A company that once paid out $80 billion annually -- $60 billion in benefits and $20 billion in profits -- will, in order to satisfy the law, pay $80 billion in benefits while maintaining its $20 billion in profits. No new services have been added but prices will have increased 33% on the consumer.

in services.

If demand stays flat but outlays increase you have cost inflation.

cost because their profit can only rise when their expenditures rise. That sounds crazy and seems like it can't be right. Right? It just seems like, since the insurance company is going to make 20% profit no matter what they might rather pay for 100k appendectomies than 30k and simply pass the cost of their increased profits on to the customer and the tax payer. Somebody please explain to me how my analysis is batshit insane. I'm sure it is, I just can't see how.

By itself the MLR gives them an incentive to pay more for care and then pass the increase on in premiums. I'm thinking that there must be something else in the bill to limit this behavior, at least I hope that their is.

that are also in the ACA.

For instance, the shift to actually "curing" the problem rather than having the patient return for multiple procedures.

expanding their customer base to collect more revenue.

Or is tha wrong?

especially if they can negotiate under the table kickbacks also.

And the Exchanges make it easy to compare premiums. I, for sure, won't select the high premium plan unless it offers something else I find desirable.

does not help at all.

Their slice of the pie is set in stone. But their industry, still free of anti-trust laws, gets to determine how big the pie gets during price negotiations.

Besides the magic market force of "competition", they have every incentive in the world to negotiate higher and higher prices with providers. Ill believe in the force of "competition" when I see it working.

But rate increases are still allowed. They are still allowed, every year, to increase rates and will continue to do so (as in the past) faster than inflation.

The US is already fucked. They may be slowed in how much more they can fuck you but that's that.

Their is no MLR on providers and producers and they already get paid less than they bill.

The MLR is also already at the levels set in the law but there is a benefit and it is significant which is defining medical expenses in order to make the calculation and we have been able to tighten this up it would appear so far and just that allows us a somewhat better handle for more serious containment efforts in the future.

Another beneficial and missed side effect is that because of the last point the industry may well be forced to maintain and grow their bottom lines by actually providing care and maybe even more flexibility and choices. That won't save money or generate savings but it might force some care as the model is subtly converted from profiting from denying care to an atmosphere of providing a certain level of care out there to generate their cut.

Of course in the existing structure, such a thing is somewhat self defeating because health care cost continue to eat up GDP percentage and government's spending on the sector continues to rise or we become waiver nation or paying the cartel becomes a civic duty even as subsidies cannot keep up and it becomes a form of indentured servitude, but with little tangible in return, an ever increasing tithe.

Medicare for all.. but this is all they had the votes for and it's a good start.

Thank you, jazzimov