679 Thousand Die Due to Lack of Cable TV

[Welcome RedState and Industry Radar readers!]

We at InsureBlog estimate roughly 679,354 people died needlessly last year due to lack of access to cable or satellite TV. This is an appalling number and we are calling on Congress to do something to fix our broken television system.

Our study comes on the heels of a report by the NY Times which states that 22,000 people died in 2006 due to lack of health insurance.

So how did we arrive at our numbers?

The same way the "reporter" at the NY Times did.

The CDC reported that 2,426,264 people died in 2009. Encyclopedia.com estimates 67% of the population have cable TV and Direct TV reported 16 million subscribers or roughly 5% of the population.

Therefore, 72% of the population have cable or satellite TV while the remaining 28% suffer from lack of access to adequate television viewing.

Using the same kind of logic as the NY Times, we must assume that of the 2.4 million who died last year, roughly 1.7 million had cable or satellite TV leaving almost 680 thousand who died because they did not have access to full TV viewing.

We are calling on Congress to investigate the profits of the greedy cable & satellite company's and demand an explanation for their actions. How many lives could have been saved if everyone had the ability to watch unlimited TV without restriction?

It is clearly time to reform the way TV is delivered to the American public. The wealthiest nation on earth can send a man to the moon but cannot find a way to provide universal TV to its' citizens.

In 2008, roughly 46 million people in the United States lacked health insurance, according to the Census Bureau. The new report estimates that currently 68 adults under age 65 die every day because they don’t have (health insurance) coverage.

Compare this to over 1,860 who die every day because they do not have cable or satellite TV.

Clearly it is time to refocus our efforts on the REAL problem which is lack of access to universal TV. Wake up America. Cable and satellite TV can and will save lives.

Lies, Damn Lies, and Health Insurance

So, does lack of health insurance really increase the risk of premature death?

In a word: Nope.

As we've seen, there's no convincing evidence that lack of health insurance correlates to lack of effective care; in fact, certain kinds of health insurance will actually lead to a decreased life expectancy.

Studies which purport to correlate death with lack of health insurance have been routinely debunked, but that hasn't stopped the uber-liberal Urban Institute from continuing to peddle its faux-science:

"[A] new report warned that without comprehensive legislation, more than 275,000 adults nationwide will die over the next decade because of a lack of health insurance. Nearly 14,000 of those deaths would occur in New York State."

Of course, these numbers are based on a previously published (and debunked) study, so there's really no new ground here.

Or is there?

Fellow medblogger Megan McArdle, herself considered "uninsurable" [ed: bet she hasn't asked Bob or Bill for help], questions not just the numbers, but the underlying assumption that lack of health insurance necessarily means lack of health care:

" [W]hen you probe that claim, its accuracy is open to question. Even a rough approximation of how many people die because of lack of health insurance is hard to reach. Quite possibly, lack of health insurance has no more impact on your health than lack of flood insurance."

She points to increased risk factors of those who are uninsured, including smoking and obesity, that could also account for increased mortality independent of insurance status. She also cites research that seems to support the opposite view: that lack of health insurance has no bearing on mortality.

Controversial? Of course, but the numbers support this contention, as well.

Recommended reading.

Fox Alert!

No, not that Fox:

"(CMS) today directed Fox Insurance Company of New York to immediately suspend marketing and enrollment of new members in the organization’s Medicare Part D prescription drug plans."

Seems that the carrier, which markets Part D prescription drug plans, hasn't been playing by the rules.

While I'm not a fan of Part D plans, it's important to recognize that a lot of folks depend on them to help pay for needed medications. If you're a Fox insured, you may want to talk with your local, independent agent about alternatives.

[Hat Tip: CMS Guy Jack Cheevers]

Summing up the "Summit:" Shut up, they explained.

If this weren't so serious, it'd be funny. After all the hype and all the hope, yesterday's advanced bipartisan workshop has yielded this:

"Obama listened politely for six hours, with occasional flashes of temper, but in the end, the message was clear: It’s over. We’re moving forward without Republicans."

Hope they had a nice lunch for a change.

Stranded on Health Insurance Island

Health insurance coverage is portable, right? Most people think their plan follows them no matter where they go.

For the most part, that is true, but there are exceptions.

Especially if you live in New York.

Twenty years ago the NY legislature decided it was time to teach the health insurance companies a lesson. Tired of hearing complaints about those who could not obtain health insurance due to pre-existing medical conditions, they decided to reform health insurance.

The results were disastrous.

The bloggers at InsureBlog volunteer their time and expertise on consumer forums. Recently we encountered an individual that resides in NY but will take contract jobs in other states for extended periods of time. When his health insurance company learns that he is living in another state they cancel his insurance.

That's right. They cancel his insurance.

Why?

Because the state has created a health insurance island where only a few carriers are allowed, or willing, to operate. The regulatory environment is stifling which leads to LESS competition and HIGHER premiums.

This 20 year experiment SHOULD be a lesson for those trying to duplicate the idea of health insurance for everyone.

Unfortunately the folks in Washington are not paying attention.

Perhaps we should vote them off the island and extinguish their torch.

Live* from the "Summit"

Is Rep Paul Ryan (R-WI) a closet IB reader?

For years, we've been making the case that health care costs drive health insurance costs; in this clip from today's theatrical performance at Blair House, he explains why the President's "plan" does nothing to curb the former (while increasing the latter:



*Well, almost live.

About that "Summit" (ObamaCare© v?.0) ...

The current meme is that this morning's production will be more Kabuki theatre than substance. Personally, I think that's wrong: it's likely to be much more Noh than Kabuki.

In the event, for those of us who work for a living and find ourselves unable to break away, Dr. Robert Goldberg, President of the Center for Medicine in the Public Interest Advance, will be "live-tweeting" the goings on (so you don't have to).

His TwitterPage is here.

Have fun!

[Hat Tip: FoIB Lyndsi Thomas]

The Gipper on ObamaCare© v?.0

Someone once noted that the 10 most dangerous words in the English language are:

"I'm from the government, and I'm here to help you."

That would have been Ronald Reagan, who was a staunch supporter of personal responsibility. He was also no fan of gummint run health care:

Cavalcade of Risk #99: Safe Water Edition

Health Business Blog's David Williams interrupts a business trip to bring us this week's roundup of risky posts. From sex to insurance, you're sure to find something interesting.

A Lesson From Japan (via Fresno)

I don't profess to be a mechanical engineer (nor do I play one on TV), but it seems to me that there's a bigger issue in ToyotaGate than may seem obvious to the casual observer: when Transportation Secretary LaHood opined that one should completely avoid driving one's Toyota, sending an alarming signal to Wall Street and Main Street, he did it as one who has a vested interest in harming that automaker. After all, Toyota is a direct competitor of government-owned GM and Chrysler, who consistently rank behind Toyota in the sales department.

