Chilling, but #TruthWillOut

We generally don't do partisan politics here at IB, but this particular example of (inadvertent?) truth-telling is important:

Biden tells crowd he wants to increase premiums and make sure that healthcare is 'not quality, but only affordable'... pic.twitter.com/fNhtcW7kxx

— Sean Hannity (@seanhannity) March 6, 2020

"[W]e’ll make sure it’s not quality, but only affordable”

And that, in a nutshell, is the whole premise of a "Public Option" (or any "universal care" scheme, really).

But what, exactly, is the problem with a Public Option?

"The "Public Option" is a euphemism for Single Payer, the obvious end-game for the ObamaTax from the get-go. And how do we know this?"The [Obama] administration still intends to control medical costs by ... a single payer mechanism"

And there you have it: full circle.

#Medicaid4All

[Hat Tip: Mr Jones]

But hey, Free: A Critical Look

An oft-repeated theme here at IB is that Coverage ≠ Care. That is, having insurance (or Medicaid) is no guarantee that one will successfully obtain the care one needs. To wit:

"Twenty percent of Ohio adults reported that they or a household member go without medical care because of the cost even though more than 90 percent of them have health insurance"

So that's half of the puzzle.

We also know that all of the current crop of Democrat-party Presidential contenders favor some form of "universal" health care (be it Single Payer, a Public Option, or some other variation on that theme), often citing CanuckCare© as a model.

And of course, we've demonstrated any number of ways that the Canadian model does not, in fact, actually deliver on its health "care" promise:

"Rationing—in the form of waiting lists—has left hundreds or even thousands of Canadians to die without surgeries."

So we can safely put that little gem to bed.

But what about the idea that our Northern neighbor's health care scheme saves money? This claim, by the way, has been made by several of the aforementioned front-runners (at least as regards to nationalized health care schemes in general).

Well, as it turns out, not so much:

"Canadians spend less on health care than Americans mostly because they are not allowed to use as much — not because they are getting a better deal."

But that was then (last Spring). Surely this is a one-off?

Um....no. As co-blogger Bob V informs us:

"[I]n Ontario, the country’s largest province, the cost of nationalized health care took up 46% of its entire budget in 2010. By 2030, that number is projected to be 80%."

But hey: Canadian moolah.

The Mask Slips

Yikes!

HOLY S*IT: @AOC’s ‘policy guy’ deletes tweet saying public option won’t pay for ‘hip replacements for octogenarians’ [screenshot] https://t.co/wFEoXwddGu via @twitchyteam

— Rich Weinstein (@phillyrich1) February 13, 2019

Speaking of 50 state laboratories

Regular readers know that we've always been major cheerleaders for the state laboratory idea. That is, that each state should be free to experiment with whichever healthcare model it deems appropriate. Being the precursor to ObamaCare, Massachusetts of course comes immediately to mind. But we also note that both Colorado and Vermont have tried their hands at the universal or single payer model, with "rousing" success (for certain values of "success"):

"In 2007, Connecticut shut down its state single-payer project because it would have cost more than the entire state budget."

And a few years later, The Green Mountain State followed suit (even after hiring noted health care rocket surgeon Herr J Gruber).

Now, California's toying with implementing its own version:

"With President Trump now vowing to put forward a replacement for the Affordable Care Act in March, some California politicians and healthcare advocates are once again promoting the idea of a staterun “single-payer” system"

And that's just one of a handful of ideas (including a so-called "public option" and a MasssCare lookalike). Now one may look at The Golden State's current finances and shake one's head in disbelief, but I repeat my call for open discussion and experimentation across the fruited plain.

And good luck to Cali!

[Hat Tip: Drew M]

Zombies never die . . . do they?

"There’s been a lot of talk about the 'public option' all of a sudden."

And it's still the same bad idea it's always been.  

[From July 11 Wall Street Journal via Instapundit - with thanks.]

Coming in 2016...HillaryCar

Hillary Car is the new government mandated program in which everyone must purchase a car. Too bad if you walk to work or take public transportation. It is your responsibility to help those less fortunate and pay your fair share. Failure to comply with your individual responsibility will result in having to pay the individual responsibility payment to the IRS. Employers with 50 or more employees should also know that they will have to provide Hillary-Car to each of their employees and must pay a large portion of the cost. Failure to participate will result in employers paying an Employer Shared Responsibility payment. The law will be written to protect everyone from high costs of cars and to make sure that everyone pays their fair share of the costs associated with being a driver.

