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eridani

Profile Information

Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 01:52 AM
Number of posts: 51,905

About Me

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity

Journal Archives

Insurers drastically reduce choice in poorer counties

http://online.wsj.com/news/articles/SB10001424052702304450904579366950560009742

Hundreds of thousands of Americans in poorer counties have few choices of health insurers and face high premiums through the online exchanges created by the health-care law, according to an analysis by The Wall Street Journal of offerings in 36 states.

Consumers in 515 counties, spread across 15 states, have only one insurer selling coverage through the online marketplaces, the Journal found. In more than 80% of those counties, the sole insurer is a local Blue Cross & Blue Shield plan. Residents of wealthier, more populated counties in the U.S. receive lower-priced choices than those living in counties with a single insurer.

The price differences reflect the strategy of insurers to pick markets where they believe they can turn a profit—and avoid areas of high unemployment and a concentration of unhealthy residents they deem more risky.

Aetna Inc. and UnitedHealth Group Inc., for instance, have limited their participation in the new health-insurance marketplaces, where consumers shop for coverage, to a much smaller map than their traditional business. They offer coverage in more counties outside of the marketplaces, where plans are sold directly to consumers and federal subsidies aren't available.

Aetna targeted areas with stable levels of employment and income to attract desirable customers to its marketplace offerings, Chief Executive Mark Bertolini said last fall. "We were very careful to pick the markets" where the insurer could succeed, he said.

Reversing the trend presents a challenge because low-population areas are unlikely to draw more insurers, said Glenn Melnick, a health-care economist at RAND Corp: "I don't think the health law can overcome those economics."


Comment by Don McCanne of PNHP: We’ve always know that insurers market their plans in areas where there is the greatest potential for business success. As USC Health Finance Professor Glen Melnick explains, the Affordable Care Act cannot overcome those economics.

Clearly we have the wrong model for reform. Private insurers respond to business opportunities. Public insurance, such as a single payer national health program, simply enrolls everyone; there are no market decisions to be made.

So is it going to continue to be about private insurance markets, or will it be about patients - all patients? An improved Medicare for all would be about the latter

Obamacare’s Founding CEO Wants To Bring Single Payer To MA


http://talkingpointsmemo.com/news/donald-berwick-single-payer-massachusetts-governor-obamacare

On his first day as governor of Massachusetts, Donald Berwick promises to set up a commission tasked with finding a way to bring single payer to the Bay State. It'll have report back to him within a year -- ideally sooner.

Having run Medicare and Obamacare in Washington for 17 months, he has concluded that the existing hybrid system is too cumbersome and expensive, and that single payer is the right fix. And he's the only candidate in this year's contest who dares to go there.

"The Affordable Care Act is a majestic step forward for this country -- for the only nation that hasn't made health care a human right yet. But luckily I'm in a state that's able to take even a bigger step," Berwick told TPM in an interview. "And a single payer option -- even if the country is not ready for it, I think Massachusetts is ready and it's worth exploring."

A political novice, Berwick is an underdog candidate for the Democratic nomination in the 2014 elections -- the most outspoken progressive in the race. A pediatrician, Harvard health policy professor and former health care executive, his talent for -- and obsession with -- health management caught the eye of President Barack Obama, who in 2010 appointed him to be the Administrator of the Center for Medicare & Medicaid Services, which was tasked with getting Obamacare off the ground in its infancy. Berwick left in December 2011, after his recess appointment expired and Senate Republicans refused to confirm him.

"I've been looking hard at the Massachusetts budget and I've become more aware than ever of how the rising costs of health care are taking opportunity away from other investments," he said. "I saw it in Washington, and I see it in Massachusetts. We need to find money for transportation, education, the social safety net. ... And so I feel a sense of urgency about getting costs under control without harming patients at all."
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