The Conservative Cave
Current Events => The DUmpster => Topic started by: Freeper on July 02, 2012, 08:20:37 PM
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CatWoman (66,565 posts)
The Bomb Buried In Obamacare Explodes Today-Hallelujah!
That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time. Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.
Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.
Today, that bomb goes off.
Today, the Department of Health & Human Services issues the rules of what insurer expenditures will—and will not—qualify as a medical expense for purposes of meeting the requirement.
As it turns out, HHS isn’t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.
http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/
http://www.democraticunderground.com/1002894046
Could it be the DUmmies are finally understanding that 0bamatax is not about affordable health care, but the destruction of the insurance industry?
CatWoman (66,565 posts)
3. Hi Peggy
I'm anxiously awaiting my check!
Well as long as you get thrown a couple of bucks then you are happy.
grantcart (34,793 posts)
10. I spoke to a relative today who told me that the large insurance company he works for has left the
health care field (it was not a serious player in this area although it is a big company that most of you would recognize) because they knew that they could not get under these MLR ceilings.
This is a very very big deal.
Yep it creates jobs doesn't it? :whatever:
ErikJ (991 posts)
12. Medicare does it for 3% overhead. Pigs.
PoliticAverse (3,630 posts)
16. The 3% Medicare figure is very misleading. n/t
DUmmies are so shortsighted, as long as whoever they think is the greatest evil on any particular day is getting screwed over they celebrate. They have no concept of the nightmare that single payer will bring about, they think dealing with an insurance company is rough, just wait till the secretary of Health determines that they aren't worth spending the money for a pacemaker, and Dr 0bama gives them a pain pill and sends them home. :banghead:
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http://www.democraticunderground.com/1002894046
Could it be the DUmmies are finally understanding that 0bamatax is not about affordable health care, but the destruction of the insurance industry?
That is what they and Obama want. It's a big step towards socialized single payer care.
PoliticAverse (3,630 posts)
16. The 3% Medicare figure is very misleading. n/t
Very misleading, so much that it is an outright lie. Medicare also has the highest rate of denial of claims of any insurer.
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That is what they and Obama want. It's a big step towards socialized single payer care.
That it is true, but up until now none of them idiots seemed to grasp that concept, meanwhile us knuckle dragging freepers figured that one out before the bill was even passed.
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The overwhelming majority of health insurance companies already pay out 80-85% of what they take in via premiums.
As is typical, the catwoman primitive is reading this wrong. She's under the impression that if she pays $1000 annually in premiums (just to use a simple whole number) that if the insurance company doesn't pay out at least $800 (or $850) on her behalf, she'll be reimbursed the difference. That's not the case.
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Erm.....the company that insures you gets the rebate, not the participant. Small companies under 200 got it this year, for last year. It has been in place for a year now, I s'pose. Your employer will absorb that miniscule rebate back into their accruals to pay the huge premiums. Gee Whiz. Stupid dummies. :thatsright:
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The overwhelming majority of health insurance companies already pay out 80-85% of what they take in in premiums.
As is typical, the catwoman primitive is reading this wrong. She's under the impression that if she pays $1000 annually in premiums (just to use a simple whole number) that if the insurance company doesn't pay out at least $800 (or $850) on her behalf, she'll be reimbursed the difference. That's not the case.
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One thing I wonder about, do these rebates count against them as overhead, and just how much of the overhead is due to government regulations? So theoretically the feds could drive the overhead up so high that it would impossible for them to pay out more in benefits than for overhead.
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One thing I wonder about, do these rebates count against them as overhead, and just how much of the overhead is due to government regulations? So theoretically the feds could drive the overhead up so high that it would impossible for them to pay out more in benefits than for overhead.
My company spends approx 4.5million a year, for medical premiums alone. We were in the 80-85% MLR last year. To keep our business, we got only a 9% increase, and a 10K "wellness" credit this year. My understanding is that the credit works as a write off for our insurer. Our rates haven't gone up as much as most, but we have had a very bad year, and I anticipate a huge hit. The killer is that my company is quite employee-friendly, and we pay more than 75% of premium. I don't know how we are going to feasibly continue that as our mode of operation.
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My company spends approx 4.5million a year, for medical premiums alone. We were in the 80-85% MLR last year. To keep our business, we got only a 9% increase, and a 10K "wellness" credit this year. My understanding is that the credit works as a write off for our insurer. Our rates haven't gone up as much as most, but we have had a very bad year, and I anticipate a huge hit. The killer is that my company is quite employee-friendly, and we pay more than 75% of premium. I don't know how we are going to feasibly continue that as our mode of operation.
Well it's about time you quit your free riding. :-)
I'm still just in awe that the dems are saying that crap.
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Medicare also has the highest rate of denial of claims of any insurer.
Not so. Medicaid has two times the rate of denial on treatments as medicare. Medicare has three time the rate of denial as private insurance.
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http://www.democraticunderground.com/1002894046
Could it be the DUmmies are finally understanding that 0bamatax is not about affordable health care, but the destruction of the insurance industry?
Well as long as you get thrown a couple of bucks then you are happy.
Yep it creates jobs doesn't it? :whatever:
DUmmies are so shortsighted, as long as whoever they think is the greatest evil on any particular day is getting screwed over they celebrate. They have no concept of the nightmare that single payer will bring about, they think dealing with an insurance company is rough, just wait till the secretary of Health determines that they aren't worth spending the money for a pacemaker, and Dr 0bama gives them a pain pill and sends them home. :banghead:
What pacemaker.They won't have the overhead to further develop the technology or produce current ones.
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That is what they and Obama want. It's a big step towards socialized single payer care.
Very misleading, so much that it is an outright lie. Medicare also has the highest rate of denial of claims of any insurer.
Medicaid/Medicare also has an obscene amount of provider fraud. Moron misfits have no idea how well private carriers can detect and handle fraudulent claims which is a cost associated with their "overhead."
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Well it's about time you quit your free riding. :-)
I'm still just in awe that the dems are saying that crap.
Exactly. To both statements. :-)
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....and the twins sing.
Double your premium
Double your trouble
With double good
Double good Obamacare
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CatWoman (66,565 posts)
3. I am anxiously awaiting my check!
Your employer will absorb that miniscule rebate back into their accruals to pay the huge premiums. Gee Whiz. Stupid dummies.
Someone needs to tell CatWoman to stop waiting by the mailbox.
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Someone needs to tell CatWoman to stop waiting by the mailbox.
Naw, easier to drive by, point and laugh at her if she hangs out by her mailbox. :-)