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28 ноября, 21:46

Our Profiteering Health Insurance Industry: Should The Government Bail It Out Again?

Backtrack to 2008 to 2010, when the increasing costs and unaffordability of insurance and health care for Americans were a front-burner issue. They remain so today. Soon after coming into office, the new Obama administration worked for two years, in the name of health care "reform," to appease corporate stakeholders in our well-entrenched medical-industrial complex. The political question then was not what was in the best interests of patients and families, but how to gain the support of the major corporate players, especially the insurance, hospital, and drug industries. Following their huge campaign donations, sending more than 4,500 lobbyists to the Beltway (eight for every member of Congress) (1) and a rapidly revolving door of conflicts of interest, the Patient Protection and Affordable Care Act (PPACA, or ACA and Obamacare) was passed by a narrow margin in Congress almost seven years ago. Today, it is obvious to all that patients are still not protected by good insurance coverage at affordable rates, and that the very name of the bill is a misnomer. The costs of health care keep rising at rapid rates as insurers, hospitals and drug companies blame others for these increases. None of these industries have contained costs as they pursue their business model of making profits, with their highest priority maximizing revenues for their CEOs and shareholders. As we are now seeing, insurers exit markets when they are not sufficiently profitable, even as health care stocks have soared to the highest sector of the S & P 500. Not only did the health insurance industry get some 20 million new enrollees as a result of the ACA (mostly through Medicaid expansion), but insurers gained many ways to decrease their risk for covering enrollees' health care costs. These include offering plans covering as little as 60 percent of costs (bronze plans), receiving "risk corridor" funds protecting them from losses (now a court case), benefit designs that still discriminate against the sick, shrinking provider networks, restrictive drug formularies, offering limited-benefit bare-bones policies, and deceptive marketing practices. In no way have they contained costs, even as they have been subsidized by new enrollees through the exchanges. All the while, they have gained market power through consolidation as they consume 15 to 20 percent of U. S. health care expenditures, mostly through profiteering, administrative overhead, and bureaucratic waste. If their merger agreements survive court challenges, just three giants--Anthem/Cigna, United Health Group, and Aetna/Humana will collectively have a margin share exceeding more than 130 million Americans. (2) Insurers have segmented the market in their own interests, shifting the burden of care of sicker patients to public programs. They have increasingly privatized both Medicare and Medicaid, resulting in higher administrative costs compared with public Medicare and Medicaid. They also maximize profits by cutting staff and value of coverage, resulting in worse outcomes for patients compared with public plans. (3) Most people are unaware that the government already pays for about 64 percent of total health care spending--about $1.9 trillion in 2013, much of that by subsidizing private health care industries, especially private health insurance. There is a long history to this subsidization, dating back to policy decisions after World War II giving tax exemptions to employers for their costs of providing employer-sponsored health insurance. The ACA bailed out the industry in 2010, which is once again calling for more government subsidies to stay in business. A just-released estimate by the Department of Health and Human Services (HHS) acknowledges that the three-year risk corridor deficit from 2014 through 2016 for insurer losses will exceed $14 billion. (4) The Congressional Budget Office and the Joint Committee for Taxation estimate that the net subsidy from the federal government in 2016 for health insurance for people under age 65 and costs for Medicaid enrollees under age 65 will be $660 billion. (5) That estimate includes effects of preferential tax treatment for employer-sponsored coverage. We can anticipate that insurers will make good on their threats to leave the market when we recall that 2.4 million private Medicare beneficiaries were abandoned in 2002, when they lost their Medicare + Choice coverage despite infusion of more federal dollars. (6) The incoming Trump administration and Republican-controlled Congress will be pressured to continue a further federal bailout of the private health insurance industry. But why whip a dead horse? It is past time to learn that corporate greed and the business model do not, and will never, serve the common good. As Wendell Potter, former Cigna executive and author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans, observes: Folks, we are guilty of magical thinking. We've fallen for insurers' deception and misdirection, hook, line and sinker. And many of us can't be persuaded that we are being duped. Meanwhile, the shareholders of the big for-profits are laughing all the way to the bank. Every single day. (7) We--Americans needing health care, employers, federal and state governments, and all of us taxpayers--cannot afford another bailout of the health insurance industry, especially since we have a real fix-- single-payer, not-for-profit national health insurance, Medicare for All. It will provide universal access to care for our entire population, save us all money, give us free choice of physician and hospital, and improve our health care outcomes in a reformed system dedicated to service and the public interest. Corporate stakeholders with their political and economic power, and their lobbyists (most unregistered) are again pushing for continued government bailouts of this industry, which has not earned it. Another bailout cannot reverse the health insurance industry's continuing death spiral. John Geyman, M.D. is the author of The Human Face of ObamaCare: Promises vs. Reality and What Comes Next and How Obamacare is Unsustainable: Why We Need a Single-Payer Solution For All Americans visit: http://www.johngeymanmd.org Sources: 1. Eaton, J, Pell, MB. Lobbyists swarm capitol to influence health reform. Washington, D.C. The Center for Public Integrity, February 23, 2010) 2. Mattioli, D, Hoffman, L, Mathews, AW. Anthem hears $48 billion Cigna deal. Wall Street Journal, July 23, 2015: A1 3. Geyman, JP. The health insurance industry's last-ditch holdup. The Huffington Post, August 15, 2016.) 4. Blase, B. A taxpayer bailout of ObamaCare insurers just got a lot more expensive. Forbes, November 21, 2016.) 5. CBO and JCT. Federal subsidies for health insurance coverage for people under 65: 2016 to 2026. March 24, 2016. 6. Waldholz, M. Prescriptions. Medicare seniors face confusion as HMOs bail out of program. Wall Street Journal, October 3, 2002: D4.) 7. (Potter, W. It's way past time for us to stop deluding ourselves about private health insurers. The Progressive Populist, September 1, 2016: p. 20.) -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

