Blue Cross Blue Shield to Leave USVI Owing Local Health Providers Massive Sums

FYI - Full statute

§ 224. Withdrawal of insurer; reinsurance

(a) No insurer shall withdraw from this territory until its direct liability to its policyholders and obligees under all its insurance contracts then in force in this territory has been assumed by another authorized insurer under an agreement approved by the Commissioner. In the case of a life insurer, its liability pursuant to contracts issued in this territory in settlement of proceeds under its policies shall likewise be so assumed.

(b) The Commissioner may waive this requirement if he finds upon examination that a withdrawing insurer is then fully solvent and that the protection to be given its policyholders in this territory will not be impaired by the waiver.

(c) The assuming insurer shall within a reasonable time replace the assumed insurance contracts with its own, or by endorsement thereon acknowledge its liability thereunder.

this is what i was referencing

I don't understand the negative comments about The Source. But since complaints have been voiced I feel compelled to comment that were there a forum proofreader on board here, he or she would be working 24/7 and quickly need additional staff. Additional staff, of course, to restrain the assertion of personal views cloaked as fact.

I know exactly what you were referencing and the one obviously has absolutely nothing to do with the other which not only anyone with any degree of reading comprehension can understand but which I responded to. As suggested, if you have something of merit or of relevance to offer to my thoughts about the legal sustainability of the clause in question, then please share. Otherwise why waste time trying to come up with irrelevancies simply designed to goad - or in forumspeak, "trolling".

I know exactly what you were referencing and the one obviously has absolutely nothing to do with the other which not only anyone with any degree of reading comprehension can understand but which I responded to. As suggested, if you have something of merit or of relevance to offer to my thoughts about the legal sustainability of the clause in question, then please share. Otherwise why waste time trying to come up with irrelevancies simply designed to goad - or in forumspeak, "trolling".

LOL! Say what????

You responded to an irrelevant comment in the first place. Speee1dy and I responded to that comment. That's not trolling in forumspeak, or any other language.

LOL! Say what????

You responded to an irrelevant comment in the first place. Speee1dy and I responded to that comment. That's not trolling in forumspeak, or any other language.

This is not complicated. Two different issues. One related to media reporting and negative comments on same, one related to the legal sustainability of an article of VI law.

/popcorn

The islands could easily adopt Kaiser model plan where the hospital assumes all risk for treatment and funding comes from sales tax, tourist tax and copays at the time of service. All residents are insured. The hospitals could also drop out of Medicare and all associated headaches of quality reporting, Joint Commision, core measures, EMRetc for Medicare PITA money. BTW quality reporting measures costs $15B annually in US.

Hospitals are government entities here. Let the hospitals be community property reporting to the Board. Purge the system from all the non performing personnel. Bring strong management team. Put nurses back to patient care as opposed to being bloated mid level administration. The midlevels primarily exist to satisfy crazy policies of Medicare. Untying from the government could cut a lot of red tape. The hospitals have absolute monopoly here. That monopoly could be leveraged.

Insurers are running away from VI as costs are more bloated here than on Mainland. Insurers pay premium here because of free services to uninsured and immigrants. I think Cigna could be next. This cost shifting is madness. Healthcare can be affordable if done right. Thailand has done it. Singapore has done it. So much care can be delivered inexpensively if red tape is cut. All that needs to be done is bypass US to purchase drugs and equipment and lability maddens of US can be easily controlled.

Don't chase the cutting edge of medicine. Stick to the well proven clinical pathways. 90% of population need quality basic care. Start working on health awerness, proper nutrition, preventive care.

This was once strong, healthy and fit population. Western diet and lifestyle made them sick. Same thing that happened to Pacific Islanders in HI.

LOL! Say what????

You responded to an irrelevant comment in the first place. Speee1dy and I responded to that comment. That's not trolling in forumspeak, or any other language.

This is not complicated. Two different issues. One related to media reporting and negative comments on same, one related to the legal sustainability of an article of VI law.

SMHO&O. Kind of my whole point. Too much obtuseness for one day for me. TTFN.

The islands could easily adopt Kaiser model plan where the hospital assumes all risk for treatment and funding comes from sales tax, tourist tax and copays at the time of service. All residents are insured. The hospitals could also drop out of Medicare and all associated headaches of quality reporting, Joint Commision, core measures, EMRetc for Medicare PITA money. BTW quality reporting measures costs $15B annually in US.

Hospitals are government entities here. Let the hospitals be community property reporting to the Board. Purge the system from all the non performing personnel. Bring strong management team. Put nurses back to patient care as opposed to being bloated mid level administration. The midlevels primarily exist to satisfy crazy policies of Medicare. Untying from the government could cut a lot of red tape. The hospitals have absolute monopoly here. That monopoly could be leveraged.

Insurers are running away from VI as costs are more bloated here than on Mainland. Insurers pay premium here because of free services to uninsured and immigrants. I think Cigna could be next. This cost shifting is madness. Healthcare can be affordable if done right. Thailand has done it. Singapore has done it. So much care can be delivered inexpensively if red tape is cut. All that needs to be done is bypass US to purchase drugs and equipment and lability maddens of US can be easily controlled.

