Health Insurance Regulators Struggle To Define What Makes a Rate Hike "Unreasonable"

Thanks to the Affordable Care Act's provision requiring governmental review of health insurance premium hikes, state health insurance regulators are currently in the process of trying to pin down just what it is that makes an insurance premium hike "unreasonable." Turns out no one really knows for sure—and, in fact, no increase at all might qualify: According to a staffer with the Minnesota Department of Commerce, "even a zero increase might be unreasonable, if an insurer was at the same time cutting benefits offered in the policy." [Bold added.]

Technically, the federal government doesn't yet have the authority to reject rates, but a proposal from Sen. Dianne Fienstein to regulate health insurance like a public utility makes it clear that's where this effort is leading. How'd that work out in Massachusetts, where Governor Deval Patrick recently rejected about 90 percent of this year's proposed rate hikes? Not so well:

The state's four biggest health insurers today posted first-quarter losses totaling more than $150 million, with three of the carriers blaming the bulk of their deficit on the Patrick administration's decision to cap rate increases for individuals and small businesses.

Without a close scouring of the insurance company books, it's impossible to say for certain whether the losses are actually due to the rate caps, as the insurers claim. But this provides at least a strong suggestion that the Bay State's rate review and rejection program isn't going so well: It's tough to implement health reform that works through the private system if the reforms put the private system out of business.

Comments

[Hugh Akston]

I'm sure they'll know it when they see it.

[Obamalosi]

It's tough to implement health reform that works through the private system if the reforms put the private system out of business.

Excellent /Montgomery Burns voice off.

[Chony]

Waah, Waah, Waaah! Quit whining libertards, bend over and take it!

Bwaaaahaaaaaahaaaaaaa

[Tulpa]

It's tough to implement health reform that works through the private system if the reforms put the private system out of business.

But it's easy to force implementation of socialized medicine if you do that.

[Libertymike]

Not if there is an alternative to monopoly justice. If we had our own protective organizations prepared to kill all those who would socialize anything, we would not have to suffer the consequences of the chaos and disorder wrought by those who champion the state as our saviour-like you.

[Marshall Gill]

If we had our own protective organizations prepared to kill all those who would socialize anything

Why limit it to those who would socialize anything? How about killing everyone who is going to commit a murder? Determining who that is shouldn't be any more difficult than "those who would socialize". Why not simply a list of people that Mike thinks should be killed?

[Tulpa]

If that en-dash is correct, then thank you, I have always considered myself savior-like (not least because I eschew limey spellings).

If that's supposed to be an em-dash, I've never championed the state as anyone's savior. I view it like I view my lower intestine, something that's necessary for life as I know it but also stinky, and potentially dangerous if its products are not closely monitored.

[Groovus Maximus]

Hmmmm, your response to Number 2 over the weekend already belies your coprophelia Tulpa. However you are correct on all counts of the cited properties of the lower intestine. I might suggest more dietary fiber, and certain foods can make one more flatulent, as can some RX and OTC meds. If Don Tulpa is a little cranky, then dispersal of Tulpaseed(tm) is less likely and exacerbating your crankiness.

[Barry Obama]

Dammit Rahm! This guy is onto us. Discredit him or something...

[Pro Libertate]

Yes, destroying the private sector to replace it with a single public "option" does seem to be the plan.

But it's not socialism!

[Groovus Maximus]

No. Not at all, Pro'L Dib.

Just one of the many ways you can be Offended Many Ways at Once.

[Groovus Maximus]

I know it's bad form to quote oneself but here's a few other ways you can be offended. My predictions, from last year, of what would happen if HCR was passed.

[ChicagoTom]

Without a close scouring of the insurance company books, it's impossible to say for certain whether the losses are actually due to the rate caps, as the insurers claim

This is kind of an important thing to find out, no?

I dunno the details, but if going through their books when they want to hike rates isn't part of the law, then it should be.

It's tough to implement health reform that works through the private system if the reforms put the private system out of business.

One could argue that the private firms need to modify their business model to figure out how to make money in the new regulatory structure.

As it stands a big part of their business model was basically, collect as many premiums as possible and deny and reject and rescind as many legitimate claims from policyholders as possible --- especially policyholders who have the misfortune of getting something expensive to treat like cancer.

Maybe their business model was crap and it needs to change.

Maybe some insurance companies deserve go out of business.

[Greer]

I dunno the details, but if going through their books when they want to hike rates isn't part of the law, then it should be.

Because, of course, the government has a right, nay, duty, to go through the books of companies to make sure they conform to the government's ideas of what a reasonable profit should be. God, what if a company made a profit, that would mean there must be children dying in the street somewhere.

Maybe their business model was crap and it needs to change.

Maybe their business model was fine until the government poked it's big ass into it.

Maybe some insurance companies deserve go out of business

Well, if I'm rooting, I'm hoping the government goes out of business first. But it'll never happen with so many other businesses to suck dry.

[dfd]

I dunno the details, but if going through their books when they want to hike rates isn't part of the law, then it should be.

If the government has to go over a company's books to decide what it can charge for its products, then the government is running the company in all but name only and it might as well be honest about it and not pretend otherwise with this farce of program. Even more so when the very same government that is running the company is also compelling you to do business with it or another company it just happens to be running as well. Come on this is either socialism or that other ism where the government takes a heavy hand in running so-called "private" industry for the greater good of the nation. So which is it?

Funny though, I don't suppose if Chicago Tony... er Tom wanted a raise that he would be quite as sanguine about the government scouring his books to make sure it's reasonable.

[ChicagoTom]

Funny though, I don't suppose if Chicago Tony... er Tom wanted a raise that he would be quite as sanguine about the government scouring his books to make sure it's reasonable.

Doens't the gov't already get to go through corporate books via the IRS? It's called an audit.

What's the difference here? If you are doing business in a heavily regulated industry, and one of the things regulated is the price, why would an audit to show that the justification for the rate hike isn't a bunch of BS be terrible?

Or should everyone who cries poor just have their claims taken at face value and be granted?

We've already established that there isn't a real market in insurance, and it's regulated quite heavily. So going through their books when they cry poor is a logical next step.

[Libertymike]

CT, do you have health insurance? If so, who pays for it? Entirely you? Entirely your employer? Entirely your spouse's employer? Do a portion of the premiums come from you? If so, how big a portion?

[Invisible Finger]

Really, CT, how fucking stupid can you possibly be. We had Fannie and Freddie running scams for years with the BLESSING of government. In order for a real audit to take place, the auditor has to first prove their trustworthiness. The government has FAILED in that arena. We've had 19 insolvent banks given free taxpayer money. Your mindset merely produces Too Big To Fail insurance companies.

[prolefeed]

We've already established that there isn't a real market in insurance

As a former insurance underwriter, I can assure you that you don't know what the fuck you're talking about.

[MJ]

"...why would an audit to show that the justification for the rate hike isn't a bunch of BS be terrible?"

Because the governemnet does not necessarliy have the expertise to make that judgement and have incentive to fudge the audit for political reasons.

[Tulpa]

If the alternative is having the government refuse all rate hikes, then going through their books before deciding can't be any worse. Libertopia is, for better or worse, not an option.

[Night Elf Mohawk]

I dunno the details, but if going through their books when they want to hike rates isn't part of the law, then it should be.

Hmm, government control of nominally private enterprises. It's on the tip of my tongue... Faster? Fasting? Fastism? It sounds like that but I can't think of the word.

[Nephilium]

Fisting!

It's definitely an "F" word...

Wait... I've got it...

F*cough**cough**cough*

[CatoTheElder]

Hint: Italy circa 1930.

[Invisible Finger]

One could argue that the private firms need to modify their business model to figure out how to make money in the new regulatory structure.

Sure, if one were a passive-aggressive asshole like yourself.

[Ted S.]

And when business pointed out that the new regulations would force them to take writedowns on their profits (as they were madated to point out), Henry Waxman wanted to grandstand and interrogate them.

[Tig Moo]

LOL, yet again the Sheeple get the short end of the stick LOL

http://www.total-anonymity.se.tc

[Hugh Akston]

You're a heartless motherfucker, anonymitybot.

[The Art-P.O.G.]

Well said, Akston.

[Sean W. Malone]

There's a "joke" that Walter Block likes to tell... It goes like this;

Three businessmen are in jail. They each ask each other what they're in there for.

First guy says, "I'm in here cause I charged less than all my competitors and was accused of 'cut-throat' competition."

Second guy says, "Yah? Well I'm in here cause I charged more than my competitors and I was accused of price-gouging!"

They look at the third guy and he says; "Wow, well I charged exactly the same price as everybody else, and they accused me of collusion and monopolistic practices."

Get it?

Yeah... It's not funny when it happens for real either.

[Groovus Maximus]

Thanks SWM. No. No, it's not funny. Only a sociopath could find amusement is such an arrangement.

[Tulpa]

Hate to spoil the joke, but the difference has to be significant to be convicted of price gouging or price dumping. An analogue of your joke would prove that humans can't possibly live since they die if their body temperature gets too low or too high.

[Groovus Maximus]

Tulpa, there are days your Vulcan half just makes me want to strangle you. I prescribe a wild weekend of donating Tulpaseed(tm) to hot nubile women.

[Sean W. Malone]

One way or another, it's not government's business to determine what the right price of any good is. Prices are subjective and dependent on a wide array of factors and the free variance of price is one of the most important requirements of a functioning economy. Businesses that price "too high" or "too low" will be judged by the market - making it a political issue is the problem.

[prolefeed]

Without a close scouring of the insurance company books, it's impossible to say for certain whether the losses are actually due to the rate caps, as the insurers claim

This is kind of an important thing to find out, no?

I dunno the details, but if going through their books when they want to hike rates isn't part of the law, then it should be.

I sure you "dunno the details", and neither do the arseholes who will be charged with determining rate adequacy of some business they aren't responsible for if they run it into the ground by denying needed rate increases.

This is none of the government's goddamn business -- literally.

And why the Democrats need to lose a buttload of seats this midterm to get them to back off this socialist crap.

[ChicagoTom]

I sure you "dunno the details", and neither do the arseholes who will be charged with determining rate adequacy of some business they aren't responsible for if they run it into the ground by denying needed rate increases.

Isn't that kind of the point? To make sure that they are "needed" rather simply wanted or desired or an easy way to make more profit and give bigger bonuses to execs?

Health insurance rate increases should have to be justified.

[Hazel Meade]

If the government wasn't forcing insurance companies to "insure" people who are already sick, these rate increases would not be happening.

[The Gubmint]

Isn't that kind of the point? To make sure that they are "needed" rather simply wanted or desired or an easy way to make more profit and give bigger bonuses to execs?

That reminds me, we need to have a talk about your salary; in particular, we're not convinced that you need the whole thing.

[Barack Obama]

What do you think I was talking about two weeks ago? At some point you've earned enough money, right?

[ChicagoTom]

they aren't responsible for if they run it into the ground

You know who rant these companies to the ground? The companies themseleves. If they werent such bad actors and pissed off their helpless customers so much, there would have been no demand for reform.

And now Im supposed to feel bad because an industry whose main function is gouging customers and finding new and interesting ways to deny people the benefits they have been paying for and deserve is gonna have the government up their ass and possible run out of business?

Boo FUCKING Hoo!

All of these wounds are self inflicted.

Single pay

[ChicagoTom]

Single pay

Bahh..hit submit by mistake

I should have said:

Single payor, like the rest of the modern world industrialized world has, can't come fast enough.

[Tman]

Ok CT, I'll bite.

Riddle me this:

If the government makes it illegal for healthcare companies to deny coverage based on pre-existing conditions, why would I ever buy health insurance when I know that as soon as I get sick I can just apply and get approved for coverage?

Difficulty: You can't use "because the government will fine you if you don't get coverage" because the fine isn't anywhere close to what premiums cost.

This should be a hoot.

[Night Elf Mohawk]

The health insurance will cover pre-existing conditions but will it cover previously incurred cost?

The scenario in which you are diagnosed with cancer and then buy insurance is one thing and goes along with your question.

A different scenario is you are uninsured but are in an auto accident or are otherwise injured in a manner that requires immediate, expensive treatment before you can get a chance to buy insurance. Would the insurance have to cover treatment you received before you bought the policy? It seems like that is different from just a pre-existing condition and might be the thing that convinces people to buy insurance ahead of time.

[LBJ's Ghost]

That's called a tax audit. The purpose is to determine if the proper amount of taxes were paid. Its NOT to determine if the company charged consumers too much for their service or products.

There's another mechanism to determine if the company charges too much for their goods or services- it's called the free market.

If an insurance company's business model is to jack up rates and deny most claims consumers will go elsewhere.

Besides, do you really think that an institution (the govt) that can't keep it's own finances in order is going to tell a privately owned company how to run their business (see GM for more info).

[LBJ's Ghost]

Damn nested comments. It should be above.

[ChicagoTom]

If an insurance company's business model is to jack up rates and deny most claims consumers will go elsewhere.

Except that most states only have 1 or two providers, and insurance companies have an anti-trust exemption and can collude and fix prices.

And then consider that most people get their insurance from their employer, so they can't just leave.

In Illinois, my employer every year "shops around" between the couple of insurance companies to see if they can avoid paying double digit premium increases. And most the time they stay where they are because no one is offering a better deal without downgrading coverage.

Going elsewhere is BS. There just isn't a real alternative.

[Hazel Meade]

Except that most states only have 1 or two providers, and insurance companies have an anti-trust exemption and can collude and fix prices.

And then consider that most people get their insurance from their employer, so they can't just leave.

Yeah, and those insurance cartels are created by state mandates.

[ChicagoTom]

If the government makes it illegal for healthcare companies to deny coverage based on pre-existing conditions, why would I ever buy health insurance when I know that as soon as I get sick I can just apply and get approved for coverage?

In reality, gaming the system isn't that easy. If you are involved in an accident or taken to a hospital in an emergency situation, you won't have time to enroll in insurance. If I cut off a finger im not gonna wait a few days to get some coverage and then go to the doctor to have it sewed up/stiched back on.

So now we are left with the situation of being diagnosed with something serious, like cancer or something, and then going out and buying insurance. But here's the rub, this is already happening. Doctors are already diagnosing patients without insurance and then telling them to go out and get coverage before they put it in their medical records. This type of compassionate fraud happens already. So I don't see what the difference is, practically speaking.

But here is the answer you were probably hoping for:

I hope people do game the health insurance companies and they go out of business and universal health care/single payer takes it place.

That's also why I really hope that the SCOTUS rules the individual mandate unconstitutional.

That's the only good way. Have everyone covered from birth automatically and you don't have problems like "pre-existing conditions.

[Hazel Meade]

I wouldn't be so confident that the American people are going to want single payer after you've destroyed the insurance market.

[Tman]

In reality, gaming the system isn't that easy.

Categorically untrue.

[Tman]

This type of compassionate fraud happens already. So I don't see what the difference is, practically speaking.

Good, so we both agree that this is a horrible very bad no good way to run a healthcare system, with the lying and frauding and whatnot. Compassionate, sure, but fiscally untenable.

I hope people do game the health insurance companies and they go out of business and universal health care/single payer takes it place.

You hope that a government that already loses tens of billions of dollars a year to fraudulent medicare claims will take over the rest of the money pile?

Have everyone covered from birth automatically and you don't have problems like "pre-existing conditions.

