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View Diary: Health Insurers Refuse to Rescind "Unreasonable" Rates; Snub Feds (250 comments)

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  •  What is their Medical Loss Ratio? (1+ / 0-)
    Recommended by:
    SquirrelWhisperer

    It is not enough to say a 13% increase is "unreasonable" if you have no idea what their MLR was.

    I thought the MLR was supposed to be the deciding factor. No?

    •  Doesn't matter (4+ / 0-)
      Recommended by:
      james321, Pluto, m00finsan, George Hier

      As an accountant, I could make your MLR just about anything I wanted by classifying different expenses as direct losses vs. overhead.

      There is something fundamentally wrong when the cost of medical care is considered a "loss".  I mean, what if you were a car manufacturer and the cost of making a car was considered a "loss?"

      #Occupy Wallstreet - Politicians will not support the movement until it is too big to fail.

      by Sychotic1 on Mon Jan 16, 2012 at 10:33:19 AM PST

      [ Parent ]

      •  Well.. it is poor terminology.. (0+ / 0-)

        It is actually a Medical Benefit Ratio in terms of how ACA defines it.  not a loss..

        But I thought all of this was settled this past fall on what exactly can be used to compute the ratio?

      •  I don't think that is true (0+ / 0-)

        At least if you are ethical.  MLR isn't calculated based on the insurance companies representation.  They must make itemized reports for their expenditures.  For example, executive salary must be classified as administrative, as well as benefits.  Even broker payments must be included as admin costs (brokers are very unhappy about this). It is far more regulated than most assume. Though,
         It won't prevent outright fraud like reclassifying employee benefits as doctor payments.  
        Here is some basic info http://www.healthcarereformmagazine.com/...

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