The administration has announced that the Democrat House majority will remove Section 1233 from HR3200 – the House version of Obamacare. This is the so-called death panel provision.
I hope no one who reads this blog is so naive as to believe this settles the matter.
The administration still intends to control medical costs by
(1) reducing fraud and waste
(2) reducing admin cost thru a single payer mechanism and
(3) limiting payments for Americans' medical treatments.
That third objective will not go away. Section 1233 has been put aside for the moment, as a political expedient to induce people who disagree with Obamacare to quiet down and get out of the way.
Meanwhile, anyone remember Barbara Wagner? Her case illustrates exactly what governments do when they are in charge of medical care. This case predicts how the Federal Government will administer a single-payer medical insurance plan.
Wagner is an Oregon woman whose cancer returned from remission in early 2008 [ed: and about whom we blogged here]. Wagner was covered under the Oregon Health Plan (a Medicaid plan). Her doctor prescribed a new cancer drug for her. But the State of Oregon health plan denied payment for the medicine. It wrote Wagner a letter, stating the plan would pay for comfort care, including "physician aid in dying," - - that’s better known in Oregon as assisted suicide.
Wagner appealed the State’s decision twice and the State denied her appeal both times.
But the the state assured Wagner that there was no malice intended:
“Dr. Som Saha, chairman of the commission that sets policy for the Oregon Health Plan, said Wagner is making an "unfortunate interpretation" of the letter and that no one is telling her the health plan will only pay for her to die.
See? No malice. Only an “unfortunate interpretation.” All better now, right?
Technically this story proves the Obama administration is telling the truth.
There may be a commission, but no officials are “telling us” it is a death panel. I mean now really, who would tell us that anyway? Fer cryin out loud, it’s a HEALTH Plan Commission. HEALTH, not death. Don’t you see, health has nothing to do with death? So, everyone can stop worrying. No government official is telling us that there will be death panels. That must mean if you don’t get the care your doctor prescribes, it’s just “unfortunate”. People who say otherwise are uninformed. People who say otherwise are repeating fishy things and should be reported to the authorities.
Oh yeah – Barbara Wagner died. May God bless her.
It is sad that her story has receded from public memory - thanks in no small part to our bumbling media – while buffoons like Nancy Pelosi are given the headlines. But you can be certain that the tactics by which the administration intends to reduce medical care spending will impose limits on government payments. And that will mean fewer treatments available for people who are receiving them now.
Monday, August 17, 2009
Nose + Face (Some Assembly Required)
On the one hand, this would seem to be good news for proponents of the status quo:
As we've repeatedly shown, the so-called "Public Option" was never a good or viable idea, although the recent rumors of its demise are, um, exaggerated. Nevertheless, the sooner that monstrosity is off the table, the sooner we can begin to look for meaningful, realistic and sustainable solutions.
Which is why I, for one, am quite puzzled at the left's seeming to throw in the towel on health care reform (or, as it's evolved, health insurance reform). If it's PO or nothing, and PO gets thrown under the bus, then who's going to be supporting a major overhaul? The right? Maybe, but I thought this was supposed to be a bipartisan effort. And if it is defeated, it's obviously not going to be at the hands of the Republicans (the minority party in the House, and facing a filibuster-proof Senate).
We are not proponents of the status quo; the current system needs work, beginning with identifying the real culprits: the cost of health care and so many mandated benefits. If the left is going to pick up its ball and go home to sulk, we're more than up to the challenge of crafting sustainable, reasonable reform.
CDHP News: Lukewarm
Late last year, the Guardian Life Insurance company surveyed 1,000 working folks, specifically looking for their attitudes and opinions about Consumer Driven Health Care. Not surprisingly, the survey found that there's a lot of misinformation about CDHP, and that if we're going to have a meaningful national debate about its role, we need to clear those up.
While "traditional" plans still hold the lion's share of the market, consumer driven products (e.g. HSA's, HRA's, etc) are gaining ground, with some 14% of the market. Still, given that the current version of HSA's has been around for almost half a decade, I found that result disappointing (although not, frankly, surprising). The survey focused on the group market, though, so these numbers may or may not translate to the individual.
Part of the problem with that anemic enrollment is that almost half the respondents (44%) believe that such plans are actually more expensive than PPO's or similar plans, and almost a third (29%) are very concerned about what would happen if there was a catastrophic claim. There are two problems with this, of course:
First, high deductible plans are almost always going to have lower premiums than comparable co-pay plans. This just makes sense: if the carrier is off the risk for the little claims, they can charge less premium. The second problem is that, come a major claim, the high deductible plan will have - at worst - no greater out-of-pocket exposure than the co-pay plan, and often a lower one.
Another interesting find is that " (a) strong majority of consumers (85%) want more control over decisions that affect their health care, and 81% think health care costs should be transparent. Nevertheless, 33% of workers feel overwhelmed by too much information already."
That's really a shame. On the one hand, it illustrates that people do want to have some say in their own care, and a majority (think they) want more transparency in that care. On the other hand, there are still a lot of folks who are saying "TMI!" Still, they represent a minority opinion, and can easily avoid that overload (just swear off WebMD and Google).
Having done a number of employee enrollment meetings over the years, I wasn't the least bit surprised by the finding that over half (53%) of those surveyed listed co-payments for doc and hospital visits, not price, as their number one concern. That's not news to me (nor, I suspect, my colleagues): after carefully explaining how the high deductible plan and accompanying savings account work, the number one question I'm asked is always "okay, Mr Stern, that's really great. But what's my co-pay?" After explaining again how the plan works, and that there are no co-pays, the second question I'm asked is always "oh, that makes sense. So, then, what's my co-pay?"
I'm not trying to make fun of the employees here - after all, we're the ones who've been pushing $10 and $15 co-pays for years - but to illustrate the uphill battle we face if we're going to break through that 14% barrier. In the event, the complete results are here, and I'd recommend reading through it for even more insights.
Thursday, August 13, 2009
"Mini-Med" Update: STOP! [UPDATED & BUMPED]
[Please scroll down for update]
Just got this from one of the "mini-med" (limited benefit) companies. Seems that the Empire State has decided to review "all companies that sell Limited Medical Plans in their state for various reasons." As a result, this particular carrier is pre-emptively suspending sales of its products in New York. I'm sure that, as the day goes on, I'll be receiving similar notices from other carriers in that market.
A quick look around the New York DOI site yielded no additional information on this; I've emailed this particular carrier for more details.
We'll keep you posted.
UPDATE: No thanks to the carrier who sent out the original "alert," we've been able to confirm that the New York Department of Insurance is, in fact, "reviewing the sales practices of insurance companies that provide limited benefit health insurance plans." It's also worth noting that, despite the growing number of carriers offering these plans, the email in the original post was the only one I've received on this. Strange.
In the event, Gov David Paterson is concerned that these "plans provide less coverage than what consumers are led to believe."
That's probably correct: unfortunately, sometimes people believe what they want to believe, and agents sometimes feed into that assumption.
In addition to requesting information from the carriers who market these plans, the DOI is planning a series of public hearings on the matter. For more details, here's the press release.
Weird Carrier Tricks [UPDATED & BUMPED]
[Please scroll down for update]
This one would initially seem to fall under our Stupid Carrier Tricks category, but it also seems to have a "happy ending:"
Hunh?
Apparently, Heather Toplak is a 35 year old breast cancer survivor, who needs annual blood screenings to determine if she's still in remission. Such tests are generally considered "standard of care," meaning that they're usually covered expenses, unlike much more expensive scans. This can save the insurer (and thus, its policyholders) a lot of money, which would seem to be a good thing.
During her battle with the cancer, Anthem apparently had no qualms about paying for various treatments and procedures [ed: Hey, aren't they supposed to fight these types of claim tooth and nail, and then cancel the offending insured's coverage? Looks like someone didn't get the memo!]. The follow-up blood test was denied as "not medically necessary," and recommended that she instead undergo a (much more expensive) Pet Scan. One presumes, given her condition, that she would have already met most (if not all) of her own out-of-pocket maximum, meaning that Anthem would have footed most or all of that bill.
Now, the twist: Mrs Toplak contacted her local TV-news troubleshooter, who in turn contacted the insurer. Anthem has reversed its decision, and "has agreed to pay for the [blood test]. Not only that, they are changing their policy on paying for these blood tests going forward."
Kudos!
The story still left a few unanswered questions:
■ Why was an Arizona woman covered by Anthem (since that state is served by BCBS of Arizona)?
■ What type of policy did she have, a co-pay plan or an HSA?
That second question is important because it's generally presumed that folks with HSA plans are more attuned to these issues.
I've emailed the reporter for clarification. So far, I haven't heard back. We'll let you know if and when we do.
[Hat Tip: FoIB Rick B]
UPDATE: In the comments, reader John H tells us that Mrs Toplak is most likely covered under the "Bluecard" program, which enables folks who live in states served by other "Blues" to have essentially seamless cover.
And we've heard from Carey Peña, the reporter on whose work we based this post. She tells us that she appreciates our "posting the story and hope that it helps advance the conversation."
In response to our question regarding the type of coverage involved, she writes:
"I’m not at liberty to answer your questions due to the privacy that I extend to my interview subjects. However I am more than happy to forward your link and request to Mrs. Toplak and if she wants, she can contact you directly with additional information."
That's an entirely reasonable response; we'll let you know if we hear from Mrs Toplak.
Slashing CEO Comp, Saving Money?
Our own Bob V has made this point before, but it bears repeating, and who better than FoIB Flarin' Karen. She notes that Cigna's CEO reportedly makes some $30 million a year. She further notes that Cigna insures about 11 million people. She then observes:
Amen!
Wednesday, August 12, 2009
Forget Chilling - Try Freezing!
We were perplexed and a bit put out by the Obamistration's Big Brother effort with the tattle-tale email addy.
And were alarmed when this was expanded to an entire website given over to collecting "misinformation."
But this is beyond stunning:
When one surfs the 'net, one invariably picks up these little info gathering pieces of code, which are used for a variety of purposes (some benign, some not so much). The best definition I could find says that cookies are "a piece of text that a Web server can store on a user's hard disk. Cookies allow a Web site to store information on a user's machine and later retrieve it."
As noted above by the ACLU (not exactly a bastion of right-wing ideology), it has long been our gummint's policy to eschew cookies, encouraging citizen participation.
But that was then, and this is now:
"Without explaining this reversal of policy, the OMB is seeking to allow the mass collection of personal information of every user of a federal government website."
This means, for example, that if you visit that Big Brother site, our most transparent administration ever will be able to see many (perhaps most) of the websites that you've previously visited. And because of in-place regulations, once this data is collected, they are forbidden to destroy it.
Now, one might say that this is no big deal, because there's no way they can match up your "hit" with any personally identifiable information.
And one would be wrong:
How many of us shop online? How many use our real names (or even parts of our real names) in email addresses and when leaving comments? These are easily "picked up" by various cookies, and could potentially become government policy. Before you fit me for a tin-foil hat, do a little research and prove me wrong.
But be convincing.
And, perhaps, be afraid.
Pithy: Health care "Reform" in a Nutshell
From Ace of Spades:
"Health care in the US is covered by three main systems-- Medicare, medicaid, and private insurance.
The third is solvent, and can make all of its payments for the foreseeable future.
Barack Obama's plan is to take the one system meeting its obligations and fold it into the two systems that are bankrupt."
Tuesday, August 11, 2009
Anyone? Bueller?
When a pharmaceutical company pays physicians e.g., for recommending medications or for producing academic studies funded wholly or in part by the pharma company, we have come to believe (we are given to believe) that such payments invariably compromise the physician's judgment and render the physician's work and subsequent advice or recommendations highly suspect.
So then, how is it that if Medicare (acting under Section 1233 HR3200), were to pay physicians to initiate end-of-life planning with patients, the payments do not compromise the physician's work or judgment, and do not call into question whatever subsequent advice or counsel that the physician might offer?
Can anyone 'splain that one to me?
So then, how is it that if Medicare (acting under Section 1233 HR3200), were to pay physicians to initiate end-of-life planning with patients, the payments do not compromise the physician's work or judgment, and do not call into question whatever subsequent advice or counsel that the physician might offer?
Can anyone 'splain that one to me?
ObamaCare Saves Social Security
Little noticed in the hubbub and misinformation surrounding ObamaCare is the fact that this section of the bill has the potential for actually saving Social Security from bankruptcy:
"Subject to paragraphs (3) and (4), the 7 term ‘advance care planning consultation’ means a consultation between the individual and a practitioner [doctor] ... if ... the individual involved has not had such a consultation within the last 5 years." [From Page 425 of the America’s Affordable Health Choices Act of 2009, Revised Standard Edition]
The implication here is that, no less frequently than every half decade, our seniors will be required to have these discussions with their doctor. Now, that may not sound so insidious, but as Washington Post (not exactly a right-wing publication) editor Charles Lane notes, "Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they're just trying to facilitate choice -- even if patients opt for expensive life-prolonging care. I think they protest too much: If it's all about obviating suffering, emotional or physical, what's it doing in a measure to "bend the curve" on health-care costs?"
Good question.
A bit later (on page 432), we find a new government mandate that seems to provide at least a partial answer:
"For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life sustaining treatment."
What better way to bring the problem of life expectancy back under control?
Brilliant!
D'ya rilly not know how a public plan would "compete" ?
[Welcome Wizbang readers!]
If anyone is uncertain how a public insurance plan option will actually "compete" with private insurers, all one needs to do is look at how Medicare "competes" with private Medicare Advantage plans.
Seniors have a choice to enroll in "original Medicare" or any Medicare Advantage plan available in their area. Medicare Advantage plans are available in most parts of the U.S.
Clearly, these private Medicare Advantage plans are competing with Medicare for membership. So – how’s that been going?
As of March 2009, Kaiser Family Foundation estimated total Medicare Advantage enrollment was about 10 million seniors. That’s 22% of the total Medicare-eligible population of 45 million – about one out of five. Wait, there’s more: since 2003, the enrollment in Medicare Advantage plans has doubled. Sounds like the private companies are doing a great job competing with Medicare, right? Wait, there's more.
President Obama announced before his Inauguration his intention to eliminate Medicare Advantage plans. Obama said:
"We’ve got to eliminate programs that don’t work, and I’ll give you an example . . . We are spending a lot of money subsidizing the insurance companies around something called Medicare Advantage, a program that gives them subsidies to accept Medicare recipients but doesn’t necessarily make people on Medicare healthier."
