Aetna Chairman Interview

JaJae · 03-29-2010, 03:52 PM

Good interview. The chairman of Aetna, Ron Williams, is interviewed by Business Week. In that interview he basically says Obama was wrong/lied about some key issues.

First, he says insurance premiums will increase and won't be decreased by $2,500 a year as Obama promised.

Secondly, he says your health insurance plan may change and your doctor may no longer be covered under the changes to your plan. Therefore, if you have insurance and you're happy with it... you may not be able to keep it. If you like you're doctor and you're happy with your doctor, you may not be able to keep them.

Aetna's Ron Williams on Health Care: What to Expect
At the Table: Charlie Rose talks to Aetna's Ron Williams

By Charlie Rose

Nixon couldn't do it. Clinton couldn't do it. But on Mar. 23, after decades of debate, lobbying, and political wrangling, Barack Obama signed health reform into law. What does this new mandate mean for individuals, companies, and the health-care industry? On Mar. 24, I talked with one of the executives on the firing line, Chairman and CEO Ron Williams of Aetna (AET), which provides health-insurance benefits to more than 36 million Americans.

CHARLIE ROSE
How do you assess the health-reform bill just signed by President Obama?

RONALD A. WILLIAMS
I think it is a significant milestone because it will give millions of people access to health-care services. I would probably have done things a little differently. But this is now an opportunity to get to work on the fundamental affordability of health-care services, [because] the mischaracterization of our industry as the problem really didn't permit us to work in a collaborative way.

My impression is that the President listened to doctors, nurses, insurance companies, and every other element of the health-care community.
There was good dialogue, but for a variety of reasons there was a point in the dialogue—in the summer—when the focus shifted from health-care reform to health-insurance reform. But it's not too late. We're committed to looking beyond where we are now and getting back to what we need to do to really achieve affordability.

Will insurance premiums go up?
The answer is yes, and some of the things that will drive those premiums are significant additional taxes the industry will ultimately have to pay in the first year.

The President said that this bill would not have any impact on people who already had coverage, that it was about the uninsured, that there would be no change. Will this legislation change the coverage of people who are already paying for it?
My perception is, yes, things will change. You might not have a plan that includes the exact same doctors. You might have plans that have richer benefits, and therefore you're going to pay more for benefits you may or may not want. It would have been a better message to say, we're going to make certain you maintain your eligibility.

Clay Christensen of Harvard Business School said recently that in health care, competition does not help control costs but rather drives them up. He said the structure of the system pits hospitals that want to fill their beds against insurers that want to minimize reimbursement and access. His answer was the health-care provider and health-care insurer should be one and the same, suggesting an integrated system like Kaiser Permanente in California.
Well, I think it's an interesting idea. But all health care, ultimately, is local. There are communities where that model has worked well. Kaiser and Group Health of Puget Sound are examples of where that's worked very well. But it requires a unique physician culture. And even firms like Kaiser, which has tried to expand into other geographies, have found that it's incredibly hard to replicate. Where it can work, it's a fine model. It's just not going to work in most communities.

During this year of debate that you talked about, there was a moment in which Health & Human Services Secretary Kathleen Sebelius was concerned by Anthem Blue Cross in California proposing a 39% rate hike and wanted an answer from the insurance company and the industry as to why this was happening? Was it justifiable, especially at a time of recession? What was the answer?
I'll leave it to others to explain the exact increase, because it wasn't our firm that was doing it, but the generic answer I gave the Secretary was first you had an increase from the underlying rate of medical costs—inflation from hospitals, physicians, drugs, devices, technology. You then had the fact that as a result of the economy, healthy members who had been insured for some time but found themselves in tight economic circumstances were canceling their insurance. So you lose the subsidy that is keeping the premium affordable for the insurance pool. At the same time you had a third factor: Healthy young members, as a result of the economy, not entering the insurance pool. Finally there is simply the aging of the population in the insurance pool. And I think that to blame the premium on the health plan really doesn't get at the underlying forces.

