<p>“Insurance companies are required, by law, to maintain a certain reserve to pay claims. This is the same for your auto insurance, homeowners insurance, and health insurance. Yes, insurance companies are increasing rates to build up their reserves for 2014 and beyond. If they did not do that, they would go bankrupt. Your insurance company isn’t any help if they aren’t in business.”</p>
<p>No Steve, insurance companies are trying to defeat the Affordable Care Act, just as they did with Hillary Clinton’s attempt.</p>
<p>Insurance companies spent millions of dollars trying to defeat the U.S. health-care overhaul, saying it would raise costs and disrupt coverage. Instead, profit margins at the companies widened to levels not seen since before the recession, a Bloomberg Government study shows.</p>
<p>Insurers led by WellPoint Inc. (WLP), the biggest by membership, recorded their highest combined quarterly net income of the past decade after the law was signed in 2010, said Peter Gosselin, the study author and senior health-care analyst for Bloomberg Government. The Standard & Poor’s 500 Managed Health-Care Index rose 36 percent in the period, four times more than the S&P 500.</p>
<p>“The industry that was the loudest, most persistent critic of this law, the industry whose analysts and executives predicted it would suffer immensely because of the law, has thrived,” Gosselin said. “There is a shift to government work under way that is going to represent a fundamental change in their business model.”</p>
<p>Actually, I would love for Anthem Blue Cross to go out of business, because that would mean they could no longer run our entire health care system. It’s time for single-payer, long long past time.</p>
<p>"“We will continue to examine the fundamental issues at the heart of rising healthcare costs, including the prevention of chronic disease, increasing the quality of care and reducing unnecessary health expenses,” said Darrel Ng, spokesman for Anthem Blue Cross, the state’s largest for-profit health insurer.</p>
<p>Consumer advocates and others are skeptical, however, questioning whether insurers are doing enough to hold down costs. These latest increases follow years of 20% to 30% rate hikes for families that are at the center of a looming fight between the insurance industry and its critics over a proposed ballot measure seeking tougher rate regulation."</p>
<p>Again, let us revisit all of this in say 2015 or 2016 and see which insurance companies are still in business…I for one am glad our insurance company has increased profits to whether the storm of all health reform come 2014. The simple answer would be to require insurance companies and health systems to be not for profit like several states have in place already…that doesn’t mean that they aren’t still making ooodles of money, but they have to return those profits to their policyholders and they do that in the form of lower rates.</p>
<p>dstark–I posted several articles that outlined how much illegal immigrants are costing the state of California. In those costs, health care is considered. Read all of the articles and it is outlined in there.</p>
<p>I am also waiting for you to detail your true cost of your insurance, after the tax breaks you are entitled to that the ‘wage slaves’ are not. Being self-employed for many years and being able to take those tax deductions for health costs and other things, reducing our effective tax rate to less than 5% most years, your true cost of insurance is FAR less than you are making it out to be here.</p>
<p>dstark–there are several elements that make up an insurance premium, the number one is your claim history. You are a high user, by your admission, you are also getting older, you live in a state where there are high numbers of low income people and illegal immigrants, you insist on keeping your grandfathered plan and you are in a high cost of living state. ALL of these, and more, go to increase your rates. Like I said, you are looking at one portion of your rate increase. When you add 2.9 BILLION dollars to any state budget whether that be education costs, health insurance premiums, etc. everything suffers. That 2.9 billion is reducing the amount of money that is put into Medicaid, for example, so people that would have previously qualified no longer do, many of those people are going without insurance so any time they go to the doctor, ER, etc. they are increasing YOUR costs because the doctor, hospital, etc. has to offset their costs on paying customers.</p>
<p>You have chosen your path and one of the consequences of your choice is higher health insurance premiums. You do have many options and choices available to you, however you aren’t interested in those. It is not the fault of the insurance company that you have made the choices you have. If you did not see a decline in your tax rate because of $16,000 in premiums and another $10,000+ out of pocket costs, your income is very high. What percent of your income are your medical costs?</p>
<p>You can figure out various scenarios about what deductions a taxpayer gets and what the net costs are.</p>
<p>I am not insisting on grandfathered plans.</p>
<p>The insurance company is threatening me with more and larger increases if I switch…makes it very difficult to make a decision.</p>
<p>I am going to look at other plans…</p>
