Good on the MVNHS©!

It appears that the Much Vaunted National Health Service© has learned a lesson from us Colonials:

"The lives of more than 5,000 cancer sufferers will be saved each year under an £800 million [about $1.25 Billion] government drive to make England’s survival rates among the best in Europe ... Under the plans, GPs will be given the power to order a range of cancer tests direct from hospitals without having to refer the patient first to a consultant."

It's true that there are still a few plans here in the States that require such a referral, but a) they're few and far between and, b) one isn't forced to buy such plans (yet). It's also true that our cancer survival rates soar above our Cousins Across the Ponds'. On the downside, that 5,000 survivors apparently represents about one third of 1% of those who might otherwise succumb. Baby steps and all that.

In the event, about $15 million of that total will go towards encouraging folks to "see their doctor sooner if they develop symptoms." Sounds sensible.

Cavalcade of Risk #122 now up!

David Williams presents this week's roundup of risky posts. Take a chance and stop on by! And please note: If your post is included, you are expected to link back to the Cav in a timely manner.

On the Oregon Trail

FoIB Holly R forwarded the link to this story, about which I can only ask "on what planet is Hannah Wallace living?" It is so full of inconsistencies and outright misinformation, one wonders how The Onion could possibly do better.

Let's start at the beginning, shall we?

"For a writer living in New York state, there were plenty of reasonably priced plans"

Really? The actual numbers tell a different story.

Ms Wallace continues apace:

"That’s largely because in Oregon, “medical underwriting”—during which insurance companies cherry-pick healthier customers ... it’s one of five states with so-called “guaranteed-issue” laws that mandate insurance companies cover anybody regardless of health status."

(See above)

“The last thing we want to be doing as a state is hampering that sector with high insurance costs. It’s exactly the wrong way to stimulate the economy ... Yet this is precisely what Oregon is doing by not providing affordable health insurance options."

We've written about Oregon's insurance situation before; they have a very effective (if lethal) way of dealing with increased health care costs (which, of course, drive health insurance costs).

But wait, there's more!

"The only plan I can find here that would cover my pre-existing condition costs more than half my rent"

This is another of those little "throwaway" canards that's never made any sense to me: what does one's rent have to do with one's insurance? If Ms Wallace lived with her parents, then her insurance would be infinitely higher than her rent, yet that is no more meaningless (or meaningful) than her comparison.

She continues:

"I don’t want just so I don’t become one of the 51 million Americans who are uninsured."

And again with the oft-debunked number of uninsured (anyone else notice how that number keeps growing, despite the advent of wonderful ObamaCare©?). It's a bogus number to begin with; that it keeps growing is itself a wonder.

Are we done yet? Of course not:

“What really needs to happen for you is that it needs to be 2014 ... when the new Patient Protection and Affordable Care Act ... will eventually force insurance companies to cover everyone, pre-existing conditions or not. They have had to cover sick children since September; adults, however, have to wait until January 1, 2014—three long years away."

Except they haven't; healthy kids hardest hit. And if you want to see what's in store for '14, you need look no farther than the current ObamaPool© programs. These are guaranteed issue plans which cover all pre-existing conditions (sound familiar, Hannah?), yet their reception has been, well, underwhelming. Why would any rational person believe that's going to change in 3 years?

Bu the very best (well, funniest) line comes near the end:

"For freelancers ... Massachusetts is mecca"

Oh, absolutely, it's just been so successful! If that's Mecca, then one shudders to think what Armageddon looks like.

Grand Rounds: It's (Not Really) Complicated

Tony Chen presents an outstanding edition of Grand Rounds. It's obvious that he's read every submission, and worked hard to make them flow together (no mean feat when you consider subjects from diabetes to autism). Best of all, it's not overly long (as these things can grow to be), so it's easy to read through.

ObamaCare© Repeal Update

The vote on the (aptly named) "Repealing the Job-Killing Health Care Law Act" has been postponed due to Saturday's tragedy in Tucson.

There is no question that the events over the weekend were horrific, but I have to question whether this is an appropriate response. I'd be very interested in our readers' take on this:

Should Congress postpone the vote to repeal ObamaCare©?

• 
  
  Yes


• 
  
  No

view results
Free vote poll

Ohio Department of Insurance News: Update

FoIB Holly R just dashed my hopes....er, alerted us to this new development:

"In his first official acts as governor after the inauguration, Kasich named Lt. Gov. Mary Taylor director of the Ohio Department of Insurance..."

Mazel Tov, Mary!

The Blues play chicken with Shecantbeserious

The term "neener-neener!" comes to mind:

"Another big California health insurer has stunned individual policyholders ... this time it's Blue Shield of California seeking cumulative hikes of as much as 59%."

