The (Doc) Fix is in....Or is it?

FoIB Holly R tips us that the so-called "Doc Fix" is in, meaning that (as we discussed over the weekend) providers' fees have once again been spared the axe:"Congress agreed to a one-month delay in Medicare payment cuts to doctors yesterday, giving a short-term reprieve to a looming crisis over treatment of the nation’s senior citizens."Except that it really doesn't. Let's ask Kelley Beloff, our resident...

And what is the most significant way the Federales control their medical care costs ?

Milliman has calculated the cost-shift from Medicare and Medicaid into the private sector as roughly $90 billion a year, or 15% of private insurance costs.In brief, this happens because:(1) the government plans pay less than what the medical service providers think their services are worth (2) How does the government get away with this? Just as Hank says, "because they're the government". (3) service...

Post-Thanksgiving Grand Rounds

Our friends Jay and Louise Norris of the Colorado Health Insurance Insider blog host this week's terrific round-up of interesting and diverse medblog pos...

In Vino....What?

At the Jewish New Year, which we call Rosh HaShannah ("Head of the Year"), we celebrate by dipping apples in honey. There are various interpretations of this ritual, but the most prevalent one is that the apple represents life ("the circle of life") and, of course, the honey represents sweetness.We also offer a "kiddush," a blessing over wine as we toast the New Year.And how, exactly, does any of...

Presenting Ezra the (Not So) Magnificent!

Once again, Ezra the Disingenuous demonstrates his inability to prove an argument. Last time out, he tried to (re)sell the snake oil that is RomneyCare, only to be taken to the woodshed by Bob. This time, he wants us to believe that the federally implemented national health care system known as Medicare is just hunky dory,...

The (True) Cost of Health Care

An overarching theme here at IB has been that health care costs drive health insurance costs. While this may seem obvious to us, it bears repeating.Why, you ask?Well, a fundamental precept of ObamaCare© is that by controlling health insurance costs, health care costs can be better controlled. This is patently and (more important) demonstrably untrue:"What Anderson might not know, however, is how Sutter's...

Karma's a (W)itch

Looks like somebody didn't send in their WaiverMania check to HHS Secretary Shecantbeserious:"One of the largest union-administered health-insurance funds in New York is dropping coverage for the children of more than 30,000 low-wage home attendants ... The union blamed financial problems it said were caused by the ... new national health-insurance requirements."Looks like they won't be #112 on "the...

MVNHS©: A Most Deadly Game

Our Cousins Across the Pond©, whose "health care" scheme we're attempting to emulate, have a little problem:"Nineteen hospital trusts are today exposed as having alarmingly high death rates in a major report that also reveals how hundreds of people are dying needlessly because of substandard NHS care."Okay, so not so "little," after all. A new report, compiled by the British Department of "Health,"...

We have to pass this bill so that you can find out what is in it

Perhaps missed in the excitement over other wonderful things we have been finding out about health insurance reform, here is a snippet from the Institute of Medicine:"At the request of the Secretary of HHS, the IOM is undertaking a study that will make recommendations on the criteria and methods for determining and updating the essential health benefits package."At first I misread this. At first...

Medicare and Cancer: Both Underwater

The first being metaphorically, of course:"Want an appointment with kidney specialist Adam Weinstein of Easton, Md.? If you're a senior covered by Medicare, the wait is eight weeks ... Top-ranked primary care doctor Linda Yau is one of three physicians with the District's Foxhall Internists group who recently announced they will no longer be accepting Medicare patients."So why is our Medicare health...

Cavalcade of Risk #119: Call for Submissions

Nina Kallen makes her CavRisk hosting debut next Wednesday (December 1). Submissions are due this Monday (the 29th). Please remember to include:■ Your blog's url■ Your post's url■ The post's trackback URL (if available)■ A (brief) summary of the postAnd PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).NB: The Cav is about risk, but not necessarily or exclusively...

Your New Health Care Plan

(Click to embiggen)[Hat Tip: FoIB Jeff...

About that "You can keep it" Promise

As with so many others, this one has not only gone under the bus, but the driver backed up to make sure it was good and dead:"No matter how we reform health care, we will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor, period. If you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away, no...

Trickle Down Effect of Obamacare

Hurricane Obamacare is a category 5 storm that will make landfall in January, 2014 but already we are feeling the effects of the feeder bands buffeting the country. On Monday HHS confirmed that the MLR (medical loss ratio's) as defined in Obamacrap would go into effect in 2011 without modification. We explored some of the impact of this MLR in yesterday's post.But the MLR is much more insidious...

Obamacare Puts the Squeeze on Health Insurance

The Spectator informs us that HHS has finally spoken with regard to the MLR (medical loss ratio) guidelines for health insurance companies. The MLR dictates how much of every premium dollar health insurance companies must spend on claims.On the surface this may sound nice but in practicality it is smoke and mirrors.When you consider that health insurance is marketed in (at least for now)...

ACO: Told ya so!

