Wednesday, February 21, 2018

Tacos, Tequila and (Medical) Tourism

Medical Tourism has been a frequent topic here at IB, so this tweet from FoIB Dr Kris Held caught my eye:
Perhaps not-so-coincidentally, I recently received this in email:

[click here for full graphic]

There are, of course, downsides to traveling to foreign lands for health care, and one wonders how (or even if) such care is covered under one's insurance. But there's no question that actually receiving timely care seems to be a lot more important than owning an insurance ID card that doesn't actually provide it.

[Hat Tip: Lisa B]

Tuesday, February 20, 2018

"Skimpy" Insurance

Tomayto, tomahto. From CMS Secretary Seema Verma:

And Reuters' more, um, progressive take:

"U.S. to extend skimpy health insurance outside of Obamacare"

Well first, no one's "extending" anything: Short Term Medical plans have been around for a long, long time.

And let's talk about that rather loaded term: "skimpy"

Most STM's offer deductibles as low as $500 (or lower), with out-of-pocket exposure (MOOP) limited to a few thousand dollars.

Contrast that to typical ObamaPlans with deductibles over $7,000 a person, and MOOPs in the tens of thousands. But yeah, the STMs are "skimpy."

All this particular ruling does is restore the maximum policy length to the status quo ante, before the previous administration unilaterally (and illegally) cut those short.

So which one's "skimpy," skippy?

[Reuters Hat Tip: FoIB Holly R]

Monday, February 19, 2018

Monday Morning LinkFest

Interesting story about the (perhaps not so precious) Much Vaunted National Health System©, courtesy of co-blogger Mike:

"[Prime Minister Teresa] May spoke of the importance of “taking a balanced approach to government spending, so we get our debt falling but can also invest in the things that matter -- our schools, our police and our precious NHS.”

The article's author points out that this is a rather odd description of a government bureaucracy, and he goes on to explain why it's rather troubling.

It's been a while since we've posted on Alzheimer's; last May we noted that "[m]aple syrup isn't just delicious, it could also cure Alzheimer's disease."

Now, thanks to FoIB Holly R, we learn that "scientists have successfully reversed Alzheimer's in a middle-aged lab mouse."

That's the (potentially) good news.

The bad news is that the day before this breakthrough was announced, another clinical trial of the med was called off "due to safety fears."

Hopefully they can get those resolved.

A Lone Star state mother appears to have chosen poorly:

"A Texas mother of two died Sunday from flu complications after reportedly deciding that the $116 medication to treat the virus was too costly."

As FoIB Jeff M (who tipped us to this sad story) observed, "the funeral is likely to cost even more."

Her widower defended her decision thusly:

"She wouldn't go get medicine because she's a mama. Mamas are tough ...  I don't think she is being irresponsible. I don't think she thought she was that sick. It happened so quick."

The truly tragic part is that her husband actually picked up the drugs for her, but by then it was too late.

Tragic, but easily preventable.

Friday, February 16, 2018

STCi: Revisited

It's been a while since we talked about Short Term Care insurance coverage:

"Short-term care (also known as Recovery Care or “LTC Lite”) is not a new product but it has been gaining ground in the last 2 years ... With its shorter underwriting cycle, high-issue rates, and low premiums it’s becoming increasing popular"

As may be, but contra this take, we really haven't seen much discussion of this product in the intervening five-and-a-half years, so one wonders about its appeal.

On the other hand, there must be something positive about it; we recently received this educational video on a related plan from our friends at Guarantee Trust Life:

GTL's Short-Term Home Health Care Insurance from Guarantee Trust Life Insurance on Vimeo.

Thanks, GTL!

Thursday, February 15, 2018

Post-Valentine's Health Wonk Review

Steve Anderson hosts this month's eclectic collection of health care wonkery, with a decidedly Olympian effort.

Do check it out!

Celebrating Obamacare's Exchange "Success"

Last week a new report came out - albeit not from CMS - showing Obamacare's enrollment results for 2018. The headlines make the case that enrollment is "stable", that the law "isn't dead". Another headline by the AP's Ricardo Alonzo-Zaldivar portrays it as a success "despite efforts to dismantle the ACA" by the Trump Administration. Fast Company's headline goes as far as to say Obamacare is "still pretty popular" despite attempts to "kill it."

