Category: Insurance

This is the Best Idea that I have Heard all Day

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The canvassing board in Michigan has just certified the language for a petition to prevent hospitals to overcharge the uninsured:

The Board of State Canvassers on Monday unanimously approved the form a statewide ballot initiative petition that aims to prohibit a health care provider from charging a higher price to some for medical goods or services.

A group called Stop Overcharging is backing the “citizen initiated” legislation, which would limit a hospital or provider to charging somebody any more than 150 percent of the lowest amount the provider had accepted as payment in full.

The example they give is if somebody was charged $2,000 for an MRI but the provider accepted $600 as payment in full, the provider couldn’t force an uninsured person or auto accident victim to pay more than $900.

It’s something that has come up in the discussion of no-fault reforms. The petition is designed to incite action from the state legislature on that topic.

“We would hope that they would, we would wish that they would, but we’re preparing if they wouldn’t,” said Rocky Raczkowski, a former state lawmaker who is heading up the petition drive.

………

The Board of State Canvassers unanimously approved the petition as to form, meaning it meets state guidelines and can be circulated.

The group can start collecting signatures after the Nov. 4 election, and Raczkowski said they plan to move quickly. Asked if paid circulators would be circulating the petitions, he said the group was still examining its options.

There is some political baggage along with this, it seems to be associated with insurance “Reforms” that favor the auto insurance industry, but the idea that part of the healthcare delivery problem in the USA is the price of healthcare appears to be gaining currency, and this is a good thing.

The idea that, for example, the cost of an identical service can vary by over an order of magnitude at the same hospital in the is much, if not most of the problem here.

The New York Times revealed something very similar recently, when it discovered that many hospitals employed ER physicians who were out of network, who then price gouged patients, since they were not covered by any agreement with insurance carriers:

When Jennifer Hopper raced to the emergency room after her husband, Craig, took a baseball in the face, she made sure they went to a hospital in their insurance network in Texas. So when they got a $937 bill from the emergency room doctor, she called the insurer, assuming it was in error.

But the bill was correct: UnitedHealthcare, the insurance company, had paid its customary fee of $151.02 and expected the Hoppers to pay the remaining $785.98, because the doctor at Seton Northwest Hospital in Austin did not participate in their network.

“It never occurred to me that the first line of defense, the person you have to see in an in-network emergency room, could be out of the network,” said Ms. Hopper, who has spent months fighting the bill. “In-network means we just get the building? I thought the doctor came with the E.R.”

Patients have no choice about which physician they see when they go to an emergency room, even if they have the presence of mind to visit a hospital that is in their insurance network. In the piles of forms that patients sign in those chaotic first moments is often an acknowledgment that they understand some providers may be out of network.

Note that this sort of shenanigans is why ER doctors income has gone up in recent years.

ER’s are going Wall Street, and the only people who win in this game are the worst among us.

Obamacare Follies

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It turns out that large employers, particularly ones with large numbers of low paid employees, can issue complying plans that do not cover hospitalization>:

Lance Shnider is confident Obamacare regulators knew exactly what they were doing when they created an online calculator that gives a green light to new employer coverage without hospital benefits.

“There’s not a glitch in this system,” said Shnider, president of Voluntary Benefits Agency, an Ohio firm working with some 100 employers to implement such plans. “This is the way the calculator was designed.”

Timothy Jost is pretty sure the whole thing was a mistake.

“There’s got to be a problem with the calculator,” said Jost, a law professor at Washington and Lee University and health-benefits authority. Letting employers avoid health-law penalties by offering plans without hospital benefits “is certainly not what Congress intended,” he said.

As companies prepare to offer medical coverage for 2015, debate has grown over government software that critics say can trap workers in inadequate plans while barring them from subsidies to buy fuller coverage on their own.

………

Companies considering such plans include a restaurant chain with 1,000 workers, a trucking firm with 500 employees and dependents, a delicatessen, a fur farm and firms working the oil boom in upper Midwest, Flunker said.

Employer interest in the plans “is definitely picking up pretty quickly,” said Kevin Schlotman, director of benefits at Benovation, an Ohio firm that designs and administers health coverage. “These are organizations that are facing a significant increase in expenses. They’re trying to do their best.”

I rather imagine that WalMart is working to set up something like this.

Evil is as evil does.

