Wednesday, March 31, 2010

When Politicians Run Health Care

From National Review Online:

"I have compiled a series of facts about stimulus spending ... Democratic districts received one-and-a-half times as many awards as Republican ones."

So what has that to do with health care?

When unelected - and unaccountable - government bureaucrats control access to health care (not just health insurance), they get to decide who gets care.

And who doesn't.

When one registers to vote, one declares a party affiliation (or, in the case of Independents, non-affiliation). So the question arises:

How surprised will (should?) we be when "Democratic voters received one-and-a-half times as much health care as Republican ones?"

Inquiring minds want to know.

ObamaCare© and You: Late March MVNHS© Report

Now that ObamaCare© is the law of the land, what kinds of changes can we look forward to? For enlightenment, we turn our sights eastward, across the Atlantic to that leading light of nationalized health care, Britain's Much Vaunted National Health System©.

The Ambulance Dance

Pretty much by definition, a state-run and financed health care delivery system is going to mean rationing; one form is the controversial practice of "boarding;" that is, keeping patients outside the actual facility so that they're not counted as actual, you know, "patients." Once they hit the door, the meter starts running.

In its rush to reach the bottom of the health care barrel, the MVNHS© is now paying ambulance drivers "£38 [about $57 US] for every casualty that ambulance staff "keep out of Accident and Emergency" (A&E) departments after a 999 call has been made."

But we daren't call them "death panels."

[Hat Tip: Bob Vineyard]

■ Reconstructing Patsy

What's the difference between Pamela Anderson and Farah Fawcett? Well, one has had numerous "enhancement" procedures on a purely voluntary basis, while one suffered from cancer. A reasonable person would agree that there's no reason for health insurance, whether from an insurance carrier or the government, to pay for the former; after all, there was no pressing medical need for the former Bay Watch actress to further inflate her swimsuit.

On the other hand, few reasonable folks would begrudge a cancer survivor the funds and facilities to reconstruct what nature wrought in the wake of a devastating illness, particularly one with no known behavioral cause.

And yet, that's exactly what the MVNHS© has done:

"Mother-of-four Patsy Parsons had a large section of her left breast removed when she was diagnosed [with breast cancer] two years ago and was told she was entitled to have it rebuilt free of charge."

But it's the government, so they can change their minds, and one has precious few (if any) alternatives. In this case, the local hospital, under the control of government bureaucrats, has deemed her case "'low priority, routine' cosmetic surgery."

But of course.

What We Really Meant Was . . .

You would think that folks who went to law school, and even though they never really held a real job, would know how to say what they meant when it comes to writing a law that impacts 340 million people or so.

But apparently that is not the case.

CNN is reporting that the health insurance industry has beat their swords into plowshares are are now bowing before the Great Wizards of Obamaland.

In a letter to Health and Human Services Secretary Kathleen Sebelius, the president of America's Health Insurance Plans -- Karen Ignagni -- said the nation's insurance companies would not try to find loopholes in the new health care law.

Sebelius had sent a letter to Ignagni on Monday warning against any efforts by health insurers to avoid the new law's intent to halt the industry practice of denying coverage for children with pre-existing conditions.


Seems to me if the law had been written to include language to reflect the intent there would be no need for HHS Sebelius to come back and write an addendum.

Apparently her years as insurance commissioner were spent in a fog.

The provision involving coverage for kids takes effect on September 23, six months after Obama signed the bill into law, Sebelius said.

Now the game is going to get interesting.

How much will rates for children rise for policies effective after 9/23/10? Will it be 100%? Or maybe 300%?

Will the respective state departments of insurance be able to comply with that deadline in time to grant the new rate increases or will carriers simply stop writing plans that cover children after 9/23?

Let's watch the folks in DC start to squirm on this one.

Tuesday, March 30, 2010

Insurers Save ObamaCare© From Itself

As we recently observed, the "pass-anything-now" crowd managed to screw up one of the simpler components of ObamaCare©; that is, by failing to distinguish between those who are insured and those who are not, the effort left potentially thousands of children without access to guaranteed eligibility for insurance.

And so the "big, bad insurance industry," in the form of the AHIP (Association of Health Insurance Plans), has stepped up, and vowed to fix that loophole for the President and his minions:

"(I)nsurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year."

This is clearly a favor to HHS Secretary Shecantbeserious, because it saves her (and her staff) the embarrassment of trying to fix a brand spanking new initiative. While I disagree with AHIP's position (and hope that at least one or two carriers demonstrate enough spine to follow the letter of the law), I'm impressed that they're at least trying to what they (mistakenly) believe is "the right thing."

Grand Rounds - "Reform" edition

Evan Falchuk hosts this week's edition of Grand Rounds, focused primarily on health care "reform." It's a tremendous effort, with interesting and helpful links from pretty much every angle.

Monday, March 29, 2010

Passover 5770/2010

Tonight marks the first night of Passover. It's "early" this year (since our holidays are tied to a lunar calendar, it's difficult to know from year to year how close it falls to Easter). Passover is a celebration of freedom, which is in even starker contrast this year than last.

It's easy to get caught up in the politics and polity of the day, but this is a season of liberation from tyranny [ed: irony?], and of rejoicing in tradition and ritual. So to our Jewish readers: Chag Pesach Sameach!

And for all of our readers, a bit of perspective:

Blue Cross Blamed in Baby Death

The facts be damned, no reason to let a good story stand in the way of the truth, especially if it supports your cause.

The Star-Telegram posted a story about a newborn that was denied health insurance coverage due to a pre-existing condition. The story is tragic. No one will argue that. But just as sad is when someone leaves out relevant facts in order to advance their cause.

Baby Houston Tracy was born with a serious heart defect. Something called d-transposition of the great arteries of the heart. The paper reports the following.

Surgery would correct it, but within days of Houston's birth March 15, Tracy learned that his application for health insurance to cover his son had been denied. The reason: a pre-existing condition.

To those who want to advance a cause, in this case, health insurance reform, these few bits of truth are enough to fan the flames of revolt against the big, bad health insurance company.

But to those who know how insurance really works, something is missing.

But first, consider this.

Can a dead person apply for life insurance and be issued a policy? Is it possible to have an auto accident and then apply for auto insurance a few days later and expect the insurance company to pay for damages incurred in that wreck?

The answer is no.

But some would want you to believe it is possible to buy insurance AFTER you get sick and expect the health insurance company to pay for it.

Unfortunately for all of us, this is exactly what will happen once we get to 2014.

But for now we have a different set of rules.

In this particular case there are facts missing from the story. Nowhere does it mention if the parents, either of them, had health insurance at the time the baby was born. Nor does it mention if the mother was covered by Medicaid.

If either parent had health insurance prior to the birth, there would be no need to make application for health insurance. The baby would automatically be covered, including any pre-existing condition, as long as the carrier was notified of the birth within 31 days of the birth.

If the mother had Medicaid, not only would the cost of pre-natal care and delivery be paid for by the taxpayers, the child would be eligible for SCHIP from birth until at least their first birthday if not beyond.

Therefore it is logical to conclude that the parents were totally irresponsible and did not purchase health insurance in advance of the pregnancy, nor did the mother apply for Medicaid.

But who wants to read a story where the headline reads, "Parents Fail to Purchase Health Insurance, Baby Dies".

No, a much better headline is "Blue Cross Kills Newborn".

Friday, March 26, 2010

The REAL Costs of ObamaCare©

Viva ObamaCare©!

Let me get this straight: health care "reform" means taxing women for being women, providing for public funded abortions, and cutting benefits for seniors, while providing viagra to convicted sex offenders?

What could possibly go wrong?

NB: I will not approve, and will retroactively delete, any comments characterizing this maneuver as a "Republican trick." Why? Two words: "deem and pass."

Castrocare vs. Sicko

Thanks to Michael Moore and his "documentary" on Castrocare, the world knows that everyone in Cuba get's free health care. We recently discovered that Fidel likes the new Obamacare plan that will be coming soon to a mall near you.

But just how well does Castrocare work? Thanks to Professor Stern we find that the system doesn't quite live up to the campaign promise.

It seems that Castrocare is a two-tier system.

One is first class, reserved for the wealthy citizens and medical tourists that come for care and bring bundles of cash.

The other is for everyone else.

Then there is the real Cuban system, the one that ordinary people must use — and it is wretched. Testimony and documentation on the subject are vast. Hospitals and clinics are crumbling. Conditions are so unsanitary, patients may be better off at home, whatever home is. If they do have to go to the hospital, they must bring their own bedsheets, soap, towels, food, light bulbs — even toilet paper. And basic medications are scarce. In Sicko, even sophisticated medications are plentiful and cheap. In the real Cuba, finding an aspirin can be a chore. And an antibiotic will fetch a fortune on the black market.

A nurse spoke to Isabel Vincent of Canada’s National Post. “We have nothing,” said the nurse. “I haven’t seen aspirin in a Cuban store here for more than a year. If you have any pills in your purse, I’ll take them. Even if they have passed their expiry date.”

The equipment that doctors have to work with is either antiquated or nonexistent. Doctors have been known to reuse latex gloves — there is no choice. When they travel to the island, on errands of mercy, American doctors make sure to take as much equipment and as many supplies as they can carry. One told the Associated Press, “The [Cuban] doctors are pretty well trained, but they have nothing to work with. It’s like operating with knives and spoons.”

Somehow Michael Moore missed this side of Castrocare.

Perhaps the voters in our last election who wanted free health care missed the downside of providing coverage for everyone.

If you can't wait for Obamacare, go to Cuba. Just don't forget to bring a suitcase full of money so you can get that first class care.

Thursday, March 25, 2010

As I Was Saying: It's NOT About Health Care

In an earlier post, I opined that ObamaCare© is not, and never was, about health care, but about government control. By way of support, we heard from "noted right-wing tea-partier, Representative John Dingell (D-MI)," who explicitly stated as much.

Now comes another wing-nut, Sen Max Baucus (D:MT), who confirms my thesis:

"Too often, much of late, the last couple three years the mal-distribution of income in America is gone up way too much, the wealthy are getting way, way too wealthy, and the middle income class is left behind ... This legislation will have the effect of addressing that mal-distribution of income in America."

Still think this is about health care?

[Hat Tip: Ace of Spades]

Castro Likes Obamacare

"It is really incredible that 234 years after the Declaration of Independence ... the government of that country has approved medical attention for the majority of its citizens, something that Cuba was able to do half a century ago," Castro wrote.

That was Fidel.

His brother Raul had this to day about Castrocare.

Cuba provides free health care and education to all its citizens, and heavily subsidizes food, housing, utilities and transportation, policies that have earned it global praise. The government has warned that some of those benefits are no longer sustainable given Cuba's ever-struggling economy, though it has so far not made major changes.

In recent speeches, Raul Castro has singled out medicine as an area where the government needs to be spending less, but he has not elaborated.

But if it is free why will they have to spend less?

Is there a lesson to be learned there?

Sol-Tax, Bo-Tax and Ko-Tax

Who knew that ObamaCare© was so sexist?! Turns out, there are some pretty obnoxious new taxes built in, including:

■ A 10% tax on indoor tanning facilities. It's interesting to note that they've specified "indoor" facilities: a cynic might believe that this opens the door (so to speak) for an "outdoor" tanning tax. That's not so far-fetched, really: if they can make you buy health insurance, they can make you pay to go outside.

■ In a blatently sexist move, women will face a tax on certain monthly "necessities." Ostensibly, both men and women will also pay more for certain birth-control items. I thought the liberals' trope was "keep the government off our bodies and out of our bedrooms?" Guess not so much, anymore.

■ The "Bo-Tax" is apparently out - although you never really know with this bunch. Good news for Ms Pelosi, yes?

Under Pressure...

While I don't personally suffer from high blood pressure, I am considered a carrier. That's one reason that this video, from "Big Pharma" member Novartis Pharmaceuticals, may save some lives:

The complementary website has even more information and additional resources. Live well, be well, stay well.

[Hat Tip: BJ DeHut on behalf of Novartis Pharmaceuticals]

Wednesday, March 24, 2010

Cato Gets it (Way!) Wrong [UPDATED]

I am usually the Cato Institute's biggest fan, but in an email I received yesterday, they were completely off base:

"It makes intuitive sense that President Obama's health plan, which would expand health insurance coverage to an estimated 30 million currently uninsured Americans, would improve their health."

Um, no:

If they were trying to be tongue-in-cheek, then they failed utterly to accomplish their goal.

If, on the other hand, they were positing a thesis, then they were remarkably tone-deaf: there is nothing in this bill about health care - only insurance and policy. Nor was it ever designed to address either the delivery of health care or reining in the cost of that care.

Of course, for Nancy, et al, this is a feature, not a bug.

UPDATE: In the comments, FoIB Rick B takes me to task for failing to acknowledge various portions of ObamaCare© which seem to support Cato's position.

In rebuttal, I offer the testimony of that noted right-wing tea-partier, Representative John Dingell (D-MI):

"It takes a long time to do the necessary administrative steps that have to be taken to put the legislation together to control the people."

I rest my case.

Cavalcade of Risk #101: Up Down Under

Andrew at Oz Risk presents this week's round-up of risky posts. Make like a kangaroo and hop over to it!

