Blue Cross Premium Increases To Be Resubmitted in California – Algorithms for “Desired Results”?
Posted Apr 30 2010 9:24am
This is certainly a welcome sign here to have the reports substantiated to ensure that the grounds for any increases are indeed correct. I talk about this quite a bit and just because a great looking report with tons of statistics generated by mathematical algorithms look convincing and we assume they are accurate doesn’t always mean they are. This has been going on for a long time and on Wall Street too, sometimes maybe a big game of “Liar’s Poker” if you will. Sure, there’s marketing and sales that comes into play here too, but we need honest representation and not “desired” numbers presented. Blue Cross said anything submitted erroneously was not done on purpose and said errors were not made intentionally. Ok, so now we have to figure out how to show that the report had errors.
With technology today and risk management formulas everywhere we turn, sure there’s a lot of room for “desired” results as there is for errors too, both happen. We are at the point in time today where we really need algorithms on both sides for accurate reporting as consumers are getting wiser simply due to the fact that ethics are getting in the way here and people want to know why. We gain a ton of of knowledge with formulas too, but it’s now to the point to where technology is required to tell the difference between those perhaps for profit and those that lead to better lifestyles, jobs, better health and those that are there to put humans into groups for making dollars. Certainly it bothers me and many others to see hedge funds created to “bet” against how long certain disease groups will live as what is happening on Wall Street too, this is just plain sickening. There’s no shortage by any means to create hedge funds for betting, so why do we have to bet on disease and people that are afflicted?
It is not rocket science to see that bigger than ever profits and bigger than ever rate increases don’t mix, at least for consumers, and on the other hand the insurers are also not a bottomless pit either, but somewhere in all of this there needs to be balance and accurate reporting done. Even the biggest scams, like the Madoff case had programmers with “dirty algorithms” that helped keep it going with creating “desired” results.
It’s time to remove that “8-track” tape player and go “digital” as we are finding the 8-track methodologies don’t apply and don’t work anymore. The executive branch of the government has a huge task upgrading infrastructure all over the place after years of neglect with those who continued to play the music with their 8-track tapes, like our former administration pretty much did; in other words in order to audit and keep everyone on the honest side here, the same technologies are needed on both sides.
This is a good sign that the reports were questioned and something that needs to be done on a constant basis to make sure that profit is not exceeding realistic numbers needed to provide care. When desired results fail to meet with current “real”assets, well we know what happens then, the bottom falls out, like what we experienced on Wall Street when consumer and investor confidence falls to a ground zero. The longer we “fool” ourselves with desired results, the worse it gets and it all will eventually shuffle out and the results are not pretty. BD
LOS ANGELES — Insurance giant Anthem Blue Cross drew public outrage and criticism by President Barack Obama as a poster child for out-of-control health care costs when it proposed raising rates for Californians by as much as 39 percent.
On Thursday, Los Angeles-based Anthem withdrew plans for the increase.
Anthem made the decision after an independent audit determined the company's justification for raising premiums was based on flawed data, state Insurance Commissioner Steve Poizner said.
The decision also came one day after Anthem's parent, Wellpoint, Inc. of Indianapolis, announced its first-quarter profit soared by 51 percent
He added that state officials immediately suspected Anthem's original proposal was inaccurate, but company officials insisted it was not. However, the company agreed to the independent evaluation by outside experts that subsequently uncovered the errors.
The study, more than 100 pages in length, will be released in the next few days, Poizner said. He said the cost of the study, which was not disclosed, is being billed to Anthem.