Does that prove they no longer care about costs and are jacking premiums up or the opposite?

teedubbya wrote:

It seems that the general reaction so far to exchange premiums has been that they are expensive.

Remember, if they lower medical costs they have to refund premiums.

HockeyDad wrote:

This will all be irrelevant when Hillary get single payer passed.

ZRX1200 wrote:

Cost of care is high on the list and always has been. I work with it every day.

As for not listing prices etc.... I spent the better part of a decade negotiating hospital and physician contracts and while joe consumer may not be aware, the actual pricing has changed considerably and the competition is occuring in the insurance industry based on volume vs. pricing vs. network composition. Provider reimbursment has undergone a squeeze for many years and continues to, not to mention the utilization end (readmissions etc.).

The growing cost of care is right in the middle of the crosshairs. Not solved, and I'm no fan of OCare, but to suggest no one is focusing on costs is incorrect in my opinion.

teedubbya wrote:

LOL - is that so?

Premium cost is varried geographically. I've not seen anything solid one way or another. Especially anything actuarily sound taking into consideration all variable.

I am well aware of the cost to premium ratio but to think they in no way will attempt to lower costs as a result is a stretch at best. It is still in their best interest to lower costs.

We used to base provider referal pools on projected costs (for profit HMO) and often had to readjust when costs came in lower than projected (thus cutting checks to off set the difference). Haveing a lower than expected cost over any time period was still a good thing. We still got ours and the cheaper our product the better.

On the other side (working for a health system) we negotiated percent of premium contracts with insurance companies in which we got X% of the total premium collected (I'm over simplifying a bit). I didn't see an effort to increase or lack of effort to decrease cost there.

teedubbya wrote:

I don't claim to know anything about the 'system', but I do recall reading that some sort of standard pricing schedule is derived from surveys of physicians themselves who estimate times for procedures. If so, it would quite obviously be in their favor to 'round up' or guestimate high. And what about all those news stories a few months ago about a hip surgery costing 12 grand in one hospital, but over 200K in another??? Doc on the radio the other day said he gets a couple hundred for doing a circumcision in his office, but if he does it at the local hospital, the patient gets charged five to seven times as much.
I was in the hospital last summer and got no less than 15 statements and bills -- I have no fn clue what anything cost, how much my insurance paid or what the docs got. I want transparency. Until then, f 'em all. I aint getting sick no more.

dstieger wrote:

You're probably right. It is all just status quo at the insurance companies despite the ACA.

HockeyDad wrote:

^ closer to my opinion other than they got a money grab and more customers

teedubbya wrote:

That will all depend on how many actually sign up on the exchanges.

HockeyDad wrote:

I dunno if 1 person signs up that didn't before it makes it sort of true. Of course you may have folks falling out because their employer dumps things so you are right the jury is still out.

teedubbya wrote:

[-x 😳 😳

DrMaddVibe wrote:

Yes.
I'm glad that our highly efficient federal government is taking over the healthcare insurance market.

tailgater wrote: