The Individual Mandate is Evil [UPDATED]

The other day, I had breakfast with an old friend and mentor. In the course of discussing ObamaCare, he asked me which part I considered the most egregious. I think I surprised him when I said it wasn't coverage for abortions or illegal aliens, or even the so-called "Public Option" which most offended me.

It's the individual mandate.

Now, one might think that, because I sell insurance for a living, I'd be all for a law that required folks to buy what I sell. But I'm an American first, and I find this particular idea repugnant and, frankly, unAmerican. Here's why:

There is no precedent for requiring us to buy a product or service simply for living. There are those who argue, incorrectly, that we're required to buy automobile insurance. But they neglect to finish the sentence: "if one chooses to own and/or operate a car." Many folks go through life relying on public or alternate transportation, never having the need or requirement to buy auto insurance. But there are no choices here: simply being alive would require one to buy insurance.

Second, this is far beyond a slippery slope: if the government can require you to buy something you don't need or want, then it can require you to do anything. There simply is no limit.

Third, a friend of mine recently raised a First Amendment issue: what about those folks who, because of their religion, don't use medical services? Would Scientologists and the Amish (for example) be exempted from this requirement? If not, then they're paying for something that they cannot use due to their faith. This is a gross infringement on their 1st Amendment rights. If they are exempt, then how many folks will join (or claim to join) one of these faiths in order to avoid the mandate, and how would that square with its goals?

There is just no valid case to be made for such a law, and its adoption would be a very, very bad thing.

UPDATE: It appears that the most egregious penalties vis: the Individual Mandate have beentoned down in Dr Harry's version of ObamaCare:

‘‘(C) INDEXING OF AMOUNT.—In the case
5 of any calendar year beginning after 2017, the
6 applicable dollar amount shall be equal to $750,
7 increased by an amount equal to—
8 ‘‘(i) $750, multiplied by
9 ‘‘(ii) the cost-of-living adjustment de
10 termined under section 1(f)(3) for the cal
11 endar year, determined by substituting
12 ‘calendar year 2016’ for ‘calendar year
13 1992’ in subparagraph (B) thereof.
14 If the amount of any increase under clause (i)
15 is not a multiple of $50, such increase shall be
16 rounded to the next lowest multiple of $50."

In other words, a penalty far less than called for by Nurse Nancy's edition.

And it also appears that they've dropped the threat of jail-time:

"WAIVER OF CRIMINAL AND CIVIL PENALTIES AND INTEREST.
—In the case of any failure
12 by a taxpayer to timely pay any tax imposed by this
13 section—
14 ‘‘(A) such taxpayer shall not be subject to
15 any criminal prosecution or penalty with respect
16 to such failure,"

That subsection goes on to say that penalties will be that the gummint gets to keep any tax refunds, that kind of thing.

On the other hand, it will still be illegal to choose to be uninsured. So the principle that one will be required to buy insurance remains unchanged.

And here I thought these guys were pro-choice.

[Update Hat Tip: Ace of Spades]

Just What the Doctor Ordered...

Via RedState:

Indian Insurance

The more time the House and Senate bills spend in the light of day, the more insidious they become. Pages 264 - 265 tell us that Indians whose income is below 300% of the FPL will receive free health care.

My wife has some Cherokee in her ancestry if you go back far enough. Suppose she can qualify?

Page 443 of the bill substitutes "legal residents" with the language "those lawfully residing in the United States."

What is that all about?

Page 369 of the bill protects workers from retribution if they complain that their employer is not providing health insurance benefits.

If you are an Indian does that mean your employer doesn't have to provide coverage?

Isn't this fun?

Paging Dr. Facebook

Nathalie Blanchard is on medical leave after being diagnosed with major depression. She is collecting monthly sick leave benefits from Manulife. This was not a problem until she decided to take a trip and post some pics on Facebook.

When Blanchard called Manulife, the company said that "I'm available to work, because of Facebook," she told CBC News this week.

She said her insurance agent described several pictures Blanchard posted on the popular social networking site, including ones showing her having a good time at a Chippendales bar show, at her birthday party and on a sun holiday — evidence that she is no longer depressed, Manulife said.

When my wife is depressed, a trip to Chippendales always cheers her up. Apparently Manulife views it differently.

Blanchard said that on her doctor's advice, she tried to have fun, including nights out at her local bar with friends and short getaways to sun destinations, as a way to forget her problems.

She also doesn’t understand how Manulife accessed her photos because her Facebook profile is locked and only people she approves can look at what she posts.

Apparently Canadian insurance companies can be as dastardly as U.S. based ones.

Her lawyer Tom Lavin said Manulife's investigation was inappropriate.

"I don't think for judging a mental state that Facebook is a very good tool," he said, adding that he has requested another psychiatric evaluation for Blanchard.

Well of course not.

If Facebook can diagnose psych issues then why do we need real docs? Paging Dr. Facebook . . .

Stupid Government Tricks - Senate Edition

The folks at The Heritage Foundation have nailed it in today's Morning Bell. This should be required reading of anyone, ESPECIALLY those who will be called to vote on the legislation.

Excerpt . . .

Last Saturday night Speaker Nancy Pelosi (D-CA) forced through a vote on her 2,032 page health care bill only a few days after releasing it to the public. Now Senate Majority Leader Harry Reid (D-NV) is poised for another Saturday night cram down, forcing a Senate cloture vote mere days before his 2,074 page bill was given to Senators. Yet again, Congress will be forced to vote on a bill that none of them have actually read. More importantly, as we pour through the details, it becomes obvious that none of them even believe the plan will do what the bill says.

Kills Jobs: All told, the Reid Bill raises taxes by $370.2 billion over the next ten years with many of those taxes starting to be collected this year while unemployment is at 10.2% and rising. Worse, the bill includes a job killing employer mandate which taxes companies for hiring people. Specifically, companies with more than 50 employees that do not offer a health plan approved by federal bureaucrats will be forced to pay a $750 per employee job tax.

Hurts Small Businesses: The Reid Bill acknowledges it is terrible public policy for small businesses and tries to address this problem by including a “small business tax credit” to minimize the impact of the job killing employer mandates and regulation-caused rises in private health insurance premiums. But the tax credit only lasts two years and largely excludes small business owners, small businesses with high-average payrolls, and firms with 25 or more workers. After all exclusions, essentially the only eligible firms are those firms with 10 or fewer workers as well as those with low-income workers—the least likely to offer coverage even with a significant price reduction.

For the rest of the story, click the link above to Heritage.

This is truly another example of a stupid government trick.

Stupid Carrier Tricks: Anthem Renewal Edition

One of my groups recently received their annual Anthem renewal. They've been with that carrier for several years, absorbing a number of rate increases because, based on demographics and health, it still beat the new business offers from the other carriers. This time, though, Anthem threw in a little twist, one which I inadvertently missed for a bit.

Generally, a renewal quote will include a recap of the current plan design and premium, and the new rates for that plan design. This is standard, and well-accepted. Where a particular plan design is no longer offered, the closest "new" design is substituted, and there's a notation to that effect.

Not this time.

The underlying medical plan didn't change (much), but instead of prescription plan "x" they subbed in plan "z," without noting the substitution. The renewal rate, even with the lesser benefit plan, was 29% higher than last year. Definitely time to shop again.

This was both easier and harder than last time 'round: harder because, as we've noted before, we need to submit completed applications to get realistic bids; easier because the demographics and health of the group had changed in a positive way.

After submitting the ubiquitous UHC applications to several carriers, it looked like we were stuck once again: none of the offers were really outstanding; UHC's was close, but added a $100 per person prescription deductible (in addition to the underlying plan's deductible). I really have no problem with that: rx costs comprise a disproportionate share of claims, and encouraging more consumer awareness of these costs is a good thing. Still, why switch carriers for essentially the same plan and rate?

Or so we thought.

In re-reviewing (no, that's not a typo) the renewal, the business owner and I finally noticed that the Anthem prescription benefit had changed, and not for the better. We asked Anthem if we could still get the same rx plan as we'd had and, if so, at what additional cost. Turns out, they would be happy to restore the full benefits, at an additional cost of about 15% of the premium (about $5000 per year). That earned a double-take, but the numbers didn't lie. No wonder they'd snuck in the rx change: if they'd sent the real renewal, it would have been a 35% hit.

Ouch!

Fortunately, I had put the UHC process on hold, but not cancelled it, so we were able to successfully transition there. A happy ending, but: a very bitter taste as a result of the underhanded way that Anthem presented its renewal.

Lesson: review those renewals very carefully, because what you see may not be what you thought you were supposed to get.

Getting to 60

When it is your money Congress is spending, there is no limit. Care to guess how much Sen. Mary Landrieu want's for a yes vote for health insurance reform?

Try $100 million.

On page 432 of the Reid bill, there is a section increasing federal Medicaid subsidies for “certain states recovering from a major disaster.”

The section spends two pages defining which “states” would qualify, saying, among other things, that it would be states that “during the preceding 7 fiscal years” have been declared a “major disaster area.”

I am told the section applies to exactly one state: Louisiana, the home of moderate Democrat Mary Landrieu, who has been playing hard to get on the health care bill.

In other words, the bill spends two pages describing would could be written with a single world: Louisiana. (This may also help explain why the bill is long.)

No kidding.

This falls under the category of saving or creating a health insurance reform bill.

Change you can believe in.

This Just In: "Told Ya So..."

Last evening, in our report on HarryCare (aka HariKariCare), we noted:

"Absent these [Medicare] cuts ... there are no savings, only additional expenditures."

Now comes word from the Congressional Budget Office that:

"CBO estimates that enacting both H.R. 3961 and H.R. 3962 would add $89 billion to budget deficits over the 2010–2019 period."

[ed: 3961 increases reimbursement rates, and 3962 is the so-called "Affordable Health Care for America Act"]

So instead of decreasing the deficit by some $127 billion, it would actually increase it by $89 billion (that's a 216 billion dollar hole Sen Reid just dug).

