Health insurers not responsible for rising premiums, exec says

By Annette Boyle

With just 10 percent of health insurance premiums going to health plans, blaming insurance companies for rising rates makes little sense, according to an opinion piece published in the Albany Business Review.

Physicians and hospitals account for 55 percent of health costs, while pharmaceuticals represent 22 percent--up 6 percent in the last year alone, writes John D. Bennett, M.D., president and CEO of Capital District Physicians' Health Plan. Meanwhile, the percentage going to plan administration has hit a historic low.

Insurers have taken significant financial hits on Affordable Care Act marketplace plans due to enrollees who have been sicker and more expensive than expected. At the same time, hospitals and drug companies have posted double-digit profits, according to Bennett. Government efforts to reduce health insurance costs without addressing rising hospital and drug costs have led to rising copays, narrow networks and limited choices for consumers and employers, he adds.

Insurers have strived to negotiate prices with pharmaceutical manufacturers, but these efforts can also alienate some consumers who find their medications excluded from their coverage, FierceHealthPayer has reported.

State and federal governments must take legislative action to "rein in the true drivers of healthcare costs" rather than focus solely on rising premiums as insurers go through rate request processes this summer, according to the article.

To learn more:
- read the opinion piece