2017医保，Arizona涨幅超过100%，至少了解下情况再说话吧 The increases vary heavily by state, with Indiana and Massachusetts seeing an average 3% decline in costs while Arizona tops out with a 116% average increase.
chali1234 发表于 1/21/2017 6:25:21 PM
Arizona’s health insurance exchange was once among the more robust in the nation. In 2015, there were 11 carriers offering plans in the exchange, some state-wide, and some in select counties. By 2016, that had dropped to eight.
And for 2017, there are only two — Blue Cross Blue Shield of Arizona, and Ambetter by Health Net (Ambetter acquired Health Net, and the plans became “Ambetter by Health Net” as of January 2017). In virtually all of the state, there is only one insurer offering coverage in the exchange. In Pima county, there are two carriers participating, although one is only offering Catastrophic plans, which aren’t available to most enrollees。
自从2014年开始，obama care plans medical loss ratio 一直都超过100%。还没有算保险公司的administration expenses。即使在2014年以前，individual market的comprehensive plans loss ratio也没有这么低过! 如果是short term plans，倒是有可能。各个state的department of insurance 又不是吃干饭的。rate filling第一件事就是看loss ratio好不好!
自从2014年开始，obama care plans medical loss ratio 一直都超过100%。还没有算保险公司的administration expenses。即使在2014年以前，individual market的comprehensive plans loss ratio也没有这么低过! 如果是short term plans，倒是有可能。各个state的department of insurance 又不是吃干饭的。rate filling第一件事就是看loss ratio好不好!
自从2014年开始，obama care plans medical loss ratio 一直都超过100%。还没有算保险公司的administration expenses。即使在2014年以前，individual market的comprehensive plans loss ratio也没有这么低过! 如果是short term plans，倒是有可能。各个state的department of insurance 又不是吃干饭的。rate filling第一件事就是看loss ratio好不好!
The breakup of the Bell System was mandated on January 8, 1982, by an agreed consent decree providing that AT&T Corporation would, as had been initially proposed by AT&T, relinquish control of the Bell Operating Companies that had provided local telephone service in the United States and Canada up until that point.[1]This effectively took the monopoly that was the Bell System and split it into entirely separate companies that would continue to provide telephone service.
Post-breakup structure Main article: Regional Bell Operating Company
The breakup of the Bell System resulted in creation of seven independent companies that were formed from the original twenty-two AT&T-controlled members of the System.[5]
At the time of the breakup, these companies were:
Ameritech, acquired by SBC in 1999, now part of AT&T Inc. Bell Atlantic (acquired GTE in 2000 to form Verizon Communications) BellSouth, acquired AT&T Inc. in 2006 NYNEX, acquired by Bell Atlantic in 1996, now part of Verizon Communications Pacific Telesis, acquired by SBC in 1997, now part of AT&T Inc. Southwestern Bell (later SBC, now AT&T Inc.), which acquired AT&T Corporation in 2005 US West, acquired by Qwest in 2000, which in turn was acquired by CenturyLink in 2011
In addition, there were two members of the Bell System that were only partially owned by AT&T. Both of these companies were monopolies in their coverage areas, received Western Electric equipment and had agreements with AT&T whereby they were provided with long distance service. They continued to exist in their pre-breakup form after antitrust case, but no longer directly received Western Electric equipment, and were no longer bound to use AT&T as their long distance provider.[5] These companies were:
Cincinnati Bell, now the only Bell System member never owned by a Baby Bell, covering the Cincinnati metropolitan area Southern New England Telephone (SNET), acquired by SBC in 1998, now part of Frontier Communications, covering Connecticut.
Arizona’s health insurance exchange was once among the more robust in the nation. In 2015, there were 11 carriers offering plans in the exchange, some state-wide, and some in select counties. By 2016, that had dropped to eight.
