Movin' on up (Again)!

When last we mentioned it, InsureBlog was ranked 10th out of all the health-related blogs tracked by Wikio. Last month, we had moved into the #5 spot, and Wikio Community Executive Nicolas Boiteux informed us today that the September rankings have us in the #3 slot. In an email, Nicolas told me that they "create a 'top 500' for the different categories" (e.g. health).

Wow!

I was also pleased to see that we're ranked #1122 out of all the blogs that Wikio tracks this way (some 37,000 web logs); this puts us in the top 3%. Thanks to all of our readers, who make this effort worthwhile, and to my co-bloggers for their much appreciated contributions.

Told Ya So!

Thanks to regular reader (and commenter) Scuzz, we learn of a horrendous example of one of our favorite memes here ("health care costs drive health insurance costs"):

"Several months after back surgery, Linda Burdick sat holding a hospital bill for almost $60,000. ... Burdick hired two billing investigators. After demanding an itemized accounting, health care navigators Lin Osborn and Beth Morgan believe Burdick was overcharged by $40,000."

That's a lot of overcharge. For example, she was charged over $1,700 (each!) for a half dozen surgical screws [ed: don't you dare - this is a family blog!]. The moral of the story is to be proactive; just because a provider says you owe additional money doesn't make it so.

And beware of balance billing: if you're in network, it's strictly forbidden. It's always a good idea to check your EOB's (Explanation of Benefits); these are the forms that your carrier will send you to let you know what charges have been paid and why.

And, of course, for more egregious cases, there are a number of claims services that can help you get to the truth. These usually involve a fee, but can literally pay for themselves with one mistaken claim.

[Hat Tip: Scuzz]

UPDATE: In the comments, Lisa Emmrich has links to another story of provider gouging.

The Feds, Health Care, and Illegals

Although we're known more for championing transparency in health care and rallying against socialized medicine, I hadn't realized that we've also written quite a bit about illegal immigration's drain on our health care system:

Some are contractors who sue the citizen who hired them.

Some are quadriplegics left unattended and unwanted, with little hope and no resources.

Some are cancer patients who cost Texas taxpayers some $12 million.

Regardless, we all pay for them via increased taxes and higher insurance premiums. And the tab keeps getting higher. In fact, in the story referneced directly above, we learned that at least one Texas hospital planned to curtail cancer treatments to illegal immigrants.

In nearby Arizona, "Tucson-area hospitals estimate that providing emergency care for illegal immigrants has cost them more than $66 million since 2005;" The good news (such as it is) is that the Federal government (you know, thee and me) repaid them about a quarter of that. Since 2005, Medicare has been matching a certain percentage of expenses that hospitals incur under EMTALA, in order to offset those costs.

But that gravy train appears to have come to a grinding halt:

"(O)n Oct. 1, the beginning of the federal 2009 fiscal year...the reimbursement program ends."

Even under the reimbursement program, "local hospitals try to send illegal immigrants who need expensive or long-term care back to their country of origin." Not a bad idea (cf: "Schengen Convention"), but it doesn't always work: if we don't know who someone really is, how do we know their country of origin? And of course, there are those who are too ill to be transported. But health care costs money, which has to come from somewhere. Unsurprisingly, you and I foot a lot of that bill:

"Under Section 1011 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the government designated $250 million a year to be divided among the 50 states for emergency care of illegal immigrants. Arizona received $44.5 million in fiscal year 2007."

On the one hand, that's a lot (our) money; on the other, it gets spent awfully fast. And, as previously noted, that program goes away in another month or so, leaving hospitals scrambling to figure out their next move. Of course, a new congress could renew (or reinstate) the program, letting the hospitals off the hook for at least some expenses, for a while. The question, of course, is how much money we're willing to throw at the problem.

Time will tell.

Medical Bankruptcy (Revisited)

Many people are struggling to pay their bills, including health care bills. They rock along living paycheck to paycheck and then sudden illness or an accident happens.

We have looked at medical bankruptcy before, here and here, but perhaps it is time to revisit.

An article from CNN lists the 5 mistakes you make that can land you in debt. Good information, but it comes up short.

The lead in is a wake up call to most people.

It took the Trim family of Arlington, Texas, three hours to go $15,000 into debt.

That's some shopping spree.

How did they rack up that much debt?

That didn't even count bills from the doctors and the ambulance service. Plus, Trim, who has insurance, owed more than $1,100 in copayments from when he'd had kidney stones earlier in the year.

Which leads us to the question of the hour. Did he have insurance?

His son did not have insurance. Trim said it was "very expensive" to add him to his own policy at the private school where he's an IT director. His wife, Gayle, had just started a job as an executive assistant at a commercial real estate company and wasn't yet eligible for insurance.

While much is made about those who lack health insurance, this story has a mixed message.

In addition to the $15k trip to the ER the Trimm's had $1,100 in unpaid COPAYMENTS from earlier in the year when they (presumably) had health insurance.

For some at least the issue is not having health insurance or not, it is a problem of living paycheck to paycheck.

Four-in-ten workers (41 percent) say they often or always live paycheck to paycheck, according to CareerBuilder.com's latest survey.

Failing to plan for events such as the car breaking down, a major appliance that gives up the ghost, or a medical emergency.

Because workers' paychecks are often spent before they even hit the bank, saving is often not an option. One-in-five said they don't set aside any money for savings each month. Twenty-eight percent save $100 or less per month and 16 percent save less than $50.

According to Znet, 77% of households have cable, satellite or both.

And there is credit card debt.

According to Cardweb, 61% of consumers carry over debt from one month to the next, 31% pay their cards off each month and 7% of households don't have a credit card. The average balance of those who carry a balance is $9,900.

Maybe the problem isn't so much who has health insurance and who doesn't, but who is doing a better job of managing their income.

But the American public isn't the only one who can't manage money.

During each of the last 5 years Congress has spent in excess of $500,000,000 MORE than it took in. The total debt owed by government agencies exceeds $9.3 TRILLION.

It get's worse.

According to USA Today US household's share of the national debt is a staggering $516,348!

Modern accounting requires that corporations, state governments and local governments count expenses immediately when a transaction occurs, even if the payment will be made later.

The federal government does not follow the rule, so promises for Social Security and Medicare don't show up when the government reports its financial condition.

We are a nation of glutton's and suffering from financial obesity. The issue of unpaid medical bills is only the tip of the iceberg.

On top of all this we are in an election year and politician's, including those running for Congress, are promising more and more while they can't cover their existing debts.

This is a train wreck.

Cavalcade of Risk #59 is up

Host John Leppard has this week's edition of risk-related posts from around the blogosphere. Take a chance and stop on by.

You, too, can host a Cav. We've got openings available for Late Fall, so drop us a line to grab yours.

Beating the Revenooers...