ObamaCare© Can't Even Screw Up Correctly

As Bob notes below, "Coverage for Kids" is one of the few "benefits" that are supposed to come into immediate effect. Of course, this will result in increased premiums for those "children" (they're old enough to vote and drink, but still on Mommy and Daddy's policy?), but at least they can't be turned down for any pre-existing conditions, right?

Um, no:

"Under the new law, insurance companies still would be able to refuse new coverage to children because of a pre-existing medical problem."

Those already insured will have their pre-ex problems covered shortly, but those currently uninsured are likely to stay that way for a while. Gee, who could have seen this coming?

Handy Dandy Calculator

How much will taxpayers contribute toward the cost of subsidizing your health insurance? Inquiring minds want to know.

The folks at Kaiser Foundation have set up this handy calculator.

[Click pic for interactive calculator]

Of course if the amount you must pay after the transfer of wealth subsidy is still too much, you can pay the penalty for non-compliance.

We Have Ways . . .

Don't want to buy health insurance? No problem. The IRS will send you a tax bill. CNN reports the IRS may need as many as 16,000 new insurance police to enforce the law.

The penalty tax for non-compliance?

An adult who does not have health insurance by 2014 would be penalized $95 or 1 percent of income, whichever is greater, so long as the amount does not exceed the price tag of a basic health plan. But by 2016, the penalty increases to $695 for an uninsured adult, and up to $2,085 per household, or 2.5 percent of income, whichever is greater.

Let's see. Buy health insurance or pay the greater of $95 or 1% of your income.

According to USA Today the average family health insurance premium is 2009 was $13,375.

The U.S. Census Bureau reports average 4-person family income for the last 12 months is $60,298.

OK math whizzes, let's work this through.

Buy health insurance for your family and pay $13,375, or

pay a $95 penalty, or

1% of your income which is roughly $603.

Which of the following does not belong? $95 . . . $13,375 . . . or $603.

Of course the prez also said family insurance premiums would drop by $2500 or 3000%, whichever is greater.

Reality check.

Yes Joe, this really IS a BFD . . .

The Face of ObamaCare©

Do As I Say, Not As I Do

How many of us have heard this before? It is uttered as if to say, I am better than you, so I don't have to follow my own advice.

Regarding health insurance reform. The new bill signed by El Presidente is a game changer in a lot of ways. But guess who is exempt.

Federal government employees.

CBS News tell us this:

page 158 of the legislation, which appears to create a carve out for senior staff members in the leadership offices and on congressional committees, essentially exempting those senior Democrat staffers who wrote the bill from being forced to purchase health care plans in the same way as other Americans.

Those who drafted, and voted on the health insurance reform bill, don't have to follow the same rules they have imposed on the rest of us.

Seems a bit elitist, doesn't it?

As Speaker Pelosi said a few weeks ago, it’s only after this legislation is passed that we’ll truly find out what’s in it.

Truer words were never spoken.

Tuesday, March 23, 2010

Health Insurance Reform - 2010 Timeline

Perhaps you are wondering how the new health insurance reform legislation will affect you. So are a lot of folks. In spite of a year plus of haggling, we are just as much in the dark as we were when the backroom deals were done.

Here is our best guesstimate of what to expect during 2010. Using a list provided by WJLA, here goes.

Sets up a high-risk health insurance pool to provide affordable coverage for uninsured people with medical problems.

This is a national high risk pool. We have no idea what kind of benefits will be provided or what the premiums will be.

Neither does the White House, Congress or CBO.

Starting six months after enactment, requires all health insurance plans to maintain dependent coverage for children until they turn 26; prohibits insurers from denying coverage to children because of pre-existing health problems.

Health insurance premiums for children, and family plans that include children, will rise. Rough guess would be a 50% increase for children's rates. Could be higher.

If mental health parity is included, double the rates for children.

Begins narrowing the Medicare prescription coverage gap by providing a $250 rebate to seniors in the gap, which starts this year once they have spent $2,830. It would be fully closed by 2020.

Look for an increase in PDP or Medicare Part D premiums. Initial increases will be nominal but will accelerate over the next few years as risk is shifted from the individual to the insurance carrier.

Reduces projected Medicare payments to hospitals, home health agencies, nursing homes, hospices and other providers.

Unless "doc fix" is passed, expect increased difficulty in finding a PCP that will accept new patients.

Imposes 10 percent sales tax on indoor tanning.

Pay more for tanning services. George Hamilton will not be pleased.

Jumping into the pool...

Currently, some 35 states have some form of "high risk pool" for folks with significant and/or chronic health problems. They are expensive to "join," expensive to maintain, and continue to fail to address underlying issues.

But mostly, they're expensive.

And that's at the state level, where there's more direct electoral accountability.

One ObamaCare provision set to go into effect relatively quickly is a national high-risk pool. We'll have more on this and other provisions in the weeks and months ahead, but for now, here's your afternoon chuckle:

"Unlike some existing state high-risk pool programs, which can be expensive, the new program is supposed to keep rates closer to standard premiums paid by healthy people."


Will History Repeat?

The health insurance reform bill has been signed but the battle is not over. In the minds of many it has just escalated to the next level.

Even though the Democrat's acknowledge this bill does not comply with the wishes of the people they continue to say something was better than nothing. They voted for change but it remains to be seen how well this will be received over the next few months as the economy continues in a tailspin, jobs are lost, homes and commercial buildings are foreclosed and more banks than ever fail.

Health insurance reform may not be the final straw, but it is certainly the wind that fan's the flames of discontent.

Those who know and remember political history will recall the Medicare Catastrophic Coverage Act of 1988.

The bill provided enhancements to existing Medicare coverage including a new, outpatient Rx benefit. Some of the cost of the changes would be passed on to Medicare beneficiaries.

All Medicare Part B beneficiaries must pay an extra $4 premium each month above the normal Medicare Part A premium. By 1993, the extra premium would have been $10.20 per month. All individuals who were entitled to Part A benefits for more than six months during a tax year and owed at least $150 in federal income taxes would also have paid a supplemental premium of 15% for each $150 for 1989, 25% for 1990, 26% for 1991, 27% for 1992, and 28% for 1993. For tax years starting after 1993, the annual limit would have been tied to increases in the costs of Medicare. The maximum supplemental premium would have been $800 per Medicare beneficiary, or $1600 per couple enrolled in Medicare for tax year 1989; $850 and $1700, respectively, for tax year 1990; $900 and $1800, respectively, for tax year 1991; $950 and $1900, respectively, for tax year 1992; and $1050 and $2100, respectively, for tax year 1993.

The gray panthers revolted and the bill was repealed the following year.

