Yo Quiero Obamacare?

Comes now the Kaiser Foundation and the Kalifornia Endowment that wants to make sure non-English speaking inhabitants know about Obamacare.

This animated clip is designed to capture the attention of those who live here but have not mastered our native tongue and make sure they know about the coming "free" health care.

Although only 16 percent of the U.S. population is Latino, Latinos represent 31 percent of the non-elderly uninsured. And only 35 percent of the Latino population nationwide receives their health insurance coverage through an employer.

”Too many Californians still do not know how the new health law impacts them and yet nearly 5 million stand to benefit from it,” said Robert K. Ross MD, president and CEO of The Endowment. “Many of those individuals are from our Spanish-speaking community. This translation is an example of our commitment to reach and educate millions of Latino and lower-income individuals about how our health care system is changing and how they can take advantage of the new provisions under the new law.”

5 million huh?

Why don't they just do like the fast food restaurants and provide cards with pictures of what hurts. Visitors can just point to the afflicted part and receive care.

To boldly go where no patient has gone before

Here is a previously-unreported flavor of the “medical tourism” phenomenon.

InsureBlog has occasionally reported on medical tourism over the past several years.

The new flavor is "circumvention medical tourism" - - medical tourism for services that are illegal in the patient's home country but legal in the destination country.

The author of the linked circumvention article further believes that the “home” country should criminalize this behavior – which I suppose means that when the tourist comes home, she would be subject to prosecution.

I disagree, because I think there are practical as well as legal problems. However the suggestion does reminds me of a baseball story. A batter called out on strikes hurls his bat into the air. The umpire watches the bat spin upwards, then tells the player, “son if that bat comes down, you’re out of the game!”

Peering in to a Crystal Ball

Do you want a look at what the future of health care will be? Here are some things you won't get on the 6 o'clock news.

During a recent conversation with insurance carrier "inside" contacts we discussed current and future trends as a result of Obamneycrap.

Several carriers have stepped up DTC (direct to consumer) advertising and have created or beefed up a staff of inside sales people to deal direct with consumer inquiries. Carriers have always had a sales staff, such as it is. To be honest, it is a crap shoot at best. The chances of getting meaningful answers to your questions are slim.

The staff is trained to take your order, not offer suggestions or point out limitations of one policy over another. I probably rewrite half a dozen policies a year for clients that have bought direct from a carrier only to later discover the policy didn't work as promised.

But I digress . . .

Truth is, the inside sales idea isn't working well. One carrier admitted they have cut their staff by 50% from a year ago. The problems?

Sales are off.

Applications submitted by the staff are not pre-screened for medical conditions which result in a higher declination rate vs. agent originated applications.

Inside sales staff applications that result in an offer as a general rule don't stay on the books as long as agent generated applications.

In short, the idea of DTC sales isn't efficient.

None of this was eye-opening. I have known about the deficiencies of DTC sales for some time, and this is not unique to one carrier.

The next conversation was a bit more enlightening.

It seems medical providers, doctor's and hospitals, are asking for significantly higher reimbursement rates. In some cases as much as a 30% pay raise.

It should be obvious to regular IB readers that health insurance carriers are simply conduits. When health care costs rise so must premiums.

This isn't rocket surgery.

What was surprising was the backside of this conversation.

It seems providers are unwilling to sign long term contracts for network pricing that extend beyond 2013.

If you have been sleeping under a rock, you should know that Obamneycrap, unless repealed or gutted, will fully unfold on January 1, 2014.

Did the light bulb go on?

Non incandescent of course . . .

Providers don't want to agree to pricing agreements that will extend in to 2014.

Shocking.

This is a perfect storm brewing, all set in to motion by government intervention. I don't think the public is going to be pleased with what they get.

Higher prices. Fewer choices. Poppa Washington.

Unlimited Demand Meets Limited Dollars

The problem with "free" anything, especially health care, is it isn't really free. Someone has to pay for the item or service.

Another issue is when things are free, such as an all-you-can-eat buffet, some will abuse the system.

Then there are folks who really do need help, financially and otherwise, but there just aren't enough dollars to provide the resources.

The Atlanta Journal Constitution had an eye-opening piece on the shortage of mental health resources.

Evette King recently sat in her south Atlanta home fretting about how she could avoid eviction without someone to watch, feed and bathe her severely autistic son so she can work and pay the bills.

Last spring, King’s 19-year-old son, Gerald Stephens, joined a growing number of Georgians with mental illness or developmental disabilities who have been discharged or are at risk of being cut off from a state program that has been a life line for thousands of elderly and disabled people for the past 15 years.

