Blue Cross raises California health care premiums 39%
California’s largest for-profit health insurance company, Anthem Blue Cross, has notified their 800,000 individual policy holders to expect an increase in premium rates of up to 39%.
Considering the rate hike comes in the middle of the profound economic disaster that is California, it takes a pretty cold-blooded company to institute such a boost. But then, nobody should be particularly surprised when considering that, just last year, the company raised premiums for many of these same people by up to 68%.
California Insurance Commissioner, Steve Poizner, who is engaged in a primary battle for the California GOP gubernatorial nomination, has weighed in big saying that he is hiring an independent actuarial firm to determine if the price increase is reasonable.
Even HHS Secretary Kathleen Sebelius has sent a letter to Anthem’s president calling foul.
But to those about to be slammed with the increase, I wouldn’t get too excited by all this government action.
In California, the Insurance Department can regulate the premium charges on home and automobile insurance. Not so for health insurance. Regulators can, technically, ‘oversee’ the increased cost but they have no power whatsoever to control these charges. Thus, it is anyone’s guess what it means to ‘oversee’ when you can’t regulate.
As for Secretary Sebelius, while she can write tough letters letting us know the Obama Administration cares, she too has no authority to regulate these premium charges.
What does Anthem have to say about the matter?
In a statement, Anthem Blue Cross attributed the increased premiums to a bad economy and rising health care costs, forcing members to drop coverage, which “leaves fewer people, often with significantly greater medical needs, in the insured pool.”
Via ABC News
Is it me or is that the greatest circular argument ever? Because of the bad economy, members have had to drop their coverage leaving them uninsured. Because the healthy people can no longer afford the coverage, that leaves more sick people in the pool, raising the costs to the insurance company and forcing them to raise premium costs for those who can continue to pay for their coverage.
I don’t suppose this ever occurred to Anthem, but based on their logic, were they to lower their prices, they would attract more members, rather than force members to drop out, greatly improving the ratio of healthy to sick in their insurance pool. This would leave them with the opportunity to earn more profit.
But these are tough times. No doubt Anthem has been struggling to make money in this difficult economic environment.
Or not.
In Sebelius’ letter, the Secretary points out –
Anthem Blue Cross’s parent company, Wellpoint Inc., earned a record $2.7 billion in profits for the last quarter of 2009. Its quarterly sales grew to $19 billion, up 26 percent from $15.1 billion in the comparable 2008 period, Sebelius pointed out.
Via ABC News
For you consumer driven health care and free market believers, you might be interested to know that there is virtually no competition in California when it comes to individual health insurance policies. Anthem pretty much has the market sewn up.
And for those who buy into the GOP nonsense that the answer to rising health insurance costs is to allow insurance companies to sell their policies across state lines, you might care to note that Anthem Blue Cross is the California branch office for Wisconsin based Wellpoint, Inc.
It is worth noting that those who have individual policies with Anthem are middle class Californians who can – or previously could – afford to pay the already high premium charges.
For Jeff Sher of San Francisco, who is both an independent health insurance agent and an Anthem customer, his 38 percent increase comes on top of a 41 percent increase last year. That means that in just a year, his premium increased from $273 to $530 per month, or 94 percent. Sher, who is 59, said he hasn’t needed to see a doctor in seven or eight years.
Via San Francisco Gate
What happens when the middle class can no longer afford health insurance?
Like it or not, say hello to single-payer government provided insurance. It’s one thing to leave the poor or those just above the poverty line without health care coverage. The truth is, they don’t vote in sufficient numbers to get the attention of the politicians.
However, it’s quite another when the middle class no longer can afford coverage.
So far, California’s GOP congressional caucus has been conspicuously silent on the subject. And, contrary to what most think, there are quite a few Republicans representing the state in Congress.
So, Darrell Issa – are you out there, brother? We know you are and can’t wait hear what you have to say about all this? 
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[...] Blue Cross raises California health care premiums 39% [...]
My question is why does BC/BS have the California health insurance market “sewn up”? It’s certainly not on the basis of their pricing. Are there other factors preventing competition?
