Wednesday, June 17, 2015

The political vapors want to talk about the increases and not the decreases.

Not all insurance companies are going to see the same result. Some CEOs saw an opportunity to be taken seriously and made their policies more attractive right from the start. 

We all know if a health insurance is to work it will have to invite enough members to keep it affordable. The companies that didn't have a vision for the future are having problems. They are now experiencing higher expenses for each member. So, there are increases for those companies.

June 2, 2015
By Margot Sanger-Katz
Insurance companies (click here) have begun announcing rate increases for the health care plans they will sell next year on the Obamacare marketplaces, and a handy new website from the federal government makes searching for rate change requests easier than ever.
Some of the rate increases are substantial. But for several reasons, simply looking at the current numbers can be misleading.
And when my colleague Reed Abelson wrote about requests that are coming in, she also noted that some rates are coming down.... 

In order to compete initially, there is a better than 50 percent chance the insurance companies asking for increases under rated their costs intentionally. I would expect the Executive Branch to scrutinize the rate increases for their moral content as well. If there are companies providing for decreases they have to be assessed for their efficency. 

It seems to me insurance companies that are demanding increases never did their homework in the first place. They can't compete anymore. What good are they?

...Customer loyalty is lower than many experts expected: More than a quarter of 2014 customers switched plans for 2015 — many, according to a recent survey, to get a better deal....

I will be changing health insurance companies for 2016. I had to file three complaints with the state regarding breaches in contract. I have a physical/paper copy of my contract. I have had to copy the contract three times to file my complaints. 

I was feeling badly I had three complaints currently, so I called the state's office of insurance compliance. I wanted to know why I was running across so many contract compliance problems. I was told I was not the exception. 

The waiting time for complaints was far beyond the 30 days to reply from the company. I was also told the agency has budget cuts and less personnel, but, they were getting far higher numbers of complaints about breaches in contracts. 

The point is the companies that are not living up to their contracts, may have far less personnel processing claims according to the contract. 

One of my medications was a Tier 2 drug and it was treated as a 'special permission' medication and the insurance refused to pay it. My doctor had to write to the company to bring about coverage beyond the 30 days they were required to provide. I had been taking that medication over 6 years. 

The entire dynamics is complicated and is impacted for many reasons. This is not simply the health care insurance system is proving to be more expensive than expected. There are significant problems by lack of funding for processing in government offices and at the insurance companies.

Americans need to make their choices and wade through a few years until this mess finally settles down. Besides that I know there if fraud by MDs offices and their billing contractors besides.  

This is what occurs when private industry is involved. We all remember how we got here in the first place. People died because of decisions by health care insurance companies.  

There are no angels and devils here. What is here is reality and it is still scary.