MassCare Floundering

It's lobster season (or so I've been told), and the water's boiling on the progenitor of ObamaCare::

"Sure enough, 79% of the newly insured are on public programs. Health costs—Medicaid, RomneyCare’s subsidies, public-employee compensation—will consume some 54% of the state budget in 2012, up from about 24% in 2001"

Oy, that's a 225% increase in the overall "curve." Adding insult to injury, health care spending by the state's government has increased almost 60%. And to top it all off, the Bay State "spends more per capita on health care than any other state ... Costs are 27% higher than the U.S. average"

So, more money, but better care, right?

Right??

Maybe not:

"Under [a recently passed “cost containment” bill], all Massachusetts doctors, hospitals and other providers must register with a new state bureaucracy as a condition of licensure—that is, permission to practice. They’ll be required to track and report their financial performance, price and cost trends, state-sanctioned quality measures, market share and other metrics."

More red-tape means less time for health care delivery.  But wait, it gets even more Orwellian:

"No registered provider is allowed to make “any material change to its operations or governance structure ... without the commission’s approval ... As the commission polices the market, it can decide to supervise the behavior of ... doctors and hospitals that are spending too much on patient care."

Well, I'm sure that will gladden the hearts of actual health care providers. Because that kind of thinking worked out so well in the 70's.

Arghhhhh!

Some days I wonder why I even bother answering the phone . . .

Hello

Hi Bob, this is Greg. We talked last year about health insurance and it was too expensive then but I understand premiums have dropped under the Obama plan.

Really? Premiums in my world are going up more than they would if not for Obamacare.

Well I heard they are going down and the health insurance companies can't turn anyone down because of a medical condition.

True, but that starts in 2014.

We now want to look at a group plan. My wife has a business and we think some of them might like to buy health insurance. Can you come out next week, show us some rates and tell us how it works? We know the group rates are much lower so we can probably afford something then.

For starters, group health rates are at least double a comparable individual major medical plan. The carrier will require the company to pay at least 50% of the employee cost and you must have at least 75% of the eligible employees participate. If your participation does not meet the requirements you have to pay more of the premium.

That can't be. My accountant bought a group plan and it was less premium. They didn't have to cover any of their employees.

I have only been doing this since 1975. Perhaps the rules changed last week and I didn't get the memo. How long has your accountant been writing health insurance?

I don't know why anyone would buy health insurance unless they were sick. It is so expensive now, young people can't afford it. That's why we have our kids on PeachCare (SCHIP) because it is free and better than any health insurance plan we would have to pay for. The government made health insurance affordable for kids, why not adults?

It sure seems like you have a handle on things. Obviously I can't help you. Have a nice day.

He's baaaack!

My better half and I spent last week in beautiful, friendy and clean Montreal. It was an amazing trip, a truly historic city filled with friendly, warm and helpful people, great food and interesting sights (and sites). I would recommend it to anyone who wants a taste of Europe without a "hop across the pond."

A very special Thank You to Bob for holding down the fort here at IB all week. He's a great co-blogger, and an even better friend.

Now, back to the grindstone for moi.

Social Security No Return

Social Security beneficiaries retiring in 2012 and later are in for a rude surprise. Your return on investment is the same as if you had buried your money in the back yard or stuffed it in a mattress.



Lifetime Social Security taxes and benefits for people turning 65 in different decades. The lifetime value of taxes is based on the value of accumulated taxes paid, as if those taxes were put into an account that earned an annual 2 percent interest rate, plus inflation. The examples are for a married couple in which both spouses earned average wages ($43,500 in 2011). Projected benefits assume that both spouses have average life spans after turning 65. Want more benefits? Live longer.


If you turned 65 in 1960:
Lifetime Social Security benefits: $259,000.
Lifetime Social Security taxes: $36,000.
___
If you turned 65 in 1980:
Lifetime benefits: $452,000.
Lifetime taxes: $192,000.
___
If you turned 65 in 2010:
Lifetime benefits: $555,000.
Lifetime taxes: $588,000.
___
If you turn 65 in 2030:
Lifetime benefits: $699,000.
Lifetime taxes: $796,000.
___
In 1960, a 65-year-old woman could expect to live 16 more years, on average, and a 65-year-old man could expect to live 13 more years. In 2030, a 65-year-old woman could expect to live 21 more years, on average, and a 65-year-old man could expect to live 19 more years.

