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Why selling insurance across state lines makes no sense.

Casca XV said:
THIS THREAD IS A TOTAL FAIL......."Georgetown University Study Team" That says it all. In other words a group of people who have no experience in the real world private sector economy. Who have never run a business or made a dime outside Govt funded academia, and who are 96% Leftists.

By the way, the only candidate who was getting money from insurance corporations was Hillary. What have you been living under a rock lately?
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What's your problem with it? Where is it wrong?
 
PeteEU said:
So it has happened.. the US has become communist. Screw competition and lower prices.. put laws and regulations in place to prevent the free market and competition..

Why does this article smell like a paid piece from the insurance industry?
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Maybe that smell is fear.
 
radcen said:
It may then be "in network".
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Only if the hospitals and Doctors are willing to accept them, for some of these insurance companies that would not be the case but often people do not know the restrictions of their policy until after they have to use it. Ever read your policy, most are legal mumbo jumbo and they have the right to change the terms at will.
 
Casca XV said:
THIS THREAD IS A TOTAL FAIL......."Georgetown University Study Team" That says it all. In other words a group of people who have no experience in the real world private sector economy. Who have never run a business or made a dime outside Govt funded academia, and who are 96% Leftists.
By the way, the only candidate who was getting money from insurance corporations was Hillary. What have you been living under a rock lately?
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Georgetown is a private university.
 
radcen said:
Overall I agree with you that the system is run with greed, and a big part of that is legal protectionism that both the insurance industry and the healthcare industry have been able to get from the politicians, but insurers and health providers do indeed negotiate things all the time, as well. It is very common for there to be two prices (or more) for a given procedure. One for individuals who pay out-of-pocket, and another for an insurance company who has pre-negotiated a lower price for said given procedure. Even different insurance companies may not pay the same price, depends on their negotiating power and abilities of each insurance company.
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And I would believe you if it was not for

Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences | The Huffington Post

based on

https://www.cms.gov/Research-Statis...orts/Medicare-Provider-Charge-Data/index.html

Here it is clear.. there is no negotiation. Some hospitals and insurers work together to pump up prices massively. And due to the lack of choice and information, the consumer is screwed over (and companies). That you within a couple of miles can have 2 hospitals where the price for one procedure is 99k and the other is "only" 21k... shows that the system does not work and there is next to no negotiation. There is no choice and the true costs are hidden.
 
Casper said:
Only if the hospitals and Doctors are willing to accept them, for some of these insurance companies that would not be the case but often people do not know the restrictions of their policy until after they have to use it. Ever read your policy, most are legal mumbo jumbo and they have the right to change the terms at will.
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That's why I said "may". I have local facilities right here that are in my network, and some that are not, and it's always changing. Geographic location does not determine this, which is how I read the person's point that I was responding to.
 
StillBallin75 said:
The biggest reason why selling insurance across state lines is a ****ing idiotic solution is because if that were the case, all the insurance companies would just move to the states with the least restrictions (like, say, provisions for people with pre-existing conditions for example), like how all credit card companies seem to be headquartered in the Dakotas.
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And they would consolidate into too-big-to-fail insurance companies. Just like what happened with the banks.
 
PeteEU said:
And I would believe you if it was not for

Hospital Prices No Longer Secret As New Data Reveals Bewildering System, Staggering Cost Differences | The Huffington Post

based on

https://www.cms.gov/Research-Statis...orts/Medicare-Provider-Charge-Data/index.html

Here it is clear.. there is no negotiation. Some hospitals and insurers work together to pump up prices massively. And due to the lack of choice and information, the consumer is screwed over (and companies). That you within a couple of miles can have 2 hospitals where the price for one procedure is 99k and the other is "only" 21k... shows that the system does not work and there is next to no negotiation. There is no choice and the true costs are hidden.
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Your article is from 2013. My personal example is from 2011. Things may have changed, but I'm skeptical.

I went in for a sleep study test. It was the beginning of the calendar year and I had used zero of my yearly $1000 deductible at that point. The price for the test(s), all inclusive, was $2400(-ish). That's what I was quoted if I paid out-of-pocket.

Long story short, I paid a total of $1100. $1000 to cover my entire deductible for the year, and $100 co-pay for that specific procedure. That leaves $1300(-ish), right?

Ha! Not so. My insurance company paid $34. They had pre-negioated sleep study costs with that particular health care provider from $2400(-ish) to $1134.

I used to have paperwork to show this, and used to show people, but I think I long ago tossed them.
 
ReverendHellh0und said:
Why would one sell a plan in a state where everything was "out of network"?
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I think you're catching on to the source of insurer disinterest in this proposal.

PeteEU said:
Here it is clear.. there is no negotiation. Some hospitals and insurers work together to pump up prices massively. And due to the lack of choice and information, the consumer is screwed over (and companies). That you within a couple of miles can have 2 hospitals where the price for one procedure is 99k and the other is "only" 21k... shows that the system does not work and there is next to no negotiation. There is no choice and the true costs are hidden.
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The fact that prices vary wildly from facility to facility (and even from payer to payer at a given facility) just illustrates the point that prices are determined via contract negotiations between each facility and each insurer.

You seem to be implying that if a new insurer comes into the market, they'll sit down at the negotiating table with the dominant hospital and get more favorable prices than established insurers in the market who generate more business for the hospital. I'm not sure why you think that would be the case.
 
StillBallin75 said:
The biggest reason why selling insurance across state lines is a ****ing idiotic solution is because if that were the case, all the insurance companies would just move to the states with the least restrictions (like, say, provisions for people with pre-existing conditions for example), like how all credit card companies seem to be headquartered in the Dakotas.
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No person or corporation understanding economics is ever going to sell a product for a hundred bucks today knowing that it will need to spend millions tomorrow to fulfill its obligations. Few individuals are going to spend a few hundred per month for a potentially useful product if that product will be available for a hundred the day you require millions. That's the problem with preexisting conditions. The only solution to that problem is charity.

