Wednesday, December 23, 2009
Tuesday, December 22, 2009
Friday, December 18, 2009
A recent "Investor's Business Daily" article provided very interesting statistics from a
survey by the United Nations International Health Organization.
Percentage of men and women who survived a cancer five years after diagnosis:
Percentage of patients diagnosed with diabetes who received treatment within six months:
Percentage of seniors needing hip replacement who received it within six months:
Percentage referred to a medical specialist who see one within one month:
Number of MRI scanners (a prime diagnostic tool) per million people:
Percentage of seniors (65+), with low income, who say they are in "excellent health":
I don't know about you, but I don't want "Universal Healthcare" comparable to England or Canada .
Moreover, it was Sen. Harry Reid who said, "Elderly Americans must learn to accept the inconveniences of old age."
Thursday, December 17, 2009
“This isn’t an energy bill. This is an attempt by a majority to take over one sixth of the U.S. economy — to vastly expand the reach and the role of government into the health care decisions of every single American — and they want to be done after one substantive amendment. This is absolutely inexcusable.
“I think Senator Snowe put it best on Tuesday:
‘Given the enormity and complexity,’ she said, ‘I don’t see anything magical about the Christmas deadline if this bill is going to become law in 2014.’
“And I think Senator Snowe’s comments on a lack of bipartisanship at the outset of this debate are also right on point.
“Here’s what she said in late November:
‘I am truly disappointed we are commencing our historic debate on one of the most significant and pressing domestic issues of our time with a process that has forestalled our ability to arrive at broader agreement on some of the most crucial elements of health care reform. The bottom line is, the most consequential health care legislation in the history of our country and the reordering of $33 trillion in health care spending over the coming decade shouldn’t be determined by one vote-margin strategies – surely we can and must do better.’
“The only conceivable justification for rushing this bill is the overwhelming opposition of the American people. Democrats know that the longer Americans see this bill the less they like it. Here’s the latest from Pew. It came out just yesterday.
“A majority (58 percent) of those who have heard a lot about the bills oppose them while only 32 percent favor them.”
“There is no justification for this blind rush — except a political one, and that’s not good enough for the American people.
“And there’s no justification for forcing the Senate to vote on a bill none of us has seen.
“Americans already oppose this bill. The process is just as bad.
“It’s completely reckless, completely irresponsible.”
Friday, December 11, 2009
“The number one thing is to fight right now the government takeover of our economy.”
To illustrate the scope of that takeover, she cited “an economist from Arizona State University” who calculated that by January 2009, government had already taken ownership or control of 30 percent of our economy. “Now if President Obama gets his way with health care, that’s an additional 18 percent of the economy” — for a total of 48 percent. Cap and trade would add another 8 percent, for 56 percent total. Rep. Barney Frank’s bill that the Financial Services Committee votes on tomorrow would raise that another 15 percent for a grand total of 69 percent, she calculated.
“It isn’t within our lifetime that we’ve gone to socialism,” Bachmann said. “It’s within 18 months!”
Spreading New York's bad medicine
By STEPHEN T. PARENTE & TARREN BRAGDON
Last Updated: 9:05 PM, December 9, 2009
Posted: 1:42 AM, December 9, 2009
New York's individual health-insurance market is not often held up as a national model, and for good rea son. It's the most regulated, most expensive and, as a result, one of the smallest in the country, with only a few costly health plans available.
Since New York policymakers inflicted costly regulations on insurers in 1994, enrollment in the individual insurance market has plummeted by 96 percent.
Current prices are staggering. In New York City, the cheapest individual plan costs $9,036 a year for a single person and $26,460 for a family. In contrast, the Congressional Budget Office estimates the average national family premium at $12,000 to $15,000 a year.
Yet both the House and the Senate health-reform bills would make the rest of America look more like New York's dysfunctional market -- and then force New Yorkers to foot a larger share of the trillion-dollar cost.
Only five states now have New York-style insurance regulations, but both bills force those rules on all 50 states and then force people to buy coverage or face tax penalties. Think about it: If 45 states don't regulate insurance like New York does, there is probably a very good reason. And there is: These regulations drive up costs and limit choices.
Adding insult to expensive injury, Congress also plans to expand Medicaid coverage. Here, too, New York is an example of what not to do. The Empire State has the most expensive Medicaid program in the country -- spending as much as Texas, Florida and Illinois combined.
