Just for the record

As most everyone is probably aware by now, Queen Elizabeth was admitted to the hospital a few days ago. However, a less-reported part of the story is noted in the 6th paragraph of this NBC News online report:

"She was being treated at the King Edward VII Hospital in London, a private facility."

Well, then, that would not be an NHS Hospital, would it?

Captain Obvious in da house

As Bob spent most of the morning pointing out (here and here), The ObamaTax does little but increase our costs; whether they're called premiums or taxes is of little consequence to our checkbooks.

A new study by the National Center for Policy Analysis finds that, contra-ObamaTax expectations, "Americans, who on average fill a dozen prescriptions a year, would benefit from free competition."

No kidding.

In some ways, this is the Fox Butterfield Effect hard at work:

"[T]he study argues that the many new regulations, often enacted in the name of protecting consumers, are having the opposite effect, placing barriers to efficiency"

That is - and this will be no surprise to regular IB readers - the regs are there specifically to create those barriers. Anyone who's been paying attention the past 3 years understands this: decreased efficiency leads to more regulations, and thus more government overreach.

But then, that's been the real game all along.

The Glass Half Empty

Here's some helpful health news:

"A German study suggests that people who are overly optimistic about their future actually faced greater risk of disability or death within 10 years than did those pessimists who expected their future to be worse."

Oy.

Cavalcade of Risk #178: It's Olio Time

Health Business Blog's David Williams hosts this week's jam-packed episode of the Cavalcade of Risk. From skydiving to the ultimate bad-first-day-on-the-job, you're sure to find something interesting.

Kudos, David!

Another Ethical Conundrum [Updated & Bumped]

By now, you've probably read about the death of an elderly woman in a California "nursing home." While the loss of life is sad, it's important to cut through the chattering to look at what really seems to have happened.

As I read through various accounts, it became clear to me that the "nursing home" was anything but: it was a retirement "home" which offered little to no care. And, in fact, would-be residents sign a consent form acknowledging this. The home itself appears to be part of a three-level "continuum" of care: those with little or no need for medical help are in the retirement section; those who need some additional levels of care are in an assisted living facility; and those who need skilled care are in an area geared towards their special needs.

Assuming this is correct (and it seems to be), then the sequence of events makes sense: after all, if you live in (say) an apartment complex, you don't expect the landlord to do anything more than call 911. It seems to me that, despite the hue and cry of cold-hearted capitalism, the onus is on the retiree ("tenant"), not the folks at the front desk. If one has agreed - in writing - to a certain level of non-care, then that is what one should receive: no more, and no less.

What say you?

Should the retirement home be held accountable for the death of a resident?
	Yes
	No
	Depends (Please explain in comments)
pollcode.com free polls

[UPDATE] Thanks to FoIB Holly R, we now learn that the "victim" in this little tale had left explicit instructions that she "die naturally and without any kind of life prolonging intervention."

So, does that change the calculus here?

How about this, then:

"[T]he company issued a statement saying the employee's failure to heed a 911 dispatcher's was the result of a misunderstanding of the company's emergency medical practices."

Curioser and curioser.

[Originally posted March 5, 2013]

Florida Scott-free?

Well here's a switch. Even as (Republican) Gov Rick Scott agreed to ObamaTax-funded Medicaid expansion, his own state lawmakers handed it right back to him:

"Florida legislature rejects ObamaCare Medicaid expansion ... The House made the right decision today to not draft a committee bill expanding Medicaid under [The ObamaTax]."

Gov Scott, the ball's in your court.

Wasn't Ezekiel Emanuel sort of "Projecting" here?

Ezekiel Emanuel, brother of Rahm Emanuel and President Obama’s health care adviser during the Obamacare debate, conceded last month that medical insurance premiums are rising.  But, he suggests, the reason is a sinister insurance industry money grab because, don't forget, ACA will make them lower their medical insurance premiums next year:

“[It's] in anticipation of 2014 and the fact that we’re going to have real competition in the exchanges and rates are going to come down,” he said when asked why insurance rates are rising as much as 25 percent. “It’s in anticipation of this dramatically changed marketplace and I think that’s what they’re doing.  Everyone is sort of [saying] ‘well. we don’t know what the future is, so let’s lock in as much money as we can.”

Oh, is THAT the sort of argument that impresses state insurance rate regulators?

Yeah, right Ezekiel.

On the other hand Ezekiel, thank you for the insight into how the Obama administration sort of went about locking in as much federal spending as it did, when launching its own stunningly irresponsible federal spending spree:

First claim you will not add "one dime" to the deficit.

Then raise federal spending by 20%  (btw, not including ACA)

Finally throw up hands and dig in heels over a 2% reduction. 

So it appears our present government grabs for spending and locks it in, sort of based on "we don't know what the future is."  Maybe.  But Ezekiel, that is certainly not sort of how insurance premiums are set.