The market can and will determine the best policy for an individual customer if the market is allowed to function. Limiting competition by disallowing multi state or individually designed policies limit the market.
 
Mycroft said:
We can't have people making their own choices...and taking responsibility for them...now, can we. No, we should instead rely on the government to provide us with a one-size-fits-all "choice" and...when it all goes to ****...we can just blame the government instead of ourselves.

/s
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You don't make your own choices. You want the government to take responsibility.

When you go into the grocery store to buy food, you assume that everything you buy is safe. You assume that the list of ingredients is accurate. You assume that it comes from where it says it comes from. You assume that the expiration date is accurate. You assume that the meat you're buying has been treated with the proper sanitary procedures. You assume that any problems will result in mandatory recalls.

You assume that the toys you buy your children aren't coated in lead paint. You assume that your car has been manufactured to certain safety standards. You assume that your furnace has the proper safeguards. You assume that the water treatment plant is accurately measuring water quality. You assume that the pills you're taking are all the same, and subjected to the quality control. When there's a huge snowfall, you don't go about shoveling the streets yourself, you expect the government to do it for you.


Has anyone checked more than a few of these things?

You don't take personal responsibility for the vast majority of your life. None of us do. It would be impossible for any of us to go through life "taking responsibility" for all of our own choices. We are not in the middle ages living in our own sewage, we have a modern society. So it would be nice if our political ideologies could likewise progress.
 
jimbo said:
No person or corporation understanding economics is ever going to sell a product for a hundred bucks today knowing that it will need to spend millions tomorrow to fulfill its obligations. Few individuals are going to spend a few hundred per month for a potentially useful product if that product will be available for a hundred the day you require millions. That's the problem with preexisting conditions. The only solution to that problem is charity.
The market can and will determine the best policy for an individual customer if the market is allowed to function. Limiting competition by disallowing multi state or individually designed policies limit the market.
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Well, I'd say the only solution would be a single-payer system, Medicare-for-all.
 
ReverendHellh0und said:
Consumers aren't clamouring for them because they don't understand.

Insurers don't want it as it increases supply, thus reducing demand via introduction of competition. The rest of the speculative opinion piece does not get better.
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Not just that. Economies of scale get applied as well as reduced overhead from maintaining fully independent offices in every state as well as all the processes involved, it could not be farmed out.
 
Incisor said:
Well, I'd say the only solution would be a single-payer system, Medicare-for-all.
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You would.

You understand, do you not, that there is no single payer system? Probably not.

The government has no money of its own, and relies on our money to fund its programs. So it's an OPM system you propose.

In general the farther my money gets from my wallet, the less bang for the buck I get.
 
StillBallin75 said:
The biggest reason why selling insurance across state lines is a ****ing idiotic solution is because if that were the case, all the insurance companies would just move to the states with the least restrictions (like, say, provisions for people with pre-existing conditions for example), like how all credit card companies seem to be headquartered in the Dakotas.
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So what? Still in the USA. Pre-existing conditions clause still stands and is not being removed. Some will move, some will stay.
 
Paperview said:
Exactly.
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Not exactly, who cares if they move, pre-existing condition clause would still stand. If they want to move to another city or state then so be it, still in the USA.
 
Casper said:
Not if the State has banned them from doing business, almost always because of poor business practices such as not paying the claims in a timely manner or not paying at all.
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Well don't do business in the state you are banned from, if a company is conducting poor business practices then they should be banned. Jesus is this rocket science?
 
Greenbeard said:
Indeed they can and do. But they don't get to carry along another state's regulatory climate (and ignore that of the particular state they're selling in) now. That's what across-state-lines proposals seek to change.
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So you think this is a problem that is impossible to solve? Have you no creativity, they will figure it out just like all business do.
 
jimbo said:
You understand, do you not, that there is no single payer system? Probably not.
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Well, Medicare is a single-payer system and it seems to work just fine. I just don't see why there has to be a profit motive tied to the administration of payments to your provider. That's all insurance companies do; administration. And for this administration they take as much as 20%. Medicare does the same administration, but does it for 3%. So what's the better deal? Multiple payors also put the bargaining power in the hands of the drug companies and medical providers. They can play insurers off one another, driving up drug costs. That's why our drugs cost so much more here than everywhere else. Mostly because Medicare is barred from using its leverage as the largest provider to negotiate cheaper drug costs (a consequence of Bush's Medicare Part-D).


The government has no money of its own, and relies on our money to fund its programs. So it's an OPM system you propose. In general the farther my money gets from my wallet, the less bang for the buck I get.
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I'll never understand this philosophy. The government is us. We are the government. So we use tax revenue to fund programs like Medicare for us.
 
RBIII said:
So what? Still in the USA. Pre-existing conditions clause still stands and is not being removed. Some will move, some will stay.
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Hard to see how letting insurance companies sell across state lines won't end up in a too-big-to-fail scenario, like what happened with the banks.
 
StillBallin75 said:
The biggest reason why selling insurance across state lines is a ****ing idiotic solution is because if that were the case, all the insurance companies would just move to the states with the least restrictions (like, say, provisions for people with pre-existing conditions for example), like how all credit card companies seem to be headquartered in the Dakotas.
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Restrictions for insurance sales are dictated by the location of the buyer, not the seller.
 
PeteEU said:
So it has happened.. the US has become communist.
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Not at all. Protecting higher profits IS very capitalistic.

Screw competition and lower prices.
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Competition and lower prices lower profits that is contrary to capitalism. Well some form of it.

Why does this article smell like a paid piece from the insurance industry?
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Because they are trying to protect their profits.
 
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