New York's Medicaid program is the fourth largest among all the states as a percentage of the population enrolled, yet the state's rate of uninsured ranks 24th highest in the country. Of the 26 states with a lower rate of uninsured than New York, only two have a larger share of residents on Medicaid.
Clearly, doubling down on Medicaid is not the right path to universal coverage -- yet Congress wants to push millions of Americans into Medicaid and thrust new costs onto the states.
Read more: http://www.nypost.com/p/news/opinion/opedcolumnists/spreading_new_york_bad_medicine_5f6AoI9hr8WKAjwlzuSj7H#ixzz0ZO8RazRX
Read more: http://www.nypost.com/p/news/opinion/opedcolumnists/spreading_new_york_bad_medicine_5f6AoI9hr8WKAjwlzuSj7H#ixzz0ZO85KC2p
Tuesday, December 8, 2009
Premiums for small business will go down. Small businesses are likely to see premiums drop by 1 to 4 percent under the proposal due to lower prices. These lower prices come from:
- Small businesses are likely to see premiums drop by 1 to 4. Really? No underwriting, no pre-eexisting conditions and the price will drop? Try dropping the crack pipe.
- Right now, each small business has to consult with a broker or hire someone to collate plan information, assist employees with decisions, and handle issues as they arise. Under reform, in the exchange, there will be people whose job it is to provide plan information and facilitate enrollment. You can keep the plan you have but you won't need your broker any longer as a government employee will now come out to your location, explain the coverage and collate all your enrollment data as part of facillitating enrollment. These new federal exchange employees will no doubt possess all the answers to your questions regarding HIPAA, ADA, FMLA, COBRA, ARRA.
- CBO attributes savings to “providing a centralized marketplace in which consumers could compare the premiums of relatively standardized insurance products.” This includes competitive pressure from a public health insurance option. You mean like the brokers did before the state took on this role?
Physicians spend on average about 140 hours and $68,000 a year just dealing with health insurance bureaucracy.[v] By simplifying and standardizing paperwork and computerizing medical records, doctors will be able to focus on caring for their patients instead of dealing with bureaucracy. CBO estimates nearly $20 billion in Federal savings over 10 years, with additional savings accruing to businesses and families.[vi] This is great news. The government can just hand over that slick paperless system Medicare and Medicaid use today to eliminate waste. Medicare has been around since 1965 so they must have a bulletproof administrative process worked out by now right? I guess that's the $20B handed over to special interests as part of the spendulous package that has seized up investment in EHR's like the potion they poured into the cash for clunkers while HHS defined "meaningful use"?
- Businesses can keep what they have.
- CBO affirms that any proposed benefit mandates would not affect the small or large group markets: “The requirement would have relatively little effect on premiums in the small group market, however, because most policies sold in that market already cover those services and would continue to cover them under current law.”
Tuesday, December 1, 2009
A study in the January-February 2009 issue of the journal Health Affairs concluded that 75 percent of the country’s $2.5 trillion in health care spending has to do with four increasingly prevalent chronic diseases: obesity, Type 2 diabetes, heart disease and cancer. Most cases of these diseases, the report stated, are preventable because they are caused by behaviors like poor diets, inadequate exercise and smoking.
Obesity alone threatens to overwhelm the system. In a recent study, Kenneth Thorpe, chairman of the department of health policy and management at the Rollins School of Public Health at Emory University, found that if trends continued, annual health care costs related to obesity would total $344 billion by 2018, or more than 20 percent of total health care spending. (It now accounts for 9 percent.)
Dr. Thorpe also said that if the incidence of obesity fell to its 1987 level, it would free enough money to cover the nation’s uninsured population.
Of course the New York Times would never think of pointing out such an obvious fact during the health care debate on its editorial page.
For the record I made the same point about the cost of unhealthy behavior on this blog in April 2007.
Wednesday, November 25, 2009
Tuesday, November 17, 2009
The task force also recommends against teaching breast self-examination because no data exists to show it reduces deaths. That would be news to many women including my best friends wife who recently detected a lump which turned out to be malignant breast cancer. I suppose if you are a professional athlete wearing pink the last few weeks you were duped and 25 years of messaging to raise awareness was pointless?
The timing of such an announcement during breast cancer awareness month is suspect and at a time when healthcare reform awaits a senate vote is simply outright stupid. Yet it does foretell what we can expect under Obamacare when clinical guidelines rooted in data supplant physician judgement. I thought the American Cancer Society's chief medical officer succinctly summarized the core issue;
Dr. Otis Brawley, the American Cancer Society's chief medical officer...said the statistics suggest the task force is “essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them.”
Brawley added that the task force is saying screening 1,339 women in their 50s to save one life makes it worthwhile in that age group, but that screening 1,904 women in their 40s to save one life isn't.
The American Cancer Society, he said, believes the benefit outweighs the harm in both cases.And this is precisely why The US survival rates for breast cancer surpass nations worldwide with socialized medicine. Women's groups should be rightly up in arms over this edict. Watch it hit the fan over the next few days.
Monday, November 16, 2009
Friday, October 30, 2009
Big U.S. Companies Balk at Health Care Public Option
Excerpt: "Some of the nation's largest companies pushed back against U.S. Democrats' plans to deliver a government-run insurance option in a healthcare overhaul, decrying it as a step backward that would drive up costs for employers and their workers. The Business Roundtable, comprised of chief executives at Verizon Communications . . ., JPMorgan . . ., General Electric . . ., Wal-Mart . . . and other companies that together employ more than 12 million people, said the federal government is inefficient and would underpay providers. That would result in providers boosting prices for private insurers and employers, the group said on Wednesday." (Reuters)
Business Groups Push Hard Against the Senate Health Reform Bill
Excerpt: "Lobbyists for employers thought they had staved off a public plan in the Senate after the Finance Committee opted not to include the idea in its version of the health legislation. They were caught by surprise when the public plan resurfaced and Majority Leader Harry Reid (D., Nev.) said it would be in the bill brought to the Senate floor, albeit with an option for states not to participate." (The Wall Street Journal)
Constitutionality of Health Overhaul Questioned: Legal Scholars Divided Over Congress' Authority
Excerpt: "On top of all the other obstacles facing President Obama in his quest to pass health reform is this one: Does the U.S. Constitution allow the government to require uninsured Americans to buy medical insurance or impose a tax penalty if they refuse? Congress has never before required citizens to purchase any good or service, but that is what both House and Senate health bills would mandate." (The Washington Times)
Wednesday, October 28, 2009
Here is a great blog that offers insights into the real objective of the public option.
Now the democrats are starting to eat their own, witness Robert Reich here pointing out how obamacare shafts the middle class and ignores the current economic woes our nation faces that are the elephant in the living room.
Thursday, October 1, 2009
Friday, September 25, 2009
Thursday, September 24, 2009
- Marcus Tullus Cicero (106-43 B.C.)
Friday, September 18, 2009
Ever spend any time on itunes looking at random app's? I admit I do. I look at the free ones because I'm cheap. Anyhow I run across one called FML and its very popular. I click and look at it to find;
If you’ve never been the website FMyLife, it’s kind of like Twitter for losers who just can’t get a break… people post very short anecdotes about how F’d their lives are, always ending with the abbreviated mantra “FML”, and then the rest of the world votes on whether the person’s life is truly F’d or if they got what they deserved. Here are a few:
There is something sad about a culture that competes to demonstrate how terrible their life is, not too mention how shallow is the individual who lifts himself by tearing down another in the comments section of a website or blog? But we have all seen such individuals. The web has coarsened our national rhetoric. Just another reminder why you need to communicate the access to your EAP.
Thursday, September 17, 2009
Meanwhile, The President is slated for a full Ginsburg on the Sunday talk shows followed by Letterman on Monday for a full hour. Making dogfood is just not a pretty sight.
Wednesday, September 16, 2009
— Karl Marx
As a general matter, if an employee is offered employer-provided health insurance coverage, the individual would be ineligible for a health care affordability tax credit for health insurance purchased through a state exchange. An employee who is offered coverage that does not have an actuarial value of at least 65 percent or who is offered unaffordable coverage by their employer, however, can be eligible for the tax credit. Unaffordable is defined as 13 percent of the employee’s income. A Medicaid-eligible individual can always choose to leave the employer’s coverage and enroll in Medicaid. In this circumstance, the employer is not required to pay a fee.
Your government has deemed spending 12.99% of your before tax income on health care premiums is affordable and you do not qualify for a health care affordability tax credit.
How's that change working out for you now?
Senator Baucus has released his long awaited Health Care legislation.The full text of the America’s Health Future Act is available here
Let me call your attention to just one aspect of the proposed bill from Senator Baucus's press release.
Tuesday, September 15, 2009
Excellent summary of the challenges our nation faces in bending the health care cost curve down.
Fewer and fewer Americans are at low risk for cardiovascular disease, according to an important and frightening new report on long term trends from the National Health and Nutrition Examination Surveys (NHANES) of adults 25-74 years of age.
In the most recent survey (1999-2004) only about 8% of US adults had a low risk profile, despite favorable trends in reducing smoking and cutting cholesterol. The overall increase in risk was due to the increased prevalence of diabetes, obesity, and hypertension, said the CDC’s Earl Ford, and his colleagues, in their report in Circulation.
Of major concern, the long term trend observed by the study was troubling. Following the early 1970s, when very few people had low risk factor profiles, progress appeared to be made, as the survey found substantial increases in the proportion of people with low risk profiles in the late 1980s and early 1990s. But then the hopeful trend reversed in the mid 1990s, apparently in accord with the increase in obesity and diabetes
Low risk was defined as;
•not currently smoking
•total cholesterol <200 mg/dL and not using cholesterol-lowering drugs
•blood pressure <120/80 mm Hg and not using antihypertensive drugs
•BMI <25 kg/m²
•no previous diagnosis of diabetese
WSJ Health Blog has an interesting piece up on just how prevalent non compliance for prescription medicines is today that will be of interest to those benchmarking pharmaceutical compliance. This is a coachable moment for wellness advocates as 1/3 of americans do not adhere to their prescription routine.
Monday, September 14, 2009
What is the out of pocket maximum?
Who is in the network?
What is the co-pay, if there is one?
What are the coinsurance levels?
What does the plan cover?
What is excluded?
What does it cost?
Does my HSA go away?
What coverage is available for prescription drugs?
"While there are some difficult issues to be worked out...If you misrepresent this plan We will call you out"
How could someone possibly misrepresent the plan? There is no plan. There is only the expectation a newly created government bureaucracy free from any political pressure will create an insurance exchange that will define a plan options that will reduce out of pocket costs for all Americans while expanding coverage to the uninsured allowing everyone to retain coverage they like, with the doctor they like, without rationing, while preserving Medicare and not adding a penny to the deficit while simultaneously bending the cost curve down on Medicare spending. Call me a skeptic, hell call me out Mr President but just how you propose to do these things would interest many Americans. Do tell. Americans who ask the questions above deserve answers and by the way it coarsens the national debate when David Axlerod goes on television and suggests they are wrong for asking the basic questions anyone purchasing healthcare would ask. If you are going to sell health care reform you need to have answers for basic questions about costs and benefits or else your're just asking Americans to trust you and congress to get it right. We trust you, Nancy Pelosi & Harry Reid like the Shamwow salesman on cable TVwho you increasingly resemble except that shamwow guy at least covers costs and benefits. The shamwow guy does not pretend to be anything but a salesman, a charlatan and a snakeoil salesman. You could learn from him.
Saturday, September 12, 2009
Friday, September 11, 2009
Today we mark the eighth anniversary of 9-11.
The following two videos are 'moving' to say the least. They are must views by all, lest we forget that horrific day in our history and those who are sacrificing to ensure America never has to experience that again.
NEVER forget and ALWAYS remember there are evil people who want to harm us and our nation - some of which are right here on our soil.
And, do not let this Day be remade into a day of 'national service' by those in government who do not appreciate nor understand the greatness of our nation, the wisdom of our Founders or the cost of freedom.
September 11 is, and must remain a day of rememberance, reflection, thanks, prayer, honor, and a reminder of our vulnerabilty.
May God bless our great nation.
Friday, September 4, 2009
Teddy Roosevelt was a giant in the progressive era. As our nation debates health care reform and the President addresses congress next week I am struck by the prescience of TR articulating his famous man in the arena speech in one of the lesser known passages. My own belief is that it offers great insight into the outcry President Obama faces as evidenced by his rapidly dropping poll numbers. The comparison between two Presidents is striking.
