Wednesday, February 29, 2012

Swedish Meatball Surgery, Part XVI

When Swedish health care "professionals" aren't out trying to score hot nurses, they're apparently turning away fellow citizens who've suffered broken necks:

"A man from northern Sweden was sent home from his local clinic with a handful of painkillers ... Every time he moved or sat up his vertebral column moved three centimetres, which is enough to risk causing paralysis"

What is it about nationalized health care systems that's so darned attractive to Ms Shecantbeserious?

Gee, Mme Secretary, I wonder why...

From the lips of Ms Shecantbeserious:

"The private [health insurance] market is in a death spiral"


For someone like Mme Secretary this is, of course, a feature, not a bug.

But it's what happens when you impose rate controls, mandate coverage for non-medically necessary items, give away health insurance to irresponsible folks, and gin up phony "Exchanges."

Quelle surprise.

As Maine Goes, So Goes the Nation . . .

An offshoot of Obamaneycrap is the battle over how much regulation can be imposed on insurance carriers that operate in a free market. One of the side battles addresses premium rate increases.

We have long maintained that government intervention and price oversight is unnecessary in a competitive market. Health insurance premiums are self regulating.

If a carrier charges too much for a product, they lose market share to competitors. It really is that simple.

Of course the DC know-it-all's, many who have never held a real job much less managed a payroll, believe the only way to protect the consumer is through price controls.

Yeah, the Nixon wage-price controls worked so well . . .

Anthem Blue Cross in Maine wanted a premium increase. The Dept of Insurance said no. Included in their request for increase was a profit margin of 3.2%.

Not a guaranteed profit mind you, but if everything falls in place as expected, after all bills are paid (including claims), about $3 out of every $100 in revenue, would remain to pay stockholders AND taxes.

Bear in mind that a 3% profit margin is not excessive. Banks have a 5% margin. Retail food services operate off a 5 - 6% margin. Household products, an 8% margin. So 3% is not a lot of money.

The Maine Dept. of Insurance said 1% was fair and that was supposed to be the end of it.

So Anthem appealed to the state Supreme Court and this is what happened.

In its ruling, the Supreme Judicial Court said that Maine’s insurance superintendent had “properly balanced the competing interests” in arriving at an approved rate increase of 5.2 percent. The insurer, a unit of Wellpoint, the nation’s largest insurer, had sought a 3 percent profit margin as part of an overall 9.2 percent increase in health insurance rates for policies sold to individuals in 2011. It argued that state regulators’ decision to grant a 1 percent profit margin violated state law and the U.S. Constitution by depriving the company of a “fair and reasonable return.”

Anthem can appeal the decision and ask the court to reconsider their decision or file an appeal with the U.S. Supreme Court.

But that's a bit silly don't you think?

Now consider this comment.

“This is great news for consumers because it reaffirms that a state insurance regulator, when they have the authority, can do a balanced, comprehensive review of rates,” Kofman, now a researcher at Georgetown University’s Health Policy Institute.

Whoopee. The consumers can save 2% on their premiums.

But what if Anthem decides they no longer want to play ball and they pull out of the state? Maine is one of those unique places where over regulation has resulted in most health insurance carriers pulling out of the state.

In Maine, health insurance is subject to both guaranteed issue rules and community rating. The result is health insurance premiums that are some of the highest in the country and the market is dominated by essentially one carrier . . . Anthem.

My guess is Maine needs Anthem more than Anthem needs Maine.

The Grinch may end up stealing any opportunity for citizens of Maine to purchase health insurance from any source.

Gardisil Update: Told Ya So

Chock up another one for our prescience. Some 3 1/2 years ago, we discussed the possibility that young boys would also be given this tried-but-untrue panacea. Now comes word that "the American Academy of Pediatrics is fully recommending that boys get the shots as well."

And why is that?

Well, follow the money:

"The new policy should end any resistance among health insurers to covering HPV vaccines for boys"

At $130 a pop, no less.

Exit question: How long 'til HHS Secretary Shecantbeserious mandates that this be covered at 100%, as well? Sauce for the gander, and all that.

Tuesday, February 28, 2012

Breaking a Self-Imposed Embargo

I had decided some time ago to take a break from posting on the upcoming SCOTUS ObamneyCare© case, but Hot Air's Ed Morrissey has a post on a fascinating and refreshingly unique theory espoused by the Institute for Justice.

According to its website, the IfJ is "our nation's only libertarian public interest law firm ... We seek a rule of law under which individuals can control their destinies as free and responsible members of society."

And they've filed an amicus brief in the aforementioned case, based on the age-old caveat that a contract entered into under duress is non-enforceable. Their stance is that, because insurance is, in fact, a contract, forcing one under penalty of law to sign on the dotted line renders it moot.

Florida International University Constitutional Law Professor Elizabeth Price Foley, who helped draft the brief, explains:

Compact Fizzling?

Carrying on Bob's fizzling metaphor from this morning, we have a follow-up to our post on the efforts of the Ohio Health Care Compact (OHCC) folks to get some traction. Briefly, the HCC initiative would supercede ObamneyCare©, and put Buckeyes' health care decisions back in our control. I reached out to OHHC for additional information, and have finally received their reply.

Dianna Greenwood, the group's Outreach Coordinator, tells me that "unfortunately due to some issues, our committee will not be working on the Health Care Compact in Ohio. However, we all believe that this is still important legislation pending in the Ohio Senate and wanted to make sure that you received our answers."

So she in turn passed us along to Tea Party Patriots' State Coordinator Marianne Gasecki, who answered most of our questions:

InsureBlog: Let's start with a little background. How did this effort begin, who came up with the idea of using state compacts?

Marianne Gasecki: The Health Care Compact Alliance presented this idea at a Tea Party Patriots Conference of local coordinators in February of 2011. After a period of discussion, it was voted on by the coordinators and considered to be an exciting opportunity with great promise for not just healthcare, but other issues.

IB: Who funds this effort?

MG: To date, any efforts in Ohio have been minimal in cost due to the fact that it is mostly presentations at local tea party groups or other organizations, or meetings with legislators. Any costs have been covered by the individuals on the Ohio Health Care Compact Committee. Any efforts performed nationally, are most likely funded by the Health Care Compact Alliance.

[ed: I'll be contacting the Alliance folks ASAP]

IB: In the video, it's never clear which states we'd be joining in a compact. Texas is implied, and you mention "teams on the ground in 37 states," yet they've been passed into law in only 4. It's already 2012, with less than two years to go until full implementation. Aren't you concerned about timing?

MG: No. We know and understand that this is a long term project and are willing to go the distance. States such as Indiana will be added to the list shortly, as it has already cleared the house and is advancing quickly through their Senate. This is also an excellent tool to be used when questioning candidates regarding their sincerity in the belief of state sovereignty vs. a one size fits all centralized government.

IB: I also have some questions from my co-bloggers. Bob would like to know if there's enough money to meet federal requirements and address other financial obligations.

MG: Once the compact is ratified it supersedes federal law, and therefore federal requirements and obligations. Funds collected from the states by the federal government would be returned to the states with no strings attached. What needs to be reiterated is that these compacts are not policy making contracts. The compacts are just giving the states the authority to create policy that best suits the needs of their state. They can change nothing, or can change everything.

IB: Bob also points out that your FAQ states "The member states get funding according to the formula in the HCC." How does that work?

MG: The best explanation is that the amount for each state represents the total amount of money the federal government returned to that state in 2010. It includes ALL health care spending, minus the spending for veterans or for Native American Indians. That figure includes all grants, all appropriations, all Medicare spending, all Medicaid spending that the federal government sends to a state. 2010 is the base funding for each state moving forward with the HCC which, for Ohio, was about $35 billion.

IB: Finally, Mike observes that "the FAQ references "sale of insurance across state lines." He agrees with me that this is a deflection, not an answer. So: "why would the Compact make any difference?" In short, while it's a very nice video, neither it nor the FAQ explicitly lay out the end-game, other than "we opt out of ObamaCare." Yet you claim that "health care [is] in need of urgent reform." How do you square that circle?

MG: I think most people agree that layers of bureaucracy make everything more expensive and less efficient, whether it be in the private sector or government. But the compact is really about self governance. If you believe the states should have the opportunity to provide a more cost effective health care system rather than a one-size-fits-all federal program, then the compact idea for health care, as well as other issues, will look very promising to you. Again, it's not a policy document, as much as it is a document to give authority back to the states, bringing it closer to the people it directly affects.

Thanks, Marianne, for your time and candor.

And we'll be following up with the national Health Care Compact organization, as well.

Hedging Bets

Not sure what to make of this:

"The cost of providing health care insurance to the hedge fund community is rising at a slower rate for the first time in years ... insurance carriers raised their rates between 2% and 8%, on average, for hedge fund managers and their employees in 2011. This represents a marked improvement from the 6% to 18% rate hikes ... last year’s survey of 2010 rates."

What is there about the "hedge fund community" that would (apparently) shield them from some of the worst aspects of ObamneyCare©? My first thought was that many (most?) of these plans are probably self-funded, but the article says it's more likely demographics (primarily age). Another factor cited is that a lot of these plans "have less generous benefits than those in previous years."

So a Kia costs less than a Mercedes?

Who'da thunk it?

[Hat Tip: Mitch Ackles]

Medicare Fraudbuster Fizzles

Launched last summer, a $77 million computer system to stop Medicare fraud before it happens had prevented just one suspicious payment by Christmas. That saved taxpayers exactly $7,591.

Lawmakers had expected the system to finally allow Medicare to stanch a $60-billion-a-year fraud hemorrhage. Now they’re worried that cautious bureaucrats lacking a clear game plan will compromise its performance.

Medicare officials say it’s unfair to grade the new technology on a single statistic.

Maybe it's just me, but I would expect a bit more for a $77 million computer.

Monday, February 27, 2012

Rosemary's Health News

Time to break out that new standard, Days of Wine and Rosemary. Last week, we reported on the newest study touting the benefits of an occasional libation. Today, we learn that one of my favorite herbs has similarly beneficial effects on one's intelligence:

"Now researchers have used essential plant oils to see how much rosemary can improve brain power and mood ... Results indicated the 1,8-cineole taken into the blood through sniffing the plant improved brain performance. Those with higher levels had better speed and accuracy."

Rosemary-infused vodka, anyone?

HSA Update

Courtesy of our friends at FlexBank, some interesting late-model HSA factoids:

■ This year's (2012) max contribution ceiling is $3100 for singles and $6250 for families. If your employer is kicking in a few bucks (lucky you!), it'll count towards that total.

Thanks to ObamneyCare©, you'll need a doc's scrip for any Over-The-Counter (OTC) meds you want to run through your account.

You can't pay your regular health insurance premiums from your HSA, but COBRA, Long Term Care insurance and Medicare premiums are generally eligible.

This is VERY cool, and something I hadn't known: Mileage to obtain medical care is an eligible expense under a Health Savings Account. You can reimburse yourself at 23 cents/mile, but you'll need to keep very careful records.

[Hat Tip: Lou G]

Catholic Obamacare Bomb

Years ago there was a margarine commercial with the tag line "It isn't nice to fool Mother Nature." Comes now Obamacare that wants to tell everyone, regardless of religious persuasion, that they must pay for contraceptives by way of their health insurance plan.

The big push back so far has been the Catholic church, but it seems other groups including Protestants, Jews and even Muslims have tossed their hat in the ring as well in protest of the birth control segment of Obamacare.

The battle just heated up.

Francis Cardinal George, Archbishop of Chicago (home to Obama) has tossed down the gauntlet.

In a missive to parishioners on the first Sunday of Lent, Cardinal George warns that the Catholic Church will shut down its hospitals, clinics, and charities before submitting to the mandate — and provides a little history lesson as well:

What will happen if the HHS regulations are not rescinded? A Catholic institution, so far as I can see right now, will have one of four choices: 1) secularize itself, breaking its connection to the church, her moral and social teachings and the oversight of its ministry by the local bishop. This is a form of theft. It means the church will not be permitted to have an institutional voice in public life. 2) Pay exorbitant annual fines to avoid paying for insurance policies that cover abortifacient drugs, artificial contraception and sterilization. This is not economically sustainable. 3) Sell the institution to a non-Catholic group or to a local government. 4) Close down. …

Since 1915, the Catholic bishops of the United States have taught that basic health care should be accessible to all in a just society. Two years ago, we asked that whatever instruments were crafted to care for all, the Hyde and Weldon and Church amendments restricting funding for abortion and respecting institutional conscience continue to be incorporated into law. They were excluded. As well, the present health care reform act doesn’t cover entire sections of the U.S. population. It is not universal.

The provision of health care should not demand “giving up” religious liberty. Liberty of religion is more than freedom of worship. Freedom of worship was guaranteed in the Constitution of the former Soviet Union. You could go to church, if you could find one. The church, however, could do nothing except conduct religious rites in places of worship-no schools, religious publications, health care institutions, organized charity, ministry for justice and the works of mercy that flow naturally from a living faith. All of these were co-opted by the government. We fought a long cold war to defeat that vision of society.