You also get death panels. Because now the government decides whether or not your grandmother gets that treatment or whether your stage 3 cancer is worth treating. Ask Britain how much they like being told "no" by the government- ""Don't treat the old and unhealthy, say doctors"-
"Patients forced to live in agony after NHS refuses to pay for painkilling injections"

Morons like you think that single payer is the answer, but if that's what we get in the US we will no longer have the lowest cancer survival rates in the world, nor will we maintain our innovative marketplace that produces medical technology that saves lives and eases pain.

Single payer is not a silver bullet, and there are a lot more problems with socialized healthcare systems than Europeans are willing to admit. That's why so many of the rich ones STILL come to the US for urgent care.

[Libertymike]

CT- Are you prepared to sacrifice your life so that we have communist medicine?

[Tulpa]

The rest of the industrialized world has significant restrictions on speech, also. Are you salivating for us to catch up to them in that respect, too?

[ChicagoTom]

The rest of the industrialized world has significant restrictions on speech, also. Are you salivating for us to catch up to them in that respect, too?

Really, you think this is a rational argument?

Other places have some bad things so therefore emulating anything at all from those other places is inherently bad?

[CJ]

It's neither more nor less rational than "it's good because everybody else is doing it too," which is what you were implying.

[CJ]

And that's Tulpa's point, incidentally. The fact that a large number of other people use a given system implies nothing in and of itself about the value of that system.

Which is a great thing. If it did work as an argument, the necessary conclusion would be that from the moment a global majority is established for any given policy, that policy should never be revised or revisited.

[Hazel Meade]

Yeah, it was the insurance companies who decided they were going to cover people who were already sick.

Uh huh.

[LBJ's Ghost]

Can I buy auto insurance after I total my car? Would my wrecked car be considered a pre-existing condition?

[Hazel Meade]

finding new and interesting ways to deny people the benefits they have been paying for and deserve

You mean, denying people the benefits they haven't paid for, because they were already sick before they bought insurance. What do you think "pre-existing condition" refers to?

[ChicagoTom]

You mean, denying people the benefits they haven't paid for, because they were already sick before they bought insurance. What do you think "pre-existing condition" refers to?

No, I mean just what I said. People who have been paying and are denied benefits when they try to make a valid claim.

Most people who get rescinded didn't lie about anything. They didn't willfully omit anything.

There are tons of examples of people who get cancer and get denied because they failed to report that they were treated for acne some 10 years ago. These types of examples are all to common.

[Hazel Meade]

So the solution is to pass a law saying that insurance companies can never ever deny any claims, regardless of whether the person knew they were sick or not?

[ChicagoTom]

So the solution is to pass a law saying that insurance companies can never ever deny any claims, regardless of whether the person knew they were sick or not?

I think the real solution is for the government to provide everyone health care/health insurance from birth, and then no one will have a "pre-existing" condition.

But what's your solution? There are people who are sick, chronically sick, that can't afford treatment and aren't insurable? What is your solution for all of them? Pound Sand? Pray? Charity? Die?

[Hazel Meade]

I think the real solution is for the government to provide everyone health care/health insurance from birth, and then no one will have a "pre-existing" condition.

Because everyone knows there are infinite dollars around to provide everyone with free health care from birth to death. And so the government will never, ever, have to decide when to deny someone a treatment.

There are people who are sick, chronically sick, that can't afford treatment and aren't insurable? What is your solution for all of them? Pound Sand? Pray? Charity? Die?

Any and all. There are plenty of people who die on waiting lists or are denied treatment under single-payer systems.

At least with a free market system you have proper price signals in place so that resources are better allocated towards things that are in demand, instead of those decisions being made by how many votes it will buy in Florida.

[West Texas Boy]

I gotta say, you're a good troll. You're wrongheaded and way too didactic, but at least you're keeping up with the argument and not throwing irrelevant bombs and running off. Good for you, Tom.

[Hazel Meade]

finding new and interesting ways to deny people the benefits they have been paying for and deserve

You mean, denying people the benefits they haven't paid for, because they were already sick before they bought insurance. What do you think "pre-existing condition" refers to?

