A Positive Tax Development

If you haven't already, do check out FoIB Joe Kristan's recently updated and beautified Tax Updates blog.

As always, there's great (and interesting) content, now with new features (including Ol' Joe's picture).

For cutting edge info on the tax scene, check out the (new and improved) Tax Updates blog.

A Difficult Situation

I received a phone call last week from a young man with a difficult problem. I’m wondering if one of the IB readers can think of a solution.

He was working for a 50+ person company that had a self-funded plan through a large carrier. The company was having financial problems and had notified the employees that the plan would terminate as of July 31, 2007. Because of this, he enrolled on his wife’s medical plan effective August 1. On July 14, the employee was involved in a serious bicycle accident, spent five days in the hospital and incurred in medical expenses in excess of $100K.

In early August, a bank seized the assets of the company…they were obviously in default on some agreement…and sold them to a third party. This has left no money to pay the medical bills.

Who’s going to pay the hospital and the doctors? There's nothing left of the company to pay anything. The health insurance carrier? They issued the Certificate off Credible Coverage showing a July 31 date termination date. It's not unreasonable to assume that a document showing a July 31 coverage end date actually means that the coverage is in effect through July 31. The company's General Liability policy? Assuming, that is, that it had employee benefit coverage. If not, would their P/C broker's E&O policy come into play? How about the Directors and Officers insurance policy? A strong argument could be made that a self-funded plan is unsuitable for a financially troubled company. The corporate officers must have known the company’s financial position...especially if the company was in (or close to) a default position on a loan. And lastly, what about the health insurance broker’s E&O policy? If the broker was aware of the company financial position and failed to recommend a change to a fully insured plan, does he (or she) share responsibility?

Beats me…I referred him to a good plaintiff attorney who works in this area. All I know for sure is that a client’s friend is lying sleepless at night, worried he’s going to lose his house.

Medical Tourism (with a twist)

Medical tourism (that is, traveling outside the country for medical care) has been a recurring theme here at IB. The rationale for this phenomenon has been almost exclusively for price; quality of care has been, if considered at all, an afterthought.

But what if that quality of care was the primary reason to travel outside one's native land for needed health care?

"[Canadian] Liberal MP Belinda Stronach, who is battling breast cancer, travelled to California last June for an operation that was recommended as part of her treatment."

And just why did the Hon Ms Stronach make the trip? For treatment of a "later-stage" operation in the U.S. after a Toronto doctor referred her.

But hold on there, pardner. I thought that the "free" Canadian health care system was far superior to our own "broken" one. Why would a leading Canadian pol make the trip stateside if that were true?

Well, one might suppose that since it was her very life on the line, she knew that she could trust good old American know-how over her fellow countrymen's less effective level of care.

Granted, Ms Stronach has some political "issues" of her own (as chronicled by the indefatigable Cap'n Ed), but she apparently knows a good thing when she sees it:

"MacEachern said the decision was made because the U.S. hospital was the best place to have it done due to the type of surgery required."

"The best place."

Hmmm...

Mixed Messages

Quick: What's the American Cancer Society's number one issue?

Most (if not all) of us probably answered "well, cancer, of course." And we would be wrong:

"The American Cancer Society on Monday began a $15 million advertising campaign that seeks to make expansion of health insurance a top priority for presidential candidates ... The ads, which feature two cancer patients, will air about nine times weekly and will target politically active viewers."

So the ACS has decided to give up on its ads about the dangers of smoking and other risky behaviors in which we're prone to indulge, nor will it tout the importance of potentially life-saving cancer screenings. In their place, we'll see a year-long series of advocacy pieces about the wonders of "universal health care." Ironically, they won't mention that such systems themselves do a pretty poor job of fighting the disease.

Instead of focusing on (and funding) research to actually cure a deadly disease, the ACS is choosing to play politics, with money it ostensibly raised for that aforementioned research. I can hardly wait for next year, when they decide that global warming causes cancer, and start running ads about that.

The reality is that this is purely politics, with no scientific basis, and a deliberate sidetracking of funds for that purpose. How many patients will now die because the ACS has lied about the uses for which its fundraising was driven?