All vehicles must have these ten essential features:

1.       Anti-lock breaks

2.       Seat warmers

3.       Moonroof

4.       Halogen lights

5.       Navigation

6.       Remote keyless entry

7.       Power Windows

8.       Roadside assistance

9.       Cigarette lighters (for Obama)

10.     Rearview Cameras

In addition to these 10 features all vehicles must now fall within four narrow bands of options (called Actuarial Vehicle bands) relating to vehicle model. Those who are under the age of 30 can also purchase a stripped down model. The five levels are:  Hydrogen, Oxygen, Carbon, Lead, and Sulphur.

No matter which plan you choose oil changes, tire rotations, replacement wiper blades and other government approved preventive services are free. Also free are other preventive maintenance services for when your car hits mileage milestones. If you are fortunate enough to be female you get free gas as well. Sorry men, you have to pay for it.

Cars will be purchased through a new online Marketplace. Instead of working with Autotrader.com or Cars.com the government will be creating a whole new site that will make buying a car as easy as buying an insurance policy!

The good news for consumers is if your income is under 400% of the Federal Poverty Level (FPL) you will qualify for a government subsidy to help pay the cost of your car. Those who are fortunate enough to be below 138% of the FPL may be entitled to Medi-Car. In this case you will be given a free BMW. Never mind the fact that it might be impossible to find a certified dealer to service your vehicle.

To help pay for this new program several new taxes are being imposed on various industries. There is a 2.3% tax on oil companies, a 2.7% tax on those dealerships who sell you the car, and a new 10% tax on car washes and detail shops. Also, beginning in 2020 any car purchased that is too high in price (referred to as the Cleveland Clinic Tax) will result in your dealership paying a 40% excise tax.

HillaryCar believes in competition. Creating this new marketplace will enable existing car manufacturers with an opportunity to grow their business through competitive pricing while also limiting the amount they can keep in administrative costs and profits. Car manufacturers will now be required to retain no more than 20% of the price of their vehicle sales. HillaryCar will also introduce new Car-ops – government funded non-profit car manufacturers – to compete against existing manufacturers.

Based on existing makes and models we have determined that the following vehicles will be available under the law:

Unfortunately several models didn't meet the narrow Actuarial Vehicle band values. These included the Lexus GS, the Cadillac SRX, and the Chrysler 200. You will also note that SUV’s are no longer an option. This is because they don’t meet the required emission standards set forth in the law (sorry Jeep!). In addition, Buick and Lincoln declined to participate in the vehicle marketplace.

HillaryCar will be rolled out to congress on December 24^th at 11:30pm in 2016. There will be no debate and the public will have 72 hours to read the 2000 page bill. Not to worry though as most of the language will be very vague and rule making will be left up to the Department of Transportation and Department of Energy.

The Public Option Lives!

Co-blogger Mike was eerily prescient last summer when he wrote about the Public Option as it relates to Medicare Advantage plans:

"Medicare has not chosen to respond to its Medicare Advantage competition by improving its own product. Instead, Medicare chose to respond to its competition by using its power to kill its competitor, rather than compete with it.  That illustrates pretty well how governments tend to "compete" and we all need to keep this in mind when the "public option" idea again surfaces."

Indeed.

But what does that have to do with the price of tea in China?

Well, as Our Betters in DC© continue to "streamline" ObamaTax alternatives, they've (perhaps unwittingly) turned the spotlight once again to the Public Option, which for so long has been presumed dead.

So, what's the "Public Option," you may ask?

Well:

"The "Public Option" is a euphemism for Single Payer, the obvious end-game for the ObamaTax from the get-go.

And how do we know this?

"The administration still intends to control medical costs by ... a single payer mechanism"

That is, the government sets up its own health insurance racket scheme to "compete" with the private sector. Of course, the private sector is made up of commercial carriers that are enjoined from collaborating in a way that the government is not. The government, of course, has the lawful power of force, which it can use to ensure an unfair and insurmountable market advantage. Thus, the end of the private insurance business.