ACO's (Accountable Care Organizations) are an ObamaCare© invention purportedly designed to increase access to, and affordability of, health care. As we've seen, of course, they do neither. But why take just our word for it? Writing in the New York Times (hardly a bastion of right-wing thinking), Robert Pear notes:"Consumer advocates fear that the health care law could worsen some of the very problems...

We have to pass this legislation so that you can find out what is in it

"Consumer advocates fear that the health care law could worsen some of the very problems it was meant to solve — by reducing competition, driving up costs and creating incentives for doctors and hospitals to stint on care, in order to retain their cost-saving bonuses."Nawwww . . . . Reeeally?Didn’t consumer advocates tell us back when that Obamacare would increase competition, reduce costs and increase...

Do you see it? I don't see it . . . Part 2

[Part 1 is here]Only this July, Kathleen Whatshername at HHS told the nation that $5 billion was now available for the hundreds of thousands of people who can't get insurance because of a pre-existing condition. The average person could be forgiven for believing that this was a crisis of near-Biblical proportions. OK, so what happened?Well, on November 12, I read that a grand total of 8,011 people...

Do you see it? I don't see it . . . Part 1

Barack Obama, in an interview with "60 Minutes" recorded 11/4/2010 said several important things - - but in my opinion this is not one of them:(scroll down to #3) "unemployment insurance, most economists will tell you, is probably the single most important thing we can do to improve the economy.”The President’s statement prompted me to look up some history about earlier recessions in America. I...

Oy Canada! Part #1,387

So CanuckCare© is superior to our own (soon-to-be-replaced) system? By one metric, at least, sure:"Canada does guarantee its citizens ... access to a Web site to check on wait times for surgeries."Well, that's helpful!Of course here, we have no need for such a site, since we don't really have wait times for necessary surgery. Ooops.As noted health policy wonk David Hogberg notes, "Ms. Gorsuch in fact...

Medical Necessity vs (Stupid) Mandates

A dear friend sent me the link to this story:"Regence BlueShield has been ordered to pay $148,000 to nearly a thousand women who were wrongly denied coverage of prescription birth control ... Regence had denied coverage of IUDs, or intra-uterine devices"As a tried and true liberal, she was pleased that the carrier was "punished" for failing to provide coverage for these devices. The problem, of course,...

"We're from the gummint...."

Reader Sam B offers this frustrating tale of how new IRS regulations cost him a day's work. It's important to understand, however, that Sam's no ordinary businessman: he's a successful small business owner and an SBA Small Business Development consultant. In other words, he's an actual expert in starting and growing small businesses, and an accomplished one, at that. The following tale is relevant...

The Rest of the Story . . .

Bloomberg is reporting that a non-profit cooperative to "help small businesses in South Carolina find affordable health insurance for their workers."So?If they expect to operate as a MEWA (Multi Employer Welfare Association) good luck. Most of those have either been declared illegal or have gone out of business, often due to shady business practices.Perhaps all they will do is operate as a "super"...

Medicare Premiums Headed North

FoIB Roger D sent us some very interesting information regarding 2011 Medicare premiums and benefits. To review, Medicare Part A covers hospital expenses, and is subject to an annual deductible. Starting in January, that cost goes up to $1132, an increase of some 3%. While that may not seem like a big hit, keep in mind that a lot of seniors will see no offsetting increase in their Social Security...

Cavalcade of Risk #118 now online

Louise Norris presents a special pre-Thanksgiving Cavalcade of Risk. It's stuffed full of great risk-related posts, but it's sure not a turk...

Big News for Grandpa

Well, well, well. Perhaps HHS Secretary Shecantbeserious is a closet IB reader. A while back, we reported that one way for a group to quickly lose "Grandfathered" status would be to switch carriers (while keeping benefits essentially the same). This is a tried-and-true strategy, with a long history of success. Unfortunately, it appeared that Ms Shecantbeserious had put a stop to it. Can't have folks...

Sir Willy Wonka to the rescue!

Recently, we discussed the terrific new "Twinkies Diet," which demonstrated that even those spongy treats hold promise. Now comes word that another perennial IB favorite, chocolate, has even greater health potential. Scientists working with candy giant Mars are even now busy deciphering the genome of cacao, from which chocolate is processed:"Researchers ... are scouring the genome of the tree Theobroma...

Grand Rounds visits Dr Who

Nurse Kim, proprietess of Emergiblog, presents this week's collection of great medbloggi...

Microcephalic Mongoloid Idiots

In 2005, my wife was tripped by a stray dog's leash, fell and fractured her wrist. As part of the recovery, she needed some minor physical therapy. At the time, we were covered by Health Net. Our doctor recommended a local PT company, and after verifying that they were a participating provider, she went for some treatment....

Comin' up short

Supply and demand can be a real, um...bear. A major goal of ObamaCare© is to provide health insurance to more people. This may or may not be a laudable goal, but it's a pretty naive one. When more people are insured, there is a greater demand for medical services.But is there an ample supply to meet those increased needs?Short answer: No.According to Dr Mark Siegel, a professor of medicine and Doctor...

