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• Anonymous

  This description of the new insurance option, involving lots of jargon and vague warnings (“destabilize Maine’s insurance market”) is practically opaque.  

  What we know for certain is this:  Insurance companies are jumping for joy because LePage gave them pretty much all they wanted by signing off on recent fast-track legislation:

  http://www.iwatchnews.org/2011/10/06/6883/analysis-health-insurers-win-big-maine

  No longer are people in Maine protected because of certain medical conditions or remote geographic location.  No longer does age protect people:

  “The new law also allows insurers to charge older Maine residents far
  more than is allowable today. Given the fact that Maine has the
  country’s oldest population, that means skyrocketing premiums for a
  large percentage of the state’s residents.”

  Don’t let jargon fool you.  The people of Maine have been taken for an ugly ride.

• Anonymous

  thanks for nothing LePage, you make much from this?

• Anonymous

  This is going to be a huge fail, we need a universal system. we also need to fund medical research to bring down the cost of medications.

• Anonymous

  Makes me wonder if we as a state put everyone in one plan and put that plan out to bid, what kind of figures could we get?

• http://pulse.yahoo.com/_7T3YNF6MG3FPEAVTFIJC44VQUI Dlbrt

  Jargon Like CAPTIVE Insurance.

  Nothing really new there.

  We have been held CAPTIVE by the Health Insurance Industry for years!

• Anonymous

  Yes, the British model you espouse is working so well. What is it with you leftists when you seek failure and then try to shoehorn the rest of us into your disasters?

• Anonymous

  Finally some good news on insurance. Thank you Mr. LePage!
  Too bad years of liberal policies destroyed the insurance system in Maine.

• Guest

  Also by the liberal democrats in charge all those years.

  Thank you AGAIN Gov Lepage.

• Anonymous

  Take a deep breath and relax a little.  Most large employers that provide health insurance to their employees self-insure.   What’s happening here is that small employers are banding together and forming an entity that will allow them to also “self-insure” their employee base.  To the extent that  they can provide the same or better insurance for their employees for less cost it is a win-win for everybody.   This same concept has been in place in Maine for many years with respect to workers comp insurance.

• Anonymous

  Too bad tea-drinking chuckleheads and Republican pawns are unable to understand the benefits of universal coverage.

• Anonymous

  “Joint liability” means every small business is liable even if it isn’t one of their employees making the claim.  ‘Market destabilization’ is also a threat.  If there is a single large claim for, say, $2 million, all the businesses in the captive might have to pay up–the question is, how much does each pay?

  Most important, if you read the link I provided, you’ll see how premium caps have been removed by LePage, and the people of Maine are now vulnerable to higher costs on insurance than ever before.

  “A dismal state of affairs: Mainers face higher premiums with fewer protections”

  http://www.iwatchnews.org/2011/10/06/6883/analysis-health-insurers-win-big-maine

• Anonymous

  The odd thing is that collective purchasing (depsite sounding like a socialist plot) has been an economically viable way to deal with all manner of purchases. Why is it only now that businesses are beginning to see the advantage when it comes to insurance when they’ve been doing it for years with products and merchandise? As for people like countyguy2010 who seem to think that “liberal policies” destroyed the system (was there really ever a “system” in Maine), businesses could have been doing this all along as there was NEVER  any policy prohibiting it, but they CHOSE not to do so, rather they just whined and complained until someone created a scenario where they had little choice. What’s happened is that the Affordable Health Care Act has provided the incentive for businesses to do it.

• Anonymous

  How does removing premium caps help Mainers?  We’re about to get gouged, as this expose reveals:

  http://www.iwatchnews.org/2011/10/06/6883/analysis-health-insurers-win-big-maine

  Quoting from the article:  “A dismal state of affairs.  Mainers face higher premiums with fewer protections.”

  If you respond to me, try giving an argument why the removal of premium caps is going to help Mainers, instead of just spouting your own opinion.

  Say something with substance.  I dare you.  I’d like to really debate this, instead of face an opponent who gives no reasons at all.

• Anonymous

  Single payer is still the way to go, at least to those who care about quality and cost. Americans pay twice what consumers in ALL OTHER developed countries pay, and our outcomes by any measurement, are worse. This probably is not surprising in a country that, despite being told that we may have only 5 years until global warming  and the negative feedback loops become irreversible, continues as if nothing is wrong. Today’s Americans have to be about the stupidest people that ever lived.

• Anonymous

  You have no idea what you are speaking about. Letting small business have the same benefits and ability to lower what they pay to insurance companies as big companies do is a “bad thing”? Why is that sprucy?

• Anonymous

  Canadians are happier and healthier than us, and their economy is thriving.  

• Anonymous

  Actually getting the Captive approved was on Baldacci’s watch, to which he thought was a great plan.

• Anonymous

  Exactly.  This finally begins to level the playing field by enabling small business provide health benefits to employees and still be cost competitive with the larger national/multinational corporations that self-insure. 