Given the high price of individual health care plans, there aren’t that many customers to go around. When you consider how much money Anthem has available to market in the state, nobody is all that anxious to take them on. The amount of market share that could be taken from them isn’t worth it.
In response to another comment. See in context »Per your OP Anthem has 800K policy holders in California, which sounds like a huge market. Saying there aren’t enough customers to go around to make competition worthwhile doesn’t sound right.
Speaking as one that has shopped for health insurance many times I couldn’t care less about advertising, it’s cost vs benefit that is important. I can’t imagine people in Caifornia don’t feel the same way.
I think there must be other factors affecting competition in California. Your OP seems dismissive of competition but it seems to me lack of competition is a major problem in this case.
In response to another comment. See in context »I’m not dismissive of competition at all. I love competition. But there is a danger is applying how you might go about something to what others do.
In response to another comment. See in context »If you are suggesting there is some regulatory bar to others competing with Blue Cross in California, there is not. Nobody wants to be in the individual policy business to begin with. They want group policies. It only makes sense for an insurer to handle that business if they can get enough mass to make it worth their while.
If you doubt this, consider why companies like Aetna recently informed hundreds of thousands of their individual market customers that they were ending their coverage because they simply could not make money on the policies.By putting in such enormous increases, Blue Cross in CA is begging people to get out. But they are stuck because they have nowhere else to go.
Don’t assume that this is purely a criticism of Blue Cross. Assume that this is an example of why the private model is beginning to fail – not only for the customers but for the insurance companies themselves. Soon, there will be no choice but for government to step in, whether we like it or not.
dagoat,
In response to another comment. See in context »I am a long time member of Blue Cross in California and I can tell you from personal experience that the healthcare system in California (if not in other states) is a complicated, dysfunctional collusion between hospitals, doctors and for profit corporate insurance. It is designed as such to be opaque, arcane and exclusive. I was in the hospital a few years ago and was given nausea medication during my stay to counteract the effects of pain meds. I found out later that I was given “cadillac” nausea meds that cost $600 per dose injections when the pill form would have been $60! There was no reason at all that I could not have been given the pills. When I called Blue Cross to inform them of what I considered to be criminal gouging, they informed me that their contract with that hospital allowed for the doctors to prescribe whatever they wanted, no questions asked. Does the word collusion come to mind? How far does it go?
I hear you – however, keep in mind that you should be grateful that the hospital negotiated a deal with the insurer permitting the doctors to prescribe as they see fit. Things are different now. Doctors often have to jump through insane hoops to get the insurance companies to approve procedures and medicines they legitimately believe is necessary. There are always two sides to this story.
In response to another comment. See in context »On the contrary, Rick. I have no illusion that doctors are any less of a problem in our current system than for profit insurance companies. (*See my reply to dagoat) I am the poster child for MRI’s. I have had over 20 in the last ten years all trying to find the source of my debillitating nerve pain. That’s one every six months. You think I didn’t try to get the subsequent physicians to revisit the previous MRI? Instead, they would rather shuffle me off to an imaging office they or their buddies own for another dose of radiation, rather than take the time to read the previous reports or view the images. No, doctors and their 10 minutes/patient mentality are as much to blame for this mess as the insurance companies.
In response to another comment. See in context »Scott- I appreciate what you are saying. I do have some questions.
I know you live in California but I don’t know where. I live in Los Angeles. A number of my physicians are part of the Cedar Sinai system. As a result each can see the results of my CT’s etc. through the central computer at Cedars- and they do. Indeed, I have one situation which requires monitoring. Because as a cancer survivor, I have to get CT’s every three months, this is done in my primary oncologist’s office. The other oncologist who is watching for something else, doesn’t even make me come into his office. He simply pulls up the CT results and has a look on his computer screen. No additional CT and no charge for his doing it!
I wonder if you could solve some of your problems by the choices you are making in your medical care. I know that similar systems exist in San Francisco and San Diego.
If I can help you in this regard, feel free to ask. I have a sense you can improve your situation with some different choices.
In response to another comment. See in context »scott-
Obviously I don’t know your particular situation but anti-nausea medications in hospitals are usually given IV since pills can be vomited back up and IV meds cannot.
