Monday, April 20, 2015

What a difference a decade makes...

With the spate of folks expected to retire in the near future, and their (understandable) concern about how they're going to pay for their health care, the folks at LifeHealthPro have put together 5 helpful charts that seek to predict how much that care's going to cost.

Here's the first one, from the perspective of a 65 year old couple:

[click pic to embiggen]

There are a handful more here.

Saturday, April 18, 2015

Most Excellent Perm vs Term Review

Over at LifeHealthPro, an insurance agent (and financial planner), eviscerates populist "advisor" Dave Ramsey on the latter's arguments against permanent insurance versus term.

Highly recommended.

Two caveats:

First, I sell a decent amount of term insurance, as it does, in fact have its uses; permanent plans are no panaceas in and of themselves.

Second, I think Michael misses the real problem with the 'buy term and invest the difference" scenario: almost all the folks who buy into this end up spending the difference, not saving it.

Friday, April 17, 2015

An important message from...Brussels?

So this arrived in email:

"Anthem is committed to providing our brokers with best-in-class service, and we are always looking for ways to make it easier for you to do business with us – and to help you better serve your clients. Currently, we’re working with a research firm called North American Testing Organization (NATO) to conduct an online broker satisfaction survey to help us better understand your needs."

I must admit to a bit of a spit-take upon reading that I might be contacted by (that other) NATO, but must settle for these wannabe's.

Be interesting to see what they ask ... I was told there'd be no geography.

How NOT to do Narrow Networks

We've long noted that one of the negative - and completely foreseeable - consequences of the ObamaTax is the rise of so-called "narrow" networks:

"Nationwide, about half of all exchange plans feature narrow networks ... Those narrow network plans cost up to 17% less on average than plans with broad networks."

It also means that you're less likely to be able to keep your doc, or even find one willing to take on new patients.

And it certainly doesn't help when a doctor decides to implement his own version:

"A Long Island cardiologist had the office of another doctor torched, then hired someone who turned out to be an undercover police officer in a failed attempt to have the doctor hurt or killed"

Geeze, doc, have a heart!

Thursday, April 16, 2015

Yeah, about keeping your Doc

As we've long documented, increasing the demand for care (more folks with insurance) will of necessity run into the brick wall of supply of said care. That is, when everyone has access to "free" healthcare, who's going to provide it, especially with narrow networks reimbursing providers less and less?

Well, some enterprising Golden State folks have come up with an intriguing (if ill-fated) idea:

"Physician Retraining and Reentry (PRR) an online program designed to give experienced, medically licensed physicians and specialists, retired or otherwise, the opportunity to practice adult outpatient primary care in understaffed clinics across the country."

So the first question would be: um, why now, when reimbursements are at an all-time low and headed south? Follow-up: why do you suppose all these folks retired in the first place? (Hint: see Question #1)

But all is not lost, dear readers, because they've come up with a fool-proof way to fill in the gaps:

"The program has also given new hope to disabled surgeons who are no longer able to practice surgery"

To be fair, the folks at PRR aren't (necessarily) advocating that disabled surgeons start operating again, merely "treat patients in a primary care setting." What, exactly, that would entail is left to the imagination of the reader.

(Sorry 'bout that)

While I certainly applaud the group's willingness to think outside the box, I'm just not seeing a path to success here.

[Hat Tip: Gabriela Torres-Soler]

Wednesday, April 15, 2015

Who is Reading Your Medical File? The more things change (Part 2)

Last week, we broke the story of how some medical records, particularly those stored on off-shore servers, are likely not protected by HIPAA's privacy reg's. I reached out to Dr Rob Lamberts (whom we've previously interviewed) for his thoughts on this as a provider:

Very troubling issues here.  The question of “who has the record” is the most important one.  There needs to be a certainty of who has access to the records unless the patient is made aware of that insecurity and gives consent.  An example of insecurity is the use of Google Spreadsheets for monitoring blood pressure, etc which people sometimes share with their doctors.  They should be aware that there is an insecurity of these records, and their consent to use them can be seen as acceptable in a narrow usage.  Similarly, the tendency of patients in my practice to communicate via email must be covered by some sort of agreement in which the patient agrees that their use of email is “at their own risk” and that our practice will make every effort to only communicate securely.

