Health Premiums to Jump Again Next Year

Washington Post ^ | 06/24/03 | Bill Brubaker

[bedolido]

Health insurance premiums in the United States are heading up again next year -- and sharply, according to a major insurer and new data from large employers.

Kaiser Permanente, the nation's largest HMO, said yesterday that its members in the Washington area -- numbering more than 500,000 -- can expect an average percentage increase in rates in the "mid teens" next year.

"The increases will range from 4 percent for some plans to 35 percent for others," said Susan Whyte Simon, a Kaiser spokeswoman.

Like other insurers, California-based Kaiser says it is responding to increased medical and prescription-drug costs.

Across the country, HMO premiums could rise 18 percent next year, according to preliminary data released yesterday by benefits consultant Hewitt Associates.

Rate hikes by HMOs in the Washington area could average 20 percent, though increases may be reduced after employers complete negotiations with health insurers later this summer, said Michael Murphy, a Hewitt executive.

The Hewitt data cover only HMOs. But employers are bracing for double-digit rate increases in all of their health insurance plans, including higher-priced PPOs, said Kate Sullivan, health policy director of the U.S. Chamber of Commerce.

"For large employers, 2004 would be the fourth straight year of double-digit rate increases," she said. "And this could be the first year that we're looking at going over 20 percent for premium increases, on average" for employers of all sizes.

Officials of other large insurers that serve the Washington area, including Aetna Inc., UnitedHealthcare, CareFirst BlueCross BlueShield and Mid Atlantic Medical Services Inc., said yesterday that they did not have information on 2004 rates.

[afraidfortherepublic]

We just got another 25% increase on top of last year's 25% increase on top of a 30% increase the year before. We just keep raising the co-pay and reducing the plan coverage to keep it affordable. I'm told that Wisconsin is one of the worst, as far as premiums go, because our state has the lowest reimbursement rate for Medicare of all the states. Therefore the doctors and hospitals make up their losses on the non-Medicare folks by charging higher rates. Thus our premiums are higher.

I don't know if that is true, but I do know that procedures in Minnesota and Illinois cost a third less than they do in Wisconsin.

[Mr. Bird]

I'm a firm believer in high co-pays for routine care. As long as people see no disincentive to visit the doctor for a runny nose or minor stomach ache, premium costs will continue to rise. Employers are paying ridiculous sums in premiums for their employees, which means they have less to pay in wages. Reform can only occur if both sides, patient and insurer, take some responsibility. This would require patient responsibility for routine care, and insurers meeting their obligations in the event of excessive illness.

[Tarheel]

I found the following quite interesting. It is a year old but certainly indicative of what is happening nationwide--states and cities are suffering to say nothing of the rest of us who are getting 'hit in the hip' in many ways.

The Tarheel

Boston Business Journal - March 18, 2002

http://boston.bizjournals.com/boston/stories/2002/03/18/story4.html

Hub trails nation in Medicare payback

Tied with Little Rock, payment rates in Hub among the lowest

Allison Connolly Journal Staff

Boston has sunk to the bottom of the rankings of Medicare reimbursement rates, according to a national study, prompting some observers to speculate that local doctors, who in some cases are already being paid less than they're spending on care, will be squeezed even tighter.

"In some communities, Medicare is a good payer and in others, like in Boston, it is not," said Paul Ginsburg, president of the Washington, D.C.-based Center for Studying Health System Change and the economist who wrote the study.

Boston shares its last-place ranking with Little Rock, Ark.

According to the study, Boston reimbursements for Medicare, which pays for elder health care, lags behind private insurance payments by as much as 67 cents on the dollar. The study reported that private payers here will reimburse, on average, up to 150 percent more than Medicare.

For 2002, Medicare fees paid to doctors will be cut by 5.4 percent under a federal formula used to decide reimbursement rates, which vary from county to county. The American Medical Association estimates the cuts in Medicare reimbursement will cost doctors nationwide about $7 billion this year and even more in 2003, when rates are expected to decline further......

© 2002 American City Business Journals Inc.

[Mr. Bird]

Interestingly, that Boston situation is a result of a failure to gouge Medicare. If a doc doesn't document all primary and secondary diagnoses, the cost of care exceeds the reimbursement. Smart docs regularly have their records audited independently to find out where they are leaving money on the table. It sounds like Boston has a bunch of docs who don't document very well.

[Tarheel]

You are correct in your comments, especially the one on increasing the co-pay to decrease the frivolous visits to the doctor. I would like to add the spector of lawsuits to health care practitioners/hospitals to the increased costs of practicing medicine. It is time to get these suits under control--both the monetary awards and the numbers of suits.