Do you feel like the insurance industry was demonized in this debate that took place over the last year?
Yes, I do. And I think our 35,000 employees at Aetna were perplexed and really, I think, very disappointed in the leadership of the country and their selection to demonize and impugn the motives of employees, doctors, nurses, and pharmacists.

By that, you mean the President.
I mean everyone involved.

A Wall Street Journal editorial on Mar. 22 said the first result of reform will be turmoil in the insurance industry, and as small insurers find it impossible to make money, a wave of consolidation is likely. You've already said premiums are going to go up. Are we also going to see consolidation?
I'm much more worried about the solvency question. If you're a small plan and you experience costs that you simply weren't able to price for, there could very well be insolvencies. It's been a long time since we've seen them in the insurance industry, but the insurance commissioners know what can happen.

Aetna's Ron Williams on Health Care: What to Expect - BusinessWeek

Black is the interviewer, Blue is Rob Williams. Aetna insures more than 36 million Americans.

Pro Street · 03-29-2010, 03:59 PM

Quickly, and not on-topic- I apologize for this, however is it not noticable the dialogue shaping?

Do you feel like the insurance industry was demonized in this debate that took place over the last year?
Yes, I do. And I think our 35,000 employees at Aetna were perplexed and really, I think, very disappointed in the leadership of the country and their selection to demonize and impugn the motives of employees, doctors, nurses, and pharmacists.

By that, you mean the President.
I mean everyone involved

.

Pro Street · 03-29-2010, 04:19 PM

To comment, several things come to mind.

He is right in many cases. Why would a plan change? It wouldn't as a result of the bill, but as the insurer's reaction and adjustments to the change. Regardless of the reason or justification, there should be clarity in that.

Also, intergrated systems, especially where it'd likely be a monopoly of one insurer/provider, would lead to corruption on untold scales. I agree with the CEO that it just would not work.

I'm for some kind of reform but against how it was, and continues to be handled. It's a huge issue that parties use as a political platform in which the entire American populace suffers on a whole.

The reall fallout from this will not be seen for several enrollment periods.

stolz25 · 03-29-2010, 05:20 PM

My wife's doctor retired in protest. It's a bit of a shame, she liked her quite a bit.

Henry · 03-29-2010, 05:28 PM

I don't know what would drive you to trust a company which kicks paying customers with cancer off their insurance, denies children with pre-existing conditions any chance of being able to pay for treatment, and denying payments at every turn to struggling families who paid medical insurance their whole life so they wouldn't go bankrupt

His complaints don't make any sense either, the bill that was passed was basically the Baucus bill in which Republican Senators were on CSPAN successfully adding a plethora of amendments, and also added things pre-markup in negotiations in the gang of six. Baucus's former staffer was a health insurance lobbyist involved in the negotiations. To say it somehow morphed into a different bill is without basis.

Of course he's going to say premiums are going to rise, what business executive would say they opposed the president for 14 months and they were stupidly wrong to do so?

I don't know why having a plan with greater benefits and better doctors is saying someone is going to be forced out of seeing their doctor.

Then he argues against insurers closing shop, not shocking

Amazingly, he says that because there was no mandate in California, insurance prices went up

I don't see anything where he says the president was wrong or lied about anything

Henry · 03-29-2010, 05:29 PM

Originally Posted by Pro Street

To comment, several things come to mind.

He is right in many cases. Why would a plan change? It wouldn't as a result of the bill, but as the insurer's reaction and adjustments to the change. Regardless of the reason or justification, there should be clarity in that.

Also, intergrated systems, especially where it'd likely be a monopoly of one insurer/provider, would lead to corruption on untold scales. I agree with the CEO that it just would not work.

I'm for some kind of reform but against how it was, and continues to be handled. It's a huge issue that parties use as a political platform in which the entire American populace suffers on a whole.

The reall fallout from this will not be seen for several enrollment periods.

What about the current law do you dislike?

JaJae · 03-29-2010, 05:38 PM

Originally Posted by stolz25

My wife's doctor retired in protest. It's a bit of a shame, she liked her quite a bit.