Doctors Don't Need Health Insurance

Aetna health insurance plans are some of the best available in Georgia, but some of them are lacking in coverage. I tell folks that, when looking at a health insurance policy, look at what it does NOT cover before deciding if it is right for you or not.

"I'm a health care provider and I don't think I will get sick, so I don't need comprehensive health insurance that includes prescription drug coverage."

That was the line used to justify this woman's position during a phone interview.

She called me looking for dental insurance. Something most people don't need.

She has an Aetna PPO Value 10,000 plan. Not a bad plan . . . until you get sick.

Non-preferred brand name drugs are not covered. That includes most cancer drugs.

Preferred brand drugs are covered but only up to $5,000 per year. Someone who is ill can run through that amount in a few months.

The plan also has a $1,000,000 annual limit on all benefits.

But back to the health care provider.

"I can always change my plan if needed because of portability laws."

Really?

Portability only applies to group health insurance plans. She has an individual health insurance plan.

"As long as I don't have a break in coverage they have to cover my pre-existing conditions."

True . . . assuming they will even accept you. Of course if you are really sick, needing a medication that runs $5,000 per month what are your chances of them taking you on as a policyholder?

"I'm not planning on getting sick."

I decided it was time to end this call. Probably should have asked if she worked in Washington. That is the kind of argument I would expect to hear out of those folks.

Meanwhile, Over at the MVNHS©...

Woe to the British citizen who develops liver cancer. That great example of socialized medicine continues to implement its own brand of Death Panel (coming soon to a hospital near you?):

"The health watchdog has blocked a critical liver cancer drug, saying it is too pricey for the state health service ... the drug — Nexavar — is one of the only options left, and it has been shown to prolong life by almost four months on average."

Of course, some lives are more equal than others, and the Brits have apparently decided (much like our Congress) that sickies really should move on.

Of course, that's only bad news for those folks fortunate enough to live long enough to even get liver cancer. If you're a baby Brit, then you'd better hope you went full-term:

"Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed."

The infant was born about 4 months early, and so his life was deemed unimportant enough to waste precious health care dollars in saving. What a compassionate system.

Quick - let's have that here!

About that "Public Option:" He who makes the rules...

Sometimes, seeing something in action is far more convincing than just discussing it:



[Hat Tip: Lyndsi Thomas]

German health care costs: Uber oder unter alles?

I was struck by the chart that accompanied this Wall Street Journal article today (scroll down).

The chart lists 5 countries (Netherlands, France, Switzerland, Germany, and Canada) whose overall health care spending - according to OECD data - is between 9.8% and 11.0% of GDP.

Not that long ago, spending in the US was at 11% of GDP and pundits were predicting disaster. Well, now these 5 countries are at that level.

I think this information suggests that these nations have not really "solved" the problem of health care spending because they have failed to stabilize their health care spending. They have maintained a lower overall spending level than the US (which may be related to other factors, e.g. behaviors, diet, income levels, etc) but they have not stabilized the growth of their costs and as a result have caught up to where the US was, not so long ago. It's tempting to believe their costs will continue to grow and will reach the level where we are now, in not so many more years. Shouldn’t we know for sure whether that’s true?

So wouldn't it be useful to compare per capita US health care spending for our Medicare population with the corresponding per capita numbers in other countries for their over-65 populations? Such a comparative analysis could be designed so as to reflect like populations, insured in like manners by federal programs of health insurance (Medicare in the US, the national health systems in the other countries). If per capita US expenditures for this population are consistent with the other countries', well then that could be evidence that extending a Medicare-like, federal, single-payer system to the rest of our population would result in lower spending - like the rest of THEIR populations. If the US per capita expenditures are higher, that could mean that universal single payer systems may not be so effective as is widely believed.

I'd be surprised if this comparative analysis has not already been done - but I've been unable to locate anything. Yet.

[Graphic courtesy WSJ]

On Phantom Numbers

So Sen Reid has (finally) deigned to share with his Senate colleagues his phantasmagorical health care "reform" package.

O frabjous day!

According to the Congressional Budget Office, this all-in-one solution will cost a mere $849 billion, while allegedly reducing the federal deficit by some "$127 billion over the next ten years."

I understand that it slices and dices, as well.

To put that purported $127 billion in perspective: it represents, over 10 years, less than last month's deficit alone.

That bears repeating: if (and that's a big if) it really meets expectations, Sen Reid's baby will cut, over 10 years, the equivalent of one month's deficit. Color me underwhelmed.

It does this, by the way, by drastically cutting Medicare expenses to seniors, to the tune of half a trillion dollars. If, in fact, it cuts them at all.

Hunh?

Since 1997, there have been regularly scheduled Medicare reimbursement "adjustments" (i.e. decreases), every one of which has been deferred. That is, there have been no actual cuts to Medicare reimbursement schedules. Now we're to believe that, willy nilly, after 12 years of non-activity the gummint is suddenly going to get serious about cutting providers' Medicare reimbursements?

Perhaps I can interest you in a bridge, as well.

Absent these cuts (on which the CBO "scoring" is predicated), there are no savings, only additional expenditures. Of course, with these cuts, Seniors will "enjoy" a double whammy: being thrown under the bus, and drastically reduced medical services when they hit the ER (and beyond).

Regardless, The Gang That Couldn't Count Straight© has some credibility issues when it comes to these massive expenditures to solve economic problems. Here's another 1,000 words to illustrate:

[Chart Courtesy Innocent Bystanders]

[Hat Tip: Ace of Spades]

For Your Reading Pleasure...

Ladies and Gentlemen, I present to you H.R. 3590, aka HarryCare.

All 2,074 fun-filled pages.

Enjoy.

Irony, Thy Name is Obama

Perhaps the most annoying type of TV commercial is the (apocryphal?) car dealer who claims to lose money on each sale, but will "make it up on the volume." Ostensibly, this is supposed to mean that he'll sell so many cars that he'll end up with a profit.

Unless you're a state Attorney General, you probably understand enough economics to know that, if you're losing money on each car, you're going to lose more money on lots of cars.

Okay, that last sentence is unfair; let's make it more accurate: Unless you're a state Attorney General or the President of the United States, you probably understand enough economics to know that, if you're losing money on each car, you're going to lose more money on lots of cars.

As witness:

"President Barack Obama gave his sternest warning yet about the need to contain rising U.S. deficits, saying on Wednesday that if government debt were to pile up too much, it could lead to a double-dip recession."

So let's get this straight: if we don't cut spending, we're going to continue to further damage an already floundering economy, and the way to cut spending is to spend almost $2 trillion dollars on a government takeover of our health care system?

Gosh, what kind of mileage does that baby get?

[ed: Our apologies to car salesfolks for comparing them to President Obama]

In the Hot Seat (Again)

Several months ago, the very pleasant Claire McGuire interviewed me on behalf of FoIB Chris Brooks' Term Life Insurance Policy blog. Claire was researching a piece on whether (and how) disclosing one's medical history could adversely affect one's life insurance application.

The results of that interview are part of a very interesting post now up at Chris' blog.

Ignorant Government Tricks: Economics and the Flu

It appears that officials in some states aren't familiar with the concept of market-driven solutions. Case in point from today's McPaper:

"Some pharmacies are charging three times what others are for a scarce liquid form of the H1N1 drug Tamiflu used by children, USA TODAY has found. At least two states' attorneys general are investigating."

Apparently, "at least two states attorneys general" are clueless: increasing the price of something in short supply is a feature, not a bug. That is, the price increases because there's a shortage, not the other way around. When the cost of something is artificially depressed, the demand goes up, and shortages ensue. In this case, the relatively low cost of the vaccine (the article quotes $43, although I've seen it for much less locally) encourages folks who are at low risk of getting H1N1 (or, if they do, experiencing much difficulty) to get it anyway, reducing the supply available to those who are at-risk. By making the opportunity cost (and, of course, the nominal one, as well) more painful, it alleviates pressure on the supply chain. This is a good thing because more of the vaccine is then available to those truly in need.

It's akin to the price of hotel rooms after a major weather disaster: if rates remain fairly low, some families figure "hey, we'll get two or three rooms so the kids have some space;" this reduces the available supply for those who come in later. Temporarily increasing room rates discourages this behavior. It's basic economics.

Seems like that concept is lost on gummint-types.

Cavalcade of Risk #92: FAQ's

Jason Shafrin hosts this week's Q&A version of the Cavalcade of Risk. It's a safe bet that you'll learn something new.

Group Term Life Insurance - Open Enrollment

For some, open enrollment is going on as employees scramble to make elections for the coming year. I consulted with a client today on their options.

The family has been covered under a family major medical plan but his wife has recently returned to work and has been offered a benefit package. The health plan is good and very inexpensive for her after factoring in the employer contribution.

Like most employer plans, the heavy cost is shifted to the employee that has a family looking for coverage. After reviewing the benefits of their current plan vs. the one through the employer and weighing the cost of both plans the husband decided to keep what he has now.

The husband and children will remain on the current plan, the wife will choose the employer plan.

We then looked at other benefits such as life insurance, dental and vision. The dental and vision plans both have nominal premiums (due to heavy employer subsidy) and were essentially a no-brainer.

He dismissed the life insurance but I encouraged him to look at it further. Like many plans, the employee will receive life insurance at no charge that is a multiple of salary.

Free is good.

They also have a dependent life insurance plan that allows the wife to buy $50,000 of life insurance on her husband. Since this is open enrollment he can pick up the insurance without evidence of insurability.

This last item is a key in the decision process.

My client has cancer.

He has been battling cancer for 2 years. He applied for SSDI (Social Security Disability Insurance) in January and was approved in three weeks.

No one is approved that quickly.

If he were to apply for life insurance in the open market he would be denied. I strongly encouraged him to pick up as much life insurance as he can get under the employer plan.