<p>My precondition made it very difficult to switch to other places. I had an irregular heartbeat. I haven’t had one in 4 years and I take zero medication. The doctors could not figure out why I had this.</p>
<p>If it makes you feel better the guy sitting next to me was born with a heart murmer…and he thinks he is paying over 2000 a month pre-tax for one of his kids and himself. He is going to check later. He tried to switch companies but nobody would take him. He has never had a
Problem.</p>
<p>It’s not just me…</p>
<p>My former neighbor across the street paid the same as I do…no issues with his family either.</p>
<p>We are all sole- proprietors though.</p>
<p>I could come up with other examples in my small world.</p>
<p>And then there are articles like the one in the LA Times.</p>
<p>Ok, so your costs are for a FAMILY plan. You made it sound like you were paying that for INDIVIDUAL plans. Your family plan cost are inline with employer sponsored plans across the country…as are your increases.</p>
<p>When is the last time you shopped your plans? If you are sole proprietors you can get a group plan for as few as 2 employees, you and your DH, as long as you work 20 hours/month qualify.</p>
<p>If you look at the individual plans for Anthem in CA, the top of the line plan would run you $12,552/year for a family of 2 adults and 2 children under the age of 25. That is with $4500 deductible, HSA plan and 100% coverage after. If you didn’t use your plan at all, it would be in your best interest to investigate HSA plans, put away money into your HSA and let it grow–tax free. It’s a smart financial move for high income earners.</p>
<p>I wouldn’t only price out plans with Anthem. I don’t know all of the local carriers in CA but price out all of the national carriers, especially if you have kids going out of state to college. </p>
<p>In your posts you kept talking about “my” plan, not “our” plan which led me to think you had an individual plan. Our family plan runs $14K/year and we have a table rating of 1 (best possible rates). They go up to 67 so someone on the exact same plan as us could have costs in the $23K range, all based on claim history.</p>
<p>“Mini – the woman I roomed with told me that – she was a senior planner in BC’s provincial health administration, so I assume she knew of what she spoke. (This was about 4 years ago now.)”</p>
<p>I have close secondhand experience of BC’s health care, and over time. Again, here in Washington State, with the highest ranking insurance company in the state, it took my d. 8 1/2 MONTHS to get the operation she needed. I can’t speak for the rest of Canada. Our employees in BC have received topnotch, quality integrative care for a whole host of conditions, quickly and efficiently. We’ve never had anyone wait for more than three weeks for ANYTHING. NO ONE uses the emergency room for primary care. Undocumented immigrants get care. Pharmaceuticals are affordable. Preventive care services are routine. No one goes bankrupt paying for health care. No one goes without care because they can’t pay for it. Doctors don’t get paid not to make referrals. </p>
<p>And they only spend about 60% per capita of what we do in the U.S. Make it 70% and its Shangri-La. </p>
<p>Here? I’d start with Medicare for all. Bring everyone into the system. And then start to improve it. But, first, everyone has to be covered, and the insurance companies have to go.</p>
<p>What’s interesting here is that the majority of hip and knee replacements in the U.S. are paid for in the SOCIALIZED SINGLE-PAYOR part of our health care system (Medicare).</p>
<p>dstark-the plan I looked at for you may have individual deductibles of $4500, so still well under the $7500 but probably not a cap at $15,000, probably the full $18,000 but your premiums are $3000-8000 less depending on your current increase. There were less expensive plans with higher deductibles, etc. as well. Again, in your situation, I would very much go with a HSA plan, fund it at the $6350 each year (or 7350 if your are over 55) and leave the money in there, only touch it if you REALLY need it. Over time build that to at least what your full deductible will be and you won’t have to worry about costs down the road. The real benefit comes when you retire (over age 65 even if you are not retired) and you can use those funds to pay for all kinds of things, Medical Advantage premiums, assisted living costs, etc. You get tax free savings when you deposit money into your HSA, it grows tax free (and you can invest in mutual funds once you hit certain amount in your account) and you use it tax free for qualified expenses.</p>
<p>Also, depending on your zip code, your numbers may vary some. I just picked a random San Fran zip code for the numbers I looked at because generally rates are higher in bigger cities.</p>
<p>I saw this earlier and wanted to comment… The individual doctor may be getting that much, but more money is flowing into the clinic to pay all of the salaries, the utilities, etc.</p>
<p>It’s illegal for a physician to accept less than what Medicare/Medicaid will pay and I would guess it’s probably illegal for the insurance companies to try paying less than that amount. Medicare pays something like 79% (and dropping) and Medicaid like 71% (and dropping).</p>
<p>dstark-I kept trying to figure out how you were paying so much for an individual plan :). Your numbers were just not computing. Now that I am comparing apples to apples, my brain is working again :).</p>