While many have focused on the changes that will affect under age 65 major medical, it is almost forgotten that significant changes will touch Medicare participants. Most notably, some of the free to almost free Medicare Advantage plans that have been so popular will be eliminated.

Will the torch and pitchfork crowd rise up again and force a repeal of Obamacare?

Stay tuned . . .

National Diabetes Alert Day

Today is Diabetes Alert Day, an effort by the Centers for Medicare & Medicaid Services to promote "increased awareness of the diabetes-related preventive services covered by Medicare."

Thanks to FoIB (and trusted CMS Guy) Jack Cheevers, we're pleased to provide links to some helpful, and important, resources for those with diabetes:

■ The MLN (Medicare Learning Network) Preventive Services Educational Products Web Page

■ Quick Reference Information: Medicare Preventive Services


■ Diabetes-Related Services Brochure

For even more information, be sure to visit the National Diabetes Education Program, as well as our favorite diabetes blogger, Diabetes Mine.

Celebrating Women: Grand Rounds is up!

Grand Rounds is now up over at Dr Bates' place. She does a great job with a theme that could have easily gone overboard.

Monday, March 22, 2010

An open letter to the Director of the Census...

March 18, 2010:

Dear Census Director:

I trust this comment will find you in good health – both good physical health and mental health. Frankly, you have created quite a problem for me, and many others, and I don’t how how to handle it without being in violation of your instructions concerning the 2010 Census. I trust my inquiry will not interfere with your mental health, but I feel compelled to ask a question. It is based upon the following:

On March 16th I received a letter from you stating, in part (in bold type yet) “Please complete and mail back the enclosed census form today. ” Clear enough, I opened the census form, and what do I find – Question 1: “How many additional people were living or staying in this house, apartment, or mobile home on April 1, 2010.” This is creating quite a problem for me – How can I mail back the form on March 20th (as you have instructed) which says how many people are living in my house on April 1.?

I am sure there are others with similar problems, so what do I do?

Please advise.

Thank you, in advance, for your courtesy.


P.S. – Is it true that you are being considered for the chief operating officer for Obamacare? You seem to be well-qualified.

The Will of the People

[Welcome Industry Radar readers!]

We will soon have a new health insurance program to deal with. Doesn't matter if you are rich or poor. Everyone will pay for it.

Health care, and health insurance, is not free. Never was. Never will be.

85% of the population already has health insurance.

This legislation was not about them. It was about the 15% who don't have health insurance.

To use a talking point, now 30 million Americans will have health insurance when they didn't have it before.

Think about it.

30 million.

Less than 10% of the population.

Most of those could well afford health insurance but would rather spend their money on other things. They just didn't want health insurance.

Until it was free.

Now they will take it because they believed it would not cost them a thing.

For about half of those, it will be free. Of the 30 million, roughly 16 million will be put on the welfare health care system known as Medicaid.

Most doc's don't accept Medicaid patients. The government reimbursement is low. Many of those on Medicaid fail to keep their appointment which further drives up the cost of care that is passed on to the rest of us. A doctor client who stopped treating Medicaid patients over 20 years ago commented that patients who don't pay anything for their care are more contentious and arrogant than paying patients.

That may be just him.

Or it could be the rule rather than the exception.

Others are waiting on that $2500 reduction in premiums.

And a chicken in every pot, a car in every garage.

All that is missing are the millions that will flow from a wealthy Nigerian to pay for this.

Smaller cars, bigger health insurance premiums and taxes, Poppa Washington.

ObamaCare Passes: So Now What?

Comedian Bill Bauer presciently - and sardonically - observed that "we have a winner." The victors in yesterday's historic, and pyrrhic, victory would be wise to remember that the new law of the land does nothing to curb runaway health care costs, except (perhaps) in the breach. For now, taxes and insurance premiums will rise, and essential services for our seniors will begin to evaporate. And those in dire health straits will not see a quick nor marked improvement in their care.

Had the bill(s) been about health care (not health insurance), then we would have seen consumer-centric products such as HSA's promoted, not gutted. We would have seen tort reform enacted, so that defensive medicine didn't continue to to so adversely impact health care and health insurance costs.

Time will tell, of course: the political blogs are abuzz with all the various options still open to those opposed to the destruction of the world's best health care system. We'll continue to concentrate on the insurance and health care issues for which we've become known, looking to the systems employed by our Neighbors to the North© and the MVNHS© for advanced warnings.

Saturday, March 20, 2010

The Public Be Damned

"Each time the President leads a big push for his health care plan, his job approval ratings suffer."

Interesting, eh?

In school I learned this: Throughout history and around the world, whenever governments long ignore or deny the will of the people and instead invent "legal" ways to force the governments will on an unwilling people, a democracy does not exist and a republic is not present. Freedoms begin to erode.

Now Congress has invented a "legal" way to deem the unpopular health care reform bill enacted, without even voting on it. So maybe the preceding paragraph is really worth thinking about as we await this Congressional action.

The Public be damned.

Color Me Red

About that health reform bill. The one that is supposed to be deficit neutral. The CBO says the "doc fix" to correct the cuts in Medicare put reform in the red.

The Congressional Budget Office said Friday that rolling back a programmed cut in Medicare fees to doctors would cost $208 billion over 10 years. If added back to the health care overhaul bill, it would wipe out all the deficit reduction, leaving the legislation $59 billion in the red.

The so-called doc fix was part of the original House bill. Because of its high cost, Democrats decided to pursue it separately. Republicans say the cost should not be ignored. Congress has usually waived the cuts to doctors year by year.

Like no one saw this one coming . . .

Friday, March 19, 2010

The Jobs Killer

According to the Washington Examiner, the folks at Caterpillar, the worlds largest manufacturer of construction equipment, have this to say about Obamacare.

Obamacare will take a huge chunk out of the American economy, so says Caterpillar, Inc., which said in a letter to House leadership that the bill under consideration would increase the company's health care costs by more than $100 million in the first year alone

Well yeah, but they are a big company. They can absorb that cost, right?

The Peoria-based company is one of many hard-hit employers in Illinois, which has an unemployment rate of 12.2 percent. It's delusional to think that adding $100 million to their operating costs won't make it more difficult to hire. In fact, this is exactly what 130 economists said in their letter to President Obama yesterday saying that the bill was unquestionably a job killer.

Do you think Washington could be wrong about the impact and real cost of Obamacare?

[Hat Tip: Lyndsi Thomas]

Cavalcade of Risk #101: Call for submissions

Andrew at Oz Risk hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 22nd). He would like to remind you to 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.

We're now scheduling for May - please drop us a line to claim your slot.