After I explained the way the plan will work, that he will not be required to answer health questions or submit to a physical exam, he agreed that purchasing life insurance through the employer was a good idea.

So did I.

How Much?

It's been a while since we've discussed transparency in health care. Thanks to commenter Christine Lynch, here's a pretty good summary of why it may be overdue:

Skip that Mammogram? Maybe... [UPDATED & BUMPED]

[Please scroll down for updates]

Earlier this year, we reported on surprising news that perhaps PAP tests weren't "all that." Now comes news that, for many 40-something women, mammograms may not be "all that," either:

"Most women don't need a mammogram in their 40s and should get one every two years starting at 50 ... It's a major reversal that conflicts with the American Cancer Society's long-standing position."

But wait, it gets better (or worse):

"[B]reast self-exams do no good and women shouldn't be taught to do them."

If this was just any old think-tank, one might be tempted to call this irresponsible and potentially dangerous advice. But it isn't, it's "the U.S. Preventive Services Task Force, whose stance influences coverage of screening tests by Medicare and many insurance companies."

In the other corner, of course, Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, responds that "[o]ur concern is that as a result of that confusion, women may elect not to get screened at all. And that, to me, would be a serious problem."

So which is it?

Hard to say, but even the ACS has apparently been "backing off promoting breast self-exams in recent years because of scant evidence of their effectiveness."

And since most health insurance plans cover mammograms, some at no cost to the insured, it's unlikely that we'll see demand for them sagging. And we'll leave it at that.

[Hat Tip: SoIB Joyce Ferreiro]

UPDATE: There may be a diabolical undercurrent to the panel's findings. Hot Air's Ed Morrissey reports that as recently as 6 months ago, the same panel was sounding the alarm in a statistically insignificant drop in the number of 40-something women having these exams. Now, they're lauding the same outcome. What's changed? Under ObamaCare, "the government will be paying for a lot more of these exams ... That will put a serious strain on resources, especially since many of the providers will look to avoid dealing with government-managed care and its poor compensation rates."

Ed also notes that none of the 16 members of the U.S Preventive Services Task Force is an oncologist.

Death and Taxes: An Ethical Dilemna

FoIB and tax-blogger extraordinaire Joe Kristan has an intriguing post about organ donations, taxes and the thousands of patients who've died as the result of a perhaps mis-guided policy.

What do you think?

Health Care Reform Disappearing Act

Health insurance reform is about give and take. If you waddle through the maze and countless pages in all the various bills before Congress you really have to wonder what is going to come out on the other end if and when this massive spending bill is finalized.

I have wondered about all the new taxes to pay for health insurance (supposedly for the uninsured) but something I read this morning crystalized the games they are playing in Washington with our money. The AP reported this on the tax credits that everyone got as part of our share of stimulus.

The tax credit, which is supposed to pay individuals up to $400 and couples up to $800, was President Barack Obama's signature tax break in the massive stimulus package enacted in February.

Most workers started receiving the credit through small increases in their paychecks in April. The tax credit was made available through new withholding tables issued by the Internal Revenue Service.

The withholding tables, however do not take into account taxpayers with multiple jobs or married couples in which both people work. They also don't take into account Social Security recipients with jobs that provided taxable income.

The Social Security Administration sent out $250 payments to more than 50 million retirees in the spring as part of the economic stimulus package. The payments were meant to provide a boost for people who didn't' qualify for the tax credit.

However, they went to many retirees who also received the credit. Those retirees will have the $250 payment deducted from their tax credit — but not until they file their tax returns next year, long after the money may have been spent.

That's a bit of a rude awakening.

President Obama called and he wants his money back.

Congress is doing the same thing with health insurance reform under the guise of taxing the rich to pay for health insurance for the poor.

That finding from a new Associated Press poll will be welcome news for House Democrats, who proposed doing just that in their sweeping remake of the U.S. medical system, which passed earlier this month and would extend coverage to millions of uninsured Americans.

The poll found participants sour on other ways of paying for the health overhaul that is being considered in Congress, including taxing insurers on high-value coverage packages derided by President Barack Obama and Democrats as "Cadillac plans."

That approach is being weighed in the Senate. It is one of the few proposals in any congressional legislation that analysts say would help reduce the nation's health expenditures, but it has come under fire from organized labor and has little support in the House.

Lawmakers also are looking at levying new taxes on insurance companies, drug companies and medical device makers.

Think about this for a moment.

They want to assess health insurance companies, drug companies and medical device makers to pay for health insurance for the poor. But what happens when the tax is imposed?

Drug companies will pass the tax on to consumers who will pay more for medication. Prescriptions covered by health insurance will be more expensive which will result in higher premiums.

Medical devices like pacemakers and wheelchairs will become more expensive which will result in higher costs to the consumer and health insurance company. This mean higher premiums.

Of course let's not forget that drugs, pacemakers and wheelchairs are also covered by Medicare and Medicaid, so those costs will increase as well.

And that tax on health insurance companies? It will be passed through as well to those who pay the premium.

As health insurance premiums rise, to cover the cost of new taxes, higher prices for medication, pacemakers and wheelchairs those plans are in danger of becoming a "Cadillac" plan . . . which will be taxed.

These changes don't even take into account the required 30%+ increase in premiums caused by health insurance reform that mandates more expansive (and expensive) coverage for wellness and mental health parity as well as the "no restrictions on pre-existing conditions" requirement.

So just like the government is giving us a break by lowering our withholding taxes and tossing a bone to Social Security beneficiaries, then taking it back next April, they are doing the same thing with health insurance reform.

Giving us more benefits (no pre-existing, low copays, wellness, mental health parity) which increase premiums so we will have to pay more tax. Actually, it is a double tax.

We pay the tax the first time when we consume goods like medication and medical devices, and then we pay again because we were forced to buy an expensive "Cadillac" plan.

This is a dog only a politician could love.

Change you can believe in. Yes you can.

Pre-Thanksgiving Grand Rounds

FoIB Louise Norris hosts this week's edition of Grand Rounds, and there's a lot for which to be grateful. For one, she's obviously taken the time to read every submission, and offers her own thoughts on each.

The Gang That Couldn't Count Straight: Spendulus & Health Care

Back in the day, we poked fun at then-Presidential candidate Obama's claim that he'd been to "all 57 states." Not having a Harvard Law degree, we relied on our high school teachers' claims that there were but 50. But it appears that President Obama's Spendulous efforts are indeed reaching all 57 states:

"In Arizona's 9th Congressional District, 30 jobs have been saved or created with just $761,420 in federal stimulus spending. At least that's what the website set up by the Obama Administration to track the $787 billion stimulus says."

Good news, right?

Well, not so much:

"There is no 9th Congressional District in Arizona; the state has only eight Congressional Districts."

Ooops.

But that's just a fluke, right? A one off?

Well....

"There's no 86th Congressional District in Arizona either, but the government's recovery.gov Web site says $34 million in stimulus money has been spent there."

And the list goes on from there.

Quick - Put these guys in charge of our health care!

It's no fable, it's the Carnival of Personal Finance

Miss M (as in M is for Money) hosts this week's roundup of finance posts, built round some old chestnuts.

CMS on ObamaCare: Epic Fail

Two of the major (purported) benefits of ObamaCare cited by its proponents are reduction of health care costs and increased availability of health insurance. Advocates also claim that we can achieve these two goals while saving tax-payer money.

As we recently noted, a study by Wellpoint put the lie to these assertions.

Now comes another report, this one from that noted mouthpiece for private insurers, the Centers for Medicare and Medicaid Services (CMS), which drives the nails even deeper into the coffin:

"With the exception of the proposed reductions in Medicare payment updates for institutional providers, the provisions of H.R. 3962 would not have a significant impact on future health care cost growth rates."

In fact, absent those hundreds of billions of dollars in Medicare cuts, the cost of health care actually increases under Obamacare. And that's based on historically low-ball gummint-touted numbers. The reality is likely to be far worse.

There's bad news about the much-touted "Public Option," as well:

"[P]ublic plan premiums would be roughly 4 percent higher than private as a result of antiselection by enrollees." [emphasis in original]

So much for the promise of lower health insurance costs.

But then, that's what we've been saying all along.

[Hat Tip: Politico]

Suicide Insurance? Setting the Record Straight

PoliBlogger Michelle Malkin has an update on a tragic story from September; news junkies may recall that a census worker was found dead, apparently hung. On his stomach was scrawled the word "Fed," leading many to believe that this was a cold-blooded murder. Suspicion fell on moonshiners and "rednecks," but there was scant evidence to support either of these theories (among others).

According to new information released by the authorities, it appears that this may well have been an elaborately staged suicide, the point of which was to leave the proceeds of a life insurance policy to the victim's son. Unfortunately, the news reports cited by Ms Malkin leave much to be desired vis: suicide and life insurance.

For example:

"Life insurance policies typically do not cover suicides within a certain time period after the policy begins."

Correct, to a point.

And:

"“If it’s deemed suicide, there’s no point in even looking at insurance,” the son said. “There’s no such thing as suicide insurance."

Again, correct - to a point.

Until just after the Great Depression [ed: what was so "great" about it?], 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.

So no, there is no "suicide insurance;" but that was never really the point in the first place.

Swine Flu Deaths Increase - Fact or Fiction?

On 11/6/2009 the CDC reported there were 129 swine flu related deaths year to date beginning 4/26/2009 and going forward. Six days later Fox news is reporting the CDC claims 4,000 have died as a result of swine flu.

So which is it?

Have over 3,800 people died in the last 6 days from swine flu? Are these swine flu cases "saved or created" like so many other numbers coming out of Washington these days?

Is it just a coincidence that the number of deaths increased after the House voted to approve H.R. 3962?

Is this just another stupid government trick?

Change you can believe in.

Cavalcade of Risk #92: Call for submissions

Next week's Cav is hosted by Jason Shafrin, the Health Care Economist. Submissions are due this Monday (the 16th), and Jason would like to remind you to include:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

Thanks, and have a GREAT Weekend!