What better way to make a dramatic and immediate dent in the Japanese car company than to declare its vehicles unsafe, regardless of the truth (whatever that may be). If a financial advisor recommends a particular stock, for example, he's required to unambiguously disclose the fact that he owns part of the company issuing it. Why isn't someone in LaHood's position required to make the same "full disclosure?"

What does this have to do with insurance?

When the government runs both parts of the health care system - delivery and financing - then it has a vested interest in doing away with its competition. That's especially critical to the financing (insurance) side: as we've pointed out on numerous occasions, one cannot compete with the government.

We already see this in HHS Secretary Shecantbeserious' call for investigating Anthem's rate increases recently in the news. She (or her successor) will be in charge of all such approvals under the president's "plan." And of course many of us remember the joys of price controls.

If (when?) a version of the so-called "Public Option" is implemented, how can carriers hope to compete when the government is the final arbiter?

Scary.

Oy Canada!: Premier Update

Earlier this month, we reported on the Canadian Premier [ed: comparable to our "Governor"] who chose to ignore his country's fine - and FREE! - health care system in favor of one of those evil, greedy American providers. This blatant and unmitigated attack on socialized medicine came at a time when our own country is considering such a system, and undermines our efforts to nationalize our own broken and inadequate health care system.

Even more appalling is the reason this ungrateful pol gave for his decision:

"An unapologetic Danny Williams says he was aware his trip to the United States for heart surgery earlier this month would spark outcry, but he concluded his personal health trumped any public fallout over the controversial decision."

How dare he?!

Impugning the superior - and FREE! - Canadian system just because he wanted effective health care. And it gets worse:

"[H]e went to Miami to have a "minimally invasive" surgery..."

So one can't count on the outstanding - and FREE! - Candian system for even minor ailments?

Please remind me why this would be worth emulating.

Obamacare© v?.0: A Quick Update

■ It appears that the president's "plan" does, in fact, include federal funding for abortions.

■ The so-called "grandfather" provision, which was purported to allow one to keep one's current plan, is, in fact, no such thing: the requirements for such plans would render them unaffordable.

■ We haven't really discussed the issue of price controls in the "plan.' While one might consider this a bit odd given our history and theme, it's really not: there's no way to implement it without running up against the brick wall that is McCarran-Ferguson.

Is it dead? Well, we've discussed ZombieCare© before, but I wouldn't be betting the house (or the House) on its passage.

Grand Rounds: It's Alimentary!

Dr Michael Kirsch presents this week's collection of the best medblog posts. It's a lot to digest, but quite satisfying.

Obamacare© v?.0: Um, About Those Taxes....

Remember when Candidate Obama promised that no one who makes under $250k a year would see their taxes increase?

Well, promises were made to be broken:

"The president’s proposal would result in higher implicit tax rates on low-wage workers than the House and Senate bills.

The president’s proposal would result in greater incentives for higher-income workers to drop coverage than under the House and Senate bills. That would cause insurance markets to unravel even faster."

That's the word from FoIB Mike Cannon, Director of Health Policy Studies for the Cato Institute.

For more, click here for a livestream of a new forum detailing Obamacare© v?.0.

CBO Blog: ObamaCare© v?.0

So how much, exactly, is Obamacare© v?.0 going to cost us? The current figure being tossed around is "$950 billion over 10 years," which is some $75 billion over the Senate's Christmas Eve version.

But how accurate is that, really?

Turns out, not so much:

"Therefore, CBO cannot provide a cost estimate for the proposal without additional detail."

Ooops.

Tell me again about that "most transparent administration, evah!"

First Impressions: Much ado...

[NB: Bob’s take is here]

At first glance, the president's "new" health care "reform" proposal is just smoke. We'll address key points in a moment, but first, a question:

Where was this 7 months ago?

Were I a Congresscritter, having just spent the past many months fending off disgruntled constituents and jockeying for position amongst my peers, I'd be mighty steamed about now.

Fortunately, I'm not.

Several things immediately jump out:

■ No mention of federal funds for abortions, pro or con. The House's "Stupak Amendment" is nowhere to be seen, which will make it difficult for pro-life legislators to sign on. On the other hand, neither is such funding explicitly mandated, which will upset pro-abortion backers.

■ The evil and unconstitutional "individual mandate" is, however, present.

■ The CornHustler deal is officially off the table. No word yet on the "Louisiana Purchase."

■ The so-called "Cadillac Tax" is still there, punishing folks who have no control over the cost of their policies.

■ Finally, please explain to me why we need a massive new entitlement program to "to fight fraud, waste, and abuse in Medicare and Medicaid." Isn't that something we should be doing anyway?

If there's any "good news," it's that the so-called "Public Option" (the not-so-stealthy means to gummint-run health care) is nowhere to be seen.

More later.

[Hat Tip: RedState]

The Obama-Sebelius Health Plan

The much hyped proposal on health insurance reform has finally hit the web. You can probably find many versions, but the most concise and readable form can be found here.

So what new and exciting things are in this proposal?

Virtually nothing.

It is as if Obama and Sebelius failed to study for the final exam and instead decided to cheat by copying from the person sitting next to them in class.

Problem is, they are not copying off the smart kid's paper.

Most of the cost saving measures are just a rehash of what we have heard all along. Eliminate waste, fraud and abuse.

I have to ask, as I have been asking all along, why do we need a trillion dollar bill, or any bill at all, to make the government do what they should be doing all along?

Of course many of the provisions will increase premiums, and do so substantially, rather than making health insurance more affordable. Apparently the folks in DC haven't been paying attention to what happened when the NY version of Obamacare was passed 20 years ago.

Another provision that will increase premiums is the proposal to close the "donut hole" on Medicare Prescription Drug Plans. That means premiums for PDP coverage will increase, significantly in some cases. Wonder how the seniors feel about that one?

The one new wrinkle is federal oversight of health insurance premiums. Apparently the folks in Washington feel the states aren't doing their job and need big brother looking over their shoulder.

This is a pure political power play. If this idea is implemented it will backfire. Consider this.

If health insurance carriers are prohibited from obtaining rate increases at renewal, or those increases are unfairly limited to an arbitrary figure, guess what will happen. Any number of things including . . .

Carriers will simply withdraw from the market. This has already happened in states like NY where there are only a handful of carriers offering a limited choice of plans and none of them affordable.

Yeah, that works so well in NY let's take that idea and run with it in the other states.

