Grapes, blueberries and miracles

In addition to its potential cancer-fighting benefits, turns out that red wine (and blueberries!) contain a "miracle molecule" that may prevent "Help, I've fallen and I can't get up!" Syndrome. We've written about resveratrol before (most recently here), and its ability to fight Alzheimer's and cancer. But scientists have now found another benefit:

"As these animal [lab mice] age, they lose some of their motor coordination. Very similar as to humans do as they age. And when we gave them out the resveratrol, the older mouse has less loss of motor coordination.”

Although red wine is most often cited as a primary source, resveratrol is also found in blueberries. In fact:

"We just used blueberries in our study and actually when they eat the whole fruit it’s actually more effective than the resveratrol alone and you don’t need as much.”

So there.

That Compassionate British Health System

It appears that the MVNHS© has some competition:

"A disabled man who lost both legs and four fingers to diabetes has been asked to prove he is unable to work by the Department of Work and Pensions"

One supposes that he could easily find a job as a mid-level bureauweenie in the Department of Work and Pensions, since that doesn't seem to entail much physical exertion. Of course, he may be over-qualified on the intelligence front.

Plan to fix COBRA and help small businesses

The income I make administering COBRA for employers aside, I have always thought it was a terrible idea. Not just because it was so poorly written that employers had to spend two decades in court to learn to comply, but why should employers be liable for the medical care of ex-employees?

The most ironic part of COBRA, as implemented, is society determined we should help those losing their insurance transition to new insurance, yet society passed the cost onto a very small population of people. People only take COBRA if the premium is less then they expect to have in claims; very few people take COBRA because it is the responsible thing to do. Employers can expect COBRA electors to not only be money losers but big time money losers, that keep a hand in their pocket for 18, 29, or 36 months.This burden doesn't fall on society but 25, or how ever many people work at the company, people that are unfortunate to have worked with this individual, or a family member, previously.

I have seen healthy groups turn into max rated cases or companies even have to drop insurance due to cost from COBRA enrollees. If you believe the public should step up and help these individuals then the public should foot the bill.

I would suggest that individuals eligible for federal COBRA be enrolled into Medicare under the same provisions as current law. Eligible for 18-36 months, ends when other coverage is available, priced at a more age appropriate rate. Not only would this end the burden on employers but would lower cost if Medicare could ever do anything about their fraud as Medicare reimburses less then most private insurance.

CMS, through the IRS. would also be in a far better position to police individuals becoming eligible with other coverage.

Employers could then invest this savings in current employees and their benefits. They would also be out from under the huge liability of sending a notice to the wrong address or failure to comply with other notification requirements that could bankrupt them.

Where did all the doctors go?

A recent report by Merritt Hawkins, one of the country’s largest physician recruiting firms, shows that by 2014, 75% of all physicians will be working for hospitals or large groups. How could this have happened?

“Squeezed by high costs and shrinking insurance reimbursements, independent doctors are closing up shop or going to work at hospitals or bigger group practices where they aren't directly responsible for overhead costs.”

For those who regularly read InsureBlog, I have reported on how the lack of increased insurance reimbursements is decimating the private medical doctor. Seems like not much has changed:

"Our projection reaffirms the trend that fewer and fewer doctors are going into solo practice or staying in solo practice," Travis Singleton, senior vice president with Merritt Hawkins, told CNN. "It shows that no one wants to hire a solo doctor; no one wants to be a solo doctor. This is a dying breed of physician that is quickly disappearing from the American landscape"

Having worked with representatives of Merritt Hawkins, I can attest to how difficult it is for a small practice to recruit a new physician. The trend for medical school graduates is to seek out a six figure job, working only 40 hours a week, in a great location, with great schools and amenities. I then asked the representative if they want a pony with that. Gone are the days when a doctor graduates from medical school, hangs out their shingle and then works to built up a clientele of patients. Of course during this process, the doctor “eats what he kills”, meaning his income comes directly from the number of patients that he sees. Hospitals and large groups have the ability to pay a physician a salary at graduation that is often only achieved after a decade of working:

Life Insurance Festival

Jeff Rose is putting together a special collection of Life Insurance-themed posts:

"Its motivation is to make sure that every couple that is in need of life insurance has it, and make sure they have enough coverage."

The special event takes place this Wednesday (the 22nd) at Jeff's place (click here for details).

MVNHS©: Come die with us

This is what happens when faceless, nameless, unaccountable bureauweenies are in charge of health care:

"Up to 1,200 needless deaths, patients abused, staff bullied to meet targets"

Under the Much Vaunted National Health System©, "trusts" (the oxymoronic term that the MVNHS© uses for "hospitals"), must meet strict guidelines when rationing health care, usually to the detriment of those allegedly receiving that care (or not). It's hard to fault the folks repsonsible for enforcing those targets, since they're tasked with doing so, and their own livelihoods depend on how those numbers stack up.