First, a little background: life insurance companies come in (essentially) two flavors, stock and mutual. Stock companies are owned by (wait for it...) stockholders, who may or may not own policies issued by a given carrier. Any dividends accruing from the stock are distributed to the folks who own shares.

Mutual companies are owned (primarily) by their policyholders; buying a policy automatically makes you a part owner. Dividends from these companies generally flow back to their insureds. Dividends on these policies can be used to pay premiums, or provide additional insurance, or paid directly in cash. As with any such arrangement, dividends are not guaranteed.

But the focus here really isn't on dividends, but ownership itself. What does that really mean? It's not as if the president of the company calls up each policyholder for suggestions or ideas. From a practical standpoint, there are really only two benefits: one is, of course, the aforementioned dividends. The other is the potential for a nice settlement if (when?) a mutual company "demutualizes." That's not as scary as it sounds; it just means the carrier decides it doesn't want to be a mutual company anymore, and goes through a (lengthy) process to convert itself into a stock company.

That's all well and good, but let's remember that the "owners" are the policyholders, and they're entitled to "a piece of the action." So when a company demutualizes, it essentially "cashes out" the policyholders' ownership, and sends everyone a check representing their fair share. This can amount to a nice little windfall, but it can also mean tax problems. After all, what's the basis for the value? Is this a capital gains situation? Ordinary income? Or something else entirely?

For a long, long time, the IRS has taken the position that policyholders "hadn't paid anything for the shares and owed taxes on the full amount when the shares were sold. Cash distributions also were fully taxable."

Yikes!

Could that be right?

Well, for the past 7 years, Minnesota-based accountant Charles Ulrich has said "no." His thinking is that folks "had paid for their ownership rights through their premiums so the distributions should have been tax-free." In other words, he took the underlying insurance principle and applied it to the tax law. Pretty cool.

And now, pretty successful:

"A federal court recently agreed with his interpretation."

And this is no small victory: Ulrich thinks that there are some 30 million policyholders who've received such distributions. MetLife alone settled with 11 million insureds back in 2000, to the tune of $7 billion. That's a lot of dec pages.

Of course, the IRS wasn't exactly a big fan of Ulrich's efforts, and accused him of "promoting abusive tax shelters." They even demanded his client list, which he refused to turn over. Eventually, the Feds gave up on that tack.

Of course, the IRS has virtually unlimited funds and resources, and could appeal this decision. They could also fight future such claims, hoping for a different result. So the story's not completely over.

But it sure has a happy ending for Mr Ulrich, his clients, and a host of folks who may get a nice refund check from the Feds.

Promising Diabetes News...

The Lone Star State is in the forefront of research into this dread disease, and a Dallas-based researcher "says he's pulled off a medical first: successfully treating mice and rats dying of insulin-dependent diabetes without using insulin."

Dr Roger Unger thinks this has great potential, but actual human testing (and treatment) is a few years away. The key to the process is fat cells; actually, a "protein hormone that plays a key role in regulating energy intake and energy expenditure" called leptin.

Using Leptin-based treatments could help with several facets of diabetes, including "rapid weight loss and altered blood chemistry that make the untreated disease fatal." And of course, one supposes most folks would be pleased to be "off the needle" (not to mention the cost savings accruing from no longer having to buy insulin).

A lot of questions remain, of course. For one thing, there's concern that the effect may be short-term. For another, there's no guarantee that success in rodents will translate to curing people. Still, one hopes that this will indeed be the case.

Good for science!

Piling On Socialized Health Care...

At the risk of striking a metabolically-challenged equine, I'd like to share with you something I received in a recent email:

"Government-controlled health care systems promote longer wait times, reduced quality of care and denials of coverage. Learn first-hand from patients, health care workers and thought leaders from health care systems abroad to learn more about potential costs and consequences of government-run health care systems."

While the idea of a nationalized system sounds good, we've seen that there's scant evidence that it's superior to our own. And because statistics themselves tell only a part of the story, it may be intructive to hear what actually happens to real people, folks just like you and me, who are forced to deal with such systems.

It's not a pretty sight.

[Hat Tip: Elizabeth Terrell]

Going Dutch

"Universal" health care is the buzz. It seems everyone wants to know why other countries have "free" health care and we don't.

But no one ever bother's to find out if these other systems work.

The short answer is, they all have flaws. None are perfect.

But one system seems to have promise.

Starting in 2006 residents of the Netherlands were required to have health insurance.

Period.

The government subsidizes policies for adults who can’t afford to pay premiums and makes “risk-equalization” payments to insurers that cover the elderly and those with some chronic conditions such as diabetes.

The government (taxpayer) subsidizes policies for low income residents and those who have high risk medical conditions.

The idea behind the Dutch is that individuals will enroll in health plans that provide the coverage they need instead of a one-size-fits-all plan chosen by an employer. And individuals will pay more attention to health costs, which are largely ignored when the government picks up the tab.

I think it has promise.

Blind Ambition

Remember Mitt Romney? The good looking guy who had his sights set on a house on Pennsylvania Avenue. Native son of the former Michigan governor. Family man. Chief architect of RomneyCare.

It seems like those who have eyes on the presidency are all talking about making health care available and affordable for everyone.

If Taxachussetts can make headlines for having one of the highest percentage of citizen's with health insurance, why not the rest of the country?

Anyone making campaign promises and pointing to the "success" of Massachusetts might want to look at the facts.

Since legislation was passed in 2006 mandating health insurance coverage for all citizens the number of uninsured have dropped from 657,000 to 307,000.

A success, right?

Among these 350,000 newly covered people, some 174,000 joined Commonwealth Care, a government-supported plan that insures families of four up to 300 percent of the federal poverty line, or roughly $63,000 in annual income. Another 55,000 people joined Medicaid, which is funded by local and federal tax dollars. Only about 18,000 have purchased private insurance.

That means 332,000 opted for health insurance funded by taxpayers.

Folks who make up to $63,000 per year.

Before the legislation, taxpayer funded plans were available but not mandated.

Oops!

Pacific Research Institute's Sally Pipes writes that "the program is in intensive care, surviving only on massive infusions of other people's money."

How much is massive?

RomneyCare should cost taxpayers $625 million in 2008. That's $153 million, or 32 percent, beyond this year's original $472 million appropriation. For 2009, costs may hit $869 million, or another $244 million, 39 percent premium above today's already vertiginous spending curve.

Well it's only money, right?

Unfortunately, Massachusetts's residents love "free" and cheap health care, at someone else's expense. As usual these days, everybody parties, and then taxpayers spend the next morning collecting the empty bottles and cleaning the overflowing ashtrays. This mop-up will cost at least $129 million in new taxes

Toga! Toga! Toga!

Man Bites Dog

If it bleeds it leads.

Bad news sells. Good news doesn't.