But is it true that Medicare Advantage plans "don’t work"? No. It's not true. If they didn’t work 10 MILLION people would not have voluntarily enrolled. If they didn’t work the enrollment would not have DOUBLED in the past 5 years. Medicare Advantage plans work just fine.
Well then, is it true that the government "subsidizes" private Medicare Advantage policies? No. It's not true. It pays premiums to the insurance companies that it would otherwise have paid to itself. That is not a "subsidy".
Well, then, what is really going on?
Here it is: the private plans are beating Medicare fair and square, and the new administration doesn't like that one bit. Why? Because it shows that a single-payer plan might not be needed, and might not be such a good idea anyway. So Obama decided to change the rules – NOT to make Medicare more competitive – but to eliminate its competition. And that is EXACTLY how the government can be expected to act to protect its public health insurance option against private companies.
If anyone is uncertain how a public insurance plan option will actually "compete" with private insurers, all one needs to do is look at how Medicare "competes" with private Medicare Advantage plans.
Seniors have a choice to enroll in "original Medicare" or any Medicare Advantage plan available in their area. Medicare Advantage plans are available in most parts of the U.S.
Clearly, these private Medicare Advantage plans are competing with Medicare for membership. So – how’s that been going?
As of March 2009, Kaiser Family Foundation estimated total Medicare Advantage enrollment was about 10 million seniors. That’s 22% of the total Medicare-eligible population of 45 million – about one out of five. Wait, there’s more: since 2003, the enrollment in Medicare Advantage plans has doubled. Sounds like the private companies are doing a great job competing with Medicare, right? Wait, there's more.
President Obama announced before his Inauguration his intention to eliminate Medicare Advantage plans. Obama said:
"We’ve got to eliminate programs that don’t work, and I’ll give you an example . . . We are spending a lot of money subsidizing the insurance companies around something called Medicare Advantage, a program that gives them subsidies to accept Medicare recipients but doesn’t necessarily make people on Medicare healthier."
But is it true that Medicare Advantage plans "don’t work"? No. It's not true. If they didn’t work 10 MILLION people would not have voluntarily enrolled. If they didn’t work the enrollment would not have DOUBLED in the past 5 years. Medicare Advantage plans work just fine.
Well then, is it true that the government "subsidizes" private Medicare Advantage policies? No. It's not true. It pays premiums to the insurance companies that it would otherwise have paid to itself. That is not a "subsidy".
Well, then, what is really going on?
Here it is: the private plans are beating Medicare fair and square, and the new administration doesn't like that one bit. Why? Because it shows that a single-payer plan might not be needed, and might not be such a good idea anyway. So Obama decided to change the rules – NOT to make Medicare more competitive – but to eliminate its competition. And that is EXACTLY how the government can be expected to act to protect its public health insurance option against private companies.
Grand Rounds: Reality Check edition
Dr Rich hosts this week's roundup of medblog posts, focusing on, as he puts it, "health (insurance) reforms." It's an amazing piece of work, with copious commentary on each post. It may seem a bit overwhelming, but it's definitely worth the effort.
Monday, August 10, 2009
Pick yer poison
I found this at Instapundit. It’s a Rasmussen poll finding released August 10 that everyone should think about:
"When it comes to health care decisions, 51% of the nation’s voters fear the federal government more than private insurance companies. The latest Rasmussen Reports national telephone survey finds that 41% hold the opposite view and fear the insurance companies more. Seven percent (7%) are not sure who they fear the most."
And when government IS the insurance company, perhaps even the 7% undecided will at last be able to figure out which they fear most. Ya think?
UPDATE [HGS]: Great minds thinking alike; I just finished writing a post on this, and found Mike's already on the case. Here's my take on the polling:
Nancy McBotox's assertion notwithstanding, respected pollster Scott Rasmussen's latest findings indicate that, in a showdown between those "eeeevil" insurers and gummint bureaucrats, We The People are a darned sight more afraid of the latter than the former:
"When it comes to health care decisions, 51% of the nation’s voters fear the federal government more than private insurance companies."
And even those who claim to fear insurers more than the government are unlikely to buy into the ad hominem: "just 25% agree with House Speaker Nancy Pelosi that health insurance companies are "villains."
The news just keeps getting worse for ObamaCare advocates:
"(A) solid majority of those over 40 fear the government more."
We know that ObamaCare has Granny securely in its sights, and it appears that our "mature" citizenry is becoming more and more aware of this. And they're unlikely to take kindly to being called "unAmerican" by our Betters in Washington©.
[Hat Tip: Powerline]
"When it comes to health care decisions, 51% of the nation’s voters fear the federal government more than private insurance companies. The latest Rasmussen Reports national telephone survey finds that 41% hold the opposite view and fear the insurance companies more. Seven percent (7%) are not sure who they fear the most."
And when government IS the insurance company, perhaps even the 7% undecided will at last be able to figure out which they fear most. Ya think?
UPDATE [HGS]: Great minds thinking alike; I just finished writing a post on this, and found Mike's already on the case. Here's my take on the polling:
Nancy McBotox's assertion notwithstanding, respected pollster Scott Rasmussen's latest findings indicate that, in a showdown between those "eeeevil" insurers and gummint bureaucrats, We The People are a darned sight more afraid of the latter than the former:
"When it comes to health care decisions, 51% of the nation’s voters fear the federal government more than private insurance companies."
And even those who claim to fear insurers more than the government are unlikely to buy into the ad hominem: "just 25% agree with House Speaker Nancy Pelosi that health insurance companies are "villains."
The news just keeps getting worse for ObamaCare advocates:
"(A) solid majority of those over 40 fear the government more."
We know that ObamaCare has Granny securely in its sights, and it appears that our "mature" citizenry is becoming more and more aware of this. And they're unlikely to take kindly to being called "unAmerican" by our Betters in Washington©.
[Hat Tip: Powerline]
Winston Smith Goes to Washington [UPDATED!]
Apparently, the Obamistration is doubling down in its fight against transparency in health care reform. Rather than back down on it's Big Brother efforts to silence critics (aka informed and concerned taxpayers), PresBo has not only called out the literal dogs, but the virtual hounds, as well:
In the spirit of civic cooperation, I've already played cyber-Stasi, supplying the Reality Check folks with this subversive claim regarding the cost of health care. Be a shame if that effort were duplicated by our readers.
And by the way, we've always been at war with Eastasia.
UPDATE - More Subversive and Dangerous "Fishiness:" Noted Right-Wing Extremist and Notorious Republican Operative Robert Reich cynically slams the Obamistration's backroom deal with Big Pharma (in exchange for caving on using the power of the gummint to drive down rx costs, Pharma has agreed to spend over $150 Million in pro-ObamaCare advertising). Writes Reich:
Talk about Hope! and Change!
Better report him to the Under Ministry of Truth.
MVNHS©: Trix R 4 Kids (and so is the Swine Flu Hotline)
About two years ago, we reported on the strange case of the physicians' teenaged son delivering a baby. At the time, we noted that he did so at the urging of his parents in a bid for the Guiness Book of World Records. The Guiness folks quite rightly saw this as "bad medicine."
And so what are we to make of this?
