Tuesday, July 17, 2007

Grand Rounds...

Just keeps on getting better and better. This week's host, 22 year old Canadian Medical student Vitum Medicinus takes an interesting approach: not content with including helpful context and a thoughtful layout, VM explains why each post is a "must-read," and even hands out "awards" based on a post's topic.
There are almost 3 dozen excellent choices, so you really can't go wrong with any of them. That said, I was particularly intrigued by Ad Libitum's post on various privacy and HIPAA issues arise when one writes about a patient or client; equally interesting, what if you're the patient or client?

Monday, July 16, 2007

Tranny Deduction

Consumer driven healthcare has generally been about price transparency and patient empowerment. We've talked about various tax advantages inherent in "alternative benefit plans" like FSA's and HSA's. These advantages flow from an IRS document (213d) which delineate what's "kosher" for such reimbursements.

Obvious expenses include prescription med's, non-reimbursed office visits, even orthopedic hosiery. Obviously non-eligible expenses include hot tubs* and ski trips to Aspen.

But what about sex-change operations?

[ed: Hunh?]

Well, hip replacement surgery is okey-dokey, as is breast-reconstruction following a cancer-related mastectomy. Wouldn't it follow, then that gender-realignment procedures would be eligible for consideration?

Well, according to those neanderthals at the IRS, the answer is "no:"

And there it stands; the gentleman, er, lady in question has sued the IRS, seeking to have the substantial cost of the surgery made eligible for special tax treatment. The IRS maintains that this is elective, cosmetic surgery; the plaintiff argues that it's medically necessary.

Should make for some fascinating Court TV.

[*See comments for an update]

Late-Breaking Carnival Monday

A jam-packed edition of the Carnival of Personal Finance awaits you at MintCN blog. There's an amazing 70 entries, lots of helpful categories and context, and a twist: along with each post actually submitted, the our host includes a link to the very first post on that blog. Very cool.
The Silicon Valley Blogger has an unusual post: we've all heard of discrimination based on race, or religion, or sexual orientation. But based on your name? It's for real.

Friday, July 13, 2007

Cavalcade #30: Submissions Due

Just a reminder that submissions for next week's CoR are due Monday (the 16th). Our host, Richard Eskow, asks that you PLEASE include:
■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post
You can submit them via Blog Carnival or email.
We still have Fall '07 hosting slots available. Hosting is fun, easy, and gets you off the "nag" list. Just drop us a line!

Thursday, July 12, 2007

Health Wonk Review

Fellow insurance blogger Jay Norris presents a terrific HWR. Chock full of interesting posts and helpful context, it is, as Jay notes, "the cream of the crop of recent entries in the ongoing US health care policy discussion."
Unfortunately, Jay's site (the Colorado Health Insurance Insider) is experiencing some tech problems, so the HWR seems to come and go. Hitting the "refresh" button sometimes helps; we'll let you know when it's running at 100%.
UPDATE: Well, it seems that Jay's got some of the tech issues resolved, and I was able to look through the 17 entries. They all looked interesting (and indeed, I would encourage folks to read all of them when they have the time), but Roy Poses' item on DTC goes Door-to-Door is a must-read.

Wednesday, July 11, 2007

Joinin' the Club...

We were invited to join early on, and we did; it seems like a good way to judge the depth of interest on this side of the debate.
■ Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
■ “Universal coverage” could be achieved only by forcing everyone to buy health insurance or by having government provide health insurance to all, neither of which is desirable.
■ In a free society, people should have the right to refuse health insurance.
■ If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”
Seems pretty straightforward to us, and apparently to quite a few others: in addition to IB, members include such diverse folks as the Illinois Policy Institute, big time econblogger Arnold Kling, even Andrew Sullivan (that one stopped me cold).
We'll have more on the 'Club as details become available.
[A big Thank You to Tom Tullis for the terrific graphic]

Tuesday, July 10, 2007

Lying with Numbers...

