dodging regulations in proposed health reform

The topic of insurance companies agreeing to cover those with pre-existing conditions and then circumventing regulations came up at the last discussion. For how they could easily do that, try www.calnurses.org, and scroll down to "Insurer Admits Industry Could Circumvent Proposed Regulations." Moral of story: adverse selection lives. Bonus: Michigan content.

Hello Tom,

I wrote a reply to this the other day, clicked on the wrong key and lost my long reply, so I gave up for that day. I looked at the link you listed here. In my humble opinion, I felt that the speaker from BCBS of MI was telling their typical propaganda (sp?). BCBS of MI often complains about their role as the insurer of last resort in MI. However, if you look at the numbers, they have a near monopoly on our state. When you have millions of subscribers, you can afford the risk of the few very sick. BCBS of MI receives significant tax writeoffs for their role as the insurer of last resort & hey make a lot of money ... so I tend to think these comments are propaganda.

In reference to their comments about designing policies to attract the most healthy members .. last time I looked at the stats for MI ... we are the 9th in the US in the number of obese individuals .. its harder to attract a lot of healthy people in MI. In reality, the majority of contracts are bid by employer groups, and an insurer must bid to take all of the members in their group; they can't pick and choose the ones they want.

Another issue is the number of state mandates for health policies .. these are extensive .. it really would be hard to design a policy for healthier members that met the state and federal laws. There are some specia policy types that may attract this kind of group .. they are called Consumer Directed Health Plans. They have very high deductibles, usually paired with health savings accounts ... they really haven't taken off .. in terms of attracting a significant group of subscribers. These policies may be smart for the healthy & wealthy.

I work in the healthcare industry & look forward to contributing here.

Kathy

Thanks, Kathy for your reply. One thing that's great about this group is the diversity of views. I appreciate you sharing your expertise. I still think that adverse selection (insurers trying to attract healthier customers, so they pay less in claims) will be a problem with an individual mandate, and could saddle any public option with higher costs. But the points you make are good ones. It looks like we'll find out for sure when the Obama signs the bill.

tom