Don't chase the cutting edge of medicine. Stick to the well proven clinical pathways. 90% of population need quality basic care. Start working on health awerness, proper nutrition, preventive care.

This was once strong, healthy and fit population. Western diet and lifestyle made them sick. Same thing that happened to Pacific Islanders in HI.

Really? LMAO

*-)

/popcorn

Doctors call for universal healthcare, abolish insurance companies.

http://www.occupy.com/article/us-doctors-call-universal-healthcare-abolish-insurance-companies

I'm laughing, too. No sales tax and tourist taxes go to promote the territory as a destination.

Nobody gets it. The VI is too small a pool for any for profit health insurer to break even let alone make a profit. The existing model will never work here so if you want health insurance it's best to work for the federal government, local government, national company, well funded non profit, or a few private local companies. Or be prepared to die or go broke if you're injured or have a disease like cancer and are trying to stay alive. Those are your choices and that's what it's like working for most micro businesses in the US and the USVI. Well, that's how I see it and that's how I saw it before I moved here.

The politicians always say they are for "small businesses" as the economic driving force, but those small businesses are disadvantaged because very few can afford to offer benefits that compare to large corporations.

We need so many revolutions in the U.S., but Bernie hasn't taken health care on as one of his revolutionary issues. Until someone does, the only health insurance I would feel confortable with is some type of federal coverage.

[aquote="Gator's Mom"]

The islands could easily adopt Kaiser model plan where the hospital assumes all risk for treatment and funding comes from sales tax, tourist tax and copays at the time of service. All residents are insured. The hospitals could also drop out of Medicare and all associated headaches of quality reporting, Joint Commision, core measures, EMRetc for Medicare PITA money. BTW quality reporting measures costs $15B annually in US.

Hospitals are government entities here. Let the hospitals be community property reporting to the Board. Purge the system from all the non performing personnel. Bring strong management team. Put nurses back to patient care as opposed to being bloated mid level administration. The midlevels primarily exist to satisfy crazy policies of Medicare. Untying from the government could cut a lot of red tape. The hospitals have absolute monopoly here. That monopoly could be leveraged.

Insurers are running away from VI as costs are more bloated here than on Mainland. Insurers pay premium here because of free services to uninsured and immigrants. I think Cigna could be next. This cost shifting is madness. Healthcare can be affordable if done right. Thailand has done it. Singapore has done it. So much care can be delivered inexpensively if red tape is cut. All that needs to be done is bypass US to purchase drugs and equipment and lability maddens of US can be easily controlled.

Don't chase the cutting edge of medicine. Stick to the well proven clinical pathways. 90% of population need quality basic care. Start working on health awerness, proper nutrition, preventive care.

This was once strong, healthy and fit population. Western diet and lifestyle made them sick. Same thing that happened to Pacific Islanders in HI.

Really? LMAO

I'm laughing, too. No sales tax and tourist taxes go to promote the territory as a destination.

Nobody gets it. The VI is too small a pool for any for profit health insurer to break even let alone make a profit. The existing model will never work here so if you want health insurance it's best to work for the federal government, local government, national company, well funded non profit, or a few private local companies. Or be prepared to die or go broke if you're injured or have a disease like cancer and are trying to stay alive. Those are your choices and that's what it's like working for most micro businesses in the US and the USVI. Well, that's how I see it and that's how I saw it before I moved here.

The politicians always say they are for "small businesses" as the economic driving force, but those small businesses are disadvantaged because very few can afford to offer benefits that compare to large corporations.

We need so many revolutions in the U.S., but Bernie hasn't taken health care on as one of his revolutionary issues. Until someone does, the only health insurance I would feel confortable with is some type of federal coverage.

[aquote="Gator's Mom"]

The islands could easily adopt Kaiser model plan where the hospital assumes all risk for treatment and funding comes from sales tax, tourist tax and copays at the time of service. All residents are insured. The hospitals could also drop out of Medicare and all associated headaches of quality reporting, Joint Commision, core measures, EMRetc for Medicare PITA money. BTW quality reporting measures costs $15B annually in US.

Hospitals are government entities here. Let the hospitals be community property reporting to the Board. Purge the system from all the non performing personnel. Bring strong management team. Put nurses back to patient care as opposed to being bloated mid level administration. The midlevels primarily exist to satisfy crazy policies of Medicare. Untying from the government could cut a lot of red tape. The hospitals have absolute monopoly here. That monopoly could be leveraged.

Insurers are running away from VI as costs are more bloated here than on Mainland. Insurers pay premium here because of free services to uninsured and immigrants. I think Cigna could be next. This cost shifting is madness. Healthcare can be affordable if done right. Thailand has done it. Singapore has done it. So much care can be delivered inexpensively if red tape is cut. All that needs to be done is bypass US to purchase drugs and equipment and lability maddens of US can be easily controlled.

