Too many tests and images are being ordered by insurance companies--malpractice insurance companies, that is.   "Defensive medecine" (to protect the MDs and their insurers) leads to diagnostic delays for those who really need such procedures while adding to costs, and, frankly, in the case of intrustive tests, adding to human suffering.

I've stated it before:  There will be no real "health care reform" without serious tort reform.  But since many lawmakers are former trial lawyers I hold out little hope.

From Pennlive. PA's secretary of health struck down some proposed large increases by insurance carriers. I especially like Highmark whining about losing money last year . . . I think I can show them how to cut about $10 million in costs real fast.


Pa. chopped down biggest Obamacare price increases

When the federally-run health insurance marketplace reopens Sunday, shoppers will see premiums that aren't as big as they might have been.

The Pennsylvania Insurance Department said it reduced the biggest rate hikes sought by health insurers, including some that topped 25 percent.

The end result, according to the insurance department, is that the average monthly premium for the lowest-priced sliver plan in Pennsylvania will be $222, which the department said is $42 less than the national average. That figure doesn't include federal subsidies intended to make the coverage more affordable.

The plans available on the federally-run exchange created as a result of the Affordable Care Act, or Obamacare, are sold by private health insurers.

In the midstate, they from companies such as CapitalBlue Cross, Highmark, Geisinger Health Plan and Aetna.

Earlier in the year, some of the proposed increases from Pennsylvania insurers drew national attention, and fueled arguments that Obamacare coverage would become too expensive for people it was intended to help.

But the proposals underwent scrutiny by the Pennsylvania Insurance Department, which said it "ultimately approved final rates that are significantly lower than were originally proposed."

In explaining their rate hike requests, insurers said people who bought coverage on the exchange turned out to be significantly sicker than expected and generated medical bills far excess of the premiums they paid.

The insurance department said in approving the requests, it took into account factors including costs of claims and the insurer's financial reserves. In the case of the six companies that requested increases of more than 25 percent, the department asked them to phase the increases in over future years.

According to Pennsylvania Insurance Commissioner Teresa Miller, there are 19 insurers selling coverage for individuals in the state, and 23 offering plans for small businesses with 50 employees or less. Of the 19 selling individual plans, 12 have increases from last year of less than 10 percent. All of the companies selling plans for small groups have increases of less than 10 percent, the department said.

Still, it's possible that many returning shoppers will discover the plan they had in 2015 isn't available in 2016. Highmark, which had the most exchange-based customers in 2015, recently said it lost $318 million on those customers during the first have of the year. It subsequently announced it would offer only about 10 plans, down from about two dozen, with the plans adjusted in order to hold down costs. Highmark's cost controls include tactics such as narrowing the provider network and offering increased case management and wellness support to chronically ill customers.

The healthcare.gov marketplace is open Nov. 1 to Jan. 31. People who want their coverage to be available on Jan. 1 should enroll by mid-December

Last edited by Rongone (10/31/2015 2:33 pm)

I still don't get what it is CEO's do that warrants such preposterous paychecks.

Is it because it's what's expected?  

Is a CEO that vital to a company?  If they are, is it a good idea to have that amount of control in the hands of one person?