My suggestion: find another outlet for your charitable contributions and fundraising efforts (such as this one).

Starting now.

UPDATE: If you're in southwestern Ohio, this is a worthy cause, too:

Something New

As we're dragged, kicking and screaming, into the 21st century, we're trying some new "blog tech" (well, new to us old fogeys). So, Bob did our first YouTube embed, and he and I are taking a swing at online polling. If it goes over well, we may add it as a weekly feature (with new questions each week, of course).

Our first one may be found near the top of the righthand sidebar. We're still looking for a tool to allow us to embed it in a given post.Have fun!

Cavalcade of Risk #35 is up!

A little late, but well worth the wait, Justin at the Investments & Loans blog has an outstanding Cav. Fighting an ever increasing load of spam submissions (and calling folks on it, as he should), Justin has an eclectic collection of risk-related posts.

Do check it out.

And don't forget, you can host one, too. Just drop us a line.

Tech Bleg (Polling Widget)

Okay, we'd like to post an online poll, but do not want to "upgrade" our Blogger setup. I've tried a bunch of different "free poll" tools, all of which give me html code, and none of which work. I get all kinds of "can't open tag" kinds of error messages, etc. It would be nice if we could "embed" a poll in a post, as opposed to on the sidebar.

Any suggestions?

(Already tried vizu, freepoll, adpoll, and several others)

Is More Better?

A while back, we looked at whether the HPV vaccine was a good idea or a Big Pharma profit center. This morning's McPaper brings us a full page ad from Generation Rescue, an autism advocacy group (no, they don't advocate for autism, but on behalf of folks afflicted with it). It's their contention that the increasing number of vaccinations "recommended" by the CDC may be responsible for an increase in the number of children diagnosed with autoism.

Obviously, correlation does not mean causation, but it doesn't preclude it, either.

So the group commissioned an in-depth study of chillun on the west coast (some 17,000 of them), to see if there was any overlap between those who'd been vaccinated and those with autism. The results are here.

It's kind of interesting, and scary. Turns out, of those surveyed, vaccinated boys were 2.5 times more likely to have neurological disorders (such as autism) than those who had not "had all their shots." Interestingly, GenRes isn't calling for a boycott or moratorium, but rather more study of the issue. As one who supports consumer empowerment and transparency in health care, I certainly applaud and support that.

Which isn't to say that the GenRes study was without flaws. As they themselves ask: "Are parent responses a reliable indicator of a child's diagnostic status?" Well maybe, and maybe not. But that just underscores the need to ask more questions. As I opined in that HPV vaccination post, "the risks here are great, and the downside is particularly troublesome."

Medical Care Disconnect

According to the L A Times "(n)early two dozen private hospitals in Los Angeles and Orange counties, accounting for up to 15% of beds in the region, are in dire financial straits and in danger of bankruptcy or closure, according to hospital administrators, industry experts and state data."

This is not the first time we've talked about the dire financial straits in which hospitals have found themselves, sometimes justifiably.

But it underscores a critical problem: how to balance the public good (adequate access to necessary health care services) with the funding necessary to pay for it. One way, of course, is to increase reimbursement rates. This may be difficult, however, given Medicare's notorious (and ever increasing) tight-fistedness [ed: you just made up that word!]. Insurers follow suit, of course, when they can, but lack the purchasing power of the gummint-run health care program.

Of course, California's solution is to require everyone to buy insurance (rotsa ruck with that), and subsidize folks who "can't afford it." And where would that subsidy come from (remember, the gummint has no money, it simply confiscates what it needs from the taxpayer)? Let's see, now: How about we add an additional 4% tax on the already overburdened hospital system? Yeah, that sounds about right.

Not.

...a failure to communicate

There are few (if any) things insurance agents sell that are simpler than fixed annuities, particularly immediate ones. These are instruments that are used to provide an inexhaustible (or nearly so) stream of income to folks who need one.

