Employee Benefit News: Health Insurers Must Justify Premium Increases

Interesting article but I find the headline more interesting than the content. It really illustrates the misdirection of much of the health care reform discussions. The majority of Americans and apparently the current administration believe that the whole health care problem with quality and cost is the insurers. It really is misdirection and very misleading. The actual profit margins of insurers is really a very small percentage (<5%) of the total medical spend. The real driver for increased premiums is the under utilization and increased unit cost of medical services. Why do we not require the same disclosure from our medical providers? I am aware of several hospitals and speciality groups negoiating double digit  reimbursement increases (up to 30%). In part they claim it is to off-set the scheduled 30% reduction in medicare reimbursement rates.  We should also require them to justify these large increases. As the article points out, the insurers are making record profits...but so are many of the health systems, all at the expense of the patients.  Lets have a fair and honest discussion with complete transparency of all parties.  The profit margin of the insurers is only a small part of the problem, and in fact eliminating all the margin, i.e. reducing the cost by 5%, does not make the average family premium of $19,400 much more affordable.  Instead of focusing on 5% of the problem lets focus on the 95%. A great starting point is let's focus on the 30% of all medical services that currently are delivered that add little or no clinical value, or on the 500 preventable deaths a day from medical errors.  Until that happens we believe we have a tool that can help purchasers start to address these issues by directly connecting them to the high quality efficient providers that could reduce medical spend by as much as 30%. Check us out!