These children are being paid over $27 an hour to assess callers' risk of swine flu, determine if they qualify for treatment (i.e. medically diagnose), and then arrange for those who qualify to pick up their meds. Needless to say, this has met with some, um, resistance and concern by some adults:
"Liberal Democrat health spokesman Sandra Gidley called the news worrying.
'Expecting people with little or no experience to work on such a complex subject is irresponsible ... It's bad enough that people can answer three questions and bingo, you get Tamiflu. The danger is that the Government, far far from being prepared as it claimed, is actually rushing things through in a way that is bad for the public.'" [ed: emphasis added]
"(R)ushing things through in a way that is bad for the public."
Now, where have we heard that before?
HR3200, America’s Affordable Health Choices Act of 2009
Why is much of the public suddenly and so vehemently opposed to this Bill? Aside from its length (1,018 pages) and aside from the ongoing political circus around it, (examples, here and here) I think there are fundamental reasons that the public is alarmed by, and therefore opposed to the Bill. Overall, my take is that opposition is fueled by an Administration that cannot seem to give simple, straight answers to good questions the public is asking. And strategically the Administration is caught in traps largely of its own making.
It fell into the first trap by biting off more than it can chew. The problem that has been aching for a solution is access to adequate health care for the uninsured. There are long-term possible cures for this problem, but until then the immediate aspirin tablet is to insure them. In a strategic blunder, the Administration determined that nothing short of radical surgery on 100% of the health insurance in the U.S. would suffice to fix the problem of the uninsured 15%. In so doing, it got way ahead of the problem. The Administration also got way ahead of the American people who (I believe) would have supported reasonable proposals to insure the uninsured but are correct to resist this enormous, top-down, governmental intrusion into their own private insurance. Besides, in some respects, the uninsured represent failure of government in the first place.
Second, the Administration walked into a logical trap. The Administration claims that radical change to American health insurance is essential to America’s future economic well-being. But at the same time, the Administration assures the public that the change it has in mind will allow anyone who likes their current insurance, to keep it. A large majority of Americans are insured, and like their current insurance enough that they resent a mandate to change it. Change without change will save the economy? Yeah, that’s gonna happen.
The Administration also created a financial trap for itself. After persuading Congress to pass a $700 billion economic “stimulus” that greatly increased the deficit, Obama promised that he will not sign any health insurance bill that increases the deficit. OK, fine. But now CBO has determined that the health insurance bill requires significant additional federal spending, that it will increase the deficit, and the farther out the analysis goes, the worse the financial picture gets. So at this point, regardless of the street-level protests that are taking place, the bill appears DOA. As a result, the Administration is scrambling to find reasons to justify going ahead anyhow. But their reasons are making the situation worse, because they aren’t addressing what has the public worried. Example: the notion that the bill can be financed by additional taxes on high income taxpayers. But CBO already said it can’t. So all taxpayers have even more reason to worry their taxes will be raised. Example: the notion that the bill can be financed by insurance “savings” from elsewhere. But where will most savings come from if not from the elderly population that uses the majority of medical resources? So Medicare participants and their families worry even more that this bill tosses grandma under the next bus. Example: the Administration has done an absolutely wretched job of explaining Section 1233, Advance Care Planning Consultation, to Medicare participants. In fact, I’d like to know what Section 1233 means, too - and I won’t be eligible for Medicare for years (0.75 years, to be precise).
It fell into the first trap by biting off more than it can chew. The problem that has been aching for a solution is access to adequate health care for the uninsured. There are long-term possible cures for this problem, but until then the immediate aspirin tablet is to insure them. In a strategic blunder, the Administration determined that nothing short of radical surgery on 100% of the health insurance in the U.S. would suffice to fix the problem of the uninsured 15%. In so doing, it got way ahead of the problem. The Administration also got way ahead of the American people who (I believe) would have supported reasonable proposals to insure the uninsured but are correct to resist this enormous, top-down, governmental intrusion into their own private insurance. Besides, in some respects, the uninsured represent failure of government in the first place.
Second, the Administration walked into a logical trap. The Administration claims that radical change to American health insurance is essential to America’s future economic well-being. But at the same time, the Administration assures the public that the change it has in mind will allow anyone who likes their current insurance, to keep it. A large majority of Americans are insured, and like their current insurance enough that they resent a mandate to change it. Change without change will save the economy? Yeah, that’s gonna happen.
The Administration also created a financial trap for itself. After persuading Congress to pass a $700 billion economic “stimulus” that greatly increased the deficit, Obama promised that he will not sign any health insurance bill that increases the deficit. OK, fine. But now CBO has determined that the health insurance bill requires significant additional federal spending, that it will increase the deficit, and the farther out the analysis goes, the worse the financial picture gets. So at this point, regardless of the street-level protests that are taking place, the bill appears DOA. As a result, the Administration is scrambling to find reasons to justify going ahead anyhow. But their reasons are making the situation worse, because they aren’t addressing what has the public worried. Example: the notion that the bill can be financed by additional taxes on high income taxpayers. But CBO already said it can’t. So all taxpayers have even more reason to worry their taxes will be raised. Example: the notion that the bill can be financed by insurance “savings” from elsewhere. But where will most savings come from if not from the elderly population that uses the majority of medical resources? So Medicare participants and their families worry even more that this bill tosses grandma under the next bus. Example: the Administration has done an absolutely wretched job of explaining Section 1233, Advance Care Planning Consultation, to Medicare participants. In fact, I’d like to know what Section 1233 means, too - and I won’t be eligible for Medicare for years (0.75 years, to be precise).
Tres Bon Carnival of Personal Finance
Kelly at Almost Frugal, an American who's lived in France for the past 9 years, presents this week's Carnival of Personal Finance. Don't miss her collection of French quotes about money, and some really interesting and helpful posts on personal finance.
Saturday, August 08, 2009
This Sceptered Isle, Part XIX - It's a dog's life
Really? A dog's life?
Well, that is one physician's opinion:
"In the last few years, I have had the opportunity to compare the human and veterinary health services of Great Britain, and on the whole it is better to be a dog."
Arf!
Well, that is one physician's opinion:
"In the last few years, I have had the opportunity to compare the human and veterinary health services of Great Britain, and on the whole it is better to be a dog."
Arf!
Friday, August 07, 2009
So It's Come to This [UPDATED & BUMPED, VIDEO ADDED]
Apparently, The PiP© (Party in Power) really doesn't want to "debate" health care reform:
But of course, this was simply an isolated event, not connected with "community organizers" or anything, right?
Well...
"The meeting was organized ... the Service Employees International Union, other unions and Organizing for America, a liberal group that grew out of the Obama presidential campaign."
I'm shocked, just shocked I tell you.
[Hat Tip: Red State]
UPDATE: And it's not just in Tampa. The violence against those who dare to speak out against ObamaCare is growing:
Mr Gladney, who is black, also claims that one of those who assaulted him - who was also black - used a racial epithet.
And here I thought that "dissent is the highest form of patriotism."
UPDATE 2 (with video) - PresBo Piles On:
Oh No he didn't!
Oh Yes he did:
Oh No he didn't!
Oh Yes he did:
Seems Our Fearless Leader doesn't want to hear from us. So much for "civil debate."