One of my clients is a law firm which represents a local company which had a defined benefit retirement program for some long-time employees. Such programs are designed to provide a fixed, usually small, retirement income. The company has a number of folks who have reached retirement age (or are approaching it), and wanted to offload the administrative details. A Single Premium Immediate Annuity is an ideal vehicle for this, because it provides a guaranteed income for the retiree, and zero effort (past writing the check) by the company. The law firm wins, because they provide the resource (that would be moi) to handle the transaction, and I win because there's a nice (although not outrageous) commission check for my efforts.

I've done a few of these for the firm, and in July, they asked me to do another one. I use a "wholesaler" that provides me with quotes based on criteria I provide (the monthly benefit amount, age and sex of the annuitant, A M Best rating of the carrier, etc) as well as the paperwork I'll need to write the case. I trust them to get me accurate information and proper forms.

Until now, I've had no complaints.

The wholesaler (whom we'll refer to here as XYZ) gave me the three quotes I requested, and we settled on a carrier. I received the quotes and forms via email (which is very convenient), we completed the paperwork, and I overnighted the completed case to XYZ on August 7. We had requested a payment date of August 31, which I presumed wouldn't be a problem (annuities such as this aren't underwritten like a life or health insurance policy; it's more enrollment than application). Case closed, or so I thought.

Mid-September, I get a call from the law firm, asking where the check was. Turns out, the retiree ("annuitant") hadn't received it. That didn't sound right to me, so I sent off an email to XYZ (the wholesaler) inquiring about it. The answer I received did not bode well: apparently, there were several forms missing, which would have to be completed before any check was cut. The carrier was firm: unless and until they had all the forms, they would put a hold on all funds.

Major oops.

As one can imagine, this didn't sit well with me; after all, I had counted on XYZ to provide me with all the proper documentation, and had in good faith secured the information, signatures and check. It seemed to me that XYZ had an obligation to supply me with all the necessary paperwork, and they had two opportunities to make sure all was in order: once when they emailed the forms to me, and again when they received the FedEx package I had sent back. I had no way of knowing what was missing, because I don't work directly with the carrier. I explained this to a number of folks as I made my way up the corporate ladder, becoming more and more frustrated as I did so.

In Part 2, we discuss how problems like this get resolved.

Cavalcade #35: Submissions Due

Just a reminder that submissions for next week's CoR are due this Monday (the 24th). Our host, Justin Broadbent-Shaw of the Investments and Loans blog, asks that you PLEASE include:

■ Your blog's url

■ Your post's url

■ The post's trackback URL (if available)

■ A (brief) summary of the post

You can submit them via Blog Carnival or email.

NEWS FLASH: The October 10 edition is still available; PLEASE let us know if you'd like to host it.

UPDATE: Hooray for Bob Laszewski, who's taken the 10/10 Cav. Thank you!

Health Wonk Review is up

FoIB Joe Paduda (founder and chief bottle washer of the HWR) hosts this week's "Back to School" edition, with over two dozen of the most interesting and insightful posts on health care policy and polity.

Transparency in health care is a frequent topic here at IB; The Health Care Blog's Brian Klepper is also a proponent, but with an interesting twist: in a "sauce-for-the-gander" post, Brian thinks we should be demanding the same from health plans, not just providers.

Oy Canada (Again)!

From time to time, we like to take a look at our Neighbors to the North(tm), to get a sense of how well their health care system, so often touted here in the 'States as "health care nirvana," is faring.

Alas, not so good.

When even the president of the American Medical Association (AMA) finds major fault lines, it's time to reevaluate how much stock we should put in that kind of system. Less than a month ago, his Canadian counterpart opined that their "system was built to meet the needs of the underprivileged. It is now failing both them and everyone else, because it has not adapted to the times."

Ooops.

What could have gone so drastically wrong?

Well, for starters, Michael Moore's fantasy about the bullet-proof Canadian health care system turns out to have missed the target, by a wide margin:

"Annual survey data for the past four years indicate that these perceived access problems have worsened or remained about the same, with no significant improvement for any single service. Moreover, about half of the respondents believe that health care services will get somewhat worse (34%) or much worse (15%) during the next two to three years."

