Health Wonk Review: The Bard's edition

Louise Norris presents this week's intellectually stimulating ode to Billy Shakespeare, aka the Health Wonk Review. What makes Louise's HWR's so great is the time and care she puts into making sure each post includes context that shows she's read each and every one.

Kudos, Louise!

Burying the Lede

In newspaper parlance, "burying the lede" means to "begin a news story with nonessential details," or to obfuscate the actual "news." In this case, the New York Times lauds the ObamaTax, quoting sources in New York that claim it will reduce premiums in the individual market by 50%.

[ed: Gosh, whatever happened to the president's promise that they'd plunge 3000 percent?]

To hear Gov Cuomo tell it, "New York’s health benefits exchange will offer the type of real competition that helps drive down health insurance costs for consumers and businesses"

There's just one little problem:

It's a meaningless claim.

How's that, you ask?

Simple, but it takes 12 paragraphs to get to the real reason rates may be lower:

"While the rates will fall over all, apples-to-apples comparisons are impossible from this year to next because all of the plans are essentially new insurance products."

The new "metal" plans have much higher out-of-pocket exposures than plans currently allowed to be marketed in the Empire State; it's really not difficult to understand why Kia's cost less than BMW's.

But that doesn't fit the meme.

Scamster Tricks

So I return from lunch to find a voicemail from a distraught young lady. Seems she had bought health insurance this morning (or so she believed) but didn't have sufficient funds in her checking account to cover the premium, and wanted to make sure that, once that was fixed, her coverage would begin tomorrow, as agreed.

What makes this interesting is that I had no idea what she was talking about. I am a relatively successful agent, but I don't have so many clients that I can't remember one from a few hours earlier (more's the pity, one supposes).

After some probing, it turned out that the young lady had spoken with - and given all her private health, checking account and other personal information to - a "Patrick" Stern (no relation). The more I asked, and the more she shared, the more alarm bells were going off in my head. For one thing, I explained to her, the company from which she purportedly bought her policy does not sell health insurance.

For another, no professional agent is going to take an application over the phone (too easy to claim fraud, and where, exactly, does one "sign" over the phone line?). Add to that the fact that the call-back number she'd been given appeared to be non-functional and, well, we have a problem.

Based on recent ObamaScam stories, I asked her if perhaps the gentleman had mentioned the "new health care law." She told me that "Patrick" had called her husband, who'd directed him to call her.

So much of this screams "scam" that I gave her two pieces of advice: first, that she should call her bank to determine whether her account had, in fact, already been dinged, and that if it hadn't, she should freeze the account. I also gave her the consumer hotline number for the Florida Department of Insurance (she's a Sunshine State resident), and suggested that she share her entire story with them as soon as possible.

Fingers crossed hopefully for a happy ending to this one.

5 Years in the Making: An OmniCare Update

We first started covering the OmniCare prescritpion drug whistleblower/kickback debacle just over 5 years ago; our most recent update was early last year, when we noted that the government's position on the whole mess was, erm, equivocal.

And now, thanks to tenacious FoIB Holly R, we (seem to) have resolution:

"A federal judge in Chicago has approved a settlement between Omnicare Inc., the U.S. government and two states, bringing an end to a whistleblower lawsuit filed under the False Claims Act"

Whew.

Medicare Lives to See Another Day

Medicare apparently will live to see another day or two as long as people stop getting sick and living longer.          

A recent report could have been written by Mark Twain. Reports of an early demise are greatly exaggerated.

Medicare has two more years to live than previously thought. The program's trustees recently estimated that the "depletion date for the trust fund is 2026, two years later than was shown in last year's report."

Philadelphia Enquirer

That's good new for short timers.

Not so much if you have just started on Medicare or are hoping it will be around when you turn 65

And that may be an underestimate. The projections are "based on the trustees' intermediate set of assumptions," which include sharp reductions in payments to doctors and other providers that Congress has routinely overruled in the past.

So if doctors and hospitals are willing to work for less money they can help save Medicare.

No problem.

Obamacare will only make things worse.

Obamacare simply takes money out of Medicare and lavishes it on other programs, such as Medicaid. The original Congressional Budget Office estimate of the cost of the law was $940 billion over 10 years. Earlier this year, the agency revised its estimate to $1.8 trillion over the decade 2014 to 2023.

Rob the old to pay the poor.

But wait. The NEW cost estimate for Obamacare has DOUBLED?

This doesn't look good.

Cost of PCORI tax

This week we are gathering data for clients to file their PCORI Tax payment, and explaining it to them. Between our time, the groups' time, the Broker, and CPA it takes hours and cost at least a couple hundred dollars per group.

The tax on the first three groups I have done this AM;

$11
$8
$15

And they wonder why wages stagnate, small businesses don't hire or offer insurance, and the economy doesn't grow....

Friends with Benefits

It appears that those who are benefitting most from the financial side of the Patient Protection Act have been engaged with the Administration in some capacity over the years. Here's a short list of who has been "rewarded".

Sara Horowitz - Her organization, The Freelancers Union, was chosen to receive a $340 million loan to start a new insurance CO-OP in New York. She led one of George Soros' organizations who also was linked to President Obama back when he was in the Illinois legislature.

Anne Filipiac - She served in the White House as Deputy Director of Public Engagement and had a prominent leadership role in the 2008 Obama for America campaign. She also worked at HHS. Now she is President for Enroll America. We all know how much the administration and HHS admire her organization, right Kathleen?

Planned Parenthood will be serving as navigators. They will be receiving grants to help educate and enroll consumers into the very services they provide. Seems like a pretty sweet deal.

Trevor Neilson - Former member of the Clinton Administration who is now president of Global Philanthropy Group has been targeted by the White House to get celebrity endorsements from the likes of his client list that includes: Eva Longoria, John Legend, and Madonna to name a few. Mr. Neilson served as one of President Obama's surrogates during the 2012 campaign.

The advertising firm Porter Novelli was founded by William D. Novelli, who was the CEO of  AARP from 2001-2009. Catherine “Kiki” McLean is a senior partner and managing director of Porter Novelli.  She is a Democratic Party operative who worked for the campaigns of Al Gore, John Kerry, and Hillary Clinton, as well as the 2008 presidential campaign of Barack Obama.  McLean was hired by Porter Novelli in June of 2009. Since 2010, Porter Novelli has been awarded $49 million in HHS contracts.

Must be nice knowing your time and donations can come back tenfold.