This is what happens when you decide that the source of the problem must be “partners” in a solution.

The free market aspects of  American healthcare are what cause the high prices and opacity and poor outcomes. 

Expecting that stapling a few regulations on this system would fix it was delusional.

Seriously, Republican Judges are Just Phoning it in Now

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In the Hobby Lobby case, we have Justice Alito pulling a religious privilege for corporations out of thing air, but not for blood transfusions or psychology, because the people who oppose medical procedures are, Jehova’s Witnesses and Scientologists,  are icky.

They did the same thing with 150 years of precedent on recess appointments, etc.

Now with the ruling of the DC Court of appeals on Obamacare subsidies, they went off the deep end, and ruled that the subsidies only apply to states that have set up their own exchanges.

2 hours later, the 4th circuit court of appeals ruled the other way.

What’s more in the 4th Circuit’s opinion has an assent that absolutely nails the amazing level of hackitude in the DC Circuit’s opinion:

In fact, Appellants’ reading is not literal; it’s cramped. No case stands for the proposition that literal readings should take place in a vacuum, acontextually, and untethered from other parts of the operative text; indeed, the case law indicates the opposite. National Association of Home Builders v. Defenders of Wildlife, 551 U.S. 644, 666 (2007). So does common sense: If I ask for pizza from Pizza Hut for lunch but clarify that I would be fine with a pizza from Domino’s, and I then specify that I want ham and pepperoni on my pizza from Pizza Hut, my friend who returns from Domino’s with a ham and pepperoni pizza has still complied with a literal construction of my lunch order. That is this case: Congress specified that Exchanges should be established and run by the states, but the contingency provision permits federal officials to act in place of the state when it fails to establish an Exchange. The premium tax credit calculation subprovision later specifies certain conditions regarding state-run Exchanges, but that does not mean that a
literal reading of that provision somehow precludes its applicability to substitute federally-run Exchanges or erases the contingency provision out of the statute.

Seriously, conservative Judges will take any cockamamie fringe idea that some desperate for tenure right law professor, desperate for tenure can scrawl on a bathroom wall, and they are running with it.

They have completely lost it, because, to quote Blazing Saddles, “The Sheriff is a Ni!!!”

Detroit Retirees Vote to Cut Own Pensions, Bond Scum Plan to Fight it in Court

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I understand how insurance works: You sell insurance, and when someone makes a claim, you do whatever you can to screw your policy holders.

In the case of Detroit pensioners, who have no access social security as municipal employees, made concessessions, but the bond insurers want it all:

Two major bond insurers that could lose billions on Detroit’s bankruptcy blasted the city’s plan to pay retirees more than financial creditors and vowed to fight retirees’ endorsement of the deal.

After pensioners voted by a wide margin to accept cuts and allow the Detroit Institute of Arts to spin off into an independent charitable trust, bond insurers Syncora and Financial Guaranty Insurance Co. (FGIC) pledged to continue their vigorous legal fight against the city.

Judge Steven Rhodes will now conduct a confirmation trial starting Aug. 14 to consider evidence and witness testimony before determining whether the plan is fair, feasible and legal and can be approved.

The bond insurers — which backed a $1.4-billion debt deal brokered in 2005 by Mayor Kwame Kilpatrick’s administration to fund pensions — voted no on the city’s offer to them, which ranged from 0 to 10 cents on the dollar.

BTW, they want the Detroit Institute of Art, one of the finest art collections in the United States, to sell off all of its art, because they cheated Detroit with their (probably illegal) interest rate swaps, fair and square.

Not enough bullets.

Insurance Companies Go Postal on Advair, Sales Collapse

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It appears that pharmacy managers have decided that spending 5x as much as a French patient does is stupid:

Hallelujah. I never thought I’d see the day that I’d praise an insurance company. But the proverbial Atlas just shrugged.
Insurance company pharmacy benefit managers, who have apparently had it with drug companies charging American consumers ridiculously high, and ever-increasing, prices for prescription drugs, are starting to say “enough.”

 At the top of the list is my asthma drug, Advair.

 Some big insurance company pharmacy benefits managers are simply no longer permitting their plans to cover Advair. Or at best, they’ve relegated Advair to the lower “third tier,” which means the patient has to pay so much of the price that they simply won’t buy the drug at all.
As a result, Advair sales plummeted 30% this year in the US.