Other options include reducing benefits on renewal. Yes, the premium increase is moderated but the true increase is offset by a corresponding reduction in benefits.

Another possibility is to eliminate the plan you have when it comes up for renewal. You cannot keep the plan you have but will be permitted to swap the old plan for this newer one with similar benefits but at a higher rate than DC allows.

These are just a few ways to deal with the stupidity of placating voters by offering them a plum that is rotten.

Of course if either Obama or Sebelius had ever held a real job in the private sector they would know that their plan is as bogus as a $3 bill and will never work.

That assumes they have the votes to get this through Congress.

I wouldn't bet the farm on that happening.

So one might ask if there is anything positive in the Obama-Sebelius proposal. Actually, there is.

Among other things they supposedly eliminate the special deals cut in the massive vote buying moves in exchange for support of the previous House & Senate bills. I applaud that and would suggest that they don't stop with this proposal but eliminate all these shady dealings that anywhere else would be a criminal act.

One other provision in this proposal is the expansion of Community Health Centers. This is a good thing.

The only complaint is they are only investing $11 billion for this program. That is one area where I would suggest an increase.

Of course it could be paid for by eliminating waste, fraud and abuse . . .

Drugs Fuel WellPoint Profits

[Welcome Industry Radar readers!]

The Obamahouse and media have seized on the WellPoint Blue Cross profits and are using the bully pulpit to drum up support for health insurance reform. ABC News provides some insight into the profit structure of WellPoint and for those who are paying attention, takes the hot air out of the Obama-Sebelius tag team attack.

Let's take a look at the ABC News interview with WellPoint CEO Angela Braly.

Q: How does WellPoint make its money?

A: The Indianapolis insurer made about $4.7 billion in 2009, a total stoked by the $2.2 billion it received from the sale of a pharmacy benefits management subsidiary.

Outside that, WellPoint made most of its money through employer-sponsored group health insurance. It reported $2.4 billion in operating profit from that segment last year, which amounts to about 58 percent of its total earnings.

The insurer has said it gets only about 10 percent of its operating income from individual health insurance like the kind it sells in California.

For sure, $4.7 billion sounds like a lot of money to the average Joe.

But so does a $1.4 trillion dollar deficit. I don't recall anyone complaining about that.

But I digress . . .

WellPoint made almost half their profit through the sale of a PBM subsidiary. MOST of their profit comes from employer group health insurance plans.

No one is complaining about that either. So what about those individual health insurance plans that have a target on their back?

Only 10% of their revenue, not profit, revenue, comes from the sale of individual health insurance.

The interview goes on to address why individual health insurance premiums in California will be increasing by double digits, and why businesses don't set prices based on profits.

Interesting read.

At least for those with an open mind.

Or those who don't have a personal agenda . . .

With Change Comes Consequence

Twenty years ago, when Obama was organizing communities, the folks in New York set about to reform health care. The L.A. Times summarizes the consequences of that decision.

The legislators had a simple goal. Pass a law requiring insurers to accept anyone, regardless of their health.

Decisions, and change, have consequences.

Premiums in New York are now the highest in the nation by some measures, with individual health coverage costing about $9,000 a year on average. And nearly one in seven New Yorkers still lacks health coverage, a greater proportion than before the law was passed.

The state has become a victim of a dangerous dynamic in insurance markets. Laws allowing consumers to buy insurance at any time often saddle companies with a lot of high-cost customers.

That in turn drives up premiums, pushing away younger, healthier people who are vital to a functioning insurance system.

So why isn't Washington talking about this?

Well, if you have to ask . . .

The law allowed consumers to buy insurance after they became sick with only a relatively short waiting period. They could also drop it when they no longer needed it.

The New York insurance market did not collapse, as some insurers had warned. But in the ensuing years, more older and sicker New Yorkers bought individual health plans. And premiums shot upward.

Since 2001, the average premiums for a health plan on the individual market in New York has nearly tripled, according to the state Insurance Department. In some counties, it is impossible to buy an individual plan for less than $12,000 a year.

But Obamacare is supposed to bring premiums down, not drive them up. Is there something they are not telling us?

Again, if you have to ask . . .

One might say that NY is an aberration.

Well yeah, you can say that, but it doesn't make it true.

In New Jersey, which enacted similar insurance rules at the same time as New York, researchers found that the regulations contributed to a 50% decline in enrollment in individual health plans and a two- to threefold increase in premiums.

Kentucky and Washington were forced to roll back their new insurance rules in the 1990s after insurance companies abandoned the state market. In Washington, the three largest insurers simply stopped issuing coverage to individuals.

But Obamacare is supposed to increase competition, bringing down premiums.

Yeah, that's what they are telling us, but just saying it doesn't make it true.

Changes have consequences.

Yes they can.

McCarran-Ferguson vs Sebelius

Once again, our dim-bulb Secretary of Health and Human Services has failed her civics test:

"Over the last year, America's largest insurance companies haverequested premium increases of 56 percent in Michigan, 24 percent inConnecticut, 23 percent in Maine, 20 percent in Oregon, and 16 percentin Rhode Island, to name just a few states."

So what?

That's a problem, obviously, for insured folks in those states; who are, fortunately, protected by their states' department of insurance. And that's the beauty of the system: if you don't like how that department's working (or not working), then you vote the suckers out. At some level, they're accountable to the electorate.

Furthermore, she can huff and puff all she wants but, at the end of the day, she has exactly as much authority over the carriers as they're willing to cede to her. It astounds me that their CEO's don't just tell her (and her congressional enablers) that they have zero authority to regulate at this level.

Of course, I'm just an insurance industry shill (but not a shameless one!), so I'm merely touting the company line, right?

Not at all:

"This spat deserves more attention, because its real lesson is what will happen to health insurance costs around the country if ObamaCare passes." [emphasis in original]

Really? How's that?

"Wellpoint's rate hikes are the direct result of the Golden State's insurance regulations—the kind that Democrats want to impose on all 50 states."

Case in point: COBRA subsidies (about which we've written extensively). Prior to ARRA, few people elected COBRA, most opting for individually underwritten (and usually much cheaper) health plans. ARRA essentially paid folks to keep their insurance, and run up claims. This had two major, negative effects: it increased carriers' loss ratios (thereby driving up health insurance costs) and accelerated health care spending (thereby driving up health care costs, which in turn increased health insurance costs). Wow, a two-fer.

Lost in all the publicity-mongering in DC is the fundamental disconnect the policitcal class has with even basic level economics: profits aren't profit margins, and it's the latter that truly count. Does this mean that carriers can't work harder to avoid dramatic premium increases? Of course not, but as long as the public demands first dollar coverage for strep tests and bruised knees, instead of considering high deductible plans, there's not a lot of wiggle room.

