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Cluster Headache Help and Support >> Medications,  Treatments,  Therapies >> Blue Cross of California ( ppo )
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Message started by Lenny on Feb 7th, 2010 at 12:02pm

Title: Blue Cross of California ( ppo )
Post by Lenny on Feb 7th, 2010 at 12:02pm
I just received yesterday in the mail that my premiums have gone up almost 40% ???Needless to say i called them and they are closed on the weekends (they always had someone to speak to on the weekends from what i remember) or atleast the first part of the day on Saturday's..... WTF...I spoke with my nephew yesterday and he has the same company ( he is 30 years old ) same with him...It's getting a little too fuck.n ridiculous of what they are doing ( i can see  10-15% )but 40 unbelievable.....Is this happening to every state or just here?????Just a little upset to say the least >:( >:( >:( >:( >:( Lenny

Title: Re: Blue Cross of California ( ppo )
Post by Bob_Johnson on Feb 7th, 2010 at 12:34pm
Lenny, if you seriously want to understand U.S. health care, read, MONEY-DRIVEN MEDICINE, Au. Maggie Mahar. A very balanced view written by an author who has years of work experience in/with financial publications. (Now in paperback, I believe.)

It covers all the issues which are part of the healthcare reform effort but with historical information showing how we got to the present state and without the political cant which distorts.

In one sentence: the U.S. spends twice as much $ per capita as do European countries and has, overall, poorer outcomes. The volume of hard, data driven studies, which affirm this judgment  are there for the having--and this book is a good starting place.

If you want one easy answer to your question, a friend of mine regularly comments re. heatlh insurance outfits: "It's easy to make money saying, 'NO!'."

T.R. Reid has a couple of books and two video programs in which he reports his several years of traveling around the world looking at different health care systems. Worth your time. He recently gave a speech in which he summarized his studies: It's a moral issue. To paraphrase him: You can't have a good health care system which is constructed on defending profit centers vs. providing care for those in need.

Or, as two of my neighbors, who are staunch fundamentalists, said to me last month: "We don't believe that we have a moral responsibility to provide health care to those without OR to provide jobs for the unemployed." That is as harsh a statement as I have ever heard on the subjects but I do belive that, in some softer ways of thinking & acting, many Americans don't get too distressed--as long as the  have their snug nest.

Title: Re: Blue Cross of California ( ppo )
Post by NancyB on Feb 7th, 2010 at 1:33pm
I'm going to stick my neck ut here and just say ahead of time that I'm a liberal. Having said that, social medicine is imperfect, but better than what we've got. Lived in Quebec for 3 years and my husband is a Canuck so have some experience with it. Taxes are a killer , but no-one goes bankrupt because they were sick.

Title: Re: Blue Cross of California ( ppo )
Post by sch on Feb 7th, 2010 at 6:25pm
I think the health care system pretty much sucks world wide. That being said.... I've seen a lot of posts on this brd from folks in the UK and Canada and a lot of them had already completed their current cycle before they were able to see their gp or a specialist.

Title: Re: Blue Cross of California ( ppo )
Post by Bob_Johnson on Feb 7th, 2010 at 8:38pm
"When you have no basis of argument, abuse the plaintiff"
Cicero (106 BC - 43 BC)


Title: Re: Blue Cross of California ( ppo )
Post by Headache Boy uk on Feb 7th, 2010 at 8:57pm

Quote:
I think the health care system pretty much sucks world wide. That being said.... I've seen a lot of posts on this brd from folks in the UK and Canada and a lot of them had already completed their current cycle before they were able to see their gp or a specialist.


with new reforms in the NHS you can usually see your GP within a day but specialists can have a 6 month waiting list .But one very good thing is that every one pays the same £7.40 per item for scripts unless they have a condition which makes them legible for an exemption certificate. So not perfect but it dose give every one access to the drugs that need.

Nigel

Title: Re: Blue Cross of California ( ppo )
Post by Bob P on Feb 8th, 2010 at 7:26am
Hi Lenny.  I'm with PERS Choice which is an Anthem Blue Cross PPO in Calif.  My premium is $487.25 per month for one person.  I think that's up 2 or 3 % from last year.

Title: Re: Blue Cross of California ( ppo )
Post by Melissa on Feb 9th, 2010 at 12:24pm
From what I understand, the rate increase is just in CA (we have Anthem BC/BS also). 


Title: Re: Blue Cross of California ( ppo )
Post by Bob P on Feb 9th, 2010 at 12:58pm
It's also just the "individual" policy holders.  Group polices aren't getting dinged.

