Kamis, 15 November 2012

HHS Subpoena

Subpoena [Latin, Under penalty.] A formal document that orders a named individual to appear before a duly authorized body at a fixed time to give testimony.

Apparently the folks over at the House Ways and Means Committee feel HHS Sec. Shebullshits isn't being truthful about her stewardship of OUR tax dollars.

Imagine that.

The subpoena demands that Sebelius turn over documents about how taxpayer dollars are being used to promote the law through public relations, advertising and message testing. The committee is asking for all documents covering the period from January 2008 to today
.
Politico, "Ways and Means issues Obamacare subpoena"


I suppose Obamacare is not popular in its' own right, so our tax dollars need to be used to SELL us on the benefits almost 3 years AFTER the law was forced on the American people by the least transparent administration in history.

An initial request for information was sent to HHS in June. On October 24, 2012 a letter from two members of the Ways and Means was sent to HHS giving them an October 31 deadline to release documents or else face a subpoena.


“The lack of response leads me to believe that this administration is either unwilling to disclose why they are using taxpayer dollars to market their unpopular law or are unable to keep track of how those taxpayer dollars are being spent,” Camp said in a statement Wednesday. “Either way, the American people deserve to know where their hard-earned money is going … after months of being unresponsive, I am left with no choice but to compel their cooperation.”

What we have here is a failure to communicate.


Rabu, 14 November 2012

Um, D'unh?!

I don't get why this would be "news:"

"Obamacare to Jack Up Insurance Premiums ... According to a survey from the National Business Group on Health, employers  expect their health insurance costs to increase 7%."

Hey fellas? Stop inhaling: only 7%? You wish.

And this:

"60% of those employers plan to ask workers to pay higher monthly premiums."

Also ignores reality. As we pointed out many years ago:

"Companies do not pay taxes, and they do not pay for health insurance.

In case you missed that, let me repeat: Companies – businesses – pay neither taxes nor insurance premiums.

Companies do collect (sales) taxes, and pass them on to the states in which they do business. They also include any business taxes due in the price of the product or service. They pay employees a portion of their salary, and forward the balance to the insurance carrier (and/or state government).

They do not actually pay the taxes, nor the insurance premiums
."

So this whole notion that employers are going to be asking what employees they have left to "contribute" more towards their premium is silly. And it ignores the fact that a lot of employers will be dumping either full-time employees or their group health insurance plans. Or both.

Of course, we'll continue to hear about how it's all the fault of business, but the reality is that businesses exist to make money, not to pay increasignly high labor costs (such as health insurance premiums). And now that our own Not So Vaunted Health System© (nee: ObamaCare) has been affirmed, this is just the beginning.

Kinda wish we'd read it before they passed it, no?

Medicare Reform - Asking Seniors to Pay More


Medicare reform is coming. Which cuts will be enacted, and how you will be affected? Doctors and other medical providers face a 26% automatic pay cut in January unless Congress acts fast.

Doctors are healers in a sense, but they are also small business owners. They can no more afford to take a 26% pay cut than you can afford a similar cut in your Social Security check.

The danger of a fiscal cliff is just 6 weeks away and we have a lame duck Congress. Medicare reform is not completely on their radar

Medicare reform - Which cuts will be enacted, and how you will be affected?

Don't kid yourself. All of us will be expected to share in the hurt of Medicare reform.
Lawmakers are wrestling with finding a balance between asking beneficiaries to pay more for Medicare services and reducing payments to Medicare providers, such as hospitals and nursing homes. Those providers, who are already expecting their Medicare payments to grow at a slower rate over the next decade as part of the 2010 health law, likely would fight additional cuts.  And beneficiaries, many who are on fixed incomes, will not want to pay more for Medicare services.
Kaiser Health News, "Fiscal cliff Medicare"

We hear about Medicare reform as it affects provider cuts, but how often do you hear the phrase "but you will have to pay more"?

Politicians hate to deliver bad news, especially when it involves a large voting block of angry seniors. That is why they introduce change as impacting others, not you.

Doctors earn more than most folks. At some point the government says "they have earned enough". According to some politicians, it is time for high income earners to pay their "fair share".

Of course their fair share, as defined by DC, is higher taxes and a 26% pay cut.

Both of those ideas clash with your access to health care. Why will a doctor be willing to treat a senior on Medicare when they can earn twice as much with non-Medicare patients?

That is only one way in which Medicare reform will impact you.

The folks in Congress also want you to pay more for your insurance, and pay more when you receive medical services.
Members of both political parties and some health care analysts have long thought that spending could be slowed if patients, including Medicare beneficiaries, put up more of their own money for health services. Some have suggested raising seniors' share of the Medicare Part B premium (which covers doctor visits and other outpatient services) from 25 percent to 35 percent and imposing co-payments for home health services or the first 20 days of a skilled nursing facility stay.
You might want to read that again.

If Congress gets their way, Medicare reform means your Medicare Part B premium will rise, your copay's will rise, and your Medigap premiums will rise.

