Saturday, March 20, 2010

The Massachusetts Model: Rates Rising Through the Roof

Just wanted to give you a peek at what you can expect in the future, America.

Enjoy!

"Health insurers seeking rate hike; Requests test Patrick’s resolve" by Robert Weisman, Globe Staff | March 6, 2010

Three weeks after Governor Deval Patrick warned that his administration might turn down health insurance premium increases it deemed excessive for individuals and small businesses, insurers have asked the state to approve rate hikes of 8 to 32 percent for April 1.

Related: Memory Hole: Why the Nation Doesn't Need Massachusetts Health Care

That's why prices are out of control, and everybody knows it.

You should then see the lame excuses the executives offer up as the politicians pretend they can't see it.

Patrick last month said the state Division of Insurance would review rate increases exceeding 4.8 percent as part of a broader effort to rein in health care expenses. If the insurers’ latest round of increases is rejected, it would mark the first time Massachusetts has capped health insurance rates.

I wouldn't be getting my hopes up, readers.

Insurers say such a move would cause confusion in the marketplace, as they already have negotiated contracts with many individuals and small businesses at the new rates. Capping the rates would also result in immediate financial losses, insurers assert, forcing them to cut payments to health providers and threatening the viability of weaker hospitals.

Like the future, America?

Executives from Blue Cross and Blue Shield of Massachusetts, the state’s largest health insurer, have asked state officials to delay their decision on rates. And the Massachusetts Association of Health Plans, a trade group representing 11 other insurers in the state, has asked for time to let insurers propose cost-savings alternatives of their own.

“Rushing into this could be perceived as putting price controls on health costs rather than making decisions based on sound actuarial data,’’ said Blue Cross-Blue Shield vice president Jay McQuaide, who blamed the increase in premiums mostly on the rise in medical spending. “This would cause significant disruption in the providing of health services.’’

Yup, but they want to CAP the COST of YOUR COVERAGE, Bay Staters!

They are calling it a "global payment (read on).

But small businesses say years of double-digit increases have strained their finances, crippling their ability to expand and create jobs.

Gee, I wonder where all that money went.

State regulators have long been empowered by law to disapprove health insurance rates, but have never done so.

Why would they?

That is where the campaign loot comes in, and why costs are in the stratosphere.

The past practice has been for insurers to file premium rate increases with the Division of Insurance as a courtesy on the day they take effect....

Sigh.

Well, at least now you know who is calling the health care shots around here.

Many small businesses and individuals are urging the Patrick administration to stand firm and reject the premium rate increases.

He won't, watch.

“We keep scratching our heads, wondering how these increases can be justified,’’ said Jon B. Hurst, president of the Retailers Association of Massachusetts, which represents 3,100 small businesses. “Our members are seeing their sales drop, and they’re wondering how health care costs can grow by double digits.’’

Smells like a GOLDEN GOUGE, 'er, GOOSE to me!!

Shishir Mehta, owner of Fastsigns Inc. of Waltham, which has five employees who make signs and banners for corporations and trade shows, said he received a 30 percent premium increase effective April 1, while other small business owners he knows have been hit with 40 percent increases. “It’s very frustrating,’’ Mehta said.

Related: The Massachusetts Model: Destroying Small Business

Sure they are not trying to do that?

In a letter to employees of Watertown-based Tufts Health Plan yesterday, obtained by the Globe, chief executive James Roosevelt Jr. said insurers must do what they can to keep costs reasonable. “Nonetheless,’’ he wrote, “the governor’s actions, by being one-sided and not considering medical expense, have the potential for creating chaos in the marketplace as 4.8 percent covers roughly only one-third of the current provider rate increases. Those actions address the symptom without addressing the disease’’ of rising health costs....

I can't him you over the oinking at the trough.

The tug of war between insurers and individual and small business customers comes amid efforts on several fronts to halt the spiraling cost of health care. Last year, a state commission was formed, supported by key legislators, with the goal of slowing the rise in the use of medical services. It urged scrapping the current fee-for-service system and paying providers a per-patient annual fee, called a global payment, to cover all of a patient’s medical care.

And if you exceed your payments?

See: The Massachusetts Model: Doctors' Diet

Yeah, DON'T GET SICK in Massachushitts!!!

By putting health care providers on a budget, policy makers hope to discourage unnecessary tests and procedures and improve coordination of care, both of which could save money....

Think RATIONING, readers!

And it is going national!

Even as businesses and individuals feel the pinch of surging health costs, three of the four largest state health insurers last week posted financial reports showing operating losses for 2009.

Related: The Massachusetts Model: Partners' Profits

They must have been the lucky ones, huh?

Of course, investment income amounted in profits.

WTF are health insurance companies doing gambling money?

Forcing insurers to limit their premium increases to 4.8 percent over the next year “would be a significant financial hit,’’ said Thomas Croswell, chief operating officer of Tufts Health Plan. “We’re not in a particularly strong position to absorb something like this.’’

Yeah, whatever.

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Of course, the state is not going to do anything about it now:

"As costs soar, Mass. foresees change in health insurance rules; Many required to have it cannot afford coverage" by Kay Lazar, Globe Staff | March 12, 2010

State regulators said yesterday that they will probably change the complex formula they use to determine how many Massachusetts residents face a tax penalty for not having health insurance, because spiraling costs are making coverage unaffordable for too many people.

So what are they going to do for you?

Each year, the Massachusetts Health Insurance Connector Authority board updates the formula it uses to determine whether health insurance is affordable for individuals, couples, and families and whether people in each group should face a tax penalty for not having coverage. The state’s landmark 2006 health law requires nearly everyone to have health insurance or to pay a stiff tax penalty....

That's your future, Americans!

In the past, some board members have worried that loosening the rules too much would undermine the state’s health law, because it would result in fewer people being required to purchase health insurance.

And less tax loot.

The board chairman, Jay Gonzalez, who is also the secretary for administration and finance, said the board will begin studying a potential change in its formula “to try to develop a more rational approach.’’

The board voted to make only modest tweaks in this year’s formula for people who make more than three times the federal poverty level, which translates to $32,496 annually for an individual.

Translation: They did nothing to help you, Bay-Staters!

The vast majority of people, who get insurance through their employer, are unlikely to be affected by the change.

The thousands of people who receive state-subsidized insurance through Commonwealth Care will not face any premium increases this year.

So WHO WILL?

The POOR on Mass-Health?

(Actually, yeah)

I got the cut and cost increases?

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