Monday, October 23, 2017

Dragonlock 3 Kickstarter Counting Down

If you're a gamer you need to at least take a look at this, especially if you're even thinking about making the move to 3D printing.

FoIB Fat Dragon Games has pulled out all the stops: cutting edge designs, outstanding stretch rewards and excellent support.

Take a look.

Sunday, October 22, 2017

Shaking the Faith

As pointed out in several posts on this blog, sometimes the Christian Health Care Sharing Ministries have thorns.

Skyrocketing Obamacare premiums (which were not supposed to happen) have left far too many people seeking shelter from the storm in these non-insurance plans.

Sometimes they work very well.

Except when they don't.

The Self Pay Patient initiated this post in November of 2013, long before the reality of the Obamacare serpent took a bite out of your wallet. If you, or anyone you know, are considering one of these offbeat plans, take a while to read through the article but pay special attention to the comments which are still being added.

Here is a ssssssampling . . . .

When my COBRA coverage ran out I began coverage with CHCM in August 2016. In October of that year I developed a kidney stone. 

I gathered all of my bills and submitted them online with CHCM.

My claim from October had still not been paid. Yesterday I received a notice dated April 19, 2017 that since I was no longer a paying member my medical claims are no longer eligible for payment! I had paid for 7 months of coverage and had one medical incident and they refuse to pay even a portion of it.  - April 25, 2017 at 9:06 am

We have no way of verifying this claim. But if true, claims submitted are denied if you are not a "dues paying member" once the clam has been adjudicated.

My family was a member CHM through out 2016. We took my son to the emergency room one late night of a large local hospital. It ended up being a non-issue and we were in and out in 15 minutes. The hospital charged us about $1,1,00 and would not accept any Health Care Sharing negotiated discounts. When I talked to the CFO of the hospital about this, he told to feel lucky that it wasn’t a major incident

I also had some health issues for the end of 2016 that were hard to diagnose, but simple to treat. We turned those bills into CHM and were denied because we were no longer with them in 2017 even though we paid premiums to them when the services were provided. We were told that it is their policy that if you leave them, they will not pay for reimbursement. - May 5, 2017 at 5:19 pm

Looks like we are on a roll here.

If your claims are not paid when you WANT to leave the plan, keep paying the dues.

Kind of like the Hotel California of health care claims.

There are dozens of comments dating back to 2013. Buyer beware.

#Obamacare #ChristianHealthCareSharingMinistries

Making Strides: Lagniappe and Gratitude

Well that was a great time: Yesterday was our Making Strides Against Breast Cancer walk. Thanks to the generous contributions of our friends and family, I was privileged to raise over $1,000.

Collectively, our team raised over $3,600, and came in 9th out of 480 teams.

Wow!

Thank you so much to all of you who so generously supported this wonderful opportunity!

Friday, October 20, 2017

Making Strides Against Breast Cancer: Last Chance...

Once again, I'm raising money with my team: Love, Hope and Faith. Our walk is tomorrow (October 21st) and I'd really like to break the $1,100 mark.

Will you please help out by making a donation - Thank You!!

Thank you!

Thursday, October 19, 2017

3D Kickstarter Counting Down

FoIB Fat Dragon Games' latest 3D DragonLock Kickstarter is winding down, and if you're even the least bit interested in cutting edge 3D printed game terrain (or think you some day might be), this is a must-have:

"Snap-link dungeon terrain on Kickstarter, don't miss out on FREE stretch rewards, and our GM SCREEN OF DOOM"

Wednesday, October 18, 2017

Cost Sharing Reductions: It's Not Sabotage. It's Not a Bailout: Part 2

In Part 1, we learned the difference between subsidies and the much misunderstood CSR's, and why ending the latter isn't a bailout. Now we learn why it's also not "sabotage:"


It's Not Sabotage

Obviously if the Government won't pay their obligation and an insurer still must offer the better level of benefits they will have to factor these expected claims costs into their standard rates. This will push premiums up substantially. Many studies have been done on the financial impact but for ease of math let's assume it will increase costs to Silver plans by 20%.

Yes, 20% is a lot. But keep in mind rate increases in 2014, 2015, and 2016 all rose by significant amounts too. We didn't hear cries of "sabotage" back then. Instead we heard "this won't impact very many people because subsidies (tax credits) will protect them from the increases." So, how is this different? It's not. In fact, because the increases are on Silver plans it will raise the tax credit amounts and reduce the costs for Bronze, Gold, and Platinum plans to those who qualify for subsidies.

This leaves one income group potentially getting the shaft on Silver plan premiums. Anyone who doesn't qualify for a tax credit/subsidy must pay full price. It's easy to assume that these people will suffer because all the discussion - even in this post - has focused for insurance plans sold ON exchange. It's true that insurers must price the same product equally both on-exchange and off-exchange. But, insurers can also offer plans off-exchange that have slight benefit variations at different prices.

