"we are now on an .... inescapable path.... to a single-payer system for mostAmericans and thank goodness for it"

By Owen Paine on Saturday December 10, 2011 11:23 AM


"This is the true `bomb' contained in Obamacare .......the medical loss ratio, that requires health insurancecompanies to spend 80% of the consumers' premium dollarsthey collect -- 85% for large group insurers -- onactual medical care rather than overhead, marketingexpenses and profit. Failure on the part of insurers tomeet this requirement will result in the insurers havingto send their customers a rebate check representing theamount in which they underspend on actual medical care."

"...there is absolutely no way for-profithealth insurers are going to be able to learn how to getby and still make a profit while being forced to spendat least 80 percent of their receipts providing theircustomers with the coverage for which they paid. If theycould, we likely would never have seen the extraordinaryefforts made by these companies to avoid paying benefitsto their customers at the very moment they need it the most."

Comments (7)


there may well be a briar patch scam underway here

who plucked this 80-85 ratio
off the local sky hook anyway

but regardless
the headline is the thing

"inescapable path to a single-payer system "


But cf. this item also from Forbes:


... in a competitive market it’s entirely normal for an insurer to have a loss ratio higher than 80%. There are plenty of entirely profitable and growing insurance companies that have loss ratios over 100%....

There are two entirely different income streams for an insurance company. One is the premiums that are paid in.... The second is ... the investment income gained from having those premiums in between their collection and the need to pay them out again on a claim.

Depending upon what type of insurance policy you’re writing that gap, the time you get to hold the money for, can be really quite large.


i think accounting magic
in combination with timing non sync between inflows and outflows
will make the briary of 80-85% a comfort zone extra-ordinaire

a floor ratio put in place
two shaggy dog stories too low


in other words there are flows and there are flows
and a miss match is often as good or better
then a match

now of course
some diabolical horny fingered
green eye shade type
given full access
subpena powers
and time enough
could get to the short hairs of this
and put the flesh of said cast iron regulation
squarely around the spirit of same
not off on a side track
near a false bottom boat
full of Orwelliam mixed metaphors
and a dead meat rack a mile long

but all things considered and gathering together a million loose ends

i wouldn't count on it dorothy


It's from fucking Forbes for Christ's sake. Don't believe ANYTHING from this whiny billionaire's rag,he's worse than fucking Murdoch.


I can't imagine anything worse than fucking Murdoch. Except metaphorically, of course.

Al Schumann:

Obamaphiles are forever discovering hidden progressive legislative devices. They headline the rigorous requirements and pay scanty attention to the corporate absolution fine print. The fine print rejiggers the basis for judging the rigor of the requirements. Lo! It appears, like magic, that the regulated industry is now in greater compliance than it ever was before and the compliance has been thoughtfully grandfathered to handle ongoing or pending litigation.

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