Title: Re: Blue Cross of California ( ppo )
Post by Melissa on Feb 14th, 2010 at 8:16am

Quote:
Anthem Blue Cross to delay rate increases

The scheduled March 1 hike of up to 39% for individual health insurance policies will not take effect before May 1. In the meantime, California regulators will analyze the legality of the increases.

By Marc Lifsher

February 14, 2010

Reporting from Sacramento

Anthem Blue Cross on Saturday announced it would delay until May 1 controversial price increases of up to 39% for its individual health insurance policyholders in California, but maintained its rates were fair, legal and necessary.

The announcement followed a barrage of criticism in recent weeks from policyholders, consumer advocates, regulators, state legislators, members of Congress and the Obama administration.

State Insurance Commissioner Steve Poizner said Saturday that he secured an agreement with Anthem to postpone for at least two months the increases that had been set to take effect March 1 for many of the estimated 800,000 policyholders.

The delay, he said, would give state regulators time to have newly hired outside health-insurance actuarial experts analyze Anthem's rates to make sure they don't violate California law.

"We have instructed the actuaries to review the rates with a fine-tooth comb to ensure they comply with state law that requires that 70 cents of every dollar in premiums is spent on medical benefits," Poizner said. "Should they find that these rate increases were unwarranted, I will immediately take action to get Anthem Blue Cross to follow the law and lower their rates."

In Washington, Secretary of Health and Human Services Kathleen Sebelius said the agreement "underscores the urgency of passing real health insurance reform." She has been critical of the insurer's explanations of the rate hikes.

"While a two-month delay offers some temporary relief," she said, "what California families need is long-term health insurance security, so that they don't face sharply higher prices or fewer benefits."

Anthem is the largest for-profit insurer in California, and it is a unit of insurance giant WellPoint Inc. of Indianapolis.

Headquartered in Woodland Hills, Anthem said it welcomed the state's review and was confident that regulators would find its rates to be justified. The company blamed the increases on rising medical costs and an exodus of health consumers from its ranks caused by job loss and consumer belt-tightening.

WellPoint executive Brian Sassi, who oversees the company's individual policies nationwide, defended the increases in a statement. "Anthem filed these rates with the appropriate regulators in November of 2009," he said. "They are actuarially sound and in full compliance with all requirements in the law.

"Our decision to agree to postpone the rate adjustments does not change the underlying issue," the statement continued. "All health plans are in the same situation, trying to deal with the steadily increasing medical costs in the delivery system, which are not sustainable."

The proposed rate hike should average about 25%, and less than a quarter of the company's policyholders should see increases of 35% to 39%, the company said. Some customers can expect rate reductions, it added.

As public criticism of the rates grew, so did action by government officials. Anthem faces three inquiries over its rates, which followed what policyholders say were large increases last year.

In addition to the inquiry by state insurance regulators, Congress has opened an investigation, and a panel of the House Committee on Energy and Commerce has scheduled a hearing Feb. 24. The California Assembly's health committee will conduct a hearing Feb. 23.

Poizner said Saturday that he was doubtful of Anthem's position. Those kinds of jumps appear to be out of line "in the middle of a deep recession when people are struggling," he said.

And he said he has a "healthy skepticism" about Anthem's assertion that it spends at least 70% of its revenues from sales of individual health insurance policies on medical care for its customers.

Poizner said he has the legal authority to suspend Anthem's license to sell insurance in California if he finds that the company has violated state law.

California consumer advocacy groups also welcomed the two-month delay, but said they feared that state law doesn't give the commissioner enough authority to approve or disapprove changes in health insurance rates.

That may be why Poizner's office said little publicly when it first reviewed Anthem's rate increase filing last fall, said Anthony Wright, executive director of Health Access California, a statewide consumer healthcare coalition in Sacramento.

"It basically got rubber-stamped a couple of months ago," Wright said. "But after the spotlight came on, there was a reason to look further into the reasons for the rate increase."

Jerry Flanagan, health policy director at Consumer Watchdog in Santa Monica, said Anthem's efforts may prompt a backlash. He urged the Legislature to give Poizner more power to review and possibly disapprove new rates. "Existing law is inadequate to restrain rate increases," he said.

State lawmakers, led by Assemblyman Dave Jones (D-Sacramento), are pursuing bills that make health insurance just as highly regulated in California as automobile insurance. Proposition 103, an initiative approved by voters in 1988, requires that automobile insurers get approval from the insurance commissioner before they can raise or lower rates.

Jones, who is chairman of the Assembly health committee, said Proposition 103-type regulation is the only way to keep consumer health costs in check. Although such legislation failed in 2007 and 2009, Jones predicted that the outcome could be different this year because "the public tolerance for these outrageous rate hikes has been exhausted."

marc.lifsher@latimes.com

Times staff writer Duke Helfand contributed to this report.



Copyright © 2010, The Los Angeles Times

Title: Re: Blue Cross of California ( ppo )
Post by Lenny on Feb 14th, 2010 at 1:45pm
With many thanks to all that responded to this.....Mine was exacley 39% increase and so was my nephew,i am just curious of what % of the policyholders got that.....I don't go to doc that often and neither does he.....IMHO.....The bottom line is all about the profits $$$ for these public co.....According to a report that i read,5 of the nations largest health care providers  including (blue-cross-which is wellpoint) made huge profits in 2009......56% more than 2008.....So why the hike.....Greedy bastards.....

Title: Re: Blue Cross of California ( ppo )
Post by deltadarlin on Feb 14th, 2010 at 2:50pm
Lenny,
I'm not sure where you're getting our information from, but I think that you could be wrong with regards to *profits* made by insurance companies.

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Title: Re: Blue Cross of California ( ppo )
Post by Lenny on Feb 14th, 2010 at 3:39pm
[quote author=74757C64717471627C797E100 link=1265562147/11#11 date=1266177024]Lenny,
I'm not sure where you're getting our information from, but I think that you could be wrong with regards to *profits* made by insurance companies.

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:-? :-? :-? :-? :-?

I got mine from yahoo (finance).....Type in the symbol for wellpoint WLP and you will see what i read...same on wsj (wall street journal online)which states( and i quote) that wellpoint made a  4.75 billion dollar profit in the last quarter of 2009..........Please go to those sites and then tell me what you come up with.....I would post the link but not (tech-savy)enough to do.....What is one to beleive???.....Lenny

Title: Re: Blue Cross of California ( ppo )
Post by BC_Battler on Feb 14th, 2010 at 6:45pm
The insurance companies are evil, Lenny. I have done a little digging into WLP and they have a track record of trying to screw people over. California Blue Cross has gotten into hot water a number times for shady practices, and insurance companies are just getting more and more ridiculous when it comes to denying claims and raising rates.

I live in Canada, but a friend of mine used to be a senior manager for an insurance co in the US. He quit after getting a promotion. "Why did you quit when you were still moving up?" I asked him. "Because I became senior enough to find out what we were actually doing to people. I couldn't sleep at night," he said.

I feel for all of you in California and hope that the 39% increase is stopped. Best of luck, all.


Title: Re: Blue Cross of California ( ppo )
Post by Bob P on Feb 15th, 2010 at 7:04am
Delta is talking % and Lenny is talking $.  A small percentage profit for a huge company equals lots of dollars.  But because the lots of dollars is a small percentage, that means there are a lot of dollars going out the door also.

There are a lot of other health related organizations, other than insurance companies, on Delta's list that make a much higher percentage profit and help drive up the cost of healthcare that insurance has to cover.

I just don't think insurance companies are the problem.  The Obamanation has just tried to make them the common enemy so it can push it's own agenda.  Now they are going after finance, the evil bankers! (Goldman-Sachs was Obama's second largest campaign contributor).

It's all BS!

Title: Re: Blue Cross of California ( ppo )
Post by Kevin_M on Feb 15th, 2010 at 8:11am

Bob P wrote on Feb 15th, 2010 at 7:04am:
I just don't think insurance companies are the problem. 



From Melissa's article:


Quote:
The company blamed the increases on rising medical costs and an exodus of health consumers from its ranks caused by job loss and consumer belt-tightening.


Rising health costs seem a given, but spreading costs over a shrinking number of subcribers doing business with them is influencial.  However, the premium increases would seem to drive more subscribers elsewhere, decreasing the spreading of costs even more, spiraling to higher premiums. 

It would seem to create a standing invitation to competition testing inelasticity of demand, or perhaps knowing this time permits some sort of restriction of competition stemming from:


Quote:
"All health plans are in the same situation, trying to deal with the steadily increasing medical costs in the delivery system, which are not sustainable."


Added to a reduced cost spreading basis.







Quote:
... price increases of up to 39% for its individual health insurance policyholders ...

The proposed rate hike should average about 25%, and less than a quarter of the company's policyholders should see increases of 35% to 39%, the company said. Some customers can expect rate reductions, it added.


They appear to have a target market somewhere, maybe to be more aggressive garnering large corps., individual policyholders don't seem it.


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