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About Those MNSure Weighted Rate Increases

Category: Health Care
Posted: 10/25/14 10:58

by Dave Mindeman

Republicans have latched onto this idea of MNSure rates being calculated by a "weighted average".

Let's examine that.

The weighted average assumes that the same people will renew the same policy they chose last year. If Policy A is chosen by 10 times more people than Policy B, then the increase in Policy A is more relevant.

Here is the problem with that.

The MNSure exchange is a market place. If the policy holder thinks that the increase in premium is unwarranted, they can shop for a new policy at a different price. The number of people renewing policies could be completely different.

So the weighted averages would then be meaningless.

Sure, you can calculate a hypothetical number from that scenario and yes, it could be valid. But using a straight average like the Commerce Department did also has merit and is just as valid a number.

Also, let me address this idea that the administration "coerced" lower rates from the insurance carriers.

Well, I sure as hell hope they did.

You have regulators for a reason. Utility rates are always subject to intervention by the utility commission. They affect the final rates. The ACA also has regulators watching insurance rates - I'm not sure they have the regulatory power that the utility regulators have, but there job is oversight on rates that gouge.

They should be offering their opinions on rates and pointing out problem areas.

That is the whole idea in keeping rates affordable.

I know it is important and desperate for the MN GOP to keep attacking MNSure....after all, they have virtually nothing else of actual relevance to attack, but it is a convoluted one at best.
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Sen. Hann Continues Assault On MNSure - But With Bogus Criticism

Category: Health Care
Posted: 10/04/14 23:44

by Dave Mindeman

Minnesota's Republicans get so frustrated when they aren't allowed to use their version of mathematics. It is almost embarrassing to watch the tantrums being thrown over how they want to play the game on MNSure.

They had a point when the MNSure exchange opened because the programming was awful and the exchange left people in a constant state of frustration. But since then, the GOP line is to continue to bad mouth the site and criticize Obamacare in general. And that line of attack has turned into a failure of credibility for their own part.

Continuing their version of how things operate, they are calling the recent data about rate increases of 4.5% totally bogus. And they say that based on how Senator David Hann thinks the numbers should be arrived at:

Senate Minority Leader David Hann says the calculation should have weighed how much of MNsure's market each plan had. And he said it should have included the largest and cheapest provider, PreferredOne, which is dropping out next year.

Here is why what Hann is saying is the actual bogus statement.

First, he says that the calculated increases should be "weighted" by current market share. Except it is CURRENT market share. When people again sign up for health insurance, they will be evaluating which policies are in their own best interest (remember, this is free market!) and the market share of each carrier WILL drastically change. In fact, the carriers that keep their premiums down will probably increase their own market share. So, the only way you can take an average insurance increase in premium is to take the carriers numbers as equal based on the new market they are now entering.

Secondly, he wants to include PreferredOne plans. Really? They removed themselves from the exchange - priced their policies for a different market - and will no longer be involved with Federal subsidies. How in the world could MNSure include them in the exchange averages, IF THEY ARE NOT PART OF THE EXCHANGE?

I understand the MN GOP's desperate need to find more fault with the MNSure exchange. The awful beginning was bad. But people did get health insurance and many people are actually happy with the result. And the electorate is starting to take a second look at the rates, the lower number of people who are uninsured, and the improvement in the exchange.

We still have more work to do, but "bogus" criticisms from Sen. Hann are more of a statement about his own credibility than actual problems with the MNSure exchange.
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The Mike McFadden "Solution" To Health Care

Category: Health Care
Posted: 09/27/14 10:34

by Dave Mindeman

Did you see Mike McFadden's health care "ideas"? A magical 6 pages (which you could fit onto one if you wanted to) of health care fixes. Oh why did we not do this before?

Truth is....we have tried all of this before....and it doesn't work.

Where do I begin.

He begins with a cost critique of Obamacare. His sources for the data come from the Manhattan Institute and the Freedom Foundation...both are right wing think tanks with slanted data.

He criticizes quality and lack of access by citing the New Hampshire exchange which had only one insurer - Anthem Blue Cross - in its network. But he doesn't mention that for next year, New Hampshire already has 5 carriers signed up and that all of the hospitals in the state will be involved with at least 3 of the 5 carriers.