Using my example above, an insurer will offer this plan both on and off exchange. The new plan without CSR funding will cost 20% more. The smart insurer will also create a plan that closely mirrors their original plan with a slight tweak - let's say a $6,200 deductible. Because this plan is only offered off-exchange the insurer doesn't have to include the 20% mark up to fund CSR risk. This solves the problem of the 400% and above person not being able to afford a Silver plan.

So, who does this hurt? Over the next 10 years CSR payments are expected to cost more than $200 billion. It's either going to come from Congress appropriating the funds or through higher premium tax credits given to consumers.

The answer is it hurts everyone. Because those in DC want to focus on political agendas and not the real problem we all suffer. Higher taxes, higher premiums, lesser benefits, market uncertainty. All will continue. Because nobody wants to focus on the 80% side of the equation. That 80% side is the actual costs of care.

Cost Sharing Reductions: It's Not Sabotage. It's Not a Bailout: Part 1


Congress and the media are hyperventilating over the Trump Administration announcement that they will end Cost Sharing Reductions (CSR). The result is news feeds full of over-exaggeration, misrepresentation, blatant lies, and name calling. One side of the political aisle calls it sabotage. The other says it's an insurer bailout. Reality is, it's neither.


Before I explain, let's first start by answering what is the cost sharing reduction (CSR) and how does it work? It's quite simple when it's not used as a political football. But, like everything in our political world, the more the bureauweenie can confuse the consumer, the more reliant the consumer becomes on the bureauweenie.

Obamacare has two methods of "financial assistance" written in to the law to help low income individuals. The first method is premium tax credits to help pay health insurance premiums. Those have been funded and have nothing to do with the second method, CSR's.

Under Obamacare, insurance companies are required to offer people making between 100% and 250% of the Federal Poverty Level Silver level insurance plans that have lower deductibles, copays, coinsurance and out-of-pocket-maximums than the standard Silver level plans. Pricing for these plans are equal to Silver level plans that don't include the CSR's. In exchange for offering these better benefits to low income individuals, Obamacare made a promise that they would refund insurers for the claims they incur between the better benefit Silver CSR options and the standard Silver plans.

Here's an example: three 42-year old's who live in the same zip code that purchase insurance through the exchange. Each has a different income. The first has an income of $19,500, the second has an income of $30,250 and the third an income of $55,000. The actual monthly cost of the lowest priced Silver plan is $248.57. It includes a deductible of $6,100, an out-of-pocket limit of $7,000 and has an office visit copay at $30.

The first person has an income below 250% of the poverty level and the other two don't. So, under Obamacare the first person is eligible for a premium tax credit (subsidy) AND a Silver plan that has better benefits (CSR). His benefits include a $1,100 deductible, an out-of-pocket limit of $2,000 and an office visit copay of $15.

The second person has an income just above 250% but below 400% of the poverty level. Under Obamacare he is eligible for a premium tax credit (subsidy) but not a Silver plan with CSR. He will pay less than the full premium price but have the standard plan with a $6,100 deductible.

The third person is over 400% of the poverty level. He pays full price for the standard insurance plan.

Now that we understand CSR's let's explain why it's not a bailout or sabotage.

It's Not a Bailout

When insurers price their plans they are based on the standard plan. This is where the $248.57 premium comes from. The insurance company math nerds (actuaries and underwriters) develop rates based off assumed risk. This risk does not include the difference between the standard plan benefits and the better plan benefits available to those between 100% and 250% of FPL. The Federal Government -through Obamacare - agreed to reimburse insurers for these claims that they have not financially accounted for.

The amount the insurer hasn't accounted for is the difference in deductible, copay, coinsurance, and maximum out-of-pocket the consumer is liable for. Let's assume all three guys from above have a claim for $25,000. The lowest income guy is only liable for a maximum of $2,000. The second and third guys would be liable for $7,000. Insurers priced for $7,000 out-of-pocket knowing that Obamacare promised to pay the difference in claims between the standard plan limit and the better benefit limit due to Cost Sharing Reductions. In this scenario the difference in the first guy's liability and the standard liability ($7,000-$2,000) would be submitted by the insurer to the Government for reimbursement. It's also important to note that if the first guy is healthy with no claims the Government doesn't pay the insurance company at all.

As you can see, this isn't a bailout to insurers. It's reimbursement for claims they incur that weren't factored in to insurer pricing. Under Obamacare the law states that CSR's are a financial obligation of the Federal Government to insurers. Failure to pay represents a default of our Government.

We explain how it's not "Sabotage" in Part 2.

