Letter from the Publisher – Jun 2012

By on June 16, 2012

It looks like my insurance company will be sending me a check. According to an April article I read in The Washington Post, medical insurance companies will be reimbursing customers this August (coincidentally, of course, before elections) for a “medical loss ratio”. These companies were supposed to adhere to the 2010 health care laws that specify 80% of our premiums have to go to our medical expenses (the rest of it is supposed to cover the insurance company’s costs). Now, that wasn’t my first rodeo. I knew what was going to happen next.

Sure enough, one week later I got a letter from my insurance company (the third of its kind in the past year) saying they were raising my premiums… again. They wrote a very nice form letter that was just vague enough for me to have to interpret:

What they said: Your rate is changing due to increased consumer demand for services and rising medical costs.

What they meant: The government is making us cover more health issues. Yes, we know charging you more money doesn’t make health care affordable, but we aren’t the government and can’t operate at a deficit.

What they said: Your rate is going up because of medical advances.

What they meant: We needed to write this to make you think you might live longer if you keep paying us.

What they said: We are keeping costs down by pursuing the best rates for health care products and services on your behalf.

What they meant: We get to tell the doctors what we want to pay them, and keep the rest of the money.

What they said: We are making more tools available to help you better manage your health and out-of-pocket expenses.

What they meant: We want you to think that by paying more out of pocket, it’ll keep your premium costs down. It’s a trick. We have no intention of ever lowering your premium.

What they said: We are working to get a higher quality health care from

our network providers, such as doctors and hospitals.

What they meant: Yeah… we’re going to go with the cheapest option no matter what. We just want to give you a reason why you can’t see that specialist anymore.

What they said: You have a choice.

What they meant: You can go without insurance.

What they said: We encourage you to call with questions.

What they meant: We don’t want you to call, but we have to put that in the letter to sound polite. Just in case you take us seriously, though, we have a nice automated system that will make you insane. But don’t expect us to pay for a psychiatrist.

So, I suppose when/if I receive a check this fall, I’m going to get another letter from my insurance company telling me how wonderful they are to give me my money back. I believe the estimated average check was around $127 and since my monthly insurance cost has gone up more than that in the past year, at least I have comfort in knowing where my extra premium went for one of those months.