Saturday, January 31, 2015

One Decade Down, Next to Go

It is humbling to consider that today marks our 10th Blogiversary. Well over 7,000 posts and millions of views, numerous awards and links from the New York Times, Wall Street Journal, Forbes, Fox and others.

And, of course, the very best co-bloggers on the 'net.

But most important: our terrific, engaging and interested readers.

Thank you all for 10 great years - and now on to 20!

Friday, January 30, 2015

And speaking of Medicaid...

As Bob recently noted, Indiana has become the 28th state to climb on board the  Medicaid expansion train (wreck). He also pointed out that there's already a shortage of providers willing to take on Medicaid patients.

Wonder why?

Well, our friend Dr Val has a pretty graphic answer:

Click on over to read the whole story (and definitely check out the comments).

Another Installment of: That's NOT how it works

It seems like only a  week ago that we referenced our 2nd ever post - wait, it was a week ago that we did that! And here we are again, talking about insurance fraud. And this one's a doozy:

"Irina Vorotinov has been charged by ... with defrauding Mutual of Omaha Insurance Company of more than $2 million in life insurance proceeds by falsely claiming that her former husband had died."

Turns out - Spoiler Alert! - the ex- was, in fact, very much alive, and caught on film years after his alleged death.


Thursday, January 29, 2015

Super(bowl) Health Wonk Review is up

Our favorite health care economist, Jason Shafrin, hosts this week's festive round-up of health care policy and polity. It's cold outside, so come in and warm up with some great reads.

Wednesday, January 28, 2015

Popcorn State Expansion

On February 1, 2015 Indiana will become the 28th state to expand Medicaid. Good news (I suppose) for
those under 138% of the FPL. No more insurance premiums.

But you may have trouble finding a doctor. This is nothing new nor indigenous to Indiana. Medicaid participants in all states have trouble finding doctors willing to take them as new (or even old) patients.
About 765,600 Hoosiers lacked insurance in 2013, according to the Kaiser Family Foundation. The state has estimated more than 300,000 Hoosiers — or 56 percent of those newly eligible for Medicaid — could enroll in the first year and more than 400,000 would sign up during the second year. - Indy Star
Agents that wrote Obamacare subsidized plans on those under 138% of the FPL can probably expect to lose those clients ....... and the revenue.

How is the expansion funded?
The federal government pays for 100 percent of the cost through 2016. That declines gradually to 90 percent by 2020, assuming Indiana's waiver is extended past three years. Indiana's share — estimated to be about $1.6 billion between 2015 and 2021 — will be paid for through the state's existing cigarette tax and from a tax on hospitals.
Funded by the federal government, which doesn't have any money.

And funded by smokers and hospitals.

Increasing the cost of cigarettes probably isn't bad in the big scheme of things but taxes on hospitals will increase the cost of health care. How is this a good thing?

So, what is a Hoosier any way? I have heard it comes from "Hoosier mama" which I suppose is a version of "Yo mama".

Regardless, I wonder if this is a good thing or not.

Some thoughts on subsidies

So, been having a bit of a Twitter-tussle with a well-regarded friend and colleague. At issue is the future of ObamaTax subsidies as we look forward to the resolution of Burwell/King/Halbig.

Which got me to thinking: Why we're having this discussion at all? After all, President Obama explicitly promised us that, under the ObamaTax, premiums would decrease 3000%, and that we would have comprehensive, affordable coverage.

If this were truly the case, then why would we need bribes subsidies in the first place? After all, who wouldn't want cheap, useful insurance coverage? Why would we need to be cajoled, nay, forced into buying it if it was such a great bargain?

And if, as Mike pointed out years ago, the folks in DC actually did their jobs, would we need to be expanding Medicaid?

Thought not.

Tuesday, January 27, 2015

Tuesday Spindle-clearing

In no particular order:

■ Coming as a surprise to no one who's been paying attention:

"A quarter of firms that that had offered insurance to their employees last year were canceling their health plans this year, and another 25% said they planned to do so next year."

This in Michigan, and focused on smaller companies not (yet) subject to the Employer Mandate. Talk about blizzards...

Could treating Alzheimer's really be this simple?