The Skinny on Fat Mums versus the MVNHS©

It's not enough that the MVNHS© considers newborns "at risk" if their mums are a bit zaftig.

Now comes word that expectant mums may not have the opportunity to actually be admitted to hospital (as the Brits say):

"Mothers-to-be who have a body mass index (BMI) of over 34, the equivalent of an average woman of 5ft 6ins weighing 15 stone, will be turned away from Weston General Hospital, Weston-super-Mare, Somerset."

Ooops, better watch that weight gain, gals!

Fear not, though, portly preggies have to travel but 20 miles to the next closest facility. Assuming, of course, that they can make it that far when contractions are minutes apart.

Quick - Let's do that here!

Unconstitutional, But "Fair"

Seems that the lower chamber of Congress echoes the sentiments of the upper:



"The legislation is very fair in this respect."

Dear. Lord.

[Video courtesy of RedState]

Southwest Ohio Network Alert: Medical Mutual Edition

Once again, Premier Health (and its associated hospital network, including Miami Valley) is on the outs with a major carrier. This time, Medical Mutual of Ohio has declined to renew its contract with Premier, effective January 1st of next year (about 7 weeks away). This could mean a potentially huge disruption of service: in addition to over 100 local doc's, the network includes Miami Valley and Good Samaritan Hospitals, and a home health care agency.

This isn't the first time that the network has clashed with insurers: about this time last year, Humana and Premier parted ways, and have yet to reconcile. And a few years before that, Anthem and Premier separated for quite some time before they kissed and made up.

My guess, based on the timing, is that MMO is looking to pressure Premier into concessions on price; this isn't a bad tactic, per se, and could result in some savings for their insureds. This far out, it gives both sides time to posture, and still come to an agreement before the clock runs out.

We'll keep you posted.

Small Town, Big (Insurance) Troubles

Recently, FoIB Rick Byrne tipped me to a fascinating, if convoluted, story out of northeast Ohio. There's as much small-town politics as group health insurance in this tale; I'll be focusing on the latter as much as possible.

Briefly, this suburb of Youngstown is home to some 12,000 residents. It's governed by an eight-person city council, and and has about 60 employees. These employees (and some of the city council staff) are covered by a group health insurance plan issued by Anthem, which has recently notified them of a renewal rate increase.

And thus our story unfolds.

A short time ago, one of the council members proposed deleting staff from the group plan. Dan Yemma, an insurance broker himself (although not the agent for the city's plan), thought that only certain classes of employees should be covered, and that shrinking the group would be an efficient way to save money. For whatever reason, this proposal was deep-sixed, and things went on as they had.

To a point:

The Anthem renewal increase was for 13% (a not unreasonable percentage in this market, but well above the city's anticipated budget for insurance). The agent of record, Michael Caparso, agreed to "shop" the group, which is generally a good idea. Until recently, this would have involved simply generating a census (a list of employees, their family status and ages, etc) and adding whatever additional underwriting information was available (autistic dependendents, pregnant spouses, etc) in order to generate a "pre-screened" rate. Absent that medical information, the carrier would simply issue a "street rate" quote; that is, one which assumed (rightly or wrongly) that everyone was in fine health. In the past year or so, though, carriers have become more stringent in their screening process, and now require completed applications (or waiver form) for each employee. This can be a real burden if one is seeking quotes from multiple carriers; the good news is that pretty much every carrier will generate a quote off of a UHC application.

And so, the agent supplied apps to everyone, and all but one were completed and returned. The one holdout was the aforementioned council member with an apparent axe to grind. He refused to submit either a completed application or a waiver; without that, the carriers wouldn't issue a "pre-screened" quote.

[ed: it should be noted that throughout the linked article and the emails I've received, folks keep referring to these as "binding quotes." They are not: a "binding quote" in this instance is an oxymoron. What they're really talking about are "pre-screened" numbers]

The city's dilemna was that they really couldn't afford the 13% hit from Anthem, but their agent's hands were tied because of the missing form.

And there things stood. And (apparently) stand.

When I first read Rick's email, I was a bit puzzled by a number of issues. First, I didn't understand why the other council members didn't force their recalcitrant colleague to cough up the form (although I really didn't know what leverage they may have had to do so). I was also puzzled by the revelation that the city auditor, who was tasked with getting and evaluating the quotes, was on the city's plan and apparently felt it was her only option. Finally, I wondered about some of the things that Mr Yemma allegedly said, which did not reflect well on his professionalism or ethics. A number of things just didn't add up for me, and so I decided to do a little research.

Jeanne Starmack, the reporter who broke the initial story, quickly and graciously responded to my email asking if she'd be willing to discuss the situation. In reply to my questions, Ms Starmack told me that, as of the 5th, Mr Yemma had yet to submit either a completed application or a waiver. She also noted that the other council members really had no means by which to force him to comply: "He's not an employee, he's an elected official and they can't make him do anything." That makes sense, of course, and explains why there's been no official sanctions. I had wondered if there was perhaps some professional jealousy involved (since he's an agent, but not the agent), but Ms Starmack quickly quashed that. She also helped me understand exactly which kinds of folks he'd have preferred be taken off the plan: "the city council, the mayor, the law director and the auditor." Interestingly, she also told me that the city's group insurance is the auditor's "only source of insurance."

Ms Starmack told me that, in a series of emails, the auditor and Mr Yemma had quite a few disagreements about what was necessary to obtain pre-screened quotes. According to the article, and Ms Starmack's email, Mr Yemma claimed that it was not, in fact, necessary for him to submit an app or waiver in order to obtain the necessary quotes. Since we already know that this is untrue, I was a bit nonplussed that he would make this claim; as an agent himself, he either knew it and was lying, or he'd slept through a few CE classes. Neither of those alternatives seemed likely to me.

In Part 2, we'll learn the Insurance Department's reaction, as well as information directly from two principles: Mr Yemma and the city auditor.

[A Very Warm InsureBlog Thank You to Jeanne Starmack for her help]

Health Wonk Review, Live from Colorado

FoIB Louise Norris hosts this week's round up of wonky posts, with an emphasis on PelosiCare. Lots of good stuff here, do check it out.

Constitution?! We don't need no stinkin' Constitution!

Or so opines Sen Jack Reed (D-RI). Addressing one of the many new mandates included in PelosiCare (buy insurance or go to jail) the Constitutionally-challenged senator observed that:

"it is not unusual that the Congress has required individuals to do things, like sign up for the draft and do many other things too, which I don’t think are explicitly contained [in the Constitution]."

[ed: our apologies to readers who must now clean their monitors]

Really, Senator? You're equating forcing citizens to buy something they may not want or need, with serving in the armed forces? Putting aside for the moment the sheer audacity of this position, let's examine what the Constitution says about the draft:

"The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence ... To raise and support Armies ... To provide and maintain a Navy ... [and to] make Rules for the Government and Regulation of the land and naval Forces" [Article I, Section 8]

Now let's see what the Constitution has to say about forcing Americans to buy health insurance:

...

Singing lessons are over.

Maine is the Charlie Brown of Health Care

Poor Charlie Brown. Problems with the kite eating tree. Lucy always pulls the football away just as he is about to kick it. A dog that is more popular than him.

Maine is the Charlie Brown of health care. The state’s legislators have tried for decades to fix its system, but their efforts have always fallen short: health insurance premiums are still among the least affordable in the nation, health care spending per person is among the highest and hospital emergency rooms are among the most crowded. Indeed, many overhauls to the system have done little more than squeeze a balloon — solving one problem while worsening another.

Sound familiar?

Like the great health care debate in Washington.

But like the Peanuts character, the state keeps trying. Indeed, Senator Olympia J. Snowe, Maine’s senior United States senator and so far one of only two Republicans in Congress to vote for an overhaul, spent two years in the late 1970s as chairwoman of the State Legislature’s joint Health and Human Services Committee pushing small reform efforts. “That’s where I garnered an enormous deference to the issue of health care and its complexities,” Ms. Snowe said in an interview.

Based on what I have read Ms. Snowe in Washington it seems like she hasn't learned that much over the last 30 years. If she can't fix health care for Mainiacs then how can she expect to fix it for a nation of 330 million?

To conservatives, Maine proves that government efforts to strictly regulate the nation’s health insurance market are doomed. Many of the reform proposals circulating on Capitol Hill have already been tried in Maine.

“These reforms are very well-intentioned, but in reality they have yet to produce the promised results or even be financially sustainable,” said Tarren R. Bragdon, chief executive of the Maine Heritage Policy Center, a conservative research organization in Portland.

And nothing in the House or Senate version will do anything to control the cost of health care either.

To others, Maine’s failures show why some reforms can be tackled only on a national level. Maine has the nation’s oldest population, its poor are among the sickest, and its median income ranks low.

That sounds like the Medicare population. Another government albatross that is a financial Titanic.

Every time the government tries to fix things it only get's worse and costs more than it did before. Why is that so difficult to follow?

More COBRA Bites

Earlier this year, IB was the "go-to" place for COBRA/ARRA info, and we certainly wouldn't want to let our readers down. This morning's email brought news from COBRA admin Ceridian about new developments on the COBRA and ARRA front.

First, that 65% COBRA subsidy on which so many folks count? Well, it sunsets at the end of this year. If and/or when that happens, folks who lose their group benefits on or after December 31st won't be eligible for the subsidy (although insureds currently receiving it won't be cut off on that date).

Second, there are currently two House bills and one in the Senate that seek to extend the subsidy into (at least) next year. As Ceridean notes, with unemployment officially at over 10% (and unofficially at 22%), it's a pretty good bet that a lot more folks will be clamoring, not to mention eligible, for the subsidy. This, of course, will put even more pressure on Congress to "do something."

We'll keep you posted as things develop.