Still, that's scant consolation to (for example), the "[f]our members of one family. including a new-born baby girl [who] died within 18 months after of blunders at the hospital."

One might think, based on that example alone, that bureaucratic heads would roll. One would be wrong:

"Not a single official has been disciplined over the worst-ever NHS hospital scandal"

Yet this is precisely the system being implemented here under ObamaCare. Ms Shecantbeserious must be gleeful.

Women, Women Everywhere and Not a CEO Among Them

I have spent most of my working career in healthcare, a total of 12 years.  Three years as a Social Worker and Family Counselor, and then nine years as a Health Care Executive, working in private medical practices as a manager.  I am currently looking for a job but I am either over qualified for a manager’s position or under qualified for a director’s position.  As a dual master holder, MSW and MBA, with a total of 17 years working, 14 as a manager, I was dismayed at how I could still be under qualified until I found this article:

“Women in Healthcare Report: 4% of CEOs, 73% of Managers”

The article points out that, according to Bureau of Labor Statistics, 73% of medical and health service managers are women.  This has been my experience.  Whenever I attend one of my  professional groups meetings or seminars, the room is very heavy with estrogen; half the room menstruating, the other half in menopause, which means that 50% of the women will be too hot or too cold or both.

“Despite the central role women play in healthcare, RockHealth uncovered some stunning statistics about the dirth [sic] of women running startups that are getting funded. Consider that while women compose 73% of medical and health services managers, only 4% of healthcare CEOs were women. In the 2011 Venture Funded Digital Health database that RockHealth created, they looked at organizations who received over $2M in venture funding — zero had a female CEO. So far in 2012, only 3 venture-backed digital health startups who raised 2 million dollars or more had female CEOs. The report also outlines other interesting statistics such as the percentage of TEDMED speakers who were female.”

The report shows the of the 100 women surveyed, almost 50% report a lack of self confidence while about 18% cite lack of education, and about 42% cite no connection with senior leadership; in other words, lack of a mentor.  I would like to add another reason:   Managers of private medical offices, not affiliated with large groups or hospitals, are by and large women who have worked their way up through the ranks of the office and  have no or little formal education, but have decades of experience.  Additionally, managing a medical office is very different from management in a hospital or large practice.  In an office, the manager is the one responsible for making sure that all aspects of the office run efficiently.

Another (Painful) Ethical Conundrum

Imagine that you've had a devastating stroke, one which left you completely paralyzed, yet in full control of your mental capacity. You are a prisoner in your own body, completely dependent on others for your own sustenance and life.

And you have 20 or more years of this to look forward to.

Such is the case of Tony Nicklinson, a (now former) businessman who, at age 51, suffered exactly that catastrophic event, and has now asked a court for permission to end his own life.

Of course, being completely paralyzed means that he'll need some help with that, which is why the law's involved in the first place. That this scenario is being played out in England is, of course, excruciatingly ironic; after all, the MVNHS© itself seems to have little problem killing off less cumbersome patients.

In the event, the British High Court has denied his request, sentencing him to another few decades of suffering. The court's reasoning is that, because he's not terminally ill, "it would be wrong 'for the court to depart from the long established position that voluntary euthanasia is murder, however understandable the motives may be...'"

One wonders whether this is a valid point....

Cavalcade of Risk #164: Call for submissions

Emily Holbrook hosts next week's Cavalcade of Risk - Entries are due by Monday (the 20th).

To submit your risk-related post, just click here to email it.

You'll need to provide:

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

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

Thanks!

Disability and the unexpected

The step-son of our very close friends was in a terrible motorcycle accident recently: he was pulling out of his driveway when he was hit by a car, smashing his leg and spleen, crushing his spine and resulting in what appears to be major head and brain trauma.

Obviously, he hadn't planned to be hit by a car, but this is why they're called "accidents:" no one plans them, life happens.

Which brings us to the question of how he'll feed his family, pay his bills, and (hopefully) continue saving for retirement (assuming he's even/ever able to return to work). I have no idea whether or not he has disability income ("paycheck") insurance, but I sure hope he does.

What brings this to mind is an email I recently received from MassMutual (one of the premier DI carriers), which included some interesting (and thought-provoking) information. In the past 10 years, for example, for its disability insurance policyholders aged 35 or younger, MM had over 1,000 policyholders go on claim for at least 90 days.

