Competition lacking among private health insurers

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Originally Posted by RandomGuy

How does Texas have one of the strictest insurance commissions? (not sure what that means)

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In terms of requirements to get the underwriting to justify policy rates. I am not sure if it's annual or if it's biannual but all P&C rate tables of any company wanting to do business in Texas have to be approved on the basis of the actuarial data.

The medical insurance industry doesn't have to show anything as a matter of course like P&C does.

For example BlueShield doesn't have to get their actuarial work justified to insure Jon Doe age 26 nonsmoker with a 10% copay blah blah blah in the state of Texas.

OTOH if All State wants to sell Mr. Doe a minimum policy 50/100/25 they have to go to the TIC and get approval for charging a 26 yo male living in location A, with record B and driving a C class car.

The TIC has been telling insurers for years now to take their HO rates and try again. It's why you heard a bunch of shit about how they could no longer insure homes in Texas and tried to nonrenew a bunch of policies. TIC would not allow them to use short term risk assessment.

It's also why the insurance industry is freaking out becaues the long term risk outlooks are changing due to climate change.

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Originally Posted by boutons_deux

"Originally Posted by Marcus Bryant
LOL. Uh yeah, us "losers" who would pay for it for your free riding ass."

taxpayers pay for the uninsured health care already.

and "free riding assholes" are those employees who get tax-free benefit (aka income) from employers (tax deductible) health insurance.

If employees had to pay their full after-tax health insurance (as do self-employed people), we would have had, by popular pressure, a hardcore public insurance option decades ago.

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I can agree with this. I really do not understand the resistance to it like we see.

Tying health insurance to payroll is bad juju yet the party that claims to be 'business friendly' doesn't see it that way.

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Originally Posted by FuzzyLumpkins

In terms of requirements to get the underwriting to justify policy rates. I am not sure if it's annual or if it's biannual but all P&C rate tables of any company wanting to do business in Texas have to be approved on the basis of the actuarial data.

The medical insurance industry doesn't have to show anything as a matter of course like P&C does.

For example BlueShield doesn't have to get their actuarial work justified to insure Jon Doe age 26 nonsmoker with a 10% copay blah blah blah in the state of Texas.

OTOH if All State wants to sell Mr. Doe a minimum policy 50/100/25 they have to go to the TIC and get approval for charging a 26 yo male living in location A, with record B and driving a C class car.

The TIC has been telling insurers for years now to take their HO rates and try again. It's why you heard a bunch of shit about how they could no longer insure homes in Texas and tried to nonrenew a bunch of policies. TIC would not allow them to use short term risk assessment.

It's also why the insurance industry is freaking out becaues the long term risk outlooks are changing due to climate change.

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(nods) Understood. (FWIW: Texas does not have a "Commission", it has a "Department", although the Department does have a Commissioner)

All HMO's have their actuarial assumptions examined periodically. Their rates are looked at, just not approved or micromanaged for every minor variance. It would not be really feasible to do so for health insurance, simply because it is far more complex than simple liability for cars.

This is kind of interesting to me, so if you have any links to the background info, let me know. I like to keep up.

It is worth noting that part of Obamacare limits profits at HMO's to a certain percentage of profits relative to the benefits offered/paid. That is something that is regularly monitored.

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Originally Posted by boutons_deux

"Originally Posted by Marcus Bryant
LOL. Uh yeah, us "losers" who would pay for it for your free riding ass."

taxpayers pay for the uninsured health care already.

and "free riding assholes" are those employees who get tax-free benefit (aka income) from employers (tax deductible) health insurance.

If employees had to pay their full after-tax health insurance (as do self-employed people), we would have had, by popular pressure, a hardcore public insurance option decades ago.

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Don't forget the other subsidy we all pay:

Higher interest rates on loans.

A lot of debt gets either canceled or restructured in bankruptcy. One of the leading causes of personal bankruptcies, if not *the* leading cause, are medical bills.

The medical bills that don't get paid, get passed on to those who do pay, AND the other debts, like car notes, personal credit, etc. that also get restructured get passed on to those who do make their debt payments.

This represents a subsidy buried in EVERYTHING. All the services you buy, all the goods, no matter what country they are made in.

These costs are hidden from us, but they exist in a very real sense. Single payor systems would bring all these hidden costs out into the open, total them up, and let us deal with a concrete knowable problem, instead of letting them fester in the dark, like we do now.

