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	<title>Comments on: Healthcare Reform on the Back of a Napkin</title>
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	<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/</link>
	<description>A Generalist in a World of Specialists</description>
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		<title>By: Deadhedge</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17354</link>
		<dc:creator>Deadhedge</dc:creator>
		<pubDate>Wed, 30 Sep 2009 05:40:52 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17354</guid>
		<description>I pull insurance data off the Oregon Insurance division website for my job.  The group insured market has shrunk by 20% which includes all employers.  That includes lay offs, going out of business, and groups not offering insurance.  I don&#039;t how how much of that 20% is the business no longer existing vs not offering health insurance so I estimated 15% based on what I was seeing in the small group market.

However, even if it&#039;s 10% or 5%, the point is, that price still matters.

With your point B, every single group regardless of size, renews their insurance once per year and thus shops for insurance once per year.  When even a 1o,000 person group renews, don&#039;t you think that insurance companies try to get their business and send them proposals?  Do you think any size group will consider a proposal that saves them money?  Even union groups shop for insurance (as I have worked on those RFP&#039;s) or how else would you ensure that you get a competitive price?</description>
		<content:encoded><![CDATA[<p>I pull insurance data off the Oregon Insurance division website for my job.  The group insured market has shrunk by 20% which includes all employers.  That includes lay offs, going out of business, and groups not offering insurance.  I don&#8217;t how how much of that 20% is the business no longer existing vs not offering health insurance so I estimated 15% based on what I was seeing in the small group market.</p>
<p>However, even if it&#8217;s 10% or 5%, the point is, that price still matters.</p>
<p>With your point B, every single group regardless of size, renews their insurance once per year and thus shops for insurance once per year.  When even a 1o,000 person group renews, don&#8217;t you think that insurance companies try to get their business and send them proposals?  Do you think any size group will consider a proposal that saves them money?  Even union groups shop for insurance (as I have worked on those RFP&#8217;s) or how else would you ensure that you get a competitive price?</p>
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		<title>By: Brice Stacey</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17340</link>
		<dc:creator>Brice Stacey</dc:creator>
		<pubDate>Fri, 25 Sep 2009 21:44:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17340</guid>
		<description>@Deadhedge,
Those are interesting stats. I&#039;m curious what percentage of the employer insured employees that 15% would affect. I think it might be inflated because A) most businesses are small businesses and B) most businesses able to shop around would most likely be a small company.</description>
		<content:encoded><![CDATA[<p>@Deadhedge,<br />
Those are interesting stats. I&#8217;m curious what percentage of the employer insured employees that 15% would affect. I think it might be inflated because A) most businesses are small businesses and B) most businesses able to shop around would most likely be a small company.</p>
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		<title>By: Deadhedge</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17339</link>
		<dc:creator>Deadhedge</dc:creator>
		<pubDate>Fri, 25 Sep 2009 21:33:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17339</guid>
		<description>@Brice,
15% of employers in my state stopped buying insurance this year, 5% of individual stopped buying insurance, and countless others bought less insurance.  Companies shop when their policies renew every year.

Companies do shop and they do choose not to buy insurance because theny can no longer afford it. Or they make employees pay more or they no longer cover dependents.

Insurance have as much at stake in lower costs as everyone else.</description>
		<content:encoded><![CDATA[<p>@Brice,<br />
15% of employers in my state stopped buying insurance this year, 5% of individual stopped buying insurance, and countless others bought less insurance.  Companies shop when their policies renew every year.</p>
<p>Companies do shop and they do choose not to buy insurance because theny can no longer afford it. Or they make employees pay more or they no longer cover dependents.</p>
<p>Insurance have as much at stake in lower costs as everyone else.</p>
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		<title>By: Akshay Kapur</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17314</link>
		<dc:creator>Akshay Kapur</dc:creator>
		<pubDate>Mon, 31 Aug 2009 13:20:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17314</guid>
		<description>Cameron,

Glad to have you back and posting! 

Thanks very much for the link love.  I&#039;m happy to do my part in keeping people abreast of what&#039;s going on.  Don&#039;t know where the cards are going to land, but once the media attention subsides, get ready to hear the great stuff people have been up to in the background helping health care get back on track.  

Notwithstanding what Palin and the media have done, I have more hope that things will get better.  And it&#039;ll come from the supply side.  

