Overall costs, not insurer profits, are causing premiums to explode.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
In this episode, Marc discusses a new study that shows overall costs, not insurer profits, are causing premiums to explode.
Key Takeaways:
There is a familiar story in American healthcare: health insurance companies are the reason healthcare costs so much.
But a new study shows that overall healthcare costs not insurer profits drive premium increases.
Researchers looked at commercial insurance data from 2011 through 2024.
Average premiums increased by 78.4% during that period — an increase of $3,143 per enrollee.
But underlying healthcare spending increased by $2,844.
Thus, 91% of premium growth was associated with growth in healthcare spending.
Just 9% went toward insurer markup.
Medical loss ratio requirements limit insurer margins.
During the period studied, insurer markup (admin expense and margin) fell from
18.6% to 14.9% in 2024.
Certainly, make insurers more accountable.
But the current political argument over insurer greed keeps us from focusing on the real issue – the need for real healthcare reform: Price reform, pivoting to primary care and care management, and real affordable access.
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Resources:
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance
