Wednesday, September 30, 2009
Tuesday, September 29, 2009
Monday, September 28, 2009
"My colleagues, this is our opportunity to make history," Chairman Max Baucus implored last week as the Senate Finance Committee opened consideration of his bill. Politicians, in their most self-important moments, see themselves as instruments of national destiny. They yearn to be remembered as the architects and agents of great social and economic transformations. They want to be at the signing ceremony; they want a pen.One can almost envision Sen. Baucus in a powdered wig, white stockings and buckle shoes signing on in large fashion as John Hancock did with the Declaration of Independence.
One study "found that every year in America, lack of health coverage leads to 45,000 deaths," he told the committee. "No one should die because they cannot afford health care. This bill would fix that."Oh really?
But wait, there's more!
"These reforms would give Americans real savings," Baucus said. The Congressional Budget Office "tells us that the [insurance] rating reforms and exchanges in our proposal would significantly lower premiums in the individual market." As well, the bill wouldn't increase the budget deficit and "starts reducing the deficit within 10 years."How could anyone be against that?
Unfortunately, just having insurance doesn't automatically improve people's health. Sometimes more medical care doesn't really help. Sometimes people don't go to doctors when they should or follow instructions (take medicine, alter lifestyles).Say it ain't so!
Indeed, many people don't even sign up for insurance to which they're entitled. An Urban Institute study estimated that 10.9 million people eligible for Medicaid or the Children's Health Insurance Program in 2007 didn't enroll.Why would someone refuse FREE health insurance? Inquiring minds want to know.
And how about those 45,000 who died because they didn't have health insurance?
The 45,000 figure cited by Baucus is itself an unreliable statistical construct built on many assumptions. It's based on a study of 9,004 people ages 17 to 64 who were examined between 1988 and 1994. By 2000, 351 had died; of these, 60 were uninsured. The crude death rates among the insured (3 percent of whom died) and uninsured (3.3 percent) were within the statistical margin of error. After adjustments for age, income and other factors, the authors concluded that being uninsured raises the risk of death by 40 percent. They then extrapolated this to the entire population by two techniques, one producing an estimate of 35,327 premature deaths and another of 44,789.Oops!
OK, but we will still have lower health insurance premiums, right?
Here is what the CBO had to say about that.
"Premiums in the new insurance exchanges would tend to be higher than the average premiums in the current-law individual market -- again with other factors held equal -- because the new policies would have to cover pre-existing medical conditions and could not deny coverage to people with high expected costs for health care.""Higher than average premiums" because the NEW policies will have to cover pre-existing conditions and cannot deny coverage. Somehow this information has never passed the lips of the politicians who are promising lower, more affordable health care and health insurance.
So how many want to pay higher taxes to cover people who won't take advantage of "free" health insurance, higher health insurance premiums to cover pre-existing conditions and "no refusal" policies, and questionable improvement in health outcomes . . . just to satisfy the ego of their favorite politician?
Health care reform is a sham.
Smaller cars, bigger (more expensive) health insurance, Poppa Washington.
Saturday, September 26, 2009
Friday, September 25, 2009
Use a facial moisturizer with an SPF of at least 30 to limit the sun’s damage every day, not just when you’re at the beach.
Shield your face with a hat and sunglasses when you’re outdoors, particularly on sunny days.
Avoid tanning beds. Those ultraviolet rays can be even more intense than the sun’s and can increase your risk of skin cancer.
Don’t smoke. Tobacco ranks second only to sunlight in its dire effects on skin.
Try not to rub your eyes. Treat hay fever so you’re less itchy and not tempted to rub.
Sleep on your back. Mashing your face into a pillow can cause lines to form over time.
Get an annual eye exam. If you can’t see clearly, you’re likely to squint, which can create wrinkles.
That's a good list, but we think they missed a few.
Facial moisturizers are good, but we prefer a chocolate facial mask. It's kind of like having your cake and eating it too.
CR suggest using a hat and sunglasses while outside on a sunny day. That is a good idea, but not a great one. We are partial to the middle Eastern approach to protecting your face.
While it is true that smoking can cause wrinkles, not everyone is affected in the same way.