The citizen must have high ideals, and yet he must be able to achieve them in practical fashion. No permanent good comes from aspirations so lofty that they have grown fantastic and have become impossible and indeed undesirable to realize. The impractical visionary is far less often the guide and precursor than he is the embittered foe of the real reformer, of the man who, with stumblings and shortcoming, yet does in some shape, in practical fashion, give effect to the hopes and desires of those who strive for better things. Woe to the empty phrase-maker, to the empty idealist, who, instead of making ready the ground for the man of action, turns against him when he appears and hampers him when he does work! Moreover, the preacher of ideals must remember how sorry and contemptible is the figure which he will cut, how great the damage that he will do, if he does not himself, in his own life, strive measurably to realize the ideals that he preaches for others. Let him remember also that the worth of the ideal must be largely determined by the success with which it can in practice be realized. We should abhor the so-called "practical" men whose practicality assumes the shape of that peculiar baseness which finds its expression in disbelief in morality and decency, in disregard of high standards of living and conduct. Such a creature is the worst enemy of the body of politic. But only less desirable as a citizen is his nominal opponent and real ally, the man of fantastic vision who makes the impossible better forever the enemy of the possible good.
Saturday, August 29, 2009
On the one hand we have avowed statists like the President, Speaker Pelosi, Majority Leader Harry Reid and many congressional democrats who favor what I call the Field of Dreams approach. The essence of this approach is if you build it they will come. Components include an entirely new Federal Bureacracy including a healhcare exchange to sell you the coverage you are required to buy from the public plan which was designed by a federal committee largely appointed by the President. Proponents of this approach know they cannot come right out and take a stand for single payer for many reasons;
1. The blue dogs would be savaged in future elections by seniors who lost the Medicare Advantage coverage they loved when the reimbursement was cut to fund the coverage for the uninsured.
2. The vanguard of the proletariat that is our present near supermajority does not believe the American people are smart enough to understand the intricate issues involved in health care reform like rationing. No matter they will act for all us little people. It is why we elected them in their minds.
3. Demonizing the insurance companies, the HMO's ( a federal creation by the way) and the rich doctors is a proven tactic which tosses red meat to their base while diverting attention from the fact the government accounts for 60% of the health care spend today.
4. Incrementalism works and Medicare remains the sacred cow.
5. Polls show many Americans are satisfied with their own coverage and their own doctors and will resist overt change as congress is learning at the townhalls.
6. Someone might point out that universal coverage mandated by the states and controlled has not stopped medical inflation in workers compensation.
On the other hand we have voices speaking out for market solutions that are being shouted down as obstructionists, mere drones who articulate platitudes from Fox News or talk radio. No one is focused on what unites us as American's. We have only the extremes and no statesman. No one is looking at the root cause of the current crisis but is rather seeking to exploit the crisis for their own self interest.
One of the insurance companies I worked for years ago developed a fully integrated product to cover health care, workers compensation, short term disability, long term disability. If we build it they will come said the visionaries in marketing. Very few employers bought the product because they wanted the flexibility to replace vendors by product. They resisted also resisted having all their products with one vendor as a problem in one area would require them to move all products. Nothing was unbundled you see. An infamous story circulated at the company where an executive stood before senior management pleading for more money time until the market recognized the value and was chastised by the CFO; "You keep coming in hereselling the same dog food and the dog just won't eat that crap". He built it but they did not come. Obamacare reminds me of that dog food. And the dog still won't eat that crap.
Monday, August 24, 2009
In January I blogged about the impact on COBRA the ARRA spendulous package would have. Evidence is emerging that COBRA elections have doubled on average and in savaged areas of the economy like manufacturing COBRA elections are up 800% according to a Hewitt survey.
Health Care reform is all over the news yet according to the Hewitt survey COBRA elections saw the smallest increase of any segment increasing from 10% to 12%. Why is that you might ask? It is due to the fact that employment remains strong in this economic segment and those who lose their job can find another.
I find it ironic that amidst the highest unemployment figures in the U.S. since the great depresssion and facing a recovery which the only economist who predicted the subprime meltdown predicts will be anaemic and below trend in advanced economies with a big risk of a double dip recession one who questions the wisdom of enacting central planning in the healthcare sector is dismissed as bearing false witness by the leader of the free world.
Friday, August 21, 2009
Of the 21 top Democratic House leadership members and chairmen, five come
from districts carried by John McCain, but the average vote in the other 16
districts was 71 percent to 27 percent for Obama. Like Los Angeles’ Maxine
Waters and New York’s Anthony Weiner, they are ideologically and geographically
insulated from the skepticism generating from the great middle of the
It’s a mistake that the architect of Medicaid and Medicare, Lyndon Johnson, never made. A Southern Democrat—sometimes derided by liberals as an “Eisenhower Democrat” when he was Majority Leader of the Senate—understood the need for bipartisan support for any major social reforms: His Medicare bill received the support of 70 House Republicans and 16 Senate Republicans. Even Newt Gingrich got it—his Welfare reforms gained the support of 101 Democrats at the high-water mark of the second Republican Revolution.
Liberals are in deep denial about the source of the president’s falling poll numbers during this summer’s health-care debate. They think the problem—perceptions of arrogant over-reaching liberalism—is the cure. It’s the same self-serving mistake that the extremes always make.
President Obama needs to depolarize the health-care debate. He got off-message because he got off-center. Embracing a bipartisan bill that replaces the public option with a nonprofit co-op will not “muddy” the debate but help clarify it. It will not
be a retreat but a way forward.
Lyndon Johnson once joked that “the difference between liberals and cannibals is that cannibals don’t eat their friends and family members.” In half-century-long history of failed health-care reforms from Harry Truman on down, liberal cannibalism has been as much to blame for defeats as fear-mongering from the far right.
The perfect cannot be the enemy of the good. The goal is to decrease costs and increase coverage. If today’s liberals don’t understand the lesson of their own political history and insist on attacking their president, they will have the failure of
this health-care reform on their hands.
Thursday, August 20, 2009
- Fact #1 Health Care reform will include coverage for illegal aliens. What Obama is not stating is that he favors immigration reform in 2010 that places illegal immigrants on a glide path to citizenship. In the insurance industry we would call that an error of omission--the failure to mention a material fact.
- Fact#2 Americans already pay taxes to cover the uninsured in Federal Taxes and Local Taxes. Further expanding Medicaid will only add to the unfunded mandates imposed on Americans by Washington as we have all noticed by the emergence of tea parties on the news each evening. To quote the bi-partisan CBO ;
"The tables included in the report summarize our preliminary assessment of the coverage provisions’ budgetary effects and their likely impact on rates and sources of insurance coverage for the nonelderly population. According to that assessment, enacting those provisions by themselves would result in a net increase in federal budget deficits of $1,042 billion over the 2010–2019 period. By 2019, CBO and the JCT staff estimate, the number of nonelderly people who are uninsured would be reduced by about 37 million, leaving about 17 million nonelderly residents uninsured (nearly half of whom would be unauthorized immigrants)."
So lets just say fact #2 is essentially that Americans already know they pay for illegal immigrants today and are mad as hell the supermajority is seeking to increase what they pay by a $trillion while the President and congressional democrats tell us we are uninformed and that any health care reform cannot add to our debt. In America we call that **&%#^%!!! Is it any wonder today's Rassussen Poll shows that 54% of all Americans who fear government will do too much is up ten points from 44% in January... BTW see all my uninsured posts here. Illegal aliens know how to access free health care and thus lack an incentive as well as the income frequently to purchase their own.
- Fact #3 You can keep your coverage and no one will be forced into government run healthcare. Lets once again see what the CBO has to say on this whopper of a lie.
Under the proposal, nearly 90 percent of workers would be employed by firms that
would either have to offer qualified coverage and contribute a significant share
toward the premium or pay a tax equal to 8 percent of their total payroll. That “playor-
pay” penalty would constitute a substantial portion of the average cost of providing
insurance coverage, which has been estimated at about 12 percent of payroll currently
(but which would rise over time). In dollar terms, the penalty would obviously vary
depending on a firm’s payroll; for example, a firm with average wages of $40,000 per
year that did not offer qualified coverage would have to pay a penalty of $3,200 per
worker. Moreover, that penalty would make no direct contribution to those workers’
insurance costs; they would then need to obtain coverage from another source in
order to fulfill the individual mandate.
Workers who get insurance through their employer receive a significant subsidy
because the cost of that insurance is not treated as taxable earnings for the worker and
thus avoids both income and payroll taxes. In most cases, that exclusion applies to the
portion of the premium that workers pay as well as the amount the employer
contributes. On average, that tax exclusion gives workers a subsidy of roughly
30 percent for purchasing insurance through their employer—a subsidy that would be forgone if the employer chose not to offer coverage and the workers instead obtained coverage in the new insurance exchanges.
Bottom line is that the lie that you can keep your present coverage is patently false on multiple levels.
- It does not account for the behavior rational employers will display faced with a tax or mandate to offer health coverage. Unintended consequences abound in politics.
- It does not account for the tax impact on workers who not only get to purchase their own heath care when their employer drops coverage but also lose the tax advantage CBO cites at 30% of the value of employer provided health care. I thought it was John McCain who wanted to tax American's on the value of their health care?
- Access to private insurers for individuals whose employers drop group coverage will be through an exchange created by the federal government which will be up running and ready to guide you in your coverage selection. Really? Sort of like Medicare.Gov does so well now?
- Self-funded plans will face mandates to cover items which they do not today and employers who have spent years investing in wellness and behavioral incentives to achieve a competitive advantage in their industry and have actually bent their own health care cost curve down will now face audits by the government who has no experience or expertise in achieving the same.
Fact #4 It is the Democratic Majority not Radical Republicans, Insurance companies, Doctors, pharmaceutical Companies and Fringe Elements Bearing False Witness who are obstructing Passage of Health Reform.
Rather than share my own thoughts on this matter let me quote Camille Paglia writing in Salon who very succinctly captures the state of our nation.
But who would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises -- or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.
There is plenty of blame to go around. Obama's aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.
You can keep your doctor; you can keep your insurance, if you're happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.
I just don't get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.
As with the massive boondoggle of the stimulus package, which Obama foolishly let Congress turn into a pork rut, too much has been attempted all at once; focused, targeted initiatives would, instead, have won wide public support. How is it possible that Democrats, through their own clumsiness and arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist Republicans is nonsensical, because Democrats control the White House and both Houses of Congress. It isn't conservative rumors or lies that are stopping healthcare legislation; it's the justifiable alarm of an electorate that has been cut out of the loop and is watching its representatives construct a tangled labyrinth for others but not for themselves. No, the airheads of Congress will keep their own plush healthcare plan -- it's the rest of us guinea pigs who will be thrown to the wolves.
Fact # 5 Health Reform Will Raise Not Lower The Cost of Health Care For The Average American It Will raise Costs
Under the proposed exchanges being considered the government will mandate all benefits which must be offered by either public or private plans and will audit self funded plans. Larger employers who self fund have frequently achieved lower health care costs than insured plans. Thats what happens when you invest in wellness since as I have posted here about 70% of health care costs are attributable to behaviors that we control namely not exercising, smoking, drinking, not eating correctly and all the other things your Mom warned you about. Where I ask in the health reform proposals are the sections which specify the wellness incentives necessary to change the behaviors which drive 70% of the cost? They do not exist today but wait for the regualtions to show up by bureaucratic edict in 5 years along with the junk food taxes,soda taxes, higher alcohol taxes, couch potato tax and BMI tax.
There is an excellent summary here of why health insurance costs so much.
Recently I was listening to a radio program in which the host explained that in a few states health insurance policies issued by Blue Cross/Blue Shield were available at extremely reasonable prices, about $100 a month. The very first caller into the program demanded to know exactly what the annual deductible was in plans like this. When the host said $3,000 to $5,000 the caller responded, that isn't health insurance but catastrophic insurance. It's too expensive and that's why we need health care reform from Washington, he continued.
And there lies one of the problems with the health insurance reform debate. State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit. We've been schooled in this attitude by politicians who have mandated that health insurance do things that we'd never expect from other kinds of insurance, and by consumer advocates who will demand our legislators do something about a health insurance company that doesn't cover some optional procedure that has nothing to do with life and death.
What effect do you think imposing congresses vision of an appropriate health benefit package including every special interest mandate imaginable on America's largest self-funded employers would have on America's ability to compete in a global economy?
About 20% of the cost of health care for working Americans can be attributed to Prescription Drugs. While the average American does not go to the doctor or hospital each month they do use their health plan for presciption drugs each month on average. The White house proudly announced they had secured $8B in cost reductions annually from the pharmaceutical industry for the next 10 years. In contrast, Medicare spends $800B annually on prescription drugs but the white house deal leaves intact an agreement with pharmaceutical companies and the PBM's that handle Medicare not to negotiate prescription drug prices. This is madness. This is insane. It is incompetence. And one might reasonably question the ethics and judgement of an administration which cuts a deal on pharmaceuticals with parties that are now funding tv ads in support of health reform through an ad agency formerly owned by a current advisor to the president David Axlerod. But I digress, he point not negotiating over drug prices raises costs for Medicare and Senior citizens and makes American companies less competitive
One Big Truth
So why is health reform so urgent now? It's simply a matter of convenience. There is the fiscal crisis followed by the bailouts and the stimulus that all require new taxation. Obama's agenda is Education, Energy and Health Care. On the health care front reform was supposed to bend the cost of Medicare/Medicaid and reduce the deficit but since he cannot overtly mention his intention to tax the hell out of the middle class along with the rich he is going to do so under the guise of cap and trade and health care reform. You see the way health insurance works is that young healthy people subsidize generally older and sicker people. Medicare has a $38T deficit and Part D is just getting rolling. By requiring all Ameicans to purchase insurance through a government exchange including mandated benefits you do not want or need you eliminate the private insurance markets while simultaneously generating all the excess revenue you need to continue the enormous ponzi scheme we all know Medicare to be at its core. Once the insurer's are gone Uncle Sugar can dictate terms while using exploding costs to achieve the holy grail of single payer when the rationing can begin.Madoff gets prosecuted and Obama gets re-elected and the Democrats get to run in 2010 having delivered health insurance reform. Yet Obama and congressional leaders are discovering American's are on to the scam and we are sick of the lies and fingerpointing.