Some of these were surprising to me:

■ A 35 year old male with chronic fatigue syndrome whose claim is now over 10 years old

■ A 29 year old woman, also 10+ years on claim, with a lung disorder

■ One guy with hypertensive heart disease was only 28 when he went on claim over 5 years ago

Is your disability income insurance up-to-date? Are you sure? Life happens.

[h/t: Howard Klebanow]

What if they gave an ObamaParty...

And no one came? The National Association of Insurance Commissioners (NAIC), in its headlong rush towards obsolescence, has a brilliant idea - to form:

"a new working group comprised of state insurance commissioners in order to create a forum for the many states that ... are not adhering to the formal state health care exchange implementation path outlined in [ObamaCare]."

This is a high-profile, highly volatile issue, one which needs to be approached with seriousness of purpose.

Oh, one slight wrinkle:

"There are no members yet, but the NAIC is going to circulate a notice to see who wants to join."

Rotsa ruck with that, fellas.

Health Wonk Review: Brainiac edition

Jaan Siderov presents an amazing Health Wonk Review - chock full of interesting posts, including one from econ-blogger Jason Shafrin confirming our own fears about provider availability.

Failures in Journalism and pimping Jost

Recently, Bill Toland of the Pittsburgh Post-Gazatte uncritically parroted Tim Jost's talking points about self-funding for small groups. As an actual, you know, expert in the field, I'll break it down (and apart) for you:

"The insurance companies have found a way around the [Affordable CareAct]”

First, why do so many employers, small and large, self fund? Because it has proven to be the most cost effective way to deliver the highest quality benefit plan since ERISA was passed in 1974. Prior to the HMO explosion in the 90s, and the dominance of Carrier PPO networks since, there was a large and vibrant small group self-funded market. Carriers such as Vasa Brougher and Perico specialized in it. As they did 20 years ago, small groups today have started to look at self funding again. And contrary to Mr Jost’s claim, PPACA is a very minor reason why the market has rebounded, and certainly doesn't explain why the market rebounded prior to 2010.

Found? They are selling the same policies they have been selling continually since the late 70s and early 80s. This is hardly the devious plot to circumvent PPACA Jost is trying to trick people into believing. What has been found is a new and dishonest excuse for those that have been opposed to self funding for decades to make another run at it. Remember that Jost is attempting to get existing model guidelines increased, if PPACA is the reason small groups are looking at self funding now, why were the much lower current limitations proposed years ago?

Yup, there's an app for that, too

Two new and interesting insurance-related apps:

■ First up, Pro Publica ("an independent, non-profit newsroom that produces investigative journalism in the public interest") has a tool that makes it "easy to search nearly 118,000 deficiencies found during government inspections at 14,565 nursing homes nationwide." It comprises over 20,000 nursing home inspection reports, almost all of which are pretty current.

■ The Insurance Information Institute has developed a free mobile disaster preparedness app for the iPhone. The program "provides consumers with a library of preloaded checklists to learn about important property protection and preparedness steps." You can even generate your own customized checklists.

Kudos to PP and III.

What happens when you rely on government

When you rely on government your counting on someone without a vested concern for your health and well being to do what is right. Actually looking out for you or doing what is right is not what is in their best interest, people believing that is what they are doing while turning over large sums of tax money and power is. This sad story out of Norway ties a lot of recent events together.

http://www.wgbhnews.org/post/norways-massacre-could-have-been-stopped-sooner-commission-concludes

 "The police response [to the island attack] was slowed down by a series of blunders, including flaws in communication systems and the breakdown of an overloaded boat carrying a police anti-terror unit. Meanwhile, Norway's only police helicopter was left unused, its crew on vacation. Breivik's shooting spree lasted for more than one hour before he surrendered to police."

The Local says that "two local police officers who arrived first on the lakeshore should have done everything possible to get to the island, according to police instructions in the event of a shooting. Instead they remained on shore, saying they couldn't find a boat to take them to the island."

When an elite police force finally arrived, its members had to borrow two pleasure boats to go a short distance from shore to the island.

Like politicians always do they hold hearings and promise nothing like this will ever happen again, then spend a bunch more money. When it comes to our health and safety we often don't get a second chance. If you survive your left to suffer the damages as long as you live. Veterans that suffered for decades under poor VA care don't get those years back. Kids raised on third world public housing projects don't get their youths back. Future generations of tax payors don't get back the trillions lost to fraud.

One thing that does endure is the wealth these politicians and their friends swim in until they die then pass on to their family. As part of tax reform maybe we should consider a 100% death tax on any politician that served more then 4 years with no exclusions.  