That doesn't portend well for a system which stateside advocates fervently wish for us to emulate. In fact, the leadership of the Canadian Medical Association is now on record as recommending "that Canadians be entitled to obtain government-funded treatment outside their home jurisdiction or within the private sector," if those who run the system don't find a way to effectively rectify its many failings, including rationing and excessive waiting times for services.

And for those who think that the future of nationalized health care is all sunshine and flowers, consider this:

"Among the 800 physicians participating online, 39% said that Canada's health care system should allow for an increased role for private financing and delivery of health care services. A rather low 63% said they would recommend medicine as a rewarding career to aspiring young people."

That defines a vicious cycle; is that really the kind of system we want here?

Shopping Grand Rounds

Six Until Me's Kerri hosts a clever, entertaining and informative Grand Rounds. Laid out as a story unfolding as she meanders the supermarket, Kerri manages to tie informative but disparate posts together around common themes. Unique and highly readable.

Regular readers know that we're big on consumer empowerment, which means increased consumer knowledge. Walter at Highlight Health cautions us, though, to step back and assess just what it is that we think we know, because it might be wrong.

Universal Unhealthy Care

The pols are out in force of late: The Junior Senator from New York proposes HillaryCare II, a $110 billion (to start) program to bring about a gummint-run [ed: don't you mean gummint-mandated?] health system. Meanwhile, the non-Senator from North Carolina is waving a big stick, threatening to cut off Congress (and, to be fair, the executive branch, as well) from their cushy health plans if they don't pass "universal care" by mid-ought nine.

If nothing else, these are ambitious folks, so perhaps they're to be forgiven for overlooking the salient fact that these types of plans don't work.

I know, I know, they work great in England, and France, and Canada (or not, as the case may be). But they've proven themselves to be something less than stellar here. No one likes to mention it, but we already have a gummint-run health care system (several, in fact), and the problems become increasingly absurd, and yet painful:

"An obscure provision slipped into a $120 billion Iraq spending bill in May threatens to leave some poor and disabled Medicaid recipients without prescription drugs in October."

Ooops.

Never mind why Medicaid prescription benefits became part of an Iraq war bill (then again, it is a War on Terror, and few things are more terrifying than "I'm from the government, and I'm here to help you").

"In a case of unintended consequences..."

By far the best clause in the whole article, and one which should give any thinking person pause before even contemplating the idea of giving the feds even more control over our health care.

Carnival Time!

The Carnival of Personal Finance is up at Money, Matter, and More Musings blog. Our host has whittled the 100 submissions down to a more manageable (heh!) 88 posts, neatly categorized in helpful little "chunks."

One of our major themes here at IB is personal responsibility. We obviously apply this to insurance and health care decisions but, as the folks at One Million and Beyond point out, it's also critical in how we manage our debts, as well.

Loose Cannon Update

Recently, we noted that FoIB and Cato Institute biggie Michael Cannon had an op-ed in USA Today. Well, building on his new-found celebrity (notoriety?), Michael will be a featured guest on this evening's edition of ABC's 20/20. In fact, the whole show is on the health care delivery and finance debate, facilitated by John Stossel.

As they say: Check your local listings.

US life expectancy rises to an all time high...

There's an interesting article published today on Reuters that says that the US life expectancy continues to rise, following a decades long trend. That's absolutely amazing considering the shoddy level of health care that we enjoy. Oh. Wait. Maybe it's not so shoddy after all...

Just Can't Win

The headline reads "Health Insurance Premiums Vault Past Inflation."

The only reasonable response is "And so?"

In the very same edition of USAToday, we find that housing costs (which include ever-increasing property taxes) easily eclipse even health insurance, while the price of gasoline continues to climb to Olympian levels, as well.

What do these things all have in common (other than the obvious)?

Things cost more to buy.

It's called economics, and it's not that complicated: prices for goods and services rise to meet demand, and some things are more in demand than others.

And so, to borrow a line of thought from Mike, how come we don't see a push for nationalizing mortgage brokers? Or gas stations?

It's kind of frustrating that, according to USAToday, health insurance premiums rose a measly 6.1% last year, but that's not good enough: that increase was higher than the rate of inflation. But that really tells us very little: as noted above, the cost of a lot of things we need and use increased at a higher rate. What's critical, and missing from the article, is the rate of medical inflation. After all, the increasing cost of providing care drives the cost of financing it.