Flawed premise, Predictable results

Over the past few months, Bob's done a yeoman's job of tracking the Epic Fail that is the PCIP (Pre-Existing Condition Insurance Plan). The stated purpose of said plan is to make health insurance available to the (approximately) 375,000 Americans whom HHS Secretary Shecantbeserious claims are currently uninsured because of pre-existing medical problems.At least, that's how many folks Ms Shecantbeserious...

ObamaCare© Waivering: 111 and counting...

As previously noted, HHS Secretary Shecantbeserious has no compunctions about handing out ObamaCare© waivers to select businesses, including McDonald's and Local 25 SEIU. In fact, over 100 such waivers have already been granted, on a completely rational, fair and transparent basis.And if you believe that last part, I've got a great deal on some primo real estate for you.The truth is far more disturbing:[Video...

Social Security Cuts?

The bi-partisan deficit reduction report is getting a lot of play, especially the part about cutting Social Security and Medicare. As someone on the precipice of Medicare (but not Social Security) I can identify with the backlash.So why am I close to Medicare eligibility but not Social Security?Because in 1983 Social Security benefits were amended to cut benefits for people born after 1937. The amended...

Damn Lies and Statistics

In 2001, Joel Best published a book called: “Damned Lies and Statistics: Untangling Numbers from the Media, Politicians, and Activists”. It, or the successor volume, should be required reading for everybody in High School civics class.A recent letter crossed my desk that reminded me of that book. Written by the NAIC Consumer representatives to the Chairs of the NAIC Exchange Subgroup, it cites some...

Cavalcade of Risk #118: Call for Submissions

Jay Norris hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 15th). Please remember to include:■ Your blog's url■ Your post's url■ The post's trackback URL (if available)■ A (brief) summary of the postAnd PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).You can submit your post via Blog Carnival or ema...

Latebreaking LTCi Market Update

From FoIB Jeff M:"MetLife Inc. says it will no longer sell new long term care (LTC) insurance policies in either the individual or group markets after the end of the year."Citing "the financial challenges facing the LTCI industry in the current environment," the carrier is folding up and walking away. The "good" news is the carrier will continue to service existing clients (for now - we'll see how...

Veteran's Day Health Wonk Review now online

Heather Kelley makes an excellent hosting debut with her Veteran's Day Edition of Health Wonk Review at her INQRI Blog. It's always exciting to welcome a new host into the fold, and Heather does not disappoi...

It's for the children...

Although this particular item is local to the Cincinnati area, it could very well hold lessons for other venues:"Disagreements over health care benefits could unravel 10 months of progress ... The district wants teachers to pay more than twice as much for health care costs"In a classic example of unstoppable force versus immovable object, the district, facing substantial budget shortfalls, wants its...

Tuesday Afternoon Linkfest

First up, regular readers may recall our recent post on John Hancock's substantial (unprecedented?) rate hike. Thanks to FoIB Jeff M, we learn that they've also announced a moratorium on new group LTCi cases. Not to be outdone, fellow LTCi biggie GenWorth has announced that it's "seeking an increase of 18% on PCS I and PCS II LTC products." They cite "lower than expected lapse rates."That's an interesting...

Joe Barton Hits, Misses

Over at RedState, Rep Joe Barton (R-TX), opines on the potential future of ObamaCare© under the (not so) tender ministrations of a Republican House. He scores with his suggestion that the bill itself be repealed [ed: fat chance of that, for now], and offers what he considers some good alternatives for future consideration. It's with some of these "suggestions" that I take issue:■ "ban insurers from...

Veteran's Day Grand Rounds

Now up at Nurse Ratched's Place, a tribute to those who have served our country, including some that may surprise you (Jimi Hendrix??!...

Outstanding Food Pyramid News

This is just tremendous news for those of us struggling to find an effective, simple way to shed pounds:"Twinkies. Nutty bars. Powdered donuts ... For 10 weeks, Mark Haub, a professor of human nutrition ... ate one of these sugary cakelets every three hours, instead of meals. To add variety in his steady stream of Hostess and Little Debbie snacks, Haub munched on Doritos chips, sugary cereals and...

Pee on the MVNHS©? There's an app for that!

Offered without comment:"British health officials are hard at work on a new app that will allow users to pee into their cell phones and find out within minutes if they have an ST...

Unfortunate Industry Tricks: PBM's vs Common Sense

Let's start with a premise and a fact:Premise: increasing health care costs lead to increasing health insurance costs (premiums).Fact: most (all?) insurance carriers use Pharmacy Benefit Managers to help both the cost of care and of insurance.By way of background: PBM's are (allegedly) a cost-efficient way for carriers to offload the administrative functions of filling prescriptions. Now, one might...

PCIP Rate Reduction

The folks in Washington, the ones who gave us Obamacare, have figured out a way to spur growth in the pre-existing health insurance program (PCIP). When PCIP was created they estimated 4 million citizens would qualify for the plan but expected 200,000 would eventually enroll.To date, only 8,000 have actually signed up with 1,657 coming from Pennsylvania (161 in Georgia).Why Pennsylvania? The Keystone...