Health insurers need to stop being wimps

[Greenbeard]

Sarah Kliff at the WashPo has a nice little article today on one of my favorite subjects: the inability or unwillingness of many health insurers to stand up to powerful health care providers to keep prices in check.

Health insurers don’t have a great reputation. Some even think they’re evil. Others say they’re heartless. But the real problem, according to a new paper in the journal Health Affairs, might be that when insurers sit across the negotiating table from hospitals and other providers, they turn into wimps.

For their part, health insurance plans aren’t putting much downward pressure on those prices. In discussing interviews with insurers and hospital administrators, Berenson describes insurers as seemingly “resigned” to the fact that hospitals will demand higher payments for their services.

“According to both plan and provider representatives we interviewed,” the researchers write, “health plans have not recently been aggressive in negotiations with powerful providers....Terms such as truce and detente were used to describe the current state of relations between health plans and powerful hospitals. As a respondent from a must-have hospital said, Blue Cross Blue Shield is ‘such a big player and we are such a big player—we have to come to terms.’”

This is a point I've made a number of times (including here and here). There are multiple things that make insurance premiums go up--e.g. the proportion of sick people in your insurance pool, utilization of services, etc--but a big factor is the prices that providers are able to extort from insurers, even those who should have enough market power to push back.

One other interesting aside in the article:

The Affordable Care Act could help push prices down by requiring additional review for any premium increases over 10 percent. The rule could give health plan an incentive to demand lower prices from hospitals, if only to dodge additional regulatory scrutiny.

This, too, is something I've touched on before. Massachusetts was a bit of a test case for this concept when the Patrick administration decided to ramp up its rate review in 2010. The result: the president of Blue Cross Blue Shield of Massachusetts admitted "It sent a message to the entire health care community...that we had to change" (the third quarter health insurance base rate increases in Massachusetts announced a few days ago average 1.2%, down from 1.8% in the second quarter). Not a panacea but a useful tool.

Finding ways to "inspire" health insurers to show a little more backbone at the negotiating table is necessary if prices are to be kept in check. This was the motivation behind the now-abandoned public health insurance option concept, it's a potential goal of rate review, and it's something that could conceivably be nudged a bit by the introduction of new competitors, like the consumer-owned co-ops currently being seeded and the insurance plans that will now be able to operate in multiple states. However, there are limits to the latter mechanism, as diluting the health insurance market also dilutes the clout of each insurer at the negotiating table with providers, thus negating part of what it's trying to achieve here.

The other, more powerful option is one that comes up here and there (and has been operating successfully in Maryland for several decades). But there isn't much need for more detail on it in this thread, it's described in an older one: http://www.usmessageboard.com/healt...-on-equalizing-payments-for-medical-care.html

 

[EdwardBaiamonte]

Finding ways to "inspire" health insurers to show a little more backbone

Why do they need to show backbone?? The Democrats have made competition illegal??

 

[ronekenn]

Health insurance is not a thing which is done just by signing the paper. It is the thing, a policy which includes various factors regarding the payment which has to be done at the time of requirement. There are various clause and closures which a person has to look out before dealing and then the actual insurance is done.

 

[OohPooPahDoo]

Medical care in America is expensive yes but is best in world

The extra expense you are paying isn't going to making your health care any better.

 

[EdwardBaiamonte]

Medical care in America is expensive yes but is best in world

The extra expense you are paying isn't going to making your health care any better.

America is the most expensive in the world by a factor of 2 because it is the most socialist in the world and because we can afford to waste more than other countries.

 

[starcraftzzz]

Finding ways to "inspire" health insurers to show a little more backbone

Why do they need to show backbone?? The Democrats have made competition illegal??

Yes democrats passing a law that makes health companies compete is them making it illegal

 

[EdwardBaiamonte]

Finding ways to "inspire" health insurers to show a little more backbone

Why do they need to show backbone?? The Democrats have made competition illegal??

Yes democrats passing a law that makes health companies compete is them making it illegal

what law is that?? the liberal clean forgot to say

 

[starcraftzzz]

Why do they need to show backbone?? The Democrats have made competition illegal??

Yes democrats passing a law that makes health companies compete is them making it illegal

what law is that?? the liberal clean forgot to say

Obamacare you ignorant retard
Perhaps if you spent some time thinking and doing research instead of trying to improve your shitty ego you’d be less of an ignorant dumbass.
I’d ask you what legislation enacted by democrats make competition illegal but then you’d have to think and that is beyond you

 

[EdwardBaiamonte]

Yes democrats passing a law that makes health companies compete is them making it illegal

what law is that?? the liberal clean forgot to say

Obamacare you ignorant retard

dear, Obama had two communist parents, he is for single-payer, not Republican capitalist free market competition!

Almost anybody, even a child, would know that?

 

[starcraftzzz]

what law is that?? the liberal clean forgot to say

Obamacare you ignorant retard

dear, Obama had two communist parents, he is for single-payer, not Republican capitalist free market competition!

Almost anybody, even a child, would know that?

Jesus are you really so stupid that you think the poltiicla leans of Obamas parents means Obamacare does not do what it does?
Come back when you are intelligent enough to think Obamas parents political leanings mean legsiation passed when they’ve been dead for years does not do what that legislation does
Also come back when your response isn’t “Obama making it so health care has competition means he does not support competition”
Jesus using your logic you wanting competition means you are a communist. So go to china you libtard

I await for the postage of the bill that banned insurance competition but then again since what you say is pure made up bullshit Ill be waiting a long time
Also when you are too stupid toi quote correctly its pathedic

 

[EdwardBaiamonte]

Jesus are you really so stupid that you think the poltiicla leans of Obamas parents means Obamacare does not do what it does?

dear, it not the leanings of his parents its that BO accepted his parent's communism. We know he did based on his book, "Dreams from my [Communist] Father," friendship with the communists Rev. Wright and Frank Marshall Davis, plus, the support he gets from the CPUSA, his support of single-payer, and a Senate voting record to the left of Bernie Sanders'.