The other salient fact which jumps out in that story is this 'throw away:' a business owner, by simply adding a modest deductible, saw his rates climb a paltry 5%, two years running. That in itself is remarkable, but he also added an HRA (Health Reimbursement Arrangement) to mitigate his employees' increased exposure. The best part? "So far, not very many of his workers have needed to take him up on the offer."

Now what does that tell us?

Well, for one thing, the owner has a wise and competent agent, who helped him to see how a simple rearrangement of benefits could help his own, and his employees', bottom line. But the other, perhaps more important message is that a lot of folks pay for insurance that they don't even use.

Unfortunately, according to the Kaiser Foundation study on which the article's based, the number of insured employees who've enrolled in higher deductible plans hasn't grown much, which is a shame.

Just think how much lower rates would be if they did.

Cavalcade of Risk #34 is up!

Host David Williams, of the Health Business Blog, hosts this week's round up of risky posts from around the blogosphere.

David did an outstanding job, and you can, too: just drop us a line to reserve your Cav.

L'Shannah Tova, 5768!

Our Jewish readers, as well as half the IB team, celebrate our New Year (Rosh HaShannah - the head of the year) beginning this evening. For some, this is a one-day holiday; others celebrate for two. Regardless, it's less a time of champagne and fireworks as for introspection and rededication.

You may be wondering about that photo. Every week, my better half bakes two special loaves of bread, called challah; one for our family, and one for another, older couple who are among our dearest friends. It is traditional to bake a special challah for Rosh HaShannah; it's the same basic recipe, but the bread is braided into round loaves, and topped with a sprinkling of sugar (for a sweet new year).

Those two pictured above came out of our oven just a few minutes ago (and boy, do I wish we had pod-smelling technology!). What a delightful, special, and meaningful way to usher in the New Year.

This season is also a time to thank those who have been helpful, indeed inspirational to us through the past year. And so I especially thank our readers, and my esteemed co-bloggers: Bob Vineyard, Bill Halper and Mike Feehan.

May your New Year be filled with joy, health, prosperity and peace.

Grand Rounds

This week's edition of Grand Rounds is hosted at The Efficient MD. There's a theme with this one: innovations in health care (and new tech). Clocking in at two dozen posts (including several blogs with two each, which I had thought was counter to GR guidelines, but what do I know?), this is one of the smaller 'Rounds I've seen in a while, which is actually quite nice (I'm sort of a quality over quantity kind of guy).

As a gadget-lover, I was intrigued by Gene Ostrovsky's report on a new type of wheelchair, one operated by essentially "thinking" at it. Skeptical? So was I, but the video that accompanies the post is compelling.

9/11: 2007

A year ago, we paid tribute to Jerome Robert Lohez, who perished in the flames and destruction of the World Trade Center.

In his memory, and those of his fellow Americans who died on that horrible day, I'm honored (if saddened) to reprise that post:

As regular InsureBlog readers know, my better half has long maintained that “there are no coincidences.” That is, she believes that everything happens for a reason, although we may not be aware just what that reason is.

As for me, I’ve gradually become 90% convinced that she’s right on this (in everything else, of course, she’s 100% right). But one evening, a few weeks ago, that all changed.

I have a confession: My name is Henry, and I’m a news junkie. It is my habit to stay up way too late reading news blogs. Which I was doing several weeks ago, when I came across an item about one man’s extraordinary effort [ed: back online] to harness the power of the blogosphere, in tribute to our fellow Americans who died in The Towers, exactly five years ago today.

The concept was deceptively simple: 2996 victims, 2996 blogs, each one remembering a single person. Bloggers were invited to sign up, and each was assigned – at random – one name.

Stop for a moment, and consider this: one blogger, reading one news item, decides it’s the right thing to do, signs up, and is assigned the name of a person he’s never even heard of, let alone met. We’ll come back to this shortly.

And so I was assigned the name of Jerome Robert Lohez, given a photo of him, and told the briefest of biographical information: age 30, lived in Jersey City, New Jersey.
That was it. A name, a face, a place.