So, why bring this up now? The Public Option is dead, right?

Maybe so, maybe not:

"The BHP [Basic Health Program] system could appeal to states that would have liked to see Congress offer a government-run, "public option" health insurance throughout the country, in addition to or in place of the PPACA exchange system"

In fact, the power of the government's purse is so strong, there's no "maybe" about it. Seems to me that this alone dwarfs the current Halbig/King/Burwell kerfluffle: by definition, the Public Option is itself simply one big subsidy.

Sweet.

Chicken Soup for the Health Care Policy

We've long documented the utter failure of nationalized "health care" schemes to rein in costs any more efficiently than our previous, market-based system. From Jolly Old to The Great White, failure is, in fact, an option.

And so it goes in the Holy Land, as well:

"The cost per household for supplementary health insurance from one’s public health fund and for commercial (private) health insurance increased significantly – by 8.5 percent – in 2013, compared to only 4% in 2012."

Catch that? Even (especially?) in nationalized systems, "supplemental" coverage is de rigueur . And what does that portend for the Israeli (to name just one) system?

Well:

"This is a likely sign that public insurance coverage is not regarded by citizens as enough and that accessibility to care from the public health funds and hospitals is declining."

No kidding.

[Hat Tip: FoIB Holly R]

The Continuing Rise of Medicare Advantage

Last week, the economist Austin Frakt said in the NY Times that “Today, 30 percent of Medicare beneficiaries are enrolled in a Medicare Advantage plan, more than at any time in history. In some states, like Hawaii and Minnesota, about half of Medicare beneficiaries are in such plans. This is despite the fact that government payments to plans were cut by the Affordable Care Act. They’re down eight percentage points from their peak in 2009, as measured relative to the cost of traditional Medicare coverage.”

None of this is news.  Back in January the Aetna CEO said the same thing and we commented on it:

CMS pays private insurers to take over the risk for each senior who enrolls for Medicare Advantage.  At one time, the average CMS payment was 114% of the cost for traditional Medicare enrollees. These higher payments were partly because of risk-adjusters in the CMS payment formula – and partly because Medicare Advantage provides better coverage than traditional Medicare.  However – and this is important information – Bertolini said the average government payment to Medicare Advantage insurers is now down to 106%, and is “headed to zero.”  

In other words, private Medicare Advantage insurers believe they have figured out how to provide better benefits and better service than traditional Medicare, for the SAME cost. That's big.

It's big because it would bring good news all around: CMS will shed even more traditional Medicare risk – and cost – thus reducing its financial strain; private insurers will pick up even more Medicare Advantage enrollment on a profitable basis even when paid the same as the cost of traditional Medicare; the taxpayers will benefit if there is reduced need for higher taxes to support traditional Medicare; and seniors who prefer Medicare Advantage over traditional Medicare will still have that highly popular option available to them.

Frakt continues, “One answer is that baby boomers, who are just entering Medicare-eligibility age, are more accustomed to the types of insurance Medicare Advantage offers, such as H.M.O.s”

Bertolini also said that back in January.   Today's employees are increasingly willing to sign up for Medicare Advantage when they reach age 65, because they have had years in which to become familiar with managed care.  I think that means enrollment growth in Medicare Advantage is likely to accelerate over the next few years; an accelerating trend would of course be compounded as more “boomers” retire.

Frakt continues “Another answer is that prior generations of retirees may have been more likely to have had coverage from former employers that wrap around traditional Medicare, filling in its gaps. This coverage has become less common as employer-sponsored retirement benefits have eroded generally.”

Frakt is correct about the withering of employer-based retiree coverage but I disagree that is a reason more of us are specifically choosing Medicare Advantage. 

I'm enrolled in a Medicare Advantage policy.  I did not enroll because my former employer ended retiree coverage; I enrolled in it because Medicare Advantage is a better deal for me then traditional Medicare.  Even today, without employer-sponsored coverage, retirees can purchase government-approved Medicare Supplement policies that fill in the traditional Medicare "gaps."  Yet retirees increasingly prefer Medicare Advantage over traditional Medicare with Supplements.  Frakt does not explain this preference. 

I think the answer is: because Medicare Advantage offers much better coverage; is a simpler arrangement; is easier to use; is thus a better value; and thus a smarter buy.