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Originally Posted by FuzzyLumpkins

The TIC has been telling insurers for years now to take their HO rates and try again. It's why you heard a bunch of shit about how they could no longer insure homes in Texas and tried to nonrenew a bunch of policies. TIC would not allow them to use short term risk assessment.

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The problem, to my understanding, was that they realized their risk modeling was woefully inadequate, and a lot of them had geographic concentrations that they didn't know about. They erred far on the side of setting their rates a bit high.

Some of the better ones, like USAA, have started getting VERY granular in their modeling processes, meaning they can set rates according to very local conditions, so this should help.

One has to remember, that the brewhaha with Texas Windstorm IA (TWIA vis a vis the Isaac claims), and the ability of insurers to get reinsurance plays no small part in whether or not these types of policies get offered.

The state only has to review the rates if they are hiked by more than 10%. i understand there are more risk factors but even then that ain't shit.

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Originally Posted by Marcus Bryant

LOL. Uh yeah, us "losers" who would pay for it for your free riding ass.

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I don't have health insurance and I am in my 50's. I have the option not to carry insurance now and that is what I choose. If I have a huge medical cost I am not paying . The bill will indirectly go on you with higher insurance costs for you.

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Originally Posted by FuzzyLumpkins

The state only has to review the rates if they are hiked by more than 10%. i understand there are more risk factors but even then that ain't shit.

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Well, there is a balance between rate setting and allowing companies the flexibility to operate in changing conditions.

It is not in anyone's interest to put a straightjacket on rates, then force companies to either exit the market, or accept losses if your rates don't keep up with what the market is doing.

States that micromanage insurance rates tend to have ill-served markets, in my experience.

I am pretty sure TDI keeps an eye on health insurers to keep them from acting in a predatory manner.

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Originally Posted by RandomGuy

Well, there is a balance between rate setting and allowing companies the flexibility to operate in changing conditions.

It is not in anyone's interest to put a straightjacket on rates, then force companies to either exit the market, or accept losses if your rates don't keep up with what the market is doing.

States that micromanage insurance rates tend to have ill-served markets, in my experience.

I am pretty sure TDI keeps an eye on health insurers to keep them from acting in a predatory manner.

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But they don't. The only time they even look is if the hike is over 10%. As you can probably guess that has happened quite a lot. I am sure you are familiar with how much the rates have skyrocketed in the last decade especially in the last 3 years due to the excuse that is the ACA. There is no empirical data there.

Here's the rub: for the last three years, of the cases they have reviewed in the last three years have had no action taken. State law does not give them the teeth to do so anyway and a state governemtn that allows itself to get led by the nose by Perry has done nothing at all. this is a very serious issue.

http://www.npr.org/blogs/health/2012...nce-rate-hikes

And I am sorry but spare me 'flexibility' argument. All I see is an upward trend and a market trend that just screams collusion. Insurers dictate the demand and hospitals the supply and there is no oversight whatsoever. All the while rates quadruple.

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Originally Posted by FuzzyLumpkins

But they don't. The only time they even look is if the hike is over 10%. As you can probably guess that has happened quite a lot. I am sure you are familiar with how much the rates have skyrocketed in the last decade especially in the last 3 years due to the excuse that is the ACA. There is no empirical data there.

Here's the rub: for the last three years, of the cases they have reviewed in the last three years have had no action taken. State law does not give them the teeth to do so anyway and a state governemtn that allows itself to get led by the nose by Perry has done nothing at all. this is a very serious issue.

http://www.npr.org/blogs/health/2012...nce-rate-hikes

And I am sorry but spare me 'flexibility' argument. All I see is an upward trend and a market trend that just screams collusion. Insurers dictate the demand and hospitals the supply and there is no oversight whatsoever. All the while rates quadruple.

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Correlation is not cause.

I will do a bit of digging.

9% or 1o% revenue increase, every year, compounded, no objection? I, and every PE predator, will take it.

hmm, looks like I'm a little late

HCA: The Unsustainble Private Equity Bubble in US Health Care

http://www.forbes.com/sites/stevedenning/2012/08/15/private-equity-wont-fix-health-care-either/


Health Care REIT to Buy Sunrise Senior Living

http://dealbook.nytimes.com/2012/08/22/health-care-reit-to-buy-sunrise-senior-living/


I think Carlisle, etc are already owners of senior homes.