• Anonymous

  Starting off rudely does not help you gain credence with undecided readers looking for rational debate.  And you ignored the part of my argument about premium caps being removed for Mainers, and how this is going to result in much larger premiums.

  As for MaineSense, even the member quoted says it is only “palatable” and only as “long as you go into it with the right number of people and everyone pulling in the same direction.”

  Think about it.  A big claim comes in.  Member Company X can’t or won’t pay.  The Members start to squabble about who pays how much of the claim.  This could lead to gridlock or even lawsuits.

  There is also the problem of “market destabilization.” 

  So far, you haven’t dealt with any of the issues brought up by the article, you’ve only made unsubstantiated claims about “benefits.”  Prove it.

   Be professional.  Impress independent readers.

• Anonymous

  Here’s another problem:  Member company X has a lot of claims from its employees pulling from the insurance pool.  Other companies feel X should pay more than it does.  X disagrees.  Squabbling results.  Arguments and anger erupt over who should pay how much into the captive.

  Are you starting to see the problems with joint liability yet?  Think two or three new layers of bureacufacy.

• Anonymous

  “Joint Liability” is a reality, but it is a risk that can be managed.  Think re-insurance for large unanticipated claims.   Businesses that have joined self-insured groups for Workers Comp are very familiar with both the concept of Joint Liability and re-insurance.   

• Anonymous

  Here’s another problem:  Member company X has a lot of claims from its
  employees pulling from the insurance pool.  Other companies feel X
  should pay more than it does.  X disagrees.  Squabbling results. 
  Arguments and anger erupt over who should pay how much into the captive.

  Are you starting to see the problems with joint liability yet?  Think two or three new layers of bureaucracy.  This is why the MaineSense member in the article above says it can work but only if everyone in the membership is “pulling in the same direction.”

• Anonymous

  Talk about bureaucracy within bureaucracy! 

  Reinsurance is insurance purchased by an insurance company from another insurance company.  Is everyone following this? 

  So collectives like MaineSense, if they go for re-insurance, aren’t really independent of the big insurance companies–because they have to take out risk-management policies from them.

  Does this seem sane and safe to everyone?  Does it seem truly understandable and risk free?

• Anonymous

  I suppose you can always craft worse case scenarios that result in maintaining an unsatisfactory status quo.  However I can tell you that I was a member of a self-insured group for many years and everyone in the membership did pull in the same directions because it was in their best interest to do so.  With respect to claims experience and cost allocation, the rules were well defined and transparent. In my experience there never were arguments and anger among the members because the rules of the game were well-defined and everyone shared a common goal. 

• hugh curran

  Here’s part of an article by Wendell Potter who was an executive  in the health insurance industry & has now become a watchdog for consumer interests: ”…By the time the governor and legislators were sworn in earlier this year, the insurance industry must have had its wish list ready and its lobbyists poised to begin drafting industry-friendly legislation for lawmakers to introduce.The insurers hit the jackpot in the spring when the industry’s legislative allies rushed a bill through—which LePage quickly signed—that will indeed reform the state’s health insurance marketplace—exactly the way insurers want. In many ways, it is taking the state in the opposite direction of the consumer protections enacted as part of the health reform legislation that Congress passed last year. The state law took effect last month. In anticipation of the law becoming effective, insurers prepared new rate quotes that enabled them to increase premiums—in many cases dramatically—for policies that renewed Oct. 1. The industry’s lobbyists must have been pinching themselves that they were able to get everything they wanted to ensure their employers will reap handsome profits over the next few years. In addition, the state’s insurers are in firm control of a committee the governor appointed to advise lawmakers on how to set up the state exchange, or insurance marketplace, required by the federal law. It’s hard to imagine what else they could have asked for that they didn’t get.To give you an idea of just how quickly the industry’s bill made it to LePage’s desk compared to other important pieces of legislation, consider this: lawmakers passed the measure just a week and a half after the first public hearing on the bill. By contrast, the legislature devoted 48 days to the contentious debate over whether to call the whoopee pie the state’s official dessert or the state’s official treat. Seriously.The fast-tracking of the insurance industry’s bill was ordered by legislative leaders so that consumer advocates would have virtually no time to amend or kill the bill, which with the stroke of LePages’s pen abolished consumer protections enacted over two decades of previous gubernatorial administrations. Among other things, the legislation did away with hard-fought protections for rural families that had required insurers to have at least one doctor in their provider networks within 30 miles of where those families lived and at least one hospital within 60 miles. As a result, many families in the far northern reaches of the state will have to drive several hours to get to a doctor or hospital in their insurers’ networks.The new law also allows insurers to charge older Maine residents far more than is allowable today. Given the fact that Maine has the country’s oldest population, that means skyrocketing premiums for a large percentage of the state’s residents.Before the law was enacted, insurers could not charge older residents more than one and a half times as much as younger residents. Now they can charge them three times as much, which is the limit established in the federal reform law. The new Maine law will let insurers charge older residents five times as much if they can get around the federal law.As a result, some small businesses with the older workers are already seeing their policies soar by 90 percent or more.The new law also allows for the sale of out-of-state insurance policies from four of the five other New England states (Connecticut, Massachusetts, New Hampshire, and Rhode Island), which means that the Maine Bureau of Insurance will have no jurisdiction over those policies. Maine residents who buy those out-of-state policies will get no protection from Maine’s insurance regulators.Finally, insurers in the state will no longer have to file for a rate review by state regulators unless their rate increases are 10 percent or more.With all of these changes, there is no doubt insurers that do business in the state will be able to achieve profit margins never before even imagined. Regular Mainers, on the other hand, are not going to fare nearly as well.”