Don't chase the cutting edge of medicine. Stick to the well proven clinical pathways. 90% of population need quality basic care. Start working on health awerness, proper nutrition, preventive care.

This was once strong, healthy and fit population. Western diet and lifestyle made them sick. Same thing that happened to Pacific Islanders in HI.

Really? LMAO

It's that time of year with all the smiling faces graduating from UVI. Among them, I'm sure, entrepreneurial spirits with great ideas for the community. I wonder how many will be able to stay in the VI once they have families and require dependable health care.

It's that time of year with all the smiling faces graduating from UVI. Among them, I'm sure, entrepreneurial spirits with great ideas for the community. I wonder how many will be able to stay in the VI once they have families and require dependable health care.

Dependable health care isn't at a premium, it's the cost of individual health insurance which is a problem - and it's been that way for at least the last 20 years. I've no doubt that BCBS will be replaced as a group insurance carrier but there's been little done to resolve the problem of affordable individual coverage.

It's that time of year with all the smiling faces graduating from UVI. Among them, I'm sure, entrepreneurial spirits with great ideas for the community. I wonder how many will be able to stay in the VI once they have families and require dependable health care.

Dependable health care isn't at a premium, it's the cost of individual health insurance which is a problem - and it's been that way for at least the last 20 years. I've no doubt that BCBS will be replaced as a group insurance carrier but there's been little done to resolve the problem of affordable individual coverage.

May I ask what you consider affordable? family and individual plans?

In FL, my individual coverage (without employer supplement) is about $600 per month. That is what I'll be paying as a retiree in the VI.

An ACA individual plan would be more with reduced coverage (and won't work in VI).

What I consider affordable isn't relevant. The average annual VI salary is $35K and your premium of $600/month would be a tough nut to crack on that salary. If your ACA plan (yes, I do know it's not available here!) would be more than $600/month then one must assume you're in a high income bracket.

If you're making $35K a year you'll pay full ride for ACA.

But I'm not young.

*-)

/popcorn

Doctors call for universal healthcare, abolish insurance companies.

http://www.occupy.com/article/us-doctors-call-universal-healthcare-abolish-insurance-companies

Does anyone know who else does 2-50 employee based health care plans besides BCBS?
I believe United Health Care used to. not sure if they still do or who else might

They still do.

So just curious, hypothetically, if you and your spouse created and incorporated some type of business that both of you were employed by, couldn't you then get health insurance?
Also, in regards to the ACA why didn't the government force the issue to get it? I don't know all the facts, just wondering if anyone can enlighten us as to why? Seems if this is one of the biggest issues on the island, you would think someone would have thought it would be extremely important to obtain for many of the residents who don't have any health care. Cost prohibitive? At least this way the hospitals could operate with guaranteed income coming in. IDK

Also, in regards to the ACA why didn't the government force the issue to get it? I don't know all the facts, just wondering if anyone can enlighten us as to why?

This should help answer the question:
http://stthomassource.com/content/news/local-news/2013/07/12/no-obamacare-health-insurance-exchange-usvi

Thanks, seems a little short sighted by the gov't, but what do I know? They were worried about a difference of 5 million, bet they waste that and more every year. Also I would think it would have created jobs as the hospitals would be paid therefore they could have hired more individuals, which would have led to more tax revenue for the islands. But again, what do I know.

So just curious, hypothetically, if you and your spouse created and incorporated some type of business that both of you were employed by, couldn't you then get health insurance?
Also, in regards to the ACA why didn't the government force the issue to get it? I don't know all the facts, just wondering if anyone can enlighten us as to why? Seems if this is one of the biggest issues on the island, you would think someone would have thought it would be extremely important to obtain for many of the residents who don't have any health care. Cost prohibitive? At least this way the hospitals could operate with guaranteed income coming in. IDK

30,000 residents are covered by USVI government plans
32,000 residents are covered by Medicare or Medicaid
20,000 residents are covered by other group plans (estimate)
23,000 residents are uninsured or self-insured (though Source estimates at 30,000)

Interesting, the USVI government supplements the two hospitals with over $40 million annually ($42 million budgeted in 2016).

So demographically, who has insurance and who doesn't?

And, in the end, is any one denied health care services? Is access to health care (good or bad), a right privilege in the USVI?

The financial risk pool in the VI is too low to sustain ACA type plans over time - even if hospitals were reorganized and annual supplements directed to a risk pool rather than bracing up the hospitals (and their inefficiencies).

The average person in the US consumes $10,000 worth of health care services, inclusive of insurance premiums, each year.

Well there's the problem 30,000 in gov't plans.

The barbs may fly but this is purely an observation based on decades watching and helping "transplants" come and go and is intended solely to be helpful. Taking an interest in and being involved in community affairs is absolutely healthy but assuming what "our" problems are and, more, what we "should" do to fix them will only lead to frustration and a more difficult than necessary adaptation to island living.