Dangerous Precedent

Aetna did a very stupid thing. They allowed themselves to be bullied in to paying an extra-contractual claim after bowing to pressure from the Twitter-brain crowd.   


Arijit Guha, an Arizona State student bought a limited benefit student health insurance plan. Every one I have reviewed is terribly flawed and overpriced for the "benefit" you receive.


This one is no different.They even include a "disclaimer"

Your student health insurance coverage,offered by Aetna Student Health*, may notmeet the minimum standards required bythe health care reform law for therestrictions on annual dollar limits. Theannual dollar limits ensure that consumershave sufficient access to medical benefitsthroughout the annual term of the policy

The above language applies to the 2012 - 2013 policy year. We have no way of knowing if similar language was included in the one purchased by Guha. Currently receiving treatment for stage 4 colon cancer, Guha quickly exhausted his $300,000 lifetime limit on benefits under the Aetna student health insurance plan.

After multiple surgeries and costly chemotherapy sessions, the 31-year-old Phoenix man quickly surpassed the $300,000 lifetime limit on his Aetna student-health-insurance plan with another $118,000 in medical bills left unpaid.

 Facing the prospect of medical bankruptcy, Guha launched a website, Poop Strong, and sold T-shirts and trinkets to raise money to pay for his costly chemotherapy and other medical bills. He also has used Twitter to rail against what he considers the outsized profits of Aetna and the health-insurance industry. 

To his surprise, Aetna CEO Mark T. Bertolini engaged Guha via Twitter and addressed the student's plight. The result? Aetna agreed to pay the student's medical costs despite his policy's maxed-out coverage.

While generous and noble, paying extra-contractual claims because of public pressure is foolhardy. Future policyholders can simply claim ignorance of the provisions in their policy and engage in social blackmail in hopes of getting the carrier to pay up.


Now comes a new school year and a chance (perhaps) to purchase a new Aetna plan. Even if he qualifies, most student health plans exclude pre-existing medical conditions.


Oh well. Perhaps Aetna's CEO Bertolini will offer to cover those expenses as well. After all, he has set a precedent.

Obamacare Payola?

Most who followed the "progress" of Obamacare through both houses of Congress are familiar with political payoffs such as the Cornhusker Deal, the Louisiana Purchase and other backroom shenanigans to win votes. If this is business as usual we are in big trouble as a country.


But almost 4 years after the year long snow job was pulled off on the American public it now appears the plot thickens.


Politico reports there is evidence Jim Messina, Obama's campaign manager, may have cut deals on behalf of "big Pharma" to insure the passage of Obamacare.

A House Energy and Commerce Committee report out Tuesday is stocked with emails sent from private addresses and meetings scheduled away from the building to avoid official record. Among these are several sent to a pharmaceutical industry lobbyist by Messina, then President Barack Obama’s then-deputy White House chief of staff, making promises about language for the health care reforms despite the resistance of then-House Speaker Nancy Pelosi to the measure.

“I will roll [P]elosi to get the 4 billion,” Messina wrote Pharmaceutical Research and Manufacturers of America (PhRMA) lobbyist Jeffrey Forbes from his personal account just days before the Affordable Care Act cleared Congress in March 2010. “As you may have heard I am literally rolling over the house. But there just isn’t 8-10 billion.”

Ah yes, Mrs. Pelosi. The Speaker that famously declared "We have to pass the bill in order to know what was in it."


Now perhaps we know why she said that.


She didn't build that by herself . . .

“What we have learned from our many investigations is that, time and again, the Obama administration’s actions have failed to match the president’s lofty rhetoric on transparency,” Stearns said.

No kidding.


But then, it IS the Chicago way of politics.

After POLITICO published a story in February 2011 on meetings arranged at offices on Jackson Place near the White House, White House press secretary Jay Carney said “the guiding principle here is transparency, and we believe that — nobody is, that I’m aware of, is hiding where they’re meeting.”

“It is routine for the White House officials to meet with all types of people, including lobbyists, and frequently here,” Carney said. “The suggestion that we’re not being transparent is laughable given the unbelievable precedent this administration has set in its — closing the door, the revolving door, and releasing these records.”

Is this the same Carney that either did not know or refused to answer the direct question, "What is the capital of Israel"?


This is reminiscent of the infamous Watergate hearings and the staged memory loss of the participants.

Cavalcade of Risk #163: Call for submissions

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