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Health Insurance Rates

Many people in the country feel that health insurance rates in America have become unaffordable for the average family.  The numbers sit somewhere at 49 million people without health insurance in America.  This number is up from 2005 when the rate was around 47 million. 

Health Insurance Rates For The Average Family

Most families are paying upwards of $10,000 for a family policy.  Although employers are paying the majority of the premiums, only 60% of them are even offering health insurance.  Individual health insurance rates are around $4,500.  What is somewhat surprising is that individual health insurance rates are lower than group rates! That’s because group insurer have to include others with pre-existing conditions, poor lifestyle choices and general high risk candidates in your rate.

There was a time, not too long ago when the non working poor could get Medicaid and the problem was solved.  It soon became clear that the working poor had to make a choice between basic needs and health insurance.  Basic needs won that battle.  State health departments began to rise to the occasion by implementing programs to offset health insurance rates.  Tax credits were issued.  Now the problem has impacted the middle class, the working majority, and many argue that something has to be done on the national level. 

Health Insurance Rates Got To This Point Gradually

Remember in the 1980’s, when the idea of Health Maintenance Organizations (HMO)s, and related organizations were thought to be a great idea for curbing health care costs?  The health care industry concluded that the public was abusing health care benefits.  There were people going to their physicians for frivolous reasons and wanted to discuss numerous ailments. 

On the other end, insurance companies saw doctors billing them for unnecessary procedures.  Hospital stays could be reduced to more out-patient options.  Medicaid was being hit hard.  Someone had to get a handle on things thus health maintenance became a health industry name.  This introduction included primary care physicians (PCP), then came Preferred Provider Organizations (PPO), and Point of Service plan (POS). 

Health Insurance Rates Signal Fraud

Now we are at a place where health insurance rates are exceeding the rate of inflation.  The inflation rate is around 2.5% while health insurance rates rose 6% in the past year; an improvement over previous years.   The increase in health insurance rates directly mimics the rising costs of medical (which also outstrips the pace of inflation) and many would argue that the best way to bring health insurance rates back in check is to force health care providers to offer more transparent pricing. Many would make the case that increased transparency in health care pricing would lead to cheap health insurance in the future.

However, it is also recognized that there may be a need to limit abusive practices as one way to save money.  Let’s face the truth about the amount of abuse in Health care:

     • Insurance Companies overcharging subscribers/Manipulating Rates      • Consumers abusing minimum income requirements      • Prescription fraud and theft

     The Health Care Anti-Fraud Association (HCAFA) polices:

  1. Provider Fraud                                  

  2. Managed Care Fraud

  3. Consumer Fraud                                

  4. Disability Insurance Fraud

  5. Broker/Agent/Employee Fraud

The Way Health Insurance Rates Are Established

Major insurance companies use a system called Ingenix to determine health insurance rates.  Ingenix is a subsidiary of United Health.  It establishes usual customary rates based on variables of common ailments, conditions, and treatments.  This system has been confronted with controversy. 

Attorney General Cuomo of New York is suing Ingenix for price manipulation and fraud that is expected to reach into the billions.  It is questionable when a parent company of an outfit who actually owns the system determines how much it gets to put into its own pockets. 

Many Federal and State Government officials are beginning to take notice. Los Angeles City Attorney R. Delgadillio has set up a fraud website for consumers to report health insurance fraud.

Health Insurance Rates Could Impact The Nation

It is apparent that something has to change in the healthcare industry.  Our leaders can not just allow health insurance rates to keep increasing exponentially.  A lack of health insurance will impact our nation tremendously.  Preventive medicine strides will fall by the wayside.  People will be showing up in emergency rooms with late stage conditions.  Physicians will start to close private practices due to excessive malpractice fees.

Your Solution To Rising Health Insurance Rates

There have been some solutions proposed for the rise in health insurance rates.  Aside from the proposals that the Presidential candidates have made, there are some who feel they have solutions. 

There are a few who suggest that we do away with HMOs and allow people to pick their own physicians and maybe even pay them directly.  Then there are others who believe that there should be a third party system to establish and regulate health insurance rates. 

Although we have a regulating system, we need to possibly expand it as big as the conglomerates it regulates. Solutions need to be tried to see if we can have some positive impact on health insurance rates, before health insurance becomes a luxury for only the rich in this country.

What can you, as an individual, do to protect yourself and your family? Your best bet is to be very aware of your options. Know your needs, and get numerous quotes from multiple providers. There are discounts available, so be certain to ask about them. By being an informed consumer, you really can save yourself a lot of money, and protect your most valuable asset: your health.

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If you want to get information about your own personal health insurance rates, click on the quote tool at the top of this page and get started comparing rate quotes from top health insurance companies. Get started finding health insurance now!