But, but, but:

"HHS will require that health insurance companies “disclose and justify any rate increases of 10 percent or more.”

What to do, what to do.

Well, as Mike pointed out in his post, "rate hearings will also remind people in every state what a fraud the government has perpetrated in claiming to have "reformed" health care." And hearings there will be:

"[Newly elected CA Insurance Commissioner Dave] Jones said the Blue Shield move underscored the need for the Legislature to give the insurance commissioner legal authority to regulate insurance rates the same way he does automobile coverage.

At present, the commissioner can block increases only if insurers spend less than 70% of premium income on claims. Jones' office said Blue Shield's March 1 increase was under review."

There we go again, comparing health insurance and auto insurance. They are not the same, and their rate structures are based on very different methodologies. Not to mention the fact that auto policies aren't (currently) required to cover oil changes and tune-ups. What do you think would happen to auto rates if (when?) they do?

The bigger issue, of course, is "why?" The Blues claim that "the increases were the result of fast-rising healthcare costs and other expenses resulting from new healthcare laws." But of course that can't be true: after all, the folks who passed the bill so that we could see what's in it promised us that it would result in lower, not higher, insurance costs.

The wheels on the bus go thump-thump-thump.

The Benefits Package: New Year's Edition

Welcome to the first Benefits Package of the new year (and, indeed, of the new decade). We're grateful to Evan for the opportunity to be the first "non-Evan" hosts, and to this week's participants for sharing their insights and ideas.

I'm also pleased to help launch a new "niche carnival;" that is, one with a more narrowly defined focus. It seems to me that these smaller versions are less intimidating for hosts and readers alike. Certainly, it's a lot easier to edit and post a carnival with 8 or 10 (or a dozen!) entries than some of the "big boys." So if you're even remotely interested in hosting a future edition, please drop Evan a note: I guarantee you you'll find it a simple, yet rewarding, experience.

And now, on with the show:

■ David Kerrigan looks under the hood at what, exactly, drives the decision to keep or change group insurance carriers. You may be surprised at the role played by network size.

■ The Cato Institute's Michael Cannon wonders if the administration is perhaps playing fast and lose with their numbers-crunching, at least regarding how it deals with expenditures and the private sector. Great food for thought.

■ Anne Freedman combines some (scary) statistics with good old-fashioned common sense as she explores the growing problem of an aging work-force. Specifically, older workers may be playing an outsized role in keeping out "new blood." This doesn't bode well for our current unemployment situation.

■ Only David Williams could combine coupons, bullets and FuzzBusters and come up with an intriguing post on why it's bad policy for drug companies to make your co-payment for you.

■ Benefits Package founder (and uber-wonk blogger) Evan Falchuk shares some important lessons he learned from a group of Longhorn business folks. He's careful to point out that it's less prediction than recognition.

■ Another great health policy wonk, David Harlow, takes aim at Jeff Goldsmith's recent article on Accountable Care Organizations (ACO's). While acknowledging that Mr G makes some valid points, David's convinced that the basic ACO model is still salvageable.

■ Jennifer Benz and Ed Bray provide us with a handy two-minute overview of PPACA (known around these parts as ObamaCare©); just the ticket when the boss asks "what's this all about?" It's handy, brief and timely.

■ There's no question that prescription drug prices play a key role in how much we pay for health benefits. George Van Antwerp lays out the case for efficient innovation in how PBM's (Pharmacy Benefits Managers) market themselves to demonstrate the value they bring to the table.

■ Just as pharmacy benefits impact the cost of health care, so may improved utilization of Information Technology (IT). Blogging at Action for Better Healthcare, Kester Freeman reports on a new IT initiative currently underway by IBM and Premier Health Alliance that hopes to effectively address the issue.

■ As Keith McMurdy explains, pension benefits are also affected by the current economic downturn, and could lead to a "withdrawal liability" problem.

■ In our own contribution, we discuss how some employers are going mental over mandates.

And that wraps up the Benefits Package, Third Edition. Be sure to stop by Jennifer Benz's place on the 24th for the next exciting installment!

CBO Yo-Yo

Have you ever watched a game of Ping-Pong? Your head constantly swivels back-and-forth, following the ball as it (hopefully) passes over the net. That's kinda how it feels watching the Congressional Budget Office (CBO) whipsaw over how much repealing ObamaCare© will cost.

Er, save:

"The Congressional Budget Office, in an email to Capitol Hill staffers... has said that repealing the national health care law would reduce net spending by $540 billion in the ten year period from 2012 through 2021 ... Repealing the bill would also eliminate $770 billion in taxes."