As Bob often points out, we don't expect our car insurance to pay for wiper blades and oil changes; just imagine how expensive it would be if it did. I would add only that one needn't imagine the result, one need only look at the current state of health insurance.

Cavalcade of Risk #99: Call for submissions

The Health Business Blog's David Williams hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 22nd). David 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

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

BTW, we still have an open hosting slot for April 21st - just drop us a line to claim it.

Volunteering for Long Term Care insurance

Although we've discussed LTCi before, it's always been about individuals buying these plans on their own. But that's not the only way one can buy a plan:

"According to Top Trends in Voluntary Benefits, a study conducted in 2009 ... revealed that 84% of employer-respondents indicated that they offer voluntary benefits ... Long-term care insurance placed third in the survey, with 51% of participating companies offering the coverage."

The idea is that one can purchase a policy on a perhaps more favorable basis this way (carriers often relax underwriting rules and offer discounted premiums for worksite products). There's also the perceived advantage of payroll deduction for your premiums, so you that don't have to write another check each month (or year).

The downside to these kinds of plans is that they offer a limited choice of benefits, and not all of these plans may be "portable" (that is, that one can keep the plan if one leaves that employer). Another thing to check when considering a worksite type plan is whether or no it's Partnership Compliant, which I believe will become more and more important as time goes on.

Still, it's certainly a viable option, and one to at least consider.

[Hat Tip: John Hancock Life]

Once Again, Facts Trump (DC) Fantasy

Consider this graph:

[Courtesy Innocent Bystanders]

Again, the light blue line represents what the gummint told us would happen if we didn't hurry up and pass the Spendulus; the dark blue represents how well the Spendulus was supposed to work, and the red line shows what really happened. Not a pretty picture.

And these folks want to run our health care system?

Somebody definitely inhaled.

Health Wonk Review: Relationships edition

Where can you find Kermit the Frog and Phil the Doctor discussing health care wonkery? At Brady Augustine's place, there's where!

Estate Tax, Estate Tax, Wherefore Art Thou?

Used to be, when one died with more than a few dollars in the bank, there would be an estate tax payable to Uncle Sam. Calculating in advance what that would be was, in fact, more art than science, but was an integral part of the estate planning process. Often, if an estate was sizeable enough, some form of life insurance would become part of the overall plan, since it would provide immediate and inexpensive dollars to pay the taxes due.

This year, there is no estate tax in place - at least not yet. The previous legislation expired, and Congress has yet to get around to replacing it (a sure bet, since dead folks don't complain). The problem is, no one knows if or when such legislation will be enacted, and whether or not it will be retroactive back to the first of this year [ed: I have a bridge in Brooklyn to sell to anyone betting against it]. In the face of uncertainty, then, what's one to do?

According to U S News and World Report, this failure to act "has moved from an oversight and embarrassment to a growing real-world problem. To recap: the estate tax was reduced over the past decade in a 2001 law that said estate taxes would disappear totally in 2010, and then return in 2011 in a very punitive form."

So is it a good idea to die in 2010?

Probably not (at least not any better than any other year): there's a little known but potentially devastating twist that seems to have gone under a lot of folks' radars: previously, beneficiaries ("heirs") were able to declare the value of that which they received on a "stepped up basis." That is, they would receive, say, a piece of land that was worth $1 million when their benefactor died, and their ownership would begin at that $1 million mark, not the $35,000 grandpa had paid for it:

"But as part of the end of the estate tax this year, this treatment of assets also was ended. Now, the value of the estate is subject to tax on the difference between its current market value and the value when it was originally obtained by the estate holder."

Ouch!

So absent either clear guidance on how estate taxes (if any) will be calculated, and absent this rather valuable treatment of proceeds received from someone's estate, a number of new issues arise: namely, how does one even begin to calculate how much to set aside (or insure) for potential estate taxes? And another, less obvious question, brought to my attention from the Director of Advanced Sales from a well-respected life insurer:

"No one knows what to advise a client to do. I've read several articles that advise anyone appointed executor of an estate to decline it. Then the court would have to appoint someone ... and then if that person declines [what then]? Don't know what would happen if the court couldn't find anyone to accept the job and the personal liability that goes with it."

Indeed.

[Hat Tip: FoIB Brian D]

Headache AND Breast Cancer Relief

Is there anything that aspirin can't do?

"Breast cancer survivors who take aspirin regularly may be less likely to die or have their cancer return, U.S. researchers reported Tuesday."

I think the first part of that sentence is incorrect: after all, isn't everyone's chance of dying 100%? Still, it's good to know that, in addition to staving off strokes and heart attacks, the lowly and inexpensive acetylsalicylic acid can help extend the lives of breast cancer patients and survivors.

Shame on the MVNHS©!

It's been a while since we've mentioned the failing (failed?) Much Vaunted National Health System:

"Information released by the ­Department of Health after a freedom of information request showed that hospitals were not complying with safety alerts issued by the National Patient Safety Agency (NPSA)."

The problem is that, while the British health system may talk a good game, implementing even such basic level services as patient safety seems beyond their ken. In this case, over 100 hospitals and other health care providers have yet to show that they've complied with a 2007 alert mandating them to make sure that injectables would be used safely.

But that's not all: over two dozen providers haven't confirmed their compliance with a directive "designed to reduce the risk of patients ­falling out of bed." And over 80 hospitals and providers had failed to take "required actions" outlined in patient safety alerts covering opioid (painkilling) medicines."

And even that's not all: some 50 hospitals haven't even figured out that keeping providers' hands clean reduces the number of patient infections.

Louis Pasteur is whirling dervishly in his grave.

What's the Billing Code for "Red Hot Lover?"

It's one thing for a physician to carry on an illicit love affair with a patient. While unethical and potentially dangerous, it's at least possible to understand the motivation. But in a case that redefines the term "chutzpah:"

"Dr. Daniel R. Lerom is listed in documents as having a long-standing sexual relationship with his Lakeland patient ... Each time the two had sex ... the doctor would bill her Blue Cross Blue Shield Insurance for their "sessions."

Oy.

Talk about overutilization!

No word yet from our Guru on whether this would qualify for reimbursement under an HSA or Flex Plan.

[Hat Tip: Ace of Spades]

A Good Deal, or Another Unethical Scam?

We've written before about both variable annuities and stranger-owned life insurance (SOLI), but some enterprising (?) investor types have figured out a new twist that combines these seemingly disparate vehicles:

"Terminal Illness? $2,000 in CASH, Immediately Available." ... "He recruited dozens of terminally ill people to, in effect, serve as paid fronts for purchases of the product, variable annuities."