Yes, a pillow over your face can cause wrinkles, sometimes it can lead to something worse.
So there you have it.
Enjoy a wrinkle free day!
Thursday, September 24, 2009
[Hat Tip: RWN]
Wednesday, September 23, 2009
Since 45,000 didn't have health insurance it is logical to assume that 2,381,264 had health insurance but died anyway.
So if you have health insurance be prepared to die.
We now return you to normal programming.
Tuesday, September 22, 2009
tighter regulation of the industry is needed to protect consumers and slow the spiraling cost of medical coverage.OK, so how does more regulation lead to lower insurance premiums? Every time the government get's involved things get worse and premiums increase, not decrease.
It never fails.
Far from destroying the profitability of health insurance companies, the new regulations envisioned by President Obama would enhance competition and choice for consumers while creating a bounty of new customers, Biden said.Enhance competition and choice. Everything in HR 3200, and even the Baucus bill, will lead to fewer health insurance companies and fewer plans.
If premiums increase with health care reform, and they will, where will this "bounty" of new customers come from?
Health insurance premiums in states rose between 88 percent and 145 percent in the past decade, far outpacing wages and overall inflation, which increased 38 percent and 28 percent, respectively, over the same period, according to a new Kaiser Family Foundation study cited by the White House.There is a problem with this kind of study. It fails to explain why health insurance premiums increased.
The answer is simple. Premiums are driven by claims.
More people are submitting more claims at least in part because health care doesn't cost them very much. A $20 doc copay and a $25 Rx copay is all it takes to cover a $200 or more bill.
Medical care inflation is 5 - 7% but premiums rise by a multiple of that because claims are increasing at double digit rates.
Biden said new rules should prevent insurance companies from declining coverage to people with preexisting conditions, should limit out-of-pocket expenses and should not allow companies to drop coverage for patients who are seriously ill.Coverage is usually not dropped except for failure to pay the premium or fraud.
The other provisions, declining coverage for pre-ex conditions and limiting out of pocket will make health insurance LESS affordable, not more affordable.
On the other side, even the spokesman for AHIP shows his ignorance.
"Premiums track directly with the underlying cost of medical care," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, a lobbying group that represents nearly 1,300 plans.Premiums track claims, not the cost of medical care.
This may seem like semantics, but the cost of a doc visit or drug is not the issue. It is the total expenditure on claims that impacts premiums.
What kind of idiots are working there?
I think there are 5 major deficiencies in all the reform proposals now in the House and Senate:
(1) none addresses the underlying problem. The underlying problem is not the cost of insurance. It’s the cost of medical care. These proposals contain zilch to reduce the cost of medical care. Why is that? The public should be asking.
(2) all bite off more than they can chew. About 15% of the population is uninsured. Why does it follow that 100% of the present system must be radically changed to effect reform for the 15%? That's what this administration seeks to do. Why is that? The public should be asking.
(3) the cost of the proposals is unreasonable. After the enormous commitment of TARP funds and after another enormous commitment of funds to the so-called economic “stimulus” and considering the enormous looming expenditures in cap & trade bills, the the federal deficits have ballooned by 2X’s to 3X’s with no end in sight. The public rightly fears that these trillions of federal spending will be followed by high taxation and inflation. But the government pretends there’s no problem. Why is that? The public should be asking.
(4) the financing doesn’t add up. The administration has repeatedly stated its proposed reforms are necessary to save our economy. The president stated that “our health care problem IS our deficit problem; nothing else comes close.” Yet the administration is proposing insurance reforms that would cost the government a trillion dollars. That’s running through Hell in gasoline pants. Even after assuming massive tax increases and Medicare cuts, CBO projects that the proposals will increase the federal deficits – and the farther out it projects results, the worse the deficits become. The administration ignores the CBO scoring. The administration is also asking us to believe that its proposals will pay for themselves; will not increase the deficit by an additional dime; and will be funded largely thru elimination of the same Medicare "waste and fraud" that every president since Johnson has pledged to eliminate. Why should anyone believe that? The public should be asking.
