Tag: "insurance"

“It’s Awful, Just Awful”

That’s how an insurance industry executive, who spoke on condition of anonymity, describes the prospect for a successful health insurance exchange, as reported in The New York Times:

Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans…

By eaobamacare on trackrly this year, people inside and outside the federal bureaucracy were raising red flags. “We foresee a train wreck,” an insurance executive working on information technology said in a February interview. “We don’t have the I.T. specifications. The level of angst in health plans is growing by leaps and bounds. The political people in the administration do not understand how far behind they are.”

…just a trickle of the 14.6 million people who have visited the federal exchange so far have managed to enroll in insurance plans, according to executives of major insurance companies who receive enrollment files from the government. And some of those enrollments are marred by mistakes. Insurance executives said the government had sent some enrollment files to the wrong insurer, confusing companies that have similar names but are in different states. Other files were unusable because crucial information was missing, they said.

Oct 14, 2013 | 12 comments | by

The ACA will Cause a “Seismic Shift” Toward High-Deductible Health Plans

The ACA is therefore expected to cause a “seismic shift” in HDHP enrollment. Small employers newly required to purchase employees’ insurance may well choose HDHPs as the least expensive coverage option. Larger employers might adopt HDHPs to achieve ACA-regulated premium levels and avoid the 2018 “Cadillac tax.”

For individuals without employer-based insurance options, ACA-instituted health insurance exchanges will provide coverage at four levels of generosity (bronze, silver, gold, and platinum) to 5 to 10% of Americans younger than 65…Cover Oregon, for example, estimates that cost sharing for Oregon families with incomes between 200 and 399% of the poverty level will include $5,000 deductibles, 30% coinsurance for many services even after reaching the deductible, and out-of-pocket spending maximums of $8,500 to $12,700.

New England Journal of Medicine.

Oct 08, 2013 | 12 comments | by

Headlines I Wish I Hadn’t Seen

Ezra Klein: ObGTY_healthcare_websites_jtm_131001_16x9_992amaCare’s website is really bad.

Sen. Patrick J. Leahy: “There is no evidence that [bulk] phone records collection helped to thwart dozens or even several terrorist plots.”

With ObamaCare DSH cutbacks, safety net hospitals are at risk.

“You see, bronze and silver’s only good enough for everyone else in the country. For members of Congress and members of the Senate and their staff, it’s gold or nothing.”

Oct 04, 2013 | 16 comments | by

What Large Employers Are Doing

They’re sending their employees to private exchanges, armed with HSAs and HRAs:

Employers are raising deductibles, giving workers health savings accounts that look like 401(k) plans, mimicking the health law’s online insurance marketplaces and nudging patients to compare prices and shop around for treatments. Together the moves could eventually affect far more consumers than the law’s Medicaid expansion or health exchanges aimed at the uninsured and scheduled to open Oct. 1. (Kaiser Health News)

See Walgreen and others.

Sep 19, 2013 | 19 comments | by

Race to the Bottom

Within the ObamaCare exchange, that is:

To see the challenges awaiting some consumers, consider Woodland Hills-based insurer Health Net Inc.

health-netAcross Southern California the company has the lowest rates, with monthly premiums as much as $100 cheaper than the closest competitor in some cases. That will make it a popular choice among some of the 1.4 million Californians expected to purchase coverage in the state exchange next year.

But Health Net also has the fewest doctors, less than half what some other companies are offering in Southern California, according to a Times analysis of insurance data.

In Los Angeles County, for instance, Health Net customers in the state exchange would be limited to 2,316 primary-care doctors and specialists. That’s less than a third of the doctors Health Net offers to workers on employer plans. In San Diego, there are only 204 primary-care doctors to serve Health Net patients.

Other major insurers have pared their list of medical providers too, but not to Health Net’s degree. Statewide, Blue Shield of California says exchange customers will be restricted to about 50% of its regular physician network. (LA Times)

Sep 18, 2013 | 19 comments | by

It’s Third-Party Payers, Stupid

How can you write an entire column about waste in health care and never mention why there is waste? Uwe Reinhardt shows he’s up to the task at The New York Times economics blog. Maybe it’s that bottle of champagne he mentioned the other day.

Are there huge administrative costs in the market for cosmetic surgery? Not that I’m aware of. How about Lasik surgery? What about walk in clinics? Domestic medical tourism? I don’t think so.

Even with third-party payers, waste suddenly vanishes if they empower patients and get out of the way. It took all of two years for WellPoint’s cost of joint replacements at out-of-network California hospitals to almost match the in-network cost after WellPoint made patients responsible for the extra payments.

Think about that. WellPoint didn’t have to negotiate a fee with anyone. No arguing or hassling over the charge for an aspirin — or any other charge. Just patients explaining to the admissions office that they only had so much money to spend. (That’s almost as effective as global budgets and price controls without all of the unintended bad consequences!)

Is there waste in the Canadian health care system? Of course there is. It’s in the form of delayed surgeries. Cancelled surgeries. Even unnecessary surgeries. The cost of that kind of waste typically eludes the accountants however. That’s because the cost is born by the patients.

Sep 13, 2013 | 25 comments | by

Who Needs Navigators?

Health insurers are bypassing them and opening outlets alongside department stores and other typical mall tenants, reports USA Today:

Jmd HEALTHY MALL 0027Shopping center owners may not be courting them as they would Apple or trendy fashion brands, but health insurers are increasingly opening stores alongside far sexier retail tenants…

So, for the first time, insurers are fiercely competing to attract individual consumers and turning to traditional retail marketing techniques to do so, luring them into stores with special events and using splashy advertising. As any retailer knows, they have the greatest chance of converting shoppers to customers once they have them in their retail locations or on their sites.

Sep 12, 2013 | 17 comments | by

Commonwealth Report Shows Why ObamaCare Is Not Needed

obamacare-sign-350x250The Commonwealth report’s most revealing evidence comes in Exhibit 2, reproduced below. According to Commonwealth’s own survey data, fewer than one in 10 (9 percent) of Americans were always uninsured during the period 2011-2012. Among adults with incomes above 133 percent of the poverty level (just under $15,000 for a single person), only one in 20 (5 percent) Americans lacked health insurance for all of 2011 and 2012. (Chris Jacobs)

Sep 11, 2013 | 14 comments | by

Incentives

The 1,250 employees of Melton Truck Lines have two types of health insurance. The “iCare” policy requires workers and family members to get checked for blood pressure, waistline, cholesterol, triglycerides and blood sugar. The “I Don’t Care” policy requires no screening. It is 50 percent more expensive.

Jim Landers in the Dallas Morning News.

Aug 28, 2013 | 14 comments | by

Why Insurers May Want to Keep Customers in the Dark

Here is Austin Frakt, discussing a new paper by Benjamin Handel:

The difficulty consumers face in appreciating the value of plans and the resistance they exhibit in plan switching has a risk pooling effect. Think of it this way, if everyone could pick the plan that minimizes their cost, sicker individuals would end up in generous plans with higher premiums and healthier individuals in less generous plans with lower premiums. This is adverse (favorable) selection into the more (less) generous plans. That consumers don’t perfectly identify their costs under each plan and have status quo bias (inertia) undoes some of this selection.

I have long known that there is a lot of inertia under managed competition. For example, only a small percentage of federal employees switch plans every year. Of course, insurers could encourage more switching by explaining more clearly to those with health problems how they could gain financially by switching to a more generous plan. But why should they? The consumers gain is the health plan’s loss.

This is yet another way of understanding the effects of perverse incentives created by artificial health insurance markets.

Aug 26, 2013 | 21 comments | by
« Previous Page — Next Page »