Screwing the Self-Employed

shrinkmanIt's summer, officially the time for health insurance companies to jack up individual health insurance premiums by double digits. Such is the case of Regence BlueCross BlueShield of Oregon, about to increase their never ending shrinking health care coverage by 22.1% on average:

Concerns about surging health care costs drove more than 150 people Thursday to hear Oregon's largest health insurer defend its request to raise premiums an average 22 percent.

In the Oregon Insurance Division's first public hearing for a rate request in more than 20 years, administrator Teresa Miller grilled the president of Regence BlueCross BlueShield of Oregon.

Then Laura Etherton, a health policy advocate for the Oregon State Public Interest Research Group, urged the division to reject the request.

"It is not justified, and it will only make matters worse," she said.

BlueCross sticks it to the self-employed or any other small business buying individual policies every year, with a never ending shrinking pool of customers, now down to 59,447. They used to cover over 100,000 in Oregon but clearly people are dropping out because they cannot afford the premiums. Even with health insurance, these individual policies do not provide enough coverage.

It's not just Oregon, in Connecticut, health insurance premiums have risen 102% in a decade. Even worse, those buying individual health insurance pay the most if they get Cancer. This includes those who have no insurance at all!

Among these patients, those who buy private insurance on their own - instead of through an employer - pay the most out-of-pocket for their health care, compared to patients who have other forms of insurance or none at all.

Of people who had non-group health insurance, 43 out of every 100 spent more than 20 percent of their income on cancer treatment and insurance premiums.

In comparison, 26 out of every 100 people without insurance had high out-of-pocket costs, as did nine out of every 100 people whose employer paid for their insurance.

How does Regence BlueCross BlueSheild of Oregon justify yet another gouging of individuals? By lying about the actual costs of course.

BlueCross claims health care costs have risen 12.6% in a year. O'Reilly? Below is the rise in health care costs from CPI. Graphed are the percentage increases from one year previous. See anything even close to 12.6%? Of course not.



and just Health care services:



and here is just prescription drugs:



What BlueCross BlueShield is doing is sticking it to the most vulnerable, those who are individuals, and treating them as a high risk group. You get to pay individual rates, yet BlueCross gets to treat you like a high risk group. Nice huh. They are not combining and spreading the risk among all policies, bundling individual with group. Nope, individuals get a class all unto themselves, referred to as a death spiral and are clearly getting discriminated against in that process.

You know you cannot even easily find the details of such insurance premium gouging agenda, or decent details on coverage, yet the bottom line, individual health insurance is almost like having no insurance at all.

The Obama administration is supposedly lowering premiums by 40% in 17 States, but there's a catch, you have to have a medical condition and be uninsured for 6 months.

Where's the group rate for individuals, nationwide? Nowhere. Supposedly in 2014, this Obamacare mandate for all to buy health insurance will lower the premiums. Yet a study by the CBO claimed those individual premiums will actually increase by 10-13%. While half of individual policy holders will be given subsidies, it's clear, once again, the individual will get the shaft, for they will not qualify for those subsidies. To buy individual health insurance and obtain a subsidy one can only make 400% of the poverty rate level. So, not only are individuals being classified as high risk defacto, those who are doing better than only 400% above poverty will be the most exposed and vulnerable to the never ending vulture like aspects of the health insurance companies. Talk about punishment for doing well and striking out on your own, this is it!

Even worse, the self-employed are getting screwed on a tax break to be able to write off medical costs, like any other business.

Paula Fleming, a freelance copy editor in Minneapolis, spends $3,600 a year on bare-bones health insurance for herself and her husband. For the 2010 tax year, for the first time, she could deduct that amount from her income when she pays the self-employment tax, the 15 percent levy all freelancers are required to contribute to Social Security and Medicare, saving her $540. Fleming's not counting on the same break for the 2011 tax year, though, because Congress passed it solely for 2010 in last year's Small Business Jobs Act. "When the law no longer applies," she says, "that's more money out the door."

There are a host of other taxes the self-employed pay as well, including all of social security and medicare, yet the benefits of these programs are now under attack to be reduced.

While lobbyists twist the buzz phrase, innovation to really mean global labor arbitrage, American entrepreneurs suffer. The truth is those starting a business, in particular the self-employed are getting the shaft. From individual health insurance to taxes to retirement and especially in terms of getting paid, people trying to work for themselves have almost no legal recourse to collect, unlike wages.

If they want people to start businesses, they need to offer better tax advantages, and especially benefits for people. Else, one is tethered to the wage slave job, stuck being a corporate drone, simply to get some sort of health insurance. Most businesses start out as one and punishing that one when corporations are slashing jobs and shipping them overseas is unAmerican. Punishing people for striking out on their own is what is going on here and that's a policy no American, left, right, center and fringe, will sign onto.



Books of Business

You're exactly right about the sham we call private health insurance The individual policy market is the clearest example of all that is wrong with the private health insurance system. Using Books of Business and Death Spiral Pricing they force those who have developed the slightest hint of a possibility of even a minor future claim to have to remain in the current Book (they won't pass
new underwriting) - meanwhile the company makes the rates increasingly unaffordable to drive those people out of the policy (and any potential future claims expense). That way the book gets smaller, they can increase the rates to exorbitant levels based on "projected claims experience" driving out more customers who might likely have future claims (or reduce their benefits to next to nothing in order to try to afford some kind of coverage). At the same time, those in good health with no potential hint of an issue, move to new policies (and low - new so no claims experience - rates) since they will pass new underwriting.
The companies don't care if they move to a competitor because the company in turn will pick up new customers who left the competitor (but of course will pass underwriting).
And the sham starts over.

