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They are in many locations but not this one. The individual bought strictly on price without understanding that he was buying a very restricted network. He had the exact plan available with a perfectly fine network but because he isn't an agent and didn't ask bought wrong. That wasn't Ocare's fault. It was his.
We had 2 major problems before Ocare's. People couldn't pass underwriting and premiums increased every year. Ocare took care of underwriting. The issue now is premiums which is a function of price and utilization. The primary driver of utilization in Ocare is participation and adverse selection.
The current proposals address utilization by going back to various forms of restricting coverage via trusts/ associations which is underwriting. Underwriting is only a form of price competition. The cleaner the group, the lower the price. Farm Bureau is a perfect example. Stricter underwriting on same plan and network had lower rates than BCBST direct. This was the case for years and years.
Two ways to deal with premiums. Reduce numerator (claims) or increase denominator (participation). Current proposals are numerator focused and the people who are the denominator and left out got mad. Repubs discovered they have to give lip service to pre-ex and underwriting.
Another big issue is procedure price increase that will sink the ship regardless of what happens in the next few years. Price controls aren't efficient and there are no market forces when insurance is the primary way of paying.
I'd prefer we address denominator then work on procedure price but expect we don't have enough nerve to enroll everyone and Congress makes too much money off lobbyists to address price.
LOL.....speaking of lip service....
Wake up and smell the coffee!
