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How Happy Are Aetna Policy Holders Now?

Discussion in 'Political Discussion' started by Mrs.PatsFanInVa, Dec 5, 2009.

  1. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #24 Jersey

    Health insurance giant Aetna is planning to force up to 650,000 clients to drop their coverage next year as it seeks to raise additional revenue to meet profit expectations.

    In a third-quarter earnings conference call in late October, officials at Aetna announced that in an effort to improve on a less-than-anticipated profit margin in 2009, they would be raising prices on their consumers in 2010. The insurance giant predicted that the company would subsequently lose between 300,000 and 350,000 members next year from its national account as well as another 300,000 from smaller group accounts.

    Aetna actually made a profit in 2009 but not at levels that it anticipated.

    Aetna is one of the largest insurers in the private market, covering roughly 17.7 million people according to its 2008 annual report. It is also a major player in the current health care debate and inside Washington D.C. The insurance company has spent more than $2 million on lobbying just in 2009, according to the Center for Responsive Politics.

    American Medical News, which first reported the story, noted that this is not the first time the insurance giant has cut the rolls in an effort to boost profit margins. "As chronicled in a 2004 article in Health Affairs by health economist James C. Robinson, MD, PhD, Aetna completely overhauled its business between 2000 and 2003, going from 21 million members in 1999 down to 13 million in 2003, but boosting its profit margin from about 4% to higher than 7%."


    Aetna Forcing 600,000-Plus To Lose Coverage In Effort To Raise Profits
     
  2. apple strudel

    apple strudel Banned

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    Cue PF13 and Belichickfan defending Aetna's fundamental right to screw people over, and some inane banter about the free market.
     
    Last edited: Dec 5, 2009
  3. DarrylS

    DarrylS PatsFans.com Supporter PatsFans.com Supporter

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    Would like to know the medical profile of the 650K people they are dropping?? No assumptions here wait for the evidence...
     
  4. apple strudel

    apple strudel Banned

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    Why should that matter? If they have bad health then they need coverage even more, and dropping them creates a greater public health problem, and puts these people into a position where they may have to pay for health care - with its spiralling costs - out of pocket, during a recession with 10/17% unemployment. Profiteering and health care do not mix. We should have nationalized the whole system.
     
  5. DarrylS

    DarrylS PatsFans.com Supporter PatsFans.com Supporter

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    Stilll would like to know the profile, high risk, low risk, lottery... many health problems, few health problems, young and healthy???

    It is one of those inquiring minds?? If they do it,hope it is at least done randomly...
     
  6. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #24 Jersey

    It sounds like they're doing it the American way - they're simply pricing it out of range for 300,000 individual plan holders and another 350,000 members of group plans sponsored through, most likely, small businessmen who offered health care to their employess.
     
  7. DarrylS

    DarrylS PatsFans.com Supporter PatsFans.com Supporter

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    Kind of makes you happy for the Hill Burton Act....
     
  8. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

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    #24 Jersey

    This is a reminder to me that the issue with health care is COST and the Dems are doing nothing to lower costs, their bill increases costs but increases spending more and they call that saving money. If we do the public option route the costs for that will be skyrocketing too. We already know that health insurers have a very small profit margin. The insurance concept is fine but costs need to be reduced, in ways we've already talked about.

    Regarding those being dropped, I see nothing in there to suggest they won't have other options at similar prices. For instance if Blue Cross dropped me, I have other similar priced options I could pick from.
     
  9. atomdomb

    atomdomb Third String But Playing on Special Teams

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    Who cares? I pay 300 a month for my family through a Medi-share program and I am perfectly happy with my coverage. Of course, my family doesn't engage in drinking, smoking, drug use, homosexual or extra-marital sex, and other seemingly dangerous lifestyle decisions. I pay for my doctor's visits but if the bill goes over 300 dollars the medi-share picks up the difference. No underwriting was needed.

    I am surprised that no one mentioned Dr. Shetty in India. He does heart transplants and surgery for about 2000 dollars per procedure. Careful libs this article is about the power of capitalism. If this type of care comes to America most everyone will be able to get care.

    The Henry Ford of Heart Surgery - WSJ.com

    Dr. Shetty, who entered the limelight in the early 1990s as Mother Teresa's cardiac surgeon, offers cutting-edge medical care in India at a fraction of what it costs elsewhere in the world. His flagship heart hospital charges $2,000, on average, for open-heart surgery, compared with hospitals in the U.S. that are paid between $20,000 and $100,000, depending on the complexity of the surgery.

    The approach has transformed health care in India through a simple premise that works in other industries: economies of scale. By driving huge volumes, even of procedures as sophisticated, delicate and dangerous as heart surgery, Dr. Shetty has managed to drive down the cost of health care in his

    Narayana's 42 cardiac surgeons performed 3,174 cardiac bypass surgeries in 2008, more than double the 1,367 the Cleveland Clinic, a U.S. leader, did in the same year. His surgeons operated on 2,777 pediatric patients, more than double the 1,026 surgeries performed at Children's Hospital Boston.
     
