Stupid Client Tricks: Luxe Edition

If you owned three (three!) new and/or late-model Beemers, would you leave the keys in them while they sat unattended?

Well, that's apparently what a Dobbs Ferry, NY resident did:

"[P]olice Lt. James Guernieri says each of the luxury cars had a push-button ignition system. The starter doesn't work unless its accompanying fob is in or near the car.

He says the homeowner had moved all the cars on Saturday to make room for Christmas decorations. He says the man then left a fob in each car."

Must have been some great decorations.

Cavalcade of Risk #146: Strollin' through the garden

Russell Hutchinson hosts a delightful and eclectic edition of the Cavalcade of Risk. Take a moment to (virtually) smell the flowers while you're there.

On a wing and a....

When one thinks of a health care "team," one envisions doctors, nurses, and pharmacists. But how about adding one more: the Preacher (or Priest, or Rabbi)?

"Chaplains are seeking bigger roles in hospitals and in some cases joining the medical-care team, as new research shows positive spiritual guidance and discussion can help improve a patient's medical outcome."

This is, perhaps, a bit trickier than it may seem: there's a difference between religion and faith. And of course it's not so easy to quantify a chaplain's efficacy compared to, say, the surgeon's. Still, the concept is intriguing, and gaining momentum:

"Medical schools are adding courses on spirituality and health, and training residents to consider patients' spiritual needs."

Nothing prevents one from praying in pre-op, with or without the aide of a trained professional. And there's some evidence of linkage between physical and spiritual well-being:

"Studies indicate as many as 40% of patients with serious illnesses like cancer struggle with spiritual concerns, which can harm emotional and physical well-being"

Evidence of this is, by definition, somewhat anecdotal, but that doesn't make it any less valid. And there's some objective evidence that spiritual and physical well-being are connected:

"Studies indicate that chaplain visits can result in less patient anxiety, shorter hospital stays and higher satisfaction."

As the article notes, these are not definitive, but they're certainly worth exploring. Like chicken soup, what's the harm?

Matrimony vs Cancer

A while back, Bob noted that "7 percent of U.S. adults married so one or the other could get on a partner's health insurance plan."

He found that statistic "astounding," as did I.

But maybe it's not so far-fetched:

"There are some big-time benefits to the old ball and chain: Married men tend to live longer ... They're also less likely to die from cancer compared to guys who never marry."

This conclusion is based on a recent study published at BMC Health, which found that "[r]ates of all-cause and cause-specific mortality are higher among unmarried than married individuals ... excess mortality of the never-married compared to the married has increased steadily for men, in particular the elderly."

But the stats for those of the fairer sex aren't much better: "Among elderly women, the excess mortality of the never-married compared to the married has increased ... there are indications of an increasing excess mortality of the widowed."

So maybe wedding cake is a panacea.

Possible MS Breakthrough?

Multiple Sclerosis (MS) "is a chronic, often disabling disease that attacks the central nervous system (CNS) ... Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision."

Treatment is expensive, and generally used to impede the disease's progress and ease some symptoms. There's no known cure.

Or is there?

"An Italian doctor has been getting dramatic results with a new type of treatment for Multiple Sclerosis ... In an initial study, Dr. Paolo Zamboni took 65 patients with relapsing-remitting MS, performed a simple operation to unblock restricted bloodflow out of the brain - and two years after the surgery, 73% of the patients had no symptoms."

That's pretty dramatic results.

His theory is that MS is caused by a build-up of iron in the brain, and that by increasing bloodflow, it can be "flushed out."

There's still a lot of testing to do, and questions to be answered, but this could hold great promise from those with the dreaded disease.

Health insurance vs Sickness insurance

As we've noted before, Bob and I contribute to a consumer advocate's bulletin board, where we try to help folks resolve insurance-related problems. Over and over again, it becomes apparent early on that most folks don't really understand what they've bought, how it works, or what's actually covered (or excluded), all because they bought the plan and then filed it away without actually reading through it.

Courtesy of Humana, here's a pretty easy-to-understand but nonetheless comprehensive primer on how you can get the most out of your health insurance:

The Price is Wrong

As we've pointed out (repeatedly), no rational employer is going to continue offering group health benefits to employees once the Exchanges come on-line. FoIB Holly R sent me an article this morning that asks an intriguing question regarding that assumption: not about whether it's valid (it is), but what it will cost the employee once that happens.