ObamaCare vs The 57

With perhaps a third of practicing physicians threatening to "Go Galt" should ObamaCare pass, it's easy to overlook another potentially devastating effect of this monstrosity:

"Nevada, Hawaii, New Mexico, South Dakota, and Georgia will see significant reductions in dollars available to fund Medicaid and State Children's Health Insurance Programs."

Well, unless their CongressCritters can wrangle (Rangel?) a CornHustler-type deal for themselves, as well. This dire prediction comes to us from the Pacific Research Institute (a San Francisco-based think-tank). According to an email we received recently from the PRI, "federal reform could cause more people to leave state-regulated private health insurance for either federally regulated private insurance, or government-run health plans."

The net result: “reduced revenues for states charging premium taxes on state-regulated health insurance."

The issue is that by (literally) making a federal case of health care "reform," ObamaCare is poised to (deliberately?) scuttle state-based efforts, and to directly (and negatively) affect states' revenues. The report singled out the handful of states mentioned above because of the disparate impact "reform" will have on them and its citizens.

A cynic might wonder whether ObamaCare backers would consider this a bug, or a feature.

[Hat Tip: Kelly Gorton]

Thursday, March 18, 2010

In a Nutshell, Part Deux (Or: 90 Seconds to Armageddon)

Everything you need to know about ObamaCare, in a minute-and-a-half:

The Future is Now

As my better half is fond of telling me, "there are no coincidences." Her point is that everything, no matter how seemingly insignificant, happens for a reason, a purpose.

I just experienced a "no coincidence" moment.

As is my wont, I had clicked over to read the latest at PowerLine, perhaps the most thoughtfully written political blog extant. A contributor had this to say:

"[T]he care-seeking population is about to become the Baby Boomers -- i.e., the most indulged, demanding and complaining generation in a hundred years, or maybe ever. The Dems are (apparently) fixing to take over medicine at exactly the time The Giant Complaining Horde shows up at the door ... people with money will still come out ahead ... knowing I had a potential problem, I paid $4,000 out of my own pocket for an exotic annual physical exam beyond what insurance would reimburse."

This is a critical point because, as my better half has also observed, "this [ObamaCare] isn't about health care at all, it's about control" [ed: yes, I often question whether the wrong one of us actually blogs]. That is, even if it passes, it won't address the underlying problems of health care and, indeed, will most likely exacerbate them by formalizing a two- (or even three-) tiered health care system. Currently, insurers can merely deny payment for a particular med or procedure; under a gummint-run system, the bureaucracy can actually withhold treatment. And then what?

Well, then one goes outside the system to one of the practices that has chosen not to participate. Think that's far-fetched? Well, here's the other part of the coincidence. After reading the latest from the Minnesota Boys, I clicked over to another favorite site, Jewish World Review, where I found this little tidbit from Dr Peter Gott:

"[A reader writes:] My present doctor charges $3,500 a year to see me four or five times to ask how I am feeling, which is a little much. He has been my physician for the past 15 years ... He doesn't take Medicare ... What's a gal to do?"

To which the good doctor replies:

"Sadly, this is the wave of the future. Five years ago, an article appeared in The New York Times regarding such services ... The woman was tired of sitting in the waiting room for extended periods and found the idea appealing."

As would anyone who actually wanted, and needed, health care. Of course, this still leaves the problem of catastrophic claims, but I have no doubt that we'd see a spate of new cat-only plans (a natural evolution, really, of high deductible plans) to handle those. And so those who choose to essentially opt out of ObamaCare (mandates or no) will still have access to care.

And we haven't even started talking about the coming boom in Medical Tourism.

ObamaCare in a Nutshell

[9/13/12: Welcome The Blaze readers! Please take a look around the site for other interesting posts]

From FoIB Matt H:
Let me get this straight......we're trying to pass a health care plan written by a committee whose chairman says he doesn't understand it,

passed by a Congress that hasn't read it but exempts themselves from it,

to be signed by a president that also hasn't read it and who smokes,

with funding administered by a treasury chief who didn't pay his taxes,

all to be overseen by a surgeon general who is obese,

and financed by a country that's broke.

What could possibly go wrong?

Just Say No (to Medicaid)

If Ali Obaba and the 535 thieves get their way, roughly 16 million folks will get their health care through Medicaid. The welfare health care program for the poor will see their rolls swell with new applicants. But what if these people have trouble finding medical providers willing to serve them?

Consider Walgreen's for example.

Effective April 16, Walgreens drugstores across the state (WA)won't take any new Medicaid patients, saying that filling their prescriptions is a money-losing proposition

Money losing proposition.

The company, which operates 121 stores in the state, will continue filling Medicaid prescriptions for current patients.

In a news release, Walgreens said its decision to not take new Medicaid patients stemmed from a "continued reduction in reimbursement" under the state's Medicaid program, which reimburses it at less than the break-even point for 95 percent of brand-name medications dispensed to Medicaid patents.

The government's idea of cutting the cost of health care is simply to pay less for services rendered. Doesn't seem like this is going to fly in Washington state.

Sounds like a problem to me.

Change you better believe in.

That Dirty, Dirty MVNHS©

Coming soon to a hospital near us?

"A quarter of NHS Trusts are compounding the risk of hospital infections by failing to meet core standards on hygiene."

So says the Brits' Care Quality Commission, as part of its ongoing audit of hospitals' compliance with basic standards set forth by the MVNHS©. On the other hand, at least the hospitals have their priorities in order: sure, the doc's don't always wash their hands, but the staff rigidly enforces rules against visitors sitting on patient's beds or (heaven forfend!) bringing them flowers.

Gee, can't wait for that here.

Health Wonk Review: March Madness Edition

Talk about brackets to fill! Minna Jung at the Health Reform Galaxy blog presents this week's roundup of great posts on health care policy and polity. Catch the fevah!

Wednesday, March 17, 2010

About that flushing sound you hear...

Thus far flying under the radar is one of the most important and far-reaching implications of ObamaCare, its delivery. That is, where, exactly, are the bureaucrats who'll be running the health care show going to find providers to administer the actual care of sick and injured Americans?

With millions - perhaps tens of millions - of newly "insured" citizens (and non-citizens) demanding health care services, one would think that there would be some thought given as to whom these folks would see for care.

One would be wrong:

"Nearly one-third of all practicing physicians may leave the medical profession if President Obama signs current versions of health-care reform legislation into law."

That's not some anecdotal "well, my doctor said he'd bail" kind of thing. That's straight from the folks who should know: The New England Journal of Medicine. The NEJM is hardly known as a bastion of right-wing ideology, so this should have an impact.

We'll have to wait-and-see if it actually does.

About that sob story... [UPDATED]

What is it with the folks behind government-run health care that they keep putting up fake "victims" of our current system? Natoma Canfield joins The Frost Family in the growing pantheon of "victims" that really aren't:

"[T]he cancer-stricken woman who has become a centerpiece of President Obama's push for health care reform, will not lose her home over her medical bills and will probably qualify for financial aid."