The email comes in response to a request from Rep Paul Ryan (R-WI) that the CBO "score" the bill without all the double-counting of revenue and taxes that marked its initial take on the Repealing the Job-Killing Health Care Law Act on which we reported yesterday.

Anyone know if ObamaCare© covers whiplash?

ObamaCare©: "Wait" for it....

Courtesy of the "evil" folks at Anthem, we learn about a few more gotcha's in the bill we had to pass to see. In health insurance, there are two very important, and different, uses of the term "waiting period." One refers to how long a carrier can put off covering pre-existing conditions, and the other to how long an employer can put off adding a new employee to an existing plan.

First, regarding pre-ex, we already know that policies with plan years that begin (or renew) after last September can no longer apply a waiting period for "the children" (under age 19). Insureds 19 years or older may still be subject to such a wait.

Beginning in '14, of course, no such waiting periods are allowed. I'm sure that will lead to reduced premiums, right?

As to those waiting periods for group eligibility, also beginning in '14, the waiting period is capped at 90 days (this is currently the law in Ohio, anyway, so no change here). Interestingly, the "employer fine" calculation isn't applicable during that waiting period (so long as it's no more than 90 days).

Frankly, this provision doesn't really strike me as too onerous: after all, either the new guy's going to work out in 3 months, or he's not. Extending the waiting period beyond 90 days doesn't seem critical.

Benefits Package due to arrive here on the 10th [BUMPED]

We're pleased as punch to host the next edition of the new Benefits Package blog "carnival," conceived and developed by our friend Evan Falchuk. Look for it here next Monday (the 10th).

What's the Benefits Package all about?

Glad you asked!

It's a bi-weekly round-up of the best posts in health-benefits blogging. Participation is encouraged, so if you're a benefits blogger, here's the scoop, via EPS (Evan's Package Service):

Your Benefits Package is scheduled for delivery on Monday, January 10, 2011. In order to ensure proper contents, please check the packaging material for the
following:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

Please email your package's contents [Sorry, the deadline for BP#3 has passed] no later than today (January 7th) to ensure timely delivery.

Thanks, and Happy New Year!

Um, about that CBO blogpost

A number of polibloggers have seized on this claim by the Director of the Congressional Budget Office (CBO) regarding appeal of ObamaCare©:

"(W)e expect that repealing that legislation would increase budget deficits."

Of course, they leave out the back-pedaling and obfuscation part:

"The administration's chief actuary predicts that the federal government and the country will spend $310 billion more under Obamacare than we would have without the new law"

Fine, but what strikes me as most interesting is this: the previous Congress, lead exclusively by the Democrat party, managed to rack up more debt than all the previous Congresses, combined!

And now they're worried about deficits?

There's your new definition of "chutzpah."

[Hat Tip: FoIB Holly R]

Cavalcade of Risk #122 Call for submissions

David Williams hosts next week's CavRisk. welcoming in the New Year with new risks. Submissions are due by Monday (the 10th). David asks that you include:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

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

You can submit your post via Blog Carnival or email.

NB: The Cav is about risk, but not necessarily or exclusively about insurance. So feel free to think outside-the-box (e.g. driving and texting, the environment, vaccination, etc).

ObamaCare© Overreach

Once again, this administration just doesn't seem to understand its own limits. At a time when "(n)early half of voters with health insurance do not believe President Obama’s promise that they will be able to keep it under the new healthcare reform law," the rocket surgeons behind ObamaCare© think it's a good idea to not only expand federal regulation of health insurance (a blatantly unlawful move), but to exacerbate that awful decision by folding the "health reform office charged with overseeing the insurance ... into the federal Medicare agency."

Brilliant!

But of course they've tapped someone with a deep and exhaustive knowledge of insurance principles and the impact this could have on our ability to manage our care, right?

Sure they did:

"The Office of Consumer Information and Insurance Oversight was created to guide the implementation of key parts of the health overhaul law. Its director, Jay Angoff, a class-action litigator who took on insurance companies..." [emphasis added]

Oh goody: we get the love-child of HHS Secretary Shecantbeserious and John Edwards.

What could go wrong?

Health Wonk Review: Auld Acquaintance edition

The Apothecary's Avik Roy hosts this week's outstanding edition of the HWR. As fellow blogger David Williams puts it, " this is exactly the way to host a blog carnival: well-organized classification of the posts, synopsis of each, thoughtful commentary and context, not too cutesy."

Ditto!

Heh: We get results!

Less than two weeks ago, we blew the whistle on the new Medicare Death Panels. Well, FoIB Holly R tips us that "(t)he Obama administration ... will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations."