The assignment was simple: On September 11, post his name and picture.

But I’m a news junkie, and that wasn’t good enough. I had to know more about Jerome. So I Googled his name (hey, why not?) and came across a site that CNN put together in December of ’01. It had pictures and names, of course, but I also learned that Jerome, born in France, married Dening Wu some three years before The Towers fell.

One month before The Towers fell, Jerome got his Green Card, and the happy couple flew to Europe to celebrate with his family. When they got back, two days before The Towers fell, Jerome told Dening “Only in New York do we have so much sunshine."

That was Sunday, September 9, 2001.

On Tuesday morning, he left for work. And The Towers fell.

And now we've come full circle: One. Random. Name.

Jerome didn’t just work in The Towers. He worked for Empire Blue Cross and Blue Shield. He worked in the insurance industry.

90% doesn’t cut it anymore.

Thank you, Jerome, for the lives you touched, the joy you brought, your love for New York and America, and for the privilege of paying you tribute.

Au revoir, Monsieur Lohez, au revoir.

Carnival Monday!

Kevin, blogging at kmull, hosts this week's Carnival of Personal Finance. There are a lot of entries, some of which include context. He does have things well organized, with posts divvied into helpful categories.

When it was on, I absolutely loved Win Ben Stein's Money. Over at My Retirement Blog, the anonymous blogger reports that Ben's an advocate of variable annuities (tax advantaged savings vehicles with investment components). Who knew?!

And the Carnival of the Capitalists is now up at Entrepreneurs blog. It's chock full of posts. On the one hand, I like that blogger Scott Allen has a "Top 3;" on the other hand, it's obvious that he simply copied/pasted the template from Blog Carnival, with little effort at originality. Very few of the other posts reflect an actual reading of what was submitted.

One obvious and refreshing exception to that was this post by the Silicon Valley Blogger. He has a decalogue of insightful stories on various wealth-building models.

Now THAT'S a Really Bad Idea...

Seems a local couple hasn't really tried shopping for health insurance with a professional, independent agent who specializes in that field:

"The Riverside resident and his wife soon found plans that were affordable but discovered they were wrapped in restrictions, tied to minimum health care services and anchored to premiums that would skyrocket once the couple's health care costs reached a certain threshold."

That doesn't even make sense:

"affordable but...tied to restrictions."

Such as?

Well, the article doesn't say, but one can guess: a limited benefit (mini-med) plan comes to mind, as does any product from Mega Life (et al). Regardless, affordable coverage doesn't have to mean "restricted" coverage - if properly designed.

"tied to minimum health care services"

Again, I have no idea what that is supposed to mean. One might infer that it offers minimal cover for routine items, but so what?

"anchored to premiums that would skyrocket..."

First, individual plan premiums aren't tied directly to individual claims; they're "pooled" with the experience of other plan owners, which helps to levelize premium increases. Since we already know that rates are leveling off, this scenario seems unlikely.

So what do the Whorton's plan to do about this seeming impasse?

Glad you asked:

"Dan and Carly Whorton decided a savings account for their health care costs was the safer bet."

Now that's just brilliant! Why didn't I think of that? Oh, yeah, right: because it's a mindnumbingly dumb idea.

Why's that, you ask?

Simple: insurance companies pay their actuaries handsome salaries to determine the likelihood and severity of future claims. It seems a stretch that Mr Whorton, "a welder by trade," has the expertise to make accurate calculations about his family's medical expenses (not picking on welders: insurance agents, lawyers and burger flippers are equally ill-equipped). What happens, for example, if Mr W has a heart attack? Or Mrs W becomes pregnant? Or little baby W develops respiratory problems? How long will that bank account last?

Had Mr and Mrs W availed themselves of a competent advisor, they would have learned about Health Savings Accounts (for example), which would allow the W's to put money aside for future claims (on a tax advantaged basis, to boot) while enjoying the security of a health insurance plan for catastrophic claims such as noted above.