It's an excellent question, one which I had not previously seen addressed: how much is it likely to cost Joe Lunchbox to move from his employer's group health plan to one offered through the Exchange (and potentially subsidized by his fellow taxpayers)?

Turns out, the cost could be substantial:

"Lockton, a Kansas City-based company that consults with mid-sized companies on health insurance benefits ... predicts [employees'] premiums would increase anywhere from 79 to 125 percent if they lose employer coverage and have to go to the exchange."

Here's 1,000 words to explain it:

[click graphic to embiggen]

How's that Hopey-Changey thing working out?

Cavalcade of Risk #146: Call for submissions

Russell Hutchinson hosts next week's CavRisk, and wants your risk-related post. Entries are due by Monday (the 12th).

Submit your post via the The BC WorkAround.

Once there, you'll be asked to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post ("Remarks")

At the bottom of the form, you'll see a drop-down menu; simply select "Cavalcade of Risk" then press "Submit" and you're good to go.

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

Thanks!

AEP Extension - UPDATED

Apparently, those Medicare Advantage plans are still more popular than ever. So much so, in fact, that HHS Secretary Shecantbeserious has recognized that not everyone who wanted "in" was actually able to sign up (cf: blind squirrels).

Just got this in email from Anthem:

"CMS officials are providing flexibilities to current Enrollment Guidance to ensure all enrollment requests submitted during AEP are processed. The extension is for this AEP only.

[Carriers and agents] may assist beneficiaries in completing an enrollment request if the contact was initiated prior to December 8, 2011. This would only include call backs to beneficiaries who we were unable to assist on or before December 7th, due to high call volumes or difficulty in accessing CMS' On-line Enrollment Center (OEC).

All return calls must be made, and applications completed and received by 11:59 p.m. local time on Saturday, December 10th."

Heh.

UPDATE: Clarification on who's eligible for the extension:

• All marketing and/or soliciation activities must end with the close of AEP as of 11:59 p.m. on December 7, 2011.
• Agents may not accept new AEP applications after December 7, 2011.
• Agents who receive inquiries about enrolling in a Medicare plan after AEP should refer the beneficiary to the Medicare toll-free information line (1-800-633-4227) or have the beneficiary call the government-funded State Health Insurance Program (SHIP).
• If you have received AEP applications today or later, please submit the enrollment for processing. [Carrier] enrollment department will verify eligibility.

Stupid Homeowners Tricks: Again

Sometimes I weep for humananity:

"Firefighters in Tennessee let a home burn to the ground because the owners did not pay a $75 fire subscription fee"

Wait a minute, didn't we already read this last year:

"Each year, Obion County residents must pay $75 if they want fire protection from the city of South Fulton. But the Cranicks did not pay ... Because of that, not much is left of Cranick’s house."

Turns out the homeowner, Vicky Bell, is a slow learner:

"People in the city of South Fulton have fire protection, but those in the surrounding county do not unless they pay a $75 annual fee."

Ms Bell knew this, and knew that the Cranicks had recently provided empirical evidence that the system "works" as advertised. But she had a darned good excuse:

"Bell and her boyfriend said they were aware of the policy, but thought a fire would never happen to them." [emphasis added]

Uh-hunh.

In related news:

"I knew I should have bought health insurance, but thought cancer could never happen to me."

And:

"I knew I should have bought disability or long term care insurance, but thought a stroke could never happen to me."

And, finally:

"I knew I should have bought life insurance, but..."

[Hat Tip: FoIB Bill M]

Fraud, Abuse and Medicare - Updated

As we reported in September, a tenacious Medicaid beneficiary blew the whistle on fraudulent behavior by his nursing care provider:

"After checking his own medical records [he] discovered the company providing him with nursing care appeared to have overbilled Medicaid for hundreds of hours for people who were never there"

Well, Richard West is in DC today, recounting his tale for the House Oversight Committee:

“This [fraud] is wholly unacceptable,” said Rep. Trey Gowdy, R-S.C., “This is why people have lost trust in the institutions of government and why our fellow citizens have so little trust that we are spending their money as carefully as we would spend our own"

Let's hope that he, and we, finally get some justice.

Disability Insurance Update

My friend Jeremy Fink (of Assurity Employee Benefits) recently sent along the latest report from the Council for Disability Awareness on its 2011 survey regarding long-term disability (LTD) benefits.