Besides, Frakt’s use of the term “gaps” glosses over the size and seriousness of the very real inadequacies in original Medicare.  Those inadequacies have been called "gaps" for a long time; Frakt is not the first to use the term, nor will he be the last.  But calling these inadequacies "gaps" is akin to calling the Obamacare Exchange systems debacle "glitches." The term makes Medicare's inadequacies sound small, even trivial. Truth is, the inadequacies are serious, not small.

Calling them "gaps" amounts to deception by vocabulary.  

So it seems to me if the decline of employer-sponsored supplemental plans is any factor at all in the growth of Medicare Advantage, it's only because such decline has for the first time exposed the serious inadequacies in original Medicare to a significant number of retirees.   Those inadequacies are the issue.  And we retirees are noticing.

FWIW. there’s an additional factor:  more and more people – not just retirees - are also noticing the federales have done little or nothing to improve the traditional Medicare product.  Medicare has not chosen to respond to its Medicare Advantage competition by improving its own product. Instead, Medicare chose to respond to its competition by using its power to kill its competitor, rather than compete with it.  That illustrates pretty well how governments tend to "compete" and we all need to keep this in mind when the "public option" idea again surfaces.

History Lesson: Consumer Operated and Oriented Plans - CO-OP's (Part 1)

Alternative to Public Option?

Consumer Operated and Oriented Plans (CO-OP's) were included in Obamacare as an alternative to private health plans that are being offered to individuals and employer sponsored plans. These are start up insurance companies funded with taxpayer money that was set aside in the law. Each state was to have at least one or two of these not-for profit operations that would keep "profit mongering" private health insurance companies from paying extreme salaries to executives and huge dividends to wealthy investors. (Never mind MLR, although that's a completely different post)

Originally $10 billion was to be included for CO-OP's and it was going to be in the form of grants. That was in early 2009. By the time the law passed funding was cut to $6 billion and was now in the form of very low interest loans. These loans have very tight repayment measures and strict requirements on what CO-OP's can use the money for.

White House Intervention

In April of 2011 during budget negotiations - and amid concerns around Solyndra type loans - the White House caved on CO-OP funding and it was cut again by a little over $2 billion. Even more worrisome was a report from HHS in July of 2011 stating that roughly $1.4 billion of the remaining loan money would not be paid back. The last straw for funding was "The Fiscal Cliff" deal. To come to an agreement the White House agreed to eliminate all of the remaining funding for CO-OP's with the exception of a small contingency fund. They also agreed that they wouldn't take funding from any other sources to continue CO-OPs.

The results

In total Obamacare was able to distribute close to $2 billion dollars in loans before remaining funding was eliminated. The money was able to fund 24 CO-OP's in 23 states but around 40 additional applications were scrapped.

One CO-OP never got off the ground (Vermont went belly up at a cost to taxpayers of $4.5 million) and several others were either so far behind in the approval process that they weren't able to meet deadlines to sell plans in 2014 or are considered to be in financial trouble.

What is the current status of CO-OP's and how are they accommodating to the ever changing rules of Obamacare? In part 2 I'll share one CO-OP's response and initial game plan they have to enter the Ohio insurance market.
 

If you like your current agent...

Well, you know...

Still another broken ObamaTax promise:

"Nearly half of insurance brokers polled nationally have considered leaving the industry in the wake of the [ObamaTax] ... Companies' use of brokers has increased to 61 percent in 2013, compared to 56 percent in 2011"

So just when we're needed the most, a chunk of us are contemplating bailing. I must admit to having (briefly) considered this option last year. Not leaving the business, of course, just the health insurance side of it. Eventually, I abandoned that plan, but I know that quite a few others did decide to pull the plug (and several have been referring their health insurance clients and prospects my way, which is nice). Still, I'll need to make time soon to re-certify for the Exchange, which means another half-day on a .gov site that's barely navigable.

And this news comes as we learn that "45 percent of companies surveyed said they plan to increase their reliance on brokers ... when making changes to their employee health plans." So, a lot of potentially disappointed, and frustrated, small business owners.