Here's how it (allegedly) works:

The concept behind SOLI was relatively simple: offer to buy, and pay the premiums for, someone's life insurance policy. The insured reaped a quick and easy profit, and the buyer reaped one later (when the insured died). This perhaps typifies the concept of "moral hazard," but that's another post.

In the case of variable annuities, many (most?) such contracts contain a guarantee that one (or one's beneficiaries) will receive at least the amount originally invested. While this sounds a lot like life insurance, it's really not, because - in theory - there's no underwriting.

That is, the basic qualifications are a pulse and a checkbook. And the former need not be as strong as the latter:

"Because the products are sold primarily as investments, insurers generally don't ask about the health of the "annuitant," the person whose death triggers the death benefit."

Adding insult to injury (metaphorically speaking, of course), "some don't seek information about the buyer's relationship to this annuitant."

Since it's not technically an insurance policy (although it is an insurance product), the principle of "insured interest" doesn't seem to apply.

Generally, these products are bought as long term "investments," allowing the carrier to recoup potential losses. But if the buyer is, um, not long for this world, it could mean a very short term contract. And it's essentially no-lose for the "investor": if the underlying "investment" tanks, there's the death benefit guarantee. And if it does well, well...

And of course the agent (literally) who arranged the sale makes a nice commission (7.5% or more).

What makes this even more ghoulish is that the folks pushing the idea often promote it as endorsed by a particular faith. For example, one participant (it's really difficult to call her a "victim," since she profited, as well) was dying from stomach cancer when she "saw a flier from what appeared to be a Catholic charity, says her husband, Dan. Mr. Bulpitt says the family of four was on food stamps after he quit his auto-dealership job to care for his wife." She and her family received some $8,000 for her participation.

After the annuity was issued, someone (it's not clear whom, but obviously it wasn't the Bulpitt's) dropped a cool $1 million into it. When Mrs B died a few months later, the stock market had taken a tumble, and the value of her annuity was shy $13,000, which the carrier had to pony up. The only real "loser" here, of course, was the carrier; the Bulpitt's, the agent and the mysterious buyer all made out just fine.

To some extent, this is a function of how annuities have traditionally been built. The other side of the coin is that these same carriers routinely double-dip themselves: they price their life products to penalize smokers, but don't offer their smoker annuitants extra vig for a shorter expected lifespan.

One supposes that the ones with the most to lose in this equation are the stockholders of the carriers who've been targeted.

In the event, the The National Conference of Insurance Legislators is set to discuss this latest "twist" at their upcoming confab. It will be interesting to see what, if anything, they're prepared to do about it.

Or can.

Grand Rounds: The Hospital Edition

The ACP Hospitalist blog presents this week's collection of great medblog posts.

Premiums Rising - Iceberg Ahead

[Welcome Industry Radar readers!]

No, it is not your imagination. If you are trying to buy health insurance you are going to find it pricier and harder to qualify. Premiums for new health insurance plans are jumping 6% on a quarterly basis in some cases. Renewals on existing major medical coverage for individuals and families are trending at 20% in many cases. Group insurance plans for business owners are looking at 30% increases on renewals and new business rates are also higher.

In addition to higher rates, underwriting of health insurance for individuals and families is getting tougher and taking longer. Health insurance companies are almost routinely requesting doctors records before making a decision on your application and in some cases are refusing to approve coverage if you have not had a physical exam in the last 12 months.

Medical conditions that in the past were either considered a "standard" risk or elicited a nominal upcharge in premiums are now become major stumbling blocks.

We have entered a "hard" market for health insurance.

Many of the economic factors that affect businesses in the mainstream are filtering down to health insurance companies. All health insurance companies are seeing a noticeable drop in enrollment and those who are applying for health insurance are generally in poor health. Those who have individual or family health insurance are dropping coverage altogether if they consider themselves healthy.

What is left on the books are generally those who are sicker which raises claim costs relative to premium income.

Toss in the folks who opted for COBRA that normally would not have if not for the ARRA subsidy and the health insurance companies have a mess on their hands.

Insurance companies that cater to the group health insurance market are seeing participation in COBRA plans double or more. While that block was never profitable, it is even less so now and is gradually becoming a larger portion of their overall block.

In spite of what you may hear from the media and politicians, profits are being squeezed and the only way to maintain financial solvency is to increase premiums and when allowed, tighten underwriting criteria.

Here in Georgia we are seeing rates on the rise and it is becoming more difficult to get an individual or family health insurance policy issued. I would estimate at least 90% of health insurance applications are either denied or issued at something other than standard rates. Some carriers have told us they are rejecting 40 - 50% of applications for coverage.

A lot of those people come to me for assistance. Not too long ago I would review a risk profile for a prospective client, pre-screen that profile with a handful of health insurance companies, and then we could make our choice.

I still do that but I am also finding that I have to submit an application to two or three insurance companies before we get an acceptable offer.

Until the economy turns around, and it is not showing any signs of doing so, anyone looking to buy affordable health insurance in Georgia will be disappointed in how difficult it has become. No amount of rhetoric or tax dollars from Washington will cure our problems until consumers and business owners have confidence in the future of the economy.

When consumers have confidence and the ability to make purchases other than the basic necessities, businesses will start to hire and expand. We don't have a credit crisis, we have a confidence crisis. All of this is spilling over to drive up the cost of health insurance which only serves to fuel political flames.

We still have the ability to help clients find affordable health insurance in Atlanta, but it is just getting more difficult every day.

Boost Your Immunity With Sex

Consumer Reports that sex can relieve pain, elevate your mood and boost immunity.

The first two are a given. The third is a bonus.

In addition, any form of exercise burns calories and strengthens the heart muscle. And, of course, as with all forms of physical activity, the longer and more often you do it, the better.

Works for me.

Carnival of Personal Finance: Fiscally Faulty Famous Families edition

Len Penzo presents this week's roundup of financial responsibility (and irresponsibility) posts, featuring (among others) Mike Brady and Carrie Bradshaw.

Health Insurance Costs Increase: One More Reason

"Lost the remote control and can't be bothered to get up to change the channel on the TV? Don't worry, you're not lazy, you simply have sluggish cognitive tempo disorder."

Yup, you're not a "couch potato," you're a "low energy reclining unit."

The American Psychological Association, which compiles and publishes the "Diagnostics and Statistical Manual of Mental Disorders," even thinks that incessant whining is a mental disorder, worthy of therapy and treatment.

As opposed to just, you know, "dealing with it."

Of course, now that everyday travails merit diagnosis of mental illness, more meds will be dispensed - paid for by your insurance company, increasing utilization and, of course, rates.

Just how valuable are these new diagnoses?