And for 2017, there are only two — Blue Cross Blue Shield of Arizona, and Ambetter by Health Net (Ambetter acquired Health Net, and the plans became “Ambetter by Health Net” as of January 2017). In virtually all of the state, there is only one insurer offering coverage in the exchange. In Pima county, there are two carriers participating, although one is only offering Catastrophic plans, which aren’t available to most enrollees。
完全同意。奥巴马完全不知道什么是保险。以为保险公司就像他自己的钱包一样随便用，结果各大公司都挺不过三年。
加拿大全民医保，弊病是效率差，医疗占税收的大头。政府对普通医生，专科医生，药费等等都有限价。听说有些医护人员培养完去美国挣大钱了。
可这么看来美国这套系统也有其弊病。
一朋友过境做一个手术，据说医院最初报保险价40万美金，最后协商十几万现金做的。
我过境看急诊，付钱时，医院说等帐单，他们也不知道多少钱，后来搬家，打过几次电话，让等等再等等，不了了之了。我这有保險，就是酒精消毒了一下而已。
问题是保险公司州内垄断，FILING不就是走个过程吗，还不是会批准。你们哭装穷说你们损失多少，然后马上就能涨价，还是暴涨，一下就都捞回来了，其它行业其它公司没这么好的事情。其实你们本来还可以继续CUT COST，CEO和员工少拿钱，说明你们CUT COST只是装样子.
这整个医疗过程各个环节的cost都很高，保险公司绝对不是最核心的那一环。我刚进保险公司的时候真心被这么低的margin 给惊到了！而且这个行业是highly regulated,每一次的政策改变 都要导致一系列流程，系统的改变，稍不留意就会被罚款.
上两年奥八医疗本来政府承诺给我们的钱，只给了百分之二十几，可要我们交罚款的时候可一点不含糊。这几年来拜奥八所赐年年亏，公司各种cut cost, 现在恨不能让大家都wfh,减少facility cost，无数部门被外包。很多工作了二十多年的人都离开了公司。说保险公司是既得利益者我也只能呵呵了
就是因为其他保险公司全都亏损退出市场了，只剩一两个他们就可以随便涨价了。Arizona受非法移民侵害最严重的州，很多人滥用政府补贴。
剩下的这两个公司，2017年肯定还是亏。因为即使涨这么多，还是不能cover loss。不信你就看年底报表。你不知道这些人不工作天天看病多可怕。
这里面肯定有黑幕，奥黑就是慷别人的慨，中饱自己的私囊。典型的左棍假圣母。真圣母是那自己的钱救济别人，奥黑是拿别人的钱救济龙虾党
是啊，那些自己不同付钱看病的人，一点毛病就去看医生，我们每年交几万块钱的税养着他们，自己却买不起保险，硬抗，或者自费
你这都是行外话，filling都多少轮的objections啊！都是从4月到10月底，一遍一遍降价，重新pricing，最后才批。如果保险公司真的这么暴利的话，大家都开保险公司好了。
睁眼说瞎话，谁不会啊！张口暴利闭口暴利。举例子好了！
CEO工资高，我们屁民管不了! 看看同等大小的其他行业CEO工资，你就知道他们的工资合理不合理了！
自从2014年开始，obama care plans medical loss ratio 一直都超过100%。还没有算保险公司的administration expenses。即使在2014年以前，individual market的comprehensive plans loss ratio也没有这么低过! 如果是short term plans，倒是有可能。各个state的department of insurance 又不是吃干饭的。rate filling第一件事就是看loss ratio好不好!
那个时候好太多了，那时候是没有这么多人滥用保险!