In response to another comment. See in context »This is correct. When I was getting chemo, I had to have the anti-nasea medicine by IV for that precise reason.
In response to another comment. See in context »dagoat, yeah that would make sense except for the fact that I was taking at least three other medications in pill form and had not vomited once. I simply requested somthing to help with relatively mild nausea. While I had an IV, I had no idea and was not informed that I was being given injections of a drug that cost $600/per. To the tune of $12,000. during my seven day hospital stay. Heck, I would have sent my wife down to the pharmacy for an Alka Seltzer! See, this is the problem I was illustrating, ie: the gross misuse of pharmaceuticals, testing and treatment that borders on outright fraud.
In response to another comment. See in context »Scott- in reading a lot of your comments, I’m getting some clarity. I think you’re right that some bad choices have been made. I do think that you can do something about this. There is no law against discussing a treatment with a doctor to assist in making the right decision. While I know that when you’re in the hospital, you tend to follow directions, you actually could have asked your doctor why he was giving you a mega treatment for an upset stomach that you feel could have been handled by alka-seltzer. You might do better if you get more participatory. You have the benefit of caring about what the charges are – most who are insured do not. That’s terrific – but use your power as a patient to deal with it.
In response to another comment. See in context »This is class warfare, plain and simple. As much as that may sound over the top, think about it. The poor and middle classes are under increasing pressure to either join the military for a job and benefits or lower paying service industry positions for same. Or else we could just drop our health insurance and die in increasing numbers, or worse, live in chronic pain and poverty. In many ways, as you observe the last decade, the hard won freedoms and social structures that worked to lift all boats are being eroded by the inevitable outcome of unbridled greed and capitalism.
Rick,
The circular logic they use is just idiotic; when will this insanity end?
When I heard about this yesterday, my selfish instinct was to think about how this would affect my situation. Currently, the small company I work for spends about $300k/yr to provide a good policy for 30 employees and families, paying 80% of the premium. At what point would they have to throw up their hands and say enough? I have to believe a 39% increase would do it. Probably shifting more of the premium to the employee, which is already $300-400/month depending on family size.
How bad is this going to have to get for more in the middle class to start demanding that this gets fixed? Does a large part of us have to be forced into deciding whether or not to risk not buying insurance?
I have to stop, this is making me sick thinking about it; and I think my deductible just went up.
The insanity will end as the middle class is slowly (or maybe quickly) priced out of the insurance market. As the middle class finds health care protection to big a mountain to climb, the government will have no choice but to step in. This is why I believe single payer is inevitable whether you are for it or against it.
You may want to read -
trueslant.com/rickungar/2009/09/20/the-inevitability-of-an-american-single-payer-health-system/
In this piece, I lay out the argument supporting why single-payer is inevitable. What Cal. Blue Cross is doing is completely supportive of my point.
In response to another comment. See in context »The problem with your analysis of what if anything could and should be done about the proposed Anthem health Insurance premium increases is the same problem with Mr. Obama’s and the Congress’s proposed health care financing changes. You both suffer from arrogance and conceit, that you have the correct solution to what will work, unlike those whose business this is and who are trying to make a viable business underwriting health care insurance. Anthem has any army of spread sheet jockeys massaging demand numbers based upon their historical insurance prices and demand for insurance, wages and a myriad of other economic factors. Do you think in this atmosphere of populist demagogy about heath care costs that Anthem did not consider dully all other options? They really wanted being in a heavily regulated business to attract the attention of the likes of you, President Obama and the HHS Secretary? From your point of view you’re so much smarter, cleaver and knowledgeable then those whose daily business it is to provide and price health care coverage. Where did you get your deep wisdom that cutting price would work, doesn’t every business face that same option for flagging sales; why isn’t that the universal solution? Clearly you trained with the same arrogant people who ran Mr. Bush’s foreign policy; you understand everything and know all the “right” answer. We know where those ideas ended. Only an arrogant populist demagogue would believe that he’d figured it all out from the comfort of his armchair. Alternately you don’t know what the solution is and you know that, and your only looking for fig leaf analysis’s to cover a take over; a sheer power grab worthy of Hitler’s foreign policy demands and negotiations. Your observation about the lack of competition in selling individual health insurance policies in California is telling. Why wouldn’t all of the other profit seeking health insurance companies want to run into a your supposed low competition environment selling individual polices in California, raking in supposed monopoly profits? Their must be something about this environment that is not conducive to entrants getting rich or even doing business in. Go back to writing your comic books.
