Harrisburg Happening

Tuesday, June 06, 2006

Where's the Patriot on this story?

While doctors face increased costs and decreased reimbursements from various health insurers and consumers pay more and more for their health care coverage, the Blues certainly aren't singing the blues. In fact, their profits are up - way up in the case of Central Pennsylvania's Capital Blue Cross. And their CEO has to gall to say its due to decreased medical utilization because we are managing our health better. More like they put up more roadblocks to usage . . .

This from the Patriot News:

"Capital Blue Cross books increase in profitCapital Blue Cross saw its profits and reserves increase in 2005. The health insurer, based in Susquehanna Twp., had a profit of $186 million, up from $54 million in 2004. Its reserves swelled to $795 million, up from $616 million. A Capital executive attributed some of the strong performance to decreased use of medical services resulting from wellness and disease management programs. The Pennsylvania Insurance Department, which recently set limits on acceptable surplus levels for the state Blue Cross-Blue Shield plans, said Capital’s reserves are within the acceptable range. "

Why aren't their reporters asking the obvious questions - like:

1. Where's the study connecting decreased use of medical services with wellness and disease management programs?

2. Why isn't someone pushing the Insurance Department to lower those reserves?


What really galls me is that I pay premiums now, which are set aside for their potential future losses. I'm funding their future payouts for what will probably be other insureds. How about rebating some of those surpluses to the policy holders? I could put that into a long term fund for my future medical costs.

5 Comments:

Blogger GastonStreet said...

My health insurance is thru Aetna, they just informed me because of "rising healthcare costs" my premiums will be GOING UP! What gives? How can Blue Cross have lowering costs and Aetna (HMO) is going up? I smell something fishy here!

June 06, 2006  
Blogger Anniken Davenport, Esquire said...

I think it's pretty obvious - they are having us pay to create surpluses for "a rainy day." Trouble is, soon I can't afford their premiums anymore. Heck, at what I'm paying I might as well pay as I go.

June 06, 2006  
Blogger GastonStreet said...

The notice I got from Aetna said that the increase was pending approval by the State. So it seems they must show need and get approval by the legislature before they raise rates. Just another example of our State Legislature "working" for us, the taxpayers and policy holders!

June 06, 2006  
Blogger Anniken Davenport, Esquire said...

Yes - and the approval will be based on how much they get to keep in reserves rather than turn back to you and me, who paid the money in the first place. But that particular state agency relies almost entirely on the industry it regulates to come up with the reserve figures and the actuarial calculations to set the rates. I challenge them to make public the entire process including the statistics used. But it will never happen.

June 06, 2006  
Blogger Anniken Davenport, Esquire said...

Isn't it a hoot that I criticize the BLues and they put ads on the page? The Google ads are tagged to content, but I guess they aren't yet smart enough to understand context.

June 10, 2006  

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