Perhaps that is why almost nothing is said about the recent DROP in the number of uninsured.

The number of Americans without health insurance dropped by more than 1 million people in 2007, the first annual decline in seven years, U.S. Census Bureau officials announced Tuesday.

In this election year politician's want to talk about the uninsured and how their plan will save you.

What they don't tell you are the facts behind the numbers.

1 million FEWER uninsured in 2007 than the year before and the first DROP in the number of uninsured in 7 years.

"Both the percentage and number of people without health insurance decreased in 2007," David Johnson, chief of the Census Bureau's Housing and Household Economic Statistics Division

Just under 10,000,000 of the uninsured are children under the age of 18.

More than 90% of them have one or more parents who work.
60% live in two-parent families.
70% have incomes below 200% of the federal poverty level (1997).

Almost 3 out of 4 uninsured children live in homes that qualify for existing taxpayer funded plans such as Medicaid and SCHIP.

So why aren't the parents availing themselves of this coverage?

For obvious reasons, it is difficult to get a handle on how many of the uninsured are illegal aliens. Estimates range from 10 - 15 million.

This problem is worse in border states, particularly California and Texas where almost 1 in 4 residents do not have health insurance.

Atta Boy, Gov!

This would be filed under "Intelligent Government Tricks," if we had such a category. Still, given our enthusiasm for pointing out the dumb things gummint does, it seems only fair to celebrate rational decisions made by the state.

There's been a push in Ohio to make paid sick leave mandatory. This is commonly called a "stealth tax," (or "unfunded mandate") because it would force employers to pay extra wages, with no reimbursement from the state. These extra costs would be passed on to consumers, in a state economy that's already in the doldrums.

Fortunately, Democrat Governor Ted Strickland understands the economics of these kids of tactics, and has come out against the ballot issue that would enable them (Issue 4). He and Lt Governor Lee Fisher have said that the mandate would be "unworkable, unwieldy and would be detrimental to Ohio's economy."

Hear, Hear!

[Hat Tip: Ohio PIA]

It's the Outcomes, Silly

Well-meaning but ignorant folks from the AMA to AARP [ed: sorry, couldn't find any Z org's that fit the bill] have long touted gummint-run healthcare, a la Medicare, as the ideal solution to a system they consider "broken." Nationalized health care, they argue, provides the most fair and efficient means of delivery.

Um, no:

"More than 825,000 Canadian citizens are currently on waiting lists for surgery and other necessary treatments...Canada also limits access to common medical technologies."

But wait, the MVNHS© has it right!

Um, no (again):

"In Britain, more than 1 million sick citizens are currently waiting for hospital admission...Britain even has a government agency explicitly tasked with limiting people’s access to prescription drugs."

We've mentioned these problems numerous times here at IB (for example, our Oy Canada and MVNHS© series). The problem, of course, isn't the cost or availability of health insurance, it's the cost of health care. And if a system can't control that (as no socialized scheme has ever managed to do), then one is left with rationing and substandard care.

As Sally Pipes, president and CEO of the Pacific Research Institute, notes, the pundits and pols love the sound bites, but not the facts. They're quick to cite the recent World Health Organization's ranking of various countries' health care systems (which we also posted on) which placed the US near the bottom of the top 20%, behind countries like Morocco and even Costa Rica. But they looked at only two of the important factors that contribute to a nation's true health care picture: a modified definition of mortality and "fairness" (whatever that means). What the study failed to consider are much more important factors, such as cancer and cardiac care.

The truth is, our system is actually superior to socialized schemes when it comes to saving, and prolonging, lives. Why is it, for example, that Italian Prime Minister Silvio Berlusconi chose the Cleveland Clinic, over his own country's "free" medical care, when he needed heart surgery a couple of years ago? I doubt it was just for a trip to Corky and Lenny's.

And what about that "free" health care? Surely a gummint-run system guarantees better cost efficiency?

Sadly, no:

"The United States produces over half of the $175 billion in health care technology products purchased globally. In 2004, the federal government funded medical research to the tune of $18.4 billion. By contrast, the European Union — which has a significantly larger population than the United States — allocated funds equal to just $3.7 billion for medical research."

You get what you pay for.

The bottom line is that there is no "universal" health care scheme that can control costs, guarantee access and deliver consistently superior outcomes. Does this mean that our system is perfect? Of course not. But market-driven changes beat central planning committee ones every time.

[Hat Tip: Power Line]

A Latesummer's Day Grand Rounds

Dr Theresa Chan, hostess of Rural Doctoring, is a small town doc and a scholar of The Bard. She presents this week's Grand Rounds in true Shakespearean style. Unlike some of Willy's works, however, this collection is easy to follow, and full of useful info.

Go forth!

Profiles

I get daily reports from a vendor about people looking for health insurance. The demographics are interesting to say the least.

Over the last 3 days the report reveals the following.

103 people visited their site in search of coverage. (These are just those who live in Georgia).

76 did not have health insurance. Some have just recently lost insurance, usually coverage that was tied to their job. They received their COBRA notice and went through sticker shock. Most have been without coverage for months or even years. Some will have, or suspect they have, health issues. They are looking for insurance to pay for something that could be expensive.

Insurance doesn't work that way.

It doesn't matter if it is health insurance, auto, or life insurance. If you want the coverage you must buy it BEFORE you need it.

16 currently have health insurance but are also Type 1 diabetics. They will not be able to secure medically underwritten insurance and will either have to keep their current plan or go into the high risk market.

2 more have health insurance but have had a heart attack.

1 has AIDS.

4 are currently pregnant.

4 are currently insured and have indicated no significant health issues.

Pricetag for the Uninsured

[Welcome Industry Radar readers!]

Just how much do the uninsured pay for health care?

According to the WSJ, about $30,000,000,000.

If you apply the popularly quoted figure of 47,000,000 uninsured, that breaks out to less than $630 per person.

That's a bargain.

Health-care spending accounted for 16.3% of gross domestic product in 2007, or about $2.2 trillion, and that amount could nearly double in 10 years, according to federal figures. More of the cost is expected to shift to the government, even as it seeks to shrink large deficits.

Shifting cost to the government, who in turn shifts the cost to the taxpayer.

And how about those deficits?

Some doctors and hospitals donate time and forgo profit to cover poor people, and in some cases private donations cover the costs. Just how much money doctors and hospitals lose in caring for the uninsured is difficult to pin down, partly because group plans often negotiate lower payment rates than other consumers are billed.

Doctor's and hospital's forgo profits. In most cases they collect nothing.

I thought profits only existed for the insurance carriers.

"group plans often negotiate lower payment rates than other consumers are billed".

Billed charges mean nothing. All that matters is what is paid.