但是正常人的保费也涨了，你们转嫁了很多给其他人，所以不要总拿这块出来说事。
只是OBAMACARE PLAN而已，但是其它PLAN你们也都涨价了，你们在其它地方补回来了啊，你们就不能少赚点吗。你们ADMINISTRATIVE EXPENSES太高了, 其实可以砍。
You wish. 这是 o8care 为什么那么贵的根本原因。最花钱的就是这 pre-existing condition。
individual mandate要取消，这一块根本不可能给你保。不过有听说可以在 high risk pool上保，就是那种有上限的。所以 08care 取消以后, 生大病的，要么破产，要么等死。
也包括年纪大的人的保险。
公司都是group保险，有precondition也可以参保
退休之后就是medicare了。归根结底还是要鼓励人去工作。
所有individual plans(不包括grandfather plan)都是一个pool，中国pool的概念就是一荣俱荣，一损俱损。保险公司已经在裁人了，admin fee已经降低了，但是基本的customer service要保证啊，你不想打一个小时的电话给保险公司吧！唉，说了，你也不懂。对牛弹琴。
可以参保，但是不保 pre-existing condition。记得 o8care 以前好象是这样的。
还有medicare 要被减经费了。所以以后 medicare 也要变差。
大家对保险的期望值好高啊。Trump 减那么多税，征富人的遗产税也砍了，这税也砍那税也砍，保险那里可能又便宜又好？
公司group保险都是保的。你没上过班？一直吃福利？
我基本上不看病。不向你，身体那么差。不过我同事说不保 pre-existing condition。
re. 一厢情愿的车轱辘话翻来覆去的讲，没有一点常识也听不进其他mm的解释。医疗系统这个样子，不是说让保险公司员工和 CEO 都不拿钱就能解决的。因为安全政策和大法官任命，我是一直支持 Trump上台的，但是这只猫天天 copy paste ，油盐不进的什么都是 trump 英明神武的调调真是看了无语。
抓住mm问一下，也就是说我们病人接到的医院账单说保险公司付了多少多少啊其实都是幌子？那一般来说作为 provider 方，比如说给了病人一个$2000的总账单，病人假设自付$200， 剩下的 $1800其实只能从保险公司拿一个合约价而不是$1800？那这个合约价作为最大的保险公司而言一般能谈到多少呢？会不会只需要$200就搞定本来 $1800的定价？
除非保险公司的老板和雇员强烈支持反对OBAMACARE的川普, 否则就肯定是OBAMACARE的收益者, 这个是最说明问题的, 哭穷谁都会, 目的就是为自己捞更多好处
是因为你们以前太肥了,裁人很奇怪吗,美国这8年很多公司不知道裁了多少人,哪有你们这样一出来哭穷就能拼命涨价的.
理解不同的 procedure应该合约价格也不一样，但是作为大的保险公司，一般能谈到病人账单总价的百分之多少呢？因为如果病人没有收入只能cash付总价一部分的话，好像 医院也是接收的，那为什么要给有保险的病人 quote 那么高呢？ 同时保险公司也不愿意当冤大头，谈的价格必定不是provider给病人的 quote, 那他们还给病人开个这样的账单显示一个虚的价格是为啥啊？
别装了, 有倒闭的就能有新开的, 美国以前还反垄断分拆过电话公司你不知道吗. 你们就是ADMIN COST太高了,你们必须少赚,医院和药厂是有问题,但也真是给病人提供服务,你们也就是个管钱的,凭什么要赚那么多. 这楼里在保险公司工作的就是既得利益者,我反正是不信你们说的,现在主流媒体都在骗人.
你是这个楼里唯一的明白人, 真很多都自己出钱医院也不敢随便开天价账单了, 因为没人付得起, 市场自然会调节.
OBAMACARE其实就是拿纳税人的钱给医疗行业做BAILOUT, 经济不好, 美国公司大量裁员后很多人买不起医疗保险, 保险公司没人买保险还怎么赚钱, 很多人医院都不去了,医院都要CUT COST裁员, 一定会大量裁员. 所以保险公司CEO肯定支持OBMACARE.
保险公司就是少赚一点都不愿意的.
你去GOOGLE一下美国以前是怎么对电话公司反垄断的吧, 你在美国时间肯定是太短, 美国以前不是没干过, 用倒闭来威胁,你还差远了.
朗讯算什么, 去看看BELL SYSTEM电话公司的MONOPOLY是怎么被BREAKUP的. 川普团队未来可能都要对现在的媒体垄断动手的.
high risk pool 不就是有钱人生了大病没事，穷人生了大病等死吗？
中产也别自己骗自己了，一旦生大病，直接进 high risk pool，就是要么破产要么等死。
Breakup of the Bell System
https://en.wikipedia.org/wiki/Breakup_of_the_Bell_System
The breakup of the Bell System was mandated on January 8, 1982, by an agreed consent decree providing that AT&T Corporation would, as had been initially proposed by AT&T, relinquish control of the Bell Operating Companies that had provided local telephone service in the United States and Canada up until that point.[1] This effectively took the monopoly that was the Bell System and split it into entirely separate companies that would continue to provide telephone service.
