ObamaTax for Vets

No, not those vets, but veterinarians.

Now, you may be wondering what the ironically-named Patient Protection and Affordable Care Act (the ObamaTax) has to do with pet care, but it's nothing new to long-time IB readers. Almost 2 years ago, we reported on BoCare©, "to extend federal funding for vet's (as in veterinarians) in order to spend even more money (that we don't have) so that Fido can enjoy the same kind of health care that we enjoy."

Apparently, they take this pretty seriously in DC, and so now we have a new IRS rule that "some medical devices used in veterinary practices will be hit by Obamacare’s 2.3 percent device tax."

One supposes that it's fair for Fifi's leg pin be treated the same as her owner's new pacemaker, but the reality is that - of course - it ain't Fifi footin' the bill.

To be fair, that leg pin probably won't be affected, but items such as exam gloves and catheters (to name two) will be. So expect your next vet bill (not to mention your own insurance premiums) to be higher.

Why's that, you ask?

Pretty simple, really: you don't expect the vet to pick up the higher costs, do you?

What a Tangled Web We Weave . . .

Ah yes. Those pesky health insurance exchanges. So far only 17 states have agreed to set up their own exchange. Six have indicated they will enter into a partnership with the feds, which basically means the feds will fund it, make the rules and let the states run it for them.

The rest have not yet declared or have emphatically stated they don't want any part of the exchange.

So what's the big deal?

Well it seems there might be a "connection" between HHS Sec. Sebelius and the software company that will be used for the federal exchanges.

in January, HHS awarded Quality Software Services, Inc. (QSSI) what the Hill describes as “a large contract to build a federal data services hub to help run the complex federal health insurance exchange.” At that time, the director of Obamacare’s newly established Center for Consumer Information and Insurance Oversight (CCIIO) — which the Hill describes as “the office tasked with crafting rules for the national exchange” — was Steve Larsen. Larsen had been the insurance commissioner for Maryland when Obama’s HHS secretary, Kathleen Sebelius, was the insurance commissioner for Kansas, and the two are reportedly close. The CCIIO awarded the Obamacare exchange contract to QSSI while Larsen was the CCIIO’s director, and he played a central role in planning the construction of the exchanges — although it’s not known whether he made the decision to award the contract to QSSI or not.

Weekly Standard

The plot thickens.

Under the contract that it signed with HHS, QSSI’s power would be substantial — as QSSI would shape, run, and affect companies’ ability to compete to sell insurance through Obamacare’s federal exchanges. The Hill writes, “A draft statement of work for the contract awarded to QSSI states the contractor should provide services necessary to acquire, certify and decertify health plans offered on a federal exchange.” Moreover, “It stipulates the contractor should monitor agreements with health plans, ensure compliance with federal standards and” — somewhat strikingly — “take corrective action when necessary.”

QSSI, apparently realizing what a valuable asset it had in the contract, started shopping itself around. Meanwhile, Larsen left the CCIIO and took a highly paid position with Optum, a subsidiary of UnitedHealth Group, in June. Sometime this summer, UnitedHealth Group bought QSSI.

So why is the Obama administration willing to allow an insurance carrier (UHC) to run an exchange? Does this not give that carrier an unfair advantage in a "free" market place?

And what about all the health data that will be gathered on private citizens. It's bad enough that every doctor visit, lab test, etc is reported to HHS but at least some of this data will also be captured by a subsidiary of UHC.

Rx Recall: Atorvastatin [Updated]

The drug, a generic version of Lipitor), is being recalled by its manufacturer.

From Medical Mutual email:

"Ranbaxy... has announced a retail- or pharmacy-level recall of multiple lots of this medication ... The recall includes several lots of 10mg, 20mg and 40mg atorvastatin tablets distributed between September 25, 2012, and October 26, 2012. It does not include the 80mg tablets." [emphasis in original]

NB: As Mike points out in the comments, be sure to check your bottle's label. So far, at least, Ranbaxy is the only manufacturer involved in this.

The voluntary recall is due to the possibility that some batches may have been tainted by some foreign material (small glass particles).

If you've got some on your shelf, now'd be a good time to head back with it to the pharmacy.

UPDATE: And Bob sends along links to the latest on the matter from the FDA:

FDA Statement on the Ranbaxy Atorvastatin Recall

Questions and Answers on the Ranbaxy Atorvastatin Recall

Thanks Mike and Bob!

There's more than one "cliff"

We know the cost of insurance is driven upward by the rising cost of medical care.  In a similar way the cost of medical care is driven upward by the growing cultural apathy in America toward personal health care.