While many have argued that uncompensated care will translate into higher premiums to patients with private insurance, Mr. Hadley said the impact is "very small," noting that despite an increase in the number of uninsured, hospital spending on uncompensated care has been relatively stable. That is partly because the public hospitals and clinics that most often care for the uninsured often don't have many privately insured patients to absorb the costs.

"It's more through taxes than private insurance bills," Mr. Hadley said

So increased premiums AND increased taxes.

Great.

Carnival of Personal Finance

This week's roundup of all things financial is hosted by the Broke Grad Student. Featuring an Olympics theme, it's a champion effort.

Carrot or Stick?

Which produces better results?

Positive reinforcement or punishment?

It's the age-old question which now is being applied in the workplace. Some employers are willing to reward employees who make lifestyle changes such as losing weight or stop smoking while others choose to punish non-compliant workers with a higher share of the premiums.

A few states are surcharging smokers. Now Alabama will be doing likewise for overweight workers.

Obese workers must be prepared to pay a $25 per month "fine" if they are not ship shape.

The State Employees' Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don't have free health screenings.

If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program, or take steps on their own to improve their health. If they show progress in a follow-up screening, they won't be charged. But if they don't, they must pay starting in January 2011.

Seems fair enough.

Not all state employees see it that way.

"It's terrible," said health department employee Chequla Motley. "Some people come into this world big."

Computer technician Tim Colley already pays $24 a month for being a smoker and doesn't like the idea of another charge.

That's a new one on me. "I came into this world big and I am going to continue to get bigger."

You really can't control what happens in utero, but you are responsible if you feel a need to super-size every meal after that.

E-K. Daufin of Montgomery, a college professor and founder of Love Your Body, Love Yourself, which holds body acceptance workshops, said the new policy will be stressful for people like her.

People like to make excuses for coming in extra large sizes. Why can't they just admit they have a problem?

"I'm big and beautiful and doing my best to keep my stress levels down so I can stay healthy," Daufin said. "That's big, not lazy, not a glutton and certainly not deserving of the pompous, poisonous disrespect served up daily to those of us with more bounce to the ounce."

I have never met or heard of a person who lost weight and regretted it.

research shows someone with a body mass index of 35 to 39 generates $1,748 more in annual medical expenses than someone with a BMI less than 25, considered normal.

So the extra $600 doesn't even compensate for the additional cost of insuring the obese.

Carrot cake anyone?

Cavalcade of Risk #59: Submissions Due

Next week's Cavalcade of Risk is hosted by John Leppard.

John's eagerly awaiting your risk-related submission, and requests 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 your post via Blog Carnival or email.

We're scheduling mid-Fall, so please drop us a line to reserve your Cav.

Happy Wonkday!

Julie Ferguson hosts this week's edition of the Health Wonk Review. It's chock full of interesting posts featuring the best of health care policy and polity.

Check it out.

Stupid Admin Tricks

Once again, we're delighted to present a post from our favorite anonymous guest blogger (whose most recent work, on Florida's newest health care initiative, can be found here and here). Our anonymous friend is well placed enough in the industry to offer us some unique insights.

In this post, AGB laments the games that are played by some of those who administer ERISA (aka "self-insured") plans:

Here is something to consider. We have seen a rash of material misrepresentation and “gamesmanship” lately resulting in substantial claims costs. In three cases, the administrator filled out all the individual apps (not disclosing any medical information) and just had the employees sign. In another, an app was sent in three days after an incident of care but was dated on the date of the incident. Of course 1 day after the same incident of care, they requested a change in waiting period, thus making this person eligible for benefits.

The question arises: what do we do with clients that are bad actors in these cases. The standard carrier here would adjust the rates to what they should have been underwritten at and make them retroactive, while continuing the policy. Is it time for carriers to start pursuing cases as worst case rather than best case? What is the disincentive for groups to do the same thing with the next carrier if the worst that will happen is that they have to pay what they should have paid in the first place? This affects premiums for all groups in the pool, thus negatively impacting other businesses that applied in good faith.

Ultimately it is the carrier’s decision, but is it time to start moving away from the slap on the wrist and start pursuing options that would be more punitive? Is it worth it or not? Any agent or broker that did this would have their appointment terminated and possibly reported to the department of insurance. What would be the next step for these administrators?

Goofy Retirement

Let's play a game.

Suppose your employer offered a retirement plan that went something like this.

The company will withhold 6.2% of your paycheck and match it with an equal amount. The money will be used to fund a retirement plan that you can start to collect as early as age 62 if you wish.

If you leave this employer you cannot cash out your balance.

If you make it until age 62, you can begin drawing a monthly benefit for as long as you live.

If you die before reaching retirement your designated beneficiary will receive $255. If you have minor children they will receive nominal monthly checks until the turn 18, then the checks will stop.

The money you receive from Social Security will vary according to your earning power during your working years. In general, low wage earners could receive upwards of 40% or so of their pre-retirement earnings. High wage earners might be lucky if they receive 10% of pre-retirement earnings.

In other words, high achiever's are penalized while low achiever's are rewarded.

In any event, according to the Cato Institute, the amount you could have received from privately invested funds vs. from Social Security is anywhere from 3x to 6x greater.

How much better would your post-retirement standard of living be if you could have taken the same amount of money as paid in to Social Security and invested it yourself?

Social Security.

Your earnings, their rules.

That's just goofy.

Eyes and Teeth

Workers in corporate America are mostly spoiled. Until they leave their job, or their job leaves them, they are insulated and totally out of touch with health care costs in the real world.

They have no idea how much a routine office visit or prescription med's cost. They think in terms of $20 for health care.

The same is true for eye's and teeth.

Employer plans offer free or low cost annual exams. Fillings are usually $40 or less. Crowns might be $300. Eyeglasses are $40 or so unless you opt for designer frames and advanced optics.

When these orphans come to me looking for health insurance they also inquire about dental and vision insurance.

Now we start the re-education process.

Office visits to a medical doctor usually run $50 - $60 without a copay. Med's are another story, especially if you have the latest and greatest brand name.

I undertake the task of educating people not only on what health care costs, but how to effectively make better use of their dollars.

That is a major hurdle for most. But what about vision and dental insurance?

Individual vision insurance is almost impossible to find and when you can find it the premium is outrageous. According to an industry trade magazine American's spend an average of $240 per year on vision care and corrective lens.

Will someone explain why you need insurance for vision care? When you can find an insured vision plan the premium is in the $40 per month range.

Paying $500 per year to insure an average expense of $240 doesn't make sense to me.

The same magazine indicated average annual dental expenses for adults range from $1200 to $1800.

That figure seems high to me.

Two checkups and cleanings per year at $150 (or less) per visit still leaves over $1,000 in "other" dental expenses.

Reading between the lines it appears the BULK of dental expenditures are for cosmetic procedures such as bonding and teeth whitening. These procedures are usually not covered by dental insurance since they are not medically necessary.

