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Insurers Set To Raise Prices, Walk Away From Consumers: Goldman Report

First Posted: 5/5/10 Updated: 5/25/11

Wellpoint

The market concentration for health insurance is so monopolized in some areas that insurance companies are willing to raise prices and lose customers in an effort to improve their bottom line, a leading insurance broker told Wall Street analysts on Wednesday.

In a conference call organized by Goldman Sachs Global Investment Research, Steve Lewis, a highly regarded broker at the world's third largest insurance broker, Willis, painted a picture of the health insurance market in which employers seem likely to be priced out of coverage.

Noting that "price competition" between insurers was "down from a year ago," Lewis relayed that "incumbent carriers seem more willing than ever to walk away from existing business."

The phenomenon of insurers pricing their policies beyond where consumers can afford it seems to be already taking place. Last month Anthem Blue Cross told customers it would hike their health insurance premiums by as much as 39 percent (with the expectation that some would drop coverage altogether). In December, the Huffington Post reported that Aetna was planning on losing more than 600,000 customers by raising prices on their consumers in 2010.

Insurers are able to do this in part because the markets in which they operate have no adequate competition, suggests Lewis. The broker noted that "the smaller client segment" was "increasingly frustrated" with the renewal of their coverage and was "evaluating potential self-funding with stop loss protection" instead. Lewis added that employers in many markets knew "that they're not going to be able to trade down pricing very significantly" (i.e. find cheaper coverage) and, as such, would likely only change plans or become self-insured if there was a "fairly significant" disruption in service.

"As I mentioned at the outset, it was without a doubt the most challenging renewal cycle in my 20 years of this business with employers really struggling with how and what was going to drive their decision, combined with the lack of aggressive and competitive pricing in the marketplace," Lewis said.

The remarks are as clear an indication as any that while the health insurance industry suffered greatly from the recession it remains remarkably well positioned to recoup those profits going forward -- principally because companies can raise prices without worrying about the market hit it will take.

The Democratic-authored health care package would eliminate the anti-trust exemption that health insurers enjoy, require insurers to spend a high percentage of their funds on medical costs and create a commission that would oversee unexpected hikes in premiums. And yet, Lewis says that the clients he represents (employers who purchase health care coverage) have largely soured on the reform process even if they are favorable towards the overall goals.

"I think most people would acknowledge that there's a need for health care reform, employers continue to be very frustrated," he said. "But I would also say that many of them still view the legislation and the partisanship coming out of Washington as possibly the medicine worse than the disease. So, many employer groups that we're talking to feel like it would be a shame to lose an opportunity to do something with respect to health care reform. But many are starting to feel like maybe nothing is better than something in this current environment."

A call to Lewis for additional comment was not immediately returned. Below is the full transcript of his remarks


LewisGoldman
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The market concentration for health insurance is so monopolized in some areas that insurance companies are willing to raise prices and lose customers in an effort to improve their bottom line, a leadi...
The market concentration for health insurance is so monopolized in some areas that insurance companies are willing to raise prices and lose customers in an effort to improve their bottom line, a leadi...
 
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Icecube
Fortuna's #1 Leykis 101 graduate
10:49 AM on 04/12/2010
Was there any doubt?
HUFFPOST SUPER USER
Jim Pasterczyk
Banned!
12:21 AM on 03/09/2010
Time to take away their antitrust exemptions­.
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HUFFPOST SUPER USER
time4change2009
05:52 PM on 03/08/2010
The bottom line of this article...­.WE MUST FIGHT FOR STRONG, COMPETITIV­E, AFFORDABLE PUBLIC OPTION !
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ecoalex
Ecofarmer
05:48 PM on 03/08/2010
There's no markets here in rural Ca,Blue Cross is the only game in my county.The­y raised my premium 20%, and probably will raise it another 20+% in April.The people I talk to want reforms, I think the only people the repubs talk to are the health ins cos.I hope the public option is put in the bill, along with anti trust laws for the H Ins Cos.The pricing for medical care is obscene.We must have reforms NOW.
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HUFFPOST COMMUNITY MODERATOR
OswegoKayaker
Freedom's just another word . . .
01:46 PM on 03/08/2010
Insurers have been walking away for years -- trying to get rid of people who actually use their insurance and not just pay for it. Every year you get less bang for your buck. Meanwhile they make doctors file more and more paperwork requiring them to hire more and more people just to process the demands of each and every different insurance they accept -- guess who pays for this? Doesn't do a thing to make you well. Insurance companies are making health care more expensive even without their bills.

Pre-existi­ng conditions are what they usually use for anything they really don't want to pay for -- because technicall­y anything you have is pre-existi­ng except maybe breaking a bone. Soon they will be demanding DNA profiles of what you COULD get and charge you accordingl­y.

A friend of mine lives in FL and needed a major operation. She was totally underinsur­ed for something like this, being an extraordin­arily healthy person she never had to use the insurance she had which would pay for the operation but not expensive pre-testin­g, her doctor, knowing this, put her in the hospital BEFORE all the expensive pre-testin­g was done. Otherwise, I guess she would have lost her house paying for all this.

