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	<title>Comments on: Tone Deaf</title>
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	<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/</link>
	<description>Bill Coffin Editor-in-Chief</description>
	<lastBuildDate>Thu, 02 Sep 2010 21:13:50 -0400</lastBuildDate>
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		<title>By: Chuck</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-377</link>
		<dc:creator>Chuck</dc:creator>
		<pubDate>Mon, 15 Mar 2010 23:58:27 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-377</guid>
		<description>Steve - You also don&#039;t just shoot yourself just to show the firing squad that you are really not such a bad guy. That&#039;s like trying to be really nice to the terrorists so that they won&#039;t hate us so much. 

It may not do any good, but if you are being framed, you hold your head high and shout it to whoever might listen. You don&#039;t encourage actions that justify the use of even more firing squads. (&quot;See when we put them before a firing squad, they admit they don&#039;t really need those increases!&quot;).

The point is that you try to diminish the importance of timely rate increases as being perhaps &quot;actuarially justified&quot;, as if that were a minor point. Do the very simple math (2 to 5% profit margins, 40% increases) - deferring such increases do not just mean the company must settle for a little less exhorbitant profit. Doing so starts those blocks down a path of enormous losses, and multiplied across the country, financial instability.

If we are really beyond trying to &quot;get them to understand&quot;, then we may as well just shoot ourselves. In all likelihood it&#039;s not that they can&#039;t understand, it is that they don&#039;t want to because that does not fit with their ultimate goals.

I am not an apoligist for these companies. I don&#039;t see anybody doing a very good job explaining and communicating real solutions. Some companies may not like my solutions either. But at least mine are actual attempts at solutions. There are &quot;actuarially justified&quot; solutions to 40% increases if anybody really wants to hear them.

Chuck</description>
		<content:encoded><![CDATA[<p>Steve &#8211; You also don&#8217;t just shoot yourself just to show the firing squad that you are really not such a bad guy. That&#8217;s like trying to be really nice to the terrorists so that they won&#8217;t hate us so much. </p>
<p>It may not do any good, but if you are being framed, you hold your head high and shout it to whoever might listen. You don&#8217;t encourage actions that justify the use of even more firing squads. (&#8221;See when we put them before a firing squad, they admit they don&#8217;t really need those increases!&#8221;).</p>
<p>The point is that you try to diminish the importance of timely rate increases as being perhaps &#8220;actuarially justified&#8221;, as if that were a minor point. Do the very simple math (2 to 5% profit margins, 40% increases) &#8211; deferring such increases do not just mean the company must settle for a little less exhorbitant profit. Doing so starts those blocks down a path of enormous losses, and multiplied across the country, financial instability.</p>
<p>If we are really beyond trying to &#8220;get them to understand&#8221;, then we may as well just shoot ourselves. In all likelihood it&#8217;s not that they can&#8217;t understand, it is that they don&#8217;t want to because that does not fit with their ultimate goals.</p>
<p>I am not an apoligist for these companies. I don&#8217;t see anybody doing a very good job explaining and communicating real solutions. Some companies may not like my solutions either. But at least mine are actual attempts at solutions. There are &#8220;actuarially justified&#8221; solutions to 40% increases if anybody really wants to hear them.</p>
<p>Chuck</p>
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		<title>By: Steve Piontek</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-353</link>
		<dc:creator>Steve Piontek</dc:creator>
		<pubDate>Wed, 24 Feb 2010 19:38:02 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-353</guid>
		<description>Chuck,
At this point we&#039;re way beyond &quot;if they&#039;d only understand.&quot;  Health insurance has long been a political football and never more so than in the last year.  It&#039;s all about scoring points in the public arena and health insurers are target #1. 
The point of the blog was that surely WellPoint and Anthem should have recognized that and found a way to put off their rate increase.  

Do I understand what putting it off would do?  Yes I do.  But the point is that no matter how justified those increases might be actuarially they just give ammunition to those who want to blame the insurance business for the mess we&#039;re in.  The industry doesn&#039;t exist in a vacuum.  It simply can&#039;t afford to play ostrich by continuing to insist how justified such increases are when the political consequences are so great.  

When someone is saying they&#039;ll put you in front of a firing squad, you don&#039;t go and get the gun for them and offer to fill it with ammunition. 

