The Eye Popping 2016 Obamacare Rate Increases Are Out

As mentioned in an another thread this is a very useful site, it gives the overall rate increases by company, by state and gives us an early heads up on what will be needed during open enrollment (and 5 months to get our clients ready as well).

The increases, of course, are high and will hurt the non-subsidized market, just as predicted a couple of years ago.

So much of what has happened has been predicted yet very few notice
 
OK, so we are talking prevention. Now are learning that sugar and white carbs, maybe all grains, depending on other factors, can cause "inflammation" which is the real killer aspect of coronary artery disease, and vascular disease. Cholesterol levels should be looked at, but it's inflammation that is a factor in diabetes, cancer and heart disease. The Cleveland Clinic is even coming around. In the 90's an ENT doc brushed off my miracle cure for my sinus and vertigo--don't eat dairy, wheat and eggs. "I never heard that what you eat could help". PS, haven't had a sinus headache in decades.
Now, Mark Hyman, MD, a "functional medicine" doc, who teaches how to reduce inflammation, has a center at Cleveland Clinic. They say it takes 20 years for discoveries to make it into mainstream. Diet and exercise is the answer as others have said. Not always the whole answer, but a huge part. We now have a gym in the area that works with diabetics, type II, giving them exercise and dietary plans (nutritionist on staff) in connection with their docs, to help them lose weight and get off meds.
It's hard work! No one went broke selling the easier way, right? Well, maybe McDonalds if they don"t add some appealing healthier options. Pretty much that's our food and pharma culture right now, eat what you want, don't exercise, take a drug to fix it. A respected researcher at UC Davis spent 8 years researching for his book "Drugs for Life". The message, in a nutshell: being prescribed multiple "maintenance" drugs for the rest of your life, the goal being at least 5, is a feature, not a bug of big pharma's marketing plans for us.
I posted the short vid of "Sarah Connor" working out at the locked psych ward in anticipation of the Armageddon terminator machine coming after her--higher deductibles, loss of full Plan F, Medicare cutbacks, etc.-- only party kidding. Not to be dark, but, for our own well being, the buck stops at how willing am I to do the hard stuff. Not entirely, it turns out, but getting better. Joined a yoga studio, and taking Pilates. Goal is something every day, lucky if it's 3 days a week right now. Eating from the Whole 30 plan. Have lost winter weight, but that's a side effect.
My orthopedic doc says he doesn't hit the prevention side too hard, because almost no one wants to change.
 
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Reading through this thread I am surprised there is no discussion on providers' pay scale and pharmaceutical companies' profits. Dose health agent community in general think the supply side is being paid fairly?

Arizona woman's outpatient surgery bill an eye-popping $38,000


The implementation of min loss ratio seems to align the interest of insurance carriers with that of providers. When a carrier already dominates in certain market, the growth of its net profit depends on premium increase, which in turn needs to be justified by increased provider costs.
 
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providers' pay scale and pharmaceutical companies' profits.

That is a non-issue.

Pay and profits are market driven until the govt decides to intervene and screw everything up.

Why is it no one ever talks about pro athlete pay or Apple profit margin of 23%?

Someone who can barely speak English mumbles words about killing cops and assaulting women and they make millions but apparently that is OK.

Everyone wants to play Monday morning quarterback on health care charges and suddenly you think they must have attended a 48 hour crash course in medical economics.

I have had people complain about air ambulance charges of $10k and refusing to pay since they were unconscious and unable to refuse the service.
 
That is a non-issue.

Pay and profits are market driven until the govt decides to intervene and screw everything up.

Why is it no one ever talks about pro athlete pay or Apple profit margin of 23%?

Someone who can barely speak English mumbles words about killing cops and assaulting women and they make millions but apparently that is OK.

Everyone wants to play Monday morning quarterback on health care charges and suddenly you think they must have attended a 48 hour crash course in medical economics.