"Researchers say they’ve developed a nasal spray that could potentially improve memory and other mental capabilities for the more than 5 million Americans suffering from Alzheimer’s disease."

It's still a long way off (and currently being tested only on those with mild cases), but sounds promising.

Almost 5 years ago, we wrote about a "Lifespan Calculator:" an online widget that purported to predict how many days one had left. It appears that the technology is improving:

"A test to determine if elderly patients will die within 30 days of being admitted to hospital has been developed by doctors to give them the chance to go home or say goodbye to loved ones."

Corrected for accuracy:

"A test to determine if elderly patients will die within 30 days of being admitted to hospital has been developed by doctors to encourage them onto the Liverpool Pathway."

There, better.

But hey, "middle class:"

"I’m sorry sir,” the polite customer-service agent said. “There’s nothing I can do. You’re either going to have to enroll in Medicaid or you’re going to have to pay the full health-insurance rate.”

The problem, of course, is that the gentleman in question had the misfortune to fall within the one category for which the ObamaTax was supposed to work, but never quite has. As a grad student, he wasn't worried about his next BMW, but neither was he worried about his next meal. Couple that with the problem that, if one is eligible for Medicaid one is not eligible for a subsidy, and one begins to see the problem.

I really like the author's take on this, by the way: "Call me crazy, but in my book Medicaid is a last resort, not a first option."

It's so easy to forget that this is no game, no theory; it hurts real people, every day.

DC's Best Kept Secret

What with all the reports of how well Open Enrollment v2.0 has been going, it's no wonder the folks in charge want to keep this under wraps:

"It will cost the federal government – taxpayers, that is – $50,000 for every person who gets health insurance under the Obamacare law"

But that's only the tip of the proverbial iceberg:

"It will take $1.993 trillion, a number that looks like $1,993,000,000,000, to provide insurance subsidies ... and to pay for a massive expansion of Medicaid and CHIP"

But hey, worth it to provide universal health insurance coverage.

Wait, what?

"The best-case scenario described by the CBO would result in 'between 24 million and 27 million' fewer Americans being uninsured in 2025, compared to the year before the Affordable Care Act took effect."

So after 15 years and $1,993,000,000,000, they still won't have everyone covered?

Gee, sure glad they passed it to find out...

(And notice, one has to go to the UK press to find this)

Monday, January 26, 2015

Solution for Austerity Cuts in Health Care

If your government is running out of money and cutting services to balance the budget, what
do you do?

Elect a liberal.

Greece has been teetering on bankruptcy for years thanks to too much government and too many social give away programs. All that is about to change as a result of this weekends election
In Greece’s biggest hospital, the Evangelismos Hospital in Athens, conditions were worse than those I have seen in developing countries.
The moment the hospital doors open on ‘emergency’ days, people flood in. The collapse in official primary and community health care services means everyone who needs healthcare comes to A+E - whether for a major accident, medication for a long term condition or to get their child immunized. Staff told me that serious trauma cases often have to wait hours for X-rays and treatment due to understaffing and that, if too many cases come in at the same time, people die before they can be treated. - Open Democracy

The "austerity program" has saved the country but at what price? 
The government had closed all the polyclinics then reopened some recently but with only 30% of the doctors that they need. Whereas previously there had been 150 doctors providing services to the district, there were now only 50. A polyclinic for a population of 400,000 people had no gynaecologists, no dermatologists, and only two cardiologists.
 “We want our doctors back” – said one of the volunteers I spoke to. Thousands of doctors have left the country. Those that remain – including senior hospital doctors - earn about €12,000 ( $13,400 US) a year.
The good news?

Greater access to health care (presumably).

The bad news?

Eventually Greece will run out of money (again) and they are back to square one. There is no free lunch.

CoOpportunity assumes room temp

Last month, we reported on the travails of Iowa's CoOpportunity Health, a start-up recently taken over by Hawkeye State regulators. FoIB Josh Archambault tips us that they've now been shuttered:

"Iowa’s insurance regulator plans to shut down insurer CoOportunity Health, marking the first failure of one of the nonprofit cooperatives created under the Affordable Care Act."

T'won't be the last.

Saturday, January 24, 2015

P&C Files: That's *NOT* How It Works!

[click pic to embiggen]

[Hat Tip: DoIB Sarah S]