Those of you who think all will be honky dory once the Patient Protection and Affordable Care Act, kicks in and works its magic, better think again.
Last week UnitedHealth, held its first quarter 2010 conference call with Wall Street analysts. As many of us feared, the CEO explained that provisions in the PPAHCA will require UnitedHealth to pass on all the newly mandated costs in the healthcare reform act to policy holders in the form of higher premiums.
The message of Stephen Helmsley CEO of UnitedHealth to Wall Street was, new mandates will not eat into profit.
UnitedHealth will pass on to its policy holders any additional costs. If HHS intends to enforce an 80 or 85% medical loss ratio, guess what, it's going to get passed on to you and me in the form of higher premiums. Stephen Helmsley the CEO of UnitedHealth says so right here.
Stephen Helmsley - CEO UnitedHealth
We supported these elements and are fully prepared to incorporate the economic effect to these changes into our underwriting processes. We expect these changes will proceed in an orderly fashion and they are included in our revised 2010 outlook. Actuarial soundness and integrity is the core of responsible benefit underwriting pricing and regulatory over side. So we believe price changes required by rising medical cost trends and the cost associated with the revised underwriting rules required under the act will ultimately prevail across the states.
http://seekingalpha.com/...
As per the White House web site, these are the provisions which take effect "this year". The mandated MLR is an immediate provision. People who buy individual policies, are not eligible for tax credits and will see their premiums skyrocket. I do not see how and where these people will qualify for assistance. Only small business receive tax credits. I believe this will be a big problem for Democrats in November.
Skyrocketing insurance premiums can be tamed somewhat, if you buy high deductible junk insurance. These are catastrophic plans, with huge out-of-pocket costs, and what is called, insurance in name only.
Returning to the UnitedHealth conference call.
A surge in high deductible junk insurance.
Why have these high deductible plans grown so dramatically? Because they are the last remaining affordable health insurance product available.
In New York State, I pay $600.00 for a policy with a $3000 deductible and huge additional out-of-pocket costs. When will I see healthcare reform or any sort of lower premiums?
Growth has been driven by in a way of simpler and lower price point product, align the local market needs in preferences including consumer directed high detectable plan in order to we now have more than 3.3 million consumers enrolled. Consumer value products between consumer responsibility and accountability design have grown 80% year-over-year to 600,000 people.
Keep in mind if you decide to read the entire transcript, that when the UnitedHealthcare CEO says, "we're performing better than expectation", he's saying in effect, we're doing a great job of denying healthcare to premium paying enrollees. There is only one way insurers can "do better", which is to take in revenue in the form of premium dollars and pay out as little as possible for healthcare.
"Distribution channels", these are the brokers who sell health insurance, these brokers are entitled to be paid, but their commissions devour a huge chunk of our precious and very limited healthcare dollars.
And if bending the cost curve was the oft spoken intent, then keeping this parasitic industry at the heart of our broken healthcare system, makes no sense at all.
There were a lot of questions about how commissions impact the bottom line and medical loss ratios.
Steve Hemsley
I think Gail had answered that, that’s basically our relationships with the distribution channels that have been and have been for years flexible and variable, the fact that how those operate. So I think we have a wide range of options available to us as we work with the distribution channels, but also that it is important that it is a factor in the health care landscape and has to be recognized.
John Rex - JPMorgan
But I guess my point was could you writing business right now that goes into ‘11, could you still affect that business that you have already written that goes into ’11 at this point or would that have to come later?
Gail Boudreaux - EVP, President UnitedHealth
In some instances, yes; I mean, as we said, we do have a variety of relationships across our different distribution channels and we’re in the process of having those discussion with now and effecting the overall impact. But again, there is a lot in this space, so I know as I said before, and I do want to reiterate that this product is a complicated product and we do believe that the distribution channels are going to be important now and in the post reform environment. So it does really based on the different relations we have.
But the analysts are determined to get into the weeds on how much UnitedHealth pays its network of brokers and sales people.
Justin Lake - UBS
Of course, and then just a quick follow-up on the commission side?
Mike Mikan - EVP, CFO UnitedHealth
That would be about the fourth question, if I (inaudible) it, go ahead.
Justin Lake - UBS
The commission on individual and small group, I know they vary. Can you just tell us, what an average commission structure looks like for individual and small group right now?
Mike Mikan
Justin, I’d say one is that, I thing it various widely. It does change in terms of the United States market as far from homogenous. It various market-by-market and I also think it's pretty comparatively sensitive. So I prefer not to respond to that.
In light of the UnitedHealth Wall Street conference call, I'd like to revisit for a moment, the Wellpoint breast cancer rescission disaster.
The U.S. for-profit insurance industry is in a continual crusade to boost its profit margin. When it sees its medical loss ratio creep up, it needs to take action to bring it down, if it doesn't, its stock price will get battered and . . .well you know what happens. And in the U.S. where healthcare is a commodity, the insurance corporations wage war against the most vulnerable population--sick people, fighting for their lives.
As Wellpoint saw its MLR creep up, it had to target its sick policy holders, because as we know, the for-profit insurance industry exists to deliver a steady stream of good news to Wall Street analysts
This is from the Wellpoint financial outlook for fiscal 2010.
The benefit expense ratio (benefit expenses as a percentage of premium revenue) is expected to come in at approximately 84.3% in 2010 as against 82.6% in 2009. The selling, general, and administrative (SG&A) expense ratio (SG&A expenses as a percentage of premiums, administrative services fees and other revenue) is projected to be about 14.4% for fiscal 2010 as opposed to 15.9% in 2009.
WellPoint believes that savings from its cost-cutting initiatives will help offset challenges in 2010. In general, health insurers are facing a drop in enrollment in their commercial segment. Insurers such as Aetna Inc. (AET), Cigna Corp. (CI) and Humana Inc. (HUM) have resorted to job cuts to tide over difficult times.
So, if you think the lion will lie down with the lamb? Think again.
You think the insurers will make nice with the American people? Think again.
Did I do whatever I could to see the bill passed, your damn right I did, with constant reminders that this was not the change I voted for in 2008.
And those of us who believe healthcare is a right not a privilege, and who believe that healthcare is not a commodity to be traded on Wall Street, will not be silent about the huge shortcomings in the new and "reformed" U.S. healthcare system.
Some of believe that there will be a profound voter backlash in November, because Americans are being mandated to buy junk insurance with no option. We wonder why the most popular element of reform, the public option, was abandoned as roadkill by Democrats in the United States Senate.
Slinkerwink and I are very close to launching a web site which we believe will help Americans fight for their rights against the the for-profit health insurance industry. Our goal is to assist insured, uninsured and underinsured Americans.
We welcome and thank you for your support in fighting insurer atrocities.
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