Over the years, we've had our own doubts about that ubiquitous "45 million uninsured." For one thing, "uninsured" doesn't mean "without access to healthcare." For another, that number has always been a "snapshot:" it's never the same (alleged) 45 million folks from year to year (or even month to month).
And now, thanks to Junk Yard Dog blog, we learn that the number itself is (no real surprise to IB readers), ahem, "inflated:"
"Ooops" for sure.
What that means is that even if we take that "45 million" at face value (which is dubious, at best), less than 80% of those are actual, real Americans. The rest are simply skipping out on the healthcare available in their own countries.
That's a big "Oops."

Hypothetically Speaking...

We've blogged before about ethical conundrums and issues, and we've talked about how important it is to be truthful when applying for insurance.
And I believe fervently that doing the right thing is always the best choice.
One thing I would never do, for example, is encourage or condone any client misrepresenting facts when completing an insurance application. For one thing, in this age of EMR and other tech, it's just too darned easy to get "caught out," particularly when answering questions about one's own health.
Okay, Prof, so where's this heading?
Life insurance applications have always (or almost always) asked about family history: are your folks still alive? If not, when and how did they die? That kind of thing. Recently, at an online forum to which I occasionally contribute, a respected colleague discussed a recent case of his:
"So far, this person qualifies for Super Preferred. The kicker, his father passed away at age 57 of a heart attack. Now, many carriers have moved him from Super Preferred all the way down to Standard. However, there are still a few carriers that will offer Preferred and be much less expensive than the standard rates."
I've known this, of course, but for some reason I started really considering the implications:
1) What if the client had been adopted? He'd have had no way of knowing, really, whether his father was even still alive, dropped dead of a heart attack at age 32, or whatever. Does that mean he could never get super preferrred rates from certain carriers?
2) How could a carrier ever really check this? It's not like they'd have access to his father's death certificate or medical records. What if he did lie ("Dad? Oh, he was killed in a train wreck at age 92")? How would an underwriter know?
My point isn't to suggest or condone lying on an application. Rather, it's to underscore the futility of even asking the question. Yes, it's relevant (to a point): if Dad died of a stroke at age 49, then that may indicate some genetic predisposition to heart problems.
Or not.
This is one of those "gray" areas that agents (and applicants) abhor, and which carriers might be well-advised to review (and revise).

Grand Rounds

Tara Smith, Assistant Professor of Epidemiology at a university in Iowa (although she's originally from here in the Buckeye State), hosts this week's Grand Rounds. And it's truly grand: she's provided interesting categories, helpful context and gorgeous photos; who could ask for anything more? Oh yeah, and there are 3 dozen posts from which to choose.
I actually had two favorites from this crop:
Here at IB, we're all about transparency in health care (okay, that's a bit of an exaggeration, but we do spend a lot of time promoting it). The oft-unstated "other side of the coin" is the subject of Emergiblog's Kim muses on patients' responsibilities in the exchange.
And over at the Health Business Blog, David Williams has some serious questions about the relatively new, but burgeoning, "concierge" model of health care practices. He asks if some of these medico-entrpreneurs aren't using a bit of "fuzzy math" in their calculations.

Monday, July 09, 2007

It's Cool to be PC (P&C, that is)

A while back, I stumbled on a P&C (property and casualty) related blog, run by fellow insurance agent Aaron Wallrich of Wisconsin. I've been following it for a while, and find it just fascinating: a fellow cynic when it comes to carriers, with a quirky, pleasant sense of humor and self-deprecation ("Very interesting stuff for an insurance nerd like me").
If you've got an interest in seeing the P&C side of "the biz," Swift Rate is the place to go.

Carnival Monday

This week's Carnival of Personal Finance continues the trend I've grown to like: Jennifer Lynn presents a (relatively) short list of "Editor's Choice" items, followed by a list of the other submissions (most of which included helpful context).
Although I consider myself a "geek," I haven't rushed out to buy an iPhone. For one thing, I really just want my cell to make and receive phone calls, not play music, or shoot video, and I already have a Palm Pilot (all right, it's really a Clie, but I call all PDA's "Pilots"). So I really appreciated The Money Well's take on our need for "instant gratification," with the iPhone being his springboard. Interesting.
And the Carnival of the Capitalists is also up, hosted this week by The Married Cook Guy (now there's a fellow foodie!). Like the CoPF, our host chose a handful (10) of posts to highlight. While I'm pleased that we made the cut (ours is, in fact, the top post), I was disappointed that the posts that didn't weren't linked in any way. Still, that's the host's prerogative.
Since my industry seems to take a lot of grief in the profit-motive department, I found The Time and Money Group 's comparison of profit margins in different industries quite eye-opening.