Hard to believe, but it gets dumber. In addressing the estimated 70,000 local folks (a number which the authors of the article never question, even though it's preposterously large) who are uninsured (at the moment), one local official opined:

"We hope to be able to make sure that everyone in Montgomery County has some type of health care"

Yoohoo, Mrs Lieberman, every single resident already has access to health care. They may or may not be insured, but care is most definitely available.

Of course, our local pols aren't the only ones with tunnel vision:

"I think it unconscionable that the wealthiest country in the world can't provide universal coverage for its citizens."

Thus spake Tom Breitenbach, CEO of Premier Health partners, which has had its own issues with providing health care. Of course, Mr B will be the first to complain about recent cuts in Medicare, touted as a potential "jumping off point" for a nationalized health care financing and delivery system.

And we all know how well that's working out.

Cavalcade #34: Submissions Due

Just a reminder that submissions for next week's Cavalcade of Risk are due this Monday (the 10th). Our host, David Williams of the Health Business Blog, asks that you PLEASE include:

■ Your blog's url

■ Your post's url

■ The post's trackback URL (if available)

■ A (brief) summary of the post

You can submit them via Blog Carnival or email.

The October 10 edition just became available; PLEASE let us know if you'd like to host it.

Health Wonk Review is up!

This week's HWR is now available at Brian Klepper's The Doctor Weighs In blog. Brian apparently received a slew of submissions for this one, and presents over a dozen. They all have great commentary, as well. Well done, Brian!

Regular IB readers know that we are major proponents of transparency in health care. And as we've pointed out, it's not just about cost, but outcomes and satisfaction, as well. Richard Eskow, blogging at The Sentinel Effect, has a disturbing piece on the lengths to which some physicians will go to avoid accountability. Recommended.

"Blaggin'" (Bloggin' and Braggin')

A little over a year ago, our own Bob Vineyard had the story of a "factory worker who claimed his lungs were ruined as a result of mixing flavoring oils used in microwave popcorn," and who subsequently won $20 million in a jury trial.

Skipping ahead a year, we learn that "(a) pulmonary specialist at Denver's National Jewish Medical and Research Center has written to federal agencies to say doctors there believe they have the first case of a consumer who developed lung disease from the fumes of microwaving popcorn several times a day for years."

Coincidence?

I think not.

For those of you who still want to enjoy their nuker-corn, albeit without the potential side effect of dying prematurely, I heartily recommend the AB ("Good eats") method.

A Loose Cannon

[UPDATED: Please see below]

Not really, but I couldn't resist the headline. Michael Cannon, Director of Health Policy Studies for the prestigious Cato Institute (and FoIB), has a terrific and timely guest column in todays USA Today. He writes:

"Simply expanding coverage would have little effect on the quality of care, health disparities, or how long we live, nor would it stop free-riders from shifting costs to others. In fact, expanding coverage through government regulation or tax-and-transfer programs would make our problem worse."

Amen.

But that's not all:

"If we want to increase access to health care, our first priority must be to contain costs. Nothing would help more than 200 million cost-conscious consumers."

Which is another way of saying what we've been touting for quite a while: health insurance costs increase because health care costs increase.

He also reminds us that "there are not 47 million U.S. residents who can't get health insurance. According to the Department of Health and Human Services, that Census estimate "appears to overstate the uninsured substantially compared to other surveys."

As they say, read the whole thing.

UPDATE: Commenter Zagreus Ammon has some issues with some of Mr Cannon's conclusions. On his blog, he goes into further depth; he lists 8 areas of contention. This is one of the great boons of the blogosphere: relentless fact-checking and civil disagreement.

Calling Dr Welby (on a cell)

One of the worst parts of the hospital experience is being cut off from one's support system (family and friends). As a society, we've become so reliant on cellphones (including texting and emoticons) for instant communication. When that's denied us, as is usually the case in an ER or a waiting room, it can make the situation feel even worse. Of course, there may be perfectly understandable reasons for banning cell phones in these circumstances, but that doesn't make one feel any better about the sense of enforced isolation.

Well, that may soon be changing:

"(S)ome health care facilities are creating wireless networks to let patients, family members, physicians and staff members use their phones."