These stories are total spin showing media are nothing more than fairweather fans. The truth is, since 2015, Obamacare's exchange enrollment figures show that Team Obama hasn't been able to move the football down the field. What has changed, is in eight years of Obamacare we have seen goalposts moved. This allowed Team Obama to spike the football on a field that is less than half the size of what they originally were playing on.

In the original CBO score enrollment in the exchange was supposed to be 21 million in 2016, 23 million in 2017, and 24 million in 2018. By 2016 CBO set new goal posts hoping to break 13 million. Cutting the field in half was the only way Obamacare supporters could claim that insurance exchanges are working. You can see here how bad the exchanges have actually performed.

The chart is nothing to celebrate. This is not a success. This is a football team that is entrenched in mediocrity. The team has struggled to move the ball because the offense being run doesn't work. Instead of being open to a new offense, fairweather fans jumped on the bandwagon embracing changes to the rules of the game. When that didn't work they started blaming losses on the new coach who inherited a mediocre team from his predecessor.

Wednesday, February 14, 2018

Sidebar Update News

FoIB Roger Downey has launched a new health news aggregating site, and it's quite interesting:

"My Healthcare Report is the healthcare version of the Drudge Report without the politics. There is nothing else like it on the internet: I select the top story and populate the three columns below with links to the latest healthcare stories."

I like the minimalist, easy to navigate design, and there are a lot of interesting news items. We've added it to our sidebar ("Blogs of Interest").

Do check it out.

About That Individual Mandate...

For the last few months we have been hearing President Trump touting his "repeal of the individual mandate" as a huge opportunity for people to not be penalized for going without health insurance. On the Democratic side Nancy, Chuck, and their minions have been scolding Republicans for kicking 13 million people off of insurance.

This game of rhetoric is confusing to the general public. Well, never fear, here at IB we are all about educating the public as to what the reality of the latest partisan divide actually means.

First, let's get the "people are going to die/kicked off insurance" fallacy out of the way.

Democrats were quick to point out that CBO is showing that in 2026 (8 years away!) 13 million more people will be uninsured through their scoring system. In telling the story democrats have used language that insinuates people are going to be kicked off of their plans. This is a blatant lie. 

The CBO report notes that 5 million people will drop off of Medicaid, 2 million will not stay on their employer sponsored plan, and 5 million people will not buy insurance in the individual market. Note that none of these people are being forced to lose insurance. Rather they are electing not to participate. That's a huge difference.

So, what is the truth about "repealing the individual mandate"?

Quite simply put, the mandate still exists. It's still in the law. What has changed is the penalty for not purchasing health insurance has been zeroed out in the new tax law. More important, the zero doesn't begin until 2019. So not only is the mandate alive it still has teeth (alright maybe only a single tooth) for this year. Here's the actual language from the tax bill Trump signed:


(a) In General.—Section 5000A(c) is amended—
(1) in paragraph (2)(B)(iii), by striking “2.5 percent” and inserting “Zero percent”, and

(2) in paragraph (3)—
(A) by striking “$695” in subparagraph (A) and inserting “$0”, and

(B) by striking subparagraph (D).

(b) Effective Date.—The amendments made by this section shall apply to months beginning after December 31, 2018.

A swing in the political pendulum could bring the penalty for not having insurance back. Changes in congress could reopen these discussions. Striking "Zero percent" and inserting "2.5 percent" could happen. Republican's aren't telling you this.

Honesty is a lost attribute for politicians these days. Yet CNN, Fox News, and countless other media continue to promote what the inner beltway folks tell them as if it is gospel. This is why we are in the political environment we are today. Honesty doesn't get you reelected. And the best stories are the ones that are the most egregious.

Fortunately for IB readers, we aren't politicians or journalists. Instead we are insurance professionals. You know, the guys who politicians think are one step below ambulance chasers and one grade above used car salesman. 

Tuesday, February 13, 2018

#Fake ObamaCare News

Uh-oh, looks like someone misspelled 3000% rate decrease:

"Health care premiums for the skimpiest Obamacare plans in the District of Columbia are skyrocketing in 2018."

Rates for Bronze-level plans are supposed to be among the lowest (with concomitantly higher out-of-pocket exposure). The article cites the example of Daniel Turner, "a single healthy guy in Washington, D.C., with no dependents." His Bronze plan shot up almost 36%, to over $4,400 a year. Couple that with his deductible and co-insurance and he's out over $10 grand before the plan pays a nickel.

Oh, wait, he does get a "free" colonoscopy, which is worth at least a few hundred, right?