The Tarheel.

[Trust but Verify]

Wisconsin is in a bind for many reasons. one of which is Aurora. Have you seen any of the Taj-Mahal-like buildings they have constructed. I fail to see how those types of amenities contribute to the quality of the care they provide.

[Trust but Verify]

I know a family of four who is at the doctor literally weekly for one stupid thing or another. They have a $10 co-pay. If the co-pay was $25 or more, I guarabtee you they would think twice or three times about going.

Last week the older boy was there twice. Once when he was hit in the thigh playing baseball and the other when he twisted his ankle playing baseball. In both cases, the doctor ordered x-rays, which were negative. Ice and rest were then prescribed. Duh!!

[Mr. Bird]

Multiply your story by the millions, and you have a large portion of the "health care crisis" in a nutshell. It really is amazing.

[Republican Red]

My husband and I are self-employed. This month I cancelled our Kaiser personal plan of which we were paying $600 a month to start up a MSA account. Kaiser has increased premiums in the double digits every year since we've been with them.

[Mr. Bird]

. It is time to get these suits under control--both the monetary awards and the numbers of suits.

Absolutely. I would recommend a cap on pain and suffering damages, and the creation of a medical court or review board to hear malpractice claims. Today's technology and medical practices are far beyond the comprehension of 12 laypersons on a jury, or at least too far for them to be able to adequately judge whether negligence is involved in most cases. As medicine gets better, people (and juries) are reluctant to accept negative outcomes.

[cynicalman]

We can complain all we want. Everyone is a fault:

Doctors, Lawyers, Hospitals, Drug Companies, Patients, the Government.

This is an issue that must be addressed by the Bush: Somehow someway. I don't have any answers. But unless health care costs come down and down fast the Democrats have an issue and will run with it.

Its is coming to a point where some government healthcare is better than health care that the middle income cannot pay for.

Talk about letting the free market take over will not solve the problem quick enough and we will never get a true free market system.

If the republicans want to stay in power they better come up with a good, fast, correct solution to this problem. If not, soccer moms, soccer dads, soccer kids, soccer employers, soccer unions etc will look elsewhere.

Its time to face the music. Its a problem, a big problem and it needs solved.

[beelzepug]

Last night, the neighbor's nine year old daughter got a dog bite - no bleeding, skin not broken, but parents were "concerned" so 911 was called. Medics responded, code red ambulance, the whole works. Is it any wonder our healthcare costs so much?

[afraidfortherepublic]

I certainly agree with you on the building boom seen at the clinics and hospitals around here. Even our County Home for the Aged spent a bloody fortune on a new entrance and lobby last year. I wonder if that improves the care any?

St. Mary's Ozaukee did the same in the last two years in a hospital that is only about 8 years old. and Columbia is building a whole new hospital.

[Trust but Verify]

Wow. What a waste. I sure hope there wasn't a REAL emergency during this nonsense.

[Xenalyte]

If insurance and lawyers would GO THE HELL AWAY, we'd have affordable health care again.

I don't have insurance right now, and I'm doing just fine, thank you very much. (Yes, I have partaken of the health-care system since I got uninsured, and yes, I've been paying my own way.)

[Trust but Verify]

I recently visited my niece in the hospital in Racine. She had just had a baby and was in the new Women and Children's center at St Mary's Medical Center. You know it has gotten out of control when the receptionist tells you to turn left at the baby grand piano to get to the elevators.

[kms61]

What's your contingency for an accident or serious illness? That's not a rhetorical question, I'm genuinely curious. Like you, I'm responsible for my own healthcare, and I keep it affordable with a huge deductible and copay. I have, however, considered dropping insurance altogether.

[Xenalyte]

I'll have catastrophic, once I get hired permanently.

I was born in late 1968. Xena's Mom recalls the bill for my delivery as under $600.

My niece, who was born in March 2002, cost upwards of four grand.

Science hasn't come that far in 33 years - no way, nohow - and the care Mom and I got and the care my sister and niece got are totally comparable.

Except Mom actually got to stay in bed for a few extra days with me - Sis was home in 48 hours.

[Myrddin]

My coverage this year for medical for myself, my wife and remaining eligible son runs $250 per 2 week pay period. There is a $750 per person per year deductible. Prescriptions are $20 each. Many services aren't covered. You get the bill, but it doesn't count against the $750 deductible. When a service is covered, it is only for "reasonable and customary" charges. Anything more is your problem.