That is, more and more Americans are apathetic about taking even simple steps to protect their personal health in the first place.  Result:  a growing need for medical care, driving higher total medical cost and higher insurance cost.

And, keep in mind, health care (as opposed to medical care) is virtually free.

I fear what this means is that a demand-management strategy for America’s medical cost problem thru so-called "wellness" programs has little chance of success.

Why do I "fear" this is true?

Because this cultural apathy toward personal health care plays right into the worst command-and-control instincts of government.

Medical spending – Medicare, Medicaid, VHA, TRICare, etc - is the largest single slice of the national budget. Medical spending is also the largest deficit driver – Obama himself said 3 years ago “nothing else comes close”.

It seems to me that our government even now sees no alternative to hard-rationing controls. Is it so surprising that ObamaCare creates significant new machinery necessary to impose such a system? Or that the regs issued so far create even more such machinery?

In a way, I feel the country is like Wile E. Coyote. We’ve run headlong off a cliff chasing something we don't know how to catch.  Now we are temporarily hanging suspended in  mid-air; after a brief cartoon moment we face the inevitable crash to the desert floor.

Health Care is a Right

Seems there are still folks out there that believe they are entitled to unlimited, unrestricted health care, as long as someone else is paying the bill.

(Jorge) Mariscal moved from Mexico to the U.S. when he was 1 year old. Now as a 24-year-old graphic-design student, he considers it his home.He says he nearly returned to Mexico after doctors said he wouldn't be able to receive a kidney transplant in the U.S. because he is undocumented. 

Chicago Tribune

Since he came here when he was 1 it is obvious someone brought him. Why has he lived here for 23 years without ever registering?

Why did he stay here vs. going to Mexico for his surgery?As an illegal immigrant, Jorge Mariscal waited eight years for a kidney transplant he feared would never come.After years of uncertainties, Mariscal said he's excited about his future and grateful for the help he received. But he remains frustrated with a health care system that he worries might leave out an untold number of illegal immigrants in need of lifesaving treatments."Why can't we be treated the same?" he asked while sitting in his hospital room. "Health care should be a human right, not a privilege. At least give us the chance to fight for our lives with dignity."

Why can't you get a job with benefits that will pay for your medical needs? Why is it OUR collective responsibility to pay for YOUR health care?

Where is the dignity in demanding that someone else pay for your care?

Mariscal's treatment is far from over. The pills he'll need to make sure his body doesn't reject the new organ can cost upward of $10,000 a year for the rest of his life. And paying for those, just like the surgery, is complicated by his immigration status.He applied for a grant through the Simon Bolivar Foundation, a medical nonprofit, that would help cover his first year of anti-rejection pills. But without health insurance, he expects he'll have to pay for most of his medication.

In 2014 under Obamacare he will be able to purchase health insurance without restriction. I wonder if he will buy insurance then or expect the rest of us to pay for his care.

Kasich and the ObamaTax

[Original post updated and revised]

Contrary to some reports, the newly enacted House Bill 613 is not an attempt by the Ohio GOP to "[enable] socialized medicine."

In fact, it's designed to put strict limits on how "Navigators" in the new Ohio Exchange can operate, and requires them to adhere to the same regulatory and licensing guidelines as real agents, including obtaining Errors and Omissions coverage and completing Continuing Education requirements.

In fact, you can read the actual text of the bill here.

As FoIB Patrick Paule points out, the bill "also underscores the important role that ODI will play in the process.

I don't want navigators (who aren't licensed and have no E & O) to have free reign to do whatever they want in Ohio."

Excellent points!

I'll try to connect with the bill's sponsor, Barbara Sears, for her thoughts on how this will likely play out.

[Special IB Thank You! to reader Patrick Paule]

Is Life Insurance going over the (Fiscal) Cliff? [UPDATED]

Maybe:

"The potential elimination of many tax preferences currently afforded life insurance is one facet of today’s fiscal cliff discussions ... proposals include provisions that could result in the imposition of taxes and elimination of deductions for both individual and corporate-owned life insurance policies"

More ominously, the two primary tax benefits of life insurance - tax-advantaged build-up of cash values and tax-free death claims - are also under fire. This makes sense: why should responsible people gain an advantage over those who plan to fail fail to plan?

Gee, I'm just full of good news today, aren't I?

ADDENDUM: Jeff Root has an interesting post about life insurance and buy-sell arrangements, how they're used and how they work. It occurs to me that taxing the death death benefit in those situations could create a triple-whammy: the premiums aren't deductible, the death benefit would be taxable, and there may well be taxes on the transaction (sale of the business interest) as well.

Ouch!