Steve</description>
		<content:encoded><![CDATA[<p>Chuck,<br />
At this point we&#8217;re way beyond &#8220;if they&#8217;d only understand.&#8221;  Health insurance has long been a political football and never more so than in the last year.  It&#8217;s all about scoring points in the public arena and health insurers are target #1.<br />
The point of the blog was that surely WellPoint and Anthem should have recognized that and found a way to put off their rate increase.  </p>
<p>Do I understand what putting it off would do?  Yes I do.  But the point is that no matter how justified those increases might be actuarially they just give ammunition to those who want to blame the insurance business for the mess we&#8217;re in.  The industry doesn&#8217;t exist in a vacuum.  It simply can&#8217;t afford to play ostrich by continuing to insist how justified such increases are when the political consequences are so great.  </p>
<p>When someone is saying they&#8217;ll put you in front of a firing squad, you don&#8217;t go and get the gun for them and offer to fill it with ammunition. </p>
<p>Steve</p>
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		<title>By: Chuck</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-351</link>
		<dc:creator>Chuck</dc:creator>
		<pubDate>Tue, 23 Feb 2010 22:14:54 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-351</guid>
		<description>Or maybe, just maybe, they really did need the increase in order to keep the block of business viable, and maybe, just maybe, you don&#039;t really understand the business or how waiting to increase rates can negatively affect all policyholders in a block of business. I am not a health guy, but I do have a basic understanding of how this works. Very few politicians or pundits, either conservative or liberal, have a clue as to what they are talking about.  I don&#039;t know the details of this 39% increase, but here&#039;s the questions that need asking:

When was the last rate increase on this block and how much was that increase? 

You may think it is a good idea to defer, given the current political environment, but for how long? 39% is not a good idea, but wait another year and it may need to be 60% or 80%. How do you think that increase would be received?

Do you understand the differences that will occur in the experience of a block of business if you increase rates one time by 80% over four years compared to, say, 20% per year each year? While politically expedient to defer, the delay will do substantial harm to insureds (hint: think anti-selection shock).

Dismiss the actuaries and their numbers if you want, but it would be refreshing if one or two could have a seat at the debate table. We&#039;ve got politicians, lawyers, doctors, and pundits all putting their 2 cents in about how insurance should work, but when was the last time you saw an expert in insurance being interviewed on any of the news networks?

The 39% rate increase is a problem, but none of the pols and pundits really understands why these increases occur and, as a result, virtually everything being proposed to fix things is just going to make the problems worse. There are definitely needed insurance regulatory reforms that can help improve things, but until we deal with the cost of health CARE, we are (somewhat ironically) dealing only with the symptoms and not the disease.</description>
		<content:encoded><![CDATA[<p>Or maybe, just maybe, they really did need the increase in order to keep the block of business viable, and maybe, just maybe, you don&#8217;t really understand the business or how waiting to increase rates can negatively affect all policyholders in a block of business. I am not a health guy, but I do have a basic understanding of how this works. Very few politicians or pundits, either conservative or liberal, have a clue as to what they are talking about.  I don&#8217;t know the details of this 39% increase, but here&#8217;s the questions that need asking:</p>
<p>When was the last rate increase on this block and how much was that increase? </p>
<p>You may think it is a good idea to defer, given the current political environment, but for how long? 39% is not a good idea, but wait another year and it may need to be 60% or 80%. How do you think that increase would be received?</p>
<p>Do you understand the differences that will occur in the experience of a block of business if you increase rates one time by 80% over four years compared to, say, 20% per year each year? While politically expedient to defer, the delay will do substantial harm to insureds (hint: think anti-selection shock).</p>
<p>Dismiss the actuaries and their numbers if you want, but it would be refreshing if one or two could have a seat at the debate table. We&#8217;ve got politicians, lawyers, doctors, and pundits all putting their 2 cents in about how insurance should work, but when was the last time you saw an expert in insurance being interviewed on any of the news networks?</p>
<p>The 39% rate increase is a problem, but none of the pols and pundits really understands why these increases occur and, as a result, virtually everything being proposed to fix things is just going to make the problems worse. There are definitely needed insurance regulatory reforms that can help improve things, but until we deal with the cost of health CARE, we are (somewhat ironically) dealing only with the symptoms and not the disease.</p>
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		<title>By: Kate</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-346</link>
		<dc:creator>Kate</dc:creator>
		<pubDate>Tue, 23 Feb 2010 16:38:38 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-346</guid>
		<description>Nothing that some strategically placed K Street dollars can&#039;t remedy.