"Richard Bentall, professor of clinical psychology at Bangor University, said: 'Most of these diagnoses are meaningless and have no basis in science.

'But the more disorders there are, the more private business psychiatrists get.'"

Give the man a cheroot.

[Hat Tip: Ace of Spades]

Genetics and ESRD: An Israeli Breakthrough?

End Stage Renal Disease (ESRD) afflicts some 40 million Americans; of thse, some half million are considered terminal. Interestingly, "African and Hispanic Americans [are at] a double-to-quadruple risk for the disease, compared to Caucasians of European ancestry."

But that may all change:

"An Israeli research team ... has discovered new genetic data on a DNA region that could predict who will develop end-stage kidney disease."

Knowing what causes the dread disease is a first step towards developing a treatment protocol for it, and (perhaps) a cure.

Good news.

How Much Do You (Really) Need?

Recently a client asked me about increasing his life insurance coverage. As a retiree, his former employer had offered him the opportunity to purchase additional group term life coverage. I have some reservations about Group Term Life (GTL) in general, but that's another post. Suffice it to say that it offers a seemingly inexpensive way to buy more life insurance, which is a good thing.

Or is it?

Let's step back and look at what this offer really means.

First, some facts about the GTL plan offered to - let's call him Sam. Sam's in his early 60's, quite healthy and active. The plan he was offered was for $50,000 of group term insurance on a guaranteed issue basis (i.e. no medical questions, he can't be turned down). The initial rate would increase by about 50% per thousand dollars of coverage once he hit age 65. Sam asked if I could offer something comparable.

I replied that I would be happy to look around for him, but that I wasn't aware of any carrier that would offer him a guaranteed issue plan such as this one on an individual basis. At the very least, there would be some health questions. I also pointed out that the flip side of this is that, since the GTL plan takes everyone, regardless of their health, it should be easy to find a less expensive alternative; certainly one that didn't double its rates in less than five years.

Sam responded by telling me that the GTL rates increase again at age 70 by about two and a half times, while the benefit itself decreased by half. Ouch! As he pointed out, "so $50,000 of coverage costs 2.5 times as much at age 70 and results in only $25,000 of coverage. Not a great deal!"

Not much one can add to that.

But that still wasn't the most important point Sam made. In the very next sentence, he hit the nail squarely on the head: "You know the real question is how much coverage do you need? If I were to pass away today, the coverage we have is adequate to cover all of our debt. That would leave [my wife] with her current income, her pension when she retires, my social security survivor benefits, her social security, my pension survivor benefits ... and our savings/investments."

And that's the $64,000 question: How much life insurance does one need?

It's often considered blasphemy to state that a client (or potential client) has "enough life insurance," but I think that, rare as it may be, some folks do, in fact, have "enough." As agents, we're always tempted to suggest more, but the reality is that there really is a point at which it's just not necessary. For my more mature (isn't that so much nicer than "older?") clients, I suggest looking at all the things Sam mentioned, plus whatever final expenses might be, and whether or not there's a need to cover estate planning issues. And take a look at your current policies to see if they're sufficient - they may well be.

Of course, the other side of that coin is that I've never had someone reject a claim check because his/her spouse had "too much insurance, and I really don't need or want any more money."

In the event, Sam's still trying to decide whether or not he needs additional coverage. Whatever the outcome, he's done himself (and perhaps others) a real service by asking that most important question.

And *Another* PSA: Preventable Infections

One of the primary reasons that health insurance costs rise is because health care costs do. And one way to reduce the cost of health care (and thus health insurance) is to stay healthy. As I was reminded by Barbara Dunn of Kimberly-Clark-sponsored HAI Watch. Barbara tells us that their "goal is to eliminate these preventable illnesses and their often tragic consequences."

Learn more about how you can help prevent the spread of potentially deadly infections by clicking over to HAI Watch now.

Special Announcement: TeamUSA @ The Olympics

Got this in email from TeamUSA's Liza Peiffer:

"This Friday February 12, the world will gather to watch top athletes from around the globe compete in the Winter Olympic Games in Vancouver. Our athletes from Team USA ... will take the stage to represent our country. I'm hoping that you could share the news about Team USA with the readers of Insure Blog to get some excitement going.

Anyone who registers on Teamusa.org will have access to the latest info and will receive exclusive updates throughout the games. I've put all that information including some Team USA widgets and banners into this social media news release."

Let's support our great athletes. Thanks!

Is "Heavy" the "New Normal?"

[Welcome Industry Radar readers!]

Last fall, Mike reported that the MVNHS© really doesn't like moms (new or otherwise) with a little meat on them. In fact, the compassionate folks who run Britain's national health care system actually removed children from the home of one zaftig mamma.

Did they go overboard?

Well, according to researchers Down Under, "an average 140-pound woman gained 20 pounds across 10 years if she had a baby and a partner; 15 pounds if she had a partner but no baby; and 11 pounds if she were childless and without a partner."

In other words, it's apparently perfectly normal for mom's (married or otherwise) to gain a few pounds. Whether that's by design or happenstance, it's potentially good news for a lot of folks.

We'll Take a Pass: Piling on

Last week, we reported that both Louisiana and Virginia are planning to opt themselves out of ObamaCare©.

Well, you can now add The Gem State to the (growing) list:

"The "Health Freedom Act" ... would require Idaho to sue the federal government over any health insurance mandates."

It's passed the Idaho House, and now heads for that state's Senate. We'll keep you posted.

When is a Death Benefit (not) a Death Benefit?

Most life insurance policies pay a death benefit when one dies, regardless of cause (absent fraud, of course). Some plans include an "accidental death" rider, which doubles the amount paid in the event of death due to an accidental injury.

[ed: I've never understood the appeal of such a rider: how likely is it that a surviving spouse needs twice as much money if one's hit by a bus instead of dying slowly of cancer?]

And there are some policies which only pay if one dies an accidental death: called "accident plans," these are usually inexpensive (for good reason) because they don't have to pay out after, say, a long and expensive illness. Again, I fail to see the value in such plans, but folks do buy them.

Which brings us to the topic at hand: what, exactly, defines an "accidental death?"

"Your spouse goes into the hospital for surgery and winds up dead ... Are you entitled to collect?"

According to a judge in New York, "yes." In this case, a woman went in for surgery, the gas-passer screwed up, and she died of complications. The judge determined that this met the definition of "accidental death."

His is not the last word: other jurisdictions have ruled the opposite.

What do you think?



(Poll open until 2/28/10)

[Hat Tip: FoIB Fred W]

Cavalcade of Risk #98 is up!

John Leppard hosts this week's roundup of "the best risk-based writing on the web."

