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Old 11-30-2017, 11:04 AM
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Sandwiched between actuaries is a bunch of Missouri doctors politically promoting "Medicare For All."

Slide 39 is pretty interesting. Shows admin costs from 1st or 2nd quarter for "WellPoint" and "Anthem."
Guessing one of those is Aetna or Cigna?

Not sure they know who their audience is.
And, it might be the right path, but did they have some actuaries look at their presentation before presenting to a large group of actuaries?

Also, will they (and hospitals) agree to lowering their reimbursements to Medicare levels?


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Old 11-30-2017, 12:53 PM
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Old 11-30-2017, 01:40 PM
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I like how the doctor completely dodges the questions of 1) doctor's acceptance of Medicare fee schedule and 2) Medicare admin cost PMPM is twice of that from private insurer. He totally "convinced" me to support Medicare for all.

https://www.congress.gov/bill/115th-...house-bill/676

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Health insurers may not sell health insurance that duplicates the benefits provided under this bill. Insurers may sell benefits that are not medically necessary, such as cosmetic surgery benefits.
The above line from the HR 676 bill summary will certain win health actuaries over.
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Old 12-01-2017, 12:11 PM
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He totally "convinced" me to support Medicare for all.
I especially liked the touch that Medicare Advantage and Medicare Supplement plans wouldn't be needed anymore either. There seems to be a disconnect from current reality.
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Old 12-01-2017, 04:44 PM
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Quote:
Slide 39 is pretty interesting. Shows admin costs from 1st or 2nd quarter for "WellPoint" and "Anthem."
Guessing one of those is Aetna or Cigna?
He manipulates the data to show admin as % of cost rather than actual PMPM, which medicare PMPM is higher than private insurer.


Quote:
Not sure they know who their audience is.
And, it might be the right path, but did they have some actuaries look at their presentation before presenting to a large group of actuaries?
Probably not given the obvious mistake on the Anthem/Wellpoints slides.

Quote:
Also, will they (and hospitals) agree to lowering their reimbursements to Medicare levels?
The doctor dodges that question on hospital's acceptance of Medicare fee schedule. Instead he speaks about the CMS Medicare work value meeting where the Medicare Commitee, commenting that current payment model rewards more on procedure than evaluation, and works need to be done to improve the current fee schedule.

I am surprised he did not comment on price control on drugs given his background in Express Script.
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Old 12-02-2017, 10:49 PM
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I am surprised he did not comment on price control on drugs given his background in Express Script.
Didn't he? He had a slide in Canada vs US prices on selected procedures, which included some drugs. I specifically remember him saying that drug prices were out of control during that.
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Old 12-04-2017, 12:55 PM
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Didn't he? He had a slide in Canada vs US prices on selected procedures, which included some drugs. I specifically remember him saying that drug prices were out of control during that.
Oh, I probably missed that slide.

did he recommend any solution?
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Old 12-05-2017, 03:32 PM
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Oh, I probably missed that slide.

did he recommend any solution?
I think it was the general "bargaining power of a single payer" if I remember right. He had much more of an axe to grind about drugs than doctors and facilities, but I think he also didn't linger because it wasn't as much his focus/expertise.

I'm actually pretty pleased the SOA sponsored that while part, since it could be a reality that actuaries deal with regardless of any industry efforts (not to mention in other countries).
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