Obamacare just stepped in it.

A Good Start

PCIP - Deal or No Deal?

One of the good things about Obamacare, perhaps the only good thing, is PCIP. The Pre-existing Condition Insurance Plan, should be a god-send for those that are too sick to qualify medically for health insurance in the open market.

Only a very small percentage of individuals truly cannot qualify for health insurance at any given time. Many wait until after they are sick or injured before they consider buying insurance. How convoluted is that?

Others find themselves in the market through no fault of their own.

Regardless of the reason, PCIP is a "port in the storm" for those who need health insurance.

PCIP came in to existence in July, 2010. A grand scheme, it was expected that some 2oo,000 would enroll in the plan during the first year. Here we are almost two years in to the program and fewer than 50,000 have enrolled.

Given the apparent lack of interest you would think the plan is overpriced.

Not so.

A look at current data indicates this is a cash cow. Not for the taxpayers, but for those who bought the plan.

According to the Washington Post, PCIP is spending a lot of taxpayer dollars to keep the plan afloat.

Those who have enrolled in the program are projected to have significantly higher medical costs than the government initially expected. Each participant is expected to average $28,994 in medical costs in 2012, according to the report, more than double what government-contracted actuaries predicted in November 2010. Then, the analysts expected that the program would cost $13,026 per enrollee.

The costs also are significantly higher than those of similar high-risk pools that many states have operated for decades. States spent an average of $12,471 on enrollees in 2008, according to the National Association of State Comprehensive Health Insurance Plans.

Best estimates are the plans are paying out $3 for every $1 in premiums taken in and if the above projections bear out it will hit $5 in claims for every $1 in premium.

Then there is the case of Alaska. KHN reports the frozen state isn't doing a very good job of recruiting folks in to PCIP and the ones they are attracting are very expensive to treat.

A high risk pool set up under the federal health overhaul to help the uninsured who have pre-existing medical conditions expects to spend $10 million this year to cover about 50 members. That’s about $200,000 per person.

Bykerk said the high risk pool has attracted all types of high risk patients, ranging from women who were pregnant and unable to get traditional insurance to children who needed a heart transplant.

Alaska isn't the only state operating in the red.

Colorado has covered 1,087 people in its high risk pool and fears its $90 million allocation will not be enough. “Our claims experience indicates the population covered in this program have significantly higher medical needs than the general insured population,” said Kayla Arnesen, a spokeswoman for the Rocky Mountain Health Plan, which administers the high risk pool.

Kind of makes you wonder how well Obamacare is going to work in 2014. How much money will Obamacare REALLY cost once it is rolled out for everyone?

PCIP is a great deal for the insureds.

Not so much for the taxpayers supporting it.

Gender Bias?

The folks at KHN give us a bit of clarification on what is, and what isn't preventive contraception.
1) Are male-based contraceptive methods, such as vasectomies or condoms, covered by the rule?
An HHS official said on Friday that women’s preventive services guidelines apply to women only.
Sounds like someone is playing the gender card. Is it because the HHS Secretary is a woman? Does she have something against men?
2) Are over-the-counter products like female condoms, spermicides, sponges covered by the rules and, if so, will they require a prescription and how will insurers reimburse policyholders for purchases at retail stores?
Products that must be covered without cost-sharing include over-the- counter contraceptives when they are prescribed by doctors, the HHS official said Friday
So if a woman considers a relationship "sponge worthy" she must make a doctors appointment and get a prescription to buy an OTC birth control device.

Is that considered a FREE preventive care visit?
3) If a hospital stay is required for surgical procedures, such as when a women gets her tubes tied, would the procedure be covered without cost sharing?

Insurers say it is not clear if hospitalization or complications that might occur from surgery would be covered without the patient paying a co-payment or a deductible because they are not considered preventive.
Sounds like the free colonoscopy debate.
5) Who will be covered for contraceptives without co-payments?

The package of women’s preventive care benefits must be offered in all new insurance policies sold to individuals and employers starting Aug. 1, as well as in most policies that renew afterwards on the date that they renew. There is an exception for insurance provided by certain nonprofit religious employers who object to birth control.
Some groups, such as Catholic affiliated organizations, get a pass. But Obama said if an employee of a Catholic organization wants a free contraceptive the carrier must provide it for her.

Seems to me that Washington needs to stay out of our bedrooms.

