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Tag Archives: Health care reform

Very interesting start to the Republican takeover

The fun has begun. The 112th Congress has been sworn in, signaling the start of what folks on the right hope is a successful effort to take over DC in 2012. But things are getting off to a very wacky start.
First, the decision was made to hold a vote to repeal the healthcare reform bill, aka “Obamacare.” The chance of this going through is somewhere between zero and minus ten percent. But as is the case when the new team takes power, they have to make an immediate splash, and this is it.
But, wait! Hold the phone!
Shortly after the votes were held, its discovered that 2 members who participated in votes had not been sworn in with the rest of the House members, rendering their votes invalid. To their credit, House Dems didn’t use the opportunuty to call for a re-vote. But who forgets to come into the chamber for the swear-in? (Both members were out in the lobby with constituents and said the oath, but rules say they basically have to be in the chamber.)
On top of all that, after changing the rules for how bills are debated and amended, they then bypassed their own new rules.
This is going to be interesting to watch.

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QuickHit: Show me REAL Healthcare Reform

People are thinking that Republicans have a snowball’s chance in Hades of repealing the so-called Health Care Reform bill.  That’s a waste of time.  You know what would impress me?  If they turn around and say that they are going to create legislation to provide REAL healthcare reform.  Reform that addresses what the previous bill should’ve addressed–the rising costs of health care.  Every year, the costs of getting medical care goes up.  Ladies and Gentlemen, THAT is the main reason the cost of health insurance goes up every year.  So let’s see if someone comes up with a way to address that.

Healthcare Reform–What is MLR and how it may affect you

Healthcare Reform.  A topic that dominated the airwaves for months as President Obama and the Democrats attempted (and succeeded) to passing major legislation changing the way we do health care in America.  Later, we will discuss how what was passed wasn’t as much healthCARE reform as much as it was healthINSURANCE reform, but we’ll discuss that later.  For now, lets discuss MLR.

MLR, or medical loss ratio, is the amount of each dollar an insurer takes in that much be used to pay for medical coverage.  The concept is simple:  when you the insured pays a dollar of premium to, say, United Health Care, UHC is required to spend a certain amount of that dollar on things related to patient care.

Currently, that ratio is all over the map and depends on carrier as well as individual state mandates.   One may find that one carrier’s ratio may be in the 70s, while another carrier may be in the 90s.  But that is about to change.  New rules will require all carriers to have a MLR in the 80% to 85% range.    If a carrier is found to have a ratio exceeding that, they will be require to pay a rebate or refund to plan participants.  So, consumers are definitely going to get more bang for the buck, right?

Maybe.  Maybe not.

There are at least 2 ways that the new provision will most likely negatively affect consumers.  First, there are already carriers that are getting out of the major medical insurance business because they will not be able to comply.  “Big deal!” most will say.  But we all know what happens when we have fewer providers to pick from.  The amount we as consumers spend goes up because each carrier gone reduces competition.  Second, carriers are going to begin cutting commissions to insurance brokers and agents.  For many, that’s not a big deal and they could care less about it.  But there are a significant number of consumers who prefer the ability to deal with an agent who is available to explain plans and coverages as opposed to calling a particular carrier’s customer service line.  When those agents disappear, consumers will find themselves on their own in regards to figuring things out.

All this isn’t to say MLR is a bad thing.  But knowing how it may affect you is a GOOD thing!