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Let's Talk Cost
from Let's Talk Cost 2011
April 13, 2011
In 2008, the combined profits among the top 10 U.S. health insurers would have only covered about two days of medical spending.
Marie S. commented on April 13, 2011
"The nation's five largest for-profit insurers closed 2009 with a combined profit of $12.2 billion, according to a report by the advocacy group Health Care for American Now (HCAN). " Reference: http://abcnews.go.com/Health/HealthCare/health-insurers-post-record-profits/story?id=9818699
"The top executives at the five largest for-profit health insurance companies in the United States received nearly $200 million in total compensation in 2009." Reference: http://www.huffingtonpost.com/2010/08/11/health-insurance-industry_n_678289.html
"Even as the rest of the country struggled with a deep recession, U.S. health insurance companies increased their profits by 56 percent during 2009 alone." Reference: http://abcnews.go.com/Health/HealthCare/health-insurers-post-record-profits/story?id=9818699&page=1
NNNN C. commented on April 13, 2011
Marie--neither of theses comments have anything to do with BCBSNC. It is a NON-profit insurer. What is your point?
lori m. commented on April 14, 2011
To NNNN C.,
I thought this was a forum to discuss insurer facts and opinions. Does everything here have to be about BCBSNC or somehow relate to it?
Let's Talk Cost commented on April 14, 2011
Our only goal for this campaign is to foster a rational, productive discussion about rising medical costs and it certainly does not have to be related to Blue Cross and Blue Shield of North Carolina. Too much of the public debate on health care is a blame game. Everyone who participates in the health care system plays a role in rising costs — so all of us must play a role in reining in costs.
Please feel free to continue sharing all thoughts and opinions.
Nath L. commented on April 14, 2011
To NNN C
It is precisely because there are such large profits and annual salaries by a nonprofit company that it SHOULD elicit such sharp criticism. It should also make the public and consumers wonder about why BCBSNC is spending a great deal of time, money and resources recently to make sure "we don't play the blame game." This media blitz is disturbing and highly insulting for BCBS NC members who have had real, everyday issues with this insurance company getting directly involved in the doctor/patient relationship. This media campaign (and that is all it is - a media campaign to sway public attention away from the issue that the largest insurer in the state of NC is raising premiums while cutting care options) is repulsive to patients that are being denied medically necessary care. And that is THE "rational, prodcutive discussion" that is not being addressed at all.
It is not a "blame game" to put this right back on their doorstep. Everyone was very upset when the government was accused of getting involved directly in patient care and in the middle of the doctor/patient relationship. It is extremely distasteful that BCBS NC is now launching an "informative and funny" effort as they do this very thing. And this media campaign is nothing more than at attempt to divert attention from the fact that they are continuing to roll out policy after policy that denies medically necessary care. I will continue to play the "blame game" when a monopoly acts in an unethical fashion.
Marie S. commented on April 14, 2011
>>Marie--neither of theses comments have anything to do with BCBSNC. It is a NON-profit insurer. What is your point?
The original statement was:
"In 2008, the combined profits among the top 10 U.S. health insurers would have only covered about two days of medical spending."
As far as I can tell that statement had nothing to do with BCBSNC either. It really means nothing unless you provide more context to the statement.
Leslie P. commented on April 17, 2011
What we need is Insurance Company reform! They are making BILLIONS --- do you really think a "for profit" company is going to provide healthcare in an ethical and with the patients best interest in mind? NO WAY! They only care about the bottom dollar and the billions of dollars they rake in --- it's all about GREED!
Leslie P. commented on April 18, 2011
How about you provide the salaries of all of the employees (particularly CEO and upper management) of BC/BS - including that with your profit of $167.7 million profit --- come on --- you really want us to buy into your belief that insurance companies are hurting? Please, don't insult our intelligence!
Michelle Douglas commented on April 18, 2011
Public Relations Manager
Leslie P., We are very open about our goal of earning a profit margin of 3.5 to 4.5 percent. We believe that's a modest and very reasonable profit -- and also appropriate for a company that pays $4 billion in medical claims for customers each year. Health insurance is expensive because health care is expensive. Last year just over 86 cents of every premium dollar our customers paid went right back out to pay medical claims. We are doing everything we can to operate our company more efficiently, but if we want to make health insurance more affordable, don't we have to also look at the 86 cents of the dollar that's going to pay medical expenses?