Aetna Throws in the Towel

It appears Aetna is caving to Obamacare. In a recent conference meeting, Aetna CEO Bertolini declared health insurance carriers to be extinct.

Bertolini said an amalgamation of regulatory, demographic and economic factors were driving this change. The Affordable Care Act in particular, with its ban on medical underwriting, had made the traditional health insurance business model untenable in the long term, he said.

Bertolini offered a strong endorsement of the accountable health organization model, positing health insurers as uniquely suited to usher in an era of coordinated care. “We need to move the system from underwriting risk to managing populations,” he said.

Managing populations?

Sounds "big brother-ish".

Sunday, February 26, 2012

Cuts, Cuts Everywhere

While we've often discussed the (so-called) Doc Fix, Medicaid is also facing severe budgetary problems. To address these, legislators in the Evergreen State recently passed a bill that would cut off coverage for non-emergency ER visits:

"Starting April 1, Medicaid will no longer pay for [unneeded ER] visits, even when patients or parents have reason to believe they're having an emergency."

On the one hand, this seems fairly drastic, but on the other, the ER should be for, well, emergencies. The tension here is, of course, how is a lay-person supposed to know the difference between, say, a panic attack and a heart attack?

The WSJ has more:

UPDATE/ADDENDUM: In the comments, FoIB NotWithStanding makes a VERY good point:

"Emergency departments are barred from federal law from turning people away without stabilizing them ... The Washington Medicaid plan would simply not pay the emergency providers for care rendered during "unneeded" ED visits, doing nothing to penalize people for coming in unnecessarily"

The reason they're forbidden from turning folks away is a little something the Feds call EMTALA, or the Emergency Medical Treatment and Active Labor Act. As NWS points out, this becomes a damned-if-you-do/damned-if-you-don't scenario for the provider.

But hey, health care's free, right?

Saturday, February 25, 2012

Obamacare Cartoon

A not so funny cartoon about Obamacare. Apparently economists have side line jobs as fiction writers.

Let's look at some of the fantasy in this cartoon.

The cartoonist claims the current system is unfair without explaining why. Every form of insurance charges a premium based on risk factors. If health insurance is unfair, then so is life insurance, home owners insurance, auto insurance, etc.

Mr. Gruber also claims Obamacare will make health insurance "affordable" and then later claims Romneycare "cut health insurance premiums in half".


Massachusetts has some of the highest health insurance premiums in the country.

The cartoon claims carriers will no longer be able to deny coverage based on medical conditions, which is true. Of course Obamacare already imposed that restriction on children under the age of 19 and we know how well that has worked.

In addition to the disappearance of "child only" health insurance plans in most states rates for children's health insurance have doubled in many cases and when a child is considered extremely high risk their premiums can be as much as 5x standard rates.

He claims the Exchanges will control health care costs.

How so?

The Exchange is simply a market place where policies are sold in much the same way you can do right now through online marketing sites.

The Exchange has no impact at all on health care costs.

A laughable moment comes when cartoonist Gruber claims the Exchange will force carriers to compete for your business.

I don't know if this guy was asleep in class when they covered competitive markets but the government exchanges are no different from those that already exist . . . except they will be run by the government, not private enterprise.

He also claims Obamacare makes Medicare more affordable by closing the donut hole in prescription drug plans.

Pure fantasy.

Closing the donut hole may make prescription drugs more affordable but it increases Part D premiums. That is what you call rearranging the deck chairs.

Hope you enjoyed the cartoon, but there is nothing funny about it, unless you want to laugh at the ignorance of the cartoonist.

Insurance Fraud of a Different Kind

A Cayce man has been charged with insurance fraud after another man’s hand was chopped off.

Thirty-four-year-old Gerald B. Hardin faces six charges, including mail fraud for a 2008 incident in Sumter County where a man’s had was cut off with a pole saw.

Federal indictments state that Hardin and another person used a saw to intentionally cut off the hand of a third person in an insurance fraud scheme. The indictment says the men submitted claims under a homeowner’s insurance policy and three accidental death and dismemberment polices.

It says the men received more than $670,000.

Thursday, February 23, 2012

Obamacare - Wealthy Need not Apply

Class warfare now includes Obamacare. Michael Cannon at Cato posits about Mitt Romney's wealth and wonders if he has health insurance.

His assumption is, with all Romney's millions does he really need to buy health insurance.

