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The Health Insurance Industry’s Unnecessary Expenses

I have described how the healthcare insurance industry loads its expenses into direct patient care expenses to increase their profits.

The Medical-Loss Ratio calculation is not reported by the traditional media. The healthcare insurance industry spends less healthcare dollars on direct patient care after it is permitted by federal and local agencies to load its expenses into the direct patient care column.

Simply put, the healthcare insurance industry cooks the books to increase its net profit.

Another way to increase profits is to shortchange physicians on medical claims. In fact, 20% of medical claims payments are inaccurate according to the American Medical Association’s (AMA) fourth annual National Health Insurer Report Card. Claims-processing errors by health insurance companies waste billions of dollars and frustrate patients and physicians.

This is one of the reasons the RAND report about physicians controlling waste is so absurd to me. The healthcare insurance industry creates waste in order to increase net profit. Read more »

*This blog post was originally published at Repairing the Healthcare System*

Health Insurance And “Medical Loss Ratio” Foolishness

Like Ezra Klein, smart people keep saying foolish things about the health insurance business. This time it’s a pair of bloggers talking about the largest expense that health insurers face — their “medical loss ratio.”

According to Richard Dale at the Venture Cyclist:

[W]hy do they call it Medical Loss Ratio? Why is looking after me (or you) called “Medical Loss,” when the whole point of a healthcare system is to look after me (or you)?


Alan Katz, one of the leading health insurance bloggers, surprisingly links to this with approval, saying “words matter.” The problem? The word “loss” is probably one of the four oldest words in the insurance industry. I’d say the others are probably “premium,” “commission,” and “profit.” Should we start outlawing these words, too? Read more »

*This blog post was originally published at See First Blog*

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