Tuesday, May 03, 2016

Introducing The NSVNHS©

That would be the Not So Vaunted National Health Service©.

And what, you may ask, prompts this new accreditation?


"UK now has one of the worst healthcare systems in the developed world"

Well, that's just according to some disgruntled blogger, right? Not any actual, respected authority.


"The verdict, from the Organisation for Economic Co-operation and Development (OECD) ... the quality of care in the UK is “poor to mediocre” across several key health areas"


Still, it's not like the scheme is scraping the bottom of the barrel on key metrics.

Wait, what?

"The UK came 21st out of 23 countries on cervical cancer survival, 20th out of 23 countries on breast and bowel cancer survival and 19th out of 31 countries on stroke."

Fortunately, a quick fix is easily applied.


"Mark Pearson, OECD Deputy Director of Employment, Labour and Social Affairs, said many medics were too rushed to improve the care they give."

But hey, it's free!

[Hat Tip: CoBlogger Mike F]

Monday, May 02, 2016

Frightening Numbers

This is actually scary:

Consider the implications.

Aetna Selfies

Until quite recently, self-funding was generally seen as an option only for relatively large employer groups. There have been exceptions, of course (the PACE program, for example), but those have been few and far between. With the advent of the ObamaTax, however, employers are looking at alternatives to help rein in costs and try to stay ahead of the health insurance curve.

Enter Aetna, which is making its foray into this space with "Aetna Funding Advantage," available to groups with as few as 10 employees. Self-funding offers a number of advantages over more traditional, fully insured plans, not the least of which is exemption from a number of ObamaTax requirements (click here for a more detailed explication of how self-funded plans work).

Self-funded pans also offer the potential for significant cost savings over fully insured plans. There are also drawbacks, of course. One is that they're a bit more complicated than "regular" group plans, although they're not exactly rocket surgery, either.

In any case, expect to see other carriers launching their own versions as the ObamaTax continues to wreak its havoc.

DIAM Matters

May is Disability Insurance Awareness Month. We're helping to kick it ff with this timely, moving story:

Friday, April 29, 2016

From the P&C Files: Unclear on the concept


 [Hat Tip: mir&uh]

Interesting Accidental Carrier Trick

With networks getting skinnier and skinnier, receiving emergency care out-of-network is becoming a bigger and bigger challenge. Most plans still use the PPO model, so there's at least some level of coverage, albeit with substantially greater out of pocket. And of course HMO model plans will typically have none (or even more substantially reduced coverage).

UHC has just announced a set of 3 new "Accident SafeGuard" plans that seek to address this potential financial catastrophe. From email:

"Accident SafeGuard pays fixed benefit amounts for loss resulting from qualifying accidental injuries and does not limit your client to any network of hospital or doctors." [emphasis in original]

First thing, of course, is that this doesn't help if you're out-of-network for chemo or if you get sick while on vacation. But for broken limbs or the like, perhaps a valuable coverage addition. Rates will vary depending on where you live, your age, and the like, but I can't imagine they'd be terribly expensive (since qualifying expenses are pretty narrowly defined).

Insurance insurance.

Thursday, April 28, 2016

NAHU *almost* gets it

Full Disclosure: I was a member of the National Association of Health Underwriters (NAHU) for many years and was, in fact, co-founder of my local chapter. That being said, I am generally ill-disposed towards most so-called agent associations, because - by and large - they tend to represent the carriers more than the agents. On the other hand, the organization's current president has a background as an actual agent, which lends some legitimate cred to his latest offering on why some carriers have decided to forgo paying commissions on business written after Open Enrollment ended.

Here's his take:

"Carriers are cutting out their brokers because they don’t want to sell their policies."

And that, in a nutshell, is exactly right: carriers lose money on virtually every policy they sell, particularly those sold on-Exchange (primarily because the vast majority of these are subsidized).

