Friday, January 18, 2019

Heads' up: The weather and your home's pipes

Timely reminder from our friends at the Cincinnati Insurance Company:

Prevent frozen pipes in your home from The Cincinnati Insurance Company on Vimeo.

For whom the bell tolls: The Venerable Health Wonk Review

From email from our dear friends Joe Paduda and Julie Ferguson, co-founders of the long-running, highly respected Health Wonk Review:

"Hello, Health Wonker friends –

First, wishing you all a happy New year and extending thanks for your ongoing participation in Health Wonk Review.

After a baker’s dozen years  and more than 280 issues, we’ve decided to call it a day.  It’s become a bit more of a heavy lift to get varied hosts. We moved to a monthly issue to address that, but it’s still been slow going. Submissions are down too as more people abandon blogs in favor of social channels like Twitter and LinkedIn. Readership and cross posting appears to have waned, too.  Going forward, we may host an ad hoc issue occasionally under the HWR banner and invite your participation when health policy issues rise to the surface, but the regular issues will cease.

We can’t thank all of you enough – we’ve discovered new blogs, learned new things, shared some laughs and made good friends that we hope will continue into the future.

We’ll be preserving the archives and will send you a link to the new location.

Be well, and keep doing what you do so very well!

We'll miss the HWR, and can't say enough about how much effort Joe and Julie poured into it all these years. We are proud to have been with them from the beginning, and know that their efforts have been appreciated.

Thursday, January 17, 2019

Nectar of the Gods?

Merriam-Webster defines ambrosia as "the food of the Greek and Roman gods." If that's still the case today,  we have questions.

Why's that, Henry?

Well, because of this (apparently legit) item sent in by FoIB Holly R:

"A controversial startup that charges $8,000 to fill your veins with young blood to 'defeat aging' now claims to be up and running in 5 cities across the US"


The company was started about 3 years now, and is now up and, er, beating well, as they now boast a wait-list. And since its process is considered an off-label use of established medical procedure, it's apparently 'kosher' as far as the FDA is concerned.

How effective is it? Well,there's scant scientific proof of its efficacy (and by "scant" we mean "next to none"); on the other hand, what's the harm?

Tune in again in 2075 for an update.

Oh, and definitely go for the brand name, not the generic,and no word yet on whether or no it's HSA-eligible, but one doubts it's insurable (after all, what carrier actually has a heart?).

Wednesday, January 16, 2019

ObamaCare Open Enrollment v6.0: Anecdata version

We know that anecdotes ≠ data, but this item (to which we were alerted by co-blogger Bob V)  provides some helpful, personal perspective:

"Last week, we asked you to send in details of the insurance plans you purchased on the Affordable Care Act exchanges. We received more than 70 messages, mostly all with the same theme: This sh*t is too expensive, and it sucks."

Well, we've been saying that for years now, but welcome to the party!

There are a bunch of interesting example, none of which were surprising to longtime O'Care observers.

Feel free to share your own experiences in our comments section.

Tuesday, January 15, 2019

CanuckCare© Continues Swirling

But hey,it's free:

[Hat Tip: Dr Michael B]

Monday, January 14, 2019

#FakeHealthNews: Burying the Lede

Our friend Holly R tips us to this story currently making the rounds at FB:

[click to embiggen]

"Kentucky Sen. Rand Paul, one of the fiercest political critics of socialized medicine, will travel to Canada later this month to get hernia surgery"

Now why would he do that?

After all, we have many fine surgical centers here in the states, why would he choose a government-run one Up North?

Well, turns out that the opening sentence is rendered completely moot by the third:

He is scheduled to have the outpatient operation at the privately adminstered Shouldice Hernia Hospital in Thornhill, Ontario"


Transparency gone terribly wrong

We've been covering (and advocating for) transparency in health care pricing for a very long time:

"Gov. Rod R. Blagojevich today signed the Illinois Health Care Consumer’s Right-to-Know bill, which makes health care price and performance information for outpatient procedures available to all Illinois consumers."

That was over 13 years ago, and we can see how well that's worked out. Recently, co-blogger Bob V sent me a link to a story that not only indicates that we have a long way to go, but also implicitly explains why we likely will never really see true transparency:

"Her insurer’s price tool estimated less than $1,375 for a breast MRI. Then she got a bill for $3,200."