Oh, something else that caught my eye in that aforementioned e-mail: in analyzing their enrollment data, Ceridian found some interesting patterns. For example, "COBRA enrollments increased approximately 40 percent from pre-ARRA rates. About 18 percent of eligible workers chose COBRA health care continuation coverage, up from about 12 percent." Since someone else was footing up to 65% of the bill, that's not exactly a surprise. Click here for a copy of their full report.

Eleven Eleven Campaign: For Our Veterans [UPDATED & BUMPED]

[Welcome Industry Radar readers!]

The Beyond Tribute Coalition has put together a bipartisan program to raise money for veterans' groups like Gold Star Mothers, Vietnam Veterans of America, and the Wounded Warrior Project, among others.

According to its organizers "(t)he objective of the Eleven Eleven Campaign is simple: to get 11 million Americans to donate $11 to support America’s Veterans." Although we promised no math here, that's $121,000,000 for our Vets. And they've chosen a unique way to go about it: by harnessing the power of the blogosphere.

How can you help? It's simple: starting today, and continuing until we've reached that magic number, you can text "VETS" to 85944 to contribute. Or, you can simply click on the 11-11 widget near the top of the sidebar to contribute $10 (Beyond Tribute will kick in the other $1)

If you'd like to show your appreciation to those who've served, then I encourage you to contribute the cost of a couple of lattes to this great cause.

Grand Rounds: Veterans' Day Edition

Flight nurse and medblogger Emily McGee presents a Veterans' Day-themed round-up of great posts.

Wishful Thinking: Ohio Edition

If, as we've maintained here at IB, the states comprise 50 individual laboratories for health care "reform," then it makes sense to look at how these "experiments" are going. Case in point: Ohio's recently enacted HB 1 which the Department of Insurance claims, among other things, will result in some 52,000 currently uninsured Buckeye's gaining coverage.

Uh-hunh.

Immediately upon its implementation, I received this in an email from Anthem:

"Effective January 1, 2010, Anthem Blue Cross and Blue Shield will no longer offer the HIPAA-HIC (basic and standard) Open Enrollment plans in Ohio."

So what does this mean, exactly?

Currently, Ohio citizens who are either Federally Eligible Individuals (i.e. folks who were eligible for COBRA continuation, elected it, and "rode it out" for the maximum 18 months) or have been declined for individual medical insurance are offered specific, state-designed plans. Anthem was, of course, the go-to carrier for them, since it offered several "flavors" at almost-reasonable prices (although that last is debatable, they were certainly competitive). In addition, Ohio gives each carrier a "quota" of such policies to sell, based on market share. Since they're the 800 pound gorilla, they "got" the lion's share of this business [ed: way to mix those metaphors!].

Because HB1 set new - much lower - premium differentials for these plans, they become even less profitable for the carrier. If it sounds like I'm taking the carriers' side in this, it's because (for once) I am: the free market works when the government doesn't meddle. In this case, "meddling" means further restrictions on the companies' ability to make a profit, which means they're going to shed the less profitable business as quickly as possible.

What that means to insureds is that they'll have less choices, and there will be fewer "slots" available (supply and demand). It's not as if these things fly off the shelves to begin with, but they were at least a viable alternative to those with serious, chronic health issues.

So what's the lesson here? When you restrict carriers' ability to compete in the market, consumers end up with fewer choices. Maybe that was the point of this exercise (wonders the cynic), but it certainly does not bode well for similar efforts on a national scale.

1,000 Words: What (Barely) Passed

Comments Update (Good News): Importing Complete

Thanks to the folks at Disqus, our archived comments from HaloScan/Echo have been imported and are now online.

That was really the final piece of the transition, and we're pleased as punch to bid JS-Kit/Echo "adieu!"

Health Care Lottery

Health care reform has become a lottery windfall for members of Congress willing to sell their vote in exchange for dollars.

Washington correspondent Jamie Dupree Tweets and blogs on a regular basis, giving readers and insiders view of sausage making inside the beltway. It is not a pretty sight.

The recent debate in the House resulted in a narrow approval of health care reform. The debate over abortion funding with taxpayer dollars got the headlines but there was more going on behind the scenes.

Rep. Jim Costa (D-CA) made clear he had won money for a medical school in his Fresno-based district and more.

"During my negotiations to help improve the bill for our Valley, I was able to achieve funding for a medical school in the Valley, with studies at UC Merced and residency in Fresno, as well as additional incentives to bring health professionals to our Valley," Costa said in a statement.

Rep. Dennis Cardoza (D-CA) - who last week was quoted as saying he was leaning against the bill - said he won $167 million in health care funding for hospitals in his district.

So Rep. Cardoza was against the bill before he was for the bill.

Of course all of this is transparent, as promised by Obama during his bid for the White House, right?

Not necessarily.

I went through the final version of the House bill, as printed in the Congressional Record, and couldn't find anything related to what these members were taking credit for, which means that probably would be worked out through grant funding by the Obama Administration.

So when is a budget item not a budget item?

When funding falls outside the scope of health care reform.

That would mean these figures are not part of the CBO's price tag for H.R. 3962.

So what else is included in health care reform that has nothing to do with health care? Here is a partial list.

• Patterson Irrigation District Pumping Plant and Fish Screen

• Patterson Irrigation District Pipeline Project

• Diversify Level 2/Level IV Refuge Program

• Announce 2011 rescheduled water decision in the Spring, 2010

• Additional federal support for the Westside Water Use Efficiency and Conservation program

• Support the removal of restrictions under the Emergency Drought Relief Act which restrict funds to temporary projects

• Mendota Dam Replacement

• San Luis Drain Rehabilitation

Transparency you can believe in. Yes you can.

The Double Decker Secret

[Welcome Industry Radar readers!]

What do double decker buses and heart attacks have in common? Drivers of double decker buses have a lesser risk of heart attack than do drivers of more traditional buses.
The WSJ Blog reports on a study by Dr. Jeremy Morris.

Morris thought there might be some link between occupation and heart-attack risk. And when he looked at the men who worked on London’s double-decker buses, he found a striking result: The conductors — who went up and down the stairs on the bus all day long — were half as likely to die of heart attacks as the drivers, who sat at the wheel all day.

The data held up; among postal workers, Morris found, those who delivered mail by bike or on foot were far less likely to die of heart attacks than those who sat behind the counter at the post office.

New information?

Not really.

Dr. Morris reported his findings in 1953.

So why is this news?

Dr. Morris died two weeks ago at the age of 99.

He swam, rode an exercise bike or walked for at least half an hour on most days until he was well into his 90s. And in recent years, he often walked up and down the stairs of the London School of the London School of Hygiene and Tropical Health, where he was an emeritus professor.

“I’m constantly being asked: ‘Your long life, what would you advise?’ and so forth,” Morris told the FT. “To start telling other people what to do – I’m very reluctant. Except on exercise, where to a large extent I feel it’s what I’ve done myself that’s contributed to longevity.”

Sounds like good advice.

DiabetesMine and Keas Get Crackin'

Our friend and healthblogger colleague Amy Tenderich has teamed up with the former honcho of Google Health to offer a first-of-its-kind tool for the estimated 23 million American diabetics. Called the "Keas plan," this interactive, web-based program empowers these folks to actually do something about their health.

The tool goes live today; please click here for details.

Swine Flu and Goldman Sachs

Seems the folks at SNL "porked" a little fun at the CDC and Goldman Sachs over swine flu vaccines . . .



Just another stupid government trick.

Swine Flu Created or Saved

The CDC reports 129 confirmed swine flu deaths through 11/6/2009. They also indicate that, on average, there are 36,000 flu related deaths each year.

They report there are 38,000,000 doses of swine flu vaccine "ordered or available."

Why does this sound like jobs "created or saved" rhetoric?

It has been reported that doctors and clinics are running low on seasonal flu vaccine. So far, over 70,000,000 doses of seasonal flu have been delivered with another 40,000,000 on the way.

I have no idea how much of taxpayer dollars is being spent on the swine flu vaccine promotion, but I have trouble reconciling 129 deaths to 36,000 during the course of normal flu season. Not to be dismissive, because any death is not insignificant, but it seems almost like the fuss about Y2K.

It makes me wonder, after all this is over, if some will be asking "what was all the fuss?". Is this just another stupid government trick?

UPDATE [HGS]: Via Common Cents

Carnival of Personal Finance is up

This week's Carnival of Personal Finance is hosted by the Canadian Finance Blog. It's chock full of helpful tips.

Let's all waste money, shall we?

I ran into an interesting situation the other day. One of my clients is a type 1 diabetic. She tests her glucose levels roughly ten times per day, which is pretty standard for intensive glycemic control. According to the claim information that's up on their web site, Anthem is paying almost $100 per 100 test strips at her local pharmacy. She wanted to know why she couldn't just purchase them on Amazon (test strips are a non-prescription item) at $25 for 50 and send in a receipt for reimbursement. It would save Anthem almost $1800 per year.

I called Anthem. Amazon isn't a contracting provider (no surprise), so they won't reimburse her. Not even a slight chance...

I wonder how many millions of dollars Anthem is unnecessarly spending on this item alone?

Health Care Reform to Aid Vet's

Ever wonder how things become law? Someone uses YOUR tax dollars to buy votes. Keep in mind if YOU were to give money or favors to a legislator in exchange for favors you would be committing a criminal act. But that is not the case when members of Congress do likewise.

Perspective...

Quick - Let's put these rocket surgeons in charge of our health care!

On the Record with Joe Wilson

This morning, I was privileged to participate in a blogger teleconference with Rep Joe "You Lie!" Wilson (R-SC) about health care and the War on Terror. We'll focus primarily on the former, but I learned something very interesting about the latter which I'll share at the end of this post.

Rep Wilson began by acknowledging the terrible events at Ft Hood yesterday, and expressing his concern about the victims and their families. He then spoke about yesterday's demonstration in Obamington, and segued into his support of HR 3400 (a Republican version of health care "reform"). He spoke about "limited government and expanded freedom," which he believes is in direct contravention to PelosiCare.