Thursday, August 06, 2009
Cavalcade of Risk #84: Call for submissions
Russell Hutchinson hosts next week's edition. Submissions are due this Monday (the 10th). Russell requests that you include:
■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post
■ 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).
The Truth is Out There (Somewhere)...
As a public service, Uber-blogger Iowahawk has posted the latest missive from the Obamistration's Under-Ministry of Truth. Featuring the Under-Minister of Truth herself, Linda Douglass, this compelling and helpful alert should serve to alert alert readers to alarming alertness.
An excerpt:
This is important information, and our readers are advised to stay alert, alertly reading the whole thing.
On Health Care Reform and Abortion
There is perhaps no more divisive nor explosive issue than abortion, and we take no official stand on the morality of it. But as we've written over the years, we are most definitely proponents and advocates of the concept of "medical necessity" and the role it plays in risk management, of which insurance is a useful tool.
Contrary to previous reports, it now appears that the current proposal would, indeed, mandate coverage for abortion. Currently, the Hyde Amendment prohibits the use of public funds for that procedure; one supposes that there'll have to be some kind of legislative sleight-of-hand to get around that.
There's a more important consideration, though, which is whether there is ever a circumstance where abortion is "medically necessary." There are likely some obscure, rare circumstances (besides "the mental health of the mother") where this may be the case, but it's unlikely to be applicable in many cases. Absent medical necessity, it appears that this provision represents another mandated benefit, the cost of which will be borne by people who not only don't need it, but whose faith and convictions prohibit it.
The medical issue most relied upon by those who favor abortion is the mental health of the mother. We'll leave it to others far more qualified to speak to the validity of that argument, but we can look to how mental health benefits are currently covered for guidance in that area. The Mental Health Parity Act requires that certain benefit levels be covered under certain forms of insurance. For the most part, these apply only to group plans; individual plans, regulated at the state level, have much lower policy limits for Mental and Nervous. And, even on the group level, certain restrictions may be applied (for example, only in-network providers may be used, or the number of visits may be limited). So there's precedence for restricting benefits attributable to mental health.
Perhaps the larger issue will be the Law of Unintended Consequences. For example, those providers who choose to accept Medicare or Medicaid patients must adhere to the dictates of those programs. They can't balance bill, and they have to provide the services required by the programs. If a Public Plan becomes reality, those providers will have to decide whether or not to accept patients covered under that plan, which would apparently now include abortions. I can think of more than a few providers that might have significant issues with that.
And there's this: in its current form, it appears that while the Public Plan would cover abortions, it couldn't use federal funds, only whatever it takes in in premiums. I can think of a few more Unintended Consequences to that, as well: there may well be those who might choose the PP, but for the fact that they are opponents of abortion, and don't want to see their own dollars going directly to pay for someone else's abortion. And what about "partial birth abortion?" There is no medical justification for this procedure, and one wonders how (or if) it will be covered.
The other issue is one of utilization: when something's covered, it generally gets used. For example, the reason that maternity coverage on individual plans is so expensive (when it's available at all) is because carriers know that it has a 100% utilization rate. That is, everyone who buys that coverage ends up using it. By contrast, not everyone ends up with a broken wrist or cancer. So will abortion coverage (a related and elective procedure) also result in over-utilization, and hence significant rate increases?
Time will no doubt tell.
Recess! Health Wonk Review is up
Jaan Siderow presents the August Recess edition of the venerable Health Wonk Review. As usual, Jaan has done a terrific job of organizing the HWR, and offers plenty of context to go with each entry.
Enjoy!
Enjoy!
Wednesday, August 05, 2009
Nancy (with the laughing face)?
Not exactly. It’s Nancy (with a straight face) Pelosi: “The more the public knows about what we’re doing, the more they support it … “
Nancy, Nancy, Nancy. You ignorant slut.
The more people know about you and what you are doing in Congress, the LESS we support it.
Why d’ya think more people don't have happy-talk faces like yours (aside from the botox, I mean)? Why d’ya think this Congress – YOUR Congress – has the lowest popular support in memory? When have you ever thought about the people and not about yourself first (fixing your husband’s business taxes; stamping your foot until you got a bigger carbon-footprint airplane?)
Here are a few much more substantial reasons we the people don’t support you:
1.You rushed the enormous TARP spending bill thru the House, that neither you nor any other House Member read. You called it essential to America's economic recovery. You said that the House did not have time to debate it. Because if time were taken in debate, it would be too late. Over a thousand "earmarks" and unknown billions of dollars were discovered to be targeted to Democrat-connected political groups not honest job creation. It’s also a fact that 3/4 of the TARP spending in the first 4 months went to Medicaid and State fiscal stabilization funds – in other words, most of the money was used to shore up state budgets, not to create jobs. That is not the the “stimulus” you promised. Was this intentional misrepresentation, or just ignorant of you? Lucky for you, there’s a good argument for ignorant - because Nancy Pelosi, you never read the Bill.
2. You are now trying to rush the cap-and-trade bill thru the House. You say this Bill is essential to fight a holy war against global warming, and that Congress must pass it without delay – or debate. Obama himself, we now know, said cap-and-trade would cause energy prices in the U.S. to “skyrocket.” And energy costs affect just about everything else in the economy. Just as we are struggling to get thru a very deep economic recession, the Congress and the administration are intent on raising consumer costs. That infuriates the public you claim “supports it”. Intentionally or ignorantly you misrepresent this bill as essential for America, even though it is transparently a sell-out of American consumer interests. Lucky for you there’s a good argument for ignorantly - because Nancy Pelosi, you never read the Bill.
3. You falsely accused the CIA of concealing information from you about Iraqi prisoner interrogations. You lied about this because you were afraid the political winds were shifting. When the CIA proved they had briefed you all along, you accused them of lying. And when you could not prove that the CIA had lied, you changed the subject and the media covered for you. Everyone understands the truth that you had been fully briefed all along. Nancy Pelosi, you bet the public was too dumb to understand. Thank heavens for the internet.
4. What else? Oh, you’re at it again, pushing a huge and unexplored mass of health care legislation thru the House. You say it's “essential” (where have we heard that before?). You say Congress must pass it right away. (where have we heard that story before?) You say this Bill will reduce health care spending by so much, it will save our economy. Then you say this health care bill is being "misrepresented" by "evil” and “immoral” insurance companies and their minions. But you don’t say the Congressional Budget Office is “evil” or “immoral” for disclosing that the Bill will not only produce no savings, it will ADD TO the cost of our healthcare and TAKE AWAY our choices. But . . . hey, how could you possibly know if anyone were misrepresenting the Bill? Nancy Pelosi, you haven’t read it.
So Nancy, this pretty much explains why you are less popular than George Bush. The more the public knows about what you're doing, the more we know that you are not the change we can believe in.
Nancy, Nancy, Nancy. You ignorant slut.
The more people know about you and what you are doing in Congress, the LESS we support it.
Why d’ya think more people don't have happy-talk faces like yours (aside from the botox, I mean)? Why d’ya think this Congress – YOUR Congress – has the lowest popular support in memory? When have you ever thought about the people and not about yourself first (fixing your husband’s business taxes; stamping your foot until you got a bigger carbon-footprint airplane?)
