Left out of this article is the threat to the DoJ by the CEO that they should allow Aetna to merge with Humana or else they’ll pull out of the exchange. This has more to do with trying to get their way than anything else.
Agree. This is more about positioning. Eventually, the US moves to a Swiss-type system, whereby coverage is universal and private health insurance is mandatory, or the standard advanced economy model of universal with the state providing the bedrock services and infrastructure and a constellation of private insurers and reinsurers surrounding. Aetna will want a piece of the action no matter how this goes down. What is clear is that some of the free-ridership tolerated in the past, a pot of about $600 billion a year, will get reallocated.
Good article. Tierney-- you write “less options”. It would be more correct to write
“fewer options.” Thanks.
As noted, every major piece of legislation that significantly alters or disrupts an existing marketplace has always had the luxury of a willing Congress to adjust, to improve on the law. The ACA is unique because of nothing more than an obstinate Republican Party that has gerrymandered itself to (current) Congressional ownership, popular vote be damned. Donald Trump may be just what the ACA needs to unclog the toilet.
Aetna, same as every other major insurer, could give a crap about whether folks are healthy or insured or not. ALL they care about is whether they’re making money for shareholders. About whether Wall Street is happy. And whether they can get even more ridiculously huge multi-million dollar bonuses/raises. Period.
Bertollini in particular was all gung-ho about the exchanges until the DOJ sued to stop the Humana merger. After the DOJ action to avoid monopolies in the health insurance industry, immediately Bertollini turned sour on government and exchanges.
It’s time to cut out the wasteful middle man. MEDICARE FOR ALL needs to be one of the options offered nationwide. If the Private Insurers “can’t compete” with a Medicare For All (aka Public) option, then in the parlance of capitalists and private enterprise fetishists everywhere, the private insurers are not very efficient and are unable to innovate in the marketplace, therefore they should inevitably fail for the good of the marketplace. Period.
Which was preceded by the GOP’s tolerance of skyrocketing premiums and a cartel of a small number of insurance carriers conducting the equivalent of a protection racket on the American public.
In NY, for an individual Single Parent and Child plan needed for many years, there were 3 insurors: Blue Cross/Blue Shield (which I believe originated as a Not For Profit) at well over $2,000 per month, AETNA and Oxford. The plans would start at arond $600 per month and quickly escalate to over $1,000, competing with and surpassing the monthly housing expense as the largest percentage item of the family budget.
When HRC tried to address this as First Lady, they branded the attempt Hillary Care and the media went along as everyone had a grand old time to keep legislation from happening (with special help from Betsy McGauhey).
When Obama came along, the Republicans delayed delayed delayed, then offered over a thousand amendments to the legislation with an assist from Blue Dog Max Baucus’ committee. After all that, not a single Republican voted for it, and the roll call on the Vote became a platform for Boehner and others to brand the bill as a Job Killer, when the premiums in their cartel marketplace had actually become and had been for years, the real Job Killer.
The GOP and the largest insurors have never approached the ACA or the underlying problems in good faith. Prior to his implosion and resignation, Anthony Weiner was one of the few congresspeople very much on top of the insurance cartel and its abuses.
Screw that Aetna CEO! He’s noting more that a parasite pimp who profits off of denying claims.
It’s time to put these parasites out of business and go to Single Payer!
I think that this underscores the general flaws in relying on insurers in the private sector to cover people. It has always been that way, but it is a conflict. In some ways it hurts that many young people are not jumping in with numbers as expected. Partly because they are on plans for longer or wahtever.
Thank you. This article needs to be updated to include the Aetna CEO’s threat.
The legislation gave away far too much power, life and death power, to the insurance industry. This is no secret. The result is that Obamacare is an incremental reform, which doesn’t mean it hasn’t helped millions.
I shop and purchase healthcare coverage for our small company. Every year we solicit proposals from all the major healthcare companies that serve the mid-atlantic, and we are currently enrolled as a group in the ACA exchanges. I have never seen a competitive coverage quote from Aetna for our small, not even close. In fact their offerings reflect a lack of awareness of that competitive marketplace. My sense is they are still focused on their bottom line rather than being a player in the changing healthcare insurance industry. They are getting bigger and posturing for a return to the old days of big healthcare insurance profits.
" This has more to do with trying to get their way than anything else." BINGO!
Screw Aetna! Open Medicare enrollment to anyone regardless of age. Watch the Medicare premiums go down and more people jump to it!
True Story: Many years ago, in another life, I worked in the medical field. Primarily, I was administrative, study coordination, keeper of insurance library (provider contracts, applicable state & national laws, as well as basics of the company, etc.) and all things billing. This one private physician I worked for was a surgeon and he had a good number of carrier contracts. This was in a time prior to electronic claims filing – I did everything by hand in my typewriter or through an in-house printer claim form program. Though I had issues with different carriers at different times, there was one for which I had a particularly difficult time. I tried to keep up with the claims on a daily basis, weekly at worst. Some of the batches were as few as one or two, some as many as twenty or thirty. Somehow, the company would “lose” the claims or they would “never show up.” It was frustrating to say the least because the carrier required “original claim forms,” never copies (on the initial claim). A few times, I got into arguments with whatever poor “supervisor” was fortunate enough to be working that day. After the markets changed to primarily IPAs (Independent Provider Organizations or Independent Physician Organizations) and Managed Care Organizations, I happened to have lunch with a guy who was a former employee of one of the old carriers when they were one of the few kings in the market. He told me that rarely did they ever “never receive” our claims (though he’d never worked on any of mine in particular) – those claims were in “File 13,” the garbage can … once they’d been shredded. He told me this was a regular occurrence and that’s how the insurance carrier did their quarterly planning. I’d figured as much. I told him I was glad when electronic billing became the standard because it was very difficult to deny claims were received when I had electronic verification codes. He agreed, but told me they had other ways to tamp down on “the cost of lives.” By and large, the health insurance carriers in the USA are horrid creatures and need to be slayed. I personally have no issues with anyone making a decent living–all of their employees, but raping people is a whole other ballgame. I believe the ACA is a good beginning. Now, we must change Congress so the President has the ability to seek the additional changes needed for all Americans to have excellent basic healthcare and have affordable catastrophic care. In our extremely wealthy society, there is no other reason than sheer greed that it hasn’t happened before now.
- Aetna can’t make money without cherry picking its customers. They’re altering their risk pool by dropping people who aren’t healthy enough to work.
"It’s a statement that these insurers are by and large not terribly competitive the way they came in, and if they are going to make money in this market they’re going to have restructure and re-orient to the characteristics of what the consumers want.”
This. Especially as it relates to United Health. They didn’t put any thought into their entrance on to the exchanges. They sat out the first year hoping it would all go away. I sat in on industry wide calls with HHS where the United folks were WAY behind the curve a year into this deal. There’s actually some competition going on and the big guys have been structured in such an inefficient way for so long, they can’t do it.
The fact that Cigna is expanding on to exchanges is getting left out.
I believe you mean “more correcterer”.
Regarding the article itself, now would be a good time to have a public option, with some sort of tax on the private insurers to counter the cost of serving the more rural or sick populations that they are dropping.
The solution is obvious - we need a Democratic President, Senate and House. Go Vote!
Fuck Aetna.