So how much does individual dental insurance cost?

About $30 - $40 per month per adult.

And what is covered?

Almost nothing during the first year.

You can't access benefits for crowns, root canals or periodontal expenses. Orthodontia (braces) for adults is almost never covered. Braces for children can be covered after 12 months but the children have to be on on the parents plan, the premium doubles or triples and the maximum payout for orthodontia is usually $1,000 or less over their lifetime.

So the economics of insurance for eye's and teeth shakes out like this.

You can expect to spend $400 - $500 per year per person for a benefit valued at $300 or less.

My advice?

Save your money for things that really matter.

Yay Canada!

Folks who've been following our Oy Canada!© series know that we're not enamored of our neighbors' health care system (such as it is). Now comes word of an opportunity for young people to help chart a new direction for Canadian health care:

"The Fraser Institute is hosting a new Student Video Contest and students are eligible to win $10,000 in cash and electronics prizes. The topic is: Incentives Matter - Fixing Health Care in Canada."

According to email I received today from Director of Student Programs Vanessa Schneider, students who submit a short concept paper by the end of September (and post their videos by the end of October) are eligible to compete for the cash (no word yet on whether that's Canadian or real money). For details, click here.

Food for Chicks

So now it seems nurses have come up with the 100 best food for women.

I can't say how they picked these foods, but it definitely has things on here for chicks. Such as . . .

Flax seed, kale, sunflower seeds, and cottage cheese.

Is your mouth watering yet?

Soy, garlic (isn't that the stuff they use to keep away vampires?), sesame seeds (what is it with seeds?), and tofu.

Yum.

Tortilla's (finally, guy food), veggie burger (back to chick food again), spaghetti squash (you're kidding, right?) and quinoa (which is supposed to be a "fun" substitute for rice), bulgar (isn't that a country?) and chickpeas.

Chick-peas.

Not guy-peas.

Chick-peas.

Not a pizza anywhere on the list.

I hope they don't come up with a list of guy foods. If they do, I will have to hide it from my wife.

IB In The News (Again)

One of the neat fringe benefits of blogging is the opportunity for even greater exposure (no, not that kind). Mike's been on TV, and both Bob and I've been interviewed by various trade and news magazines. As a result of a post I did back in June, I was contacted by Private Payment Watch, a monthly newsletter that "reports on private payer fee schedules, reimbursement strategies on out-of-network payments, out-of-state claims, contract negotiating strategies, credentialing and more." They were interested in how providers could encourage their patients to more effectively use their HSA's.

On the basis of that post (and some helpful comments from reader Robin Fisk), I was recently interviewed by PPW for their August issue:

There's actually a bit more, and I'd recommend this newsletter to folks in the business of handling providers' accounts receiveable.

Transparency: Dead On

[Welcome Kaiser Network readers!]

Transparency in health care is a recurring theme here at IB, usually with an emphasis on costs. But in the long run, buying the cheapest item isn't always (or even usually) the least expensive route. So we also urge carriers and providers to be more proactive in discussing how well they do, not just what they charge for doing it.

In today's McPaper, Steve Sternberg and Anthony DeBarros provide us with some encouraging news on that front:

"Until today, hospital death rates were closely guarded secrets, discussed in board rooms but beyond the reach of patients whose lives are on the line. That changed this morning when USA TODAY posted on its website the government's best estimates of heart attack, heart failure and pneumonia death rates for every U.S. hospital for two years."

And they're not kidding; click here for an interactive map for hospital mortality rates in three key categories. Very cool.

As more and more of us become "connected," tools like this will become more readily used. With so many phones and PDA's now internet-capable, I can certainly see a time in the near future where most people will have ready access to this kind of information.

As with any new tech, there will be naysayers. One of the objections we hear a lot is that tools like this are nice in the abstract, but who's going to tell the ambulance driver what hospital to race for, sirens and lights blaring? And there's some validity to this: after all, if you're coding, where you go may be important, but how quickly you get there most likely takes precedence, and that generally means which facility's closest.

Still, it's a step in the right direction. The results are helpful for the consumer, of course, but for the provider as well:

"When last summer's CMS report came out, one of the 11 hospitals in the Dallas-based system, Baylor All-Saints Medical Center in Fort Worth, was found to have a heart failure death rate of 14.6%, higher than the 11.1% average.

What leapt out of a review of the patients' records was that just 10 of 31 deaths occurred in the hospital, suggesting that some deaths were due to follow-up care by local doctors and nursing homes, says Paul Convery, Baylor's chief medical officer. "This was a signal that we have to be responsible for patients after they've left our halls."

By pinpointing problem areas, hospitals can address problems that they may not have been aware of. Armed with that kind of information, appropriate changes can be instituted, thus saving even more lives.

And that's a good thing.

Social (In)Security and Disability

Recently, Bob wrote about the claims problems plaguing the Social Security Disability system. In Georgia alone, three quarters of those applying for benefits are initially rejected. Some will probably, ultimately, prevail, yet many will be shut out.

But that may not be the worst of it:

"...the Social Security Disability portion of the Old Age Security (OAS) “DI” trust fund is now in the RED on what would be defined as a “real world” cash flow basis. And, the shortfall must be borrowed by the Treasury in the credit markets as part of the growing budget deficit."

Ooops!

And the problem's growing. According to economic consultant Keith Forrest, over a million and a half folks have been added to the already burgeoning number of SSDI beneficiaries. That's an annual growth rate of about 4% per cent. Ouch!

The problem is the payroll tax for the benefit is less than 1%, and doesn't look to be growing by leaps and bounds. Now that's a recipe for disaster. But neither presidential candidate seems to be addressing this looming catastrophe.

Something to think about.

[Hat Tip: Unum]

ENnie Awards: Awesome Update

Earlier this month, FoIB Tom Tullis was up for a prestigous (and highly sought-after) industry award. This made it two years in a row for Tom's company to be in the running, which was virtually unprecedented. Online voting ended less than two weeks ago, and the results are in:

Best Miniature Product - Silver ENnie: Dragon Tiles: Forest Adventures, Fat Dragon Games

WooHoo! Congratulations, Tom, on a win well-deserved. And Thank You, InsureBlog readers, for helping to put him over the top.

Who Ya Gonna Call?

Regular reader Holly R tipped me to this interesting factoid:

"The Ohio Department of Insurance says its consumer hot line can help when Ohioans have trouble with their insurance companies...Callers must be fully insured and complaints must involve disputes of at least $500."

So far this year, the hotline has received some 1,500 calls (at $500 a pop, that's over three quarters of a million dollars, at least, so far). And what kinds of complaints does the Hotline typically get?

I called, and spoke with Larry, who was quite helpful. Larry told me that the health side of the business gets the most complaints (no real surprise there, although I had thought it might have been auto). The most frequent complaint? Delay of claims; interestingly, this cut across all lines of business, even life.