Early February NewsLinx

■ Patrick Paule sent us this link to an interesting - if infuriating - story on how the Obamastration has decided, against all precedent, to ignore the recommendations of Medicare Trustees.

Why should you care?

Well, the Trustees' projections regarding the long-term growth of health care costs underpins its own projections, and ignoring it in the budget is a recipe for potential disaster.

■ Over the weekend, the Wall Street Journal had an interview with WellPoint CEO Angela Braly. WP is currently the "largest U.S. commercial health insurer by membership ... [its] affiliated health plans in 14 states cover 34 million people—or roughly one out of nine Americans."

They also contract with some 8 in 10 of our country's primary care doc's, as well as more than 9 in 10 of its hospitals. That's a lot of providers. By contrast, Medicare can boast of only about 75% of physicians.

Ms Braly must be a closet IB reader, as she concludes (quite correctly) that "[h]ealth-care reform" soon became "health-insurance reform" exclusively. It was a pivot that was—unfortunate ... because it is not going to solve the longer-term problem."

Indeed.

■ Late last week, we received an "embargoed" news item from CMS (the gummint agency responsible for Medicare and other programs). We honored their request, and held off reporting this rather startling news:

"Growth in national health expenditures (NHE) in the United States is expected to have increased faster than the growth in the Gross Domestic Product (GDP) last year."

On the other hand:

"The projected acceleration in growth for 2009 was due in part to faster spending growth for the Medicaid program ... reflecting increasing growth in enrollment associated with the recession. Also contributing to the acceleration was faster growth in the use of a variety of health care services as many sought treatment for the H1N1 virus and an expected increase in the take-up rate for coverage provided through ... (COBRA) in response to the government's subsidization of COBRA premiums."

So let's get this straight: health care costs rose because more people sought treatment, and health expenditures rose because more people lost their jobs and looked to the (few?) remaining taxpayers to subsidize their health insurance costs?

Yet we have folks who think that having the government actually run the entire health care delivery and financing system would solve the problem?

What's in the water?

Hail Obama [UPDATED and BUMPED]

[Welcome Industry Radar readers!]

[Scroll down for update]

HHS Secretary Sebelius seems to be "hailing" the chief in her comments on proposed rate increases by Anthem Blue Cross.

The Obama administration is asking why Anthem Blue Cross is raising its health insurance rates by nearly 40 percent for some California customers while making handsome profits -- and is pointing to the rate hike as evidence of why health care reform needs to pass.

Seems to me it is evidence that Blue is doing something right. In contrast, the folks in Washington can't balance a budget. So who are they to be giving financial advice on how to run a company?

"These extraordinary increases are up to 15 times faster than inflation and threaten to make health care unaffordable

Sebelius and the folks in Washington either do not understand, or care, that there is no relationship between the overall rate of inflation and health insurance premiums.

So how does Washington deal with the rising cost of health care?

They cut reimbursement to medical providers.

Looking at the picture again, maybe it is not "hail Obama". It could be "up yours".

UPDATED and BUMPED:

It seems that HHS Secretary Sebelius as well as the White House feel they have the ability to interject themselves in a matter where they have no jurisdiction. To the best of my knowledge, the federal government does not have the ability to involve themselves in rate setting which is still the domain of the states.

Did Congress pass enabling legislation transferring control to the fed's while I was asleep?

COBRA/ARRA Extension Update

We'd be remiss if we failed to remind folks that the famed COBRA/ARRA Subsidy has been extended (along with more and more folks' status as unemployed), The good news for those affected is that "[e]ligibility for the subsidy now runs through Feb. 28 ... and the duration of the subsidy can be up to 15 months. For state continuation, the length of the subsidy period depends on a particular state’s current continuation legislation. "

That last refers to states with so-called "mini-COBRA" regs.

There are, of course, a lot of reasons to stay on COBRA when one's (former) employer is footing most of the bill; still, if one is healthy, it's usually best to get off of such a plan as quickly as possible (again, taking the subsidy into account). It's a shame that there's no mechanism to, well, pay folks to get their own plans.

Unless I'm missing something?

[Hat Tip: UHC]

Grand Rounds: Thoughtful Edition

Dr Edwin Leap jumps into his edition of this weekly roundup of the best medblog posts with enthusiasm and insight. Well done.

Prescient Carrier Tricks

Today's McPaper reports that almost 3 years ago, State Farm warned the Feds that there seemed to be some "sudden acceleration" issues with some Toyota and Lexus models. The Bloomington, Illinois-based insurance behemoth "notified NHTSA in late 2007 that it was seeing an increase in sudden acceleration trends with other" vehicles from the Japanese automaker.

A decade before that, State Farm also led the way in "identifying the increasing trend of tire tread separation" which then plagued Ford and Firestone.

Kudos, Good Neighbor©!

Pre-paid Death Taxes?

One of the varied uses of permanent life insurance is to pay estate taxes at a discount (since insurance dollars never cost as much as "real" ones). FoIB Joe Kristan takes that a step further, reporting on a proposal that would allow non-dead (not to be confused with "The UnDead," or the Grateful Dead) to prepay their estimated "death taxes."

Interesting proposition, and definitely worth reading.

Ethical Conundrum or Disgusting Scam?

"A Dignitas doctor in Zurich reviewed the Peninous' case and agreed to write a prescription for sodium pentobarbital, the lethal drug typically used for assisted suicides ... They paid Dignitas its fee of ($10,500).

The suicides took place not in a private medical facility, but in an industrial space next to a large brothel ... just two spare rooms without a bathroom. He says two Dignitas volunteers, neither a doctor, helped prepare the couple. There was just one single bed, forcing Mr. Peninou to sit in a chair near his wife when the couple took the lethal dose."

I realize that this is a lot of quoting without much comment (so far), but please bear with me just a bit longer:

"[Ludwig Minelli, founder of Dignitas] argues that anyone—the chronically ill, the mentally ill or those who are simply tired of living—deserves help to end it all."

"Chronically" ill? "Tired of living?" These are legitimate, justifiable reasons to encourage folks to commit suicide?

Or are they, instead, a sales pitch for a few dollars worth of chemicals?

I know what I think.

Tranny Deduction Update

Several summers ago, we wrote about a "57-year-old suburban Boston man [who] underwent a sex-change operation ... wrote off the $25,000 in medical expenses on her [his?] taxes ... But the IRS disallowed the deduction."

Flashing forward [ed: was that really necessary?], we learn that the "U.S. Tax Court ruled Tuesday that a Massachusetts woman should be allowed to deduct the costs of her sex-change operation."

