Fwd: qotd: Private insurers go where the money is

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-------- Original Message --------
Subject: qotd: Private insurers go where the money is
Date: Thu, 13 Feb 2014 12:03:10 -0800
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



The Wall Street Journal
February 12, 2014
For Many, Few Health-Plan Choices, High Premiums on Online Exchanges
By Timothy W. Martin and Christopher Weaver

Hundreds of thousands of Americans in poorer counties have few choices
of health insurers and face high premiums through the online exchanges
created by the health-care law, according to an analysis by The Wall
Street Journal of offerings in 36 states.

Consumers in 515 counties, spread across 15 states, have only one
insurer selling coverage through the online marketplaces, the Journal
found. In more than 80% of those counties, the sole insurer is a local
Blue Cross & Blue Shield plan. Residents of wealthier, more populated
counties in the U.S. receive lower-priced choices than those living in
counties with a single insurer.

The price differences reflect the strategy of insurers to pick markets
where they believe they can turn a profit—and avoid areas of high
unemployment and a concentration of unhealthy residents they deem more
risky.

Aetna Inc. and UnitedHealth Group Inc., for instance, have limited their
participation in the new health-insurance marketplaces, where consumers
shop for coverage, to a much smaller map than their traditional
business. They offer coverage in more counties outside of the
marketplaces, where plans are sold directly to consumers and federal
subsidies aren't available.

Aetna targeted areas with stable levels of employment and income to
attract desirable customers to its marketplace offerings, Chief
Executive Mark Bertolini said last fall. "We were very careful to pick
the markets" where the insurer could succeed, he said.

Reversing the trend presents a challenge because low-population areas
are unlikely to draw more insurers, said Glenn Melnick, a health-care
economist at RAND Corp: "I don't think the health law can overcome those
economics."

http://online.wsj.com/news/articles/SB10001424052702304450904579366950560009742


Comment: We've always know that insurers market their plans in areas
where there is the greatest potential for business success. As USC
Health Finance Professor Glen Melnick explains, the Affordable Care Act
cannot overcome those economics.

Clearly we have the wrong model for reform. Private insurers respond to
business opportunities. Public insurance, such as a single payer
national health program, simply enrolls everyone; there are no market
decisions to be made.

So is it going to continue to be about private insurance markets, or
will it be about patients - all patients? An improved Medicare for all
would be about the latter.