(5) a "public option" won’t help. There is no evidence or other reason to believe that a public option will not end up like Medicare: skimpy benefits, massive bureaucracy, rampant fraud, special new taxes - and broke. And it will drive out private plans by “competing” thru legislative fiat rather than by innovation that creates pressure for all the players to become better. That's no solution. Yet powerful factions within the administration insist the public option is essential. Why is that? The public should be asking.
It has become quite obvious that if the Congress had passed any of the current proposals “by the first of August” - as they were told to do - it would have been a serious mistake. And the Baucus proposal is even worse than anything that preceded it. Are the only birds that fly out of this administration turkeys? The public should be asking that question, too.
So what to do instead? I think physicians should be taking the lead in regard to reform of the medical delivery system, but I’m not hopeful they will - based on their passivity over the past 40 years. And it must be recognized that without a solution to the high, and increasing, cost of medical care, there can be no solution to the high and increasing cost of insurance.
As to insurance access, I think that the problems (apart from the underlying cost of medical care) are largely caused by too much government in the first place. Unfortunately, the current proposals attempt to solve these problems with still more government. Another strategy for running thru Hell in gasoline pants.
It’s my belief that the two most helpful actions government could take to make medical insurance more accessible and less expensive are: (1) allow individuals to buy insurance across state lines and (2) equalize the taxes on insurance by reducing the taxes on individual medical policies. These actions would increase competition among insurers and reduce costs for individuals. The result would be many more people able to buy insurance.
And specifically for the uninsured, the remaining unspent economic stimulus funds - about $500 billion – could be used to finance insurance for the uninsured over the next 10 years.
This administration that claims to be open to possibilities is clearly ignoring these possibilities. Why is that? The public should be asking.
Monday, September 21, 2009
Instead of cutting Medicare provider payments, suppose they were increased enough to allow the providers to make a bit of money...or at least enough to cover the cost of treatment.
To pay for the increase, the Medicare premiums would be indexed to a person's income. Below a certain income, the premiums would vanish, while above some level, they would increase up to some cap.
Why would you want this? Simple. One of the cost drivers in the private insurance sector is a transfer of unreimbursed expenses from the public sector to the private one. If it costs $500million to keep a medical facility open, somebody has to pay the bills. If the government isn't paying it's share, there's no option other than to raise the rates charged to private sector patients. Those increases are reflected back into everybody's insurance premiums. Conversely, if Medicare starts to pay more, the insurance premiums won't go down, but their rate of increase should slow.
Too bad there are so many seniors that vote...
Sunday, September 20, 2009
Friday, September 18, 2009
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post
Thursday, September 17, 2009
Getting sick is no fun, but think about the impact your illness will have on stimulating the economy.
Human illness adds two trillion dollars annually to America’s gross domestic product. Are you contributing your fair share?Personally, I have weak eyes.
Sentences set in small type make a handy eye test. If you can read this without difficulty, your eyes may be too strong and you will need the prescription drug Corneac R (dollarmycin-B) to return your vision to normal. Consult your pastor about the choice between sightlessness and personal bankruptcy.
According to my mother it has to do with a common teenage practice.
And there you have it.
Policy Updates—All of you “Far Horizons” Fifteenth Tier Plan subscribers may now choose any doctor you like, who will then refer you to the list of approved cheap doctors, ex-doctors, doctors-in-training, and veterinarians.
—“Near Horizons” Sharing & Caring Plan members: Some misunderstandings about this plan have arisen lately. Sharing your hospital bed does not reduce the per-day costs of your hospital stay, and you will be legally liable if your bedmate contracts a communicable disease.
—Be sure to ask about the new “Invisible Horizons” Plan, providing discounts and a free ballpoint pen on hospital bills of more than a million dollars per week for any fifty-two-week period when you cannot get out of bed.
—The new “Artificial Horizons” Plan for prosthetics will no longer provide separate prosthetic toes. See Pamphlet 567-A-2099 for a limited-time-only “Five-Pak” prosthetic-toe kit. (One foot per subscriber.)
—Feeling poorly? Ask about our new “Eternal Horizons” Plan option, which includes an afterlife provision covering basic medical care for eternity. Have your executor call 1-800-RIV-STYX for details. Cryogenic “Eternal Horizons” subscribers, or their survivors, must provide a matching body and head.