My doctor is very upset by it. He is the kind of doctor who isn't in it for the money. He changed careers late in life and went to medical school after being a very successful engineer. He started his own practice.

He is far from wealthy, but loves what he does. He schedules his patients well apart so he can spend quality time with each one. This means he makes less money since he doesn't throw his patients out the door. He takes the time to sit down and give you a shopping list of foods that will make you feel better, and educates you on your illness and such. He takes patients without insurance for only $40 a visit. He is the best doctor I've ever been to.

He hears Obama telling Medicare doctors to be "more efficient" to make up for the loss in revenues and he's about ready to gag. What he's saying is rush even more patients out the door, don't be as thorough, take more people and spend less time with each.

That is the crux of all of this. Increase taxes, increase premiums, cut payouts, and expect everyone to suck it up.

I was in the ER recently and all the doctors there were complaining about the bill as well.

Henry · 03-29-2010, 05:42 PM

What your doctor is saying basically is, don't touch Medicare, but if we did that, the whole country will literally, not theoretically, go bankrupt

I have no idea why an ER doctor would complain about it, this will drastically decrease their high high workload

JaJae · 03-29-2010, 06:15 PM

Originally Posted by Henry

What your doctor is saying basically is, don't touch Medicare, but if we did that, the whole country will literally, not theoretically, go bankrupt

It is more than that. These reforms operate under the principle that those in the healthcare industry are wasting money and are too wealthy. Where are all these extra taxes and government fees going to come from? From you, me, our employers and our physicians.

The problem with our healthcare system in this country is that we spend so much money on it. There really is no denying that we have some of the best quality insurance in the world. The problem was making it more cost effective. This plan takes us in the wrong direction.

I have no idea why an ER doctor would complain about it, this will drastically decrease their high high workload

It wasn't just the ER doctors, it was the nurses and the specialists seen. Everyone was talking about it. The problems they had with it surrounded around the idea of every time the government has regulated in the past things always got worse. That and the sheer cost/taxes/lies that it's budget friendly/etc turned them off from it.

Eventually it turned into a debate of "if they want to kill healthcare they should have two separate institutions like public and private schools", only if you opt for private care you should be entitled to "vouchers" or your tax money back. They basically said if all these supporters really think a government option or increased government regulation is such an improvement and so wonderful they should put their money where their mouth is and stop mucking it up for everyone else.

Henry · 03-29-2010, 06:33 PM

Originally Posted by JaJae

It is more than that. These reforms operate under the principle that those in the healthcare industry are wasting money and are too wealthy. Where are all these extra taxes and government fees going to come from? From you, me, our employers and our physicians.

The problem with our healthcare system in this country is that we spend so much money on it. There really is no denying that we have some of the best quality insurance in the world. The problem was making it more cost effective. This plan takes us in the wrong direction.

It wasn't just the ER doctors, it was the nurses and the specialists seen. Everyone was talking about it. The problems they had with it surrounded around the idea of every time the government has regulated in the past things always got worse. That and the sheer cost/taxes/lies that it's budget friendly/etc turned them off from it.

Eventually it turned into a debate of "if they want to kill healthcare they should have two separate institutions like public and private schools", only if you opt for private care you should be entitled to "vouchers" or your tax money back. They basically said if all these supporters really think a government option or increased government regulation is such an improvement and so wonderful they should put their money where their mouth is and stop mucking it up for everyone else.

Health care professionals complain about things like documentation and infection precautions

Would you really like it if your family medical history was handled in a lax manner, or your history was confusing to a doctor reviewing it

But most complaints have to do with infection precautions, and many Americans already die from infection caught in a hospital, if you sent your parents there I doubt you'd want a place with happier health care workers with a higher rate of infections

As health insurance costs continued to rise, more younger and healthier people will drop out, everyone I know who didn't have kids wanted to drop their health insurance, and when you have older and sicker people, and increasing medical inflation, premiums even for younger people will skyrocket

There are only two possible cures, a mandate or single payer

Donkey® · 03-29-2010, 06:34 PM

So let me get this straight...

Insurance Companies are more trustworthy than a black president.

Got it.