Best,
Akshay</description>
		<content:encoded><![CDATA[<p>Cameron,</p>
<p>Glad to have you back and posting! </p>
<p>Thanks very much for the link love.  I&#8217;m happy to do my part in keeping people abreast of what&#8217;s going on.  Don&#8217;t know where the cards are going to land, but once the media attention subsides, get ready to hear the great stuff people have been up to in the background helping health care get back on track.  </p>
<p>Notwithstanding what Palin and the media have done, I have more hope that things will get better.  And it&#8217;ll come from the supply side.  </p>
<p>Best,<br />
Akshay</p>
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		<title>By: Brice Stacey</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17309</link>
		<dc:creator>Brice Stacey</dc:creator>
		<pubDate>Fri, 28 Aug 2009 14:28:21 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17309</guid>
		<description>@Deadhedge I think Josh made the crucial point that insurance will still be bought regardless of the price. Insurance companies have the advantage in that few companies are agile enough to actually shop around.</description>
		<content:encoded><![CDATA[<p>@Deadhedge I think Josh made the crucial point that insurance will still be bought regardless of the price. Insurance companies have the advantage in that few companies are agile enough to actually shop around.</p>
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		<title>By: Deadhedge</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17308</link>
		<dc:creator>Deadhedge</dc:creator>
		<pubDate>Thu, 27 Aug 2009 22:57:53 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17308</guid>
		<description>@Josh R.  Insurance companies have on incentive to keep costs down because customers will keep paying a higher premium?  Stop and think about that one.  

If one insurance companies tries to lower costs and thus have a lower premium, they&#039;ll get more business.  Higher costs of premiums are driving customers out of the market.  Insurance companies have realized that if they don&#039;t keep costs down, their best case scenario is to become government employees or worst case have their industry disappear.</description>
		<content:encoded><![CDATA[<p>@Josh R.  Insurance companies have on incentive to keep costs down because customers will keep paying a higher premium?  Stop and think about that one.  </p>
<p>If one insurance companies tries to lower costs and thus have a lower premium, they&#8217;ll get more business.  Higher costs of premiums are driving customers out of the market.  Insurance companies have realized that if they don&#8217;t keep costs down, their best case scenario is to become government employees or worst case have their industry disappear.</p>
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		<title>By: Cameron Schaefer</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17307</link>
		<dc:creator>Cameron Schaefer</dc:creator>
		<pubDate>Thu, 27 Aug 2009 19:14:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17307</guid>
		<description>@ Josh,

Great input!  I really like the idea of tweeking the system so that the consumer has an interest in keeping costs down.  Any incentives that can encourage people to live a more healthy lifestyle seems to be one of the best routes to go.</description>
		<content:encoded><![CDATA[<p>@ Josh,</p>
<p>Great input!  I really like the idea of tweeking the system so that the consumer has an interest in keeping costs down.  Any incentives that can encourage people to live a more healthy lifestyle seems to be one of the best routes to go.</p>
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		<title>By: Josh R</title>
		<link>http://www.schaefersblog.com/healthcare-reform-on-the-back-of-a-napkin/comment-page-1/#comment-17306</link>
		<dc:creator>Josh R</dc:creator>
		<pubDate>Thu, 27 Aug 2009 04:57:55 +0000</pubDate>
		<guid isPermaLink="false">http://www.schaefersblog.com/?p=833#comment-17306</guid>
		<description>Not bad.  I think they miss the boat on one point though...  

Insurance companies don&#039;t have a huge incentive to keep costs down.  They have an incentive to keep unexpected costs down, but that is different.  If costs go up, premiums can go up, and the more premiums they take in the more potential profit they have..    If prices go up, companies still buy insurance for their employees.  We wind up paying the price, but we have little say in the transaction.  Too many layers..

Really the solution is to move more of the cost back to the consumer, and leave the insurance out of the big decision making process.   

The HSA High deductible plans that are out now would work as a good model.  Disastrous stuff is covered, but routine stuff is paid for out of savings.  Rather than paying a huge premium that I lose no matter what services I use, I pay a much smaller premium and can put the difference into a savings account to pay for service.  As a result the consumer has an interest in keeping costs down.  (What they don&#039;t spend, they keep)

Governments are not good at keeping costs down.  Non-profits won&#039;t do much better.  If and HMO says no, they are labeled as jerks..  If they say yes, and raise premiums to compensate for the cost, it comes accross as part of the normal market necessity.</description>
		<content:encoded><![CDATA[<p>Not bad.  I think they miss the boat on one point though&#8230;  </p>
<p>Insurance companies don&#8217;t have a huge incentive to keep costs down.  They have an incentive to keep unexpected costs down, but that is different.  If costs go up, premiums can go up, and the more premiums they take in the more potential profit they have..    If prices go up, companies still buy insurance for their employees.  We wind up paying the price, but we have little say in the transaction.  Too many layers..</p>
<p>Really the solution is to move more of the cost back to the consumer, and leave the insurance out of the big decision making process.   </p>
<p>The HSA High deductible plans that are out now would work as a good model.  Disastrous stuff is covered, but routine stuff is paid for out of savings.  Rather than paying a huge premium that I lose no matter what services I use, I pay a much smaller premium and can put the difference into a savings account to pay for service.  As a result the consumer has an interest in keeping costs down.  (What they don&#8217;t spend, they keep)</p>
<p>Governments are not good at keeping costs down.  Non-profits won&#8217;t do much better.  If and HMO says no, they are labeled as jerks..  If they say yes, and raise premiums to compensate for the cost, it comes accross as part of the normal market necessity.</p>
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