I was struck by an op-ed relating OSPIRG's efforts to open up the rate review process in Oregon. OSPIRG working in concert with DCBS brought rate review before the public in a big way. That is certainly a good thing. But how good? The trouble is, the individual and small group markets were already pretty well regulated:
Notice the horizontal axis crosses the vertical at 80%. To be clear, the medical loss ratio is the portion of premium going to medical bills. The portion above the medical loss ratio is production expense, admin and profit. That insurance portion of premium is what OSPRIG is gunning for, they've said nary a word about the money on the medical side, where the vast bulk of the dollars go.
OSPIRG's efforts are further limited in that the review process they're promoting is limited to individual and small group markets. In the latest Health Insurance in Oregon report those two groups total 36% of the private market. Which is to say, among Oregonians who have private insurance for every one who might be helped by these efforts there are almost two who will not.
Combining the market distribution with a lowball MLR pick of 80% and you get this:
Not as ineffective as Republicans when it comes to health care reform, but it sure does leave room for improvement.