Tuesday, October 17, 2017

Canary in the Coal Mine – This Sceptered Isle, Part LXXIX


Unprecedented abuse of power by NHS?  Well of course it’s abuse of power.  But unprecedented?  Not so much.  Remember this? 


Fortunately, the public outcry over that one caused NHS to back down.  Who knows what NHS will do this time?

People who believe these things cannot happen in the US are seriously misinformed. Nearly the same thing happened in my own town.  It happened to neighbors of ours whose daughter was diagnosed with mitochondrial disease.  And then the hospital and bureaucrats in the State of Massachusetts took over and tortured the whole family for years.  

People who say nothing like this happens in a nationalized insurance scheme are living in a dream world. These situations will surely arise in the US even if  - and maybe especially if - we end up with some kind of government single-payer medical welfare scheme.

Mark my words.

More ObamaCare Rate Lies

Remember this?



Well, it appears that someone didn't get the memo.

First:



From the Centenniel State:

"Colorado premiums will rise by 6% on top of existing hikes"

And finally, from the Keystone State:

"Insurance premiums for plans sold on Pennsylvania’s ObamaCare exchange will increase by an average of 30.6 percent for 2018"

It appears that most of these are as a result of President Trump's decision to follow the actual law.

Refreshing, that.

[Hat Tip: FoIB Holly R]

Friday, October 13, 2017

Obamacare - When Facts Don't Matter

Former White House COS and current Mayor of the Windy City has been quoted as saying "Never let a serious crisis go to waste.".

Taking a page from Rahmbo's playbook, the current WH resident is doing just that.

Obamacare is failing. Has been from day one. But the only folks who don't see that happening are folks that are either ignorant, those who believe the 44th president walked on water, or they are covering their ears and refusing to listen to facts.

If you are the Gordon Gekko of health insurance and believe that "Obamacare is good" no need to read further. Go to HuffPo or TMZ and have fun with that.

But the Twitterer in Chief who is not known for holding his tongue (or Twitter fingers) has thrown down the Obamacare gauntlet with this tweet.

The Democrats ObamaCare is imploding. Massive subsidy payments to their pet insurance companies has stopped. Dems should call me to fix! - The Real Donald Trump

Never let it be said that the man is indecisive.

He calls a spade a spade.

But some folks can't handle the truth.

What is extremely entertaining (to me at least) is found in the comment section below the Real Donald's tweet.

Anyone with a pre-existing condition is going to see premiums skyrocket from TrumpCare. He isn't working with the facts here. Studies, plz!

Seriously, without name calling or rudeness, here are the facts: the ACA saves lives. You are making it worse for poor people and all of us.

I wonder why Obamacare is imploding! Weird! Not sabotage, right?

Well, you get the idea.

Unless you have been indifferent to facts and truth since this mess called Obamacare came into existence.

Obamacare IS in crisis.

Obamacare HAS BEEN in crisis mode since 2013, a full year before it was completely implemented.

At this point there is no way to fix it. Too late to save it for 2018 and possibly beyond. Act II will most likely be a federally funded expansion of Medicaid for anyone not covered by employer group health insurance.

If there are any carriers offering individual health insurance in 2019 it will be those who are able to offer plans that gut the high cost parts of Obamacare, such as guaranteed issue. Medicaid  would then be not only for those who fall below a designated income level but also function as a high risk pool for those with serious health issues.

Those who want to keep Obamacare have some serious denial issues and should seek counseling while they can.

#Obamacare #TrainWreck #Snowflakes




The First Cut is the Deepest

[Note: This is an insurance-free post]

For as long as I can remember, I've always owned good kitchen knives (Wusthof, Henckels, etc). A short time back, I participated in an Indiegogo campaign for a new brand, Misen (as in mise-en-place). This new venture promised high-quality knives at more affordable prices, and I thought it looked promising.

Well, I've had my chef's knife for some months (perhaps a year?) now, and I must say that it performs very well: nice balance, able to keep an edge, comfortable grip.

What isn't so great is how well it's "aging:"


See those spots? Rust, even though I carefully hand wash and dry it after each use.

So I sent an email about it to the Misen folks (including that picture), and this is their reply:

"Hi Henry,

Thanks for sending through that photo. While not common, small stains like this can occur (even on stainless steel knives) for any number of reasons, and they’re not something to worry about!

In my experience with some other knives I’ve used in the past, a product called Bar Keeper’s Best Friend is really effective at removing minor stains like the ones in the photo. Of course, if the issue does get any more serious, please let us know and we’ll be happy to help!

All the best,
Marco
"

To which I say: Bull Feathers.

As previously noted, I've owned similar knives for many, many years, and have never experienced this, let alone in one that's practically brand new.

So I ask, dear readers, am I justified in my disappointment, or unreasonable?

Thanks!