Tuesday's elections, he observed, marked a watershed moment for those opposed to government take-over of our health care system. Given the results in Virginia and (especially) New Jersey, he thinks that Blue Dog Democrats have to be concerned about backing that kind of effort at their own re-election expense.

He spoke a bit about Afghanistan and Iraq, and then took questions from the half dozen or so of us on the call.

I had the privilege of asking the first one. Truth be told, I had at hand a number of questions, some my own, some from Mike, and chose to ask about his amendment that would require CongressCritters to go on the Public Option if it's passed. I pointed out that, two years ago, then-Senator John Edwards had proposed an essentially similar idea, which was deemed to be unenforceable. I asked Rep Wilson what he thought the chances were of its passing (slim-to-none) and whether it would be practical if it did.

He answered that the way his was worded was enforceable; that a specific class of "employee" could be carved out and put on that plan.

I followed up by asking why Speaker Pelosi was in such a rush, since Sen Reid was on record that no Senate bill exists and that they wouldn't even be considering the matter until after the first of the year. He replied that he believed that Nancy and her allies are obsessed with the government takeover of health care, in a continuing bid to "grow government." She knows that this may well be their last real chance at passing something, based on what they saw Tuesday.

Jim Hoft of Gateway Pundit then asked about Rep Wilson's take on Sen Alan Grayson's recent outbursts regarding Republican efforts. He replied that "Sen Grayson speaks for himself...truly outrageous and insulting." For those who liken Sen Grayson's comments to Rep Wilson's outburst at SOTU, he pointed out that his own was a "townhall moment;" that is, spontaneous and unscripted. By contrast, Sen Grayson spoke with the aid of storyboards, and were obviously not spur-of-the-moment.

Publius Forum's Warner Todd Huston asked if the Republican caucus had pushed any further on the constitutionality of many of the ObamaCare provisions (e.g. mandates, jail time, etc). Rep Wilson said that, should it pass, it would take litigation to determine that. He also took to task those who would equate auto insurance to health insurance; these folks point out that auto insurance is mandatory, but neglect to finish the sentence: "if you want to drive." But no one is required to own a car, whereas we are all "required to breathe." Thus, it becomes a tax simply for living.

I then asked about his thoughts on tomorrow's (potential) vote. Rep Wilson believes that the Democrats are counting on winning with a "one vote margin," but that there's not much assurance they'll have even that [ed: see link re: "(potential")]. He said that so-called "Blue Dogs risk becoming Lap Dogs" if they toe the party line.

He also pointed out that it wasn't until July that folks began to understand the "squeeze on Medicare and the elderly" that ObamaCare represents. The other major problem, he said, was how it would adversely affect small business, "the backbone of our economy." He then praised groups like the National Federation of Independent Businesses (NFIB) for their efforts to educate the public, pointing out that the additional taxes which would accrue would likely result in at least "another 1.6 million jobs lost."

Next up was Jeff Poor from NewsBusters, who stayed on the unemployment theme, quoting (Sheriff) Joe Biden's claim about the mess this administration had inherited. Rep Wilson took that as an opportunity to point out that, in hard economic times, history has shown that tax cuts are the way to go, citing both Presidents Kennedy and Reagan. He also had little use for the "Porkulus" which, he said has cost more jobs than it's saved [ed: a claim borne out by this chart].

Richard Zuendt, from Conservatives with Attitude, spent some time reviewing the profound impact of the election results in New Jersey. He was quite concerned about how the draconian cuts in Medicare will fall to the states to make up. He and Rep Wilson agreed that governors from both parties are justifiably concerned about this increase in states' costs, especially in a troubled economy.

Rep Wilson then pointed to Tenncare as a failed example of government-run health care, one which nearly bankrupted the Volunteer State.

Finally, The Hill's Tony Romm asked about the "one vote margin" which Rep Wilson had mentioned early on. He wanted to know if the vote was really going to happen tomorrow [ed: doubtful], and Rep Wilson was skeptical. He believes that Tuesday's vote put a real damper on that effort. He also pointed out that the political class was surprised at the intensity of the Republican base, as well as the cooling off of the corresponding Democrat's.

In a followup from Mr Romm, Rep Wilson was asked about AARP's endorsement of Pelosicare. The Congressman replied that folks should cut up their AARP cards, and send them back with a letter as to why [ed: sound familiar?]. He then named some other seniors' organizations that more accurately reflect their members' needs.

I mentioned at the top of this post that I learned something interesting about Afghanistan, and that country's economic woes. Rep Wilson told us that there is obviously concern about continued poppy (and thus heroin) production, but that Afghani's actually have an attractive alternative: apparently, Afghani pomegranates and grapes are highly prized in the Arab world, and are actually more profitable than poppies. There's now an effort to move Afghanistan's poppy farmers to these more profitable (and safer) crops.

And that's that. Our very Special Thanks to Lyndsi Thomas for making this happen. And again, I'll be updating this post with names and links as they become available.

UPDATE 1: Conservatives With Attitude reports on the call here.

UPDATE 2: Names and links are now in place.

A Tale of Two Bills: Show Me the Money

Let's put aside for a moment whether ObamaCare (that is, the Senate version -such as it is - and PelosiCare) includes coverage for abortions (it does) or Death Panels (it does), and focus instead on actual costs. According to the Congressional Budget Office, "in their true first 10 years, the House bill would cost $1.8 trillion, and the Senate bill would cost $1.7 trillion." [emphasis in original]

And just to drive home the point that Granny's been thrown unceremoniously under the bus, PelosiCare includes some $800 billion in Medicare cuts, which is trumped only by the Senate version's $900 billion reduction. No more cookies for you guys.

For those keeping score, those $2 trillion price tags are almost double what the Majority Leader and the Speaker have previously claimed. I'm reminded of something an old sage once observed.

Contrast those ginormous numbers with this one: "a gross cost of $61 billion that is partly offset by about $52 billion in additional revenues associated with the coverage provisions." Those provisions include such outrageous schemes as tort reform and interstate sale of insurance (Full Disclosure: Bob maintains, and I agree, that this particular change will result in premium reductions for, at best, a very short time).

Lets compare those numbers: almost $2 trillion vs about $61 billion.

To be fair, Obamacare proponents will claim, justifiably, that the so-called Boehner Amendment cited above results in about 85% of the population being insured, while their efforts would result in some 95% covered. What they won't tell you is that their 95% includes illegal aliens (it does), which account for about 20% of the 15% of the uninsured; this means that ObamaCare and BoehnerCare are within about 5% of each other with regard to covering the uninsured.

As to how much they'll cost, well, do the math.

Not Dead Yet

Late for your own funeral? Almost . . .

MSNBC reports a bricklayer showed up at his own funeral . . . but was very much alive.

A Brazilian bricklayer reportedly killed in a car crash shocked his mourning family by showing up alive at his funeral.

What family members didn't know was that Goncalves had spent the night at a truck stop talking with friends over drinks of a sugarcane liquor known as cachaca, his niece Rosa Sampaio told the O Globo newspaper. He did not get word about his own funeral until it was already happening Monday morning.

If he doesn't have life insurance, maybe now is a good time to buy it.

AARP Throws Seniors Under The Bus: Turnabout Fair Play?

After several false starts, AARP has pulled the trigger on its endorsement of PelosiCare, and the draconian Medicare cuts which will result. Any organization that seeks to put its own members at risk is, of course, free to do so, but it seems reasonable that there should be consequences for such a betrayal.

Since I've never been a member, I can't tear up my AARP membership card, enclose it with a letter expressing my disgust and disdain, and then mail that to AARP's headquarters.

But if you are, then I would encourage you to do so as soon as possible, and then head over to the American Seniors Association, which is on record as being against ObamaCare (and its various incarnations).

And if you join today (as I just did), there's a special two-fer deal going on. Making an important statement and saving money: priceless.

Showdown at the It's-Not-OK Corral

It's high noon (really!), the sun is beating down on the dry, dusty town below as the gunslingers saunter out into the middle of the street. Eyeing each other carefully, squinting from the relentless heat and light, they face off, knowing that only one will walk away.

A scene from a classic oater at InsureBlog?

Hardly.

FoIB Lyndsi Thomas tells us that "High Noon for Health Care is a joint project of an unprecedented coalition opposed to the government takeover of our heath care system."

Once there, you can email, call or even twitter your congresscritter about PelosiCare. The idea is that funneling thousands of voices further empowers each one. So click over, and use the power of the 'net to raise your voice.

Long Term Care Insurance: When's the best time to buy?

As previously noted, we don't recommend specific policies here at IB; everyone has their own needs, goals and budgets. But we do often suggest that many (perhaps most) folks might benefit from specific kinds of policies. One of these is Long Term Care insurance (LTCi), about which we've written before. But a colleague recently posted an informative and highy-readable piece on when to buy LTCi, and we're reprinting it here (with his permission).

Herman Bruns is a veteran agent in the Metro Atlanta area (does this make him a MetroGeorgian?) who specializes in the often complex field of LTCi. In response to a recent question posed at a public bulletin board which Bob and I frequent, he explains some of the factors that should be considered in deciding when to purchase this coverage:

As with most types of insurance, the ideal time to purchase LTC insurance (LTCi) is about one month before you need it. That way, you can potentially collect from the LTC carrier for a lifetime and have only paid one month’s premium. Of course, without a crystal ball, very few of us can predict when we will have a car accident or a stroke, or be diagnosed with cancer or Alzheimer’s. Many of us may be one doctor’s visit away from a diagnosis that will either cause us to pay more for LTC premiums, or possibly not even qualify for the insurance.

Christopher Reeves (Superman) never planned to fall off his horse.