(emphasis mine)

It’s a battle between two groups of parasites, and I hope that there is a way for both of them to ose.

Come to think of it, there is, it’s called Single Payer, bitches.

This Comes as No Surprise

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Maryland is dumping its healthcare exchange, and replacing it with Connecticut’s technology:

Maryland officials are set to replace the state’s online health-insurance exchange with technology from Connecticut’s insurance marketplace, according to two people familiar with the decision, an acknowledgment that a system that has cost at least $125.5 million is broken beyond repair.

The board of the Maryland exchange plans to vote on the change Tuesday, the day after the end of the first enrollment period for the state’s residents under the 2010 Affordable Care Act.

Marylanders will be able to use the exchange even as it is being overhauled. The first enrollment period opened Oct. 1 and closes Monday for insurance coverage that kicks in this year. A second open enrollment period starts Nov. 15.

Like Maryland, Connecticut was one of the first and most enthusiastic states to embrace the idea of building its own insurance exchange rather than using a federal site to implement the law’s sweeping changes in health-care coverage.

But unlike Maryland, where the system crashed within moments of launching and has limped along ever since, Connecticut’s exchange has worked as smoothly as any in the country.

I do think that this means that I have to reevaluate my assessment of O’Malley as the front-runner in the “Not Hillary” presidential primary.

Still, the fact that Maryland has decided to end its attempt and move to a working system, and that it did so before Oregon, Minnesota and Hawaii, all of whom have similar problems, was the right thing to do.

Politics Trumps Good Policy

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Congress just voted to continue subsidizing morons who choose to build in flood plains:

The House of Representatives, in a bipartisan vote of 306-91 Tuesday night, agreed to limit premium rate increases under the National Flood Insurance Program.

 The bill must still pass the Senate or be reconciled with a version of flood insurance legislation that the chamber approved in January.

 If the House version becomes law, with President Barack Obama’s signature, the measure would eliminate some of the changes made in a 2012 law that required the Federal Emergency Management Agency to raise rates to reflect flood risk. The law was intended to reduce losses to the insurance program, which is $24 billion in debt.

 Conservative, libertarian, environmental and taxpayer watchdog groups opposed the bill, arguing that rates should be based on risk. Some said subsidies should be targeted only to people who couldn’t afford higher rates.

 Rep. Jeb Hensarling, R-Texas, said during the debate that he would oppose the bill because the flood insurance program was “one reason America is going broke.”

“It forces 96 percent of Americans to subsidize the remaining 4 percent, regardless of income or need,” Hensarling said.

You know, when Jeb F%$#ing Hensarling is one of the smarter people in the room, you are at a level of stupid that buggers the mind.

Of course, if I were in Congress, I would tell Mr. Hensarling that  the additional costs for the insurance program are a direct result of anthropogenic climate change, just to f%$# with him.

Obamacare Is a Subterfuge

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When one looks at Obama, and the neoliberal free market mousketeers who surround him, one has to to wonder just how much Obama, who actually taught at the University of Chicago, is in thrall to Chicago School economic theory.

While I do think part of the motivation for putting forward what became the PPACA was an attempt to “fix” the thoroughly dysfunctional healthcare delivery system in the United States, I also think that there has been an unspoken agenda, which is to sever the relationship between employers and their employees insurance.

If you talk to most economists, and all of the conservative “freshwater” economists, they will vehemently maintain that employer provided healthcare is economically unjustified, and so should be abolished.

When you look at the implementation of healthcare reform, it seems that one constant is that the employer mandate has been repeatedly delayed and weakened.

And today, they did it again:

For the second time in a year, the Obama administration is giving certain employers extra time before they must offer health insurance to almost all their full-time workers.

Under new rules announced Monday by Treasury Department officials, employers with 50 to 99 workers will be given until 2016 — two years longer than originally envisioned under the Affordable Care Act — before they risk a federal penalty for not complying.

Companies with 100 workers or more are getting a different kind of one-year grace period. Instead of being required in 2015 to offer coverage to 95 percent of full-time workers, these bigger employers can avoid a fine by offering insurance to 70 percent of them next year.

How the administration would define employer requirements has been one of the biggest remaining questions about the way the 2010 health-care law will work in practice — and has sparked considerable lobbying. By providing the dual phase-ins for employers of different sizes, administration officials have sought to lighten the burden on the small share of affected employers that have not offered insurance in the past.

As word of the delays spread Monday, many across the ideological spectrum viewed them as an effort by the White House to defuse another health-care controversy before the fall midterm elections. The new postponements won over part, but not all, of the business community. And they caught consumer advocates, usually reliable White House allies, by surprise, particularly because administration officials had already announced in July that the employer requirements would be postponed from this year until 2015.

Congressional Republicans seized on the announcement as the latest justification for scrapping the health-care law. In particular, they renewed their opposition to the law’s requirement that most Americans have insurance, saying it is unfair to delay rules for businesses and not for individuals.

Of course it’s unfair.

That’s a feature not a bug.

It is my belief that the goal of these actions is to create a space which will allow the minimization, and eventual elimination, of employer provided healthcare, because ……… freedumb and free markets.

This also explains why Obama has been so eager to cut a “grand bargan” with the ‘phants, and why he is so enthusiastic about trade deals like the TPP where freedumb and free markets trump democracy, labor rights, and environmental protections.

Congress Does the Right Thing, and then Scrambles to Repeal It

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I am talking, of course, about the attempts to repeal changes to the federal flood insurance program, so as to stop subsidizing people who choose to live in flood prone regions:

Setting aside objections from the White House and fiscal watchdogs, a bipartisan Senate majority voted Thursday to delay rate increases in federal flood insurance for coastal property owners from Maine to California.

The 67 to 32 vote reflected mounting political opposition to big insurance hikes that Congress passed in 2012 to prop up the nation’s nearly bankrupt flood insurance program. The bill, which faces an uncertain outcome in the House, would delay the increases for up to four years for hundreds of thousands of property owners across the country, including tens of thousands in Massachusetts.

The measure also postpones the adoption of a new set of official flood maps for coastal regions, which would have dramatically expanded areas designated as prone to floods and required thousands more to obtain costly insurance. In Boston alone, the number of properties encompassed in the new maps would rise from 8,000 to 18,000.

Floods are getting worse because of anthropogenic climate change, and the original maps were too conservative, and the rates were never appropriate to the level of risk.

The solution to ameliorating damage from flooding is not to pay people to live there.

Obama Punts on Equal Healthcoverage Coverage for CEO’s, Lets the 1% Loot Again

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One of the provisions of the PPACA was that senior executives had to get the same sort of insurance as the rest of their workers.

Well, it seems that the Department of Health and Human Services has decided that it’s just too hard to come up with rules to implement this portion of the statute:

The Obama administration is delaying enforcement of another provision of the new health care law, one that prohibits employers from providing better health benefits to top executives than to other employees.

Tax officials said they would not enforce the provision this year because they had yet to issue regulations for employers to follow.

The Affordable Care Act, adopted nearly four years ago, says employer-sponsored health plans must not discriminate “in favor of highly compensated individuals” with respect to either eligibility or benefits. The government provides a substantial tax break for employer-sponsored insurance, and, as a matter of equity and fairness, lawmakers said employers should not provide more generous coverage to a select group of high-paid employees.

But translating that goal into reality has proved difficult.

Officials at the Internal Revenue Service said they were wrestling with complicated questions like how to measure the value of employee health benefits, how to define “highly compensated” and what exactly constitutes discrimination.

Bruce I. Friedland, a spokesman for the I.R.S., said employers would not have to comply until the agency issued regulations or other guidance.

This sh%$ ain’t rocket science.

Either they are dragging their feet, or they are writing Byzantinely complex rules.

The only reason for complexity is to create loopholes that millionaire campaign contributors executives can drive their Beemers through.

In Which I Use the Words “Insurance” and “Fascinating” in the Same Sentence………

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Susie Madrak’s has a post at C&L about Christie’s allies in the New Jersey Democratic Party.

While I am not an expert on New Jersey Politics, that way madness lies, I was aware that South Jersey Dems tended to be more in line with both Christie’s policies and his manner.

Normally, I would not write about Suzie’s take on this, but she reveals a deep systemic problem with governance at the state and local level throughout the United States.

Specifically, she notes how insurance is routinely used as a way to generate undeserved profits for businessmen, and undeserved political contributions for politicians:

We talked about the legislative fight over funding Philadelphia’s then-new convention center. He called it “a boondoggle.”