I am not sure where all these Republican­s are getting numbers that say their constituen­ts don't want health care reform -- but either they are not telling the truth or they are representi­ng some really stupid people.
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HUFFPOST SUPER USER
johnjam101
09:50 AM on 03/09/2010
It's all in how you ask the question. Of course many Americans including myself are unhappy with the HC Bill as is. That doesn't mean I don't want them to pass it and reform the reform.
The Republican­s are just using whatever poll advances their game plan to take back the House.
People just need to pay attention which takes time and effort and not many do this. All politician­s use polls and statistics to further their desire. Unfortunat­ely in a democracy the voters get overloaded and confused thus they vote against their own interests. We see it all the time.
12:19 PM on 03/08/2010
When even republican­s can't get health insurance and now "it's all about them" will they wake up? Doubtful..­...
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Stretchumall
"With Liberty and Justice for All"
11:21 AM on 03/08/2010
The health insurance companys are just being misunderst­ood. Our representi­tives are the ones who are just soo dumm they don't understand whats happening. The health insurance industry is Screaming to be put out of buisness but our politician­s won't do it.
Health Insurance Companys have been doing everything but Demand to be put out of buisness, but they can't just come out and say "We believe in Universal Single Payer Socialist Style health care" now can they? After all that would be "UnAmerica­n". So instead they kick people off, deny care, raise rates, etc. hoping that Somebody does Somthing. Well! What You say Congress? How bout you Senate?
Why won't you give the insurance companys what they want?
WonderingNThinking
Think Before We Sink
03:11 AM on 03/09/2010
Thanks for that!
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Levonsky
light, sweet, crude
10:59 AM on 03/08/2010
Insurance companies are the DEATH PANELS!
WonderingNThinking
Think Before We Sink
03:11 AM on 03/09/2010
My sentiments exactly
10:55 AM on 03/08/2010
I know there was a provision in the health care reform bill that would require everyone to have insurance. If that provision is still in the bill, the fact that the insurance companies raised their rates was both cynical and predictabl­e. IF that provision is in the bill, it's obvious that many people will not be able to afford private health care and will have to be subsidized by the government­. It's perfect. Kill the public option but make sure government dollars have to be funneled through an expensive middle man (private insurers). From this perspectiv­e, these companies are raising rates to get as many tax dollars as possible. Or to quote Matt Taibi of the Rolling Stone magazine, they are insuring they can insert their "blood funnels" deep into the public coffers.
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HUFFPOST SUPER USER
blueken
Finger Picking blues man
09:43 AM on 03/08/2010
I frimly believe that when employer based contracts come up for renewal there will be much weeping and wailing and nashing of teeth. After decades of increases at 3 times the inflation rate, I'm pretty sure the next increase will be in double digits. A lot of employers across the country are not going to take a big hit like that. Many of them just can't. So what are the options. Higher co-pays, greater deductable­s and more employee contributi­ons. At that point, I hope those 80% of Americans who are happy with the present system ask themselves "Why?" Why am I happy with this system? Why does it cost so much? Why are so many people denied health care?
HUFFPOST SUPER USER
pjwrites
08:09 AM on 03/08/2010
I'll do the insurance companies one better.

How about we all walk away from them, instead?
OncologyRN
The right pair of shoes can change your life.
12:54 PM on 03/08/2010
We are trying to do that but the Republican­s won't let us.
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10:20 PM on 03/07/2010
and we're listening to the "experts" at Goldman Sachs because???­?
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Mikaela Epps
09:44 PM on 03/07/2010
So what do you say to those who argue, with no incentive you will never have "the best" ?? Everywhere still believes America has the BEST medical field..

But is that due to all our IMPORTED doctors??

Just a question..
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10:13 PM on 03/07/2010
Fact is we don't have the BEST medical field any more, we don't have the BEST of anything any more. We have to get over ourselves & get real

The possible exception would be that we have the best of cowardice & greed.
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Peyton Farquhar
01:18 PM on 03/08/2010
But we do, in fact, have the "best." Congre$$ is the best government that money can buy.
08:35 AM on 03/08/2010
Being 37th is not the best.
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quillsinister
08:00 PM on 03/07/2010
It's really far past time that we took a hard look at the rest of the civilized world and admitted that socialized medicine just works better. Try to visualize the methods of our for-profit healthcare system being applied to education, or the fire department­, or the police.

Imagine:

-Hello, 911? There's someone trying to break into my house!
-We're sorry, the crime rate in your neighborho­od has been designated as a pre-existi­ng condition. Your crime protection policy has been cancelled.
-But he's breaking in the door!
-Have a nice day, and thank you for choosing InsuraSafe Police Services.
[click]

There are just some things a civilizati­on spends money on as an investment in a stronger commonweal­th. Healthcare should be one of them. And almost everywhere else, it is!
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returntocommonsense
Democracy is a verb - or at least it should be.
06:10 PM on 03/07/2010
Two possible solutions - hit them with lawsuits under the Sherman Antitrust Act and/or windfall profit tax. I can't think of a more deserving group of people
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07:31 PM on 03/07/2010
Regulate them up the wazoo.
09:35 PM on 03/07/2010
I think it is way past time for everyone to cancel their health insurance. We are pouring money into a group of dysfunctio­nal, greedy people. We are enabling them in their addiction. It is time we stopped doing it.
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Mikaela Epps
09:39 PM on 03/07/2010
Shortly after I lost my insurance from switching j
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returntocommonsense
Democracy is a verb - or at least it should be.
06:46 AM on 03/08/2010
Just don't get sick. Medical care (especiall­y hospitals) are very expensive. You need to have at least a million set aside if planning for catastroph­ic health issues such as a heart attack, cancer, a car accident that puts you in an ICU, etc.