Posted on 03/07/2019 5:45:23 AM PST by DoodleDawg
Remember when President Trump campaigned on a health care platform of eliminating "the lines around the states?" Well, that particular white whale has re-emerged.
Driving the news: The Trump administration posted a 15-page document Wednesday asking for public comment on a range of questions related to the interstate sale of health insurance — including questions about using part of the Affordable Care Act to make that change.
How it works: Critics see this as a backdoor way to deregulate insurance. If a patient in New York can buy a lightly regulated policy from Iowa, what good are New York's rules about what plans have to cover and how they have to cover it?
There are logistical hurdles: It's pretty hard to set up a network of doctors and hospitals that will work for patients in both Iowa and New York.
Between the lines: The administration already took a bit of a victory lap on this front when it expanded access to association health plans.
That wasn't a full-scale deregulation, but it did expand of a type of insurance that can cross state lines — even though, due to the difficulty of creating provider networks, those plans are generally confined to one metro area.
When you buy a car, there is a buyer and a seller involved in the transaction.
When you buy a medical insurance plan, you are buying insurance coverage for future transactions between a patient and medical facilities (and doctors). So the health care process is far more complex because you have a third party involved in every transaction -- which completely distorts the pricing of medical procedures.
The biggest problem isn't necessarily the back room deal between the insurance companies and the government ... it's the back room deal between lobbyists for every medical practitioner and the government. These organizations lobby governments all the time -- just to force insurance companies to pay for their pet procedures. That's how you get an ObamaCare law that makes insurance far more expensive because it requires insurance plans to cover procedures that most people don't want to have anyway.
I have no problem with anyone making decisions about how much coverage they need.
I really have no problem with people buying "insurance" from fly-by-night companies that go bankrupt before they pay any claims out, either. That's the customer's problem, I guess. Just don't waste my time by having the government force me to sit on a jury every time these cases go to court.
Sure is... And most are too stupid to see it. I do have one thing to argue though...
“The insurance company guarantees the health care provider a large bag of money for their services,”
The insurance companies cry about how little profit they make. Yet they are actually only paying 5-10 cents on the dollar for services billed. In the meantime they are raping the policy holders with premiums, co-pays, and deductibles. It’s all BS...
Basically they are reaping it all in and it only costs them when there is a case of emergency. until then what you are paying out of pocket BEFORE the cost of the premium is covering all the bill totals after they are negotiated down anyways. So the premium ends up being mostly profit.
And the “balance” healthcare providers don’t get from the insurance companies after “negotiating” the price is written off their taxes so that the burden goes to the taxpayers and not the insurance Co. or themselves.
Just deregulate it and all this will fix it’s self and the system will become the best and cheapest in the world within a few years.
Thanks for illuminating the problem, as your expertise shows.
>
The McCarran-Ferguson Act of 1945 stipulated that the insurance industry could not be regulated at the Federal level. This is because Congress determined that an insurance policy is a contract, not a commercial purchase ... and contract law comes under the jurisdiction of state courts.
>
Yet, they interfere vs. ‘min. wage’ and all else...Here’s where “regulate (make REGULAR) interstate commerce” should truly kick in
Five states have passed laws allowing residents to buy health insurance from out of state companies not registered in their state - Georgia in 2011, Kentucky in 2012, Maine in 2011, Wyoming in 2008, and Rhode Island in 2010. Some had restrictions, Rhode Island required the company to at least be doing business in New England, but for the most part any company licensed in another state was allowed. To date, not a single policy has been sold to any of the citizens of any of the states. If that isn't failure then what is it?
Such a transaction makes no sense for either party. For the insurance company, they have no network set up to control their costs so they have to pay whatever the service provider charges. Unless the insured makes zero claims then there is no way that they can make money charging those out-of-state customers the same premium they charge their in-state customers. For the insured, every doctors visit they make is out-of-network so they pay higher co-pays, a higher deductible, and a larger percentage of the total bill than they would if they had a policy from an in-state provider. Given that where is the incentive for either party?
They already do this on a county-by-county basis within a state. Doing the same thing on a state-by-state basis is a trivial addition. And I would bet that regulation IS a big part of it.
Deregulate and see who succeeds in competition.
I have only received one ignorant reply. Shill for the insurance industry government beuracrats somewhere else.
I have had Humana for many years. For 2018 they rolled out a new policy that effectively did away with the network system.
I can go to ANY doctor in ANY state and ANY hospital and pay the same costs.
For visits to a GP I pay $15 copay, less than the $20 copay I was paying previously.
My copay for specialists has remained the same, $45 a visit.
For procedures, tests or surgery the costs are a mixture of increases and reductions. If my GP wants an X-Ray I now pay $15 for the visit and less for the X-Ray than previously.
When my neurologist ordered an MRI because I had the worst case of vertigo he had ever seen the MRI ended up costing me $310 compared to the $900+ under the previous policy.
It was an inner ear problem so they sent me to Audiology, $45 for the visit copay and $108 for the test and procedure that would previously cost at least $700.
And they changed their pharmacy by mail. Before my savings would have been negligible so I kept my local pharmacy and paid $93/month for my meds.
Now, since all my meds are generics, my medicines cost $0.00. I go online, request a refill and in 7-10 days it’s delivered to my door.
The amount for Medicare deducted from my monthly benefits did increase by $35 but Humana is no longer deducted so there is a net savings of $70.
My savings in premiums and drug costs is currently $163/month.
A YUGE win for me.
Yeah, national networks are very doable. If the insurance company has the will.
But now I've received two.
Good info about Humana. The wife and I had Humana Medicare Advantage for a while, but they dropped the type of policy that we wanted....but only in our country. If we lived another county over, we could still have gotten it. All due to the network bullbleep. We currently have Premera Blue Cross, but we will be relocating to Texas, so we will need to transfer when we make the move.
This always seemed like a good idea to me. At the very least the large multi-state companies can save money by consolidating bureaucracies.
That is hardly an example of real competition across the entire country. Texas has made some real progress on deregulation and shown just the opposite until Obamacare destroyed the insurance industry.
I ended up with Humana because no one else could sell me a policy because of the county I lived in at the time.
When I moved to my present county I had more options but kept the Humana.
Go to the Humana website and checkout which policies are available in the part of Texas you’re moving to. Never too soon to start looking.
Yup..already made a start on that, but from the other direction (looking at what policies are available in Bexar county)....good idea to look at the Humana site as well.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.