NAIC Hits Bottom, Keeps Digging

Another one that slid in under the radar. Seems that disgraced former US Senator Ben "CornHustler" Nelson has been tapped to head up the (also disgraced)  National Association of Insurance Commissioners:

"Nelson will lead the NAIC’s efforts to meet the needs of its members and represent their interests as the primary advocate and chief spokesperson in Washington, D.C. ... His rare and valuable combination of experience in insurance and government will be a tremendous asset to our organization"

Doesn't say a lot about the integrity of the NAIC, does it?

Unclear on the Concept: Part 47

Let me begin this mini-rant with the proviso that Allison Bell, who wrote the article on which it is based, did a great job of reporting, and I am not slamming her at all. Rather, my ire is directed entirely at Ms Shecantbeserious and her (equally) ignorant minions.

As we noted this morning, Ms Shecantbeserious has dumped another 700-plus pages of "clarifications" for our amusement and/or amazement. We touched on a few, but there are, in fact, quite a few more little "gems" hidden here. Let's look at a few of them:

1) "the nuts and bolts of how new health insurance risk management programs will work"

When your plan design requires Guaranteed Issue and Community Rating, you have forfeited the right to use the term "risk management." The correct term is "income redistribution."

2) "how insurers will go about paying for the programs"

That's easy: they won't. Insurers have never paid for any claims - that's what premium payers are for (note: this is different than how, for example, Lloyds works).

3) "how the new "advanced premium tax credit" (APTC) program will work"

Let's answer that with another question: from where, exactly, is the money to pay for these expected credits going to come? Here's a hint: see #1 above

4) "[The ObamaTax] requires [HHS Secretary Shecantbeserious] and states to set up exchanges, or Web-based health insurance supermarkets, for individuals and small groups by Oct. 1."

Oh, we know all about that deadline. Notice, though, that we haven't seen any recent news on its actual implementation. Wonder why that is.

But here's my fave:

5) "The Internal Revenue would use the APTC program to give people ... help with paying for health coverage bought through an exchange ...  Jane Doe, a taxpayer, expected to report 2014 income equal to 300 percent of the federal poverty level in March 2015, the IRS would use Jane Doe's income projection to make APTC tax credits available to Jane Doe in 2014, to help her pay for health coverage in 2014."

One word, folks, one word.

Another Day, Another 700+ Pages

Could someone please tell me that a 2600+ page bill (which no one read before they passed it) plus untold hundreds (perhaps thousands) of additional pages of regulations implementing it, could possibly make our health care delivery and finance systems more efficient?

"The four rules, which are scheduled for publication in mid-March, finalize both major and minor parts of the [ObamaTax]"

A ream-and-a-half of paper for FOUR new rules?

Whatever happened to the KISS (Keep it simple) Principle?

[Hat Tip: FoIB Holly R]

Horsin' Around with Insurance

Do YOU have "Wrong Equine Coverage?"



[Hat Tip: SoIB Joyce F]

Friday Afternoon ObamaTax tidbit(s)

Had an interesting meeting with our Anthem rep this morning, and two items she shared with me stand out:

First, I've been wondering for a while about how insurance sales will work outside the Exchanges. That is, since only Exchange-compliant plans will be acceptable coverage under The ObamaTax, why would carriers bother to have two different product lines? I had guessed that they wouldn't, but our rep told me that the plans available on the Exchanges would, in fact, differ from those sold outside of them.

Exchange-based plans will be eligible for subsidies (which does not mean that purchasers will actually receive them), and have much tighter (smaller) networks. Plans sold outside the Exchanges won't be eligible for any subsidies, but will have bigger networks, and thus more offer more choice in actual health care.

The second thing she told me had to do with so-called "grandfathered" plans. I was surprised to learn that up to 50% of Anthem's individual plans are still grandfathered in. She also told me that they're expecting a major influx of fourth quarter new business.

Hunh?

It makes sense: non-grandfathered plans will stay in effect until their first renewal after January 1st. So if your plan has (for example) a February effective date, then you're most likely going to be buying a new Exchange-compliant plan early next year. But if you buy a new plan with (say) an October effective date, you've got most of 2014 before you have to switch.

Oh, and Anthem also has a consumer-friendly ObamaTax guidance tool, just click here.

Live and learn.

[Hat Tip: FoIB Beverly D]

Cavalcade of Risk #178: Call for submissions

David Williams hosts next week's Cav. Entries are due by Monday (the 4th).

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). And please only submit if you are willing to link back to the carnival if your submission is accepted.

And this is News?

It must be quite frustrating to be HHS Secretary Shecantbeserious - she's almost a "reverse Midas." That is, pretty much everything she and her minions touch become massive fails.

Latest case in point:

"Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents ... One out of every three times patients wound up in nursing homes ... they landed in facilities that failed to follow basic care requirements laid out by [Ms Shecanthbeserious]"

This is basic, day-one stuff, not advanced health care metrics. And yet we expect these ... people ... to run our entire health care system with any more competence?

Riiiight.

Health Wonk Review: Insightful Nuggets edition

Jaan Siderov hosts this week's compendium (hey, I thought we were the only folks who used that term!) of wonky healthcare-related posts. As usual, he does it with elan and good humor (not to mention modest acumen).

