ACA "bomb" goes off today?

[Ddrak]

http://www.forbes.com/sites/rickungar/2 ... halleluja/

So health insurers have to spend 80% of revenue on actual medical care now. That's going to be interesting! In the absence of a public system, I can live with that.

Dd

[Lurker]

The ACA is also shrinking the doughnut hole in prescription drug coverage, benefiting millions of seniors, and has helped slow the growth in Medicare spending, bending the cost curve. As I've said in the past, the ACA contains provisions that promote quality care over quantity. That's the only way to lower long term costs.

The law isn't perfect, but it was clearly the best possible solution that could make it through our broken Senate system.

[Harlowe]

I think the bomb is the best part of this deal. Thankfully they aren't allowed to have selling commissions included as "medical expenses". If that would have happened, this whole endeavor would be futile.

It's not perfect, but it's better than status quo.

[Embar Angylwrath]

http://www.forbes.com/sites/rickungar/2 ... halleluja/

So health insurers have to spend 80% of revenue on actual medical care now. That's going to be interesting! In the absence of a public system, I can live with that.

Dd

Except that nationally, 87% of the premium is spent on medical care.

http://www.nd.gov/ndins/uploads%5Cresou ... rivers.pdf

Nationally, 87 cents of every health insurance premium dollar is spent on medical services: 33 cents pays for physician services; 20 cents go to inpatient costs; 15 cents go to outpatient costs; 14 cents pay for medications and 5 cents pay for other medical services. The other 13 cents of every dollar is spent on administrative costs, consumer services, marketing and profit.

[Ddrak]

Except that nationally, 87% of the premium is spent on medical care.

http://www.nd.gov/ndins/uploads%5Cresou ... rivers.pdf

Nationally, 87 cents of every health insurance premium dollar is spent on medical services: 33 cents pays for physician services; 20 cents go to inpatient costs; 15 cents go to outpatient costs; 14 cents pay for medications and 5 cents pay for other medical services. The other 13 cents of every dollar is spent on administrative costs, consumer services, marketing and profit.

That's a distortion. They are counting broker commissions as "medical services", which amount to 6-10% of the total. If it really were 87% then the insurance industry would have had no issue with the 80%/85% mark.

The true number is between 70% and 90% depending on your state and whether you're looking at individual or group insurance. I've seen indications that California is pretty close to the 70% mark, particularly if you're looking at the larger for-profit companies.

Dd

[Embar Angylwrath]

I didn't see anything in that report that grouped broker commissions as a medical expense. I might have missed it, can you point that out?

[Ddrak]

Given that they are 6-10c, they can't fit anywhere else. Also, given that the numbers were provided by the insurers themselves and not an independent agent you have to assume they are using the practices they were complaining about being shut down.

Dd

[Embar Angylwrath]

Given that they are 6-10c, they can't fit anywhere else. Also, given that the numbers were provided by the insurers themselves and not an independent agent you have to assume they are using the practices they were complaining about being shut down.

Dd

Ah, I see. You're making assumptions.

[Ddrak]

Given that they are 6-10c, they can't fit anywhere else. Also, given that the numbers were provided by the insurers themselves and not an independent agent you have to assume they are using the practices they were complaining about being shut down.

Dd

Ah, I see. You're making assumptions.

Deductions in the first case. Well founded assumptions in the second that are certainly just as solid as providing information from a pro-insurer agency on how well behaved the insurers are.

Dd

[Embar Angylwrath]

Do you know what an insurance commission is? It exists to keep insurers in check. Hardly pro-insurance company.

[Ddrak]

Do you know what an insurance commission is? It exists to keep insurers in check. Hardly pro-insurance company.

/shrug. It's a Price-Waterhouse-Coopers report. You can read it if you like for a more detailed breakdown. The specifics of the administrative costs are explicitly laid out and do not include brokerage fees. Of course, given my first point which hasn't been rebutted, this was obvious anyway.

Dd