While Mitt and I have not had a teachable moment over a beer, I feel reasonably comfortable in saying the Romney clan doesn't NEED health insurance but it still might be a wise purchase.

Moving forward, Mr. Cannon notes that Gov. Romney will turn 65 in March of this year and wonders if the federal government, with all their money woes, should provide Medicare to the wealthy.

My response is, why not?

Just because Chairman Obama feels that at some point you have made enough money does DC also think that at some point you don't deserve health insurance?

Mr. Cannon asks:

If Romney does not enroll in Medicare, it would again look bad that he who forced others to purchase health insurance is opting not to obtain health insurance himself. But if he does enroll in Medicare, it’s worth asking whether the 99 percent should subsidize people like him.

I really am tiring of this 99% vs 1% argument.

As far as I know, Gov. Romney earned his money fairly and legally. And I suppose he has paid all the taxes he is legally obligated to pay and probably not a penny more.

What's wrong with that?

Beyond the fact that Gov. Romney (and many others) have paid in to Medicare for perhaps most of their life, the way Medicare is structured, when you turn 65 you are automatically enrolled in Medicare Part A.

Medicare Part B and Part D are options, but Part A is automatic.

For what it's worth, anyone turning 65 can refuse Medicare but, for most of us at least, it is not a wise choice. If you refuse Medicare you are denied from receiving your earned Social Security benefits.

OK, let's play with this a bit.

If Gov. Romney has enough cash to pay his medical bills he probably doesn't need Social Security, but . . . if he wants to pay cash for his post age 65 medical bills he may run in to a problem.

The 1997 Balanced Budget Act, Section 4507, forbids "private contracts" between doctors and patients, essentially making it illegal for a doctor to bill a (Medicare age) patient for services rendered. Private patients cannot pay cash for a Medicare covered service unless the doctor has opted out of Medicare.

So if Gov. Romney (and other wealthy individuals) need medical treatment they will be limited to providers that are not accepting ANY Medicare patients.

For you 99%'ers out there who think the wealthy should forfeit their Medicare, you need to find another drum to beat.

Take a Pill

At some point the government may decide you have had enough care and maybe you should just take a pill. Dr. Obama weighs in on waste in health care.

Thursday Link-Fest

■ First up, our friend Bob Graboyes of the NFIB explains how the ObamneyCare© tax-credit is nutty:

"A bowl of cashews is a tempting snack, but it’s relatively unimportant to someone riding five million cubic feet of hydrogen toward an electrical source."

Food for thought.

■ And speaking of food, our next item concerns the MVNHS©'s self-destructive dietary guidelines:

"My diet was an extreme version of the NHS Eat Well regime, which recommends lots of starchy foods and smaller quantities of saturated fats, cholesterol, sugar and red meat ... and yet my health had never been worse."

Read on to learn what the "experts" conveniently forgot to tell us about their "healthful" recommendations.

■ Is there a shortage of vital cancer-fighting med's here in the States? It would seem so:

"Shortages of a lifesaving chemotherapy drug for children and a cancer drug for adults have federal regulators on edge and Arizona hospitals and doctors scrambling to secure supplies and alter treatment plans ... Patients and their families are puzzled over why drugs that have been available for decades are suddenly scarce when they need them most."

Hmmm, one wonders why.

■ John Goodman wonders if the actual practice of medicine under ObamneyCare© will be worse than death panels:

"[D]octors would be given immunity from malpractice lawsuits, but only if they practice medicine according to government guidelines."

ObamaDeathWaivers©, anyone?

■ And finally, some (potentially) good news:

"Stanford researchers may have discovered a drug for a rare and often untreatable disease that leaves children with massive, and sometimes deadly, growths on their faces, necks and other parts of their bodies."

And what is that, you may ask?

Well, according to Dr Bob Dole,"[t]he drug is Viagra."

Early research shows that the ED med apparently causes these growths to shrink (counterintuitive, that).

Obamacare - At What Cost?

As Henry says, we get letters, or in this case, comments.

One of our regular readers offered his views of Obamacare and what has been accomplished to date. Below are his observations . . . as well as ours.
So let’s turn to the real story of the low costs of the first year of the ACA and what has occurred while cost increase have mitigated:
1) 2.5 million young Americans are now covered on their parents plans
At what cost?

For argument sake, let's assume a relatively low premium of $100 per month per child. If these "children" are in fact on the parents plan there is a good chance the premium is considerably higher but $100 is a place to start.