The survey, of about 75% of the players in the LTD market, includes surprising information:

■ $8.3 billion was paid out in long-term disability claims (that's about a point higher than 2009)

■ About 587,000 disabled folks received LTD payments (up slightly over '09)

■ Fifty-six percent of participating carriers reported increased claim incidence from 2009 to 2010 (most suggested this was a result of the Obamaconomy)

■ Unfortunately, fewer employers even offered LTD benefits than in the recent past

■ The top cause of new claims, representing just shy of 30% of them, was for Musculoskeletal system and connective tissue diseases (which was also the top cause for existing claims)

[Click here for the complete report.]

Think you don't need disability insurance?

Think again:

Insuring $outhpaws

About 10% of the population is left-handed, which is itself interesting because, just on the basis of common sense, one would think that the percentage would be closer to fifty. Apparently, it's a recessive trait, so lefties are left in the minority.

Which is nice, but what does this have to do with insurance?

Well, according to the Wall Street Journal, "[l]eft-handedness appears to be associated with a greater risk for a number of psychiatric and developmental disorders," which is not to say that southpaws are necessarily crazier than the rest of us normal people righties.

After almost 30 years in the insurance business, though, I can tell you that I have never seen the question "are you right- or left-handed?" on any application, and my P&C colleagues assure me that they haven't, either. But the Journal had an interesting article yesterday about the increased health risks that go along with being a lefty.

Frankly, I'm unconvinced that there's any reason for underwriters to be concerned. Still, it's interesting to contemplate, as this video explains:

Stupid Media Tricks

As we've seen so often, the media just loves its memes, to the exclusion, unfortunately, of clarity and intellectual honesty.

The latest case in point:

Health claim denials top Ohio insurance complaints

"A newspaper's analysis shows the most common complaints received by the Ohio Department of Insurance come from people who had health claims denied."

And this is news, why?

Well, because if we're looking to supplant the current private-industry model with a government-run one (and we are), what better way to demonize that pre-existing model than by pointing out how (apparently) unfair it it is.

Now, I was told that there'd be no math, but I find this interesting:

Out of the 3,100-odd claims covered by the report, "43 percent were from people whose insurers would not pay a medical bill." Now, there are an estimated 11 and a half million Buckeyes. If we take the (disputed) percentage of 15% uninsured, that leaves almost 10 million insured Ohioans, generating 1,300 claims.

That means that .0001% of Buckeyes had a big enough claims problem that they actually filed a complaint.

Ooooh.

By the way, the same report indicates that the Department of Insurance found less than 20% of those complaints credible.

Here's a question for the rocket surgeon-cum-reporter:

How many of these claims were disputed because the insured couldn't be bothered to either read his/her policy, or to stay in-network, or to have disclosed pre-existing conditions?

Here's a clue:

"The newspaper says the number of complaints is small compared with the millions of health claims handled in Ohio."

Oh, then why didn't you say so in the first place?

[Hat Tip: FoIB Holly R]

MVNHS©: If it's so darn good...

Why would one need this:

"Private Medical Insurance also known as PMI allows you to have complete reassurance of knowing that, should the need arise you and your family can receive medical treatment privately, without waiting for the NHS to treat you."

As we've pointed out innumerable times, the Much Vaunted National Health Service© is, by any rational metric, a failure: it doesn't provide anything like the level of care we enjoy (well, for now, but not for long), and it has failed completely at reining in the cost of health care. About the only thing it does do well is to kill off its patients.

So tell me again why we're seeking to emulate it?

This Sceptered Isle Part CCCII

Well, it says here that

"Tens of thousands of patients with terminal illnesses are being placed on a “death pathway”, almost double the number just two years ago, a study published today shows.

Health service guidance states that doctors should discuss with relations whether or not their loved one is placed on the scheme which allows medical staff to withdraw fluid and drugs in a patient’s final days. In many cases this is not happening, an audit has found. As many as 2,500 families were not told that their loved ones had been put on the so-called Liverpool Care Pathway, the study disclosed."

That can't possibly be true can it? Right off, the article admits that there is no such thing as "Death pathways". Whatever they are, they are officially called "Liverpool Care Pathways". See how different?

Remember that in the US such things don't and won't exist. The Fair Nancy Pelosi promised.

