Friday, December 19, 2014

Chemin d'Liverpool

The Brits have their Liverpool Pathway, and we (now) have the ACA Death Panels, and it appears that the French are well on their way, as well:

"Doctors in France will have the right to put terminally-ill patients into a deep sleep until they die, under plans unveiled [recently]that reignited a national debate on euthanasia."

Of course, when the government pays for your healthcare (as they do in France), it gets to call the shots (so to speak). And it also gets to say when said shots stop. Such is the nature of a socialized health care scheme: who pays the piper calls the tune.

Of further course, killing off your patients is a great way to cut costs and, of further course, there's no recidivism. So, win-win. Well, except for the patient.

[Hat Tip: Co-Blogger Bob]

Cavalcade of Risk #224 - Swan Song edition: Call for submissions

We'll be hosting next week's Swan Song edition right here at IB. After 8 1/2 years, the Cavalcade of Risk is folding its tent, so don't miss your last opportunity to send in a post.

Entries are due by Monday (the 22nd).

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.

Thursday, December 18, 2014

Green Mountain State Blues [UPDATED]

No sense burying the lede:

"Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state"

This will come as no surprise to regular IB readers, since we've already seen how Vermont has had major issues just running its own Exchange. Selling health insurance is child's play, though, compared to actually delivering health care, and Governor Shumlin (D-VT) - to his credit - acknowledged that, given the current state of the Obamaconomy, "[t]his is not the right time” for enacting single payer ... citing the big tax increases that would be required to pay for it."

What was perhaps even more interesting is that the plan wasn't even "true" Single Payer, since ERISA (self-funded) plans would have been given a pass. So if Single Payer can't fly in a deep blue state like Vermont, one wonders where can it?

UPDATE: Actually, this saddens me.

Why? Well, we've long supported the idea of 58 state laboratories, each one trying out new (or old) ideas to see what works, and what doesn't. Would have been quite interesting to see if Single Payer would work in Vermont (95.2% white, median income $54,000), and then whether or not that experience was transferable to other less pale, less wealthy states.

Alas, 'tis not to be.

Ho, Ho, Ho: Health Wonk Review has been delivered

Julie Ferguson presents (SWIDT?) a holiday-themed round-up of wonky posts, all ready to be unwrapped and savored. So pull up your easy chair, pull on your cardigan and reading specs, and enjoy.

Wednesday, December 17, 2014

Ola Cuba

For the first time since the Cuban missile crisis the U.S. and Cuba may soon be headed for a warmer

From one dictator to another .........

President Barack Obama declared the end of America's 'outdated approach' to Cuba Wednesday, announcing the re-establishment of diplomatic relations as well as economic and travel ties with the communist island – a historic shift in U.S. policy that aims to bring an end to a half-century of Cold War enmity.
As Obama spoke, Cuban President Raul Castro was addressing his own nation from Havana. 
Daily Mail

Maybe now you get that Crown Vic Skyliner you have always wanted, Cuban cigars and top quality free health care.

Another 1,000 words on the ObamaTax

Tuesday, December 16, 2014

Chanukkah 2014/5775

Tonight, we begin the 8-day long celebration of The Festival of Lights, Chanukkah. As everyone knows, this holiday commemorates the time, in ages past, that a candle with but one day's oil burned for over a week.

Except, it doesn't and it didn't.

The true story of Chanukkah is far more about culture and faith than Harry Potter:

"The Apocrypha's texts make it clear that the battle against Hellenization was in fact a kulturkampf among the Jews themselves ... Armed Hasmonean priests and their comrades from the rural town ofModi'in attacked urban Jews, priests and laity alike, who supported Greek reform, like the gymnasium and new rules for governing commerce  ...
So the miracle-of-the-oil celebration of Hanukkah that the rabbis later invented covers up a blood-soaked struggle that pitted Jew against Jew"

And they weren't fighting over latkes.

Oh, and Chag Chanukah Sameyach!

Monday, December 15, 2014

Nothing like a hard and fast deadline...

At 1:51 this afternoon, an email arrived from CoveredCA keeping enrollment open until Midnight, December 21.  I'm not really surprised, given the number of error messages I saw while trying to enroll people. 

URGENT! You Have Extra Time to Help Consumers Complete Enrollment for January 1st! 
Given the high volume of Californians interested in enrolling in health coverage, we’re pleased to announce that Covered California has decided to give our service partners additional time to help consumers get across the finish line and complete enrollment. Service partners will have until midnight on Sunday, December 21, 2014 to assist consumers with enrollment. This applies to both new and renewing consumers enrolling for coverage effective January 1, 2015.
Please note that while the Agent Service Center will now be open this Sunday, Dec. 21st (see below for hours), the Covered California Service Center for consumers will be closed this Sunday. You are encouraged to assist consumers with completing their applications as early this week as possible to ensure you receive the assistance you may need from our service center representatives.

While you and your consumers are given the extra time, we would appreciate your help in communicating expectations: completing enrollment after December 15th may delay invoices and proof of enrollment from the health plan the consumer has chosen.  We encourage all consumers to make a binder payment when possible to facilitate faster enrollment in their chosen plan. 
We will be providing further information about payment deadlines as soon as possible. 
In order to accommodate this change within the system, we will be taking the online system down starting midnight tonight until approximately 7 a.m. tomorrow, Tuesday, Dec. 16. 
If you should need immediate assistance, please call the Agent Service Center at (877) 453-9198. This is the most effective way to reach a service center representative for an urgent need related to enrollment. If you should receive a busy signal when calling, please hang up and try again.   
I can only imagine what the faces look like inside the various carrier's service departments.

