To: Worswick who wrote (602 ) 12/17/1997 11:21:00 AM From: Michael Burry Read Replies (1) | Respond to of 2068
In a well-managed insurance company/HMO of any type, they should have armies of actuaries that come within the ballpark of the correct IBNR figure, thus negating the need for serial charges. When a plan grows very fast, it becomes much more difficult to accurately estimate IBNR as the history isn't there. Your suggestion that IBNR will be alternate between too high and too low, resulting in a rolling break even situation with zero retained earnings over the LT, is obviously what we seem to be in right now. Will this continue? Consistent inability to estimate IBNR resulting in serial charges will certainly put any insurer into regulatory purgatory and likely bankruptcy. I would venture that especially a health insurer could not get away with such consistent problems over the long term without incurring the wrath of either customers or authorities. Let's look to the future - say Oxford survives a liquidity crisis this spring gets its books together, and continues on as a profitable company. Then in 1999 it says whoops we screwed up again, here are some more charges. Then it says so again in 2001. The regulatory authorities would put a stop to Oxford playing games with real patients' lives. Again, I ask the question is there is a recent equivalent to OXHP in this sector that you or anyone can think of? No. Aetna's, Cigna's and Pacificare's troubles were somewhat acquisition-related. Oxford, geographically and with its specific plan characteristics, has had no easy comparison - believe me I looked. A caveat: The aging population/Medicare, the increasing direct contracting between physician groups and employers, and the consumer's inexorable feeling that there is a right to the best possible care no matter the cost all are long-term threats to the ability to drive down costs. If insurers' actuaries systematically ignore these pressures, IBNR will always be too low, and charges will become serial, resulting in a poor outcome for investors throughout the industry. Good Investing, Mike