Turns out, Ms Canfield most likely qualifies for Medicaid, and of course there are any number of other state-run programs available to assist her. Not only that, but the provider, Cleveland Clinic, had already begin working with her regarding the funding of her care at that facility.

While this of course illustrates the perfidy of those bent on destroying the world's best health care system, it also highlights the fact that so many eligible folks don't avail themselves of the gummint-run programs that already exist.

There's the scandal.

[Hat Tip: FoIB Sarah S]

UPDATE: In the comments, Bob points out something I initially missed: "she had health insurance before she developed cancer, then voluntarily dropped the coverage." But it's actually even more muddled than that: in her letter to the president, she claimed that "with a maximum deductible of $2,500 she had to pay about $10,000 for care in 2009 -- while her insurance company paid just over $900."

And just as in the Frost case cited above, the White House and the media take her at her word. On its face, this claim makes no sense: if she had a generic co-pay plan, then her maximum out-of-pocket should have been in the $3500 to $4500 range; if it was an HSA style plan, even less. Under what kind of circumstances would she have had to pony up over $10,000 to the carrier's $900?

We don't know, but it's certainly a critical piece of information.

Tuesday, March 16, 2010

Health Insurance Premiums Drop 3000%

No word if this is in all 57 states or just the ones that Obama carried during the last election . . .

Is Tommy Flanagan writing Obama's material now?

Yeah, that's the ticket . . .

Who is the Biggest Loser?

Donna Simpson is proud of her plus size 600 pound figure and wants everyone to know it. Her 150 pound husband not only approves but is encouraging her to continue her pursuit of tipping the scales at 1000 pounds.

The 42-year-old from New Jersey, U.S, is set on reaching the 1,000lb mark (71st) in just two years. Remarkably she insists she is healthy, despite now needing a mobility scooter when she goes shopping.

Health, like beauty, is in the eye of the beholder. But the reality is, there is nothing healthy about weighing as much as 4 people.

Ms Simpson already holds the Guinness World Record as the world's fattest mother, when she gave birth in 2007 weighing 38stone (532 pounds).
She needed a team of 30 medics to deliver her daughter Jacqueline during a high-risk Caesarean birth.

30 medics? Doesn't sound healthy to me.

OK, let's cut to the chase. Someone this size didn't get this way because of a glandular problem or some metabolic disease. This was a conscious choice.

The article does not mention if she has health insurance or not but someone is paying for the high risk pregnancy and any other medical issues. Her care is either covered by taxpayers, those with health insurance, or both.

One thing is true. If Obamacare becomes law and she applies for health insurance companies will not be able to refuse coverage and the cost of her care will be added to your premium.

How is this change working for you?

HumanaVid: Staying Healthy and Medicare

We've long advocated personal responsibility as regards health care and health insurance; this short video underscores why keeping track of one's health can be a boon to both:

Monday, March 15, 2010

A Word about "Nomentum..."

Some time back, I was interviewed by a very nice lady from the NYT. She told me that she read IB "often," and found a lot of our information useful, but also mentioned that a lot of it seemed "inside baseball." By that she meant that we tended (still tend?) to be a bit wonky in what we choose to write about, and how we choose to write it. It's not a bad criticism, just acknowledging that we're in a fairly defined field.

One of the problems with being very "inside baseball," though, is that one tends to focus solely on the moment, at the expense of the big picture. And that's why we aren't constantly updating with the latest head count of "yea's" and "nay's" on ObamaCare. The only tabulation that counts is the one that will (might? won't?) take place on the 21st (or whenever). Until then, all the "he's switching to yes" and "she's switching to no" will drive a sane person crazy.

And we already do enough of that here.

Last, Desperate Measures?

Are we witnessing the death-throes of ObamaCare? Perhaps:

"Still seeking votes for his proposed health care overhaul, President Barack Obama appears ready to reverse his position and allow unpopular deal-sweetening measures in the hopes of finding Democratic support for legislation whose future will be decided in coming days."

"Deal-sweeteners" include "CornHustler" schemes that "could affect more than one state," the unconstitutional Individual Mandate, and premium subsidies for "poor and middle-income Americans."

None of these sound like strategies that would be understaken by folks who believe they actually have the votes to pass this monstrosity; rather, they appear to be a last-ditch effort to keep it alive.

And then there's this:

"The House Budget Committee on Sunday evening released text that will serve as the base legislation for the changes the House will seek to the Senate bill this week."

Interesting verbiage, that: "text that will serve as the base legislation."

So, technically, it's not "a bill" at all, but a roadmap. As we've seen from this excercise in futility, er, "transparency," it appears (although it's far from certain) that they've given up on the "Slaughter House Rule."

This is obviously meant as comic relief:

"The House is expected to approve the Senate's healthcare bill along with the package of changes. The Senate would then be expected to approve the package of changes under budget reconciliation rules."

Um, no they won't.

What's next?

Sunday, March 14, 2010

The Case of the 12 Percent Solution

Last summer, Bob made the excellent point that your health insurance may be making you sick. He noted that, because folks spend so little of their own money on actual health care (as opposed to health insurance), they were much more likely to avail themselves of medical services.

Now along comes Dr David Gratzer (senior fellow at the Manhattan Institute), who underscores Bob's thesis with some statistics:

"(F)or every dollar spent on health care in the United States, just 12 cents comes out of the individuals' pockets."

That's so important that it bears repeating:

"(F)or every dollar spent on health care in the United States, just 12 cents comes out of the individuals' pockets."

In short, almost 90% of our health care is paid for by someone else (or by ourselves, funneled through premiums and taxes).

Part of the problem is that so many of us rely on our employers for health insurance coverage. As Dr Dave points out, "(i)magine what food costs might be if your employer paid 88% of your grocery bill or what a trip to Saks might be like if your company covered the vast majority of the costs of the shopping spree."


Under ObamaCare, of course, it gets worse, since we wouldn't even have the choice of high deductible (or other alternative benefits) plans. And since Washington isn't exactly known as a model of efficient stewardship of taxpayer funds, well, imagine how lovely that 12% might sound a year down the road.

[Hat Tip: Lyndsi Thomas]

Saturday, March 13, 2010


The folks at Investors Business Daily wondered how Medicare would change if Obamacare becomes law. They interviewed Susan Berson of the Mintz Levin law firm in Washington, DC. She missed the first question, but managed to save most of the interview with later responses.

IBD: Let's start with the drug benefit known as Medicare Part D and the coverage void called the doughnut hole, where retirees pay full price for drugs.