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28 ноября, 17:33

With Its Anthem Deal On Trial, Cigna Says It Will Make $2B This Year

Cigna Corp. disclosed its adjusted 2016 income from operations will be more than $2 billion this year as an independent company.

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18 ноября, 18:05

Donald Trump's Top Advisor Has A Potential $2.7 Billion Obamacare Conflict Of Interest

There’s nothing odd about the founders of a health insurance company writing policy proposals after an election where the winner campaigned relentlessly on ending Obamacare. And Wednesday morning, Mario Schlosser and Josh Kushner, the founders of Oscar, a health care startup that sells insurance on the state exchanges Obamacare created, did just that. They say they want more competition in the insurance industry, and they think allowing individuals to buy health care plans with pre-tax dollars would make that happen. Oscar’s founders also expressed openness to ideas Republicans have floated in the past. What’s interesting in this case is that Kushner is the brother of Jared Kushner, who is married to Ivanka Trump, the eldest daughter of President-elect Donald Trump. Jared Kushner is also serving on the executive committee of the presidential transition, and could potentially take a senior job in the White House. Venture capitalist and Facebook board member Peter Thiel, who also sits on the executive committee of the presidential transition, is also an investor in Oscar. A spokeswoman for Josh Kushner and Oscar declined to comment beyond his blog post. Spokespeople for Thiel and the Trump transition did not return requests for comment. Anti-nepotism laws bar Kushner from taking a paid job in the White House, though he is exploring getting around that rule by taking an unpaid role advising his father-in-law, The New York Times reports.   On the campaign trail, Trump railed against Obamacare and promised to replace it with something better ― though he never said what his alternative was exactly. He told The Wall Street Journal last week that he may try the virtually impossible task of keeping popular parts of the law, like allowing children to stay on their parents’ plans into their 20s and barring insurance companies from denying coverage due to pre-existing conditions, while still reducing costs. But in all likelihood, any changes a Trump administration and a Republican-controlled Congress make would be far more favorable to insurance companies. That would create the potential for a conflict of interest ― or in the very least, the appearance of one ―  if Oscar were a run-of-the-mill health insurance company. But the potential is amplified due to the fact that Oscar was started for the express purpose of making money on the state exchanges for individual insurance. Oscar sells insurance through its website and app directly to individuals who aren’t covered by employer insurance or a government program. Individuals who aren’t covered are required to buy insurance or pay a penalty under what is called the individual mandate. The federal government partially subsidizes the plans that Oscar sells. Precisely how big that subsidy depends on the type of plan and how much money the person buying it makes. Federal conflict of interest rules say executive branch employees can’t make decisions that affect their family’s finances. That means that even if Jared Kushner accepted a job in the White House, which he has not yet, his brother Josh’s business falls outside the scope of the conflict of interest laws for federal employees. However, “there might be some question of whether it is appropriate to weigh in on decisions that have an enormous impact on [his] brother’s assets,”  said Richard Painter, a University of Minnesota law professor who was the chief ethics lawyer under President George W. Bush.  [Oscar] lost $45 million in just the past three months, and a total of more than $230 million in the past 21 months. Painter, who endorsed Democratic presidential candidate Hillary Clinton, said he would put Oscar “fairly low down the alleged conflicts of interest in the incoming Trump administration.” But the conflict is emblematic, he said, of “how the private sector responded to Obamacare.” If Obamacare is repealed, a Trump administration is “going to be hurting a lot of people who invested in the system the way it is now... People they know and people they don’t know who depend on government being predictable.” Oscar “may be a conflict that helps to temper their decision-making,” Painter said. Whether the Trump administration’s decisions could put Oscar on a stable financial path is unclear. The company lost $45 million in just the past three months, and a total of more than $230 million in the past 21 months. Like other insurance companies, Oscar’s founders thought that the new individual marketplaces that Obamacare created would be a large and profitable. While some insurers have profitably sold insurance on the exchanges, Oscar has been unable to. Oscar has spent heavily on cute ads ― it’s hard not to see them if you ride the New York City subway ― but most people opt for established brands like Blue Cross and Blue Shield or Cigna. Oscar is also different from the massive insurance companies in that it doesn’t have a diversified revenue stream like corporate plans or government health care programs. That means that while companies like Aetna can choose to either absorb losses in the individual plan market or simply pull out and focus its business elsewhere (Aetna choose the latter in August). Oscar has to date raised a reported $400 million in venture capital because Oscar is losing money on Obamacare, and Obamacare is Oscar’s entire business. Indeed, the core bet of Oscar ― that a startup with a slick app could outsmart the entire insurance industry ― is belied by who has managed to be successful selling plans on the exchanges: companies with a track record of selling plans to individual buyers. That’s experience you don’t get coding apps. But only Oscar has an intimate connection to a top adviser to President-elect Trump. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

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15 ноября, 14:30

How Real ER Doctors Countered Recent Cigna Ad Using 'TV Doctors'

VideoWhat’s the best way to mount a campaign against an insurance giant that has capitalized on narrow networks, higher deductibles and is now using “TV doctors” from Grey's anatomy, Scrubs and even the long running classic M*A*S*H to reach out to the public to encourage medical check-ups? Hint: Use Doctors #IRL, [...]

11 ноября, 02:12

After Obamacare, How Will TrumpCare Treat Insurers?

Now that the presidency of Donald Trump is certain, Obamacare is shrouded in uncertainty

10 ноября, 17:34

How is Fidelity Select Health Care Services Portfolio Fund (FSHCX) Performing/

Fidelity Select Health Care Services Portfolio Fund (FSHCX) a Zacks Rank #1 (Strong Buy) was incepted in June 1986 and managed by the Fidelity Group

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08 ноября, 02:04

Cigna (CI) Poised for Growth Despite Regulatory Hurdles

Cigna's (CI) Global Health Care and Global Supplemental Benefits businesses are performing strongly with high customer retention levels and solid revenue and earnings growth.

