Friday, April 28, 2017

Thursday, April 27, 2017

MVNHS© Strikes Again

As we've noted countless times, government-run healthcare means rationed healthcare. There just isn't any other way to manage costs (for certain values of "manage"). This time out, the Much Vaunted National Health System© has its sights set on those who smoke and/or need to shed a few stone:

"NHS bosses are planning a massive expansion of the controversial rationing that forces smokers and obese patients to wait months in pain before they can have surgery"

Keep in mind, this is in addition to the already scandalous wait times facing lean non-smokers.

On its face, this seems reasonable enough: after all, this is primarily about lifestyle choices one has made (to smoke or overindulge at the buffet). But here's the thing: these folks still pay the same in taxes as their non-smoking, skinny fellow Britons, yet are going to be denied timely medical care. But if the point of the exercise is "fairness" (as it seems to be), well: #Fail.

[Hat Tip: MisHum]

Wednesday, April 26, 2017

Zillow for Healthcare

Earlier this month, I posted on how a SoCal clinic had (finally) provided an example of my personal healthcare Holy Grail, a truly transparent healthcare pricing model. The challenge is that it's specific to this small, regional chain of clinics,and doesn't really help folks outside the immediate area, or with comparison to other providers (which don't share this information).

Now comes Amino, which "gives patients access to information on the cost of various procedures and how much experience doctors nationwide have in those procedures."

And there's no charge for using it.

The site is the brainchild of a former Zillow alum who was frustrated in his own efforts to find this kind of information for his own health issues:

"I realized just having the consumer experience that health care had offered me was really frustrating ... So I decided to build Amino to solve that.

Of course, this really isn't critical if one has no skin in the game, so it will be most valuable for folks with (for example) HSA-type plans:

When people pay their own way, they’ll start to shop and demand prices [says Twila Brase, president of the consumer group Citizens’ Council for Health Freedom] ... Lots of people wanted to force doctors to be transparent about their prices, but it didn’t matter until people pay their bills.”

Yup. Now, if we could just get to truly catastrophic coverage, these types of services should really take off.

[Hat Tip: The Political Hat]

Tuesday, April 25, 2017

Passive vs Active Mortality

A couple of months ago, we blogged on the fact that, among other failures, ObamaCare hasn't actually saved any lives, and that "public health trends since the implementation of the ACA have worsened."

Bad as that may be (and it is awful), it pretty much describes a status quo as regards pre-O'Care healthcare financing (insurance) and delivery.

But what if it's actually worse than this?

Well, thanks to FoIB Holly R, we learn that it is:

"Mortality Rates Suggests Obamacare Could Be Killing People ... equivalent to an excess 11,000 annual U.S. adult deaths relative to the pre-Obamacare steady state trends"

This despite correcting for the increasing death toll from the opioid crisis (and similar factors). In other words, ObamaCare has a body count:

Now, it's fair to say that we don't know which part of The ObamaTax is responsible for this spike, but I would argue that this is just another reason for its full repeal, not DC rocket surgeon tweaking; the stakes are just too high.

But maybe that's just me.

Feds make argument against single payer

For all the hoopla over the benefits of government-run health care schemes, one would think that the Feds would be all-in on the concept. And yet, much as Britain's MVNHS© has spawned private plans, the US government seems to be throwing at least one single-payer, government-run healthcare system under the bus:

"President Trump signed a very important bill on Wednesday that extended the Veterans Choice Program ... The bill will allow veterans to seek private care outside of the VA"

Now, there are some conditions attached: the vet must live at least 40 miles away from the nearest VA hospital, or be unable to book an appointment within a30 days. On the other hand, it's at least an acknowledgement that there aren't enough facilities, and that those that doe exist are frequently overbooked and/or understaffed.

So, at least some choice is now available to those who risked their lives in service to their country. And further proof - as if that's necessary - that single payer, government-run health care is, at best, sub-standard.

Monday, April 24, 2017

Buddy, Can You Spare a Dime?

Medical bills piling up? No problem. Just stiff the health care provider. Why not. You got the treatment. You feel better. Doctors and hospitals make a lot of money. They can afford to write off my bill.

Sadly, far too many people have that attitude.

Obamacare didn't CAUSE this problem, but the number of patients willing to skate on paying a medical bill is on the rise. Higher premiums. Higher deductibles. Higher out of pocket.

Even if the patient WANTS to pay their bill, often they can't. A Kaiser study confirms this.

Four in ten (43 percent) adults with health insurance say they have difficulty affording their deductible, and roughly a third say they have trouble affording their premiums and other cost sharing; all shares have increased since 2015. 