The program -- which provides housekeeping, transportation to adult day centers, care management and other services -- not only helps people avoid ending up in nursing homes but ultimately saves taxpayers money, advocates say. Caring for someone in the community costs thousands of dollars less each month than in a nursing home.

In 2007, however, a federal agency told the state it had to move the program known as SOURCE -- Service Options Using Resources in a Community Environment -- under a different umbrella. The new, more restrictive framework limited it to the elderly and physically disabled -- excluding some people who suffer from schizophrenia, Down syndrome, bipolar disorder, depression, and other mental and developmental disabilities.

Mental illness, severe retardation, autism and other psychiatric conditions can be impossible to deal with in anything other than an institutionalized setting. Yet over the last 30 years or so, states have closed down many of these facilities and turned many of the residents loose on the streets.

Many of them have become part of our booming homeless population. Others have ended up on welfare, living in subsidized housing, collecting food stamps and using Medicaid.

Seems all we have done is rearrange the deck chairs.

Initially the move to free residents from the asylums was part of a move by social workers to erase the "stigma" of institutionalization.

This begs the question, which is worse? Institutionalization or homelessness and welfare?

But now it goes beyond the "shame" of being segregated from society and has become a monetary issue.

The truth is, the government does not have enough money to fund unlimited health care (including mental health) for anyone that needs or wants it. The folks in DC believe Obamneycrap will save health care for all by lowering costs and forcing everyone to pay or play.

In the meanwhile they are forcing people like Evette King to make some tough decisions.

Without a caregiver to watch Gerald, who needs constant monitoring, King is only able to work a couple of days or so each week when her adult daughter can help out.

King, who also has an 11-year-old son, has scraped together enough money to keep the lights on so far, but it’s unclear how she’ll be able to keep paying rent. Gerald recently became eligible for a different Medicaid-funded program for the developmentally disabled, but thousands of people are on the waiting list, said Wells, who is working with the family

Which is more important?

Funding sidewalks to nowhere or addressing the needs of people who really need assistance?

Inside Baseball: ObamneyCare© and SCOTUS [UPDATED!]

[Poll added - see below. HGS]

NFIB's Karen R. Harned has tipped us to the (revised) schedule for ObamneyCare©'s day in (Supreme) Court. On the one hand, this is kind of dry, but on the other, folks are interested in observing this sausage-making process play out.

So, here's an abbreviated list of key dates; folks interested in the full schedule can drop me an email and I'll happily oblige:

■ January 13: Amici supporting Government on Mandate; Amicus supporting court-appointed amicus on Anti-Injunction Act

■ January 27: Government files Severability Brief; Amicus Briefs supporting Government on Severability due

■ February 6: NFIB/States Briefs Replying on Mandate; NFIB/States/Government Respond on Anti-Injunction Act

■ February 17: Court-appointed amicus on Severability; Amici supporting Government on Medicaid; Amici supporting court-appointed amicus on Severability (i.e., only mandate falls)

■ March 7: Government Replies on mandate

■ March 13: NFIB/States/Government Reply on Severability

■ March 27: 10:00 a.m.-noon Oral argument on individual mandate

■ March 28: 10-11:30 a.m. Oral argument on severability; 1:00-2:00 p.m. Oral argument on Medicaid

Cavalcade of Risk #148: Anti-Obsolescence edition

IronMan does an outstanding job with this week's round-up of risk-related posts. In what has become a tradition for him, IM has assigned value ratings for each post, as well as helpful summaries of their contents.

Do stop by, you'll be glad you did.

Tuesday Afternoon LinkFest

■ First up, American Thinker's Mike Stopa has interesting analysis about what we fear most about ObamneyCare©, and the historical ramifications of such a transformational change:

"They fear that they won't be able to continue to go to the doctor whom they trust. They fear that once a single consumer -- the government -- replaces 300 million consumers of drugs and medical technology and then begins to regulate costs ... But perhaps Americans' greatest fear of all is that Obamacare is a one-way door".

■ Next, a breast implant registry? Well, maybe:

"American health officials were urged to set up efficient mandatory registry to track breast implant patients ... When an implant deflates or things go wrong, it's very important to have because these are not life-long devices"

Who knew?

■ FoIB Jeff M tips us that "[d]octors in America are harboring an embarrassing secret: Many of them are going broke." Seems that "shrinking insurance reimbursements, changing regulations, rising business and drug costs" all conspire to bring them down.

Or maybe not so much:

"[S]ome experts counter that doctors' lack of business acumen is also to blame."

Heh.

■ Do economic factors influence health care spending? Perhaps:

"The growth of health-care spending was near a historic low at 3.9% in 2010 as the weak economy prompted people to cut back on medical care"

And yet:

"Health spending accounted for 17.9% of gross domestic product in 2010, the same as the previous year."

Imagine that.