Larry wasn't aware of what percentage of reported problems were ultimately resolved, but he did tell me that the number of complaints has gone up each year, as more folks become aware of the service.

So now you know.

Keeping Abreast . . .

As if we didn't have enough already to debate, it seems that stem cell research now has a new twist.

Much has been said about stem cells harvested from aborted fetuses and cord blood. Now adult tissue and body fluids are cultured and enhanced for cosmetic surgery.

A 51 year old woman is participating in a new way to enhance the breast.

Dr. Yoshimura jabbed the underside of the woman's left breast with a thick, long needle, drawing it in and out. At his side, an assistant slowly cranked the handle of a canister filled with an orange-colored mixture, pumping it into the needle through a tube. The substance was a fat concoction from the woman's own body -- which had been processed in an adjoining laboratory to fortify the stem cells it contained. Then it was injected into the patient to enlarge her breasts.

No stem cells are harvested, only what is already there is "fortified".

So where is the controversy?

This is uncharted territory for the U.S. Food and Drug Administration, which regulates products and devices but not procedures. However, the FDA says fat augmented with stem cells creates a "biologic product" that would require regulatory approval.

So it appears the vast right wing conspiracy folks will have a while before they have another boycott target.

During a single operation, fat is siphoned from a woman's thigh or abdomen and then processed using various techniques. The fat is injected back into the breasts. Because the patient is the donor, there is no risk of tissue rejection.

From a layman's perspective, it seems harmless enough. The biggest problem in the past with "fat transplants" was the implanted fat cells died and turned into lumps or calcification's. This procedure seems to preserve the integrity of the cells by creating a flow of fresh blood.

Dr. Yoshimura performs the transplants at Cellport Clinic in Yokohama. Perhaps this is just another venture into medical tourism.

This Week's Grand Rounds now available...

For those of us old enough to remember, libraries used to have large cabinets filled with drawers. When one needed to find a specific book, one went hunting through this Card Catalog, which used the Dewey Decimal System. It was painstaking and awkward, and I (for one) am grateful for QuickSearch and a PC.

And so is Kerri, of Six Until Me, who hosts this week's Catalog of the best medblogs, and who's built her effort around that old standby, the Card Catalog. Never fear, though, this collection's easy (and fun) to browse through.

Where Those (Premium) Dollars Go

Regular reader (and frequent commenter) Scott M clued us into a very interesting document he recently received. Like myself, Bob and Bill, Scott is an independent agent with many years of experience in the health insurance field. The missive comes from Aetna, which broke down how premium dollars are actually spent.

This particular piece is about 2 years old; I went poking around the Aetna site for an updated version, to no avail. However, I doubt that the actual numbers have changed that much in the meantime.

There are some interesting factoids here:

■ Almost 80 cents of every premium dollar is paid out to providers

■ About 6% is profits (not too shabby, but certainly not outlandish)

■ Surprisingly, state and federal taxes amount to only about 4%

There's more, and it's available for download right here.

[Hat Tip: Scott M]

A Walk Down Memory Lane

America's senior citizens are having trouble paying their medical bills and are looking to the government to help them out. Anna Price of Washington is spending $25 per week on adult diapers for her husband and that is draining their life savings.

Last week the Senate took a sizable step to ease the burden on the Prices and millions of other Americans by passing the Medicare Catastrophic Coverage Act, the most dramatic expansion of federal health insurance since its enactment in 1965. That same day the House derailed a bill that would have provided home health care for the chronically ill. It was a reminder that the Federal Government, too, has difficulty paying rising medical costs.

Read that last line again.

"the Federal Government, too, has difficulty paying rising medical costs."

Eye opening.

The Medicare extension breezed through the Senate (86 to 11) as it had through the House (328 to 72) the week before, largely because of its self- financing mechanism. The program is to be paid for by Medicare's 32 million beneficiaries, who will be charged an additional $4 monthly premium plus an income-based surtax.

Breezed through both houses. Amazing how easily they vote to spend OUR money.

The day before the vote, 2,000 delegates at the National Council of Senior Citizens convention in Las Vegas took turns manning phones to remind Congressmen that the council's 4.5 million members were watching. The 28 million-member American Association of Retired Persons also supported the bill.

56 million eye's are watching.

It is not the last Congress will hear of long-term health care. Already the elderly absorb $258 billion in federal spending, two-thirds of the Health and Human Services budget

Two thirds of the HHS budget.

Think about that.

The Medicare Catastrophic Coverage Act easily passed through Congress in 1988. For what it's worth, 1988 was also an election year.

The following year it was repealed.

Randy Pausch Last Lecture: Achieving Your Childhood Dreams

Randy's last lecture

No Free Lunches on the MVNHS©

Well, no lunches at all, actually. According to a new poll by the folks at Macmillan Cancer Support:
"...nearly half of cancer patients in England are being forced to cut back on basic necessities in order to pay for their prescriptions."

But how could this be? After all, our Cousins across the Pond enjoy a free health care system that is far superior to our own "broken system," at least according to the folks pushing for us to adopt such a plan. Yet here we have actual cases of folks being forced to choose between food and health care. I thought that only happened here?

Perhaps this is a reason why Britain's cancer survival rate is so much lower than ours.

45 year old Amanda Whetstone is a cancer survivor (so far) whose regular course of chemo has ended. The good news is that it apparently worked, the bad news is that she requires follow-up med's that take a pretty good chunk out of her fixed income (she's on the British equivalent of SSDI). She makes about $700 a month, and her meds take about $90 of that. And because of her limited income, she's putting off trips to the eye doctor and dentist (but I thought these are all free?!).

Gee, why can't we have such a great system here?

A Jug of Wine, a Loaf of Bread, and Thou

The Apostle Paul told his young charge Timothy to "Drink no longer water, but use a little wine for thy stomach's sake and thine often infirmities." (I Timothy 5:23)

Then there is the French Paradox that suggests the diet of residents of southern France which would normally produce high cholesterol in the population is offset by the frequent consumption of red wine.

So how do you follow the Bible and control cholesterol without blowing the budget in a fine restaurant?

A meal for two in a nice restaurant can easily top $100. Add in a bottle of wine and watch the tab double.

So how do you find good value in a restaurant wine list?

According to the Wall Street Journal, some of the better values lie in the more expensive wines.

The least expensive wines may be 2 - 3 times the wholesale price, while the mid to higher priced wines generally have a lower mark up.

Do your research before going to the restaurant. Some restaurants will fax their wine list on request. But you don't have to do all your research in advance.

It is possible to do some surreptitious research even at the restaurant table. Derek Benham, the owner of several California wineries, including Mark West and Avalon, suggests using an iPhone or BlackBerry to pull up a Web site like wine-searcher.com when studying a wine list. Industry insiders routinely use that site to find retail prices. "It's a two-second transaction that doesn't spoil your dinner or your date," he says.