Leslie P. commented on April 19, 2011
You can make numbers look any way you want them to. The reality is - the rest of the country is suffering and paying outrageous premiums that continue to rise, a decrease in coverage, and a decrease in approved covered services. As a mental health provider myself - sometimes I have to spend HOURS on the phone trying to take care of claims that were processed incorrectly, denials, and trying to get authorizations and verify benefits. Frequently I am given incorrect benefit information - and all of your "disclaimers" don't hold you accountable when the incorrect information is provided. On more then one occasion, I have called to verify benefits for a client hung up, called back and spoke with another person and told something COMPLETELY different. Sometimes, mental health is managed by Magellan. EVERY time I have sent claims in for a plan managed by them - it gets denied. Then I am told they probably haven't "uploaded" the information showing the coverage, so it is denied. I'm told to resubmit the claim, denied again. Call back - spend 20 minutes on hold - go through the whole scenario again - get nowhere - told to resubmit again and the cycle goes on and on and on. I have had more then one instance in which it took a YEAR for Magellan & Blue Cross to get it figured out and the claims processed correctly. Ultimately, I probably made about $2/hour on this client because of the ridiculous amount of hours I had to spend on getting the claims processed correctly. This is why good providers are starting to go off insurance panels.
The CEO of NC BC/BS made a ridiculous salary in 2010 and a bonus to boot, while the rest of the country is lucky to pay their bills. The "usual and customary" fees you pay mental health are far from usual and customary for the most part and the amount of time required to correct claims processed incorrectly, hardly makes it worth it.
Hospitals charge hundreds of dollars for a motrin and tissues given in the hospital and those of us who are committed to our clients/patients end up getting screwed.
Insurance companies are what need to be reformed. Making a profit of any kind off of peoples health, is criminal, in my opinion. If one of your family members was denied a cancer treatment that could save their life because the insurance companies didn't approve it for whatever other reason is conjured up - I think you would agree that this is not a system that works. The fact that Americans have tolerated how we have been robbed by insurance companies is beyond my comprehension. The focus of reformation needs to be on the insurance companies!
I just have to add here that your comment:
"Our only goal for this campaign is to foster a rational, productive discussion about rising medical costs and it certainly does not have to be related to Blue Cross and Blue Shield of North Carolina. Too much of the public debate on health care is a blame game. Everyone who participates in the health care system plays a role in rising costs — so all of us must play a role in reining in costs."
is a great diplomatic response - but doesn't deal with the reality of the situation. You are only feeding the blame game rather then taking responsibility for the racket YOU, as an insurance company have created. The real issues are pointless to address and discuss when YOU are not being real and dealing with your part of the problem. As others have stated, it's insulting to me as a provider as well as a consumer that you are now spending exorbitant amounts of money in advertising campaigns that could be used to pay for all those medical services/treatments that you are denying, outrageous salaries for upper management/executives, and suggesting that doctors make too much money - without looking at your own payroll.
Until insurance companies are REALLY ready to disclose ALL of the information, then this discussion is pointless and a facade of playing pretend to seek a solution, while in reality, not being transparent and forthcoming with the WHOLE picture and turning the blame on everyone else but yourselves. Again, an insult to our intelligence and simply not honest on your part.
Joshua T. commented on April 20, 2011
Sure. BCBSNC is a not-for-profit. However, that doesn't mean they don't make a profit. They make millions. "Not-for-profit" just means that they keep the money instead of giving it to shareholders.
The company recorded net income of $107.3 million for a profit margin of 2.1 percent, down from 3.6 percent in 2008 and below the company’s 3.5 percent to 4.5 percent target.
Leslie P. commented on November 12, 2011
These comments have EVERYTHING to do with BCBSNC. They reported MILLIONS in profits last year. The ignorance of Americans is incredible...wake up people...we are being scammed by this company. They increase the premiums, find more and more loopholes for covering medical costs, increase their profits, make healthcare decisions based on the bottom line (their profits and greed). Notice that in these "rational and productive discussions" they "wish to foster" that any time a question regarding salaries of executives, bonuses or disclosing the REAL numbers and information have been posed, those questions have been ignored completely. So, please, give me a break, and stop with the insult to those of us who do have some intelligence ~ you have no desire to do anything but divert the attention from yourselves and how you are scamming the American public. Shame on you!
Janice W. commented on April 14, 2011
When a service becomes so widespread that modern citizens expect to use it, it becomes like a public utility. Insurers will have tko work together, simplify plans and share data with their constituents. Pressures to cut costs will be great and to simplify choices. There should be data gathering and sharing that data with the public (and policy makers) not simply a reimbusement system. What treatments work best? How best to educate physicians?
