I believe their accounting and am sorry to have hinted they are greedy. Am sure the insurance company does not sell its services and products as line items in the insurance they sell. I am also sure the service and product revenue is from some amazing healthcare innovation they did.
That metric is compelling, but how does it measure the value proposition? According to the above chart, profits saw 4x increase over a single decade. It's interesting to compare that metric with the one you offer do you think the company's value to its customers has quadrupled in the same period?
The Affordable Care Act requires plans to have a Medical Care Ratio (medical benefits paid / premiums received) of > 80% for small plans or 85% for large plans.
Of course the remaining 15% has to cover the insurer’s administrative expenses, not just profits.
And I'm sure many companies have found ways around those requirements in various ways. And those requirements only mean something if they are actually audited and enforced. Considering how one political party has been slowly chipping away at the ACA... these companies are not working in good faith.
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Also, you dont get much for 241.9 Billion when you spend $10 for a tablet of paracetamol.
Of course the remaining 15% has to cover the insurer’s administrative expenses, not just profits.