Post-breakup structure
Main article: Regional Bell Operating Company
The breakup of the Bell System resulted in creation of seven independent companies that were formed from the original twenty-two AT&T-controlled members of the System.[5]
At the time of the breakup, these companies were:
Ameritech, acquired by SBC in 1999, now part of AT&T Inc.
Bell Atlantic (acquired GTE in 2000 to form Verizon Communications)
BellSouth, acquired AT&T Inc. in 2006
NYNEX, acquired by Bell Atlantic in 1996, now part of Verizon Communications
Pacific Telesis, acquired by SBC in 1997, now part of AT&T Inc.
Southwestern Bell (later SBC, now AT&T Inc.), which acquired AT&T Corporation in 2005
US West, acquired by Qwest in 2000, which in turn was acquired by CenturyLink in 2011
In addition, there were two members of the Bell System that were only partially owned by AT&T. Both of these companies were monopolies in their coverage areas, received Western Electric equipment and had agreements with AT&T whereby they were provided with long distance service. They continued to exist in their pre-breakup form after antitrust case, but no longer directly received Western Electric equipment, and were no longer bound to use AT&T as their long distance provider.[5] These companies were:
Cincinnati Bell, now the only Bell System member never owned by a Baby Bell, covering the Cincinnati metropolitan area
Southern New England Telephone (SNET), acquired by SBC in 1998, now part of Frontier Communications, covering Connecticut.
现在不是 obama 时代，给低收入的人有各种各样的医疗福利。年纪大又有慢性病的华人父母都是进 high risk pool 的，保险有上限的。
华人移民才多少, 要断掉给非法移民的福利保费才不会疯涨. 最好把非法移民都赶走.OBAMA滚蛋了才是保护美国的福利系统
不可以，因为律师抓住错误会告，赔上几米，几十米，谁受得了？
错，可以不买，但是一旦出了事情，不保pre-existing
把非移赶走，省太多钱了
就拿门诊的化验项目举个例子吧，住院有点相对复杂先不説。比如一个化验项目医院拿给你的账单是300刀，就是billed amount=$300。那保险公司有一个合同价，假设是$100，这个叫allowed amount。 差价$200就是adjustment。 以100刀的allowed amount 为基准，这个是你和保险公司需要付给医院的价钱，如果你的deductible是500刀，那这100刀你全部付掉。如果你没有deductible, 只有自付coinsurance是20%，那你自己付掉20刀，80刀由保险公司付。如果今年你的deductible500刀已经用完了，那100刀全部由保险公司付。
医院的billed amount是用来跟保险公司谈价格的。比如在这个基准上，给一个保险公司60%折扣，另一个可能只有40%折扣。但是基本上只有小的保险公司这样付钱的。大的保险公司都有逐项的价钱。每年涨百分之多少，以那个为基准谈。总体来说，blues的保险公司是nonprofit (比如各州blue cross, anthem...),因为members多，所以拿到的价钱一般就是最低。现在还有好多公司是自己花钱的，最多找保险公司管理个账单，这种公司自己的员工就是一个risk pool,所以self funded得公司，保险今年受到的影响相对较小。Walmart是直接跟医院签合同，不走保险公司的，按人头给钱，现在这种形式也多了，跟国内的定点医疗很像。说白了就是风险均摊，就看跟谁摊，明白了吧
不过价格一般都是按Medicare的一个百分比。同样的活大医院拿的多，小诊所少。
顺便不要脸的link一下几个月以前我自己乱写的一大堆科普healthcare的东东:
http://forums.huaren.us/showtopic.aspx?topicid=2090694&&page=1
虽然最后烂尾了😓😓😓. 感兴趣的凑合看看. 不同意的当成反面教材看也可以. debate begets better understanding. 嘿嘿.
那么温文尔雅的医生，讲起保险的时候，对奥巴马骂粗口，说所有的医生都骂死o8，屁股哦都想得出来的他那个狗屁Obama are 不work