More Fallout From Obamacare, Fewer Insurance Companies and Less Choice

We have to pass the bill so you can find out what is in it – Nancy Pelosi

Principal Financial Quits Writing Health-Care Policies

One of my harshest criticisms of Obamacare was the secretive manner in which it was written. Drafted behind closed doors by congressional staffers and lobbyists, Pelosi, Reid and Obama did not make the bill available for review before passage. The ability to deliver votes or large campaign contributions determined who had input into the bill.

Large insurance companies were one such pressure group, along with trade unions, allowed to influence the actual wording of the legislation. Although large insurance companies are motivated by profit and not the health of their patients, no one can accuse them of stupidity. A simple number these companies surreptitiously managed to slip in the bill will simultaneously guarantee their profits and destroy their competition. The article referenced is the first example of one such deception.

Hidden the 2000 pages of the health care bill is the requirement that 80-85% of health care premiums be spent of patients for actual health care. For those ignorant about the functioning of insurance companies, (Congress, Obama, the national press and the populace), such a number seems quite reasonable. It keeps those greedy insurance companies from taking too much of the money for themselves, and guarantees money for patients. In actuality, this numerical requirement will limit choice, increase costs, and insure the dominance of the legacy insurance companies.

Paying health care claims involved fixed and variable costs. These fixed costs include complex computer and software systems to deal with the arcane medicare rules prescribed by the government. Once these systems are installed, scaling them to larger operations is less expensive. Hence, as insurance companies get larger, their fixed costs become a smaller percentage of overall expenditures, which is common in many industries.

Meeting the 80% ratio is therefore far easier for larger than smaller companies, and will be virtually impossible for new start-up insurance companies. I think the 80% number was not just pulled out of the air, but probably represents the ratio already being spent by Anthem, Aetna, United Health, and the other large companies.

So in one stroke of the pen, large insurance companies have been able to force out smaller companies, eliminate the possibility of new competition and assure themselves of a 15-20% profit margin. I would say Insurance companies campaign donations were money well spent. The outcomes for the rest of us will be fewer choices, little innovation, lack of competition, and further centralization of power in the hands of a few large corporations.

The secretive manner in which Obamacare was written insures more deceptions remain to be discovered. Who knows what other pressure groups and lobbyists have slipped into the bill to protect their interests at the expense of the American people? I will not be surprised, nor am I optimistic.


Insurance Companies and Universal Health Care

Insurance companies serve a very important function in our society. The purpose of insurance is to share risk. Risk is the amount of economic loss that someone is willing to assume in an activity. For instance, a bank would not loan money for the purpose of buying a house, unless the house was protected against losses such as fire, wind and other perils. That protection is provided by a Homeowner’s policy.

A loan to purchase an automobile would not be available unless the car was insured for losses by theft or collision. That protection is provided by an auto policy.

Health insurance is a policy that shares the risk of losses caused by injuries or illness. A share of the risk is assumed by the individual through a deductible or co-pay. In-other-words, if someone visits the doctor, that individual may be required to pay the first $15 or $20 of the visit. The health insurance company assumes the risk of the remainder of the cost.

That shared risk comes about through an exchange of ‘consideration’. Consideration is value. The insured pays a premium in exchange for the promise of the insurance company to pay certain costs associated with the insured’s health care. Which brings us to the controversy surrounding the government’s efforts to institute what some call universal health care.

No matter what side of the argument you are on, in favor or against universal health care, one issue has been settled. President Obama stated publicly that it is impossible to insure the ‘uninsured’ without additional costs. So, the idea that this will be a ‘deficit neutral’ policy has been debunked by the administration itself. Either taxes go up to pay for the program, or health care will have to be rationed to keep costs neutral, or bring them down.

In response to the public out-cry about a government health care program, the administration has called the insurance companies villains. After all, insurance companies exclude preexisting conditions for some period of time when an individual enrolls (however that is not always the case with group policies), and insurance companies are making a ‘profit’.

PreExsiting Conditions

Think about the concept of risk and preexisting conditions. An individual has a home that has been damaged by fire. Would a homeowner’s insurance company now write a policy that would cover the repairs to home caused by the preexisting fire? Of course not! That is not shared risk, that is bad business.

An individual has a preexisting health condition, say diabetes. Purchasing a policy that would exclude the treatment for diabetes for a limited period of time (usually two years), now results in a shared risk. The health insurance company will cover the person for other perils, and if that individual pays the premiums over time, that exclusion regarding the preexisting condition is then dropped.

Is it possible for the government to insure everyone in the United States and force insurance companies to provide policies without regard to preexisting conditions? It is possible, but not without driving the cost of health-care way up. After all, the money to pay the doctors and hospitals have to come from somewhere and President Obama stated that ‘We are out of money’. Since the government doesn’t earn money, its only source of revenue is taxes.


Insurance companies are being cast as the bad guy since companies make a profit. Which do you prefer, companies that are well run that make a profit, or a company like General Motors that required billions of dollars of taxpayer money to bail the company out? A profit is what allows companies to expand services and provide jobs. Companies that fail to make a profit, go out-of-business.

The government not only fails to make a profit, as a well run business entity should, it runs at a deficit. The latest example is Cash for Clunkers. Not only was taxpayer money used to subsidize auto sales, now car dealers are complaining that the government is not sending the checks for the Clunkers that were promised. It appears that many buyers will have lost their old cars and now face repossession of the new cars purchased since the money for the program did not actually exist.

This does not bode well for a government run health care system.

