Friday, May 24, 2019

Outcomes vs Costs


But: #NarrativeUberAlles

Gentlemen: Start your ... needles?

Courtesy FoB Holly R:

"Some fans attending Sunday's Indianapolis 500 can get measles vaccines at the track's infield medical center."

This comes as the CDC has issued a warning about the increasing incidence of the once-eradicated disease:

"From January 1 to April 26, 2019, 704 individual cases of measles have been confirmed in 22 states including Indiana. This is an increase of 78 cases from the previous week."

At least one fan's not worried though. Local Indy aficionado Mike Dean's theory is "I think if you drink enough beer, it kind of inhibits the measles virus, so that’s been my defense."


Thursday, May 23, 2019

Gleaner Life: "Give and Grow" 2019

We've mentioned before how Gleaner Life gives back to its community of policyholders and their families:

"These "Give and Grow Grants" put real dollars directly into the hands of folks who want to help "to improve their communities through volunteer service projects."

Well, they've just announced this year's recipients, all 100 of them (Wow!), will split almost a quarter of a million dollars to help with college (and/or other post-secondary) education expenses.

The competition is available to Gleaner life clients and their families, and:
Applicants are scored individually in six basic areas:

1. Academic record
2. Leadership
3. Quality of activities and community involvement
4. Letters of recommendation
5. Explanation of financial need
6. Overall quality and completion of the application

Wednesday, May 22, 2019

MedicaidForAll: A preview


Tuesday, May 21, 2019

GoodRx for Healthcare?

A while back, our Jack Russell-mix puppy had knee surgery, and the doc prescribed 4 (yes, four - I told you she's a Jack Russell-mix) meds for her. Buying them from the vet got expensive pretty quickly, and they recommended the folks at GoodRx. This is a site (and an app) where you can procure coupons for various meds, often saving significant dollars.

This helped a lot with Maddie's meds, and we've since used it for our own. It's easy and efficient, and even better, it's free.

Well, seems like the basic idea is really taking off:

"Discount medical shopping site launches in Kansas City ... has gone live with the test version of"

We've seen this model before, of course:

"Must See TV featured an interview with Dr. Keith Smith where he outlined the unique practice at the Surgery Center of Oklahoma.The hospital operates on a cash only basis."

The Sesamecare site takes the reduced-fee, cash only model and expands it to include primary care and dental visits, eye exams and MRIs, and other services. According to the site, over 100 providers offer over 600 services, from OB-GYN to dermatology, even cardiology services. Pretty expansive.

And of course, since patients know the price of services upfront, and there's no insurance involved, there's no worry about what they will ultimately cost.

Unlike Direct Primary Care or sharing ministries, these services will generally be HSA-eligible, which also helps to offset the fact that there's not going to be much (if any) insurance reimbursement (depending on whether your plan is a PPO or an HMO).

So far, the service is available only in Kansas City [ed: I've heard that everything's up to date there], but perhaps we'll eventually see it rolled out in other markets.


[Hat Tip: Dr Gina Reghetti]

Monday, May 20, 2019

Thursday, May 16, 2019

Evergreen State Long Term Care

So the great state of Washington has passed legislation implementing what appears to be the first "Social-Insurance Program for Long-Term Care" in the nation.


But what, exactly, does that mean?

Well first, let's look at what this plan isn't:

It is not an individually owned, Partnership Compliant long term care insurance plan (it's not, in fact, 'long term care' coverage at all, but we'll circle back to that). That's not to say it's evil, fattening or carcinogenic, just noting its limitations.

On the other hand, it's also not the late, unlamented CLASS Act, so it actually seems to have some decent value, especially relative to cost.

Okay, that's nice, Henry, but what is it?

Pretty simple, really:

"All residents will pay 58 cents on every $100 of income into the state’s trust. After state residents have paid into the fund for ten years—three if they experience a catastrophic disabling event—they’ll be able to tap $100 a day up to a lifetime cap of $36,500 when they need help with daily activities such as eating, bathing, or dressing."

That is, they'll be eligible to receive up to a year of extra help with common tasks (assuming care costs $100 a day, and this amount increases each year). Which is, quite frankly, pretty remarkable. And at a tax rate of about 6/10th's of 1%, quite affordable. Given the state's average income of $70,000, that comes to about $400 a year per taxpayer.

So, is this a good deal?

Depends, no?

I'm ambivalent as to its likely result:

On the one hand, as it relates to encouraging folks to at least discuss the idea of long term care (and insuring it, obviously), raising awareness, I think that can be good.

What I'm afraid of, though, is that it will give folks a false sense of security as to the need to self-insure. I see this quite a bit with folks who think "oh, I don't need LTCi, Medicare will pay for it."

Uh, no, no it won't.

But a lot of folks believe that it does. And I'm concerned that folks will think that this is indeed Long Term Care insurance when it's not even really Short Term Care coverage.

On the gripping hand, it may well be all that many (most?) Washingtonians want, or need, or even qualify for.

Then here's this: proponents say that "[a]ll working people will pay into the fund through a payroll tax and then be able to claim a benefit when they need it."

Oh, really?

Then what happens if I pay into the plan for 20 years, and then decide to retire to Florida?

Time will tell, no?

[Hat Tip: Bill Comfort]