And he goes on to (quite correctly) point out the value that agents bring to the table (which is, of course, part of his job). And that's what we call "necessary, but insufficient;" that is, it's demonstrably true that the agent adds value in sorting through all of the options, calculations and decision-making. But I don't hear Mr Goldmann calling out state DOIs to investigate what's happening to those unpaid commissions. As we've pointed out, they are priced into the products already, a separate calculation from MLR, etc.

Instead: crickets.

Well, Mr G?

[Hat Tip: EBA Magazine]

Privatizing CanuckCare©

We've written about the Canadian health care system many times over the years. It's "free," which means that one gets what one pays for. As with all such schemes, actual care is rationed, most often by the use of long wait times that work on the basis of attrition.

That's changing, however, at least in one Province:

"Wait times ... dropped significantly in the Saskatchewan province after private, for-profit clinics were introduced to the area."

On the one hand, this would seem blindingly obvious to anyone with even the most remote grasp of how markets work. But it's a hopeful sign that, at least for now, some government bureauweenie(s) "get" it.

Interestingly, this isn't the first time our Neighbors to the North© have considered privatizing at least a part of the health care sector.

From 2009:

"Hoping to capitalize on patients who might otherwise go to the U.S. for speedier care, a network of technically illegal private clinics and surgical centers has sprung up in British Columbia, echoing a trend in Quebec."

What's Canadian for "What took you so long?"

[Hat Tip: FoIB Holly R]

Wednesday, April 27, 2016

UHC Folds, Anthem Stands Pat?

As we saw this morning, UHC continues to exit the Marketplace in state after state. Which should be a pretty strong signal of unsustainability.

But perhaps the death of the Marketplace has been exaggerated:

"Anthem ... seems inclined to help the [PPACA] public exchange system keep its doors open and products on its shelves in 2017."

So (at least) another year promised by The Blues.

Be interesting to see what their stakeholders think of this move.

Too good *not* to post

Unvetted from the web:

I've reached out to Mr Alameddine in an effort to ascertain from whence he obtained his screenshot. It's not from the 404Care.gov site (I've been on that enough times to know) but perhaps from a state-based Exchange or carrier website? Will update this post as appropriate.

UH C You Later - UPDATED

Add Iowa and Kentucky to the list of casualties - that makes 26 out of 34. UPDATED MAP BELOW

The shake up of the individual market begins. On Tuesday United Health Care announced that they were going to be leaving the individual marketplace in all but "a handful" of states in which they currently sell Obamacare policies.

This isn't something that we should be surprised to see. With losses in 2015 of $475,000,000 and projected losses in 2016 of $500,000,000 why would any business continue to operate in a losing market? Especially considering UHC's enrollment across the 34 states they participate in is only 795,000 people.

So where does UHC stand at this point? Thanks to some excellent tracking by Zach Tracer at Bloomberg we know that UHC is leaving 24 states. They have verbally agreed to participate in only two states so far for 2017.  Here's a handy little map to see where UHC stands in your state.

While we don't know the exact fallout yet, consumers should be prepared for more insurers to follow. With a couple of years of actual claims data and the constant churn happening in the individual marketplace, it's going to be difficult for insurers to find profitability in this space. At least they won't be profitable until the true costs of care are actually factored in to the premium pricing.

Then we will have what we always believed Obamacare to be, an unsustainable high risk pool paid for by your tax dollars.

Tuesday, April 26, 2016

"Junior" Fights Back: Tales from the MVNHS©

Earlier this year, we reported that "junior doctors" employed by the Much Vaunted National Health System© had engaged in a pretty severe work slowdown, in protest over "pay and working conditions." In fact, these "junior doctors" comprise up to half of all doc's in England.

As with almost all government-run enterprises, the folks in charge heard the junior doc's pleas, and agreed to a mutually beneficial resolution.

Er, no:

"U.K. Junior Doctors Withdraw Emergency Care in ‘All Out Strike’"

On the one hand, the work stoppage lasted a mere nine hours, but of course that impacted tens, perhaps hundreds of thousands of patients (for better or worse is another question entirely, of course).