The other (bigger) problem, of course, is the plight of individuals trying to navigate (Heh) the Exchanges (both public and private) by themselves. Although the ObamaTax was sold as a means to simplify consumer choice, it's really had the opposite effect. People have questions about subsidies, and plan designs, and networks, and they're not getting answers from the 404Care.gov folks.

So to whom will they turn?

Called. It.

The mask slips:

"For-profit health insurance is on some level morally offensive ... I consider it a deceptively sneaky way to get the health care system both of us really want."

So says Noam Scheiber, senior editor at The New Republic. And what, exactly, do he and Mr Moore "want?"

Ah, glad you asked:

"In wonk terms, progressives are likely to get their beloved public option one way or another, and probably not too far in the future."

The "Public Option" is a euphemism for Single Payer, the obvious end-game for the ObamaTax from the get-go.

And how do we know this?

Well, our own Mike Feehan called it over 4 years ago:

"The administration still intends to control medical costs by ... a single payer mechanism"

Now if I could only convince him to get me those pesky winning lottery numbers...

[Hat Tip: FoIB Holly R]

Stupid Government Tricks [UPDATED & BUMPED]

[Please scroll down for update]

From the Now-They're-Just-Making-(Stuff)-Up Department:

So yesterday, with 4 days to go until "The Deadline" (until they change it again, natch), the folks in Capital City have declared that those sub-par plans are okay, after all, at least when they're bought through the Exchange:

"The Obama administration said Thursday it would allow some of the millions of Americans whose insurance policies had been canceled to purchase bare-bones plans next year"

Now, in and of itself, a truly catastrophic plan isn't a bad idea. In fact, it's what a health insurance policy should be: coverage for large, unexpected claims, not every sniffle or paper cut (or birth control pills convenience items). While the mandate is evil, it would at least have been more palatable if it required folks to have at least this level of coverage. And if it were deemed Health Savings Account (HSA) compatible well, then, Bob's your uncle.

Alas, that's not to be.

But there are a few problems with how this is being handled, not the least of which is that it is blatantly, spectacularly illegal.

Here's the relevant section from the ObamaTax itself (emphasis added):

 (e) CATASTROPHIC PLAN.—
(1) IN GENERAL.—A health plan not providing a bronze, silver, gold, or platinum level of coverage shall be treated as meeting the requirements of subsection (d) with respect to any plan year if—

(i) except as provided in clause (ii), the essential health benefits determined under subsection (b), except that the plan provides no benefits for any plan year until the individual has incurred cost-sharing expenses in an amount equal to the annual limitation in effect
under subsection (c)(1) for the plan year (except as provided for in section 2713);
(2) INDIVIDUALS ELIGIBLE FOR ENROLLMENT.—An individual is described in this paragraph for any plan year if the individual—
(A) has not attained the age of 30 before the beginning of the plan year; or
(B) has a certification in effect for any plan year under this title that the individual is exempt from the requirement under section 5000A of the Internal Revenue Code of 1986 by reason of—
(i) section 5000A(e)(1) of such Code (relating to individuals without affordable coverage); or
(ii) section 5000A(e)(5) of such Code (relating to individuals with hardships).

Seems pretty clear-cut to me.

But in case it's not, the helpful folks who provided training to become certified to sell on the Exchange confirm:

Eligibility for catastrophic plans is limited to:
• Individuals under age 30
• Individuals who otherwise do not have an affordable coverage option, or who otherwise qualify for a hardship exemption to the minimum essential coverage rule

So again, we just throw the actual reg's out the window because they're, well, "inconvenient."

But that's not the only problem. With roughly 84 hours left on the clock - and a weekend taking up most of that - carriers are supposed to price these plans for people aged, oh, 35 or 45 or 55. This, despite the fact that rates have already been reviewed and approved (or not) by the 58 different states' departments of insurance, which will now also have to review and approve (or not), these new rates.

Rostsa ruck with that.

It gets better, though, if by "better" we mean "worse:" what if you've already bought an ACA-compliant policy (hey, it could happen!) but would prefer the less expensive catastrophic plan? The good news is that it appears that you can make this change (or pretty much any other) during the Open Enrollment season. Of course, you'd still be stuck with the old plan for a month, and good luck getting through to 404care.gov, but at least it's an option.

Probably.