A report from 2009 indicated that BCBS NC earned $186 million the previous year, (while raising premiums for its members).
The same report sited that the top six executives at Blue Cross each made more than $1 million for the previous year, topped by Chief Executive Bob Greczyn at close to $4 million. Greczyn's annual income included a $3 million bonus and was a 23 percent increase over 2007.
Why don't you post those ftyped of figures more prominently during this recent advertising blitz about the "discussions about rising health care costs?"
K. D. commented on April 14, 2011
You have some good questions here. Let's add a few more.
Was that $186 million revenue or "profit"? How many days of medical spending for BCBSNC does that $186 million represent? How much do other executives at other sizable not-for-profits and, conversely, for-profit companies make? For example, what do the top executives at the Red Cross make? Or Cigna or Aetna? I would assume that getting qualified individuals to run large corporations would be extremely difficult if the compensation was totally out of line with others in similar positions, but without the numbers, it is hard to make any rational argument. I, too, would be interested in knowing the numbers.
Nath L. commented on April 15, 2011
I believe you are missing my point (or my sarcasm).
Actually, I am not questioning the right of anyone (insurance executives included) to their salaries, even if I find them higher than industry average. To answer just one of your questions though, according to the Chronicle of Philanthropy, the CEO of the American Red Cross earned $446, 867 in compensation for the year 2009. I will again compare that with the almost $4 million figure from the same year for the CEO of BCBS NC. You can do the math in figuring out the difference - if we are talking about cutting costs, and all.
But back to my original point in that I find it highly disingenuous that a website that is stressing cost does so under false pretenses. This site lists the average general physician salary and asks the public if they think that is too high or too low. Let's post the executive salaries at BCBS of NC and ask the public if they think this is too high or too low. If we are having a "rational discussion", I think that is a fair question.
For the record, I am totally against the entire concept of class envy that this web site and media campaign is going out of its way to emphasize. I realize that some jobs are extremely stressful and require a great deal of leadership and skill. If successful at that post, then the people responsible for good stewardship should be rewarded accordingly. But a web site and media blitz that actively promotes a discussion (for example) of physician salaries and has people quoting that "specialists make too much money" without posting their own incomes is simply a diversionary tactic to get the public attention away from the policies that BCBS NC is currently implementing - daily. And for the record, if the cardiologist that put in a successful implant of a pacemaker in a family member gets compensated for his level of skill and success, then I have no problem with it.
I do have a problem with a company telling me - members that pay rising premium costs every year in good faith - if they think our medical well being is worth it, when these type of salary figures of their executives are flying around. I have a serious problem with that. So I will call it out again and again: one executive salary at $4 million for one year.
So given this, the only question I am really interested in is how they can have the audacity to deny procedures (please see their web site for the latest procedures that are not being covered any longer - you may want to bookmark it, they add to it daily) with the rational that they only want to foster "rational" discussion about rising medical costs.
Stop the diversionary tactics please. Come back to the point that executives that are not in the exam room with me and my doctor are making decisions about my medical care - no matter what they make in annual income, this is simply wrong.
Michelle Douglas commented on April 15, 2011
K.D./Nath, in 2010 (the most current numbers available) BCBSNC earned $5.2 billion in total revenue (premiums paid by customers). Of that we paid out $4 billion in medical claims for customers and $159.9 million in state, federal and local taxes. That left us with $167.7 million in profit for 2010, which would cover 4.5 months of claims and medical expenses for our customers. This is within the range that we are required by law to maintain.
This information is publicly available in our online media center and is filed each year (along with the compensation of our executive team) with the Department of Insurance.
Last year we spent 86 cents of every dollar we took in on medical care for our customers. Those are the expenses we all need to work to control if we want health insurance to be affordable.
Michelle Douglas commented on April 19, 2011
K.D./Nath, my colleagues have let me know that my math was wrong – our profit margin of $167 million would only pay for about 15 days of claims. Not 4.5 months. However, we keep enough in our reserves to cover roughly 4.5 months of claims. We do this because it’s prudent and fiscally responsible, and is required by state law. I hope this adds clarity, and I apologize for any confusion.
Leslie P. commented on May 27, 2011
Nath - notice you don't get a response. Hmmmm....what happened to that "open and honest discussion" they are looking for?! A testament to the joke of a campaign this is and the absurdity of it all --- and we have allowed this to go on. Shame on us!!!! Now WHAT are WE, as Americans going to do about this criminal activity????