The  storage of records in an off-site setting where the actual location and potential access to them is unknown to both physician and patient is troubling.  If the vendor is selling the doctor something that claims to “meet HIPAA security requirements” (which many 3rd party vendors do), then the onus is on the vendor.

I told Rob that I wasn't sure I agreed with that last part: It seems to me that, if I'm coming to you as a patient, I'm presuming that you have my records under lock-and-key, or at least in-house. Why is it my obligation to ask if that's the case? Rob replied:

The contract between a provider and an IT vendor is one where they take on the task of IT security (among others) in exchange for payment.  Legally, the physician has gone into that agreement in good faith, and so the vendor would be liable should there be a breach.  That is the same thing the patient does with the physician, overall.  They assume the doctor is acting in a way that is responsible with the medical records.  While I agree that there is a certain right of knowing where the records are stored, in some way we must trust that those making the sausage are being overseen by others who will make sure only reasonable things are being put into that sausage.  There is a reasonable degree of trust we must all have (which is no excuse for naiveté or gullibility).

Okay, that makes good sense from the provider's POV. I'm still not convinced that a doc using a vendor with off-shore servers isn't obligated to notify his patients of such. Now, one might argue "well, Henry, how's the doc to know?" To which I'd reply "simple: ask."

Why not?

And a Special IB Thank You to Dr Rob for his insights and willingness to share them!

The 4% Solution


"Only 4% of people who signed up for ObamaCare got the correct subsidy"


Expected, of course; actually, I'm surprised the "success" rate was that high. After all, calculating one's subsidy necessarily meant that one was guesstimating the next year's income. Since I've never seen a Ouija board with a $ sign on it, this always seemed...unlikely.

And it didn't help that the IRS sent out faulty forms to over three quarters of a million suckers filers, "nearly all of [whom] are being told they'll have to wait, maybe until Oct. 15, to straighten it out."

Oh goodie!

The good news (for certain values of "good") is that folks will get to repeat this process again in a mere 12 months. One wonders if a) the IRS will finally have the correct forms available and b) significant numbers of suckers citizens will choose to play again.

Time will tell.

[Hat Tip: RedState]

Tuesday, April 14, 2015

War on Women

The battle cry for the last few years revolves around a so-called "war on women". One political party seeks to manipulate sentiment for their side by proclaiming there is a war on women promulgated by the other party.

Incendiary comments are rife in politics and neither side has cornered the market. But in the case of the war
on women, apparently one side has a short term memory problem.
In a response to the March letter sent by Senate Health, Education, Labor and Pensions (HELP) Committee ranking member Sen. Patty Murray (D-Wash.) with 36 signatures, HHS Secretary Sylvia Mathews Burwell said the agency does not have “the legal authority to establish pregnancy as an exceptional circumstance” to create a special enrollment period.
Burwell said pregnant women could enroll in Medicaid and the Children’s Health Insurance Program (CHIP).
“Women with low and moderate incomes can enroll in these programs at any time if they qualify,” she wrote. “And, like all other qualified individuals, pregnant women can enroll in the Marketplace during the annual open enrollment period.” - The Hill

Apparently rewriting Obamacare by decree is only convenient if this is an election year.

  • granting "free" birth control
  • exemption waivers granted without regard to the law
  • delaying employer and individual penalties for non-compliance
  • extending and expanding the annual Obamacare enrollment period
  • creating a new way to define a health insurance purchase
  • allowing exchange enrollers to create an SEP in places where the law says otherwise
  • granting extensions and waiving tax penalties
  • blah, blah, blah ...............

#Obamacare #SEP  #pregnancy

Monday, April 13, 2015

HillaryCare -> ObamaTax

So, who made this promise:

"If you like Blue Cross, you can keep your Blue Cross"

If you guessed President Obama, well: close, but no cigar.

That one comes from a 1994 meeting laying out strategy for the future SoS's health care "initiative:"

[click picture to embiggen]

 Time after time....

[Hat Tip: Ace of Spades]