UPDATE: It's also worth noting that - as the ObamaTax legislation is written (not that this continues to have any significance) - Catastrophic plans are not eligible for premium subsidies. So folks who opt for this choice may be in for a rude surprise. And as Bob would remind us, this is another great reason to shop (and buy!) OFF the Public Exchange.

The "Public Option" Lives

It's that time of year when the airwaves are flooded with zombies and other assorted monsters. So it should come as no surprise that the long-thought-dead Public Option has been given new life under the ObamaTax:

"The [Obamastration] will soon take on a new role as the sponsor of at least two nationwide health insurance plans to be operated under contract with the federal government and offered to consumers in every state."

After all, who needs an Exchange when we can just cut out the middleman and go directly ro government-run health insurance? These plans will "compete" with commercial insurers, but it's not exactly a level playing field: how can private companies compete with the Federal leviathan?

The simple answer is: they can't.

It's an expansion of the Federal Employees' health plan, which has worked so well in reining in health care and insurance costs. Since these plans will be subject to regs from at least three different agencies, good luck resolving claims or other issues. Which then brings us to the role of the National Association of Insurance Commissioners (NAIC). That august body "expressed alarm at the prospect of a double standard." I'm sure the Feds will get right on that.

It's interesting timing, as well, since President Obama has decided to discontinue vital health care services for our veterans. Is there a message in this?

Methinks you already know the answer to that.

Musings: An Interview with Dr Rob

Dr Rob Lamberts, one of my very favorite med-bloggers, is making a major career change. He'll still be doctorin', of course, but in a new practice, based on a cutting-edge model of health care delivery. If you've never read any of his work, I heartily recommend that you do so.

After his residency at Indiana University in 1994, Dr Rob went into private practice with another physician (who subsequently went to Africa to do missions work). Their practice was initially owned by a hospital, but by 1996 they'd decided that it was better to leave and do "their own thing."

InsureBlog: What made you decide to chuck it all and re-boot?

Dr Lamberts: I had been frustrated as the other doctors in the practice grew more and more resistant to change. The more partners we had, the more inertia we gained. Since I am not a person to sit still when I think there are solutions to problems, I found it increasingly difficult to stay put because of others' personalities. This created conflict, which led to me looking at my options. Going solo in a practice that dealt with the insurance game and had the same limitations as the old practice was not a good solution for me, so when I found the Direct Primary Care (DPC) model it really appealed to me. In the end, my (now former) partners and I saw this as an irreparable split between us and the decision to split was mutual. They have worked it out so I don't have to draw a paycheck for up to 6 months, which gives me time to build my new practice right. They also gave me access to my patients to tell them about the new practice, which is a really generous thing on their part.

IB: You've mentioned that you may have patients that can't (or won't) follow you to your new practice, can you expand on that?

RL: The DPC model is one in which the patient pays the doctor directly for their care, usually in the form of a monthly "subscription," plus or minus a fee for visits. DPC usually limits the size of the patient pool as well, so I will only be able to take 1/3 of my total patient population even if all wanted to come (I had between 3 and 4 thousand patients in my old practice and will limit it to around 1000). Plus there is the fact that some patients are not going to be willing to pay what they see as an extra fee for care they already could get. Since nobody else in the area is doing this, the only way I can show that the value of the service will be worth the cost is to make it work. Some people will trust me in this, while others won't.

IB: I know a lot of practices are being gobbled up by hospitals eager to grow their ACO's [ed: Accountable Care Organizations]. Was this ever an option for you?

RL: Not really. If we were able to work out our differences in the old practice I would have been part of a primary care ACO that is being formed by a local IPA (group of independent primary care physicians who have allied together to do this). Primary care is quite independent in Augusta, and has recently done quite well in organizing and working together for their best interest (without risking collusion, despite what the hospitals may say). I could be part of an ACO in that setting if I wanted. In truth, however, I have grown less and less enamored with these models, as they are more driven by data and processes built around meeting care standards than they are built around good patient care.

