Insurance industry lobbyist: "Health reform without a public option would be fantastic for insurers

[Better Believe It]

Robert Laszewski - President

A policy and marketplace consulting firm specializing in assisting its clients through the significant health policy and market change afoot. Clients include health insurance companies, casualty insurance companies, HMOs, Blue Cross organizations, hospitals, and physician groups.

Health care reform without a public option ''would be fantastic'' for insurers, said Robert Laszewski, president of Health Policy and Strategy Associates, a Virginia-based health care consulting firm.

''They're going to get millions of new customers and more than a trillion in new premiums over a 10-year period,'' said Laszewski, a former industry executive. ''There's a reason they aren't running any negative ads.''

The plan also would send new business to providers.


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David Bachman is a senior research analyst at Longbow Research covering healthcare facilities. David holds an MBA in finance and strategy as well as a certificate in health systems management from Case Western Reserve University. Prior to joining Longbow Research, David spent a number of years in healthcare administration.


Another analyst, David Bachman of Longbow Research in Independence, Ohio, expects spending on doctor visits would jump $8.5 billion a year under Obama's proposal.

He also expects to see an initial increase in spending on supplies used during patient visits, amounting to roughly $2 billion per year, and billions of dollars more for diagnostic testing and prescription drugs.

Overall, Bachman said his ''back-of-the-envelope calculation'' indicates a 15 percent increase in spending at hospitals, 17 percent more for doctor visits and 10 to 12 percent more for patient supplies. Insurers will then pass those increases on to customers, he said.

''They're going to raise premiums on employers, who are going to raise costs for employees,'' Bachman said.

http://www.nytimes.com/aponline/2009/09/10/us/AP-US-Health-Care-Insurance.html

[andym]

1. There are two ways to rein them in short of single-payer

1) A strong government competitor
2) A tight cap on premiums and total cost

[Tansy_Gold]

2. A strong government competitor has just been ruled out

According to the Obama plan, the "Public Option" is the last resort for those who can't get anything else. It will not be funded by the government or taxes; it will be just a gigantic pool of the otherwise uninsured insuring themselves. They'd be better off with medical savings accounts earning some interest in a bank; at least then they wouldn't even have to pay administration costs.

How is the government, or any government agency going to regulate costs and cap premiums? You got any ideas? Do it the way they do Medicare? Then why not just DO Medicare? Otherwise you're just adding another layer of costs into an already bloated bureaucracy.

the Obama plan is nothing but a gift to the insurance companies. It does virtually nothing for the millions who do not have insurance and therefore do not have dependable, affordable health CARE. CARE got lost in the Obama equation. It's all about INSURANCE and INSURANCE COMPANIES and not about people any more.


TG

[andym]

3. It's easy to cap premiums effectively

1) create a basic plan that includes full services
2) make everyone eligible
3) Set the maximum price and have a commissioner review that each company offering the plan is in compliance.

Is it as an efficient plan as extending Medicare? No way.

But as a very cost-effective plan (that will cost the government FAR less than expanding Medicare or creating a public plan, etc) it is superior in an era when everyone is afraid to "raise" taxes. It would of course be quite the burden for the insurance companies, but I'm not sympathetic to their potential plight.

[Tansy_Gold]

5. You're leaving out too many definitions

What's a "basic plan"? How is it different from a "full plan"? Who determines that? The govt or the insurance industry?

Costs are different in different parts of the country. Just as some communities have established "living wage" laws to fit the community's costs of living, costs of health care are different.

"Basic plan" vs. "full plan" establishes two distinct tiers of coverage. If you're on the basic plan, do you get bumped if someone on the full plan wants their surgery "now" and even though they could wait and there are risks for you to wait, will they still get in ahead of you? Do they get "better" doctors?

the maximum price may put the "basic" plan out of reach for many people. that's no improvement over the shit-hole we've got now. Besides which, it's a windfall for the insurance companies, the assholes who caused the problem. yay! Let's reward them some more! :sarcasm:

I've never made a secret on this board that I'm a small-s socialist. What Obama has proposed is so vague and so tilted to the insurance industry that it makes me wanta puke. And I have spent far too much time today defending myself against the slings and arrows of people on DU who seem to think they've just been given ponies. Just wait'll they try to ride those paper horses. . . .

Fact is, Obama's plan is really really vague so he can deny he ever made any concrete promises, other than to "protect" the insurance companies. That's not leadership; that's a cop-out.


Tansy Gold

[andym]

6. Here are some easy definitions for you

1) A basic plan would cover the same conditions that Medicare covers-- it will meet people's needs

Anything more than that could be in a "full" plan. (to hold down costs for the basic plan etc)
However, it is unlikely that the insurers' full plans would be as good as this basic plan, or nearly as cost effective.

2) An example would be to cap premium (and copay etc) costs at say 5% (maybe 10%, but that might be a tad wasteful) over the cost of an average patient of Medicare with an average usage of the system. Because Medicare actually requires greater
spending for conditions associated with old age, this is probably an overestimate of the real costs, so more savings might be possible.

That would probably be as inexpensive as it could possibly be. The overhead for Medicare is currently at 3%, so we'll see if private insurers can really do everything better than the government.
To make it work, the services rendered for this basic plan would bill the providers at the Medicare rate.

Essentially this is forcing private insurers to provide Medicare, without new taxes. It's a great idea that should be given a lot more play. I think it would eventually require real Medicare for All, because Insurers will not want to do it.

3) The only expensive part would be to give subsidies to those who need them.


You can read more about the details here if you are really interested.
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6488988

[bvar22]

4. Health Reform with a WEAK and LIMITED Public Option,

like the one specified in HR 3200 will do the same.

''They're (For Profit Health Insurance Industry) going to get millions of new customers and more than a trillion in new premiums over a 10-year period,''

I can't believe that a large part of DU is celebrating this sell out.

I guess it appeals to low information voters? :shrug:

[burrowowl]

7. Yes it is!

Their stocks went up!

[brentspeak]

8. This article pretty much sums it up