Tort Reform

Doctors and hospitals must practice defensive medicine. People will sue for anything. Tort lawyers use a ‘shot-gun’ approach when filing a malpractice lawsuit. All doctors, nurses, technicians and hospitals involved in a case are named as a defendant, whether that party had any actual responsibility for the claimed injury and damage.

We need a loser pay system, which provides that anyone who brings a lawsuit and loses, is required to pay the other side’s attorney fees and expenses. That would do away with most frivolous lawsuits and bring the costs of health care down.

Big Government Solution

Government should be required to live within its means. It does not, and the government, not insurance companies, is the villain in this scenario.

The founding fathers did not foresee a large, powerful centralized government. That is what was the war of independence against England was all about. The US Constitution delegated specific powers to the Federal Government, and it does not specify taking over any private sector industry.

Medicare and Medicaid are government health care programs on the verge of collapse. Even President Obama admits Medicare cannot be sustained. No program can be sustained when it runs at a deficit and all government programs run at a deficit.

Universal Health Care will run at a deficit from day one and that is just bad business.

Insurance Company Complaints – Who Are the Top 10 Companies With the Least Number of Complaints?

The New York State Department of Insurance (DOI) just released the 2008 Annual Ranking of Automobile Insurance Complaints. The report has been issued to help consumers find the automobile insurer that best meets their needs. You can use this report to compare the ranking of the insurance company you are doing business with now, or check another company you may be considering.

This report analyzed data collected from 2006 and 2007. It only ranks companies doing business in the State of New York. However, as New York is a heavily populated state, with both big urban centers and big suburban areas, the report can be considered a good representation of insurance company performance nationwide.

How The Ranking Works

The insurance companies are ranked on a complaint ratio. The ratio is calculated by the number of complaints upheld against companies as a percentage of their total private passenger auto business.

Insurers with the fewest upheld complaints per million dollars of premiums are shown at the top of the list. The companies with the highest ratio of complaints are ranked at the bottom.

Other Information to Consider

The ranking of an insurance company is important, but it is only one characteristic that consumers should weigh when considering doing business with an insurance company. Others are:

o Referrals from friends, relatives, neighbors or co-workers about the experiences they had with their insurance companies
o Price of the premium versus perceived value
o Search the Internet for other ideas
o Check your state’s DOI website, which may contain valuable consumer information about companies doing business in your state.

What The Ranking Does and Does Not Contain

o Private passenger insurance is the only type evaluated.
o It only includes the complaints referred by consumers to the DOI. It does not include complaints made directly to the insurance companies.
o Complaints are “upheld” when the DOI agrees with a consumer that an insurance company made an inappropriate decision.
o Information from prior years is included in the tables so consumers can see if the company has improved or gotten worse.
o All companies with at least $10 million in premium in 2006 and 2007 are included in the ranking. Insurers with less than $10 million were included if they had 10 or more complaints against them.

Top Three Most Common Complaints

1. Monetary settlements – settlement amount is too low.
2. Policy terminations
3. Promptness of insurance payments

2007 Auto Complaint Listing (ranked lowest number at top, higher as you go down)

1. Mercury General Group
2. American Express, Amex Assurance, IDS Property Casualty
3. Eveready Insurance Co.
4. Electric Insurance Group
5. Amica Mutual
6. Preferred Mutual Insurance Co.
7. United Services Automobile Assurance Group (USAA)
8. Chubb
9. Utica Mutual
10. State F*arm
11. Central Services Group, Central Insurance Group, NY Central Mutual Fire Ins.
12. Main Street America Group, National Grange Mutual
13. Progressive
14. Liberty Mutual
15. Kingsway Insurance Group, Lincoln General Ins.
16. Response Insurance Group
17. Nationwide Insurance
18. American Modern Ins. Group, American Family Home Ins.
19. St. Paul Travelers
20. Unitrin Group, Kemper
21. Erie Insurance Group
22. Berkshire Hathaway Insurance, GEICO
23. Allstate Insurance
24. The Hartford Insurance Group
25. Hanover Insurance, Citizens Ins., Allmerica Financial Alliance
26. Metropolitan Group
27. American National Financial Group
28. Allianz Insurance Group
29. GMAC, Integon, MIC P&C, National General Ins. Co.
30. Zurich Ins.Group, Foremost, Maryland Casualty
31. Hannover RE Group, Clarendon National
32. State Wide Insurance
33. White Mountains Group, OneBeacon, Esurance, Auto One Ins.
34. Countrywide Insurance
35. Safeco Insurance Group
36. American International Group (AIG)
37. Tri-State Consumer Ins. Group
38. Interboro Mutual
39. Infinity Property & Casualty
40. Long Island Insurance


If your auto insurance provider is not shown on this list, it could be that they don’t sell insurance in New York. Or, it could be that their number of complaints is worse than the company in the #40 position!!

Think about this statement, my friends.

The only thing that truly matters about your auto insurance is what happens when you submit a claim. Claims are about KEEPING PROMISES. When the insurance companies don’t keep their promises, the complaints pile up!

So, why would you EVER consider doing business with any insurance company LOWER than NUMBER 10 on the list?

If you are one of the unfortunate people who experience an automobile loss of any kind, you’ll need to know how to handle your insurance claim so that you maximize your recovery. I’ll even be so bold as to say this: If you do not use the strategies for submitting a claim found in my book, you will not collect all the money you are entitled to collect. You will need to know how to take control of your insurance claim, and add hundreds or even thousands more dollars to your claim settlement. For more information, check out the website shown below in the Resource Box.