We had been working on "Patient Centered Medical Home" in our practice, and I found that it was anything but patient-centered; it was data-centered, and took my attention away from the patients. Finally, I simply don't think the hospitals are the means to truly affect meaningful change in health care. They are the businesses that have been built on over-spending on health care, on unnecessary procedures, and on consumption of medical resources. The goal of most hospitals for my patients is 180 degrees from mine: their financial gain is built on people getting procedures, going to the ER, and being hospitalized, while mine is to help them avoid all of the above. [Continued below the fold]

HHS Shecantbeserious vs The Truth

Having lost in a court of law, HHS Secretary Shecantbeserious (and her attorney) has taken the case to the court of public opinion. To wit, an op-ed in today's Washington Post, wherein she repeated the oft-used - and completely erroneous - conflation of auto and health insurance:

"Imagine what would happen if everyone waited to buy car insurance until after they got in an accident. Premiums would skyrocket, coverage would be unaffordable, and responsible drivers would be priced out of the market."

Let's recast this, shall we?

"Imagine what would happen if everyone waited to buy [health] insurance until after they got [sick]. Premiums would skyrocket, coverage would be unaffordable, and responsible [citizens] would be priced out of the market."

D'unh!

How come no one's clamoring for a law that mandates coverage for wiper blades, or that requires insurers to charge the same rate for careful drivers and those with multiple DUI's?

More importantly, there's just no comparison between the term "driver" and "citizen." That is, one need only buy car insurance if one operates a vehicle on public roads. Take the bus? Insurance not required. Ride a bike? Insurance not required. Drive the '66 Blazer on your farm? Insurance not required.

Breathe the air? Insurance required, according to Shecantbeserious and her fuzzy-minded minions.

And there's this: in most (all?) states, one isn't actually required to buy insurance even if one does drive on the public roads. One has the option to post a "bond" as proof of financial responsibility. So why isn't this an option for the purchase of health care? Seems to me, fair's fair: if you want to conflate the two, then do it right: offer the option to post a bond and allow insurers to charge appropriately for the risk.

And, of course, drop this (evil) individual mandate nonsense.

JeffLinks: Good News and Bad

From FoIB Jeff M, two interesting links. The first is good news for folks trying to figure out if they've saved enough to pay for any long term care needs that might arise, and if they might need to be looking at Long Term Care insurance. This interactive tool, from LTCi giant Genworth, includes average costs for nursing care both at home and in a facility, and can even help you determine how much these costs will escalate over time.

Now for some bad, or at least disquieting, news: if you've lost a loved one in the past few years, you know that life insurers no longer just send a check. The default option (in some cases, the only option) is a checking account from which one can withdraw funds.

Actually, that should be "checking account" since it's not a real one:

"Lohman, a public health nurse ... had always believed that her son’s life insurance funds were in a bank insured by the FDIC. That money -- like $28 billion in 1 million death-benefit accounts managed by insurers -- wasn’t actually sitting in a bank.

It was being held in Prudential’s general corporate account, earning investment income for the insurer."

And unlike a bank account, this money isn't protected by the FDIC, nor is it even held in a separate, specific account. It's just considered part of the carrier's overall assets.

I always advise my clients (well, technically, their beneficiaries) to immediately cash out that "account" and transfer the money directly to their own real bank account. What they do with the money from there is really none of my business, although I do caution folks not to go on a spending spree right away.

Thanks, Jeff!

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.

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]

Deny, deny, deny

OK, we’ve seen this kind of thing before.

Believe it or not, the DENIAL problem is worse than you think.

It occurred to me today whilst buying gas, that when I pre-pay my $30 the pump always shuts off at exactly $30 – even if my tank isn’t full yet!

Exxon-Mobil DENIES me gas!

I’m telling you, this is how gas stations in Connecticut and all over America ROUTINELY DENY gas to motorists!

What’s worse, we are DENIED gas WHEN WE NEED IT MOST!

Righteous indignation! Outrage!! Snippiness!!!

This widespread DENIAL of gas shows that the country must have a public gasoline option.

This means GOVERNMENT-SUBSIDIZED gas stations where everyone is always GUARANTEED a FULL TANK for a FIXED PRICE.

The public-option gas stations will give the oil companies some COMPETITION - for a change.

Oh, I know, some crackpots will claim competition from a public option will be unfair and will drive the private gas stations and oil companies out of business.

But they're just crackpots. Besides, who needs the gasoline companies, anyway?

Don't believe those crackpots. Let your Congressional representative and your Senators know that you DEMAND a PUBLIC GASOLINE OPTION.