Ms Smith apparently did everything right: she researched MRI facilities and prices using UHC's online cost estimator [ed: and by the way, this is not an indictment of UHC in particular; I'm confident that that same would hold true with other carriers, as well], and still got socked with a larger-than-expected bill.

But why is that? Why is something so seemingly simple so difficult to obtain? After all, when I order a Big Mac and fries, I know exactly what I;'m going to shell out. Likewise a gallon of gas or an oil change. Why is medical care immune?

Well, there's the obvious challenge that the doc can't be sure that a particular surgery will go exactly as planned, and I get that. But simple things like non-emergency MRI's should be basic, off-the-shelf, easily priced items.

Or so one would think.

But here's the dirty little not-so-secret:

"Health-care costs are difficult to pin down because prices vary widely and are part of confidential agreements between insurers and providers." [emphasis added]

Now, I actually "get" that: UHC doesn't necessarily want Humana to know the specifics of its agreement with Dr Smith. And, of course, coverage will often change depending on one's plan's design. I just don't see how to square the circle.

On the other hand, we have newer models like Direct Primary Care and facilities like the Surgery Center of Oklahoma, which operate on a strictly cash basis, no insurance needed (or, in fact, accepted). So we know that cutting out the middleman (ie insurance and/or the heavy hand of government) is a way around the conundrum.But of course, both of these have their own problems and challenges, not the least of which is the ability of one to come up with the scratch to pay for it.


Friday, January 11, 2019

ObamaCare #Winning!

Thursday, January 10, 2019

Sad news: A client story

Over the weekend, a long-time agency client took his own life. Dan was a retired (and much beloved) pediatrician who had been (recently?) diagnosed with both dementia and Parkinson's. One supposes that, as a physician, he knew what lay ahead, and decided to forego that.

Something that often comes up in these tragedies is the issue of whether or not a life insurance policy would "pay off." As with so much insurance-related "conventional wisdom," it's not actually all that simple.As we wrote back in Aught Nine:

"Until just after the Great Depression, suicide was excluded by life insurance policies. There was, it was thought, a very good reason for this: it would be against the public interest to encourage folks to kill themselves to enrich those left behind. And there's some validity to this: we don't want to make such an outcome attractive to people to leave an inheritance at the cost of one's own life.

But a lot of people who lost everything in the Depression killed themselves anyway; not for the insurance (there wouldn't be any) but out of desperation and despondence. And this left behind a lot of widows and children who lost a parent and a spouse along with their life's savings. This was also against the public interest.

So, how to reconcile these two seemingly irreconcilable principles?

New laws were enacted that required life insurance policies to cover suicide after a "reasonable" period ("reasonable" in this case meaning no more than two years). The premise is that no sane person is going to buy a policy with the intent of waiting two years to jump out a window; that a person would do this was ample demonstration of mental illness, and that would be a covered exposure. This protects the interests of innocent family members, while still discouraging a casual view of suicide

Our condolences to Dr C's family.

Not so great HIX news: SEP edition

So by now, most folks understand that it's quite the challenge to buy ObamaPlans outside the regular Open Enrollment season; that one requires a Special Enrollment Period trigger (losing group coverage, getting married or having a baby, etc) to do so. Well, the process just got a bit more onerous.

From email from our Betters in DC©:

"Special enrollment periods (SEPs) provide an opportunity to consumers who experience certain qualifying events to enroll in or change their health coverage outside of the annual Open Enrollment period.

Beginning in early 2019, Marketplace consumers may need to choose a plan in the same metal tier category (instead of from all available categories) during their SEP window. [emphasis in original]

 This impacts consumers when they:

•Currently have a Marketplace plan,
•Experience most SEP-qualifying life events, and
•Want to change from their current plan.
You can help consumers understand that their plan choices after Open Enrollment will likely be limited later in the year, even if they qualify for an SEP and want to change plans. You can encourage them to choose a plan that will meet their needs and their family’s needs until the next Open Enrollment period."

Oh goody.

Did I mention that I'm aware of precisely zero carriers paying commissions on plans outside of the regularly scheduled Open Enrollment? How come no one seems to care (since they don't reduce the premiums to reflect that fact)?