Berson: Both the Senate and the House agree that the doughnut hole needs to be closed. That would be beneficial to retirees.
People in that doughnut hole can find it very difficult to afford their drugs. The Senate bill would reduce the out-of-pocket spending by creating a coverage gap discount program where seniors could buy drugs at lower cost.
The House bill would close the coverage gap over an eight-year period and provides for an initial discount in 2010-2011. As well, the administration wants to make generics more available. ... Industry agreements have extended the patent protection of branded drugs through minor changes in the formula or resulted in deals between branded pharma and generic makers that delayed generics from coming to market.

Closing the doughnut hole will only serve to make Part D plans more expensive for everyone, including those who use few or no medications. This is akin to other portions of Obamacare that require major medical insurers to offer coverage to anyone regardless of their existing medical conditions.

The effect of both of these provisions is an increase in premiums.

I also take issue with the comment that seniors can't afford their medications when they have to pay for them under the doughnut hole. Consider that Medicare Part D only came into existence in January, 2006 one has to ask what has happened in the last four years? Prior to 2006, seniors had to pay the full cost of their meds. With Part D they only pay a portion with the plan picking up the lion's share.

The rest of the answers listed in the linked Yahoo News article are on target.

Friday, March 12, 2010

Is March 18 Really *The* Day? [UPDATED]

As we've seen, those intent on destroying the world's best health care system keep moving the goalposts, date-wise. First it was last August, then it was Christmas, now it's March 18.

So, how likely do you think it is that we'll have the vote on the 18th?

UPDATE: Just wanted to note that our last poll about whether or not "
accident only" plans should pay out if one dies of complications from a surgery. And the results are:

Yes (by a margin of 53% to 47%).

Preference Cascades and Obamacare

Preference cascade: "in which people who have been obliged to conceal their true beliefs by social pressure or sheer force suddenly discover that a lot of other people feel the same way." For example: "everyone knows that x is our only real choice," until one learns that other folks have expressed a preference for "y.' It's really an extension of group-think or peer-pressure; we don't want to be "different" because we believe that everyone else thinks a certain way. Sometimes, though, other folks do agree with us, but we don't realize it.

What happens when that assumption is challenged? Debunked?

Well, then, we are liberated from this misconception and feel free to express our own, real opinion. When we begin to understand that we are not alone in our beliefs, and feel free to speak our minds without fear that we're the lone voice:

"At least 25 House Democrats will reject the healthcare reform legislation, according to a survey by The Hill, a review of other media reports and interviews with lawmakers, aides and lobbyists."

Is this "the end" of ObamaCare?


But it is probably the beginning of the end.

Thursday, March 11, 2010

And Now a Word From the Sponsors . . .

We now return you to your regular programming.

Told Ya So?

Again, I'm still not convinced that the beast is dead, but as we noted previously, the Reconciliation Route appears to be a dead end. That theory received some major evidentiary assistance today:

"The Senate Parliamentarian has ruled that President Barack Obama must sign Congress’ original health care reform bill before the Senate can act on a companion reconciliation package ..."

This is significant because, if true, it would appear to represent an insurmountable problem for House members who might have relied on the Senate's word that reconciliation would, in fact, occur.

For those gullible CongressCritters, I've got a bridge to sell you, too.

Piling on ObamaCare v?.0

Although I'm loathe to pronounce it dead, ObamaCare seems to be in the same position as its projected "recipients:" the operation was a success, but the patient died. The problem is that, as each special interest group demands its pound of flesh, the likelihood of any bill actually passing diminishes.

Case in point:

"A group of Hispanic lawmakers on Thursday will tell President Barack Obama that they may not vote for healthcare reform unless changes are made to the bill’s immigration provisions."


As readers may recall, the PelosiCare version of "reform" would bar illegals from receiving taxpayer subsidies to buy a policy from the new Insurance Exchanges. ReidCare goes even further, prohibiting illegals from purchasing through the Exchanges at all. The Hispanic Caucus, however, is threatening to hold ObamaCare hostage unless illegals are able to both buy from the Exchanges and to take money from those who are actual, you know, legal, taxpaying citizens.

Hasta la vista, baby.

[Hat Tip: Ace of Spades]

Where Have all the Doctors Gone?

In the 60's there was a popular folk song titled "Where have all the flowers gone?", written by Pete Seeger and performed by Peter, Paul & Mary. The song was a not so thinly disguised protest of the war in Viet Nam.

We could be singing that song in the not too distant future if Obabacare becomes reality. The lyrics would change to ask, where have all the doctors gone.

Kansas radiologist, Dr. Milton Wolf, has these musings on Obabacare.

Obamacare proponents would have us believe that we will add 30 million patients to the system without adding providers, we will see no decline in the quality of care for the millions of Americans currently happy with the system, and -if you act now!- we will save money in the process. But why stop there? Why not promise it will no longer rain on weekends and every day will be a great hair day?

No bad hair days indeed. Who would believe that?

Suddenly dumping (literally) 30 million new patients seeking free health care is a problem? Yes, it is free. POTUS said so.

In his latest campaign run to drum up support for reform he said every insurance company would be required to offer free preventive care to everyone.

By free, I suppose he means the docs and labs won't charge anything, which means the insurance companies won't have to build the cost of those services into their premiums.

The justification for Obamacare has been to control costs, but the problem is there is little in Obamacare that will do that. Instead, there are provisions that will ration care and artificially set price. This is a confusion of costs and price

There is also a confusion in health care and health insurance, but why quibble over details?

As one example, consider the implications of Obamacare's financial penalty aimed at your doctor if he seeks the expert care he has determined you need. If your doctor is in the top 10 percent of primary care physicians who refer patients to specialists most frequently - no matter how valid the reasons - he will face a 5 percent penalty on all their Medicare reimbursements for the entire year.

A 5% cut, on top of the 21% required cut in Medicare reimbursements. Gosh, sounds to me like Obabacare will cut costs after all. That has got to bring down the cost of treating Medicare patients. Right?

OK, so who is this doc going rogue on Obabacare? Surely some right wing whack job with an NRA membership.

Actually, Dr. Wolf is Obama's cousin.

Wonder if he voted for change in the 2008 election?

Oy Canada! PLUS MVNHS© Losing Steam?

Even as we rush headlong into the abyss that is ObamaCare, it would be wise to consider the (tragic) fates of those who already suffer under such a system.

First up, our Neighbors to the North©:

"Kent Pankow lives in Edmonton, in a province and a country that is trying to either kill him or bankrupt him ... Suffering from brain cancer, Kent Pankow was literally forced to go to the Mayo Clinic in Rochester, Minn. for lifesaving surgery."

Such is the nature of "free" health care: if the government provides it, the government can deny it. And by the way, that argument does not apply to insurance companies, which can, at worst, withhold only payment; they cannot withhold actual treatment.