As more and more baby boomers become aware of the devastating financial and emotional effects that a long term care need can have on their family, the average age at which people purchase LTC insurance has been steadily dropping every year. Government awareness programs advising people to look into this type of insurance is also causing people to get educated on how these plans work and to start early. LTC insurance is surprising affordable when you buy it at a younger age, so more and more people are simply taking advantage of it sooner. My own personal experiences with my elderly parents and in-laws in nursing homes and assisted living (all paid out of their own pocket) caused my wife and I to purchase our plan when I was 52 and she was 50. I happily pay the premium every year, even though in the back of my mind, I hope I never have to use the insurance at all. Statistically, my wife has a much better chance of using the plan than I do.

The cost of purchasing LTC insurance goes up every year you delay. Carriers raise their rates for new purchases periodically, too. The older you get, the faster it rises. As one starts to move into their early to mid 60’s, you begin to enter into what the mathematicians call the “exponential curve” of rapid price increases. The good news is that when you buy a LTC plan from a quality carrier, you are essentially “locking in” your rate for the rest of your life. Now it is true that the rates on existing policies can and do in fact increase, but many of the top carriers in the industry have a long history of little or no rate hikes. No matter when you purchase a plan, it is always going to offer you tremendous protection for a fraction of the cost of an extended nursing home stay.

Sadly, as we grow older, many of us also get less healthy. Blood pressure, arthritis, diabetes, and other ailments show up frequently as we get into our late 50’s. Many of us simply don’t take good care of ourselves, and others of us are a product of our heredity. LTC carriers give preferred health discounts to those who qualify of between 10% and 20%, so it pays to be healthy. There are a lot more healthy 55 year olds than 65 year olds out there.

Back to the original question: when should you buy LTC insurance? Although you can buy it at any age up to 84 with some carriers as long as you can medically qualify, I would urge everyone to start considering it by age 50, and try to get it in your early to mid 50’s if at all possible. If you can handle the premiums at that time, it can be a great value……and with the power of a 5% compound benefit increase, the benefit you purchase at age 50 will immediately start growing. This will provide you with a huge plan of protection by the time you statistically will most likely need the coverage, which is in your 80’s. In the long run, even though you start paying the premium sooner, the overall amount of premium paid out can be less by starting early.

Everyone’s financial situation is different, and no one plan fits all. Not everyone can start at age 52. You may have to wait until the kids get through college to afford LTCi. You may first need to move to a more cost effective high deductible or HSA eligible health insurance plan, or wait until you are on Medicare, so you can free up the funds to pay for LTC insurance. If you are already 65 and reading this blog, then the time to buy LTCi is before you turn 66….assuming LTCi makes sense for your situation. The key is to first learn more about how LTC insurance works by speaking with an experienced LTC agent representing a variety of carriers and who can advise you as to all your options.

Thanks, Herman, for your insights and for permission to share them. Readers with additional questions or thoughts are encouraged to share them in the comments.

Got cancer? You can wait. Trust me.

The government response to health care reform is . . . wait 6 months before coverage begins.

Or 2+ years if you want to go on Medicare under SSDI.

According to Fox, the Senate version of health care reform contains this wording.

The six-month wait is in the health care bill the Senate Finance Committee approved last month. To qualify for the pool, patients must be turned down for coverage because of a pre-existing condition and uninsured for at least six months.

Seems like the government is a bit tentative about taking on risk. It can't be a profit motive, so what is it?

Obama proposed the pool in his September health care speech to Congress. Intended to serve the most vulnerable as a temporary fail-safe, it would stay in place until 2013. That's when insurance companies would be banned from denying coverage because of medical problems.

Government subsidies to make coverage more affordable for millions of uninsured would also start that year.

Has anyone bothered to question the reason for delaying major provisions of health insurance reform until 2013? You don't suppose it has anything to do with 2012 being an election year do you? Those running for re-election in 2012 can tell you to hold on, change is coming next year.

Both the House and the Senate Finance bills set aside $5 billion for the pools.

"It doesn't seem like it's near enough money," said Douglas Holtz-Eakin, who was a top domestic policy adviser for McCain. The McCain campaign ultimately concluded it could take as much as $20 billion a year to properly run risk pools, he said.

Of course this is all just a wag.

And when has the government EVER come in under projections? Even Cars for Clunkers exceeded the budgeted amount by a factor of 3. Why is there any reason to believe they are right here?

This reminds me of the new Windows 7 commercials with Mac and PC. You know the one.



So why is Obamacare better than private health insurance?

Trust me.

Where Your Swine Flu Vaccine Went

Can't find the swine flu vaccine? Maybe you aren't important enough.

The Today Show just reported that some Wall Street firms got more doses than hospitals in New York city.

What's up with that?

Yesterday I had lunch with a client who couldn't get her 4 year old daughter vaccinated at the pediatrician because they didn't have the vaccine. Calling around, she found the vaccine was being administered for free in her county at a local park. Her husband stood in line 5 hours to get their daughter vaccinated.

All you had to do was show up.

They didn't even ask for proof of citizenship.

Just more stupid government tricks.

This man is a national treasure

Ample proof here and here.

Enjoy.

From the Hot Stove League . . .

Late last week, God summoned Casey Stengel to his office. Casey (God said) I'd like to see a baseball game in Heaven. Don't we have enough old players to field a team? So let it be written, so let it be done!

Casey went back to his cubicle, his head spinning. Mantle! DiMaggio! Grove! Mathewson! Gehrig! Ruth! Hornsby! Sisler! . . . wow! (Casey said). What a team I'll have in Heaven!!

Casey decided on his lineup in no time. Then he called Satan to set up a game. But Satan seemed unsure. I dunno, Case (Satan said), do you really want to play us?

Why sure (Stengel said). Satan, I think you're afraid of us because we've got all the ball players.

Well (Satan said) maybe so, Case, maybe you do have all the players - but remember, I've got all the umpires.

. . . .

And so friends, that's why private enterprise such as insurance companies cannot compete against a "public plan". Because the government has all the umpires.

A Pair of Mysteries: Data and Laws Edition

First, the Mystery of the Missing Context: The Blogger Known as McQ takes Ezra Klein to task for missing some obvious problems with this chart:

[Chart courtesy RWN]

McQ notes, correctly, that the graph's missing some key information, including the definition of "doctor's visit" (i.e. diagnostic, treatment, routine, etc), the fact that it says nothing about the quality of the care, and that it fails to point out that a primary reason that the Medicare visit costs so much less is because that agency shifts its costs to the private sector.

But wait, there's more!

While I absolutely agree with McQ's analysis, I don't think he takes it quite far enough. For one thing, the Medicare price point in the chart is what it is because Medicare decides how much it's going to pay.

A bigger issue regarding how much the "USA fee range" (i.e. non-Medicare charges) is that, for the most part, this number is invisioble to the consumer. That is, 85% (or more) have insurance, the majority of which requires only a nominal co-pay for the typical office visit. When one is responsible for only a small portion of the bill, one is less concerned with the actual cost. It's this disconnect which helps drive the cost of the care; as the unofficial InsureBlog motto goes, "health care costs drive health insurance costs."

[Hat Tip: McQ at RWN]

Which brings us to:

The Mystery of the Missing Bill: While we find it replete with new and unnecessary bureaucracies, tax increases and health care rationing, we must at least credit Speaker Pelosi with actually having a bill to discuss (if not debate).

Which is more than we can say for Sen Reid:

"…there is no bill to release publicly — it does not exist."

Well, glad we cleared that up! Turns out, the much-discussed Baucus Bill is not, in fact, a done deal, nor (apparently) is it the de facto reform effort turned out by the Upper House. That's because, so far, there is no such bill available, it hasn't been reduced to writing. So all this talk about a vote "any day now" is just that, talk. There's nothing to vote on, much less to examine. Such is what passes for legislative action in today's Senate.

"Shut up," they explained.

Cavalcade of Risk #91 is up

Debbie Dragon hosts this week's roundup of risky posts, with a heavy emphasis on insurance. Sometimes, that's just the way it rolls.

We're scheduling for early 2010, so please drop us a line if you'd like to host a Cav.

Alien Health Care for All

Free health care for all, but not from Washington. Instead, it will be provided by aliens.

Not so far-fetched . . .

The "Trib", a media source and homie of our Prez, had this observation about the new sci-fi about aliens ("visitors") that premiered on ABC last night.

Imagine this. At a time of political turmoil, a charismatic, telegenic new leader arrives virtually out of nowhere. He offers a message of hope and reconciliation based on compromise and promises to marshal technology for a better future that will include universal health care.

The news media swoons in admiration -- one simpering anchorman even shouts at a reporter who asks a tough question: "Why don't you show some respect?!" The public is likewise smitten, except for a few nut cases who circulate batty rumors on the Internet about the leader's origins and intentions. The leader, undismayed, offers assurances that are soothing, if also just a tiny bit condescending: "Embracing change is never easy."

Methinks this reporter nails it, even if their tongue is firmly in their cheek.

Welcome to ABC's "V," the most fascinating and bound to be the most controversial new show of the fall television season. Nominally a rousing sci-fi space opera about alien invaders bent on the conquest (and digestion) of all humanity, it's also a barbed commentary on Obamamania that will infuriate the president's supporters and delight his detractors.

Indeed . . .

Obamamania has spread beyond the 57 states to infinity and beyond.

111 and Counting... [UPDATED & BUMPED]

That's the number of new federal bureaucracies contained in the PelosiCare boondoggle. From the Health Choices Administration (#6) to Comparative Effectiveness Research Trust Fund (#39) to a Clinical Prevention Stakeholders Board (#52) to the Centers for Disease Control Office of Women’s Health (#88) to, well, you get the point.

In fact, there are 6 new such agencies just for women, and (but of course), 1 for men.

There are also 2 just for "yutes," and 11 -- count 'em, 11! -- just for Indians/Native Americans.

This one's a gem: Program for treatment of child sexual abuse victims and perpetrators (#108). The perps get their piece the taxpayer pie, too. Isn't that special.

