe that some people get hit with big medical expenses that they can't ever hope to repay in their lifetimes. We as a society will benefit if we can get them on their feet as quick as we can so that they can become productive members once again. They may not be able to pay off their expenses, but the system I propose would lead to a much lower overall cost to medical expenses, and the money lost by taxpayers in supporting those whose medical expenses outstrip their resources would be more than compensated by the lower overall cost to everyone.

41 posted on 02/08/2010 7:07:24 PM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: who_would_fardels_bear

The fact that you need bum panels at all is an admission you have just scrambled socialism around.


42 posted on 02/08/2010 7:36:03 PM PST by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: who_would_fardels_bear

well then why don’t you make it illegal to sell any kind of insurance including car, home or life plus dozens of others...


43 posted on 02/08/2010 8:35:47 PM PST by tubebender (Thanks to all the Patriots who support Free Republic financially...)
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To: who_would_fardels_bear

Cosmetic procedures aren’t covered now.


44 posted on 02/08/2010 11:59:09 PM PST by kmiller1k (remain calm)
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To: who_would_fardels_bear
I would like to see tort reform to limit awards on law suits reducing malpractice insurance. And insurance companies being able to sell in 50 states, may make more lower cost plans available and more people insured. If I was younger, I'd want major medical and I could pay for my doctor visits.

This would be a start with no government program increase and no increase in taxes.

45 posted on 02/09/2010 6:56:09 AM PST by votemout
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To: HiTech RedNeck
"you need bum panels at all"

Everywhere the government hands out money there are 'bum panels': Social Security, Medicare, Food Stamps, Student Loans, etc. You and I may agree that this is all socialist nonsense that should never have been created in the first place, but there is little chance than any of these will go away completely without a reasonable substitute.

I am proposing a reasonable substitute for Medicare and Medicad. A better idea than the original proposal is that the government wouldn't loan the money directly, but just guarantee the loans by private banks like they do with student loans. Then it would be the banks that would be needing to implement something like 'bum panels' to protect their own bums, as the English would say.

46 posted on 02/09/2010 8:49:00 AM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: kmiller1k
"Cosmetic procedures aren’t covered now"

Some insurance plans cover cosmetic procedures and silly things like aromatherapy. Maybe not Medicare or Medicaid, but some private plans do. There is always the possibility that if the government gets further enmeshed in health care that they will decide to cover elective and/or silly things.

I was merely trying to anticipate any criticism that someone might have of putting taxpayer money at risk for elective or silly treatments.

47 posted on 02/09/2010 8:51:42 AM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: tubebender
"why don’t you make it illegal to sell any kind of insurance"

Although a conservative case can be made against insurance in general (e.g. everyone should cover their own assets) the various kinds of insurance have evolved very differently and should be considered individually. Some insurance such as home insurance is only required if you don't own your home: it is really to protect the lender. Some insurance is totally voluntary like life insurance.

The reason why I believe this proposed plan will work with health insurance is that government is inextricably linked into the health care industry. Because hospitals must by law treat patients that come into emergency rooms, and so must get some kind of government funding to handle these excess costs, there must be some way of getting taxpayer money to the health care providers to handle these costs.

We as taxpayers have either actively or tacitly agreed to paying for the costs of uninsured or underinsured people. We pay higher insurance premiums than we would otherwise, and huge chunks of our tax dollars go to funding Medicare, Medicaid, etc.

My proposal is to merely simplify the stream of money from taxpayer to doctor. Everyone who can pays up front. Those who can't get loans in the private sector. Those who can't get loans from traditional banks, etc. get them from banks who provide loans backed by the U.S. government. Just like school loans. Most of those loans are paid off with interest, but some of them aren't. The difference is the tax burden to the taxpayer.

Unless we are willing to just let people die in the streets, I believe the proposed plan is the simplest one with the smallest government footprint.

Can you propose a plan that has an even smaller government footprint? I would definitely support such a plan.

48 posted on 02/09/2010 9:09:47 AM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: votemout
I agree with tort reform and I also believe that doctor visits (and other minor costs) should be handled without insurance.

However, I'm not so certain that allowing insurance companies to cross borders is going to be a panacea.

California already has a large number of insurance companies operating within its borders, and yet they are all jacking up their rates year in and year out.

If we completely lower the walls between states then my fear is that you will have the same thing happening in the insurance industry that happened in the banking industry: a few large insurance companies with a virtual oligopoly on the market making bad decisions in unison and tanking the entire system.

Then of course the government would have to come in and bail them all out as the insurance companies would then be "too big to fail".

49 posted on 02/09/2010 9:15:22 AM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: who_would_fardels_bear

What stops the bigger companies from setting up another company and going into other states now?


50 posted on 02/09/2010 11:54:56 AM PST by votemout
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To: UAConservative
In particular, she said, Anthem should disclose to policyholders what share of their premiums is going toward profits

Maybe my memory is bad but aren't Blue Cross plans suppose to be run on a non-profit basis.

51 posted on 02/09/2010 12:24:28 PM PST by C19fan
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To: who_would_fardels_bear

You are correct on one point and that is the cost of medical care has gone insane since health insurance came in to vogue and the same for prescriptions. Our two kids births cost us about $500 each in the late 50s now it runs in the thousands for a natural birth but most are induced because of the threat of lawsuits and cost more. We signed up with a GP for our primary care for a flat fee where we are given all the time we need or the Dr needs. We have his cell phone,home phone and eMail. Medicare at the primary level is next to nonexistent where you wait for a appointment and then you wait in the lobby for a different doctor and he gives you 7.5 minutes or his undertrained aide sees you and hands you a brown paper bag full of samples.


52 posted on 02/09/2010 2:31:13 PM PST by tubebender (Thanks to all the Patriots who support Free Republic financially...)
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To: C19fan
Most started out that way but saw that there truly was little actual difference to the bottom line, so some of them have changed to profit making corporations. Anthem Blue Cross of CA has done exactly that. Blue Shield of CA, an entirely separate "non-profit" corporation, still retains the old model.

Liberals and Democrats see "not-for-profit" corporations as somehow sanctified and almost as holy as GovernMental institutions/agencies. They intuitively believe that non-profits are more honest and trustworthy. The fact is... that's just false and utterly untrue. One is motivated by profits, the other by high salaries and totally liberal expense accounts.

One may be as motivated to build a solid reputation with good service and fairness, as the other!!!

53 posted on 02/09/2010 3:20:09 PM PST by SierraWasp (NO MORE BOLSHEVIK PLOTTERS IN THE WHITEHOUSE!!! NO MORE IN OUR GOVERNMENT!!!)
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To: SierraWasp

Thanks for the clarification.


54 posted on 02/09/2010 3:21:55 PM PST by C19fan
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To: votemout
Nothing. I think just about every state has a version of Blue Cross / Blue shield.

So all this Republican hype about opening up the insurance market is just hype.

Large corporations would like to have the exact same laws and taxes in every state so that it will make their lives a bit easier.

They should just grow up and understand that this is a republic where each state is capable of making its own laws and if they don't affect a particular industry the exact same ways, then the corporations can buy better software or higher smarter consultants to handle the differences.

55 posted on 02/09/2010 5:32:12 PM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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To: tubebender
If more and more people move to pay as you go or pay by the month plans then maybe much of health insurance will go the way of the buggy whip.

That works for me.

56 posted on 02/09/2010 5:33:46 PM PST by who_would_fardels_bear (These fragments I have shored against my ruins)
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