07 ноября, 12:48

Бонусы на Уолл-стрит сокращаются три года подряд

Бонусы работникам финансовой отрасли Уолл-стрит по итогам 2016 года могут сократиться уже третий год подряд, что отражает период сокращения сделок M&A, ограничения торговой деятельности и сниженной доходности хедж-фондов.

03 ноября, 17:53

Cigna (CI) Beats Earnings and Revenue Estimates in Q3

Cigna Corp. (CI) reported third-quarter 2016 operating net earnings of $1.94 per share which surpassed the Zacks Consensus Estimate of $1.91.

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03 ноября, 17:01

Cigna, Too, Will Shrink Obamacare Footprint

Cigna, which had hoped to expand individual Obamacare offerings to 10 states next year, instead will remain in seven. It is leaving Georgia and Texas in 2017, but entering the Chicago market and Raleigh, North Carolina.

03 ноября, 13:57

Сегодня в США ожидается публикация нескольких важных показателей

В четверг, 3 ноября, в Соединенных Штатах Америки ожидается публикация нескольких важных показателей. В 15:30 МСК будут опубликованы данные по количеству первичных обращений за пособиями по безработице. Аналитики ожидают, что показатель составил 258 тыс. В 17:00 МСК выйдут данные по заказам в обрабатывающей промышленности и индекс экономических условий ISM в непроизводственной сфере. Согласно нашим ожиданиям, первый показатель в сентябре вырос на 0,2%, а второй оказался на уровне 56. Из второстепенной макроэкономической статистики стоит выделить недельное изменение запасов природного газа, а также количество запланированных увольнений по расчетам Challenger за октябрь. Сегодня до открытия рынка будут опубликованы финансовые результаты 3D Systems, Avon, Cigna, Time, а после закрытия торгов – CBS, Kraft Heinz, Starbucks, Tivo. Важных выступлений сегодня не ожидается.

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03 ноября, 13:56

Cigna (CI) Beats Q3 Earnings Estimate, Updates Guidance

Cigna (CI) third quarter earnings surpassed estimates on revenue and membership growth.

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03 ноября, 08:52

Сегодня в США ожидается публикация нескольких важных показателей

В четверг, 3 ноября, в Соединенных Штатах Америки ожидается публикация нескольких важных показателей. В 15:30 МСК будут опубликованы данные по количеству первичных обращений за пособиями по безработице. Аналитики ожидают, что показатель составил 258 тыс. В 17:00 МСК выйдут данные по заказам в обрабатывающей промышленности и индекс экономических условий ISM в непроизводственной сфере. Согласно нашим ожиданиям, первый показатель в сентябре вырос на 0,2%, а второй оказался на уровне 56. Из второстепенной макроэкономической статистики стоит выделить недельное изменение запасов природного газа, а также количество запланированных увольнений по расчетам Challenger за октябрь. Сегодня до открытия рынка будут опубликованы финансовые результаты 3D Systems, Avon, Cigna, Time, а после закрытия торгов – CBS, Kraft Heinz, Starbucks, Tivo. Важных выступлений сегодня не ожидается.

02 ноября, 17:38

Anthem (ANTM) Q3 Earnings Miss, Revenues Beat Estimates

Anthem Inc.'s (ANTM) third-quarter 2016 adjusted of $2.45 per share missed the Zacks Consensus Estimate of $2.49 by 1.6%.

02 ноября, 16:22

Multiline Insurance Q3 Earnings on Nov 3: CI, KMPR, FFG

Multiline insurers' earnings this quarter will benefit from benign catatstrophe losses, the better payroll and employment scenarios should also benefit insurers.

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02 ноября, 14:26

Anthem (ANTM) Misses on Q3 Earnings, Revises Guidance

Anthem (ANTM) misses on earnings

02 ноября, 00:01

Is Lincoln National (LNC) Poised to Beat on Earnings in Q3?

Lincoln National Corporation (LNC) is scheduled to report third-quarter earnings results after market close on Nov 2.