This whole report must be fictional balderdash.

DDN, Dunh! Transparency running scarce...

We've talked about health care pricing transparency from the very earliest days of the blog:

"The Illinois Department of Health will publish the average charges for as many as 30 common outpatient procedures ... According to a recent survey, 85% of Prairie State voters said that such information would “affect their decision” in health care matters, and 75% agreed that such disclosure would “create competition, lower prices and improve quality.”

So one supposes it's nice that my hometown newspaper finally gets around to noticing it, too:

"Even as consumers shoulder a greater share of the cost of surgeries and procedures, they often find it hard to come by the price data they need to make smart health care decisions upfront. Many have no idea what a procedure will cost them — and their health insurance company or the government — until the bills arrive in the mail."

Frankly, there's no real excuse for this: almost every company has some variation on the Navigator available to its insureds.

Of course, the rocket surgeons in DC are equally clueless:

“When we contacted hospitals and physicians to obtain price information for two common services (diabetes screening and knee replacement), we generally received only incomplete estimates,” the GAO said."

Really?

Yes, it would be grand if we could, in fact, implement the McDonald's Model. The problem is that most health care consumers are using (at least a few of) other people's dollars to pay for that care. The bottom line is that, until we pay directly, we need to rely on the tools we do have available. The good news, as mentioned previously, is that they are readily available from most carriers.

But that's apparently not good enough for the brain trust at the DDN:

"Neither the insurance companies nor the hospitals would give the newspaper that information ... [the DDN] obtained that data by finding Anthem Blue Cross and Blue Shield and UnitedHealthcare members who were willing to share information from their insurers’ respective price comparison databases."

The stupid is strong in this one:

"The payments vary widely."

No kidding.

But that wasn't really the point of the article, was it, Ben?

Wasn't the point that the information was unavailable before the care was provided? Yet you just shot that point in the foot, since it obviously is available to consumers who bother to look for it.

Words fail.

Another Ma$$Care Post

According to 24/7 Wall St, Bay State citizens now "enjoy" the highest state debt (per capita) of all 58. At an eye-popping $11,357 per, folks in Massachusetts have 17% more debt than runner-up Alaska (at a "mere" $9,505). Of course, Alaskans are only now having to deal with ObamneyCare©, while Bay Staters have suffered under its predecessor for years.

The good news is that, pretty soon, we'll all share in the joy of higher debt as ObamneyCare© continues to roll out (and over).

Even More Swedish Meatball-Medicine

Looks like Sweden's still more competent fielding a Bikini Team than providing health care. Proving they're not sexist when it comes to denying care - the last few outings included abandoning a little girl and an old woman - Swedish bureauweenies have decided that a man whose legs have both been amputated may not have a "permanent" disability.

Who knew they'd grow back?!

Evert Stefansson sure didn't but "the local health authority remained "uncertain if the impairment was permanent." And so his request for a powered wheelchair has been denied.

Good thing that won't happen here, right?

Student Health insurance still sucks...

A while back, Bob posted on why so-called "student health insurance" is such a bad deal. For one thing, it's over-priced, and offers limited coverage, especially if you end up ill at the end of the school year.

This is somewhat ameliorated by ObamneyCare©'s provision making it possible for "children" to stay on their parents plan until age 26.

But what if the plan itself has an internally self-contradictory mechanism that both offers coverage but then declines to pay out benefits under it?

Hunh?

Here's the issue:

"A group of Fordham University law students has organized an off-campus birth control clinic in response to the school's policy prohibiting the prescription of contraception at its campus health centers ... [Fordham's] policy states: "The Insurer is required by law to offer this coverage and pay the Covered Percentage of the Covered Charges for Contraceptive Drugs and Devices."

So what's the problem?

Well:

"[M]any students ... were turned away when they tried to obtain contraception or a prescription for it at campus health centers."

And therein lies the rub (so to speak):

If one must buy the student health insurance (as many - most? - universities require), and the policy at once states that there's coverage, but limits that coverage to University-sponsored facilities which explicitly deny coverage for a product or procedure, than one is essentially paying for something which can never actually be covered.

Now, I'm not necessarily supportive of Universities providing birth control items, and I'm definitely unhappy with a law requiring insurance coverage for lifestyle choices. But it is (apparently) the law, and it seems to me that Fordham is blatantly flouting it.