   

• Anonymous

  Sooner or later, as more companies join the collective, there will be a bad apple, or a company that goes bankrupt or for whatever reason is unable or unwilling to pay a fair share.  Also, when you increase membership, it increases the number of employees covered and the risk of a very high claim — millions of dollars –  increases.

  It’s a statistical game that relies on psychological trust in a world where the quest for profit tends to create divisiveness.  Not only that, if a collective buys risk-management insurance it is effectively paying the big insurance companies it was trying to get away from in the first place.

  Imagine an insurance company having to buy insurance from another insurance company to insure it can pay its claims.  Welcome to insanity.

• Anonymous

  SpruceDweller,  the reality is that this concept has worked just fine for Workmans Compesantion insurance.  It’s been around for years in Maine.  Do some homework, research the facts, find me evidence that self-insurance has not worked in the Workers Comp arena and then we’ll talk.

• Anonymous

  “Imagine an insurance company having o buy insuran from another insurance company to insure it can pay its claims.” 

  This is not hard to imagine because it is a common practice in the insurance industry.  It is called “re-insurance” and it protects insurance companies against unanticipated claims.   There are firms that specialize in writing this kind of insurance.

  Welcome to the real world of insurance.

• Anonymous

  The kinds and quality of claims are different.  It’s a whole other world.  You’re asking me to say that a certain technique that works in the desert will work in the Arctic.

• Anonymous

  A very dysfunctional world and now we are just heaping on another layer or two of bureaucracy and confusion.  Pretty soon businesses will be spending all their time managing their collective, instead of focusing on product.

• Anonymous

  Get over yourself  sprucy. You are ignorant of the topic and ask me to “prove it”. Prove “market destabilization” . I thought you were against big insurance companies getting heir way. Was I wrong?

  My guess is you are one of three things.
  1) A big insurance company shill.
  2) You see this as a threat to Obamacare and anything that makes insurance cheaper for the little guy is a bad thing.
  3) You don’t know what you are talking about.

  I’m betting on three.

• Anonymous

  Exactly right!!

• Anonymous

  You’re just winding the rest of us up?  You can’t really be the American you describe in your last sentence.

• Anonymous

  And so are the Norwegians and the Danish – I’m yawning, I’m yawning again, and z-z-z-z-z.

• Anonymous

  No debating you sprucy. Your arguments in the end all come down to you are bad I am good. That’s all.

• Anonymous

  Don’t forget those capitalist swedes. Ywan nitey nite.

• Anonymous

   So… what exactly is it that Maine people are getting in their health insurance coverage (other than mental health which 99% of people don’t need, and guaranteed-issue which is idiotic) that New Hampshire people are not?!  Last I checked it was about 75% cheaper for a family of 4 to buy health insurance in NH than it was in Maine.  They just have common sense rules like if you are pregnant it costs more, if you are old it costs more, if you are young, healthy & single – it costs less.  How is it that ALL of New Hampshire has it so wrong, and Maine had it so right with our completely off-the-chart health costs?  Let me guess, the government wasn’t doing enough and we needed more bureaucracy / socialism right?  Get real.

• Anonymous

  You’ve contributed nothing to this conversation.

• Anonymous

  What works in one country may not work in another, be careful of what you wish for.  Things may not seem to different at face value, but there is a lot going on in countries that allows for their system of running things to appear great, or bad, or mediocre.

• Anonymous

  Neither has Sprucy. Filled with misinformation rumors and what ifs. All the time attacking a system that allows small business to reduce their cost of insurance to them and their employees.

  and besides you hurt my feelings.

• Anonymous

  Small business has always wanted to purchase insurance collectively. There is/was indeed a law prohibiting it. The insurance companies and Democrats and Republicans in Augusta prohibited it. The recent change in Maine was slid in by some small business advocates just before the bill was passed.
  Cranky… I hate to disagree with someone who has a name like that but up ’til recently it WAS prohibited.

• Anonymous

  I’m betting on all three and would add a blind hatred to anything that doesn’t promote a leftist agenda

• midmainer

  BDN,  I think your giving too much credit to the current legislature on this program. Captives was a program inititated by Governor Baldacci and the 124th legislative session.

• midmainer

  try a little real reading, captives is a program that was made possible by Governor Baldacci and the 124th legislative session

• http://pulse.yahoo.com/_NXPTPFL746OV2VGR5WBOEUF6W4 Roger

  If the Maine government would get out of the insurance busniess and let ALL insurance companies come here that alone would reduce costs.