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View Diary: What’s Behind Wisconsin’s High Health Insurance Premiums? His Name Is Scott Walker (36 comments)

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  •  A Minnesota agency would have problems (0+ / 0-)

    certifying a Wisconsin doctor, due to distance, probably different requirements and difficulties in visiting their practice to verify what the doctor claims.  They could rely upon Wisconsin to oversee the doctor, but given the differences highlighted in this diary, will Minnesota trust that the Wisconsin doctor is actually up to the standards required of Minnesota doctors, and if he's not, can Minnesota do anything about it?  Would Minnesota want to have different standards for each state where their companies are selling insurance?  

    As for how appeals might be handled, the appeal might have to happen in the state where the insurance company is based, which would mean travel to a different state, maybe overnight, maybe multiple days.  It would be hard for a lower-income person to do, whereas in the past they could appeal to the state capitol or HQ which might be in the largest city within the state.

    •  These are non-issues. Seriously. (0+ / 0-)

      Minnesota would have problems certifying a Wisconsin doctor due to distance?

      Oh come on. Distance? Do they not have internet or telephone or mail in Minnesota? This argument about distance is just silly. Background checks take place in an office.

      My state uses Wisconsin-based NCBEX for character and fitness investigations for admission to the state bar. NCBEX is on the other side of the country and it works with no problems. Why couldn't that work for doctors?

      Would Minnesota want to have different standards for each state where their companies are selling insurance?
      Of course not. Why would they even do that?
      As for how appeals might be handled, the appeal might have to happen in the state where the insurance company is based
      How about a rule that appeals occur in the state in which the individual lives? This is simple.

      We don't even need a federal rule -- states can implement the rule on their own. A state court would unquestionably have personal jurisdiction over an insurance company which sells insurance to residents of the state.

      I mean, premiums are 112% higher in Wisconsin, and this is seriously the problem that's standing in the way?

      •  I don't know what goes into medical certification. (0+ / 0-)

        I'm sure most is just checking degrees and certifications, but there may also be questions of the medical facilities for who's in-network and who isn't.  I don't know if states would be willing to join a compact for joint certification the way that licenses in some states are accepted in others that are part of the compact - that seems to be the most likely way it would happen.  Still, if Minnesota has higher quality standards than Wisconsin, they may not wish to accept Wisconsin practitioners at something of a lesser standard.

        I'm sure it can all be worked out.  I'm just not ready to force states to accept doctors and plans when there are reasons why differences exist.  And I'm sure the doctors, pharmacists, and health care providers can provide a lengthy list of how and why things are done differently in the two states.  I highly doubt, however, that it's as simple as charging twice as much for the exact same test performed by the same practitioner in the exact same quality clinic and pocketing the markup.

        •  Not sure I get why you're talking about doctors? (0+ / 0-)

          Or rather, why you seem focused on medical licenses and quality standards?

          If two states have different regulations for practicing medicine, that has no bearing on an insurance company in one state selling coverage to residents of the other.

          Every state has laws that govern practicing medicine. Doctors would still be subject to the laws of their own states. Nothing about having an out of state insurer would have any impact on that.

          I want you to read this article: http://www.cnbc.com/...

          In regions with less competition among insurers, premiums are higher.

          That's an absurd result. There is no reason why premiums should be drastically different for two people with identical circumstances, with the sole exception of which state they live in.

          I mean, do you disagree with that?

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