  10. DarrylS

    DarrylS PatsFans.com Supporter PatsFans.com Supporter

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    As much as you want to paint it left vs. right, it is not... most of us would like to see health care costs reduced, this thread is about the greed of the insurance companies..

    Dr. Shetty is an interesting character, and can operate devoid of many of the federal and state regulations that many of our hospitals are faced with... it is interesting that he seems to be opening hospitals in surrounding areas, rather than the US..

    Wonder if he could be as cost effective on US soil??? I suspect that overregulation is a major culprit in this country, and then there will be those who argue that regulation protects us...

    Also tort reform, a state right, is favored, but in Texas there has been this effort and the Doctors and Ins companies have benefitted, but the savings have not been passed on to the consumer.. how could that be???
     
    Last edited: Dec 5, 2009
  11. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #24 Jersey

    Interesting article.....thanks for posting it. I'd not heard of Dr. Shetty before.

    I was particularly taken by the way the fee schedule works out - in fairness to all, apparently. It looks like there's a state funded insurance company which insures low income workers at a very low premium and the hospital agrees to accept, in full with no additional charge to the patient, an insurance reimbursement which is $300.00 less than the break-even price of the surgery. However, they do turn around and charge those not enrolled in the plan (and it sounds like those are people who probably make a bit more money, kinda like the middle class India citizens,) $900.00 more than the break even price and those who can afford to opt for a private or semi-private room are charged $3,500.00 more than the break-even cost.

    Interesting concept for medicine which works - a sliding scale fee and a hospital which is willing to work hand-in-hand with a state run insurance plan for low income people who otherwise couldn't afford health insurance or life saving medical care.

    You're right - why haven't we thought of that???

    Mr. Parashivappa says he can't himself pay for the surgery, but it is covered by a farmers' insurance plan that Dr. Shetty began several years ago in partnership with the state of Karnataka, which includes Bangalore.

    Nearly one third of the hospital's patients are enrolled in this insurance plan, which costs $3 a year per person and reimburses the hospital $1,200 for each cardiac surgery.

    That is about $300 below the hospital's break-even cost of $1,500 per surgery.

    The hospital makes up the difference by charging $2,400 to the 40% of its patients in the general ward who aren't enrolled in the plan. An additional 30% who opt for private or semi-private rooms pay as much as $5,000.
     
    Last edited: Dec 5, 2009
  12. Real World

    Real World Moderator Staff Member

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    I don't think Aetna is forcing anyone, to do anything. I believe they are projecting that they will lose 600-650k members as a result of their price increases for 2010. Remember, insurance companies cover costs related to health care. They are the same as your home owners policy that covers your home if it burns down, or a hurricane hits, as well as your Gieco deal that pays for any accidents with your car. If Gieco isn't making the money it feels it needs to, it raises rates. Those rates are reflective of the cost of doing business. With that in mind, every action has a reaction, and raising rates will mean losing customers who shop for a better price elswhere. If you read any article on this issue, you will see them all say one thing consistently, which is that healthcare costs increased more than they anticipated in 2009. Like BF said, and many of us in here have been repeating, it's the costs stupid. It won't matter how you cover people, if you do nothing to reduce the actual costs of care. Rationing is the only way the gubmitcare people can do that, and the people will not accept that. You don't take 5 steps back when it comes to the quality of care.

    amednews: Aetna prepares for loss of 600,000 members as it raises 2010 prices :: Nov. 30, 2009 ... American Medical News
     
  13. JackBauer

    JackBauer Pro Bowl Player

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    Health care already is rationed in the United States.

    The whole notion behind the public option is to reduce costs.
     
  14. Real World

    Real World Moderator Staff Member

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    My care isn't rationed.
     
  15. Mrs.PatsFanInVa

    Mrs.PatsFanInVa PatsFans.com Supporter PatsFans.com Supporter

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    #24 Jersey

    Sure it is. It's called price rationing. You have it because you can afford it, someone else doesn't have the same health care you have because they can't afford it. It's rationed, you're just one of the one's it was rationed to.

    For now.

    Lose your job or your income and see what happens to it.
     
  16. BelichickFan

    BelichickFan B.O. = Fugazi PatsFans.com Supporter

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    #24 Jersey

    Which is why the health care bill will cost $1T over 7 years. The "savings" are due to even bigger tax increases which will hit far more than the rich. Savings are not being achieved and that's not the "notion" behind the public option; you don't need that to reduce costs.
     
  17. sdaniels7114

    sdaniels7114 Experienced Starter w/First Big Contract

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    Forgive me, but I'd prefer a heart surgeon thinking about my heart if I was lying on the table with my chest wide open, not some irrelevant business deal. Maybe I'm nuts but I'd think any self respecting doctor would be ashamed to be mulling over a business proposal while his hands were inside some person's body.
     

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