Friday, October 13, 2017

Obamacare - When Facts Don't Matter

Former White House COS and current Mayor of the Windy City has been quoted as saying "Never let a serious crisis go to waste.".

Taking a page from Rahmbo's playbook, the current WH resident is doing just that.

Obamacare is failing. Has been from day one. But the only folks who don't see that happening are folks that are either ignorant, those who believe the 44th president walked on water, or they are covering their ears and refusing to listen to facts.

If you are the Gordon Gekko of health insurance and believe that "Obamacare is good" no need to read further. Go to HuffPo or TMZ and have fun with that.

But the Twitterer in Chief who is not known for holding his tongue (or Twitter fingers) has thrown down the Obamacare gauntlet with this tweet.

The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix! - The Real Donald Trump

Never let it be said that the man is indecisive.

He calls a spade a spade.

But some folks can't handle the truth.

What is extremely entertaining (to me at least) is found in the comment section below the Real Donald's tweet.

Anyone with a pre-existing condition is going to see premiums skyrocket from TrumpCare. He isn't working with the facts here. Studies, plz!

Seriously, without name calling or rudeness, here are the facts: the ACA saves lives. You are making it worse for poor people and all of us.

I wonder why Obamacare is imploding! Weird! Not sabotage, right?

Well, you get the idea.

Unless you have been indifferent to facts and truth since this mess called Obamacare came into existence.

Obamacare IS in crisis.

Obamacare HAS BEEN in crisis mode since 2013, a full year before it was completely implemented.

At this point there is no way to fix it. Too late to save it for 2018 and possibly beyond. Act II will most likely be a federally funded expansion of Medicaid for anyone not covered by employer group health insurance.

If there are any carriers offering individual health insurance in 2019 it will be those who are able to offer plans that gut the high cost parts of Obamacare, such as guaranteed issue. Medicaid  would then be not only for those who fall below a designated income level but also function as a high risk pool for those with serious health issues.

Those who want to keep Obamacare have some serious denial issues and should seek counseling while they can.

#Obamacare #TrainWreck #Snowflakes




The First Cut is the Deepest

[Note: This is an insurance-free post]

For as long as I can remember, I've always owned good kitchen knoves (Wusthof, Henckels, etc). A short time back, I participated in an Indiegogo campaign for a new brand, Misen (as in mise-en-place). This new venture promised high-quality knives at more affordable prices, and I thought it looked promising.

Well, I've had my chef's knife for some months (perhaps a year?) now, and I must say that it performs very well: nice balance, able to keep an edge, comfortable grip.

What isn't so great is how well it's "aging:"


See those spots? Rust, even though I carefully hand wash and dry it after each use.

So I sent an email about it to the Misen folks (including that picture), and this is their reply:

"Hi Henry,

Thanks for sending through that photo. While not common, small stains like this can occur (even on stainless steel knives) for any number of reasons, and they’re not something to worry about!

In my experience with some other knives I’ve used in the past, a product called Bar Keeper’s Best Friend is really effective at removing minor stains like the ones in the photo. Of course, if the issue does get any more serious, please let us know and we’ll be happy to help!

All the best,
Marco
"

To which I say: Bull Feathers.

As previously noted, I've owned similar knives for many, many years, and have never experienced this, let alone in one that's practically brand new.

So I ask, dear readers, am I justified in my disappointment, or unreasonable?

Thanks!


Thursday, October 12, 2017

A Better Pill ?

As a registered Democrat, I receive several emails a day from DNC telling me what to think and what to support and asking for money.  About a week ago, one of the DNC emails told me this about employer-sponsored medical insurance: 

“Today, the Trump administration announced that they're rolling back a mandate requiring employer-provided health insurance to cover contraception -- a rule that has helped at least 55 million women across the country access care.”

There are many sources (here’s one)  that discuss this rollback; it’s far more complex than DNC suggests. But whether the issue is simple or complex; whether details are offered or suppressed; and whether facts are understood or ignored - I think this issue will remain just as controversial, emotional, and resistant to logical analysis as it was before Obamacare.    

Why is that?  Because insurance for contraception has been politicized.  It's a good example how the expanding role of government in providing medical insurance, politicizes medical coverage decisions.  The experience in many other countries teaches that politicizing medical coverage decisions is usually not a good thing.

Keep in mind DNC raised the question of coverage for women who are employed and have incomes.  The great majority of working women can buy contraception using their own income.  For them, insurance is not necessary to access contraception.  So then why do some advocates insist that coverage is unacceptable if it pays a penny less than 100%?  Is $50 a month unaffordable for most working women?  $25 a month?  And why is my own party telling me that coverage less than 100% will reduce access to care for 55 million working women? 