Now, bring on the defenders of the Constitution and charges of &quot;hating our freedoms.&quot;</description>
		<content:encoded><![CDATA[<p>Nothing that some strategically placed K Street dollars can&#8217;t remedy.</p>
<p>Now, bring on the defenders of the Constitution and charges of &#8220;hating our freedoms.&#8221;</p>
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		<title>By: John</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-345</link>
		<dc:creator>John</dc:creator>
		<pubDate>Tue, 23 Feb 2010 14:59:20 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-345</guid>
		<description>On the other hand, maybe they&#039;re trying to point up the unsustainability of the individual health insurance policy for health care financing.  Every group of individual policyholders is subject to a death spiral as the sick stay in and the healthy opt out.  Health &#039;insurers&#039; all operate as benefit administrators for self-insured group plans too, and I&#039;m sure health &#039;insurers&#039; would much much prefer to simply administer a group plan that includes all Californians.  More customers, no chance of a death spiral, insurers win by putting the individual health insurance policy in the dustbin of history.
It&#039;s time to realize that &#039;the business of health insurance&#039; should be what we have traditionally thought of as the TPA business.  Proposing actuarially justified 39% premium increases is a good way to push the country in that direction.</description>
		<content:encoded><![CDATA[<p>On the other hand, maybe they&#8217;re trying to point up the unsustainability of the individual health insurance policy for health care financing.  Every group of individual policyholders is subject to a death spiral as the sick stay in and the healthy opt out.  Health &#8216;insurers&#8217; all operate as benefit administrators for self-insured group plans too, and I&#8217;m sure health &#8216;insurers&#8217; would much much prefer to simply administer a group plan that includes all Californians.  More customers, no chance of a death spiral, insurers win by putting the individual health insurance policy in the dustbin of history.<br />
It&#8217;s time to realize that &#8216;the business of health insurance&#8217; should be what we have traditionally thought of as the TPA business.  Proposing actuarially justified 39% premium increases is a good way to push the country in that direction.</p>
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		<title>By: lemonton</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-344</link>
		<dc:creator>lemonton</dc:creator>
		<pubDate>Tue, 23 Feb 2010 14:44:47 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-344</guid>
		<description>Let me offer another angle to this drama. I am sure actuaries will have their claim numbers, expense numbers, profits, etc lined up to justify a 40% increase. However, it would be good to examine the admin expenses that are included in the rate determination. When you consider that the CEO is getting $24 million; the lobbying arm AHIP alone got $20 million; and who knows how many more millions go to other lobbying activities, plus the airplanes, luxury offices, bonuses, etc. Maybe the economic condition has caused a deterioration in the market, but surely looks it has not caused deterioration in what Steve describes &quot;excesses of the health insurance business&quot;. I am sure that if tone deaf insurers tone down those exceses maybe the increase could have been a more politically palatable amount. Just a thought.</description>
		<content:encoded><![CDATA[<p>Let me offer another angle to this drama. I am sure actuaries will have their claim numbers, expense numbers, profits, etc lined up to justify a 40% increase. However, it would be good to examine the admin expenses that are included in the rate determination. When you consider that the CEO is getting $24 million; the lobbying arm AHIP alone got $20 million; and who knows how many more millions go to other lobbying activities, plus the airplanes, luxury offices, bonuses, etc. Maybe the economic condition has caused a deterioration in the market, but surely looks it has not caused deterioration in what Steve describes &#8220;excesses of the health insurance business&#8221;. I am sure that if tone deaf insurers tone down those exceses maybe the increase could have been a more politically palatable amount. Just a thought.</p>
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		<title>By: jack mannion</title>
		<link>http://lifeandhealtheditor.com/2010/02/22/tone-deaf/comment-page-1/#comment-341</link>
		<dc:creator>jack mannion</dc:creator>
		<pubDate>Mon, 22 Feb 2010 15:54:52 +0000</pubDate>
		<guid isPermaLink="false">http://lifeandhealtheditor.com/?p=115#comment-341</guid>
		<description>Steve, another excellent to the point observation of how we have a tendency to be completely tone deaf. Mistakes like these can only come back to haunt our entire industry. Keep up your penetrating articles; they refresh me every week</description>
		<content:encoded><![CDATA[<p>Steve, another excellent to the point observation of how we have a tendency to be completely tone deaf. Mistakes like these can only come back to haunt our entire industry. Keep up your penetrating articles; they refresh me every week</p>
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