Sunday, July 08, 2007

Michael and Me

I haven't seen all of Sicko, just enough to make a few comments. Yeah, the production looks good technically but basically, I think the movie should be no more relevant than, say, Hunt for Red October to an intelligent discussion of the issues of health care and health insurance. Why do I say that?

Because the undeniable fact is that insurance is expensive because health care is expensive, not the other way around. Does Moore say that? No he does not. The cost of insurance is rising because the cost of health care is rising. Does Moore say that? No, he does not. The high cost of insurance is a symptom of the deeper problem of health care costs – and if our nation cannot solve the deeper problem, we will never be rid of the symptom. Does Moore say that? No, he does not. He’s pecking around the fringes, not facing the problem itself. Worse he does not clearly articulate the problem as either health care or health insurance. Sorta like some people in Colonial times, he’s stuck a feather in his cap and called it macaroni. Of course what one sees is nonsense on stilts. But it is what it is.

So Moore confuses the difference between health care and health insurance – I think deliberately, since Moore is not a stupid man. Confusing these two hides the real problem. It ends up feeding people’s fears that they cannot afford “health care” because they can’t buy insurance when the truth is that most of us can’t afford health care because HEALTH CARE costs so freakin much!

IMO, what Moore is selling will screw us. And because I think he knows exactly what he is doing, I see him less as an advocate and more as a pimp. By pushing confusion about the deeper problem, Moore in fact is an impediment to understanding. That is why I say, the movie should be irrelevant to an intelligent discussion. Should be. But won’t be. Won’t be irrelevant because the discussion is driven by naivete, ignorance, fear, and cynical politics.

It is a natural human temptation to minimize the importance of facts one doesn’t want to be true, especially when the facts reveal problems that are very difficult to solve. In this case, I believe that the people who are most pleased with Moore’s movie don’t want certain facts to be true. Think about our government's biggest existing health insurance programs - Medicare and Medicaid. Facts are, these programs are rapidly being crushed by the cost of health care (Medicare alone has a $60 Trillion unfunded liability) and are far from effective in meeting the needs of the elderly and poor populations because of fraud, waste, federal budget politics, political corruption, organizational inflexibility, bureaucracy, and the massive amount of law & regulation that governs everything they do. Add to that the health costs driven by our own unhealthy behaviors; we are becoming a population that refuses to take responsibility for our own health except as it can come in a pill-bottle or operation that we demand someone else pay for.

Is there a single reason to suppose that these problems would go away - that our government could do a "better" job with health insurance - if only the government controlled all of it? I think the answer is obvious. No, it could not.

Many of the same people who prefer not to talk about the very real problems in our present government insurance programs, also don’t want to take seriously the problems and occasional failures in other countries’ health insurance schemes. As though if they were to admit there might be a problem elsewhere, the cause of attaining the universal health care in this country would be derailed. Is universal health care such a fragile patient that it cannot stand an honest examination?

IMO, an unwillingness to consider forthrightly the problems that all governmental insurance systems do have is a major obstacle to designing a plan that has a chance of being a “solution”. It is an obstacle because it gets in the way of clear analysis. Instead we hear far too many ad hominem attacks, or appeals to false authority, or fallacious logic, or the old chestnuts “everyone knows” and “this is a no-brainer” not to mention the usual litany of complaints about the cost of insurance, all the while ignoring the cost of health care that is responsible for the high cost of insurance.