I have had people complain about air ambulance charges of $10k and refusing to pay since they were unconscious and unable to refuse the service.

Market driven?? You cant be serious...

A free market depends on consumer choices driven by transparency. There is nothing transparent in our current system that allows cost driven choices when it comes to medical care.

Try asking your doctor how much your lab tests cost! Most will have no clue...
Doctors do not have price sheets that you can review before using them. They order tests and usually the Dr ordering them has no clue how much that test will cost the patient.

Then when you get the summary of services from the insurer it is like decoding something from the NSA to figure it out and how they came to the amount you are being billed.

A free market informs consumers of prices BEFORE services are rendered. Our healthcare system does that only AFTER services are rendered.


Years ago I had a lapse in insurance that I was unaware of. My daughter happened to have a pediatrician appointment during that lapse and had immunization shots. 2 shots cost me $1,000!!
I spoke to a client about this who is a doctor. I told him which shots they were and he had his office manager look up the pricing. They cost his office $80... the pediatrician had a 1000% mark up on it that they tried to bill to my lapsed insurance!! (my clients office marked it up by 500%)
Needless to say I negotiated the price down that I paid. I asked the pediatrician when I saw him again if he was aware that they marked up their immunizations by 1000%. His response was that they bill within the negotiated rates for the insurers... and why does it matter if insurance covers it?!


Health care costs, including RX costs, are by far the largest problem our system faces. The $100 asprin in a hospital is not a myth.


The cost of health insurance is a byproduct of the cost of medical care. Insurance costs are transparent. Medical care costs are not. Especially when they are covered by insurance. There is a "who cares if insurance covers it" attitude among doctors & hospitals. And of course the carriers dont fight it too much because it lets them justify premium increases. And I realize that MLRs have stayed fairly steady even with premium increases, but overhead does not increase at the same rate of premium increases... which equals increased profits.
 
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Market driven?? You cant be serious...

A free market depends on consumer choices driven by transparency. There is nothing transparent in our current system that allows cost driven choices when it comes to medical care.

Try asking your doctor how much your lab tests cost! Most will have no clue...
Doctors do not have price sheets that you can review before using them. They order tests and usually the Dr ordering them has no clue how much that test will cost the patient.

Then when you get the summary of services from the insurer it is like decoding something from the NSA to figure it out and how they came to the amount you are being billed.

A free market informs consumers of prices BEFORE services are rendered. Our healthcare system does that only AFTER services are rendered.


Years ago I had a lapse in insurance that I was unaware of. My daughter happened to have a pediatrician appointment during that lapse and had immunization shots. 2 shots cost me $1,000!!
I spoke to a client about this who is a doctor. I told him which shots they were and he had his office manager look up the pricing. They cost his office $80... the pediatrician had a 1000% mark up on it that they tried to bill to my lapsed insurance!!
Needless to say I negotiated the price down that I paid. I asked the pediatrician when I saw him again if he was aware that they marked up their immunizations by 1000%. His response was that they bill within the negotiated rates for the insurers... and why does it matter if insurance covers it?!


Health care costs, including RX costs, are by far the largest problem our system faces. The $100 asprin in a hospital is not a myth.


The cost of health insurance is a byproduct of the cost of medical care. Insurance costs are transparent. Medical care costs are not. Especially when they are covered by insurance. There is a "who cares if insurance covers it" attitude among doctors & hospitals. And of course the carriers dont fight it too much because it lets them justify premium increases. And I realize that MLRs have stayed fairly steady even with premium increases, but overhead does not increase at the same rate of premium increases... which equals increased profits.
Agreed great we are talking about costs!!
 
I have a question for you smart individuals here. Are these rate increases going to affect individual Medicare suppliment plans as well or are they mainly the individual plans you get on the national or state exchanges?

My father and grandmother both have a suppliment plan through BcBs Minnesota. I checked the website that contained the rate hike proposals and I didn't see any of their individual medicare plans on there. Thanks
 
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