I don’t know if you read this page very often or not. If you do then you should know that I bend over backwards to listen to opposing points of view and give them as much consideration as I possibly can. I assume that the readers are smart and have something to add that I may not have considered.
But you are an idiot.
You actually managed to get Hitler into a piece discussing a huge increase in insurance premiums in California.
Now, let’s address your stupidity.
Your fundamental point -when you aren’t busy insulting me for daring to have a point of view different than your own – is nicely stated when your write -
“You both suffer from arrogance and conceit, that you have the correct solution to what will work, unlike those whose business this is and who are trying to make a viable business underwriting health care insurance. ”
Thus, according to you, we need to leave this to the people who are IN THE BUSINESS to make THEIR business viable. In other words, what matters here is that those in the private health insurance business keep making money – leaving those who cannot afford coverage out of luck if they don’t quality as a profitable customer.
That is some kind of logic! Did you know that private health insurance in this country began as a non-profit business?
Frankly, when millions upon millions already cannot afford health care coverage- and more and more of the middle class are being added to the ranks of the uninsured so that the health insurance industry can continue to profit – maybe there’s something wrong with the model?
And, by the way, I don’t pretend to know all the answers. The purpose of this blog is to put forward the asnwers I think might work better. If you consider that arrogant, you’re entitled to your opinion. However, I can’t help but notice that you had no suggestions to propose.
If you take your head out of your butt long enough to read what I have always had to say about insurance companies, you would discover that I know their problems better than most. I also defend them when they require defending, even when it is not popular to do so.
I will tell you this – if you ever come to this page and compare me to Hitler again, I have some relatives who are survivors of the death camps who might have something to say to you. You are more than welcome to express your opinion here- even if you insist of ranting about things that have nothing to do with the post. But if you are one of those who like to make your point tossing around Hitler comparisons, this is not the place for you and your posts will be removed.
In response to another comment. See in context »Non profit insurance is not loss making insurance or a public charity, it never was in this country. No business can operate without profits; most charities can only go to breakeven. Non profit insurance did not price coverage to cover the poor or below their costs. The poor are out in the cold because governments have let them down by not empowering them with purchasing power of vouchers, and by making every health insurance policy an expensive Christmas tree for special interest provider groups, by mandating coverage of such as Chiropractors, substance abuse councilors, podiatrists etc.
I again say that your idea that the Anthem should cut price is idiotic. It resembles the joke that ends with the business cutting price to make up their losses on volume. You’re smart enough to know better, thus I again impute bad demagogic motive to your factious solutions. In short this is just a fig leaf for your advocating a takeover, a theft of their resources and further destruction of the system. These takeovers will end in rationing for there is a lack of will to pay more taxes in this country, and once the system has exhausted its capital everyone will be waiting like in much of Europe or Canada. That is the dirty secret of how Mr. Obama’s health care cost containment will function; rationing by waiting in line. Of course the political class who will then run the system will not be waiting in line.
Your right, your no Hitler; your demagogy is on par with Huey Long or Father Coughlin.
We are all still breathlessly waiting for your suggestions as to how we solve this? Again, conspicuously absent.
And, now that I know what is so deeply distressing to you about the post, might I humbly suggest that you actually try reading it before popping a vein?
If you do so, you’ll note that I never suggested that Anthem lower their prices. What I did was point out the foolishness of their logic for increasing them. My words, precisely, were –
” I don’t suppose this ever occurred to Anthem, but BASED ON THEIR LOGIC…”. This immediately follwed the paragraph where I noted the circular logic they were using.