How romantic is that?

For the less-technologically inclined, there's a simpler rule of thumb: Go for lesser-known regions and varietals. Sommeliers suggest thinking of Grüner Veltliner as an inexpensive alternative to Chardonnay. They also say Pinot Noir from Australia, Malbec from Argentina and Sauvignon Blanc from South Africa, which have gained ground in the wine market in recent years, are still good values.

Much better.

And how about just a glass?

Typically, the first glass of wine sold pays for the cost of the bottle to the restaurant. "Ninety-nine out of 100 times, the wine-by-the-glass program is going to be priced the most aggressively,"

Usually the wines by the glass are the lower priced wines and who knows how long the bottle has been open?

So don't take any chances. Get the bottle.

Stupid Government Tricks: STOLI

No, not that Stoli; Stranger Owned Life Insurance. We've actually discussed various forms of this concept before, but a quick recap is in order:

To understand STOLI, one must start with the concept of "insurable interest." Briefly, insurable interest means that one may expect to suffer a financial hardship if the insured person dies. An obvious example would be a spouse, or perhaps a key employee. It's important to note that, until now, it has been a given that insurable interest must exist at the time a policy is issued, but that requirement would subsequently go away.

When AIDS became so prevalent, a previously little-known concept, "viaticals," started to take off. Viatical contracts were a way for a dying person to sell their life insurance policy to someone else, generally through a broker, at a discounted rate. For example, one might sell a $100,000 life insurance policy for $45,000 cash. This benefited the insured, who may have had no one to whom he cared to leave the larger amount, and who wanted (or needed) a large sum of ready cash. As one might imagine, such a market was ripe for abuse, and various laws were enacted to limit the damage. Insofar as the primary beneficiaries of these plans were in the midst of a debilitating and fatal illness, this seemed an appropriate response.

Unfortunately, once that camel's nose was under the tent, the original nature of the life insurance contract was violated.

Let's step back for a moment, and discuss this unlikely sounding concept called STOLI. It refers to the sale of one's life insurance policy to someone who (apparently) has no insurable interest. This is beyond viatical settlements, and has many uses, some benign, some not so much. I've been unable to find any hard numbers regarding how many of these sales have actually taken place, how many insured's and their policies are affected. I daresay that's partly because it's such a miniscule part of the market, and rarely used. But because of a few high-profile cases abusing the idea, we now have the government effectively dictating to you how you may dispose of your own life insurance policy.

Think I'm exaggerating?

Suppose you wanted to sell your home to someone you didn't know, and the government forbade you from doing so? That would seem pretty silly, and beyond the authority of the state. But that's exactly what a life insurance policy really is: a piece of property. Permanent life insurance policies (e.g. whole life, universal life, etc) have "cash values," which are exactly the same as equity in one's home: one may borrow against the policy using its cash value exactly the way you can make a home equity loan (minus the fees, points and credit check, of course). Why would it be any less dangerous for the government to be empowered to dictate to whom we could sell our insurance policy than our home?

And yet, that's precisely the result of new legislation in Ohio. Yes, it seems like a blow against the "forces of evil," but it is in actuality a shrinking of what "private property" is supposed to mean. We've sacrificed a real right on a false premise.

And of course, the National Association of Insurance and Financial Advisors (a true oxymoron) provides the cheerleaders:

"STOLI transactions violate the essential social purpose of life insurance, which is protection...Life insurance was not intended to be used as a vehicle for financial speculation on human life” says NAIFA president Jeffrey Taggart, completely missing the point.

All this does is place an increasing burden on the insured, while relieving that same insured of a fundamental right.

Nice going.

Naked Kids

According to a report from the Robert Wood Foundation, too many children are going naked in our country.

Naked as in lacking health insurance cover.

The majority of children are (apparently) covered under some form of private insurance, either through a parent's group health plan or individual health insurance although the exact number and percentages is difficult to ascertain from the report.

Some of the conclusions of the report should be readily apparent.

Thirty-one percent of all uninsured kids in America did not visit a doctor's office last year, compared to just nine percent of children with insurance. Three out of four insured kids (77 percent) received a "well child" check-up in the past year, compared to less than half of all kids without insurance (45 percent).

Well visits in and of themselves are usually $100 or less with 50% or more of the cost of the visit subsidized by health insurance. But there are also a number of outlets for children to get free or very low cost checkups through taxpayer funded and privately funded operations. Childhood immunizations can be expensive but most of these are covered by private insurance and available at little or no cost through public health services.

Public programs are a lifeline for children who might otherwise be uninsured, especially kids with chronic conditions. About 10 million children nationwide have chronic illnesses - 3.6 million of whom are covered by SCHIP or Medicaid.

Taxpayer funded services for children with chronic or severe illness should be a priority in considering the wide array of social services. While it is the parent's responsibility to provide and care for their children we should also be willing to help out those who are truly in need.

On a personal note, I have clients and know individuals who are fully capable of providing health insurance for their children but would rather let the taxpayer bear that burden. There are countless stories of parents who work for company's or state, local and federal government operations who shift the burden of child healthcare to the taxpayer.

It seems anytime a free meal is offered there are some who will abuse that privilege. Some form of accountability needs to be in place to curb the abuse.

The report focuses on children with "special health care needs" but does not elaborate.

The latest U.S. Census Bureau data show that more than 9 million children remain uninsured nationwide

That figure represents roughly 20% of the total number of uninsured as commonly used by the press. The report indicates overall, 91% of children are insured nationwide with roughly one third covered by taxpayer funded programs and the remainder under private insurance. This compares to roughly 16% of the total population classified as uninsured.

It would appear, based on this report, we are doing a much better job of covering our children than we are the general population.

Thanks to Patrick McCabe for a heads up.

BUSTED! (An MDA Bleg)

Looks like picking on the poor folks at the MVNHS©, bureaucrats in Oregon and misguided policy wonks has caught up with me, and I'm now in the hoosegow. The good news is, it's for a good cause: The Muscular Dystrophy Association's annual fund-raising drive.

Could you help a blogger out (of gaol), and at the same time give new hope to folks who suffer from this terrible disease? Your tax-deductible donation will help families living in our community (and help guarantee me an early release!).

Just click here to make your contribution.

A few years ago, InsureBlog readers helped propel us into the Top 40 (out of 1800) blogs in raising money for our fellow Americans devastated by Hurricane Katrina. I'm hoping that we can make the same kind of difference for Jerry's Kids.

Thank You!

Cavalcade of Risk #58: Now Online!

Joe Paduda hosts this week's Cavalcade of Risk, and it's a doozy! Please stop by and check it out.

We'd love you to host your own Cav, just drop us a line to reserve yours.