The Gray Lady is spinning this like a whirling dervish, but the bottom line is that this ghoulish program has been busted. You're welcome.

And speaking of spinning, here's more of your tax dollars at work shilling for ObamaCrap:

"Try typing "Obamacare" into Google, and you'll find that the first entry is now the Obama administration's www.healthcare.gov ... You'll get the same paid-for result if you type in "Obamacare facts," "Obamacare summary," "Obamacare info ..."

And the list goes on. These people have no shame: whether it's spending tax dollars for Matlock to pimp for Medicare cuts, or this waste of taxpayer dollars, HHS Secretary Shecantbeserious and her henchmen just don't care.

AARP Waivermania

We've long noted AARP's disingenuous (some would say hypocritical) support of ObamaCare©. Well, on a tip from FoIB Bob D, we learn about the quid-pro-quo:

"While other health policies must go through a rigorous rate review under ObamaCare and justify any premium increases of more than 10 percent, AARP's Medigap policies are to be exempt from the federal review and restriction."

[ed: For an explication of that "more than 10%," see Mike's excellent analysis here]

One presumes that 10% is equal to 30 pieces of silver.

Brett Baier has more:

65 Outstanding Words

When we (virtually) cornered incoming Speaker of the House John Boehner (R-OH) last November, we asked him a rather pointed question:

"Mr. Speaker ...Did you really mean what you said about rolling back the toxic Democrat agenda, do you get what the Tea Party movement is really about, and if so, what will be your very first agenda item to defund and declaw ObamaCare? "

Little did we know that he'd answer us (and Sen Reid, et al) so unequivocally:

"Senators Reid, Durbin, Schumer, Murray and Stabenow:

Thank you for reminding us – and the American people – of the backroom deal that you struck behind closed doors with ‘Big Pharma,’ resulting in bigger profits for the drug companies, and higher prescription drug costs for 33 million seniors enrolled in Medicare Part D, at a cost to the taxpayers of $42.6 billion.

The House is going to pass legislation to repeal that now. You’re welcome."

Nice.

[Hat Tip: RedState]

Ohio Insurance News Update

No surprise here, really, but current DOI Director Mary Jo Hudson is bailing effective next Monday (the 10th). In Ohio, the DDOI is an appointed position (Hi, John! Sure, I'd love that slot!); MJ, a Miami University grad (just like me!) was named to her current position by then-Governor Ted Strickland.

No word yet on who will take her place, but knowledgeable sources tell me that keeping the MU-grad tradition going is considered paramount (did I mention that I'm an alum?), as is well-rounded experience in the field (such as, but not limited to, continuing education provider, veteran agent, outstanding blogger).

We'll keep you posted.

STOLI Ooops!

A few weeks ago, we wrote about the newest "twist" in Stranger Owned Life Insurance (STOLI). One of the conclusions we drew was that the only real "losers" in these schemes were "the poor saps who bought into this idea, and forked over $50,000 (minimum!) to do so."

We stand corrected:

"New investor lawsuits are emerging amid the wreckage of an investment boom in life-insurance policies that spectacularly collapsed ... Since the bust in the market, insurers have portrayed themselves as the victims."

[ed: the rest of the story is behind a $link]

And, having played the victim card, they're raising the stakes: over the past couple of years, insurers have filed hundreds of suits and agitated state regulators to clamp down on these after-market sales. Their rationale is that the actuarial assumptions on which these plans were based are somehow negated by the change in ownership of the plans.

I call BS: the nature of the risk hasn't changed one iota; John Doe is still John Doe, and his health and mortality risk is what it is regardless of who owns the policy. The idea that he'll meet an untimely demise at the hands of an unhappy investor is silly; the law's very clear that one can't profit from one's crimes in that way.

And of course, it's not just the insurers playing that card, "suits also have been filed by relatives of some of the deceased elderly, alleging that death benefits belong to the family members."

No, they do not. The death benefit belongs to the named beneficiary, which may well have been a family member (or members), but the owner of the policy makes that call, not his kids. Yes, an "irrevocable beneficiary" would have those rights, but then if there was such, the transaction couldn't have been completed in the first place.

And then there's this egregious misstatement: "State insurable-interest laws require an insurance buyer to have a bigger stake in the insured person's continued well-being than in his death."

No, they don't: "insurable interest" is only relevant at the time of application. Once the policy is issued, it is no longer relevant, or applicable. It's Insurance 101 stuff, and the media can't even get that right.

Now, as to the propriety and/or appropriateness of these schemes, I'll leave that to our readers' sensitivities. But the bottom line is that there's nothing inherently illegal, immoral or fattening about them.

[Hat Tip: FoIB Holly R]