Explanation of BenefitsSkip this section. No benefits are currently available.
Q. & A. of the MonthQ: My current statement lists two hundred and thirty-one charges for “brain surgery,” even though I have had no brain surgery. How can I rectify this?
A: Invalid question. Brain surgery is not covered under your plan.
Aren't you glad you asked?
Thanks to Jeff Silver for this tip . . .
Wednesday, September 16, 2009
According to the WSJ Health Blog, Medicare could save lives and money by making beneficial changes to the way they approve treatment but they choose not to.
Medicare’s three-year limit on payment for anti-organ-rejection drugs led to a woman needing a second kidney transplant, because she couldn’t afford to the medicine that would have allowed her to keep her first transplanted kidney in healthy, working condition.According to the NY Times, Melissa Whitaker found herself in a Medicare conundrum.
The cost of anti-rejection drugs for the patient? $1,000 to $3,000 a month. Cost of the second transplant? $125,000. The average Medicare expenditure per kidney transplant patient care is $17,000 yearly, while it’s $71,000 a year for dialysis patients and $106,000 for a transplant, according to the Times.
Ms. Whitaker, 31, who describes herself as “kind of a nerd,” has Alport syndrome, a genetic disorder that caused kidney failure and significant hearing loss by the time she was 14. In 1997, after undergoing daily dialysis for five years, she received her first transplant. Most of the cost of the dialysis and the transplant, totaling hundreds of thousands of dollars, was absorbed by the federal Medicare program, which provides broad coverage for those with end-stage renal disease.So rather than paying $1000 - $3000 per month for anti-rejection meds beyond the arbitrary 36 month limit, Medicare in their infinite wisdom put her back on dialysis, approved a second transplant, and started her on a new 36 month plan.
By late 2003, her transplanted kidney had failed, and she returned to dialysis, covered by the government at $9,300 a month, more than three times the cost of the pills. Then 15 months ago, Medicare paid for her second transplant — total charges, $125,000 — and the 36-month clock began ticking again.
“If they had just paid for the pills, I’d still have my kidney,” said Ms. Whitaker
The most recent report from the United States Renal Data System found that Medicare spends an average of $17,000 a year on care for kidney transplant recipients, most of it for anti-rejection drugs. That compares with $71,000 a year for dialysis patients and $106,000 for a transplant (including the first year of monitoring).This reminds me of Jay Leno's question to Hugh Grant following Hugh's incident with a transvestite hooker.
"What were they thinking?"
Tuesday, September 15, 2009
Monday, September 14, 2009
According to POTUS, the insurance industry is using WMD's (weapons of mass disintegration), also known as health insurance policies, that self destruct when you need them most.
In his speech to Congress he alleged
"More and more Americans pay their premiums, only to discover that their insurance company has dropped their coverage when they get sick, or won't pay the full cost of care. It happens every day."Those bastards!
To highlight abusive practices, Mr. Obama referred to an Illinois man who "lost his coverage in the middle of chemotherapy because his insurer found he hadn't reported gallstones that he didn't even know about." The president continued: "They delayed his treatment, and he died because of it."Actually, the carrier is not in a position to administer, advise or delay treatment. That is clearly a patient-doctor decision.
The deceased's sister testified that the insurer reinstated her brother's coverage following intervention by the Illinois Attorney General's Office. She testified that her brother received a prescribed stem-cell transplant within the desired three- to four-week "window of opportunity" from "one of the most renowned doctors in the whole world on the specific routine," that the procedure "was extremely successful," and that "it extended his life nearly three and a half years."Well yeah, but he still died so PresBO did get that right at least.
The president's second example was a Texas woman "about to get a double mastectomy when her insurance company canceled her policy because she forgot to declare a case of acne." He said that "By the time she had her insurance reinstated, her breast cancer more than doubled in size."Canceled because of failure to disclose acne? Give me a break, Barry.