Here are a few much more substantial reasons we the people don’t support you:
1.You rushed the enormous TARP spending bill thru the House, that neither you nor any other House Member read. You called it essential to America's economic recovery. You said that the House did not have time to debate it. Because if time were taken in debate, it would be too late. Over a thousand "earmarks" and unknown billions of dollars were discovered to be targeted to Democrat-connected political groups not honest job creation. It’s also a fact that 3/4 of the TARP spending in the first 4 months went to Medicaid and State fiscal stabilization funds – in other words, most of the money was used to shore up state budgets, not to create jobs. That is not the the “stimulus” you promised. Was this intentional misrepresentation, or just ignorant of you? Lucky for you, there’s a good argument for ignorant - because Nancy Pelosi, you never read the Bill.
2. You are now trying to rush the cap-and-trade bill thru the House. You say this Bill is essential to fight a holy war against global warming, and that Congress must pass it without delay – or debate. Obama himself, we now know, said cap-and-trade would cause energy prices in the U.S. to “skyrocket.” And energy costs affect just about everything else in the economy. Just as we are struggling to get thru a very deep economic recession, the Congress and the administration are intent on raising consumer costs. That infuriates the public you claim “supports it”. Intentionally or ignorantly you misrepresent this bill as essential for America, even though it is transparently a sell-out of American consumer interests. Lucky for you there’s a good argument for ignorantly - because Nancy Pelosi, you never read the Bill.
3. You falsely accused the CIA of concealing information from you about Iraqi prisoner interrogations. You lied about this because you were afraid the political winds were shifting. When the CIA proved they had briefed you all along, you accused them of lying. And when you could not prove that the CIA had lied, you changed the subject and the media covered for you. Everyone understands the truth that you had been fully briefed all along. Nancy Pelosi, you bet the public was too dumb to understand. Thank heavens for the internet.
4. What else? Oh, you’re at it again, pushing a huge and unexplored mass of health care legislation thru the House. You say it's “essential” (where have we heard that before?). You say Congress must pass it right away. (where have we heard that story before?) You say this Bill will reduce health care spending by so much, it will save our economy. Then you say this health care bill is being "misrepresented" by "evil” and “immoral” insurance companies and their minions. But you don’t say the Congressional Budget Office is “evil” or “immoral” for disclosing that the Bill will not only produce no savings, it will ADD TO the cost of our healthcare and TAKE AWAY our choices. But . . . hey, how could you possibly know if anyone were misrepresenting the Bill? Nancy Pelosi, you haven’t read it.
So Nancy, this pretty much explains why you are less popular than George Bush. The more the public knows about what you're doing, the more we know that you are not the change we can believe in.
Medical Tourism Coverage: Why in the World?
We've certainly blogged about Medical Tourism - traveling out of one's home country for medical care - but we've never really talked about how one pays for such care. Generally, these trips aren't covered by one's insurance, so they're primarily self-pay. That's fine if one has a few thousand extra dollars laying around, or can arrange financing, but what about us "regular folk?" Turns out, there's a whole cottage industry that offers to help fund these ventures, and I was fortunate enough to interview the president of one such company, Companion Global Healthcare's David Boucher. I spoke with David late last week, and asked him about how this kind of coverage works.
David's the former CEO of a hospital, and has extensive private sector experience from both that perspective and as an executive with Blue Cross of South Carolina.
IB: David, thank you for speaking with us about Medical Tourism Coverage. One of the major concerns folks have is the quality of the facilities available.
DB: Well, we don't use just any hospital; all the ones we use are JCI-accredited [ed: this is the Joint Commission International, which FoIB Rick Byrne tells us is " the same organization that Medicare requires American hospitals to be accredited by if they are to receive Medicare reimbursement."] We do an extensive onsite survey of each facility to make sure they meet - and continue to meet - our standards, not just JCI's.
IB: We've blogged about Canadians accessing American health care when their own system can't, or won't , help them. How does this impact that kind of care?
DB: It's not just Canadians, and they're not just driving to Detroit for care. Why should they, when they can get world-class care in Bangkok, and have a wonderful travel experience in the process? Our goal is the "no nurse call" metric; that is, a patient should never have to press that button. If they do, it means we haven't done our job.
Of course, we can't guarantee this every time, but our members consistently have a better experience in our foreign facilities than many American hospitals. And, of course, there are significant cost savings in using these types of facilities.
IB: That's great, but I'm looking at this as an agent, and I'm having a hard time picturing myself going to a small group client and saying, "hey, you should add - and pay for - this extra benefit." For one thing, even if MT saves on claims, why should my small business client care? His claims aren't really based on his group's experience.
A large group, especially one that's self-funded, might see some decent savings, but that's not the majority of businesses here. And from the employee's standpoint, there's even less incentive: he's got a deductible and co-insurance to pay regardless, what does he care of it saves the insurance company thousands of dollars on the other end?
DB: That's right, there'd be no real savings for small groups if we just treated this as an ancillary product, like dental or short term disability. But our plan is to package the product as an integral part of the group medical plan, and to convince carriers to add it to their portfolio as an additional benefit, a way to differentiate their policies from their competitors. We'd also like to see them make it more attractive to the employee; for example, by waiving the deductible or the co-insurance of that employee chose to use one of our overseas facilities.
We're already seeing this pay off for our individual clients, by the way; our plan is included in Companion's mini-med product. If one has a limited benefit, which by definition these products do, then one's dollars can go a lot farther by traveling for care. A $2000 daily hospital benefit goes a lot farther in Costa Rica than Dayton, for example.
And it's not just medical care. We have a Global Dental product that provides the same kind of services and pricing. And it really shines because most of the big-ticket dental items are out-of-pocket for the consumer. Dental plans typically have a $1000 or $1500 annual maximum that they'll pay; if one is looking at a procedure that costs $15000 in the states, but $6000 in, say, Costa Rica, why wouldn't you take that trip?
IB: That's a lot to consider. Thanks for all your time, and we'll pass along any questins or comments our readers might have.
David's the former CEO of a hospital, and has extensive private sector experience from both that perspective and as an executive with Blue Cross of South Carolina.
IB: David, thank you for speaking with us about Medical Tourism Coverage. One of the major concerns folks have is the quality of the facilities available.
DB: Well, we don't use just any hospital; all the ones we use are JCI-accredited [ed: this is the Joint Commission International, which FoIB Rick Byrne tells us is " the same organization that Medicare requires American hospitals to be accredited by if they are to receive Medicare reimbursement."] We do an extensive onsite survey of each facility to make sure they meet - and continue to meet - our standards, not just JCI's.
IB: We've blogged about Canadians accessing American health care when their own system can't, or won't , help them. How does this impact that kind of care?
DB: It's not just Canadians, and they're not just driving to Detroit for care. Why should they, when they can get world-class care in Bangkok, and have a wonderful travel experience in the process? Our goal is the "no nurse call" metric; that is, a patient should never have to press that button. If they do, it means we haven't done our job.
Of course, we can't guarantee this every time, but our members consistently have a better experience in our foreign facilities than many American hospitals. And, of course, there are significant cost savings in using these types of facilities.
IB: That's great, but I'm looking at this as an agent, and I'm having a hard time picturing myself going to a small group client and saying, "hey, you should add - and pay for - this extra benefit." For one thing, even if MT saves on claims, why should my small business client care? His claims aren't really based on his group's experience.