 “Then why did the Republicans end up supporting it?” I said.

 He looked at me like I was a moron. “The bonds. The insurance. Follow the money,” he said. “The Republicans are making money off all that stuff. It’s always about insurance and bonds.”

 So I took his advice, and started delving into the esoteric world of municipal insurance. I discovered that the same insurance broker had almost every single insurance contract in the county, and that he was a heavy Republican contributor – which is why he got all those contracts in the first place.

 New Jersey has a broker like that. His name is George Norcross, and he’s a Democrat — at least nominally.

 To understand why he who controls the insurance controls the politics, you need to understand just how profitable insurance is. And if you own the political apparatus that runs along with it, you have a perpetual money machine that really doesn’t require much upkeep.

 It was the experience in the county I covered that the politically-connected insurance contracts cost an average of 30% more than a municipality or other entity would pay on the open market. Much of the excess profits get kicked back through political contributions. (These contracts are almost always an exception to the open bidding process, which makes it easy. Not so much for the homeowners paying the additional millage.)

 But there are other benefits. For instance, a cooperative insurance broker who wields that much power with the carriers makes sure there are quick and speedy confidential settlements regarding messy little matters like police brutality cases or public officials who are stealing money. They control which attorneys are retained by the carriers, and they’re always politically connected.

 It may be tidy, but it’s probably not democracy.

 Here’s an example of how Norcross works — and it’s all perfectly legal, even if the taxpayers get screwed:

In another DRPA-related transaction, Norcross’s insurance firm received $410,000—not for actually doing the authority’s insurance work, but for referring that business to another insurance firm, Willis of New Jersey. While a report last year from the New Jersey comptroller was critical of that arrangement, it also noted that there was technically nothing unlawful about it, a point Norcross reiterates when I bring it up. “Look,” he says, “the report itself says nothing happened that was illegal.”

Looking at this, and how the regulatory and legal environment not only enables, but encourages this behavior.

After all, when was the last time that your heard of an indictment, much less a conviction of an insurance broker doing a shady deal with a local government?

It’s the Iron Triangle writ local.

One Reason that My Insurance is Not Through the Exchanges

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Because Maryland’s insurance exchange is completely f%$#ed up:

More than a year before Maryland launched its health insurance exchange, senior state officials failed to heed warnings that no one was ultimately accountable for the $170 million project and that the state lacked a plausible plan for how it would be ready by Oct. 1.

Over the following months, as political leaders continued to proclaim that the state’s exchange would be a national model, the system went through three different project managers, the feuding between contractors hired to build the online exchange devolved into lawsuits, and key people quit, including a top information technology official because, as he would later say, the project “was a disaster waiting to happen.”

The repeated warnings culminated days before the launch, with one from contractors testing the Web site that said it was “extremely unstable” and another from an outside consultant that urged state officials not to let residents enroll in health plans because there was “no clear picture” of what would happen when the exchange would turn on.

Within moments of its launch at noon Oct. 1, the Web site crashed in a calamitous debut that was supposed to be a crowning moment for Maryland officials who had embraced President Obama’s Affordable Care Act and pledged to build a state-run exchange that would be unparalleled.

Instead, by the next morning only four people had signed up using the Web site — and amazed that anyone had gotten through the system successfully, state officials contacted each of them to make sure they were real. The site’s problems continue to prevent Marylanders from signing up for health insurance. As of Friday, 20,358 people had selected private plans, and state officials have said they do not expect to come close to their initial goal of 150,000 by the end of March.

This report is based on a Washington Post review of thousands of pages of previously undisclosed documents, including e-mails, internal reports, audits and court records, along with interviews with dozens of current and former contractors, state officials and others. The review shows that the creation of the exchange was dysfunctional from the start and that there were repeated missteps at almost every level.

I had to do something, MHIP was going away in June, as a result of the implementation of the PPACA, but the web site is a horror show.

It pushed me to take a serious look at the plan offered by the job shop that cuts my paycheck, and it turned out that an HSA offered through my employer, with the attendant tax advantages of pretax contributions, was the best deal.

They Really do Loathe Women’s Sexuality

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Hatred and fear of women actually enjoying sex, so they must be punished, even if it is a rape:

The Republican-dominated Michigan state legislature pushed through a bill on Wednesday requiring women to purchase separate insurance policies if they want to have an abortion, the Detroit Free Press reported.

