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Edited on Thu Dec-24-09 03:48 AM by coti
To begin with, the MLR is weak in that while, in theory, 80% or 85% of insurance companies' revenue going to health costs is better than the 70-73% they had before, that increase is not enough to put a significant dent in the billions of premium dollars being wasted to corporate profits and other inefficiences, especially considering the millions of new, mandated policyholders they are gaining.
But that's not the weakest aspect of the MLR. The weakest aspect is that, as a tool, the method of regulation that the MLR uses is open to an incredible amount of manipulation. As noted in Cenk's interview with RJ Eskow, corporations have very clever accountants who, depending on who they're talking to, can make it look as if they're losing money or just as well like they're stacking up millions of dollars by the hour. It's all in how their costs are compiled and they will make sure everything even conceivably describable as a "health" cost goes into that 80/85% column- at least when talking to the Feds.
That leads me to the most dangerous part of the MLR, the part of it that makes it counterproductive: That ratio is a cost-plus mechanism, meaning that the more the insurance companies spend on health costs, the higher their profits can be. When you consider that corporations are for-profit, money-hungry machines, that sounds like a recipe for increasing healthcare costs even faster than they were increasing before.
This form of regulation isn't effective. It's actually pretty dangerous.
As for your other points-
Polls show that voters are already on the side of the public option- about 60% of them support it. Yet we still can't get the votes. Why? Because of the industry money corrupting our legislators through lobbying. The flow of that money into our politician's pockets will actually increase if this bill passes.
As for the opt-in provision, it's not clear to me whether that is in the bill yet. I heard it come up as a possibility to be added in conference. But that only brings up another concern- if they have to put in an opt-in clause, does that mean that without appropriate opt-in clauses states will be pre-empted by the legislation from beginning their own single-payer programs?
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