Justifying Your Existence

If you are elected (or appointed) to public office, how do you justify your existence?

By declaring your job is to help protect the little people from insurance carriers.

Eric Dinallo was appointed as commissioner to the NY Department of Insurance to replace Eliot Spitzer of "client number 9" fame.


Last week, he responded to a request for a rate increase from the state's largest auto insurer, GEICO, with a demand that it show the impact of higher gas prices and reduced travel on claims.

Interesting challenge.

So what did GEICO do?

They withdrew their request for a rate hike rather than go through the hassle of sorting claim data.

So is this a victory for the DOI?

Not necessarily.

Carriers will either be allowed to charge an adequate premium to cover their losses and provide a profit or they will withdraw from writing business in the state. This has been proven many times over.

The result is, fewer carriers to spread the risk and a resulting higher rate.

If carriers (like GEICO) operated in a vacuum they could charge anything they wanted and the consumer would have to pay it. But GEICO is just one of many carriers. The fact they are the largest in NY is probably attributable to having competitive rates.

So if they want to maintain market share they must remain competitive . . . even with a rate increase.

But it's not enough for health insurers to roll out double-digit premium increases every year and blame the usual suspects — drug companies, spendthrift providers — without providing the kind of real-time detail that Dinallo is asking from the auto insurers. Break down the cost factors. Explain administrative costs, including salary increases. And lay it all out in public before the premium bad news is delivered.

With this kind of idiocy, I can see health insurance carriers simply withdrawing from the state. The regulatory environment there is already prohibitive resulting in exceptionally higher premiums to cover state mandates such as community rating and guaranteed issue.

It is amazing what elected (and appointed) officials will do to prove they are worthy.

Too bad the public isn't informed enough to throw them out of office.

Oy Canada, Part #786 (more or less)

One of the problems with gummint-run health care is that it tends to hurt most those whom it was designed to help. Case in point: Edmonton resident Debbie Trelenberg had a rather large tumor growing in her abdomen, to the point that she had difficulty dressing. And worse yet, it was diagnosed as a "high-grade ovarian cancer." With prompt treatment, this particular condition was survivable, but of course health care systems run primarily by government employees aren't really interested in speedy treatment (well, unless you're in Oregon, but that's another story).

So Ms Trelenberg waited, and waited, until she (like so many of her fellow countrymen) headed south, to the "broken system" called American health care. Once in Texas, she spent almost $80,000 of her own money to pay for neeeded surgery and follow-up. The good news is that, thanks to her prompt action (and deep pockets), she has an excellent prognosis. The bad news is that her bank account may have suffered a critical injury: she "has twice been refused reimbursement by the Alberta government, most recently in June, when the Out-of-Country Health Services Appeal Panel said a wait of about four weeks was not found to be unreasonable by the surgeon who initially saw her."

Did you get that last?

"(A) wait of about four weeks was not found to be unreasonable."

That may explain why Canada's cancer survival rate is so much lower than ours, and it certainly explains how such systems actually work. I'm thinking here of the first rule of holes.

Both the surgeon who operated on Ms Trelenberg and her own family physician wrote detailed letters to the gummint bean counters, explaining in detail why speed had been so critical, and asking for them to reconsider their refusal to reimburse her. Regular readers can already guess the response:

“There is no reason that we would send patients out of province just for faster access.”

Well said sir, well said.

Grand Rounds now available

Daniel Goldberg, host of Medical Humanities blog, presents this week's round-up of the best health care posts on the 'net. Each entry has helpful comments.

Do stop by.

Homeless Health Insurance

Help for the homeless. Free water bottles, $30 spending money.

Nice touch.

In exchange for what?

Participating in Medicaid & Medi-Cal fraud.

The cost to the taxpayer?

"Tens of millions of dollars".

But hey, it's only money.

Residents said recruiters, also known as runners, would call out like street salesmen for anyone who had a multicolored Medi-Cal eligibility card: “Red, white and blue! Let it do what it do!”

A little later, the vans would leave Skid Row bound for one of the three hospitals. Some of the homeless people would receive medical treatments, court papers said, whether they needed them or not.

Why rob a bank? Stealing from a government bureaucracy is so much easier.

Investigators said recruits often received no medical care at all, or in some cases received faulty health care, as in the case of one person, identified as Recruit X, who court papers said was “given a nitroglycerin patch for her non-existent cardiopulmonary condition.” The treatment caused a dangerous drop in blood pressure that made her ill, investigators said.

She was recruited repeatedly, court papers said, and for her cooperation was paid money that she used to buy crack cocaine.

At least she put the money to good use.

USA Still #1 (NOT an Olympics Update)

While folks on both sides of the ideological divide continue to debate the efficacy of gummint-run health care, it may be instructive to see just how ineffective it is when compared to our "broken" system's ability to deal with cancer. For example, folks in Canada have a lower cancer survival rate than we do. And our friends the French, whose system was recently lauded by the World Health Organization as "the best in the world" ranks below even our Neighbors to the North.

Perhaps most surprisingly, the MVNHS© ranked fifth (out of five!), with some of the lowest cancer survival rates in the civilized world. Keep that upper lip stiff, old chaps!

And who says so? Why, that venerable (and venerated) medical journal, the Lancet. Kind of difficult to cast them as water carriers for private health insurance.

The Health Care BS blog has a telling graphic that tells the whole story.

[Hat Tip: Elizabeth A. Terrell]

UPDATE: On a related note, many pro-socialized-medicine folks like to pull out that old canard that such systems actually have lower infant mortality rates than ours. Although we've debunked this before, it bears repeating: it's a canard because it's demonstrably untrue.

How's that, you ask?

Simple: we value each and every life, and so we count every live birth regardless of the baby's life expectancy. Under gummint-run systems such as those in Canada and Germany (among many, many others), "(l)ow birth weight infants are not counted against the “live birth” statistics...a premature baby weighing 500g." [ed: 500g is a little over 1 pound]

Here, of course, such preemies are considered worth saving, and we do count them, which tends to skew the stats. Add to that the fact that these systems don't count babies who live less than a day or so, even though they were, in fact, live births. And again, we do, which also throws off the number crunchers.

In fact, those bastions of civilization, the Swedes, don't count babies who are deemed "too short." And once again, we do, and suffer the statistical consequences.

Randy Newman, eat your heart out..

Single or Married?

Is it better to be single or married?

It depends.

A new study indicates single men are gaining on married men in terms of their overall health.

we learn that modern men don’t need a wife to tell them to eat their vegetables and go to the doctor

I suppose it means they can nag themselves.

Single people might have more time to party, but they also have more time to exercise.

Tough choice.

But there is this downside.

A study by the Karolinksa Institute shows that people who are married or living with a significant other have 50 per cent less chance of being affected by Alzheimer’s disease than those living alone.

Single or married?

You pick.