Then he starts citing the old memes. He says 164,000 Minnesotans lost their health insurance. Again, let me repeat, all of those people got new insurance and it was better insurance. The bogus plans that were health care insurance in name only, had to be scrapped because they weren't close to the minimum standards required in Obamacare. Sure, the plans were cheap -IT WAS BECAUSE THEY DIDN'T COVER ANYTHING!

And I like this one.

"According to officials, 7.3 million people have enrolled in the Obamacare exchanges, a number far short of the 53 million uninsured prior to Obamacare."

You could put it another way. The uninsured population dropped 13% in one year with Obamacare. And let's be real factual and note that nearly 6 million more people could have been covered if Republican governors had just accepted the Medicare expansion!

Then we get the "plan" to lower health care costs....

1) Expand Health Care Savings Accts - Essentially this is making health care purchases tax exempt. You are still paying for it yourself, but you do get to use tax free money. McFadden thinks if he makes you purchase more of your own health care this way, then he can allow the insurance companies to cover less (like contraceptives). This was tried prior to Obamacare and costs were still escalating.

2) Increase Price Transparency - So, it is going to help that you can see the actual costs of things you could never pay for without insurance? I don't think we have to go deeper on that one.

3) Allow Small Business Pooling - Actually Obamacare addressed that but the implementation has been delayed. It is complicated to create a pool for this purpose and the same problems that have delayed it with Obamacare, would be a problem for McFadden. (He just doesn't know enough about it yet to understand that). And his assertion that small business owners with no employees (he says 78% of small business) need to have their own pool is odd. They HAVE their own pool - it is called the Obamacare Exchange.

4) Allow Individuals to Purchase Across State Lines - It's funny. One of the main assertions for McFadden's critique of health care is that the states should have more control. States do have control - they control the criteria for minimum standards that their own citizens have for health care. I could purchase much cheaper insurance in Mississippi, but it wouldn't have the same mandatory coverage or network access that I have in Minnesota. The Republicans put this option out there all the time without ever explaining the problems with that kind of implementation or the reasons that it is not allowed in the first place.

5) Reform The Tort System - A Republican favorite. Protect corporations from the trial lawyers. Actually, I cannot imagine putting limits on tort liability in the health care industry. Countless health care best practices have come from public lawsuits that pointed out the problem. Sure, it might save a little money on malpractice insurance for providers, but would that benefit the general public? Nope.

And then there is McFadden's attempt to take the popular aspects of Obamacare and just add them to the healthcare mix - AFTER he gets Obamacare repealed.


Covering Pre-Existing conditions. Children on parents insurance to age 26. Keep the ban on lifetime limits. Make subsidies optional state by state. Make oral contraceptives available over the counter.

McFadden waves his magic wand and all of that can happen. Wow.

There is a reason that those options were not part of health care prior to Obamacare. The insurance industry had to use them to keep their premium costs down. It was the only way to keep the sickest people off the roles.

The only way to implement those "benefits" was to incorporate them into a larger plan (Obamacare) that would absorb the costs and allow the system as a whole to make it all work together. Obamacare did all of that and still lowered the general cost to the consumer.

But McFadden thinks it is easy-peasy to just say "Poof!", let's do it.

And let me say something about over the counter birth control, because that seems to be the new Republican solution to appease their "religious objectors".

Yes, you could probably switch oral contraceptives to an OTC status. It has been discussed before Hobby Lobby and was probably going to happen at some point. But here are some things to consider:

- 15% of women take oral contraceptives for other medical reasons. OC's can regulate a troublesome menstrual cycle and ease painful cramping during that cycle. In these cases, oral contraceptives are medically necessary and should be a covered medical expense.

- Over the counter purchases are still purchases. They will cost less when they are OTC but it will still be a very significant cost. Retail prices can vary from $10 to $15 a month for uncomplicated generics, up to $120 to $200 per month for specialty brand products. Under Obamacare, they would be 100% covered. No cost to the consumer. McFadden's "solution" just cost you more money.

So, again, when you hear Republicans talk about health care "solutions", please realize that they really aren't solutions to anything. They are just more corporation protecting, higher out of pocket, band-aids which should never see the light of day after an election.

Health care does NOT, I repeat NOT, have a market based solution. And as McFadden always says - he's a business guy.

Don't let Mike McFadden give you the "business".
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