Also consider that employers do not pay their employees above & beyond their wages to cover food, clothing, or utilities.  Is contraception a higher priority than food, clothing, or utilities?  Is there a persuasive argument that employers are denying their employees access to food, clothing, or utilities? I’ve not seen one. Or that the federal government must step in to mandate such extra payments in the name of employee access to food, clothing, or utilities?   I think not.  And that's why I doubt that “free” contraceptive coverage for working women is necessary.   

My opinion: the fundamental issue here is less about the cost of contraception or the level of insurance coverage for it or even access to care.  Instead, the fundamental question is more about whether the federal government has a duty to mandate 100% coverage of contraception for working women.


My opinion:  coverage of contraception for employees is better left voluntary, purchased by employers who choose to purchase it (e.g., Hobby Lobby) based on their own employees' preferences and needs  And I think regardless of the employer’s choice whether to buy such coverage, it is not unreasonable to ask working women to share some part of the cost.  Maybe even the full cost.

Health Wonk Review: Pink edition

October is Breast Cancer Awareness Month, so please forgive this brief detour:

I'm raising money to fight breast cancer with my team: Love, Hope and Faith. Our walk is on Saturday, October 21st in Dayton, Ohio.

Will you please help out by making a donation - any amount helps.

Thank you!

And now, on with the show:

First up, Bradley Flansbaum isn't bullish on long term care: over 70% of seniors will need it at some time, and they're ill-prepared to pay for it. The good news is that Bradley offers some hopeful ideas about how to resolve that.

Next, Andrew Sprung makes the case that the ACA most closely resembles London after the Blitz, citing the Trump administration's meddling as the culprit, and he's not happy about the current situation, or sanguine about the program's future.

Uber Wonk Roy Poses offers his take on what he calls the Health Care Revolving Door. He's concerned about the seemingly endless stream of folks hopping from private industry into government advisory jobs, and vice versa.

HWR co-founder (and dear friend) Julie Ferguson is our guru of WC (Workers Comp), and offers us an insight into how WC costs and benefits are distributed amongst the 50 states. I know very little about WC, and found her information pretty interesting.

Our good friend (and fellow long-time HWR host) Louise Norris offers something I've never seen before. I'll let her explain:

"This post was written by myself and three colleagues: David Anderson, Charles Gaba, and Andrew Sprung. It's an overview of the different approaches that states and insurers have taken with regards to the CSR funding uncertainty for 2018, and the impact that those various approaches have on consumers and overall plan pricing."

Okay, so very interesting Henry, but what makes this unique?

Ah:

"We all published it concurrently on our blogs this morning."

Isn't that cool? I don't think I've ever seen a post co-written and then concurrently posted like this before.

Kudos!

Our friend Dr Dana Beezley-Smith has been published once again in The National Psychologist, this time on the subject of price transparency in health care (Spoiler Alert: she's for it).

Our own Mike Feehan has a scary pre-Halloween story to tell, as he warns us that the Health Insurance Fee that was temporarily put back on the shelf for 2017 will loom large next year. Why's that? Well, last year it cost insureds about $13 billion. So do the math.

The next 'Review is in two weeks over at David Williams' establishment.

Wednesday, October 11, 2017

Single Payer Blues

So let's see what our Friends Across the Pond© have been up to. Via our friend Rich W:

"A growing crisis in hospital safety is revealed in official figures showing a doubling in the number of legal warnings issued by NHS watchdogs."

Promising!

The number of "enforcement actions" (basically citations) has more than doubled in the past year, and it doesn't appear that that rate's slowing down:

"Recent actions include a warning notice to Royal Cornwall Hospitals trust after inspectors found patients dying and left to go blind after long waits for treatment."

But hey, free!

On the other hand, it's not as if our own hands are clean:

"VA conceals shoddy care and health workers' mistakes"

Ooops.

Fortunately for those who served our country, putting their lives on the line for all of us, VA healthcare professionals are top-notch.

Oh, wait:

"Medical experts from the Department of Veterans Affairs blamed one botched surgery after another on a lone podiatrist ... In 88 cases, the VA concluded, Franchini made mistakes that harmed veterans."

Good thing the VA bureauweenies caught him in time, and that he paid a severe penalty.

"They let him quietly resign and move on to private practice, then failed for years to disclose his past ... He now works as a podiatrist in New York City."

Oy.

Okay, well then, good thing this was just a one-off.

Sigh:

"In other cases, veterans’ hospitals signed secret settlement deals with dozens of doctors, nurses and health care workers that included promises to conceal serious mistakes ."

Words fail.

On the bright side, it's not as if single payer systems promote murdering patients to save precious and scarce health care dollars, right?

Um, you may want to be sitting down for this:

"Now, in Canada, a doctor can not only deny life-saving treatment for a person in their right mind who wants it, but actually have that patient, against the patient’s will and with their full mental faculties, outright executed by lethal injection."

"Free" health care: worth every penny you pay for it.