BTW, I favor universal health care. I also favor universal health insurance to help pay for health care. There is a lot of work to do because wishing does not make it so. I do not confuse health care with health insurance. I believe that the linkage of group health insurance with one’s employment, while a useful tactic for decades, has outlived its usefulness and it’s time to re-think. At the same time, I believe that any universal insurance scheme whether public or private CANNOT succeed in this country, unless the costs of health care can be reduced and the annual rate of growth in those costs is brought under meaningful control. I favor a substantial role for the private insurance sector in any universal health insurance scheme - as in France, or Germany, or Chile or other countries. IMO, a basic public insurance plan that can be supplemented by private insurance is a reasonable approach and a preferable alternative to the enormous bureaucracy that results within a fully-centralized health care and insurance system such as in the U.K. And, of course, I think that Moore’s movie should be irrelevant to an intelligent discussion of the issues with either health care or health insurance in this country.

Saturday, July 07, 2007

Flooding across the Pond

From time to time, we like to dabble a bit in the P&C (property and casualty) side of "the biz." This includes items like auto, home and liability insurance, as opposed to our regular fare of life and health.

About two years ago, we participated in the blogosphere's efforts to help victims of Hurricane Katrina (which project, apparently, was more successful than our own gummint's). And while that was a terrifically satisfying endeavor, we never underestimated the vast reserves and dedication of the P&C "cat" teams who slogged through the devastation, dispensing help and, more importantly, cash.

At the other end of the spectrum, Britain's NHS (National Health System) has been the target of more than a few of our posts, and rightly so. But our English cousins haven't (yet) nationalized their P&C industry, which is now trying to cope with floods that compare to that which we saw in NOLA. Apparently, the Brits' carriers are up to the task, but an interesting question arises:

"So why do one in four people, almost a third in Scotland and London, take a risk and not insure their contents?"

That's a lot of uninsured folks, many of whom now face financial ruin, displacement and worse. Some, of course, are just natural risk-takers, and we have many of our own of this ilk here in the 'States. For others, it's a matter of economics: if you can barely afford to eat, then insurance premiums are probably not high on your list of necessary purchases. I'm not sure I entirely buy that: the premium quoted in the Times article, £200 (about $400) a year, works out to less than $10 a week, which doesn't seem overwhelming.

Which gives rise to the real questions:

"Should we save them when the floodwater rises? Or do we stand purse-lipped at their lack of providence, as the loss adjuster with his clipboard sanctions our new suite?"

Tough choices. What was that about stiff upper lips?

Thursday, July 05, 2007

Very Cool Web Tool

FoIB Chris Parks has a (relatively) new web tool, Find Your Doc. It's fast, easy, and free.
Have you forgotten your doc's phone number? Been traveling and need the name of a local cardiologist? Go to FYD, type in a name, or city, or a specialty (or any combination thereof), and voila! (French for "violin!"), up pops name, address and phone number.
Very cool, and very useful.

Cavalcade of Risk #29 is up!

Wenchy, hostess of Wisdom from Wenchypoo, has this week's Cavalcade of Risk. She's got over a dozen risk-related posts. Please check it out.

And consider hosting a Cav yourself; Wenchy can tell you that it's easy, fun, and a nice traffic bump. Just drop us a line to sign up.

Wednesday, July 04, 2007

Happy Independence Day!

To all of our readers, please enjoy a fun (and safe) holiday!

God Bless America and those who serve her.

(For truly patriotic/geeky IB readers, these folks are actually live-blogging the Continental Congress as it ponders its options. Fascinating)

Tuesday, July 03, 2007

The Terror/Medicine Connection

[Welcome Industry Radar readers!]
Bob's been taking a lot of heat for the title of his recent post about the dangers of nationalized health care, and amidst that kerfluffle, I think a number of important issues have been left unaddressed by those who object to that title.
First, although we're a medblog, not a poliblog (political blog), there are some undeniably political undertones to the subject at hand. For example, those who feign offense at the term "terrorism" when applied to health care seem to have missed the fact that, daily, much of our "regular" media call those who blow up others "insurgents," or "militants," but rarely (if ever) "terrorists." So I not only don't think that the word is overused; if anything, it's not used enough.
Second, although this seems to have gone unremarked in the medblogosphere, many (perhaps most) of those involved in the recent terror attacks in Great Britain have themselves been physicians. One supposes that, for them, the Hippocratic oath has a somewhat unusual application:
In fact, all of the physicians involved were employees of the National Health Service. Now, whether or not it's fair to indict the entire system for the actions of a few may be up for debate, but it's no coincidence that these folks were doctors for the NHS: for some time, medical personnel have been "fast-tracked" for immigration into Britain (as they were here, as well, in our 9/10 world). One is free to draw one's own conclusions from this set of facts, of course, but it should certainly mean that the discussion is relevant.
And necessary.