Henry · 03-29-2010, 06:36 PM

Originally Posted by Donkey®

So let me get this straight...

Insurance Companies are more trustworthy than a black president.

Got it.

I believe the health insurance executive is black

However, many white, black, Asian, Hispanic people are angels and demons

What should make you distrust him is that he is a health care executive

stolz25 · 03-29-2010, 06:36 PM

Originally Posted by Henry

There are only two possible cures, a mandate or single payer

The logical fallacy of false dilemma (also called false dichotomy, the either-or fallacy) involves a situation in which only two alternatives are considered, when in fact there are other options. Closely related are failing to consider a range of options and the tendency to think in extremes, called black-and-white thinking. Strictly speaking, the prefix "di" in "dilemma" means "two". When a list of more than two choices is offered, but there are other choices not mentioned, then the fallacy is called the fallacy of false choice, or the fallacy of exhaustive hypotheses.

False dilemma - Wikipedia, the free encyclopedia

It's very rare to see this fallacy used in such an obvious manner. Thanks for the laugh.

JaJae · 03-29-2010, 06:37 PM

Originally Posted by Henry

As health insurance costs continued to rise, more younger and healthier people will drop out, everyone I know who didn't have kids wanted to drop their health insurance, and when you have older and sicker people, and increasing medical inflation, premiums even for younger people will skyrocket

There are only two possible cures, a mandate or single payer

I am really trying to follow your logic here and am not trying to be cynical. If what I say comes off abrupt I apologize ahead of time.

But it seems to me you are saying that as healthcare costs rise people won't be able to afford it or won't be willing to pay for it. Therefore you support increased government regulation to make it even more expensive, yet forced on the populace?

Not everything can be solved by further government intrusion. Sometimes the problem is government intrusion. The government in a capitalist society cannot solve all of our problems. We need to step away from the mentality of giving up our freedoms to our government whenever there is a problem.

The Great Catpiss · 03-29-2010, 06:38 PM

Originally Posted by Donkey®

So let me get this straight...

Insurance Companies are more trustworthy than a black president.

Got it.

It's quite racist for you to think that.

I honestly don't know who is more or less trustworthy. Both have proven track records for being untrustworthy. Maybe it's hopeful thinking, as I am insured, but I put more trust in my insurance company.

stolz25 · 03-29-2010, 06:38 PM

Originally Posted by Donkey®

So let me get this straight...

Insurance Companies are more trustworthy than a black president.

The beauty of having a black president; No matter what the political issue, now it can be made into a race issue.

JaJae · 03-29-2010, 06:42 PM

Originally Posted by Donkey®

So let me get this straight...

Insurance Companies are more trustworthy than a black president.

Got it.

pathetic.

Donkey® · 03-29-2010, 06:45 PM

Well you guys help me. Why else should we trust an insurance executive over your own president? When you weed out all the bullshit reasoning...add up the "coincidences" since Obama is in office (he's not born in this country, etc...) then you start to see the real reasons plain as day. He's black. It's a shame you guys won't admit it but hey...hate on.

Henry · 03-29-2010, 06:46 PM

Originally Posted by stolz25

False dilemma - Wikipedia, the free encyclopedia

It's very rare to see this fallacy used in such an obvious manner. Thanks for the laugh.

You don't have to be so rude

It can only be a false choice if there is another choice, if there is, I have no problem being wrong

I assume you have actually been wrong a point or two in your entire life?

Henry · 03-29-2010, 06:49 PM

Originally Posted by JaJae

I am really trying to follow your logic here and am not trying to be cynical. If what I say comes off abrupt I apologize ahead of time.

But it seems to me you are saying that as healthcare costs rise people won't be able to afford it or won't be willing to pay for it. Therefore you support increased government regulation to make it even more expensive, yet forced on the populace?

Not everything can be solved by further government intrusion. Sometimes the problem is government intrusion. The government in a capitalist society cannot solve all of our problems. We need to step away from the mentality of giving up our freedoms to our government whenever there is a problem.

I support a solution

Yes, the government can not solve everything, that is why we are in a capitalist democracy