Stephen M. commented on April 14, 2011
Could you provide a bit more detail here, in terms of what is included in "medical spending?"
Also, is this including ONLY the medical spending related to the individuals covered by those 10 insurers in 2008? If not, what would the infographic look like if it did?
That's a good question, Steve, and I believe Fortune's comparison was total US health care spending. I'm not aware of a comparison that has been done on total profits of all US health insurers against total US health care spending -- but that would also be interesting.
Stephen M. commented on April 15, 2011
Okay, if it is total US spending then honestly I'm afraid your infographic is a bit misleading in its implication, even if it is not inaccurate. The graphic representation shows that the profits of the 10 top companies are but a tiny piece of the pie. The implication (and presumed motive for creating the infographic) is to represent the profits as insignificant. However the pie in truth includes far more than the reach of the 10 companies.
Let's say we took the sum of salaries of the top 10 movie stars and represented it as a percentage of total spending for all entertainment in any form. I'm not sure that would be a useful statistic.
More details here would be helpful. Thanks.
Leslie P. commented on April 23, 2011
Another words Steve, Michelle's response can be translated as: I'm a diplomatic spokes person for BCBS and have no intention of giving detailed information that would reveal the true picture. This is just a marketing campaign to divert the attention from us taking any responsibility for the problem which we, as a profit making company who pays outrageous bonuses and salaries don't want to lose any money - we want to keep raking it in, and so far we have been able to get away with it - we don't want anything to effect that! In fact, we're trying to figure out how to increase our profits, salaries and bonuses at the expense of the american publics health. Why should we change anything....we've got you all fooled!
Richard S. commented on May 9, 2011
Yes Steve & Michelle, we could in principle do the analysis and understand the actual 'number of days'. The statistic would be very complex, and not all that enlightening. Leslie's point is more relevant: to present a graphic like that, with such grotesquely simplistic numbers and terms, reveals much about the mindset of the one who posted it: it's all about propaganda, not discussion. If we're going to participate in this blog, let's at least talk about real stuff (and actually, I am quite pleased at the level of the discussion I'm seeing here!)
Juan P. commented on May 13, 2011
Stephen, look for my comment on this thread. I estimate that the real number of days in 2008 was 19 and not 2 days.
I don't think they did their due diligence.
Sam M. commented on April 15, 2011
Rising costs of health care are DIRECTLY linked to private insurance companies. Every study anywhere shows that where there are two systems, a public and a private, the private FAR exceeds the public in terms of GDP.
Our Medicare, relative to GDP is about 4% and remains relatively stable. Private insurance and health care spending represents about 17% of GDP and continues to raise every year. Seems strange to me that the same Dr's and the same hospitals and the same procedures costs less if you are on Medicare.......hmmm. Much less.
This document beautifully illustrates the costs associated with private care in comparison to those of a public system.
There is no way a private insurance model will be sustainable in the long run. No other first world country continues to harass its people with these kinds of burdens. No other country has arbitrary premiums that outpace your income. No other country has co-pays, premiums AND deductibles. No other country has the madness America has regarding health care, and yet, like a child raised in an abusive home. it is seen as "normal."
It is not normal and no other people are living this way anywhere in the industrialized world.
Well R. commented on April 15, 2011
Not sure I understand why you think the Medicare model is the way to go. On average, there is plent of data that supports the notion that hospitals lose money treating Medicare patients. Medpac says 87% of all Medicare hospital stays are money-losers for the facility. 13% turn a profit, the average is only 3%.
Milliman studies show over 14% of the premiums you pay today are a direct result of hospitals and physicians shifting costs to cover this shortfall from the government patient to the private system.
In other words, if the private system didn't exist, and didn't allow for negotiation between docs and hospitals, the government would have no hospitals to send their patients to at the below cost numbers they are getting today.
In effect, insurance companies negotiating with providers does cause health INSURANCE costs to rise because network relationships are voluntary and no hospital or doc has to enroll or join, unless he gets the price he wants.
Not so with Medicare or even worse, Medicaid.
The medical system we have today, with all it's advancements, which we essentially provide to the entire world at marginal costs, while we eat all the R & D here in the U.S., would have been impossible with the financial pooling of the private insurance carriers.
Something to think about...
Sam M. commented on April 16, 2011
Well R.: It is not about Medicare per se, it is about getting all people insurance. We no longer live in a world where we can just let people die in the streets, so like it or not, yes, we ALL have to pay to make sure we are ALL covered. Welcome to the 21st century.
So the question is , "What is the best way to do that? "
In other places where there are two-tiered (or multi tiered) systems, they have put into place safety nets to make sure insurance co's do not make $8 mil. a year. In Germany, you can have private or public and there are many insurance companies, BUT your premiums are capped according to your income and there are no co pays and silly things like that. No one in Germany wants or even understands how we have let our health care system operate in a democratic society and almost 100% of their people are covered.
The UK has several systems based on the idea that health care is a right. Where the private sector has been allowed to compete too heavily, there is a weakening of the public sector (England) while places like Scotland have limited private sector involvement and thus, less contention between doctors and higher satisfaction. . However, in the UK, all people are covered and they certainly prefer it to ours.
In Canada, there is Medicare for all and private clinics are prohibited from offering services under the Health Canada Act. There are no copays, no deductibles, and only those making more than $200,000 have a premium in certain provinces. Again, almost 100% of Canadians are covered and they enjoy a longer lifespan and greater happiness. PLUS, they have a great economy, banks are #1 in the world, and they are more satisfied with their health care than we are with ours.
I could go on and on about other countries and you can do your own research. NO country has a system as silly and stupid and unsustainable as ours. They jettisoned their own For Profit models long ago as they saw it was a detriment to their economies and human rights.
A system such as ours- unlimited premiums (try explaining an $800 monthly premium to a European), outrageous co-pays and insane deductibles (we call it a "catastrophic" plan with up to $10,000 deductibles) is completely unsustainable.
So in the US, Medicare has already been proven to be the most sustainable that we have. Of course, unlike other countries, it has premiums that we suck out of our seniors and copays and a small deductible.
So no, American Medicare is still not a great plan, but if you are talking about wanting your grandkids to have a better life, is sure as heck is not going to come about with private insurance companies that are allowed to operate in any way they see fit while the rest of the world is light years ahead.
Well R.: If hospitals could eliminate the waste involved in battling with private insurers for payment, and improved clinical processes to avoid costs associated with patient harm, there would likely be plenty of room to make money under Medicare payment schedules. (Of course, if the hospitals get more efficient, that might be another excuse to reduce payments, but that's a separate argument.)
Alex A. commented on April 15, 2011
It's refreshing to see a health insurer take a proactive role in this debate (no, i don't work for Blue Cross :) . While I believe there is a LOT of room for improvement, I don't believe insurers are the core of the issue. To me, it's math - at best, the insurer % of the "pie" is 20% (Admin Costs), while the rest goes to Med (doc, hospital, pharma). It would be analgous to someone blaming the $150 Synthetic Oil as the reason their Ferrarri is so expensive (please don't attack the notion that we have a "Ferrarri" for a health system, i think you understand the point). It's a part of the system/issue, but relatively speaking, a small part. what I like about this forum is the idea of ALL parties (skapegoats) involved bringing their shared solutions and collaborating on a solution, that's what's really needed.
John W. commented on May 9, 2011
But the % of the pie is not 20% in "Admin Costs". Health insurers make money by assuming risk. The reason commerical health insurers are profitable is because the risk is spread across a healthier patient population than the Medicare population.
rick w. commented on April 15, 2011
1. DRASTICALLY INCREASED BCBS PREMIUMS WITH NO CORRESPONDING DECREASE IN COPAYS, MED COSTS, DEDUCTIBLES, ETC.--This has been done by BCBS on purpose in anticipation of the "Obamacare"'s health plan effect in the future. The consumer is being ripped off while BCBS makes enormous profits & stockpiles cash (while also rewarding upper management to the tune of $$$ millions.)
2. WASTE & FRAUD BY BCBS--I know of 11 excellent workers who were laid off in July '10 at the Winston Salem office. Their salaries couldnt have amounted to much--yet BCBS gave a $16 MILLION gift to an abandoned tobacco warehouse in W-S to be used to "update" the building for parties unknown. Just think how many employees' jobs that HUGE amount of money could have saved. The office where these folks got laid off from is having tremendous difficulty now handling the workload they've been given. AND BCBS is outsourcing work to the Phillippines, where it can be done cheaper. How does that speak for the co. and their mission? How about outsourcing the CEO & the directors' jobs?????
3. GREED & FRAUD BY PROVIDERS--These shady practices cost everybody. My advice to everyone is to look closely at your bills/staements when you receive them. If you notice something awry, or items/procedures that you didn't undergo, call BCBS & tell them. Sometimes they bill for tests that weren't done. Of course, they order such tests due to the litigious nature of our society.
