Expense report story draws plenty of emails

So, AGAIN, since Logan IS under Medicare then WHY should the County be paying $8595 for what I think they call a Supplemental B program? I have neighbors that have much cheaper medicare supplemental programs. Perhaps the supervisors could SHOP for a cheaper insurance program (especially if they are on Medicare) and they could be reimbursed for that lower amount.

Bill, the dynamics of premium costing, when Medicare is deemed primary and takes the first hit in paying for your health care, your SECONDARY coverage, if there is a balance left on any health care billing not paid by Medicare, pays LESS for the same health care services provided to you.

SO, why would you continue to pay the same premium for your seconday coverage, when they are contractually obligated to pay less under the terms of your secondary coverage that’s offset by Medicare.

You do pay a premium for both, so why aren’t you getting an actuarial premium discount on your secondary policy?

Or, have you determined the “group” your secondary coverage has you placed in, and if so, why would or should you be paying additional premium dollars to your secondary carrier who is paying out LESS loss dollars per health care incident.

I’m sure there’s a good reason why you are paying more for less coverage with your back up coverage, but I for one would ask where or how one obtains balance in premium cost; Primary vs Secondary.

I have ICD-9 material straight out of any billing department, from private to public health care facilities. It helps the patient to better understand that the jello being served doesn’t cost $750 per serving. This is where cost containment, utilization reviews and quality assurances come into play in better defining what your health care premium pay for, or not.

Bill, your insurance accounting is not much different than those throughout the world, except you have yet to identify which group you are assigned under terms of your secondary coverage and whether your GROUP is assigned a discount in premium charges when weighed against the coverage of your primary carrier.

Did you notice where Anthem BC/BS is raising their premiums because the younger half and healthy part of their book of of business is dropping out and leaving the old and older parts of the population to foot the bill and balance their financial books, even though they are paying less in losses, with Medicare picking up any and all of the health care cost from their primary position with BC/BS changing their underwriting standards to make up for lost customers and the premium dollars that once sustained BC/BS’s market share and profit margins.

We are part of that older population and the insurance industry is looking to us to keep their heads above water. If you have any actuary friends around they’ll tell you the same but with much more clarity. Their job explores chaos, reduces it to finite numbers, and then put their findings in terms we can ALL understand…even the formulas, fractions and facts. They can even pull you up as a population within a single district, county and country.

Since you can be found somewhere on a spreadsheet, and again on yet another spreadsheet, you are paying two premiums for a single health care incident where neither insurer knows what the other is doing by way of cost sharing your health care needs, other than working off each other to sustain their respective financial markets and cash flow.

I like to think of it in terms of knowing the difference…not knowing will not hurt you, unless you pick up a shovel. What you may unearth will always be your business and no others, UNLESS of course, you put your back into the digging.

Larry calls it critical thinking, which he confesses we need more of but are still coming up short. I liken his conclusions to responses we received a while back when American History by Zinn was under attack by prople who would prefer not to know and to stave off the knowledge brought to market by Zinn, they decided to use name calling as their first line of attack, and then came to the idea of book burning or have American History by Zinn removed from the bookshelves and piled up somewhere where they and their off spring no longer could or would be exposed to the harsh realities Zinn brought to the printed page.

Not knowing is a good thing. It keeps the multitudes silent and focused on mediocrity. Can critical thinking or an original thought take us somewhere else. Not really, unless you’re will to stand up in a croud and shout out that you’ve had enough. The tomatoes and cabbage heads will soon follow and challenge you to continue standing, or else.