[ChicagoTom]

You mean, denying people the benefits they haven't paid for, because they were already sick before they bought insurance. What do you think "pre-existing condition" refers to?

You are conflating your talking points, chief. They HAVE paid for the benefits. That's why they get rescinded, because they are paid up, and now they file a claim, and the insurance companies looks to fuck them over.

I'm supposed to take the criticism of someone who doesn't even know how the system works seriously?

The insurance company is responsible for not enrolling someone with pre-existing conditions. If they fail to catch it should be their fault. They have every opportunity when you enroll to check your medical history instead of waiting until you file a claim.

Instead they collect your premiums, and then, only after you dare file a claim, THEN they go looking through your history and see if there is any pre-text they can deny you coverage, no matter how flimsy.

And then the customer has to appeal to a regulator, and even if the regulator deems the pre-text BS, you have still lost precious time for treatment if you have an aggressive cancer.

And nitwits like you defend that sickening system.

[Ray Pew]

Instead they collect your premiums, and then, only after you dare file a claim, THEN they go looking through your history and see if there is any pre-text they can deny you coverage, no matter how flimsy.

And then the customer has to appeal to a regulator, and even if the regulator deems the pre-text BS, you have still lost precious time for treatment if you have an aggressive cancer.

Same scenarios exist under universal health systems. Wish all you like, but "coverage" does not equate to "service".

[ChicagoTom]

Same scenarios exist under universal health systems. Wish all you like, but "coverage" does not equate to "service".

I don't even know what this means? In a universal health care system, you don't get denied coverage for life saving medicine because of bullshit pre-texts.

The WORST case scenario is that you have to wait a while for elective or non-emergency/non-urgent care.

That's not the same as an insurance company refusing to pay for chemo when you get cancer.

[Hazel Meade]

In a universal health care system, you don't get denied coverage for life saving medicine because of bullshit pre-texts.

No, you get denied treatment because their aren't enough doctors around to treat you, because the government won't pay them properly.

[Ray Pew]

I don't even know what this means? In a universal health care system, you don't get denied coverage for life saving medicine because of bullshit pre-texts.

Nope. They never deny treatment because of bullshit pre-texts like say a treatment is too costly for the system. Never.

http://www.dailymail.co.uk/hea.....g-NHS.html

[Hazel Meade]

You are conflating your talking points, chief. They HAVE paid for the benefits. That's why they get rescinded, because they are paid up, and now they file a claim, and the insurance companies looks to fuck them over.

How about we focus on not letting insurance companies deny legitimate claims, instead of forcing them to accept fraudulent ones?

But no, you've admitted that your goal is to get to single payer, so what the fuck do you care if you fuck up the insurance market.

[Sean W. Malone]

The demand for reform has a very limited amount to do with any "self-inflicted" maladies in medical care, and the depths of economic ignorance you have to engage in to do what the government has recently done and expect anything short of utter catastrophe is incalculable.

If you actually looked at real data rather than the shit that you pull out of your ass, you'd realize that the government has been the primary and most significant actor in US health care for decades. You might also realize that the number of cases where insurers actually deny coverage is extremely rare. Somewhere around 95% of claims are paid.

Those small percent which aren't are mixed between consumer fraud and corporate malfeasance. However, dumbasses like yourself are more than happy to take the latter and pretend as if it is the norm.

The incentives in health care are so severely screwed that reform was necessary, but the "reform" we got only screws those incentives exponentially more.

And the "single-payer" systems the world over are actively crumbling as we speak. Really smart there, Tom. Yeah... Let's just double down on stupid.

[Invisible Finger]

CT, I wouldn't wish government health care on anyone but you.

[Invisible Finger]

CT, I wouldn't wish government health care on anyone but you.

[ChicagoTom]

CT, I wouldn't wish government health care on anyone but you.

I know you think you are being clever, but polling shows that Medicare and VA patients are the happiest with their coverage.

Look at Europe. They aren't dying in the streets or being denied care. That's just ideological fear mongering.

