HR 3200 - the Health Care Bill...

When congress and the american people don't/won't read the bill we are at the mercy of one person. If that person was GWB we'd all be crazed.
BHO gets a pass. READ THE THING AND PRETEND YOU ARE A LAWYER. Because those are the folks who will be deciding.

[mookiemookie]

Originally Posted by CaptainHaplo

ok TY Mookie.

But that then runs afoul of this....

SEC. 116. ENSURING VALUE AND LOWER PREMIUMS.

• (a) In General- A qualified health benefits plan shall meet a medical loss ratio as defined by the Commissioner. For any plan year in which the qualified health benefits plan does not meet such medical loss ratio, QHBP offering entity shall provide in a manner specified by the Commissioner for rebates to enrollees of payment sufficient to meet such loss ratio.

So in light of the "Value" issue -what the bill states is that any private insurer that offers a policy through said exchange - MUST take a loss in an amount determined by a government official. If they do not - they must pay the people they insure so that the meet the loss requirements.

In other words - sure you can have private insurers - as long as you find companies that are willing to take a MANDATED loss every year. So how many businesses do you think are going to be willing to participate in that? You won't find any. The system is thus rigged to push out private insureres. I could understand maybe limiting profits (and even that is stifling to business) - but MANDATING a loss? There is no way any business could operate under those conditions.

Ok, a "medical loss ratio" is defined as "the fraction of revenue from a plan's premiums that goes to pay for medical services."

It's not mandating that the private insurers must lose money. It's making sure they're paying out on claims.

This could be a good thing if they took an average of the medical loss ratio of the universe of insurers as a whole and said if you're X number of standard deviations from the mean then you get whacked with a penalty to get you back in line. I suppose it would have to do with how the minimum loss ratio is calculated, which I could not find the details on. I think it is to be determined later.

It could be bad if the bar is set too high though. It should not just be some subjective number.

Make no mistake, I don't think this is the perfect plan, and I'm not as in love with it as certain people would try to say I am.