Blue Christmas

Most people probably aren't dreaming of a Blue Christmas but the folks on Capitol Hill included
a gift to our colored health insurance company. Our Congress critters voted on a 1600 page spending bill without ever reading it.

Fortunately there are others more diligent that give us some insight into what Congress did to us.

Tucked away near the end of the 1,600-page spending bill is a long-awaited technical fix to the health overhaul law — one that benefits Blue Cross and Blue Shield insurers and has been in the works since the bill was passed in 2010.
The backstory: Many of the nonprofit ‘Blue’ health plans receive tax breaks on their expenses and reserves as part of a 1980s arrangement in which they lost their broader tax-exempt status. Under the 2010 health law, Blue plans had to spend at least 85% of their revenue from insurance premiums on medical claims to continue to qualify for the breaks.

WSJ Blog


Blue can shift some of their overhead away from the 85% MLR restriction and categorize it as claim dollars. This free's up administrative overhead for more useful items like salaries and bonuses (among other things).

But here comes the other shoe.

This bill, including Blue pork, was voted on by people who were fired by their constituents and will be sent home packing in a few days. The will of the taxpayer was circumvented again.

Have yourself a Merry (Blue) Christmas.

The Gift of the MAGI (and the 1%)

This time of year affords us the wonderful opportunity to put aside petty differences, and to focus on what really matters:

Free money.

That's right, free money, as in ObamaTax subsidies for the poorest richest among us. Hark, they passed the bill so we could learn what's in it,  and boy, it's just good news all around for those with a big nest egg and no real income.

What the heck are you babbling on about, Henry?

Well, it's like this:

As I mentioned the other day, I tend to get a number of referrals from other agents. Recently, one such referral called for an appointment, and we got together to consider her family's options. This delightful and engaging lady was recently downsized from a prestigious (and lucrative) position with a Fortune 500 company, with a generous severance package and some major bucks in the bank.

As a result of the way that they're calculated, we quickly discovered that her family was eligible for a $1,000+ per month subsidy, bringing the family's net cost (for a fairly decent plan) to about $250 a month. They're very nice, gracious, warm people, and of course I don't begrudge them their free bucks - heck, they should be thanking Nancy, Harry and Barry - but are they really the kind of people we should be subsidizing?

Apparently so.

Audits, Audits Everywhere!

Fresh on the heels of the Colorado Exchange debacle, and from the home of RomneyCare, comes this news:

"The Massachusetts Medicaid program spent $35 million on questionable claims for health care provided to low-income immigrants"

But Henry, you may object, that's Medicaid, not the ObamaTax. Unfortunately, the two will forever be conflated, as The Bay State  expanded Medicaid under the ObamaTax umbrella.

The review flagged over a quarter million questionable claims, and what's worse, it appears that most of the folks filing them are here in the US illegally. So while you take a last-minute stab at signing up for an ObamaPlan (Phase of one Open Enrollment v2.0 ends today), rejoice in the fact that folks here illegally get their healthcare for free, without having to deal with that pesky site.

[Hat Tip: Josh Archambault]

Friday, December 12, 2014

Tis the Season for Open Enrollment...

Happy Holidays from!

Thursday, December 11, 2014

Stress-relieving Agent Tricks

Long-time readers may recall the sticker I've mentioned over the years, adhered to my phone, reminding me about how to conduct myself. Yesterday, I was privileged to experience a wonderful payoff.

Many agents have opted to take a pass on the rigorous and (unnecessarily) difficult process of becoming certified to sell Exchange-based health insurance, and as a result, I've been getting more referrals than ever (my doc told me I wasn't getting enough stress, recommended selling more health insurance). Yesterday afternoon, I received a call from a young lady whose agent (a friend and colleague) had recommended that she contact me for help. Seems her current (non-grandfathered) plan was getting too expensive, and she 's pretty sure she qualifies for a subsidy.

So she went online to do some shopping, and inadvertently ended up at what I'll call a "lead-farm." This kind of site looks like the one, but instead of enrolling in a plan, one is basically giving out contact info to hundreds of agents who pay the site's proprietors for access to it.

As a result, she's already received hundred of calls and emails, and become so confused and upset that she can't sleep.

Can't have that.

I began by asking her some questions, and confirmed that she had not, in fact, actually been to the official gummint site. I further determined that her existing plan is with a reputable carrier, and is still affordable (at least for the nonce). She also mentioned that she was due to go out of town in the next few days, meaning that the looming December 15th cut-off for a January effective date was adding to her stress.

So I asked her a question: "What's the absolute worst thing if you simply went for a February 1 start date, instead?"

Silence. And then a sigh of relief.

"I can do that?" she asked.

Yup: and then I told her that the only real downside was paying an extra month of the new, higher premium on her old plan, and missing out on a month's subsidy for the new. She agreed that her sanity and peace of mind was worth far more than the few hundred dollars at stake here. and then she thanked me profusely, telling me that she could already feel the stress draining away, and actually looking forward to her road trip. We agreed to re-connect when she gets back next week.

Sometimes we forget, in the press of analyzing and commenting on the ObamaTax train-wreck, that these are real people, whose real lives are impacted, and it's such a great feeling to be able to help at least one person gain some relief from the attendant anxiety.

I, for one, am grateful for the opportunity to have done so.