As Bob says, "Smaller cars, bigger health insurance, Poppa Washington."

[Hat Tip: Red State]

UPDATE: Thanks to Bob, here's the actual list of all 111 new bureacracies.

Medicare Demos: Then and Now

Back in 1983, the Medicare system introduced its prospective payment system for hospitals. The program, considered successful, apparently represents the last time such a plan was deemed a success.

Now, Kaiser Health News confirms something we've been saying for a long time: that Medicare's alleged cost-savings mechanisms are illusory. In a ground-breaking story, KHN vets Chris Weaver and Kate Steadman examine how provisions in PelosiCare, et al may well be based on some false conclusions.

Recommended.

[Hat Tip: FoIB Kate Steadman]

A Foxx Looks at Obamacare

Virginia Foxx is a feisty lady with the ability to cut right to the heart of the problem with Obamacare. I like her style.

November Wikio Rankings: InsureBlog Exclusive

Thanks to Wikio's Clara Chappaz, we're proud to present - exclusively here at IB! - this month's new Wikio (Health) rankings. And we're mighty proud to have moved up 3 notches to the #5 spot. Thanks, Clara!

1 Highlight HEALTH 2 Kevin, M.D. - Medical Weblog 3 The Covert Rationing Blog 4 In the Pipeline 5 InsureBlog 6 The Carlat Psychiatry Blog 7 Health Care Renewal 8 Diabetes Mine 9 Six Until Me. 10 Healthcare Economist 11 DB's Medical Rants

12 Fight Aging! 13 John Goodman's Health Policy Blog 14 Doctor Anonymous 15 Pharmalot 16 The Last Psychiatrist 17 The Doctor Is In 18 Disease Management Care Blog 19 Musings of a Dinosaur 20 Schwitzer health news blog Wikio Blogs

Grand Rounds is up...

Dr Joseph Kim presents this week's round-up of great med-related posts. Do check it out.

MVNHS©: Compare and Contrast

If you haven't already done so, please take a moment to read this compelling and life-affirming guest-post.

Then, think about the implications of this:

"Cancer patients will receive funding for private treatment if they have not seen an NHS specialist within two weeks of GP referral."

This is not the current "law of the land," merely a piece of pending legislation.

Much like PelosiCare.

Sandi - Breast Cancer Survivor

Cyberspace is a wonderful thing. You can "meet" people from all over yet still never REALLY meet.

Over the last few years I have met some really great people from all walks of life. Some of their stories will lift your spirits while others will bring a tear to your eye.

This story of "Sandi" will do a little of both. She is a very brave woman who has faced a lot in the last few months. She posts regularly on a public forum and always has such a wonderful outlook on life. She recently took someone to task who was complaining about having to pay insurance premiums and "getting nothing in return".

Here (with her permission) is Sandi's story.

For years and years I paid into insurance, never had a claim, beyond just the usual that they cover, checkups, etc.

THEN, one day, I went for a routine test and lo and behold, they discovered lung cancer! 2 rounds of chemo and 35 radiation treatments later, at a conservative and just a running guess in my head, around $300,000 was expended on me. Came back to edit to let you know that ONE chemo treatment for me was around $12,000 and some change.

A few months later, I went in, AGAIN, just routine test and walked out with a recent bilateral mastectomy, two weeks later, lymph node surgery, I'm currently on the "chemo pill" and looking at that for the rest of my life, working towards having myself rebuilt (my ins. company is picking up the tab for my "boob job" with a plastic surgeon that costs in my area, around $7,000, and I'm grateful for my insurance company picking up that tab, because stuffing my bra was an option as a teenager, but now, not so much. So about now, I'm probably up to around $600K, and if my CT on 11/10 confirms that there is some "movement" in my lung cancer, then I will be back in for more chemo and if so, we will hit a million!

So, should I have been "paid back" as you claim for those years of good health, only to then have them spend close to a million or more on me to keep me alive?

You keep the change, folks, I will be happy to have my insurance!! there is NO WAY that I have paid a fraction of what they have expended on my behalf.

And keep in mind, you just may walk in one day and find that you are not so healthy and you won't be squawking about those few dollars they kept every month when you need them to expend hundreds of thousands to keep you alive and somewhat comfortable.

Disclaimer: I have no issues with paying for insurance, I have seen what it has done for me so you won't find this old girl bashing any insurance company over a few bucks I didn't use in the past. And it is PAST, not passed. Just thought you might like to know.

There was some back and forth where the original complainer tried to justify their position that there should be a refund for premiums paid that did not result in a claim. This person also indicated she had canceled her insurance in protest.

Here is Sandi's retort.

I would strongly ENCOURAGE you to go back to carrying your health insurance.

You said in your post that you have lost family members due to Cancer and that in and of itself makes you more susceptible.

If you think it was tough for your family WITH insurance, can you imagine what it will be like for you WITHOUT insurance?

I am always looking for ways to cut back and cut out out of fear of what my illness may do to me.

I am continuing to talk to you about this because those years of good health can turn on you in a heartbeat. My life turned completely upside down at 10:54 a.m. on 8/18/09 when I learned about the lung cancer, and then it started, those $12,000 chemo treatments, 10 of those, I set it out for you, but not all of the other tests, mediaendoscopy (sp), CTs, PETs, MRIs, Bone Densities and blood work and after chemo shots and on and on it goes. A new chemo pill that I will be on for the rest of my life, $50 a month, doesn't sound so bad, but that's forever, and even a frugal person like me had to do some juggling to work it in with everything else. I had a PowerPort implanted in my chest to make my life easier...

Believe me for all of your chagrin, if you walked a day in my shoes, you would be glad to trade that money over the past 5 years for NOT living like I do.

I'm fortunate than most. I don't have some big paying job, I'm a peon in a big DC lawfirm, but I learned to be careful with the little money I have, so when this hit, I was not then and am not, so far, yet, living hand to mouth. I was debt free then, am now, but for my mortgage and I have money in the bank, and while I'm no millionaire, I made it my business to become a good strong hundredaire and I can make it.

But this is not only about the physical, being "well", Cancer does other things, I thought after I finished all the lung cancer treatments they could do, well, I fairly skipped to that mammyslammer in June, figured I'd be wowing the boys at the pool no later than 2:30...not to be, they needed another one to compare, then they wanted a sonigram, then they wanted to do three biopsies...my breasts looked like they had been in a bar fight. No pool for me.

It was/is Cancer. On Sept. 8th, my copay to enter the hospital to let them cut off both my breasts was $200 and the ins. picked up the tab...I won't be wowing anyone, but thank goodness, I only had to pay that $200, the insurance is picking up the other thousands and I still have more down the road.

Not only does Cancer do a number physically that ins. pays for, there is a lot of mental things going on...I was so distraught that a vain woman like me losing her breasts I went on drugs to keep me from crying every day. Insurance pays, but I thought, it's done now, I should be OK, I let the scripts run out...bad idea, this morning I have been sitting her with tears in my eyes because I'm having a meltdown, I'm tired, MENTALLY and Physically. But thank goodness, tonight when I get off work I will take a few bucks and pick up my scripts again and no more crying jags.

I just fear that you and folks like you have no idea what an illness can do to you, and be ever so grateful that you went those years without any claims. Walk a day in my shoes and you would say "keep the change" and thank God in His Heaven it is not you, but someone else.

In response to this: Ask yourself -if i wanted "my money" back -don't you think i would have found a way to get it back by now?

No, I don't think you could! Not in a billion years will you get that money back.

In response to this: Once again I did not mean to offend anybody and hope nobody takes it personal

I am not offended, I would have to give you the Power to do that and I don't grant you that permission, and I'm not, the word is "offended", I am just worried about you and everyone who doesn't understand that 5 years/10 years/20 years means nothing when an illness hits.

I am talking to you because you are being very foolish and I don't want anyone to go through what I'm going through, and despite your 5 years of good health, you are NOT immune.

I hope you will think about what I have said and be happy to pay your premium and stay in good health, and if you don't, then have them to help you along the way...

As I said, she is a brave woman. Throughout her ordeal, she has retained her wit and positive outlook on life. I am truly blessed for having met her, and now, so are you.

One More Flu Vaccine Post

60 Minutes did another piece on the swine flu vaccine last evening. Two items stood out for me:

First, HHS Secretary Sibelius came across as especially clueless: when pressed on citizens' skepticism regarding this adminstration's clumsy attempts at frustrating transparency, she blamed talk radio and TV's Glenn Beck, rather than address the very real concerns of a substantial number of Americans who just want to make an informed decision. And the fact that the House has put forth a 2000-page behemoth which we're not supposed to question does nothing to allay these concerns. No wonder people have doubts.

Second, a University of Michigan (?) professor made an especially specious comparison, likening taking the vaccine with wearing a seat belt. This is stupid on two levels: first, seat belt use is mandatory when traveling in a car - it's the law. So far at least, taking the vaccine isn't (which is probably a good thing, since it's in short supply; unless, of course, you're a terrorist. Second, and more important, no one has ever been injured by simply buckling a seat belt, but there are any number of cases of folks who've had life-altering complications from taking vaccines.

If the goal of the piece was to reassure us that this is safe, effective and available, it failed on all counts.

The Blair Witch meets Nancy & Harry

Even though Halloween's over, be afraid.

Be very, very afraid:



[Hat Tip: Reader Fred W]

"He chose...poorly."

I'm still ambivalent about the wisdom of taking the swine flu vaccine, but I don't begrudge my fellow Americans their choice to do so. It looks, though, as if they'll have to wait, because there's another group who gets first dibs:

"(T)he Pentagon has offered to give swine flu shots to detainees [at] Guantanamo Bay, Cuba ... Detainees at JTF Guantanamo are considered to be at higher risk and therefore they will be offered the H1N1 vaccination."

Oh really? People whose mission in life is to kill Americans get to cut in line ahead of those Americans?

Words fail.