Aetna seems to think so. Last week Aetna shares rose after comments on medical costs. Of course this could be a blip given that last quarter the stock fell on a higher than expected medical loss ratio. But assuming that it’s not, given that overall premium increases are a little lower this year, this means either that Aetna has gotten a-hold of its spending a little better than expected, or that it’s done a better job underwriting and getting rid of its poorer risks. Given its history in this regard, I wonder which?