What I’m criticizing is the stupidity of their excuse. Maybe if you spent less time coming up with unique characters from history in order to vilify me – because there is nothing that requires vindictive and bubbling anger like someone putting forth an opinion – and more time actually reading what I have written, you might save the inevitable stroke that I fear is in your future. I mean, if you get pissed off to the point of Hitler references because someone has a thought about the problem of increasing health insurance premiums, you have a problem to be sure.
Since even mildly carefully reading is, apparently, a problem for you, maybe it is you who should go back to my comic books as I’m told they are a valuable aid in helping kids learn to read.
In response to another comment. See in context »BC/BS’s logic breaks down when anyone takes a good look at their EOB’s (explanation of benefits). They show what was billed, what the insurance company negotiated to pay and what you are responsible to pay. Its obscene the difference between what you would pay without insurance and with it. I had a lab expense billed at $442.00 which was negotiated to $127.00 (of which my insurance paid 70%). The fact that nobody else seems to be able to negotiate these kind of rates is one of the many things broken with our healthcare system. I am also willing to bet that with BC/BS’s increase, they are in turn NOT going to raise the amounts paid to providers
Well, I’m not entirely sure that this can be used to explain the logic break. The fundamental benefit of pooling for insurance is that the pool is in a better position to negotiate rates since they represent a larger number of people who will use the medical system. The difference between what the provider would charge you if you are uninsured versus what the insurance company pays is a benefit to the insurered and, at worst, requires a review of the provider’s practices more than the insurance company’s practices.
The real heart of the problem in the for-profit insurance industry is primarily (a) their high overhead charges, much of which is truly unnecessary, and the reality that health insurance companies actually have a small profit margin (between 3% and 5%). In an era of skyrocketing medical costs- often the result in technolgical breakthroughs that save lives but are very expensive – the private insurance model simply doesn’t work any longer. They are doing their best to perpetuate their business but, in my opinion, they are doomed. It’s only a question of how much longer they can hold on.
In response to another comment. See in context »I think someone else touched on this, but the problem I was addressing, and maybe not so well, is that most people have no idea what these things cost. I dont know what it costs a hospital to do an MRI scan, and there is no way to get that information, no way to compare, no basis to pull from. We assume that insurers are in that profit margin because thats what they report, and I am not so sure how much trust I have in those reports. I’m sure Goldman Sacs says they have a really low profit margin too
In response to another comment. See in context »I agree that we don’t really know what things cost. As to the correctness of the insurance compnay reports, we can be fairly confident in their accuracy as the large ones are all public companies. They report in accordance with security laws and their reports have to be certified by accountants who would be putting their companies on the line (as we saw with Enron) if they are dishonest. Actually, the same can be said for Goldman Sachs. Why we may not like them, there isn’t much reason to question the accuracy of their public reporting obligations.
In response to another comment. See in context »Let me try to explain some of the issues you raise in medical billing. The submitted charge is a myth; it is based upon the providers “usual charge”, how much they “normally” charge. They use this number because some people still have health insurance contracts/programs that pay what is called “usual customary and reasonable” charges (UCR). UCR is based upon what most providers charge for that particular service in a geographical area. Thus for those without a preferred provider (PPO) health care contract (not YOU) that submitted charge would be where the insurance company would start to calculate the payment. Also by billing the exorbitant up front charge, they are trying to uphold there prices by inflating the UCR study and as a high starting point for billing eligible for UCR usage (non PPO). Remember, UCR charge is based on a non PPO charge billed in a geographic area for a particular area.
What the largest insurance carriers have done is use their size to create discounted programs, and in return provide cooperating vendors with volumes of patients. The PPO payment rate is negotiated rate, and is radically below the submitted charge. The PPO rates have been the major brake so far on escalating heath care costs, you need only look at the large differences in billed charges and negotiated rates.
Finally the remaining balance (30%) is the “your responsibility” amount is the cost sharing with you and a disincentives to discourage frivolous use.
One of the earliest causes of cost escalation in this country was that Medicare for years paid “prevailing charges” or UCR. This government policy was a major cause of the beginning of the escalation of health care cost. Medicare created a large increase in demand, older less healthy people who instantly at the programs creation soaked up any excess supply of healthcare services and paid what vendors charged.
None of this makes much sense in the abstract without knowing the history but now so much of this is the result of law that has grown up around the current system of health care finance.
