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2016 Postmortem
In reply to the discussion: Avg health care spend is $6,125 (working age) and $3,628 (child) but Bernie claims you only pay $466 [View all]Bill USA
(6,436 posts)108. the 20% includes profits.
http://obamacarefacts.com/obamacare-rate-review-80-20-rule/
The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.
Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.
If your insurance company doesnt meet these requirements, youll get a rebate from your premiums.
Many insurance companies spend a substantial portion of consumers premium dollars on administrative costs [font size="+1"]and profits[/font], including executive salaries, overhead, and marketing.
The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement.
ObamaCare Rebates
If your insurance company spends more than 20% (15% in large markets) of premium dollars on expenses other than health care costs they will have to send out rebates for the difference. You may see the rebate in a number of ways:
(more)
The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR. If an insurance company uses 80 cents out of every premium dollar to pay for your medical claims and activities that improve the quality of care, the company has a Medical Loss Ratio of 80%.
Insurance companies selling to large groups (usually more than 50 employees) must spend at least 85% of premiums on care and quality improvement.
If your insurance company doesnt meet these requirements, youll get a rebate from your premiums.
Many insurance companies spend a substantial portion of consumers premium dollars on administrative costs [font size="+1"]and profits[/font], including executive salaries, overhead, and marketing.
The Affordable Care Act requires health insurance issuers to submit data on the proportion of premium revenues spent on clinical services and quality improvement.
ObamaCare Rebates
If your insurance company spends more than 20% (15% in large markets) of premium dollars on expenses other than health care costs they will have to send out rebates for the difference. You may see the rebate in a number of ways:
(more)
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Avg health care spend is $6,125 (working age) and $3,628 (child) but Bernie claims you only pay $466 [View all]
hill2016
Jan 2016
OP
Ezra Klein: Bernie Sanders’s single-payer plan isn’t a plan at all - see link
Bill USA
Jan 2016
#106
I am all for single payer. But it's not doable unless we can win BOTH House & Senate. Without
Bill USA
Jan 2016
#111
Well, many here are happy to pay twice as much as necessary for healthcare...
Human101948
Jan 2016
#23
Where do the costs magically disappear to? We eliminate the middle-man, the insurance companies
arcane1
Jan 2016
#3
And in a single-payer system, that 20% of spending goes in your pocket instead of theirs.
arcane1
Jan 2016
#15
By not wasting money on insurance companies. You know this. Why pretend otherwise?
arcane1
Jan 2016
#70
Look at the ACA Medical Loss Ratio of 15‰ and subtract out costs for admin costs that will
Hoyt
Jan 2016
#28
It pretty much the same nowadays -- same claim form, same CPT/HCPCS codes, same diagnoses codes, etc
Hoyt
Jan 2016
#67
Pretty much the same. The appeal process for most claims is resubmitting the claim form with medical
Hoyt
Jan 2016
#75
Obviously, you don't. You are just making junk up. I know the requirements are different in Canada
Hoyt
Jan 2016
#80
As much as I've tried to avoid commenting in the GD:P forum, I would like to ask you a question
R.A. Ganoush
Jan 2016
#63
Honestly, Bernie could say it would cost $20 per family and most of his fans would believe it.
DanTex
Jan 2016
#25
Is there a particular tune you like to whistle while you walk past that place where they put
cherokeeprogressive
Jan 2016
#34
RIght out of "What's the matter with Kansas" now coming from HIllarry supporters
Ferd Berfel
Jan 2016
#35
It's amazing what happens when profit is not the first concern when it comes to health.
Vinca
Jan 2016
#37
So either Hillary's oppo research team really sucks, or there is nothing to throw at Sanders..
frylock
Jan 2016
#109
Doctors in the other countries don't have giant malpractice insurance premiums to pay
Vinca
Jan 2016
#89
I guess this must be an example of that "free college free health care!" stuff that Trump, Rubio
Autumn
Jan 2016
#52
In Canada, 2013, a Canadian family of four paid $11,320 (CAD) for public health care in taxes...
Agnosticsherbet
Jan 2016
#61
I like the idea of Medicare for All, but I want to know upfront what it will cost.
Agnosticsherbet
Jan 2016
#86