A Patriotic 'Rounds

Over My Med Body brings us this week's Grand Rounds, a thoughtful (and irreverent) collection of the best medblog posts of the past week or so. Our host is a 3rd year medical student who took time away from his/her studies to put together this week's 'Rounds, complete with video, graphics and helpful context.
With over 3 dozen interesting entries, it was a challenge finding a "best of," but this post at Junk Food Science blog touched a nerve: hostess Sandy Szwarc has some disturbing news from Britain's National Health Service.
It's not pretty, but it's pretty important.

Monday, July 02, 2007

Massive Mass Ifs (Part 1)

Here's the dilemna: on the one hand, I'm generally a pretty upbeat kinda guy. On the other, I'm also a pragmatist, so when I read about massive government programs that purport to solve a problem, it's second nature to ferret out what new problems the original "solution" created.
So what's my point, you may wonder? [ed: um, yeah!]
We've written extensively about the "new" Massachusetts health insurance initiative (here, here, and here, for starters). One of the overarching themes we've addressed is that mandatory coverage without significant, realistic inducements is a non-starter. We can see that happening already, because the Mass Health Plan officially "kicked in" yesterday (July 1st).
The response appears to be underwhelming: "since October, about 130,000 have enrolled in an expanded Medicaid program or insurance that offers free or subsidized care to the poor." D'uh! But the problem is that "free" isn't the same as "mandatory," and adding more "freeloaders" to an already strained Medicare system will inevitably lead to even more taxes. Vicious cycle, indeed.
But wait, it gets better (or worse, depending on one's perspective): Most folks get their insurance through their employers. In Massachusetts, employers are now required to offer health insurance (to the tune of thousands of dollars per year for each employee), or face a devastating fine (less than $300 per employee per year). Gee, I wonder how that's going to play out [ed: cynic!].
USA Today's article gives us some real world numbers to explore, which turns out to be pretty helpful: "Glen Baker, who runs five Wendy's restaurants with 140 employees in the state and offers health insurance to his workers" asks "(w)hat's this going to do to me?" Here's how his insurance premiums work out:
Single employees pay $180 per month, and those with dependent coverage fork over $540. Not too hateful, right? But that's only half the story (well, technically, less than half): those number represent only 45% of the total premium So single cover really costs $400 a month (of which Baker's company pays $220), and family cover is a whopping $1,200 (with the employer paying well over $600). Let's do the math: $220 a month, or $300 a year? $660 a month, or $300 a year? Einstein isn't really necessary here.
In Part 2, we'll look at how those subsidies really work.
Or don't.

Personal Finance...

This week's Carnival of Personal Finance is now up, hosted by the nice folks at Blogging Away Debt. There are over 70 entries, and our hostess has tried something new: a half dozen or so "editor's choice" posts, complete with excerpts, top the list, with the remaining entries available below them.
At first, I found this a bit off-putting, but then I recalled something I wrote a few weeks ago about how unwieldy these things (carnivals) have become. I suggested that those who run the carnivals "give the host some editorial discretion and specific guidelines, and tell them to pick the best (most relevant?) 15 or 20 for the actual Carnival, but provide a listing of all the other entries." And this one certainly follows that blueprint.
One would think that with over 6 dozen (half a gross!) entries, it would be difficult to pick a favorite.
One would be wrong: how could I resist a post on money-related limericks? I couldn't, and I bet you'll sport a smile, too. Mad Kane's has the winners of its 3rd such contest.
Prepare to smile.