In response to another comment. See in context »Who are you explaining this to? It’s pretty much health care claims 101. Most readers here pretty much already know this stuff.
Now that you’ve turned from invective slinger, and angry defender of the private health insurance model to educator, why don’t you explain to us all why doctors and hospitals have to deal with eight hundred different contracts, each with a different codification and nomenclature system, thereby driving the overhead costs up into the stratosphere? This is something we’d like to hear.
In response to another comment. See in context »[...] Blue Cross raises California health care premiums 39% – Rick Ungar – The Policy Page &#… [...]
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[...] Blue Cross raises California health care premiums 39% – Rick Ungar – The Policy Page &#… [...]
I’m one of those affected – my BC/Anthem premiums are approaching my mortgage in magnitude. But we have no choice, my wife is a cancer survivor and no one else will take us.
I’d complain, but if I got a sore throat from the yelling, it would cost me too much to get it treated.
The one excuse I haven’t seen the insurance companies make -
They invest their float between the income of our premiums and the outgo of their medical payments. In the past several years, these investments have probably tanked just like everybody else’s. As a result, their customers are picking up the tab for their investment losses.
I work at a small non profit in Indiana and this happened to us this year, after similar increases in premiums and deductibles in 2009. My employer almost stopped offering health insurance, it is becoming so expensive. I have had health insurance my entire adult working life (even paying over $1000/month for myself and my daughter when I was between jobs in 2007–BCBS), but fully expect Anthem to try to discard me if anything catastrophic happens. I remember in the 80s or late 70s, BCBS was hyping a “million $” coverage plan, but when someone with the coverage actually had those costs (legitimate) they cancelled. I also cannot find out what my healthcare costs, even with insurance. My daughter had a complication free tonsillectomy in August. I was told at the time that my portion was around $500, which I immediately paid. A month later, I get a bill for $1000 more. Remember that BCBS in Virginia in the 90s was misleading customers about their percentage of costs, a procedure would be billed at $1000, customer pays 20%=$200, but BCBS would not tell the customer that they had negotiated smaller fees ($700), so their cost would be $140. Nice. The CEO had gold plated faucets and box seats at major sports games …. Death panels aren’t anywhere in Obama’s health plan, you have to look no further than health insurers coverage decisions and denials. I am also firmly convinced they automatically deny many legitimate claims, knowing that many people will not have the time, energy or knowledge to appeal. Nice business model.
“Nice business model.” Yeah, for organized crime. I’m waiting for CA AG Jerry Brown to start going after Anthem. Could be a popular plank for his Governor aspirations.
In response to another comment. See in context »Interestingly enough, the Californian official actually responsible for going after Anthem is Steve Poizner, the Insurance Commissioner and a Republican trying to run for governor against Jerry Brown. He has asked Anthem to delay their increase from March to May, but as Rick mentioned, he really has no power to make any changes.
In response to another comment. See in context »He must be torn between wanting to let businessmen do whatever they want, as a good Republican, and knowing that he can steal a march on Meg Whitman, his primary rival, by going populist.
[...] Blue Cross raises California health care premiums 39% – Rick Ungar – The Policy Page &#… [...]
[...] Blue Cross raises California health care premiums 39% – Rick Ungar – The Policy Page &#… [...]
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[...] 6.Blue Cross raises California health care premiums 39% – Rick Ungar – Pingback: Blue Cross raises California health care premiums 39% | bling … If you are suggesting there is some regulatory bar to others competing with Blue Cross in California, there is not. Nobody wants to be in the individual policy business to begin with. They want group policies. http://trueslant.com/rickungar/2010/02/09/blue-cross-raises-california-health-care-premiums-39/ [...]
[...] 13.Blue Cross raises California health care premiums 39% – Rick Ungar – Pingback: Blue Cross raises California health care premiums 39% | bling … If you are suggesting there is some regulatory bar to others competing with Blue Cross in California, there is not. Nobody wants to be in the individual policy business to begin with. They want group policies. http://trueslant.com/rickungar/2010/02/09/blue-cross-raises-california-health-care-premiums-39/ [...]