Why will Medicare supplement premiums rise?

Benefit rich plans such as Medigap plan F pay 100% of the balance of Medicare approved Part A and Part B expenses. When Medicare increases the deductibles or coinsurance your Medigap plan is obligated to pay a greater portion of each claim. When they pay more, your premiums must rise.

Some Medigap carriers are already reacting and increasing renewal rates at a higher percentage for plan F vs. other plans such as G. One of our least favorite Medicare supplement plans will increase rates 13.3% across the board.

Our more competitive carrier is raising rates 7.5% on plan F but only 6% on plan G.

Which plan would you rather have?
Raising beneficiaries' share of Part B premiums would bring the program closer to its original 50-50 split between the federal government and beneficiaries, proponents say. And they add that greater cost-sharing for services would discourage overuse of care.
Raise your hand if you believe you are over-using your Medicare benefits and think you should pay more as a way of discouraging abuse.

Medicare reform to the folks in Washington means you should you should pay more so you don't abuse your privileges. These folks are out of touch.

The election is over so it is too late to "throw the bums out" but that doesn't mean you can't call your Congress person and give them a piece of your mind. Do it now!

Can you hear me now?

The Brits' Much Vaunted National Health System© (MVNHS©) has long been a passion of ours, for (mostly) obvious reasons. The latest installment in the long-running joke that is the MVNHS© demonstrates what happens when physicians answer to bureaucrats:

"Doctors are failing to really listen to patients' views on how they want to be treated ... Involving patients in discussions about treatment could cut the cost of healthcare around the world"

Now, I'd take issue with that last - after all, "the world" is a pretty big place, and that which works in one country or culture might not translate so well to another - but the greater point is that docs in government-run health care schemes are accountable to the government, not their "patients." Indeed, since the government pays the bills, the patient really has little (if any) say.

The problem is that the payer (government) isn't the patient, who may well know best what it is that needs to be done:

"[P]reference misdiagnosis" - misinterpreting or ignoring the patient's wishes - is a significant problem which is damaging to both doctors and patients ... it can lead to, what they call, "silent" misdiagnoses - when doctors choose the wrong treatments because they fail to assess their patients' preferences correctly."

This was one of the most important aspects of consumer-driven health care (now outlawed under our own Not So Vaunted Health System©): transparency and financial empowerment (the premise and promise of Health Savings Accounts) did, in fact, rely to at least some extent on the patient's engagement with their provider.

As under the British system, the absence of this interaction can lead to devastating consequences:

"In one study they looked at, doctors believed that 71% of patients with breast cancer rate keeping their breast as a top priority, but the figure reported by patients was just 7%."

Of course there are trade-offs (life is, after all, a series of them), but divorcing the patient from his or her own care decisions seems a pretty drastic one. Of course, the person (or institution) with the gold makes the rules (cf: IPAB Death Panels).

[Hat Tip:Dr Dino Ramzi]

Selasa, 13 November 2012

Yet another example to why we should end entitlements as we know them...

From CNBC:

"Harris, a 22-year-old smoker, was set to see his cost per paycheck rise to $29.60 from $25.40. He says he has decided not to sign up for coverage. Given his low income, as Harris foregoes coverage any major medical bills could potentially fall to taxpayers through the government's Medicaid program."

$4.20, a pack a week? Maybe three packs a month and he drops insurance. Because he is busy engaging in activity that makes him more expensive to insure he can't afford insurance so the rest of us that are working get to pick up the tab.

Welcome to the Welfare State, get comfortable.

Vikings and The NSVHS©

Back in the day, Norway was known for Edvard Munch, Sonja Henie and Leif Ericson. But even the reviled Vidkun Quisling is most likely whirling in his grave over the current state of Norway's "health care" system:

"A man – let’s call him Joseph K. – is slicing up a cucumber when he suddenly cuts off the tip of his thumb. He hastens to the E.R., where a doctor clips off the finger of a plastic glove, pours antibiotic into it, slips it over the thumb, then wraps a bandage around the entire finger."

Ouch, but it gets worse. Fast forward a couple days:
"...the E.R. is simply not open at this hour. Until 3:30 P.M., the E.R. operates out of another location in the small, relatively remote town ... make an appointment if you insist, but you should know – there’s not always a doctor here!

What? There’s not always a doctor at the E.R.?

Yes, there’s not always a doctor here!
Such is care under the Norwegian government-run health care system. Regular IB readers won't be surprised to read this, but it's what we have to look forward to under the recently affirmed NSVHS© (Not So Vaunted Health System©), formerly known as ObamaCare. When the government runs things, there are always shortages - of doctors, medicines, hospital beds, you name it.

Well, to be fair, not everything is in short supply: nameless, faceless, unaccountable bureaucrats are rife (if not readily accessible). As Bob's noted on many occasions, this kind of system is a real bargain - until you need it.

[Hat Tip: Joe B]