So how much are parents, and their employers, paying to cover these young adults that, in most cases should be on their own and self sufficient?

Using our reader's figures of 2.5 million plus our figure of $100/mo this coverage comes to $250,000,000 per month that must be paid by someone.

That's an additional $3 billion in annual premiums.
2) 54 million Americans with insurance got an array of preventive care services with no copay or out of pocket
Of course we know that preventive care isn't really free, so someone has to pay for it. Annual exams at a par provider, exclusive of immunizations and anything other than routine lab, cost the insurance carrier about $250 per visit. Of course you have to run that through the MLR machine, which means the premium must be increased by $300 - $315 to cover the cost of the "free" exam.

Offering this benefit to 54 million people means around $16 billion in new premiums paid by someone.

Since when do we need insurance to pay for a $250, once a year exam?
3) Seniors saved over $4 billion in drug costs due to the donut hole closing
Gotta admit, I have no idea how to calculate this one, but for chuckles and grins let's just use the $4 billion figure and not even add any overhead costs.

That means seniors will see their PDP premiums rise by at least $4 billion to offset the closing of the donut hole.
4) 32 million seniors got an array of preventive care services with no copay or out of pocket saving billions more
Here we go again with the free preventive stuff. No reason to deviate here, although at this point MA plans and Medigap are not subject to MLR. Their loss ratios are actually richer than plans subject to MLR, so the 80% figure is being generous.

So 32 million x $250 divided by .80 adds another $10 billion to MA and Medigap premiums, out of pocket to seniors that lack MA or gap cover or to Medicare claims.

So far we have shifted some $33 billion to the pocket book of roughly 88 million people.
5) Medicare Advantage premiums are flat to down for the first time ever even though subsidies to these private insurer plans lost a 14% subsidy that will save Medicare $500 billion over 10′ years
While it is true that many MA plans did not raise premiums, there were quite a few plans that withdrew from the market place, especially in rural areas. Many seniors either transitioned to Medigap plans or simply returned to original Medicare and will pay their out of pocket costs when they can afford it.

Even with allegedly stable premiums, every plan I am familiar with increased cost sharing via higher copay's and higher out of pocket.

Focusing on MA premiums alone is a bit disingenuous.
6) Medical loss ratio rules will result in nearly $2 billion in rebates to employers and consumers. Billions more is being saved from rate increase being subject to review in all 50 states thus discouraging insurers from being able to do whatever they want in increasing rates without justifying them publicly.
Again, we are playing games here.

Maybe the billions in savings and rebates thrown around by this reader are accurate, or perhaps not. What I can say is this:

Quite a few carriers have already exited the individual major med and small group market. This translates in to less competition, fewer choices and higher premiums. Some carriers have laid off staff and transferred customer no-service overseas.

Not only are American jobs being lost over Obamacare but customer service, which has never really been a hallmark any way, has deteriorated significantly.

Of course the idea of MLR and Premium Police never made any sense to me. In a competitive environment the market, not some government body, decides what the real rate should be.
7) Medicare fraud enforcement saved a record $4.6 billion in recovered payments and the ramped up enforcement team likely reduced ongoing fraud even further by deterring criminals
Ah yes, the perennial waste, fraud and abuse argument.

Will someone please explain why we needed a 2200 page law (that no one bothered to read before passing) combined with countless under the table deals, not to mention billions of dollars in new taxes before DC did what we pay them to do any way?

That is, curb waste, fraud and abuse . . .
8) Annual and lifetime maximums no longer exist which will save many families over time from medical bankruptcy.
Medical bankruptcy is a fraud proven many times over. The additional premium for removing annual and lifetime caps is nominal, not even worth factoring in to the cost of Obamacare.
9) Children no longer face pre ex restrictions and that will apply to all of us in 2014
True, but then children in most states can not obtain insurance on their own. "Child only" plans no longer exist in almost every state, even for perfectly healthy children.

How is that working for you?

So to recap, we have about $33 billion in new premiums to cover items that were previously paid directly by consumers but without the insurance carrier overhead factored in.

We have millions of seniors that lost access to MA plans, plus millions more that now have higher PDP premiums and/or higher out of pocket costs.

American jobs have been lost and shifted overseas. Literally thousands of agents have simply given up and left the business, meaning millions of potential buyers are left to fend for themselves in the maze of health insurance or rely on the "expertise" of home office trainee's.

