seeking knowledge and laughter, putting a bullseye on inaccuracy

Health Care, Less Funny

Made it back this morning just fine. A bit tired at first, then more so throughout the day. Early to bed tonight, no doubt! But for right now, Michelle and I are watching an important interview - Bill Moyers interviewing medical insurance insider, Wendell Potter. The interview is about 30 minutes long - and important to understand why health care reform is so difficult.

This is what happens when health care insurance companies maximize profits:

There's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.