“I don’t think elective abortion should be a part of insurance,” state Rep. Nancy Jenkins (R) told the Free Press. “This doesn’t affect access to abortion. It will still be legal when this law takes effect. Who should be required to pay? Not Michigan taxpayers.”

However, the law, which takes effect in early 2014, will also ban women from purchasing the policy after becoming pregnant under any circumstances, including rape and incest, causing opponents to refer to it as a policy on “rape insurance.”

The bill passed by a 27-11 margin in the Senate, and a 62-47 vote in the House, mostly along party lines. According to the Associated Press, state Senate Minority Leader Gretchen Whitmer (D) said during the debate that she was raped 20 years ago.

“Thank God it didn’t result in a pregnancy because I can’t imagine going through what I went through and then having to consider what to do about an unwanted pregnancy from an attacker,” Whitmer was quoted as saying. “If this were law then and I had become pregnant, I would not be able to have coverage because of this. How extreme, how extreme does this measure need to be?”

What is wrong with these people?

This is not ignorance, it is raw hatred and evil.

This is an Expected Consequence of Obamacare

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I have repeatedly stated that the first problem with healthcare is not the price of healthcare, not the cost of healthcare.

Absent fiat regulation, it is more important to initiate price competition both in insurance and in medical services, which means that the pricing will be clear, and high price insurance will be eschewed by consumers, and high price medical services will be eschewed by the insurance companies.

Therefore, it comes of no surprise that insurance companies are cutting the big name providers who charge a premium:

Americans who are buying insurance plans over online exchanges, under what is known as Obamacare, will have limited access to some of the nation’s leading hospitals, including two world-renowned cancer centres.

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients’ access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country.

This was not just foreseeable, it was the inevitable consequence of the Heritage Foundation designed plan.

In the long run, this is a good thing, because the consolidation of hospitals over the past few years has not been about efficiencies, but rather about the accumulation of pricing power.

You may not like that Sloan Kettering is not in your network, but in the long run, some for of price controls are essential to fixing our broken healthcare system,

Jon Stewart and Samantha Bee Take Down the Financial Press

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On a number of occasions, I have noted that it has been illegal to take out insurance on something in which one does not have an interest in its continued existence.

So, it’s illegal to take out a policy on your neighbor’s house, because otherwise, you would have an interested in burning it down.

This problem was first addressed, in the UK at least in the by the Marine Insurance Act of 1746.

The proximate cause was people who would buy insurance on a merchant ship, and then leak the manifests and schedules to the French, who were at war with the British at the time, and they would collect the insurance payouts.

It has been the law for longer then there has been the United States.

Only in the late 1990s, they decided that it did not apply to credit default swaps, and so the ripe-for-abuse “naked” CDS was born.

Well, the Daily Show found a story on Bloomberg about how the private equity firm Blackstone Group purchased a naked CDS on a 3rd party loan to the Spanish gaming company Codere.

Blackstone then made a loan to Codere that was conditional to their making their making a payment late on the aforementioned 3rd party loan, which was a “credit event” which netted the investment firm a $15,000,000.00 payout.

What I do not understand how this isn’t insurance fraud, except, of course, a CDS isn’t insurance, except, of course, that it is.

But besides the Bloomberg article there has been crickets from the financial press, which Jon Stewart and Samantha Bee discussed last night.

Brutal

You are Welcome to Our Health Care System Design, But We Insist that in Compensation, Rob Ford Be Appointed Mayor of Some Town in Vermont…*

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While we are talking about the progress of Obamacare, it is important to note that Vermont is going with a full up single payer system:

All but ignored in the multitude of media coverage about the ACA and its problems, Vermont has become the first state in the union to pass a single-payer universal health care law for its residents. It has a snappy slogan: Everybody in, nobody out.

The system will be fully operational by 2017, funded by Medicare, Medicaid, federal money for the ACA given to Vermont, and a slight increase in taxes. Everyone will be able to go to any doctor or hospital in the state free of charge. No plans to figure out, no insurance forms to sweat over, no gotchas.