Under proposed MVNHS© regs, junior doc's would be required to work weekends and evening at "regular" pay scale, not "premium" (aka overtime, one presumes). This is necessary, of course, in order to rein in out-of-control healthcare costs.

Whoa there, Henry, wait just a second:

It is a well-known fact that government-run health care schemes systems are far more efficient than our own, and that they're able to keep strict control of health care costs with zero impact on quality or quantity of care.

Um, not so much:

"[T]he British Medical Association, the union for doctors, has countered that it will stretch an already-overburdened workforce even thinner, endangering patient safety."


Good thing that can't happen here.

[Hat Tip: FoIB Holly R]

Obama Signature Legislation and Legacy

Will Obama's legacy be the end of the best health care system in the world? This president's experiment in fascism may well go down in history as a complete failure.

Ronald Reagan told the American people: “The nine most terrifying words in the English language are ‘I’m from the government, and I’m here to help.’ ” Obama wanted to convince Americans that they were not terrifying. And the way he was going to do it was through the only great liberal legislative achievement of his presidency: Obamacare. 
He failed. Even before he leaves office, Obamacare has begun unraveling. - Washington Post

For the handful of people that have been helped by Obamacare there are thousands who now have health insurance they cannot afford, or cannot afford to use.

Health insurance carriers have lost billions. These are the same carriers that, in the years prior to Obamacare, either made a small profit on health insurance (usually 2 - 4% of premiums) or broke even.
The president promised these insurers taxpayer bailouts if they lost money, but Congress in its wisdom passed legislation barring the use of taxpayer dollars to prop up the insurers. Without the bailouts, commercial insurers are being forced to eat their losses — while more than half of the Obamacare nonprofit insurance cooperatives created under the law failed.
There is no way to spin this.

Obamacare is a failure.

#ObamacareFail  #Fascism

Monday, April 25, 2016

Top o'The Week LinkFest

Despite the best (?) efforts of its proponents, ObamaPlan enrollment continues to crater:

"More than 1 million ObamaCare exchange customers have likely dropped out since open enrollment ended on Feb. 1"

That's according to newly released numbers from a handful of states. Interestingly, 80% of those states use their own Exchange portals, while only one (Oklahoma, okay?) sends their victims citizens to 404Care.gov.

Make of that what you will.

Meanwhile, the ripples from UHC's withdrawal from most markets (as graphically reported last week by our own Patrick P) continue their impact:

"United's financial results in the Obamacare exchanges are more than a blip, they are indicative of what is happening in almost all of the states to almost all of the health plans operating in the insurance exchanges."

That is, UHC represents the (admittedly large) canary in the coal mine. If the largest health insurer can't make money in this market, one has to question the sustainability of that market itself. As uber-wonk Bob Laszewski notes, "Obamacare is not about the insurance companies, it is about the consumers that have nowhere else to purchase individual health insurance in the United States and are already finding the offerings––with subsidies or without––lousy deals."

The reality is that 85% of the folks who buy on the Exchange are being subsidized with taxpayer dollars.

And it gets worse: some 60% of those eligible for subsidies don't even bother to use them.

What's that tell ya?

Finally, via FoIB Holly R, we learn that telemedicine was actually predicted in 1925:

La plus ca change...

More O'Care Lies

We all fondly recall President Obama's pledge that rates would decrease 3000%, right?

Well - and you may want to sit down for this - turns out that he may have fudged just a teensy, tiny bit.

And by "teensy, tiny bit" we mean, well:

"Marilyn Tavenner, the president and CEO of America’s Health Insurance Plans (AHIP), said ... that the culmination of market shifts and rising health care costs will force stark increases in health insurance rates in the coming year."

On the one hand, Ms T has her own issues. On the other, it's not as if there's insufficient 3rd party evidence to support her contention. The reality is that  the ObamaTax is unsustainable, and that we're in for devastating premium increases for the foreseeable future.

Despite President O's promises.

[Hat Tip: FoIB Jeff M]