Kenneth D. commented on April 18, 2011
What does this mean in real dollars? Please quantify.
Herman N. commented on April 19, 2011
I think the term profits is misleading. They are including salaries, bonuses, etc etc for CEO's, exspenses we could never write off, paying investors dividens (huge ones), millions and millions of dollars in lobbying in washington, other political contributions. Very misleading, highly inaccurate. Thier leftovers only pay for two days because they spend the rest so they can deny patients what they actually need. Can't wait for the industry to crash, anyone that makes profit from denying people access to healthcare should be ashamed of themselves that its gotten to this point.
Sam M. commented on April 19, 2011
Amen, Herman. They will crash. They will outprice themselves and in 2014, people will NOT buy it. They will push their heels in and refuse. A change will have to come because things will not be as they are now. Totally unsustainable system built on greed and racism.
Herman, I agree completely and second that! The good news is - that what goes around comes around - I've lived long enough to know this is true. The insurance companies will get what they deserve in the long run ---- the public just needs to be sure to make sure that we have a voice and that they DON'T get bailed out....only to give their CEO's and managers bonuses! The entitlement is amazing - but it doesn't last forever and as Sam M. said---it will come back to bite them! The presentation of their "profit" is totally deceitful and does NOT tell the whole story!
goat h. commented on April 22, 2011
Angela B. commented on April 20, 2011
I work for an insurance company. We are constantly attacked as the "bad guy" in the media, in the general public, and by our neighbors. What those people do not understand is that we never make more than 3% profit each year. We fight to make sure we can continue to service as many members as possible each day in the best possible way. We care when you call in and you are in a dire situation and need help. We WANT to help! We get emotionally involved in our members lives and often times send cards (that we purchase out of our own pockets, not from premium funds) to let our members know that we care and that we are here to help. When we have meetings it is to discuss issues that could have been handled better, what went wrong, and what processes should be in place to avoid repeating the same mistakes. We love each of our members; they are our neighbors, friends, family members; and we always want to be there for them in their time of need and in times of celebration. The 3% profit is used to pay for things like paying employee salaries, facility services, utilities, etc. If you look at a for profit insurance company, you will not see a 3% profit, far from it. They are out to make a profit, we are out to make a difference.
Leslie P. commented on April 20, 2011
That has NOT been my experience as a provider OR a consumer. I have not heard that as being the experience of any of my clients, colleagues, friends or family members either. So, maybe you are an exception to the norm, but I certainly do not believe a positive and caring experience is a typical experience for the "average" consumer.
What a crock! I worked for one too and I know for a fact that everything you said is a lie!!!!!!! You act like 3% is nothing. 3% of billions of dollars is a huge amount. Now what did you say about that poor pitiful 3% your insurance company makes off the backs of it's struggling members you love so much?
You make a profit? After taxes? After paying large salaries? After a couple billion in depreciation (which is not a cash expense) and even after political contributions and lobbying costs (which are disclosed in your m-3 reconciliation but not your financial statements with the SEC)?
3% of 60 billion is a lot.
This is a load of bs! The representation of 3% profit is ridiculous. Insurance companies are making life and death decisions based on MAKING MONEY! That is the bottom line --- this is CRIMINAL. The ONLY time, I as a mental health provider, have EVER experienced an insurance company being "helpful and caring" is when there is a child dying of cancer. Then they almost have carte blanche to services --- but if they needed a medication that was not approved by the insurance companies that compassions would go right down the drain. You have clearly been as brainwashed as most of america on the "profits" of insurance companies --- just like the "profits" (or lack thereof that they claim) of the banks who then use our bailout money to pay million dollar bonuses to Execs. COME ON AMERICA -- WAKE UP AND STOP TOLERATING THIS!!!! IT'S CRIMINAL!
T3 L. commented on May 15, 2012
How come my homeowners insurance keeps going up every year but the value of the home goes down? I have never had a claim and I don't see discounts. My grandmother paid auto insurance for 50 years and never had a claim where's her bonuses? All yeah I thank my agents name is Steve maybe I don't know but he's my buddy!
Dean V. commented on April 23, 2011
I am a retired NC State Employee who has lived with BCBS management of State Health Plan for my 33+ years. State employees have seen the value of the State Health Plan decline with increase out of pocket expenses and the dependent coverage unattainable for employees. Employees have gone outside the State Health Plan many times to purchase dependent coverage for less than under the State Plan. Often to BCBS for the dependent coverage. The amount that BCBS charges the taxpayer to manage this system has continued to increase during the same time. The State Plan contract with BCBS is administered by the NC General Assembly where BCBS lobbyist are hard at work. This is a totally unfair system totally on the side of BCBS.