A large group, especially one that's self-funded, might see some decent savings, but that's not the majority of businesses here. And from the employee's standpoint, there's even less incentive: he's got a deductible and co-insurance to pay regardless, what does he care of it saves the insurance company thousands of dollars on the other end?
DB: That's right, there'd be no real savings for small groups if we just treated this as an ancillary product, like dental or short term disability. But our plan is to package the product as an integral part of the group medical plan, and to convince carriers to add it to their portfolio as an additional benefit, a way to differentiate their policies from their competitors. We'd also like to see them make it more attractive to the employee; for example, by waiving the deductible or the co-insurance of that employee chose to use one of our overseas facilities.
We're already seeing this pay off for our individual clients, by the way; our plan is included in Companion's mini-med product. If one has a limited benefit, which by definition these products do, then one's dollars can go a lot farther by traveling for care. A $2000 daily hospital benefit goes a lot farther in Costa Rica than Dayton, for example.
And it's not just medical care. We have a Global Dental product that provides the same kind of services and pricing. And it really shines because most of the big-ticket dental items are out-of-pocket for the consumer. Dental plans typically have a $1000 or $1500 annual maximum that they'll pay; if one is looking at a procedure that costs $15000 in the states, but $6000 in, say, Costa Rica, why wouldn't you take that trip?
IB: That's a lot to consider. Thanks for all your time, and we'll pass along any questins or comments our readers might have.
"That Picture" Update
A week and half ago, we reported that "the current Party in Power© doesn't much like the light of day shining on their misguided attempt to "transform" American health care. A group of Republican lawmakers" were prevented from mailing a chart of the current health care proposal to their constituents.
We're happy to report that "House Democrats agreed late last week to allow Republicans to send their constituents a mailing critical of the majority’s health care bills, after a two-week delay caused by Democratic allegations that the mailing was inaccurate."
Good news all around.
[Hat Tip: Michelle Malkin]
Shoe, Meet Other Foot... (Take Four)
For the fourth time (that I can recall), I've been interviewed by another on-line publication. This time, Kaiser Health Network (which has sent us some nice traffic over the past few years) asked for my prognostications regarding the role of agents if ObamaCare actually "happens." Since I am by nature a fairly reclusive and quiet person with few strong opinions, I was at first reluctant. But since my interviewer uttered the magic words "Kate Steadman thought you'd have an interesting take on this" well, how could I refuse?
In the event, you can read the results here.
Be kind.
Chilling Effect?
Just when it seemed the Obamistration couldn't sink any lower, now comes word of a new effort to silence critics:
Of course, anything which might be seen as opposition to a government take-over of our health care system appears to be "fishy" to its proponents. Students of history may recall that the East German Stasi used comparable tactics to keep their citizens in line.
On the other hand, I think it would be terribly irresponsible to email THIS LINK to the watchdogs; after all, it seems to directly contradict their case, and casts some serious (or are they "fishy?") doubts on their numbers.
I know I already did.
(Once again, that email address is flag@whitehouse.gov)
[Hat Tip: Ace of Spades]
Tuesday, August 04, 2009
He Said, He Said
Did our illustrious Chief Executive actually propose the demise of private health insurance in favor of a national plan, or didn't he? And do his actual, spoken words mean what we think they do? We posted the video yesterday; it seems pretty clear that the President (and his cohorts) mean precisely that they intend to do away with private sector health insurance.
But the White House claims that The Obamaman was quoted out of context; according to WH SpokesCritter Linda Douglass, "nothing can be farther from the truth. You know the people who always try to SCARE people whenever you try to bring them health-insurance reform are at it again."
So which is it? Are those opposed to a gummint-run system simply fear-mongering? Or is there fire to go with all the smoke?
You be the judge.
Drudge-protege Andrew Breitbart has posted the full, uncut quote. Take a look, and let us know what you think:
Stupid Agent Tricks: CE Edition
FoIB Rick Byrne tips us to this story from Hamilton, Ohio:
Apparently, Mr Armstrong would hold a "class" with no actual instruction, but would have agents sign-in and out as if they had been in class, and would receive much-needed Continuing Education credits.
Here's the thing: I've been to a few classes over the years that turned out to be nothing more than sales shpiels for a particular product or carrier. And I've been to my share of "snooze-fest" classes, too (full disclosure: as regular readers know, I'm also a licensed CE provider and instructor). But the sales shpiel classes were free, and the snoozers were, at least on paper, legit. Mr Armstrong, however, had a somewhat different business model:
"As part of his scheme, Mr. Armstrong established the “Friends of George” program where, for a fee, he would provide an agent with educational credits."
Shoot! Why didn't I think of that?!
The news isn't much better for those agents complicit in Mr A's little scheme. For one thing, those "classes" won't count toward the state's CE requirements, so they'll have to be made up [ed: couldn't you find a better choice of words there?], which means a triple whammy: first, they paid George whatever fee he charged; second, they'll have to pay a real provider for the make-up classes; and third, they face substantial fines by the state.
Ouch!
What strikes me as perhaps the most stupid aspect of this is that we have a paltry 20 hours to complete over the course of two years. That's less than an hour a month, and most classes don't have any kind of test or participation requirements. It's just not that hard to find legit classes, and a lot of them are free to the agent. How lazy are Mr Arnstrong's clients that they felt it appropriate to participate in his little scheme, and why would anyone trust them for their insurance needs?
9/11, 8 Years On
Project 2,996 is an online effort to remember and honor our fellow Americans who died on that September morning eight years ago. Once again, InsureBlog will be participating, and we'd urge our fellow denizens of the blogosphere to consider signing on, as well.
For details, and to sign up, just click here.
August Wikio Rankings Released - InsureBlog Exclusive
This month's Wikio Rankings are out, and once again IB has been selected to post the results. We are, of course, honored and delighted to do so:
A Wallace & Gromit Grand Rounds
Nurse Kim at Emergiblog has put together what she calls a Cracking Grand Rounds, replete with great W&G snippets. But don't let the fun animations fool you, there's a serious amount of useful info to go through, and well worth the effort.
Monday, August 03, 2009
On Trojan Horses and "The Public Option"
There are those who would caution that one shouldn't believe everything a politician says, and I agree with that. On the other hand, one would be wise to believe some of the things they say, such as the claim by the Party in Power© that the so-called "Public Option" is, in fact, the first play towards a single-payer, government-run health care system.
Now, who would dare make such an outrageous claim? Well, if you don't believe us, how about President Obama, Rep Barney Frank and Rep Jan Schakowsky:
[Hat Tip: Reader Tom T]
Snidely Whiplash, CLU
We must admit to being a bit worried when House Speaker Nancy "Botox Nan" Pelosi identified us as "the villains in this" debate, literally "carpet bombing" our clients and fellow citizens (with, one supposes, boxes of expired policy forms). After all, it's not every day that one of the most prominent figures in Washington calls your industry evil. On the other hand, we were hopeful that this little contretemps would blow over, and that the American Public© wouldn't notice our satanic inclinations.
Alas and alack, this was not to be. This morning's email brought this missive from Nieman Watchdog:
"The public option, unlike single payer, cannot recapture the $400 billion in administrative waste that private insurers generate in their drive to fight claims, deny care and screen out the sick."
Dang, are they onto us already?