Tuesday, October 10, 2017

ObamaShanda

"Majority of Households Paying Obamacare Penalty Are Low and Middle-Income"

Almost 4 out of 5 of those penalized bring in under $50,000 a year.

Please remind me what the first "A" in PPACA stands for?

As we noted yesterday, folks who don't qualify for subsides (because they make just a tad too much, but not enough to get out from underneath this trainwreck) are facing record rate increases, and now those folks who can't even afford to buy insurance are getting hit with penalties for going bare.

Something's got to give.

Methinks Maxine was right all along.

[Hat Tip: AssocAmerPhys&Surg]

Monday, October 09, 2017

ACA #Winning: More Lies

You may have seen #FakeNews items like this floating around the 'net, with glaring, fear-mongering headlines:

"Steep Premiums Challenge People Who Buy Health Insurance Without Subsidies"

Don't be fooled by them, we know the truth:

Making Strides Against Breast Cancer

Once again, I'm raising money with my team: Love, Hope and Faith. Our walk is on Saturday, October 21st in Dayton, Ohio.

Will you please help out by making a donation - any amount helps.

Thank you!

Friday, October 06, 2017

Borrowing a Ride(r)

This is interesting, from the folks at The Standard insurance company:

"With the Student Loan Rider, if you become totally disabled and can’t work, we’ll reimburse all or a portion of your student loan payments so you don’t fall behind."

Now, we've seen imaginative disability insurance products before:

"But what if, because I’m disabled, I’m not earning any income? Even if I could afford to do so (and how many disabled folks are?), I’m not allowed to contribute to my plan until and unless I’m back to work."

Hence, MassMutual's RetireGuard product, which puts money aside for your retirement for you if you're disabled. This new product from The Standard is actually a rider available to physicians and dentist, rather than a standalone policy.

How does it work?

Well, if you're a doc (or dentist) and your Standard DI plan includes this rider, then they'll "reimburse you for your monthly student loan payments if you suffer a total disability and are unable to work." So it's a paid-as-you-go arrangement.

Interesting, really: just when you thought that there's nothing new under the sun, a carrier will come along and prove you wrong.

NTTAWWT.

Thursday, October 05, 2017

From the annals of the MVNHS©

The Much Vaunted National Health Service© continues its proud tradition:

"Most recently, Professor Ted Baker-- the new chief hospital inspector-- declared it was “not fit for the 21st century.”

Ooops.

Turns out, the bureauweenies who actually run the hot mess seem perfectly okay with "[normalizing] wholly unsatisfactory treatment that endangers patients and guard against unacceptable and unsafe practices."

Examples, please?

Sure:

- Piling patients into hallways
- lack of proper patient monitoring
- shortage of oxygen and medical supplies
But hey: "Free!"

Wednesday, October 04, 2017

MidWeek LinkFest

Our friend Dr Dana Beezley-Smith has been published once again in The National Psychologist, this time on the subject of price transparency in health care (Spoiler Alert: she's for it):

"We could create cost-unconscious consumers in virtually any industry in the country if we introduced third-party coverage."

Yup - Recommended.

Via FoIB Rich W, a thousand words on the failure of Single Payer:

In email from Anthem, some good news:

"Anthem, Inc., has reached a settlement to resolve the multi-district class action litigation relating to the 2015 cyber attack against the company. The settlement did not include any finding of wrongdoing, and Anthem did not admit any wrongdoing or that any individuals were harmed as a result of the cyber attack."

Whew.

On the other hand:

"Equifax says 2.5M additional individuals potentially victimized during data breach."

Ooops.

ProTip: LifeLock (with special 10% IB discount)

Finally, remember that explicit "If you like your plan..." promise? Well - and you'll want to sit down for this - that guy lied:

"In the face of significant uncertainty surrounding the future direction of U.S. health care policy, Premier Health Plan will discontinue Premier HealthOne Off-Exchange plans on December 31, 2017. This follows Premier Health Plan's June 2017 announcement regarding the 2018 exit from the On-Exchange marketplace"

#ACAWinning #ACACompetition

Monday, October 02, 2017

And some more anecdata

Another in our (seemingly unending) series.

Amy has had her grandmothered United Healthcare HSA-compliant plan since 2013. It sports a $3,000 annual deductible, after which all covered expenses are paid for at 100%. And since it's a PPO plan, she has coverage both in and out of network.

Her current rate of $252 a month is going up by 5%, to $267 a month.

I've suggested that she kiss UHC on the mouth.

Why?

Well, she doesn't qualify for a subsidy, so the least expensive comparable Exchange plan (offered by Anthem, believe it or not) is just shy of $300 a month, but it does have a $6,550 deductible/out-of-pocket. Plus, it's an HMO plan, which means that there is essentially zero out-of-network coverage.

Now, she does have some options: for example, she can increase her deductible to $4,000 and save just shy of $400 a year, which might make some sense. We shall see.