Then to see how BCBS provides bonuses for its employees is an outrage. Bonuses and salary that is generated to part on taxpayers of NC. How much is BCBS spending of member funds to blast the media with this campaign? It is insurance companies greed that has contributed to our health care issues. The CEO of BCBS has some nerve to show his face on TV when he receives $4 million in bonuses.
Ben C. commented on April 24, 2011
What's funny is that health insurance companies stand to make more money on healthy individuals (case in point: auto insurance- more years of continued payments with little to no claims = more profits. Am I wrong on this?) However, pharmaceutical companies and hospitals make no money if there aren't visitors right? There's your conflict: health insurance companies want you to stay out of the hospital, and drug companies and hospitals want you to be a continued customer. Am I wrong? There are three businesses competing for a share of the pie, and all have differing means about going about generating revenue. Yet, all three would have the CEO's of their organizations to cut taxes on their organizations, even though they are all competing against each other, but the general public just stands by and hears words like "socialism" and public option. Gimme a break. It is that simple to diagnose the situation, harder to fix it.
Karen T. commented on April 27, 2011
Well that money would cover more if you stopped putting money in a "foundation" and quit paying all your lobbyists!! How many lobbyists do you have?? How much money do you pay them?????
Yeah . . and how much money did you throw away on your animall commercials!! Buy a clue!
This 'factoid' means nothing at all. 'profits?' 'top ten?' 'medical spending?' It's all in the definitions. How does this reconcile with 15-30% loss ratios?
Top 11 Health Insurance company revenues and profits:
"In 2008, the combined profits among the top 10 U.S. health insurers would have only covered about two days of medical spending." - Exxon makes a 1/2 a penny on a gallon of gas.
Does this include the 2-3 billion each that the companies spend (does not appear on the income statements) to pay their executives stock dividends? No? Yeah, maybe next time use numbers like "Cash flow from operating activities."
Let's Talk Cost commented on May 11, 2011
Some of you have asked what “medical spending” includes. It is based on an estimate from the Centers for Medicare & Medicaid Services (CMS), which found that health care expenditures in 2008 exceeded $2.3 trillion. That includes all spending, from insurance premiums and doctor’s fees to public health programs and prescription costs. Or, as CMS puts it, “health care goods and services, public health activities, government administration, the net cost of health insurance and research and other investment related to health care.”
This Fast Fact is not talking about medical spending related only to the top 10 insurers — it’s talking about national, all-inclusive spending.
This site was developed for the purpose of getting the discussion going. We know we need to be a part of reducing costs. That’s why want everyone to contribute and voice their opinions about BCBSNC even if they are negative.
On a related point, CMS has updated its total health care expenditure estimate for 2009. We’re now up to $2.5 trillion — about $8,086 per person.
Ok, so you took the 2.5 trillion number and divided it by 309 million (new population number per US cencus) and got $8,086. But of the 2.5 trillion, is that the amount that I pay in premiums, + my out of pocket, plus your costs, plus the moeny the doctor spends, plus what the pharmacy pays employee, plus what drug companies pay to lobbyists? I think the 2.5 trillion number has been inflated by 4-5 times. It does not cost $8,000 per person and it is completely ridiculous to assume that that number is correct.
Shannon M. commented on November 12, 2011
Wow, $8086 per person. So, If only accounted for $400 to $1000 per year for 18 years are you saying that I am owed one awesome refund from BSBSNC???? Which BTW, most spouses of people that have BSBSNC "provided" cover themselves and their children for alot less, tremendously less, and they are on group plans with their employers. So, why is BCBSNC so expensive?, goat media campaigns?
I have read on here from Directors, Human Relations people, etc... and the purpose of this site is so I can contribute to an "open discussion" to help solve problems TO reign in medical cost? You guys earn awesome salaries to run this company. Sorry, but I should not have to run your company too. I am accountable for my work, and you should be too. I barely have time for my job much less yours. If you have to justify your profits, bonuses, and salaries through media goat campaigns, something is wrong.
Kathy Higgins commented on November 18, 2011
VP of Corporate Affairs
Shannon – The $8,086 per person is an average that covers all medical spending; this ranges from insurance premiums to doctor’s fees, public health programs and prescription costs. So while some people may spend significantly less on their medical care, others may spend significantly more. I think we can both agree that it’s hard to get a true snapshot, because all of our situations are so unique.