Three in ten (29 percent) Americans report problems paying medical bills, and these problems come with real consequences for some. For example, among those reporting problems paying medical bills, seven in ten (73 percent) report cutting back spending on food, clothing, or basic household items. 

Challenges affording care also result in some Americans saying they have delayed or skipped care due to costs in the past year, including 27 percent who say they have put off or postponed getting health care they needed, 23 percent who say they have skipped a recommended medical test or treatment, and 21 percent who say they have not filled a prescription for a medicine. 

Even for those who may not have had difficulty affording care or paying medical bills, there is still a widespread worry about being able to afford needed health care services, with half of the public expressing worry about this.

Almost half of people would have difficulty paying a $500 medical bill. About one in five would not be able to pay that bill at all.

While some see this as an indictment of the current health care and health insurance system, it is also a statement about money management skills.

#MedicalDebts #UnaffordableHealthCare #Obamacare #Medicare

Ominous sign

We last seriously discussed worksite life plans back in 2011:

"The basic idea, though, remains the same: small face amounts, simplified underwriting and easily-budgeted premiums"

At the time, we noted that the market was facing a rather serious challenge:

"U.S. sales of voluntary group insurance products and individual products sold at the worksite fell 2.9% in 2010."

Now, that original post didn't differentiate between life and other insurance products available through these kinds of arrangements, but at least some of these numbers reflect life insurance sales.

Now there's even more bad news, and this is specifically related to payroll deduction (worksite marketed) life insurance:

"Middle-aged white Americans without four-year degrees are at increasing risk of dying [prematurely]."

There are, of course, any number of possible explanations for this, but Bloomberg's Jeanna Smialek puts the blame on drug and alcohol abuse, and "slowing progress against heart disease and cancer."

I'm not quite in agreement on this: after all, black men (and white women) face the same challenges, and I don't see evidence cited that they're dying any earlier. And this is drivel:

"For all the debate over whether college is worthwhile, high school graduates who go straight into the workforce have higher unemployment [and] weaker wage growth" than their college-educated peers.


They also have zero college debt, and at least least 4 years of wage-earning over their college-educated peers. And if they're in the trades, the odds are pretty good that they're going to earn more - perhaps a lot more - than the barrista with the 6 year feminist studies degree.

Something to consider.

Friday, April 21, 2017

"Is this covered by my dental plan?"

Fair question:

"[H]e performed a tooth extraction while standing on a hoverboard"

Finally! An ICD 10 code I could not find

[Hat Tip: Notorious MWR]

Dogs & Fleas

Back in the day, the insurance industry went all-in on ObamaCare (after all, what's not to love about a law that requires citizens to buy one's product?). And it appeared to be kind of a no-brainer: rack up big losses? No problemmo, we'll backstop those with a slush special fund (aka Risk Corridor). Now, at least one willing participant, Blue Cross/Shield of North Carolina, risks losing some major bucks because:

"A federal judge dealt a major blow to a health insurer's attempt to recoup millions of dollars" by rejecting the carrier's lawsuit against HHS accusing the agency of "failing to make good on its obligation to pay nearly $130 million under the ACA risk corridors program."

This shouldn't have come as a shock to BX, since the program has been notoriously underfunded for quite some time:

"In October 2015, HHS officials announced that the program had taken in only enough cash ... to pay about 16% of the amounts owed "


FoIB Jeff M wonders what affect, if any, this will have on the carrier's plans to bonus its execs millions of dollars for last year's winning performance. I think we all know the answer to that.

Thursday, April 20, 2017

Another Agent Acting (VERY) Badly

This is so wrong, on so many levels:

"An insurance agent has been indicted by a grand jury after prosecutors say she scammed an elderly woman out of nearly $40,000 in cash and annuities."

The agent, Mary Hawkey, apparently convinced her elderly victim, who suffers from dementia, to hand over some $10,000 in cash and $30,000 of annuities. Unlike the case we discussed last month, the wayward agent doesn't seem to have sold her victim new annuities, going instead for the much simpler "cash it out and pocket the proceeds" technique.

And there's this:

"That's what I'm afraid of is that there's going to be other victims out there and other families that may not know" the victim's granddaughter said.

Let's hope they're able to recover at least a portion of this poor woman's life savings.

[Hat Tip: FoIB Marita M]

Abbot & Costello do Health Wonkery

Brad Wright hosts this week's Health Wonk Review, with an eclectic assortment of interesting and provocative posts.