A health insurance story from today at work

[SHRED]

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At a meeting at work this morning we were informed that our health insurance premiums, for dependant care coverage would be going up for next year.
We have Blue Cross or Kaiser, as our "choices".

Blue Cross a 5% rise.
Kaiser a 14.80% rise.

The kicker here is when we were explained the reason for the increases by a fellow employee who is on the committee that researches health insurance where I work.
We were told that the insurance companies looked at the amount of times we went to the Doctor as a group. Kaiser found that we went "more times this last year than normal". Therefore they needed to increase the rates.

I sat there trying to absorb the horseshit I just heard. The employee was telling us this with a straight face. She said that was the reason that Kaiser gave her so we better "think twice before going to the Doctor If you get the 'sniffles'".
She was merely repeating the propaganda as fact.
Again, I was stunned.

Visions of CEO bonuses, Lear Jet trips, profit margins, and share holder interests poured through my brain.
But NO!!!! It is our fault. Holy shit.

Like sheep, most everyone only started to question what she said well after the meeting when I brought up this obvious bullshit planted in this employee reps head by these mega health corporations.

I wish I could replay that scene and ask questions during the meeting but it took a while for me to come down from my confused outrage.
The audacity of Kaiser to blame their patients is astounding.

I want to put together a flyer to distribute about Blue Cross and especially Kaiser.
It would include CEO pay and profits juxtaposed with the sarcastic statement, "But it's really our fault for the rate hikes...quit using what you are paying for".

Anyone know where I can find info?
Any other flyer ideas.

This had me upset all day and everyone I talked to about this was like, "yeah...that wasn't right".
I hate it when the victim is made the scapegoat.
I want to do more.

Frustrated.


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[iamjoy]

1. Well, It Is True

Kaiser is an HMO and a fully insured plan. Kaiser and your company agree that Kaiser will cover all of your company's employees who elect that plan for say, $3,000 per participant per year. That means all the medical expenses for all the people covered under Kaiser, Kaiser pays. Let us say the average per participant cost for the year was $3,400. Kaiser lost money on that contract. Kaiser realizes that this company has high utilization of services. So, next year, when your company negotiates rates with Kaiser, Kaiser ups its costs accordingly. In this way it is not so very different than the way insurance companies raise their rates across Florida after a hurricane hits.

A PPO (Blue Cross does both HMO and PPO) is generally a self insured plan. That means the insurance company may adjudicate claims and charge a service fee, but ultimately, your employer is paying the cost of the claims. So, they have a little more flexibility with prices, because even if the actual claims costs were higher than the estimated claims costs, a large company can absorb these losses if they are not too great (which there is back up insurance for that) or don't continue for several years.

So, there is some truth to the fact that high utilization of health plans may lead to an increase in premiums for subsequent years. Of course, it is a rare thing that insurance companies LOWER premiums. And even when they "lose" money, it seems like they still profit. Again, I think they are like the homeowner's insurance companies in that regard.

The whole idea behind the scam called "Consumer Driven Health Care" is to get people to go to the doctor less by making them pay up front.

[LibDemAlways]

2. The former head of Kaiser (who left last year)

made $2.2 million per year as of 2000, the last available data according to the attached article:

http://www.managedcaremag.com/archives/0206/0206.editorsmemo.html

I had a former co-worker who died of lymphoma in 1990 who was insured by Kaiser. They did everything they could to make sure she got the absolute minimal care and turned her down several times for treatments they deemed "experimental." She was 38 when she passed away.

[Warpy]

3. If someone had gotten really sick

you'd not only have been hit with a rate increase, there would have been huge pressure to fire the sick person and leave him with no coverage.

This is why insurance companies have to be out of health care. They fucked it up. They have destroyed any trust people once had in them. They don't belong there. They have to go.

None of the front runners seems to understand this. They're all talking about COST and not a single one is talking about CARE. They're supporting an industry that makes profits by denying coverage, denying payments, and denying care, itself.

The truth is that expanding Medicare into a universal national health insurance program is the CHEAPEST option out there, the only one that will cover all of us, and the only one that will deliver actual CARE without our having to fight for it when we are least able to and without surprising us at the end with a stack of bills for services they don't feel like covering.

There is no other option. We can't keep putting Bandaids onto a broken system and expect it to heal itself. It won't. The problem goes to the very nature of a profit driven business.

That business has no place in health care.

[madrchsod]

4. the democratic front runners do not have a clue at all about health care

they never mention dental and eye care. dental care is up front cash which can break a lower middle class family with kids and in many cases eye care is the same. all the tax credits in the world is`t going to do a family any good at the end of the year when they do not have cash during the year to pay bills or buy food.
universal health care is the only answer. the insurance companies will face the same thing as the rest of the american business..adapt,bring a better product to the market,or go out of business. universal health care will not destroy the insurance companies because there are products consumers will still need.supplemental insurance,private insurance for those who up out of federal funding,short term.long term disability payments,and insurance policys like aflac.

[Grey]

5. absolutely right. n/t