I would love being part of the French or Japanese system of health care. You get to see doctors when you want, and you wont go bankrupt when they save your life or heal you. Yeah that's a terrible system.

[Ray Pew]

Look at Europe. They aren't dying in the streets or being denied care. That's just ideological fear mongering.

The same situation exists here as well, unless you are claiming some rash of corpse littered streets that hasn't been reported.

[ChicagoTom]

The same situation exists here as well, unless you are claiming some rash of corpse littered streets that hasn't been reported.

No the same doesn't exist here.

You don't have bill collectors hounding you in order to get care. You don't file bankruptcy because of your health care costs and out of pocket expenses. You don't have companies saying "sorry that procedure isn't covered" or saying "sorry, we see you saw a doctor 10 years ago about acne so now we are going to deny you chemotherapy"

If the results are the same, as you seem to be conceding, then Europe is definitely the superior system, because it doesn't bankrupt you or send you to the poor house in order to get care.

[The Angry Optimist]

And has no real medical innovation to speak of, either, because the profit motive is what drives innovations.

You are basically trading innovation and dynamism for security and stagnation. The fact that you are forcing people to join a risk pool they have no interest in joining makes this not only pragmatically bad, but morally repugnant.

[Hazel Meade]

Which totally explains why Europeans never travel to other countries to get medical care.

Yup. No medical tourism to speak of.

[spambot]

My choices:

1) Bankrupt and alive
2) Dead from waiting for operation under single payer.

Going with door number one.

[Ray Pew]

No the same doesn't exist here.

You don't have bill collectors hounding you in order to get care. You don't file bankruptcy because of your health care costs and out of pocket expenses. You don't have companies saying "sorry that procedure isn't covered" or saying "sorry, we see you saw a doctor 10 years ago about acne so now we are going to deny you chemotherapy"

Try a new myth. The "acne" meme is obviously bullshit.

If the results are the same, as you seem to be conceding, then Europe is definitely the superior system, because it doesn't bankrupt you or send you to the poor house in order to get care.

Nice dodge. Your original insinuation was that people were dying in the streets in the U.S., which is not true. There was no discussion about collections. This is merely a distraction.

But it is likewise complete bullshit that people are not "hounded" by people wanting money. It's just that under universal healthcare systems, the group doing the hounding is the government. The payments are called taxes and tax burdens definitely DO bankrupt individuals and businesses.

[P Brooks]

One could argue that the private firms need to modify their business model to figure out how to make money in the new regulatory structure.

Are you suggesting the insurance companies should spend more on lobbyists?

[Sean W. Malone]

Since that's the only meaningful way to change a business model in health insurance at this point, I suppose that's the only option they have. That's what it means to figure out better ways to operate in the "new system" when that system is entirely politically controlled, after all.

[Hazel Meade]

My prediction is that they will become employer-only shops. Or private club-purchase. The private clubs will keep out the people with pre-existing conditions indirectly. The only insurance available on the individual market will be staggeringly expensive. To get into a private insurance club you'll have to go through a vatting process more brutal than any secret society.

[CatoTheElder]

How'd that work out in Massachusetts, where Governor Deval Patrick recently rejected about 90 percent of this year's proposed rate hikes?

Just as any reasonable person would expect ... the failure of insurance companies to turn a profit under HCR is not a bug, it's the act's primary feature.

[Dan]

Eh. If Americans didn't want socialized medicine, they shouldn't have given the Democrats complete control of the government. They did, so I'm inclined to say "tough cookies if you don't like the results".

The only downside is that I'm American too. But if I'm going to be forced to suffer along with the ignorant masses, I insist on the right to feel smug about it. 🙂

[West Texas Boy]

I agree with you. Elections have consequences, but hey, at least we elected the black guy and don't have that slimy Jack Abramoff floating around DC anymore!

Way to go voters!

[Barry Obama]

Grandma used to tell me, "Barry, just because Farouk jumps off a bridge doesn't mean you should."

Geronimo, Chicago Tom!