Wednesday LinkFest

■ As we've long noted (most recently here), The ObamaTax has proven quite lethal to the job market. As if more evidence was needed, we offer this little tidbit:

"Henderson Properties in Charlotte, has 48 employees and seven job openings. But he’s considering a hiring freeze ... if he hires two more employees, he’ll reach the 50-employee threshold that [triggers the ObamaTax Employer Mandate]"

Mr H best be thinking outside that box, as well: too many part-timers and he's screwed, too.

■ The science is settled! You and your fellow passengers can now breathe easier (or maybe not):

"A three-thousand word treatise published by The New Zealand Medical Journal on Friday has given anxious flyers prone to bouts of flatus good cause to breathe easy again, after a highly-scientific conducted by actual scientists produced empirical evidence supporting those in favour of farting on planes"

Ah, fresh air!

■ And because it's making its way - rapidly - across the 'net, here's more proof that ObamaTax advocates remain clueless:

Matt's Missed Mark

Sometimes I despair of the modern media. Case in point, Matthew Yglesias and his inane take on a recent Time article on the cost of health care. As co-blogger Nate pointed out, the magazine got almost everything wrong. But that doesn't stop the illustrious Mr Yglesias from piling on, only adding to the torrent of misinformation.

To wit:

"Time’s long investigation of American health care prices missed one thing: We pay our doctors way too much."

Really, Matt? That's what Brill missed?

First, though, it's only fair to point out that Mr Y acknowledges one rather obvious elephant in the room, one that the press routinely ignores:

"[T]he best deal of all goes to the biggest insurer around: the federal government"

This simple statement goes a long way towards explaining how programs like Medicare and Medicaid distort the cost of health care for the rest of us.

Even a blind squirrel...

Unfortunately, that's the  last time he makes sense. Consider this example of his craft:

"America has the highest-paid general practitioners in the world. And our specialists make more than specialists in every other country except the Netherlands."

So. What?

Hey Matt, ever hear of tort law? Malpractice insurance? RAC's?

In fact, our own Kelley Beloff destroyed this myth almost three years ago:

"Government has mandated that all physicians implement an Electronic Medical Records system by 2014 or face punishments ... Government has mandated that all physicians must have on staff a certified coder by 2012 or face punishment ... Any efficient medical office needs three staff members to every provider."

And the list goes on. Hey Matt, who do you think pays for all that?

But this barely hidden gem is the real prize of his vapid little excercise:

"If doctors earned less money, fewer people would want to be doctors"

Wow, Matt, that's some brilliant, almost Krugmanesque economic and financial insight there. Good thing we have a glut of practitioners to handle the influx of all those newly insured folks thanks to The ObamaTax.

Wait, what?

[Hat Tip: FoIB Holly R]

Sorry, Pool's Closed

As promised, the gates to the ObamaTax High Risk Health Insurance Pool are quickly closing.

Via email from Medical Mutual:

"[HHS Secretary Shecantbeserious] directed us to suspend enrollment for new applicants into the Ohio High Risk Pool as of the end of the day March 2, 2013 ... We will accept applications until Saturday, March 2."

Now, this (ostensibly) doesn't affect folks already on the plan, which is slated to sunset at the end of this year, when the power of the fully functioning ObamaTax goes into effect.

Oh, goody.

Hmmm . . . Freelancers? . . . Freelancers? . . .

Oh yeah, now I remember.  The Washington Examiner has the story:

“A health insurance company headed by an old friend from when President Obama was an Illinois state senator got a $340 million federal loan to establish Obamacare co-ops in New York, New Jersey and Oregon despite having a chronic record of consumer and regulatory complaints.. . . The New York-based Freelancers Insurance Company has been rated the "worst" insurer for two straight years by state regulators”

[Hat Tip: InstaPundit]

Please read the whole thing.  But - first - I would check my supply of Milk of Magnesia.  I think we're all beyond surprise and shock when stuff like this comes to light, but plain old nausea is harder to stifle.

You can read even more here where InsureBlog commented on the Freelancers' CEO giggling over her big score a couple months ago:

“It’s like venture capital for health care,” said Sara Horowitz, the group’s executive director." 

Just what we need – a federal snowstorm of high-stakes venture-capital wagers, based on political calculations, not business calculations. Another wager like Solyndra. 

Can I be the only one who is beginning to think that ACA functions best when used as a cover for laundering & distributing political pork?

MassMutual Takes the (Reverse) Plunge

As we've long noted, Long Term Care insurance rates have been headed ever higher. While John Hancock may have led the charge, other carriers haven't been lagging, and now MassMutual is set to raise new business rates in a few days. From email:

"Effective March 1, Illinois, Ohio, Puerto Rico and Vermont will be added to the list of jurisdictions approved for the SignatureCare® 500 long-term care insurance (LTCi) updated rates"

There doesn't seem to be a specific percentage available at this time. We'll update this post if that changes.

Oh, the message?

If you're thinking about buying Long tern Care insurance, don't wait too* long to make up your mind. It'll cost ya.