No wonder the insurance companies can afford lobbying and buying support - it's a license to print money vs fulfill a need

Rep. DeFazio - remove Health insurance exempt from anti-trust

Peter DeFazio has a bill to remove health insurance companies as being exempt from anti-trust.

When it comes to individual health policies, what competition? They all are horrific. I wish I could find the raw numbers and percentage declines of actual people covered, on individual health.

I'm positive on these Oregon figures I quote but it would be nice to find the national and regional raw data on numbers as well as premium increases vs. coverage.

It's terrible that

It's terrible that individuals get no tax break for taking the responsibility - and making the sacrifice - of having health insurance. This is something that public officials could change. The rich get tax breaks. Why not people buying their own coverage.

By the way, states already have anti-trust laws against insurers. The federal stuff is just grandstanding. Do something real for people. Give them the same tax break that employer groups have.

At the Regence hearing, it seemed like people weren't listening to themselves. They talked about the high cost of health care and don't seem to connect that with the reason health insurance costs a lot. You can't sell cheap health insurance to cover high costs. Just doesn't work that way. What's really ironic is to hear doctors talk about health insurers denying care. They can't deny care. Only doctors can deny care.

Regence hitting the blogs I see

Just because Oregon has the worst press corp. of almost any state, doesn't mean Regence is getting away with this one.

You're full of shit. Insurance companies can and do deny care by denying coverage and they do it every day.

You're lucky the press in Oregon sucks so badly, else, instead of 150 people protesting, you would have gotten all 59,000 policy holders there, blasting this B.S.

Bottom line, you're screwing individual health care policy holders because you can. There is no lobbyist out there, representing individuals to fight back. You can see by your own numbers and anyone reading this, I want nationwide statistics, on the number of individual health policy holders dropping like a stone. You're busy, through expense, dropping people from their health insurance defacto, by raising rates to the point no one can afford the premiums.

100k to 59k and I'm positive the number was 89k just a year and a half ago. Regence BlueCross BlueShield of Oregon is busy purging their individual health policy holder rolls by reducing coverage, dramatically and raising the premiums.

If someone actually gets sick on your individual health plans, they are bankrupt, period, thus will not be able to pay the premium and will be dropped, de facto.

Nice plant Regence BlueCross BlueShield troll. We know all about paid staffers out hitting social media to spin information.

This is why we need change!

Blue Cross Blue Shield of Michigan raised my premium by 43% this year. I had to go with a much higher deductible and less service. I have no sympathy for workers who complain about a $20 increase - try a $350 increase per month. Because grouped insured workers don't know the true cost of their own health care, they aren't aware of the extent of the greed of the insurance industry. What we need is a level playing field where everyone has health insurance, and everyone pays their own costs (yes, employers should compensate). And while we're at it, do away with the high risk categories - we're all high risk at some point in our lives, and those that work dangerous jobs - well society needs firefighters, police officers, and coal miners. We need to stop dividing ourselves and realize that we are strongest when we're in one huge group.

BlueCross raise premium 43% in one year

Folks, please write in a comment how much they raised your premium, how much they cut benefits and which state you are in.

Thanks for sharing this but they must have these state committees bought and paid for because nothing happens to rein them in at the state level.

I mean give me a break! The CPI numbers are easily available and one can get regional and state inflation numbers assuredly if they call up the BLS, BEA and simply ask.

No where near these rate increases, so claiming it's due to rising health costs is pure bunk, not justified, yet no agency, no committee, no state is stopping these insurance companies.

Oregon passed health exchanges, in effect 2014

Oregon just passed heatlh insurance exchanges.

Under the terms of the new health insurance exchange law, a nine member board will be appointed by the Governor to oversee standards for participation and ensure transparency. The governing board must include at least two consumer representatives and no more than two representatives from various health care sectors, including insurance. The board will also provide a plan for overall management of the exchange including the creation of a public corporation for the exchange by 2012.

Consumers will have more information than ever before about the policies available to them and will be able to keep policies that they got from their employer even if they leave their position. Small business is also expected to get a boost from the bill which gives them more flexibility in choosing benefits and allows employees to choose their own policies.

I don't see what good this is really going to do. It takes more work, but one can compare plans and premiums themselves now, it just takes a hell of a lot of study.

The problem is the risk pool, the premiums, and the gouging.

Also a problem with ERISA

Oregonians were agitating for something - some for single-payer.

Vermont has adopted single-payer, but it will almost certainly be struck down by federal courts because the federal Act of 2010 ('ObamaCare') failed to include amendment of ERISA.

Insurers are preparing suit against Vermont ... but maybe they won't proceed.


Meanwhile, watching Oregon

Meanwhile ... watching what happens with the Oregon State Bank thing.

Include N.C. Blue Cross

Try being 60+ and buying Blue Cross insurance in NC. My premium has increased from $200 a month to $400 in 2011 and is going to $780 in 2012. I will have to drop coverage and just die because I can't afford those kinds of rates. No one seems to care...I worked for 40+ years spent time in the service serving the country and never complained as my wages were taxed and taken. Now that I am reaching retirement age what I have been able to save will soon be gone. I will then have to sell my home give all that to the government and be living in the streets to qualify for any kind of help. No one that is just an everyday Joe can afford to live longer than the day their health begins to fail and the health system takes hold.

The young people (our children and grandchildren) should sit down and refuse to be a part of this system.... What do they have to look forward to...? starving to pay for medical help or the medicine they may need to survive.

Which is better?, refusing to be a part of a corrupt system or starving when they get old and can no longer work...