In the event, Mr Pankow suffered from a fast-growing tumor which, had it been elsewhere in his body, would have been covered. He was doubly unfortunate, though, because the government-run health care system deemed him ineligible for treatment. Which doesn't mean they refused to pay for it (although that's exactly what happened), but that the unaccountable bureaucrats explicitly refused to grant him access to care. Death Panels, anyone?

Now, $106,000 later, the poor man gets hit again:

"[T]he province will now not fund the expensive drug, Avastin, that the Mayo prescribed to keep him alive and keep the remaining tumour from increasing in size."

Again, had the tumor appeared in, for example, his lungs or colon, the government would have provided this life-saving medication. In effect, they've condemned him to a slow and painful death.

Quick, let's do that here!

[Hat Tip: FoIB Peter Krieger]

Meanwhile, across the pond, the MVNHS© faces its own Death Panel:

"Hundreds of NHS wards to be shut in secret plans"

Turns out, the folks who run that other scheme of socialized medicine haven't figured out how to rein in the cost of health care, either. So they'll do what any other service provider would in the face of increasing red ink: cut back on the delivery of said services. Again, this is the heavy hand of a government-run system: they have the gold, they make (and enforce) the rules. Such a system is inherently unsustainable, as the headline above demonstrates.

So what do sick Brits do when their government shuts them out? Well, they turn to their own health insurance plans.

What, you didn't know that our Cousins Across the Pond have figured out the shortfalls of their public health system? They're not stupid:

"[O]ne of the main reasons for the current great value of Health Insurance Policies for UK citizens [both at home and abroad] is that British providers of health insurance are being pressed by their consumers [both current and potential] to make every saving possible."

Told ya so.

Barack O'Carter Praises Cuban Health Care System

Former prez Jimmy Carter in a speech at the University of Havana pimped the Cuban health care system by declaring the following.

“My nation is hardly perfect in human rights. A very large number of our citizens are incarcerated in prison, and there is little doubt that the death penalty is imposed most harshly on those who are poor, black, or mentally ill. For more than a quarter century, we have struggled unsuccessfully to guarantee the basic right of universal health care for our people. …but Cuba has superb systems of health care and universal education.”

And this guy wasn't even running for public office or making a movie!

Of course Carter is not the only one to be misled about the status of Cuba's health care system. Notables in the main stream media have also praised their system including Peter Jennings (ABC, 1989), Barbara Walters (ABC, 2002) and Katie Couric (NBC, 1992).

Contrary to the above “news analysts” and Human Rights spokespersons, Cubans have a drastically different story to tell. And even more unluckily for Castro and his MSM auxiliaries, the internet has pulled a stunning and (to them) infuriating end run around his traditional MSM defenses. Word is getting out about the disastrous state of Cuban health care.

During that cold snap in mid-January, Cuban dissidents snuck out, via internet, a report claiming that over forty patients had somehow frozen to death in Cuba’s Mazorra mental hospital — not far from the one featured in Michael Moore’s paean to Cuban health care, Sicko.

It appears the media and others have twisted the truth about universal health care in Cuba. Just 90 miles north of Cuba is where the truly greatest health care system in the world resides. Of course if you listen to politicians, nothing could be further from the truth.

Wednesday, March 10, 2010

On the Record with Joe Wilson (Again)

Late this afternoon, I had the privilege of speaking (again) with Rep Joe "You Lie!" Wilson (R-SC) about a number of issues, most prominently ObamaCare v?.0. Rep Wilson began by mentioning his new site, Joe Means Jobs, Rep Kucinich's "Retreat from Afghanistan" resolution, and the recent vote in Iraq (interestingly, they had a 62% turnout; we're thrilled to see 55%).

I was joined on the call by Jeff Dunetz of Yid With Lid and Richard Zuendt of Conservatives With Attitude. Both of these fine sites belong primarily in the political sector of the blogosphere (as opposed to IB, which is considered a MedBlog).

Both Jeff and I asked Rep Wilson about the late-breaking Slaughter "Rule" in the House [ed: the SlaughterHouse Rules?]. This is a desperate, almost laughable, attempt to bypass a formal vote on ReidCare (more here for those who are interested). Rep Wilson was unfamiliar with the details of this latest gambit by those bent on the destruction of the world's best health care system, but quickly came up to speed.

I asked the congressman about the dozen or so states taking pre-emptive action to opt out of a gummint-run system, and he replied that not only is he quite pleased, but that it is, in fact, an organized and concerted effort, led by the ALEC (American Legislative Exchange Council). ALEC is a group of state-level legislators working together on a national level.

The congressman also pointed out that the current version(s) of "reform" have been compared to both TennCare and MassCare, both failed systems. In fact, it's his contention (and one with which I agree) that MassCare is the overarching reason that Scott Brown was elected to the Senate.

Mr Zuendt (of Conservatives With Attitude) asked about the impact of "reform" on states' budgets, and Rep Wilson replied that these are classic examples of "unfunded Federal mandates."

I then asked him how firm he felt the vote on the 18th really was, and he answered that, much to his own surprise, he agreed with Rep Waxman that "there's not a date." Looks like I might have to reset (or delete) the countdown timer on our sidebar.

Following up, I asked about reconciliation; his response was to point me to a new report by Representatives Kyl and Cantor which effectively confirms our view on the matter. TThe Kyl/Cantor document can be found here.

Our own Mike Feehan had wondered about whether or not legislators would be bribed with stimulus funds, and Bob had wondered the same about other "favors;" Rep Wilson answered both of them by characterizing the current process as "The Chicago Way." That is, a combination of carrot and stick, regardless of legality or propriety, and felt it would backfire.

He was also quick to point out the value of blogs and social media for breaking through the wall of silence thrown up by the Main Stream Media. I'm sure we all blushed.

All in all, a very interesting call, and I appreciate the Congressman's time.

A very special IB Thank You to Lyndsi Thomas for setting this up.

Outstanding Carrier Trick: UHC Reads IB

According to an email I just received, the head honcho of United HealthCare (along with four other industry titans) recently met with HHS Secretary Shecantbeserious, as well as some folks from the National Association of Insurance Commissioners, to discuss health care costs.

Mr Hemsley (the aforementioned CEO of UHC) tried to explain to Secretary Shecantbeserious, the NAIC folks and President Obama (who attended for a short time before heading out, presumably for a smoke break) that, in order to continue providing increased access to the quality care to which we've become accustomed, something must be done to rein in the costs of that care.

Or, as he put it (obviously quoting InsureBlog):

"The cost of insurance is driven by the underlying cost pressures we see throughout the health care system."

Couldn't have said it better ourselves.