………

Dr. William Hsaio, the Harvard health care economist who helped craft health systems in seven countries, was Vermont’s adviser. He estimates that Vermont will save 25 percent per capita over the current system in administrative costs and other savings. Employers will suddenly be free to give raises to their employees instead of paying for increasingly expensive health benefits. All hospitals and health-care providers in Vermont will be nonprofit. Medicare recipients will no longer need to wade through an inch-thick book to choose supplemental plans and sort out other complex options in their Medicare enrollment.

If (and it is a big if) Vermont can decide on the funding method, it should be fully implemented by 2017.

* Not my bon mot. Stolen from TP at the Stellar Parthenon BBS.

Not Eleventy Dimensional Chess, Just a Clusterf%$#

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The latest adjustment to Obamacare is a complete mess.

This is why he should have pushed for single payer, and settled for a public option, but Obama buys into the neoliberal consensus, so he took a rather uninspired idea from the f%$#ing Heritage Foundation, brushed off the dust, and presented it as the liberal “Great White Hope.”

While I will be saving a chunk of change next year, Obama chose what is the worst possible way of improving our failed healthcare system.

Why any Healthcare Reform Should Start With the Goal of F%$#ing the Insurance Companies

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I’m shocked, shocked to find that gambling is going on here!

Who could have imagined that Anthem Blue Cross and Wellpoint would used Obamacare as a mechanism to cheat their customers:

Anthem Blue Cross tricked tens of thousands of Calfornia policyholders into giving up health insurance plans from which they could not be dropped and pushing them into policies that Anthem knew would be cancelled, according to two lawsuits filed in Los Angeles.

 The lawsuits, filed Monday in Superior Court, may signal an emerging customer pushback against the approximately 900,000 cancellations in California alone of individual health insurance policies that will take effect Dec. 31.

 Before the Affordable Care Act, or Obamacare, was passed March 23, 2010, California policyholders who bought individual insurance policies and kept up with premiums were grandfathered in, meaning the insurer cannot drop them. However, policy holders who purchased their insurance after March 23, 2010, or who switched out of plans purchased before the law was enacted, are not grandfathered and must, by Jan. 1, 2014, pay for a policy that is compliant with Obamacare. In some cases that means premium increases, especially for those who don’t qualify for federal subsidies. Others will lose access to their personal physicians or trusted specialists.

 The two lawsuits allege that Anthem Blue Cross, California’s largest insurer and a unit of insurance giant WellPoint Inc., deceptively enticed tens of thousands of Californians to switch out of their grandfathered plans, a practice known as “twisting,” in violation of a state law and to cut its own costs.

This is why Obama’s initiative to bring in the insurance companies as “Stakeholders” was a disastrous decision.

They were not stakeholders, they were among healthcare’s worst offenders. Bringing them into the decision making process is akin to bringing in Willie Sutton as a bank security consultant while he was still robbing banks.*

*It should be noted that after he left the slam, Sutton did serve as a security consultant for banks, but that was after he stopped robbing banks.

Well, This Explains a Lot

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Talking Points Memo has discovered that insurance companies are deceiving their customers in an attempt to extract higher premiums out of them:

Donna received the letter canceling her insurance plan on Sept. 16. Her insurance company, LifeWise of Washington, told her that they’d identified a new plan for her. If she did nothing, she’d be covered.

 A 56-year-old Seattle resident with a 57-year-old husband and 15-year-old daughter, Donna had been looking forward to the savings that the Affordable Care Act had to offer.

 But that’s not what she found. Instead, she’d be paying an additional $300 a month for coverage. The letter made no mention of the health insurance marketplace that would soon open in Washington, where she could shop for competitive plans, and only an oblique reference to financial help that she might qualify for, if she made the effort to call and find out.

 Otherwise, she’d be automatically rolled over to a new plan — and, as the letter said, “If you’re happy with this plan, do nothing.”

 If Donna had done nothing, she would have ended up spending about $1,000 more a month for insurance than she will now that she went to the marketplace, picked the best plan for her family and accessed tax credits at the heart of the health care reform law.

 “The info that we were sent by LifeWise was totally bogus. Why the heck did they try to screw us?” Donna said. “People who are afraid of the ACA should be much more afraid of the insurance companies who will exploit their fear and end up overcharging them.”

 Donna is not alone.

Why the heck are they trying to screw you?

Because they are Insurance Companies, theat’s why they are trying to screw you.

Like the scorpion said to the turtle,  “It’s my Nature.”