The harsh reality is that health insurance is expensive because health care is expensive.
I do want to mention that the Let’s Talk Cost campaign does not affect our customer’s premiums, which are determined by the price of medical goods and services and how often those goods and services are used. We believe that the thoughts and discussion started on this website can actually lead to cost savings. And we know that there are North Carolinians who want to share their ideas, and we are listening.
Our job as a health insurer is to pay medical bills, but we feel a greater responsibility to improve the health care system in North Carolina. And we cannot change the system alone – we need everyone from doctors, to pharmaceuticals, to individuals like yourself to share their ideas and perspectives on how we can work together to rein in costs. In turn, we believe this will help create a better health care system for North Carolina.
Wow, I thought your goat commercials were offensive, but this question just out right tells us that you think we have subpar intelligence.
1 - WLP made 2.8 billion dollars in profit in 2010*
2 - We will assume that WLP is one for the big 10 and represents 10% of the group.
3 - WLP spent 44.9 billion on benefit costs.
4 - That is therefore 6.2% of all benefit costs.
5 - Out of 365 days, that is 22.7 days. Not 2!
Maybe next time, before you use a Fortune Magazine reference you will:
A: reference the edition, page number, etc.
B: recalculate the numbers so as to make sure you do not misstate actual number by 1000%.
C: use a reference that is as of 2010 not 2008.
*(I am used 2010 numbers because the 2008 financial statements did not disclose to its investors the amount of benefits paid in 2008. This cost was only disclosed in 2009 and 2010 If we were to use 2008, and assume that benefits were similar to 2009, then we could say that benefit costs were 47.2 billion, and with a net profit of 2.5 billion, the number of days would have been 19.3 days, which is still way off compared to 2 days).
Micki P. commented on May 24, 2011
Didn't BCBS start as a "non-profit". Maybe health insurers should go back to being a "non-profit". Greed seems to have taken over the world. If a CEO could live on just one billion maybe the profit factor wouldn't have to be so large.
Also, auto liability insurers give "safe driver" discounts. Maybe you could build in "good health" discounts. The less you utilize the coverage due to good health, the lower the premiums?
Robin S. commented on May 27, 2011
If this is true, why do adminstrators of the companies receive million dollar bonuses often more than once a year? Sure these companies report such absurdities. What they don't share is how much $ they invest with our premiums. Most employees own stock in the insurance company and most are share holders. They make more money than we know. I do not believe this to be true, not one little pennies worth of truth.
Christopher R. commented on May 30, 2011
Are you just jealous that someone makes more money than you do? Or are you truly wondering why a CEO of a BILLION dollar company makes 3-4 million a year to be responsible for it. Maybe they could hire let's say you....to run it for 50k 60k??? Let's see...the average athlete makes what 2-4 million a year? Exactly what do they produce? Could we cut their income back to say 80-90k a year and use the proceeds to lower health costs???? BCBS had total revenue last year of 5.2 billion DOLLARS and the CEO made 4 million for being responsible for it. That's less than 1/10th of 1 percent of the revenue. I doubt it would really make a difference to employ someone that had no idea what they were doing.
Mr. J. commented on June 22, 2011
UNC Hospital is a state supported facility that has financial assistance programs for MEDICAL and PHARMACY benefits. The program determines eligibility by income and people in your household . You can have private insurance and still qualify for this program.
Lynn D. commented on July 3, 2011
A recent New York Times article pointed out that the reserves that many of the large health insurance companies have grown significantly over the past three years. The argument the insurers will make is that these are necessary to allow for future liabilities. When I receive a proposed 29.7% increase in BCBSNC health insurance premiums these large reserves are a bit hard to swallow.
John P. commented on August 19, 2011
The fact that BCBS NC has a Public Relations Manager on here trying to spin the truth tells us all we need to know. Just cover my kids medicine!!!!!
David Kochman commented on August 25, 2011
Thank you for your comment, John. We created Let’s Talk Cost to start a dialogue about solutions to the rising costs of health care. We are pleased with the level of participation and conversations taking place among users. But, it is very important to us that we are part of that dialogue as well. Our Public Relations Manager is one of many BCBSNC employees communicating across the website. There are also comments from our Chief Medical Officer, Director of Provider Relationships, Director of Member Service Operations, and even our CEO, Brad Wilson.
We realize if we’re going to find solutions to lower costs, we must be collaborative. We need all good ideas from everyone involved in health care. I hope you will join us in sharing your ideas to help rein in medical costs.
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