We have a law that may prove yet to be unconstitutional, over half the population that have taken a "take your mitt's off my health insurance" stance, higher overall costs, fewer choices and millions of children who can only obtain health insurance by riding on their parents' plans at significantly higher premiums than existed before Obamacare.

I gotta ask again, how is this better than before?

Wednesday, February 22, 2012

Cheers to your Health: Physical and Otherwise

All things in moderation, of course, but more good news for the occasional imbiber. First:

"Alcohol is one of the only dietary practices that increases the 'good' high-density lipoprotein (HDL) cholesterol and lowers the 'bad' low-density lipoprotein (LDL) cholesterol, as well as lowers the risk of blood clots."

And no, we don't (necessarily) recommend dunking that bran muffin in a glass of Merlot.

And it's not just heart health, but that other important organ:

"Researchers in the U.S. found men who had taken enough alcohol to get mildly drunk solved more problems demanding verbal resourcefulness than sober men could, and did it more quickly."

Of course there's a fine line between "buzzed" and besotted, and this will not help with your driving skills.


Cavalcade of Risk #151: Nary a cross word edition

Van Mayhall outdoes himself with a cleverly constructed and wide-ranging Cavalcade of Risk. So sharpen that #2 and have at it.

Free Lunch for Everyone

Tuesday, February 21, 2012

We're in bidness now !

Just what the administration has been telling us we need - a new insurance company.

Watch the new company cut the cost of medical care. Probably by 25% or more !

Covering ObamaStaches©

Full disclosure: I can't grow a beard to save my life. I don't really mind, because lately, what does come in is decidedly more salt than pepper. But still.

I bring this up because of a grave and serious injustice that's still under the radar: full coverage for men's facial grooming products.

The prestigious American Mustache Institute estimates that Y-chromosomed-Americans spend upwards of $1500 a year on these products, yet are denied basic tax and insurance fairness. To that end, the organization is pushing the "Stimulus to Allow Critical Hair Expense Act, or 'STACHE Act ... It appears clear that mustache maintenance costs qualify for and should be considered as a deductible expense related to the production of income under Internal Revenue Code Section 212"

The STACHE Act would help defray these expenses by making them tax deductible. And that's a good start.

But I say: Why stop there?

It seems to me that these types of expenses are just as much healthcare-related as, for example, birth control, and should be covered at 100% by one's health insurance. This is more than an issue of fairness, though: as the AMI's Aaron Perlut notes, "trimmers, wax and other accoutrements are ... protectors of the environment -- because not shaving saves water."

But Henry, you may argue, covering these products will increase health insurance costs and besides, only (about) half of the population would benefit.


As we now know, adding the cost of inexpensive and readily-available products does nothing to increase the cost of coverage. And the argument that it would benefit only (about) 50% of Americans is irrelevant.

See? Win-win.

Obamacare - Who Benefits?

The folks over at KFF came up with this nifty map showing who will benefit the most (read as pick the pocket of the taxpayers for the highest subsidies) from Obamneycrap.

Not only is it a cool graphic, you can also use this link to find out what percent of your neighbors will be recipients of the rob the rich to give to the poor wealth redistribution strategy.

The median income for my zip code is slightly over $73,000 yet according to the map about 18% of my neighbors will have the chance to pick up a subsidy for their health insurance premiums come 2014.

My first reaction is WTH?

My next reaction is, well, that is because premiums will be at least double what they are now, so there are a lot of folks who can afford health insurance now but will find it out of reach in 2014.

According to the article, in 2014 a family of 4 can earn up to $31,809 and get free health insurance from Medicaid.

Good luck finding a doc willing to take you as a patient.

Also, families of 4 earning up to $92,200 can at least partake of some portion of the taxpayer wealth redistribution plan so they don't have to pay the full toll for health insurance.

Did you ever imagine a time when $92k would be considered poor enough to warrant a government subsidy?

MVNHS© Coming Off The Rails?

Perhaps so:

"Prime Minister David Cameron ... is working to partially privatize the NHS, beginning a massive outsourcing of medical services to private health care providers throughout the U.K."

The Much Vaunted National Health Service has a long and storied history of rationing care and and driving Brits to seek medical attention elsewhere. And of course, there's that worst-kept secret about private medical insurance "over there."

Of course, Mr C's idea has come under whithering attack from The Usual Suspects among the British press, but our own ObamneyCare© proponents are (not surprisingly) silent, thinking perhaps that if they ignore it, it will go away.

And perhaps they're right.

[Hat Tip: Hot Air]