I quickly called my masters, er, um, associates at some of the major carriers to confirm these numbers. Interestingly, every single one has a specific line-item in their budget for such things as "unsupportable but routine claims denials," "indefensible policy recissions," and one even had an item called "pre-screens: a great way to decline the sickies."
As one might imagine, I was appalled and/or relieved. The bad news is that none of the carriers had budgeted more than a token amount to these worthy efforts. The numbers are, of course, a matter of public record (every carrier files an annual report to their stockholders and state insurance departments). According to my research, it appears that most are spending less than $1,000 a year on these efforts, although one, which will remain nameless, is on track to spend upwards of $1,100 this year alone.
Still, this is a far, far cry from the "$400 billion" that the Nieman folks are alleging. Unfortunately, neither the email nor the author of the ingenious study provided any citations to back up the assertion that such a large sum is, indeed, being expended in this great cause.
'Tis a pity.
MVNHS© - Ouch!
Such is the (potential) future of American health care:
British doc's are warning that a recent decision by the MVNHS© (Much Vaunted National Health System) that patients whose back pain has no discernible cause will be denied much-needed pain meds. Of course, in keeping with the British mandate of tossing the elderly under the tram, this edict is expected to affect seniors first. And since most live on fixed incomes, the $830 cost of a single injection is likely to be a real pain in the...well, you know.
Of course, the Law of Unintended Consequences also makes a cameo:
"(T)he British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery."
That's because - at least so far - such surgeries are covered by "The System,"and therefore more attractive than continuing to live a life of pain.
But the Brits aren't the only ones feeling the tender foot of government-sponsored health care rationing on the backs of their necks:
Ooops.
Or, as the French would say, "quelle surpise!"
That European health care would become a political soccerball is, of course, to be expected. We see that here, and people are, after all, people. What is surprising, however, is how many Americans want to emulate the "success" of such a system here, at the expense of our own mostly successful experience.
The challenge is that, unless one has a realistic plan to rein in health care costs, the financing of that care (i.e. insurance) becomes problematic:
"A World Health Organization survey in 2000 found that France had the world's best health system. But that has come at a high price; health budgets have been in the red since 1988.
In 1996, France introduced targets for health insurance spending. But a decade later, the deficit had doubled to 49 billion euros ($69 billion)."
A not unexpected development, especially for folks who've been paying attention. Or, to put it another way:
"I would warn Americans that once the government gets its nose into health care, it's hard to stop the dangerous effects later," said Valentin Petkantchin, of the Institut Economique Molinari in France. He said many private providers have been pushed out, forcing a dependence on an overstretched public system."
Such, for example, has been the experience in Tennessee:
Sound familiar?
We last blogged on TennCare two years ago, and noted then that the program was in deep financial straits:
Of course, it's only gotten worse:
"Tennessee is in the process of cutting about 150,000 people from the TennCare program after a reevaluation of enrollee eligibility to participate in the state-run insurance program."
Of course, when it's a national plan, eligibility becomes more, um, interesting . And the issue of costs becomes even more pronounced. Tennessee Representative Marsha Blackburn was a mere state senator when TennCare came into being; she recalls that "supporters of the Tennessee program said it would save money, [but] it wound up eating 38 percent of the state’s budget." One wonders if CongressCritters wouldn't consider that 38% as a feature, not a bug.
Carnival of Personal Finance - Early August Edition
Bob at the Christian Personal Finance blog presents this week's collection of helpful, and potentially useful, posts on personal finance. Check it out for some great posts and unique quotes.
Sunday, August 02, 2009
Great moments in U.S. History - you had to be there
“I guess I’ll sign it - all the other guys did”
John Hancock, before signing the Declaration of Independence, July 4, 1776
“This better be good, Franklin – I don’t have a bunch of lawyers to tell me what it means”
George Washington, before signing the Constitution, September 17, 1787
“OK, OK, Seward, Stanton - just remember, YOU talked me into this, I’m not responsible”
Abraham Lincoln, before signing the Emancipation Proclamation, January 1, 1863
“I guess maybe if I sign this thing, these proceedings would be closed – what do you guys think I should do?”
General Douglas McArthur before signing the Japanese surrender treaty, September 2, 1945
“What good is reading the bill if it's a thousand pages and you don't have two days and two lawyers to find out what it means after you read the bill?”
Michigan Congressman, the Honorable John Conyers, explaining why he doesn’t have time or inclination to read a bill before he votes on it, July 28, 2009.
John Hancock, before signing the Declaration of Independence, July 4, 1776
“This better be good, Franklin – I don’t have a bunch of lawyers to tell me what it means”
George Washington, before signing the Constitution, September 17, 1787
“OK, OK, Seward, Stanton - just remember, YOU talked me into this, I’m not responsible”
Abraham Lincoln, before signing the Emancipation Proclamation, January 1, 1863
“I guess maybe if I sign this thing, these proceedings would be closed – what do you guys think I should do?”
General Douglas McArthur before signing the Japanese surrender treaty, September 2, 1945
“What good is reading the bill if it's a thousand pages and you don't have two days and two lawyers to find out what it means after you read the bill?”
Michigan Congressman, the Honorable John Conyers, explaining why he doesn’t have time or inclination to read a bill before he votes on it, July 28, 2009.
Saturday, August 01, 2009
I prefer to keep the "clunker" I have, thank you
Here are 10 reasons to refute the notion that U.S. health care system is in desperate need of a government trade-in:
1. Americans have better survival rates than Europeans for common cancers.
2. Americans have lower cancer mortality rates than Canadians.
3. Americans have better access to treatment for chronic diseases than patients in other developed countries.
4. Americans have better access to preventive cancer screening than Canadians.
5. Lower-income Americans are in better health than comparable Canadians.
6. Americans spend less time waiting for care than patients in Canada and the United Kingdom.
7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
8. Americans are more satisfied with the care they receive than Canadians.
9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain.
10. Americans are responsible for the vast majority of all health care innovations.
The linked article from which this list is taken was written by Scott W. Atlas, a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.
Dr. Atlas adds discussion of each point at the link. Read the whole thing – it will be good for you.
UPDATE [HGS]: In the comments, Marc makes the eminently reasonable request for links documenting the claims. We aim to please.
1. Americans have better survival rates than Europeans for common cancers.
2. Americans have lower cancer mortality rates than Canadians.
3. Americans have better access to treatment for chronic diseases than patients in other developed countries.
4. Americans have better access to preventive cancer screening than Canadians.
5. Lower-income Americans are in better health than comparable Canadians.
6. Americans spend less time waiting for care than patients in Canada and the United Kingdom.
7. People in countries with more government control of health care are highly dissatisfied and believe reform is needed.
8. Americans are more satisfied with the care they receive than Canadians.
9. Americans have better access to important new technologies such as medical imaging than do patients in Canada or Britain.
10. Americans are responsible for the vast majority of all health care innovations.
The linked article from which this list is taken was written by Scott W. Atlas, a senior fellow at the Hoover Institution and a professor of radiology and chief of neuroradiology at Stanford University Medical School.
Dr. Atlas adds discussion of each point at the link. Read the whole thing – it will be good for you.
UPDATE [HGS]: In the comments, Marc makes the eminently reasonable request for links documenting the claims. We aim to please.
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