The woman's testimony at the June 16 hearing confirms that her surgery was delayed several months. It also suggests that the dermatologist's chart may have described her skin condition as precancerous, that the insurer also took issue with an apparent failure to disclose an earlier problem with an irregular heartbeat, and that she knowingly underreported her weight on the application.Irregular heartbeat, depending on the nature and treatment, can be an automatic decline on the front end. Missing your weight by a few pounds is common. We don't know how much her weight was understated, but it seems to be enough to make it an issue to the carrier.
In other words, there seems to be evidence of fraud on the application. No reason to let that become an issue, right? I mean, we let mortgage fraud go on for years and that wasn't an issue.
Later in his speech, the president used Alabama to buttress his call for a government insurer to enhance competition in health insurance. He asserted that 90% of the Alabama health-insurance market is controlled by one insurer, and that high market concentration "makes it easier for insurance companies to treat their customers badly—by cherry-picking the healthiest individuals and trying to drop the sickest; by overcharging small businesses who have no leverage; and by jacking up rates."This one is a real whopper.
In fact, the Birmingham News reported immediately following the speech that the state's largest health insurer, the nonprofit Blue Cross and Blue Shield of Alabama, has about a 75% market share. A representative of the company indicated that its "profit" averaged only 0.6% of premiums the past decade, and that its administrative expense ratio is 7% of premiums, the fourth lowest among 39 Blue Cross and Blue Shield plans nationwide.Similarly, Wal-Mart dominates many markets where they operate, AND they earn a lot of profit. When is Congress going to address this inequity?
Similarly, a Dec. 31, 2007, report by the Alabama Department of Insurance indicates that the insurer's ratio of medical-claim costs to premiums for the year was 92%, with an administrative expense ratio (including claims settlement expenses) of 7.5%. Its net income, including investment income, was equivalent to 2% of premiums in that year.
In addition to these consumer friendly numbers, a survey in Consumer Reports this month reported that Blue Cross and Blue Shield of Alabama ranked second nationally in customer satisfaction among 41 preferred provider organization health plans. The insurer's apparent efficiency may explain its dominance, as opposed to a lack of competition—especially since there are no obvious barriers to entry or expansion in Alabama faced by large national health insurers such as United Healthcare and Aetna.
I know, don't encourage them.
Like the end of this month . . .
Effective 10/1/09 health insurance companies in Maryland will be required to adhere to the following.
- Prohibit carriers from asking about pre-existing medical conditions if the individual has not received care or advice during the 5 years preceding the date of the application.
- Prohibit carriers from asking about medical screening, testing or monitoring during the 5 years preceding the application
- Prohibits the carrier from attaching an exclusionary rider without prior written consent of the policyholder. (This is a red herring. Riders and rate surcharges are part of the offer which can either be accepted or rejected by the applicant).
- Allows a carrier to impose a pre-existing exclusion or limitation if that condition was not discovered during the underwriting process only if the condition was treated during the 12 months immediately preceding the application. The limitation can last for 12 months but is reduced by prior creditable coverage.
If the carrier is prohibited from asking about conditions in the prior 5 years then how will they discover the condition? Even if a condition shows up in MIB (Medical Information Bureau) or Intelliscripts or similar service the carrier can't ask about the condition. Seems to me this will lead to a lot more declines.
The other way to find out about a condition is when it manifests or is treated after the policy is issued.
You just can't make this stuff up.
According to sources, none of the carriers operating in Maryland have made any official comments on this CHANGE. It makes me wonder if they have decided internally to simply stop accepting applications for October and later effective dates.
Of course changes like this require carriers to file new applications and policies with the Maryland DOI and wait on approval. New (much higher) rates will also have to be approved.
This effectively closes the door for new, individual health insurance policies in Maryland until further notice.
Looks like Maryland is now officially part of the United States of Obamaland. Wonder if they will change their name to Mary-Obamaland?
Change you can believe in.
Yes you can.
Friday, September 11, 2009
As regular InsureBlog readers know, my better half has long maintained that “there are no coincidences.” That is, she believes that everything happens for a reason, although we may not be aware just what that reason is.
As for me, I’ve gradually become 90% convinced that she’s right on this (in everything else, of course, she’s 100% right). But one evening, a few weeks ago, that all changed.
