Insurance companies may not be able to reduce internal costs enough

Wow, private industry really can be much more efficient than the government. Somehow giving the insurance industry new customers isn't enough for them. They only want the right kind of customers, as in those who are happy to be ripped off with high internal costs. Maybe there will be no other choice but to bring back the public option if the industry can't manage to control their excessive internal costs.

The Obama administration is awaiting the recommendation of the National Association of Insurance Commissioners, meeting in Orlando this week, for how and when to implement key changes to the "Medical Loss Ratio" rule.

Under health reform, beginning 2011, insurance companies will have to spend 80% to 85% of the premiums they collect on care instead of toward their own profits and overhead costs.

Prior to reform, requirements varied from state to state. In some cases, insurers didn't have to meet any minimum requirements.

For example, some plans have a 40% loss ratio. That means individuals could be paying $1 for 40 cents of care.