While this may well have "broad implications for transgender people" (and again, do they really need to use the term "broad?"), it has even, um, broader implications for transgender folks who also have an "alternative benefit" plan (HSA, HRA, FSA). The general rule of thumb is that, if its deductable on your taxes, it's eligible for tax-advantaged reimbursement under these plans [ed: the relevant controlling authority is IRS form 213(d), which appears not to have been updated - yet - to reflect this new reality]. If that's the case, then it seems to me that we now have a whole new demographic that should be clamoring against a gummint-run health care system that would do away with many of these benefits.

Cavalcade of Risk #98: Call for submissions

John Leppard, proprietor of Healthcare Manumission, hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 8th).

John 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

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

Cutting Corners

First Tennessee did it, now Washington (state) wants to copy. Seems the folks in the great northwest believe the way to more affordable health insurance is to limit what the plan pays.

It's OK to get cancer but make sure you are well or dead in 90 days or less.

A few years back, Tennessee put in place a somewhat similar plan with an even lower annual cap ($25,000). As of 2007, the premium was about $150 a month.

Washington and several other states are struggling to maintain existing health-insurance plans for low-income people who don’t qualify for Medicaid, USAToday reported earlier this week. A program in the state that covers about 65,000 people will close later this year unless lawmakers come up with $160 million in new funding, the article said.

Keep in mind that Medicaid does not impose annual or lifetime caps on your benefits.

So if you are going to be sick in Washington better make sure you are also poor.

Mortgage Insurance: Old vs New

Back in the day, agents routinely sold "decreasing term life insurance" plans to help their clients' beneficiaries pay off a mortgage. The plan, written to coincide (generally) with the number of years on a given mortgage, had a fixed premium but a declining face amount. The idea was that, as the mortgage balance declined, so would the policy.

The most obvious problem with this approach was that the policy actually became more and more expensive with each passing year, as the same premium pruchased less and less protection. There were other problems with these plans, as well, but they remained a commonly used tool for a long while.

Today, we often use some kind of permanent plan (such as Universal Life) or "regular" term plan to cover mortgages. In fact, we often don't sell separate policies to cover a mortgage, but simply include it as part of a comprehensive package.

The problem with this approach is that it still only covers one risk: death. Of course, some people (but not nearly enough) own disability insurance, which can help pay the mortgage in the event that one becomes disabled. Another approach, which is currently being touted by Assurity Life, is to couple a Critical Illness benefit with a life insurance plan. In a video the carrier recently sent to its agents, Ken Smith (Director of Health Products) explained why this may be a good idea:

[ed: the video was distributed "for agent use only," so I can't embed or link to it here. I'll do my best to pass along Mr Smith's "pitch"]

Something like 25% of folks in the UK own a critical illness policy; of those, over 60% bought their plan as a means of covering their mortgage. After all, what's more likely to happen before one reaches age 65, death or a critical illness? Folks with life insurance protection only could face a very unpleasant surprise if they're diagnosed with cancer or have a stroke. Either of these would mean some major time off work, and an increased risk of losing the house while still very much alive.

According to Mr Smith, the cost of the additional protection is usually "less than the cost of a cup of coffee a day."

It was unclear to me whether Mr Smith was discussing a critical illness policy with a death benefit, or a life insurance policy with a critical illness benefit. I'm not aware of any life insurance plans already in force to which one could add a critical illness rider. Likewise, most CI plans don't have a death benefit. So, what's one to do?

Well, if one currently has neither, then a combination plan may be the best best. If one already owns the "old fashioned" kind of mortgage insurance (e.g. term life), then supplementing that with a separate CI plan may be the best bet. Either way, your first stop should be with a professional, independent agent who can help you sort out your options. It's one more way that insurance can help manage risk.

Why You Need Disability Insurance

'Nuff said:

Health Wonk Review is up...

Managed Care Matters' Joe Paduda hosts this week's compendium of all that's wonky in the wild, wild world of health policy and polity. It's a little late, but Joe does a great job of explaining why each post merits inclusion.

Do check it out.

Health News: (Don't) Make a Run for it!

For folks caught up in the fitness craze (and you know who you are!), there's something you should know:

"Researchers have discovered that the health benefits of aerobic exercise are determined by our genes - and can vary substantially between individuals."

Dang!

Turns out that, at least according to English researchers at the Royal Veterinary College [ed: so, are they talking about running dogs or running people?], about 1 in 5 of us get essentially no fitness benefit from excercising regularly. Which is not to say that it's necessarily a waste of time, but it does call into question some assumptions about health insurance programs that incentivize folks to excercise on a regular basis.

PSA: Toyota Owners' Alert [UPDATED]

While not strictly insurance related, folks whose Toyotas are affected by the recent recall are being urged not to drive them until they've been corrected:

"Department of Transportation Secretary Ray LaHood told lawmakers Wednesday that Toyota owners should stop driving cars affected by the recall and bring them back to the company."

This seems to me a pretty simple risk:benefit calculation (although it remains unclear how one is supposed to avoid driving a car and yet still deliver it to the dealer for service).

UPDATE (via Michelle Malkin): Secretary LaHood has now "walked back" his previous advice, explaining that "“What I said ... was obviously a misstatement ... My advice is if you have one of these vehicles, if you are in doubt, take it to the dealership today.”

Oh, well, never mind.

Ms Malkin also makes an important point about the inherent conflict of interest between a (largely) successful car company (Toyota) and those which the gummint now owns (GM, Chrysler). In fact, it is to Mr LaHood's advantage that Toyota's current problems may cause a decline in their fortunes; surely GM and Chrysler would benefit from a Toyota sales slump.

Which brings us to the larger point: a private sector company can not compete with the government. This is a lesson that must not be lost on those who continue to believe that a gummint-run health care system can coexist with a private sector one.

Sushi and Insurance

"The country is is straining under the twin burdens of an aging population and rising health care costs. At some point in the next two decades, retirees will outnumber active workers. Medical expenses per person have almost doubled since the 1990s and continue to rise."

Quick, to which country does the above quote refer?

If you guessed the US, you're not wrong, but you're not right, either:

Evan Falchuk, who provided us with the groundbreaking graph on health care costs and coverage around the globe, is referring here to Japan. Seems that this highly homogenous, incredibly ingenious, resolutely resourceful nation has much the same trouble with health care that we do. And even though their system is of the "universal" model, they have had little success is either curbing runaway health care costs or providing appropriate and timely delivery of care.

The whole article is well worth reading, but for me, the takeaway (carryout?) is simply this: "The equitable and affordable distribution of health care services is a problem across the globe."

That is, those who tout "universal" health care systems may think they're promising better, more affordable health care to a greater number of people, but they couldn't be more wrong.

[Hat Tip: Dr Val]