I have a confession: My name is Henry, and I’m a news junkie. It is my habit to stay up way too late reading news blogs. Which I was doing several weeks ago, when I came across an item about one man’s extraordinary effort to harness the power of the blogosphere, in tribute to our fellow Americans who died in The Towers, exactly five years ago today.
The concept was deceptively simple: 2996 victims, 2996 blogs, each one remembering a single person. Bloggers were invited to sign up, and each was assigned – at random – one name.
Stop for a moment, and consider this: one blogger, reading one news item, decides it’s the right thing to do, signs up, and is assigned the name of a person he’s never even heard of, let alone met. We’ll come back to this shortly.
And so I was assigned the name of Jerome Robert Lohez, given a photo of him, and told the briefest of biographical information: age 30, lived in Jersey City, New Jersey.
That was it. A name, a face, a place.
The assignment was simple: On September 11, post his name and picture.
But I’m a news junkie, and that wasn’t good enough. I had to know more about Jerome. So I Googled his name (hey, why not?) and came across a site that CNN put together in December of ’01. It had pictures and names, of course, but I also learned that Jerome, born in France, married Dening Wu some three years before The Towers fell.
One month before The Towers fell, Jerome got his Green Card, and the happy couple flew to Europe to celebrate with his family. When they got back, two days before The Towers fell, Jerome told Dening “Only in New York do we have so much sunshine."
That was Sunday, September 9, 2001.
On Tuesday morning, he left for work. And The Towers fell.
And now we've come full circle: One. Random. Name.
Jerome didn’t just work in The Towers. He worked for Empire Blue Cross and Blue Shield. He worked in the insurance industry.
90% doesn’t cut it anymore.
Thank you, Jerome, for the lives you touched, the joy you brought, your love for New York and America, and for the privilege of paying you tribute.
Au revoir, Monsieur Lohez, au revoir.
Thursday, September 10, 2009
I have empathy for this woman, and what she and her family are experiencing. But if this is the way the Obama House wants to sell health care reform, it is lost on me.
Health insurance is no different from any other form of insurance. You must purchase it BEFORE you need it.
The guy in the casket at the front of the church probably needed life insurance, but it is too late to buy it now.
This story is reminiscent of the folks standing in front of the burned out apartment building claiming they lost everything because they failed to buy renters insurance. Why is this supposed to be my problem?
Wednesday, September 09, 2009
And he said, "PAY NO ATTENTION to that public plan behind the curtain."
Oh sure, he said more than that in his brief hour upon the stage (and said it very skillfully). But the other stuff he said mainly served to spread smoke around the room in an attempt to cover up the main issue that the curtain concealed. That main issue is single-payer for all. The main issue for the administration is not, as the Great and Powerful Ob suggests, coverage of the uninsured. If coverage of the uninsured were the issue, it could be addressed without all the other government apparatus in House Bill HR3200. Or if affordable insurance were the issue, it could be addressed by tackling the cost of medical care, instead of remaining stuck on the cost of insurance. Besides, we know for certain from statements made by Democrat leadership over the years - right up to the present time and including the Great and Powerful Ob himself - that the public plan is a deliberate and strategic step toward the ultimate goal of single payer.
So there is a clear choice before us:
To obey the Great and Powerful Ob and ignore the public plan that is behind the curtain.
(I may have more to say on the speech, over the next few days. Or not.)
Travel back in time a dozen years or so and Washington granted your wish. The folks in Congress, in conjunction with HUD, Fannie Mae and Freddie Mac decided anyone who wanted a home should have one.
Poof! It happened.
Anyone could get a loan, regardless of income or credit history. Demand for housing outstripped supply which fueled a rapid increase in the price of homes.
And then it all collapsed.
The government came in. Doled out money they didn't have. A lot of money. We, the taxpayers, have not yet begun to pay the tab for the housing market collapse.
Health care reform, at least the way Washington is going about it, could end up in the same place.
Roughly 85% of the population has health insurance and everyone has access to health care.
Compare that to 70% who own homes and most of the rest are renters. The homeless population is a moving target.
Most people pay something for health insurance and health care, but about 25% of the population is covered by Medicare and Medicaid and pay little or nothing for their coverage. The cost of health care to them is significantly discounted.