Pensions and Life Insurance

This may be a bit "inside baseball," but it's sure to be of interest to folks participating in defined benefit pension plans:

"Sponsors of defined benefit pension plans will be able to use excess money in their plans to fund the purchase of life insurance for their retirees for the first time under a provision of legislation passed by Congress"

First, some background. There are basically two types of retirement plans: defined benefit and defined contribution. Social Security is an example of the former, and your 401 201(k) of the latter. Under a DB plan, the employer promises that, at retirement, you'll receive X number of dollars every month. Under a DC plan, your employer promises to put X number of dollars towards your retirement, and it will grow (or not) as time goes by.

The nice thing about DB plans are their certainty: you know how much will be coming in each month. The downside is twofold: for the employee, it puts a cap on the amount one will receive. For the employer, it's a huge burden (just ask the Post Office).

So what's the big deal about life insurance in one of these plans? Well first, it's rare that one has an opportunity to pay for life insurance with "qualified" (tax-advantaged) funds. For another, it will hopefully "enable employers to maintain retiree coverage." This is a very real concern in this sluggish economy, so every little bit helps.

Going critical

It's been a while since we've had a substantive post on Critical Illness insurance policies. Briefly, these are plans that pay a cash benefit directly to you should you suffer a covered condition (heart attack, stroke, cancer, that kind of thing). These pay in addition to any health and disability policies you may already own, and can be a real (financial) life saver.

They're available as stand-alone plans, or as riders to either life or health insurance policies. They pay a lump sum (typically multiples of $10,000), and are usually tax-free (yay!).

But why would you need such a thing?

Well, consider this:

■ 38% of American women, and 44% of men, develop cancer during their lifetimes
■ Every 40 seconds, *someone* in the US has a stroke
■ By the end of this decade, over 700,000 Americans will suffer end-stage kidney disease

[American Cancer Society and American Heart Association stats]

So, if this is something that piques your interest, speak with your insurance professional about the different options and costs.

[Hat Tip: United HealthOne]

NAIC backs of self funding?

Unlikely but they have decided to slow down and regroup at least. As reported by SIIA the ERISA working group has tabled the proposed increase to minimum self funding risk.

http://www.siia.org/i4a/pages/index.cfm?pageID=6204

 "The Committee made it clear that they did not intend to overstep their charge and did not intend to turn stop loss into health insurance. They also said they do not want to hinder employers from self-funding or from having self-funding options. The proposed change is primarily in response to medical inflation and changes in plan designs since 1995. However, as several people pointed out, this assumes that the original standard of $20,000 was appropriate and made sense, which is probably dubious given that the vast majority of states have yet to adopt the Model Act."

Did not want to hinder employers from self funding? Odd then that the proponents are campaining to do just that. Appears to be another case of politicians trying to slip something through without the public noticing and getting caught. NAIC has been trying for 20 years to kill self funding, despite what they claim in press releases this is not the end of their efforts. Just like national healthcare and other liberal agendas they will keep fighting to accomplish this goal either little by little or taking advantage of a crisis. 

Friday Afternoon Linkfest

■ First up, the folks at the Pioneer Institute are dubious that more government-directed healthcare in Massachusetts will really do all that much to contain costs:

[click to embiggen]

■ Since the science is settled, who will ultimately pick up the ObamaTax? Turns out, the "wealthiest 2 percent of Americans will take the biggest hit."

But don't start popping those corks just yet; all us "little people" will be sharing in that pain as we get "swept up in a hodgepodge of smaller tax changes that will help finance health coverage for millions in need."

Not to worry, though, since all these extra taxes will ensure that all Americans will have health insurance.

Wait, what?

■ Finally, our friend Michael Cannon (Director of Health Policy Studies at the Cato Institute), shares his recent congressional testimony about the aforementioned ObamaTax's illegal IRS rule increasing taxes and spending:

Medical Tourism: Maybe not ready for Prime Time, after all

Over the years, we've been cheering on the relatively recent phenomenon of medical tourism. On the one hand, it's been a real blessing for folks stuck in a mediocre health care system. There, the question isn't price so much as quality (or lack thereof at home).

But what about folks with access to high quality, but perhaps also high cost, care?

As we predicted a few years ago, ObamaCare seems to have increased interest in less expensive, foreign-based solutions. These are not, however, without their own problems:

"[S]ometimes, cheap medical work can come with a high price -- as the recent case of a Florida woman illustrates ...  the implanted teeth were too large and were poorly aligned. Today, she claims, she is in constant pain, has bleeding gums, and can't eat solid food."

In fairness, we have but one side of the story here, and sometimes you get what you pay for.