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RandomGuy
03-24-2009, 03:42 PM
For the Mods:
Not sure if this should be here or in the politics forum.
It seems more news-ey to me, and impacts a lot of people, so I put it here. If any one of y'all thinks it should be in the politics section and moves it:
Sorry about the trouble in advance.
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Insurers offer to stop charging sick people more
By RICARDO ALONSO-ZALDIVAR, Associated Press Writer

WASHINGTON – The health insurance industry offered Tuesday for the first time to curb its controversial practice of charging higher premiums to people with a history of medical problems.

The offer from America's Health Insurance Plans and the Blue Cross and Blue Shield Association is a potentially significant shift in the debate over reforming the nation's health care system to rein in costs and cover an estimated 48 million uninsured people. It was contained in a letter to key senators.

In the letter, the two insurance industry groups said their members are willing to "phase out the practice of varying premiums based on health status in the individual market" if all Americans are required to get coverage.

"The offer here is to transition away from risk rating, which is one of the things that makes life hell for real people," said health economist Len Nichols of the New America Foundation public policy center. "They have never in their history offered to give up risk rating."

Insurers are trying to head off the creation of a government insurance plan that would compete with them, something that liberals and many Democrats are pressing for. To try to win political support, the industry has already made a number of concessions. Last year, for example, insurers offered to end the practice of denying coverage to sick people. They also said they would support a national goal of restraining cost increases.

The latest offer goes beyond that.

Insurance companies now charge very high premiums to people who are trying to purchase coverage as individuals and have a history of medical problems, such as diabetes or skin cancer. Even if such a person is offered coverage, that individual is often unable to afford the high premiums. About 7 percent of Americans buy their coverage as individuals, while more than 60 percent have job-based insurance.

"This changes everything," said Karen Ignagni, president of America's Health Insurance Plans, the leading trade group. "When you have everyone in the system, and you can bring (financial) assistance to working families, then you can move away health status rating."

The companies left themselves several outs, however. The letter said they would still charge different premiums based on such factors as age, place of residence, family size and benefits package.

And importantly, the industry did not extend to small businesses their offer to stop charging the sick higher premiums. Small employers who offer coverage can see their premiums zoom up from one year to the next, even if just one worker or family member gets seriously ill.

Ignagni said the industry is working on separate proposals for that problem.

"We are in the process of talking with small business folks across the country," she said. "We are well on the way to proposing a series of strategies that could be implemented for them."

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FWIW, this is kind of a big deal, and shows how seriously private health insurance companies are taking the possibility that we could see some form of Health care reform in which we all get put into some kind of single-payor system.

peewee's lovechild
03-24-2009, 03:53 PM
Wow.

I never thought I'd see the day.

boutons_deux
03-24-2009, 04:11 PM
Access to telephones, electricity, HD TV is "right" in the USA, but access to health care is rationed by your ability to pay (and pay and pay and pay and pay).

CubanMustGo
03-24-2009, 04:50 PM
no risk rating = higher insurance rates for 95% of the rest to make up the difference. Not making a value judgment, but the insurance companies ARE going to get their pint of blood and if not from the risky, it will be everyone else.

I too think it total bullshit that the people who have to pay the most for care are those without insurance. My covered physical costs the insurance company a couple hundred bucks. Same thing without insurance? Over $1,000. And don't even get me started on a hospital visit.

johnsmith
03-24-2009, 04:52 PM
no risk rating = higher insurance rates for 95% of the rest to make up the difference. Not making a value judgment, but the insurance companies are going to get their pint of blood and if not from the risky, it will be everyone else.

+1

RandomGuy
03-25-2009, 08:39 AM
+1

Person A, unable to afford higher premiums, goes without medical insurance.

Person A, partly through a lack of preventive care, gets really sick again, requiring hospitalization.

Hospital gets little or no money from Person A, so it must charge its paying insured customers more to compensate.

What, pray tell, will the insurance company do after paying out the extra money added to the bills of their policyholders to make up for Person A's non-payment of their hospital bill?

Hmm?

RandomGuy
03-25-2009, 08:46 AM
oh, and by the way, you can expect your insurance premiums for every form of insurance you have to go up markedly in the next few years.

Insurers count on investment returns to cover part of their costs of claims in any given year. Lower returns means they have to set aside more money for the same amount of offered insurance. In order to maintain profitability, that extra money comes from: increased premiums.

So, in the middle of an economic downturn, people 1)lose the ability to afford health insurance from job losses, and 2)are faced with higher premiums, forcing more people on the edges to drop their health insurance.

The thing about this is called adverse selection. The people who are most likely to get sick are the ones that are most likely to jump through hoops and keep paying premiums so they don't lose coverage. This leaves you with healthy people dropping out, and sick people staying.

Care to guess how THAT affects your premiums?

oops. Nasty cycle isn't it? But hey, the free market will take care of this problem, right?