When Washington tried to expand the housing market by making mortgages available to almost everyone they interfered with free market forces and the result is the mess we have now.
The same thing will happen if they interfere with health care, but what they are attempting to do is even worse than what they did to the mortgage market.
They wanted to make mortgages available to 30% of the population but without unraveling what was working for the other 70%. Of course along the way some folks who already had a home mortgage decided to jump on the wagon and refinanced their homes up to and sometimes even exceeding the fair market value.
Washington wants to make health insurance available to everyone but in doing so, they want to completely unravel a system that is working for 85% of us and make health insurance more expensive for everyone.
It is like saying not only should everyone have a home but the home will be in an upscale neighborhood with the best schools. Everyone will have 5 bedrooms, whether they need them or not, a 3 car garage and a pool.
The health insurance plan Congress has designed allows everyone to have the best coverage starting at birth. Like the mortgage market, no one can be refused health insurance. Your health insurance plan must cover all preventive care services with no out of pocket to you. There will be no deductibles or coinsurance, only a copay for even the most expensive of services. If you earn less than $66,000 you will get money from the taxpayers to help you pay your premiums.
Sounds sweet, but just like the mortgage collapse, this plan will fail as well.
They say they want to make health insurance available and affordable for everyone but their plan will do just the opposite. Nothing proposed will lower the cost of health care, or health insurance. In fact, you could very well see the total cost of health care balloon out of sight and health insurance premiums double overnight.
There are not enough primary care physicians to handle the increased workload.
Once health care is "free" demand will outstrip supply, prices for health care will go up and the doctor shortage will result in queues.
If you want to see health insurance premiums drop two things have to happen.
Less demand for health care and more risk sharing by the insured.
Premiums for health insurance are inflated by 20 - 30% to comply with state and federal mandates.
Everyone who has health insurance now is paying for things whether they want them or not. Why? Because some politician decided there needed to be a law REQUIRING health insurance companies to cover the expense.
Mandates vary by state, so depending on where you live some of these things may be covered or not. But some of us at least are paying for services by chiropractors, podiatrists and social workers. I have never been to a chiropractor or podiatrist but I am paying an additional premium so others can use that benefit.
If not for the fact I am married to a social worker I would say I had never seen a social worker either.
I am also paying for mammograms and pap smears as well as well child care and wigs.
Don't need any of those either.
And these are just state mandates.
Because I live in Georgia I am paying an extra 1% to cover telemedicine and I don't even know what that is, but I have it.
Eliminate mandates and watch premiums drop by as much as 30%. Your $800 family insurance premium could become $560 overnight if you weren't paying for drug abuse counseling, dental anesthesia and all those other mandates. If you are single and paying $150 the premium could drop below $100 by eliminating mandated benefits.
Roughly 30% of the population is obese. Not just overweight, but obese.
Lifestyle choices, including overeating and lack of exercise consume roughly 40% of health care expenditures.
A healthier lifestyle plus eliminating mandates could reduce premiums by as much as 70%.
Now we are talking real savings, not some mumbo jumbo Washington-speak where health care reform will save or create affordable health care for everyone. Anyone who buys that line needs their head examined.
Since the politicians want to make bigger, more expensive health insurance, I am waging my own battle against high health insurance premiums for myself and my clients. Most of them understand there are things you need covered by health insurance and things that don't require health insurance.
They don't need health insurance for routine doctor visits but do need insurance to cover a surgeon or oncologist. They don't need insurance for a generic antibiotic but do need it for a $4,000 cancer drug. They don't need insurance for a minor emergency but do need insurance for a major hospital stay. They don't need insurance for maternity but do need insurance if complications arise. They don't pay an insurance company double premiums to cover a maintenance drug but choose a plan that excludes coverage and pockets the savings.
By purchasing insurance for only what they need, my clients are saving thousands of dollars each year. Instead of sending $8,000 or more to the health insurance company and never seeing it again, they are sending $4,000 and pocketing the savings in a tax sheltered account.
They don't need or want Washington to reform anything. In fact, they want less government interference in their lives and more freedom to choose.
I try to help them get their wish.
Smaller cars, bigger health insurance, Poppa Washington.