There's been a technological basis for the cell phone ban; the devices could interfere with certain medical equipment, for example. On the other hand, enhanced communication between patients (and patients' families) and provider can actually help speed up the healing process. It's an area of transparency, by the way, which we've never really addressed. Add in laptops and Blackberries, and you've got a recipe for either disaster, or better communication and outcomes:

"An increasing number of patients arrive with laptops and other means of communication and are frustrated if they cannot connect with the outside world, says Andrew Cooper, information technology manager at the Zangmeister Center, an oncology and hematology clinic in Columbus, Ohio. It has installed a $70,000 antenna system for better cellphone use."

The clinic recognized that it could use the technology to enhance the treatment process, by encouraging (and enabling) patients and families in its use:

"By putting the antenna inside the medical facility, the phone signals are reduced, and engineers can measure and better control the electromagnetic energy in-house."

Several other area hospitals are apparently following suit, although this is by no means an indication that the practice either is, or soon will be, ubiquitous. Still, competition is a wonderful thing: if enough facilities take the leap, there will be increased pressure on those who've taking a pass.

It's another example, as well, of the private sector seeing a need (and a potential improvement) and acting to "make it so."

Carny Tuesday

Okay, the title's a little strange, but the long weekend pushed our favorite Carnivals back (forward?) to today; it's an embarrasment of riches.

First up, the Carnival of Personal Finance is now available over at the Advanced Personal Finance Blog. It follows the now prevalent paradigm of "editor's favorites," followed by a listing of the other submissions. This week is really jam-packed with interesting posts. I found this post, on attaining a secure retirement over at FIRE Finance, pretty interesting.

Over at Emeritus, Dr Emer hosts this week's Grand Rounds. It's his fourth time as host of this prestigious (and no doubt challenging) carnival. He, too, followed the "Top 10 & The the Rest" model, which is fine. In the "Turnabout is Fair Play Department," Allison at Lemonade Life blogs on the patient's perspective. A lot of us will relate to her phone conversation.

And the Carnival of the Capitalists is now available at Welcome to Help, a new blog from the folks who started the CotC. There are plenty of helpful posts, each with useful context.

And while we've been debunking the "myth of the uninsured" here at IB, Warren Meyer at the Coyote Blog has been looking at the latest numbers on "poverty" to similar effect.

This blessed plot, this earth, this realm, this England - II

A pregnant woman has been told that her baby will be taken from her at birth because she is deemed capable of "emotional abuse" . . . based in part on a letter from a paediatrician she has never met . . . psychiatrists treating her say there is no evidence to suggest that she will harm her child in any way

O brave new world that hath such people in't.

You Can Run (but it ain't free!)

One of the more hare-brained schemes proposed to address our nation's issues with health care funding has been to expand Medicare coverage to folks under age 65. Although many of us have objected to this idea for a variety of reasons, it's kind of nice to have real, unambiguous proof that it would be a poor choice:

"In his drive to kick-start the French economy by creating a culture of hard work, Nicolas Sarkozy believes those who chose to retire early - under 65 - should not benefit from free health care."

Yes, yes, I know: that's France, not us. But a there's a lot of overlap among the folks who push the "Medicare for all" approach and those who advocate a nationalized system of health care. This latter group likes to point to other countries, ones which already have gummint-run health care, as "models" for us to follow (France being one example).

And what has "mes amis" knickers in a bunch? Well, it seems that folks fleeing "the much vaunted NHS" are placing a real drain on the French system [ed: I thought the Brits and the French despised each other?].

Apparently, "thousands of Britons living across France were sent "brutal" letters last week from the department of social security informing them that they would no longer be welcomed as non-paying customers of France's hugely efficient - and traditionally extremely generous - national health service."

Who knew there were so many ex-Britishers living it up in Gay Paree?

According to The Telegraph, "(t)hey will face potentially crippling private health care bills."

But I thought nationalized health care was free?

A pretty man with his own nice hair and other peoples' ideas

TIPTON, Iowa - Democratic presidential hopeful John Edwards said on Sunday that his universal health care proposal would require that Americans go to the doctor for preventive care.

Ah’m tebbly, tebbly sorry, suh – but this idea is already taken.