Why are Insurance Premiums always going up with fewer benefits?

It’s difficult for me to explain when people facing a premium increase, why.  For some reason, I feel it’s argumentative.   I’ll hear that they aren’t having claims, they watch their health, we should have Medicare for All.  I hope it won’t wind up as Medi-Cal for all, like some think ACA/Obamacare did, etc.  In addition, Covered CA agents are mandated to help people enroll in Medi Cal without any compensation!  

Thus, I’ve compiled on this just about every resource I could find to help explain why it’s so expensive to go to a doctor, hospital or get a Rx drug.   Including a feed from CHCF California Health Care Foundation on the latest health care news and trends

Please note also, that under ACA/Obamacare and even before, Insurance Companies are mandated to spend under Medical Loss Ratio Rules a certain amount 80-85% on health care costs.  My commissions have been cut because of this, as it’s not considered health care.  Thus, I’m doing more work, for less pay.  With the internet, it does help to make it up on volume.

Options to improve affordability in CA Health Market 68 pages  June 2019

President Trump said Insurance was more complicated than anyone knew.  He should have asked me or reviewed my website!

If you have comments or questions, please post those below.  You don’t have to put in your name.  

DMHC on Medical Costs

 

Life Magazine 1993 - Medical Costs have been an issue for a LONG Time

Life Magazine 1993 – Medical Costs have been an issue for a LONG Time

Dave Ramsey – Obamacare screwing up the American Economy

California Health Care Foundation
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Daily News Digest 
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President Trump
Health Care is VERY complicated
He should have asked me

Increased demand for health care.

More and more people with medical insurance are relying on the health care system as new technologies and treatments become available. This leads to a greater number of claims for payment by insurance companies, the costs of which are passed back to health care consumers.  (articles on how to be an “active consumer”) Employer-sponsored coverage  consumer demand for broad networks of hospitals and physicians and the easing of restrictions by health plans, coupled with hospital consolidation and a reduction in excess capacity, have increased the bargaining clout of some hospitals vis-à-vis health plans.

  • “Hospital spending is back with a vengeance, and the likely causes are the retreat from tightly managed care, which has increased demand for hospital services, and rising labor costs,”
  • The hospital industry says rising costs simply show rising demand.  “The driving factor is Americans are using more hospital services.”
  • But health insurance companies say hospitals negotiating for money, not simply consumer demand, fueled the increases.
  • The biggest contributor to utilization increases is advancing medical technology new drugs, medical devices, surgical procedures, and diagnostic tests.
2016 Premium Expense Breakdown
2016 Premium Expense Breakdown

AM Best TV 
US Health Insurers Profits rise due to favorable trends
Business Wire Summary 

Pent up demand when ACA started
Government Programs Medi Cal

 

 

See our historical page for many items prior to 2014 – the best are still on this, our main page.

1993 Life Magazine $64K Hospital Bill  Double Bypass & Aortic Valve Replacement www.life.com/ archives Nightline Transcript (11/12/1993) ObamaCare Price Sticker Shock? 3.2013 – Sacramento Bee

Dialysis can cost $52k/month! The average patient lives 3 years.dialysisppo.com
anthem.com cost of care 9.2011
The Insurance Companies forecast their trends based on real claims experience (Medical Loss Ratio)  and expected/contracted unit cost increases

Average Billed Charges – 2017 Transplant  Average Transplant Charges

click to enlarge and view course CA Health Line.org

Cost of developing new technologies and treatments.

Over the past decade, scientists have made significant advancements in the treatment of certain diseases. Unfortunately, just like any new product, the cost of developing these new technologies and treatments is extremely high. Plus, unlike other technology, health technology generally doesn’t decrease in price over time. How Changes in Medical Technology Affect Health Care Costs KFF.org

Increase in uncompensated care.

There are an estimated 44 million Americans who don’t have health care insurance, and the cost of providing care to this group is borne indirectly by the insured consumers.
All of these increased costs flow through insurance companies and eventually trickle down to employers in the form of higher medical costs.
“The volatile combination of rising costs, increasing premiums, and a slowing economy have set the stage for consumers to pay more for care and an increase in the number of uninsured Americans,” Ginsburg said. heartland.org/
Hospital Costs Drive Medical Inflatiom upenn.edu/ The Rising Cost of Health Care

Increasing rates of chronic disease among Americans

Obesity is a major reason in determining individuals’ future rates of healthcare use Medical care prices advanced 0.3 percent last month and were 4.3 percent higher over the year. – BLS

Huge and often unnecessary costs in the last 6 months of life

America’s aging population.

The “baby-boom” generation is entering its peak health-care-using period. In fact, over eighty million Americans will turn 50 in the next 10 years. The cost of providing health care to them will be staggering.

Here's the premium for the plan you are NOT using. This guy has $4k/month in bills
Here’s where the premium for the plan you are NOT using goes. This guy has $4k/month in bills – be thankful it’s not you.

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