Wednesday, August 19, 2009
Tuesday, August 18, 2009
This whole debate gets back to the simple question I have not heard any of
the co-op proponents answer: Just how will a co-op turn out to be any different
than North Dakota Blue Cross with its profit percentage of less than 1% and its
board a cross section of the provider, business, and consumer community?
Monday, August 17, 2009
Thursday, August 13, 2009
Wednesday, August 12, 2009
Public support for the health care reform plan proposed by President Obama and congressional Democrats has fallen to a new low as just 42% of U.S. voters now favor the plan. That’s down five points from two weeks ago and down eight points from six weeks ago.
A new Rasmussen Reports national telephone survey shows that opposition to the plan has increased to 53%, up nine points since late June.
More significantly, 44% of voters strongly oppose the health care reform effort versus 26% who strongly favor it. Intensity has been stronger among opponents of the plan since the debate began.
Sixty-seven percent (67%) of those under 30 favor the plan while 56% of those over 65 are opposed. Among senior citizens, 46% are strongly opposed.
Obama seems to be surrounded by juvenile tinhorns, bumbling mediocrities
and crass bully boys.
Case in point: the administration's grotesque
mishandling of healthcare reform, one of the most vital issues facing the
nation. Ever since Hillary Clinton's megalomaniacal annihilation of our last
best chance at reform in 1993 (all of which was suppressed by the mainstream
media when she was running for president), Democrats have been longing for that
happy day when this issue would once again be front and center.
would have thought that the sober, deliberative Barack Obama would have nothing
to propose but vague and slippery promises -- or that he would so easily cede
the leadership clout of the executive branch to a chaotic, rapacious,
solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her
smooth aplomb under pressure, has clearly gone off the deep end with her bizarre
rants about legitimate town-hall protests by American citizens. She is doing
grievous damage to the party and should immediately step down.
The president is promoting the most colossal, brazen bait-and-switch
operation since the Bush administration snookered the country into invading Iraq
with apocalyptic visions of mushroom clouds over American cities.
You can keep your doctor; you can keep your insurance, if you're happy
with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And
what if my doctor is not the one appointed by the new government medical boards
for ruling on my access to tests and specialists? And what if my insurance
company goes belly up because of undercutting by its government-bankrolled
competitor? Face it: Virtually all nationalized health systems, neither
nourished nor updated by profit-driven private investment, eventually lead to
I just don't get it. Why the insane rush to pass a bill, any bill, in
three weeks? And why such an abject failure by the Obama administration to
present the issues to the public in a rational, detailed, informational way? The
U.S. is gigantic; many of our states are bigger than whole European nations. The
bureaucracy required to institute and manage a nationalized health system here
would be Byzantine beyond belief and would vampirically absorb whatever savings
Obama thinks could be made. And the transition period would be a nightmare of
red tape and mammoth screw-ups, which we can ill afford with a faltering
As with the massive boondoggle of the stimulus package, which Obama
foolishly let Congress turn into a pork rut, too much has been attempted all at
once; focused, targeted initiatives would, instead, have won wide public
support. How is it possible that Democrats, through their own clumsiness and
arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist
Republicans is nonsensical because Democrats control all three branches of
government. It isn't conservative rumors or lies that are stopping healthcare
legislation; it's the justifiable alarm of an electorate that has been cut out
of the loop and is watching its representatives construct a tangled labyrinth
for others but not for themselves. No, the airheads of Congress will keep their
own plush healthcare plan -- it's the rest of us guinea pigs who will be thrown
to the wolves.
Wednesday, August 5, 2009
Insurance is designed to protect against an unforeseen future loss. Forcing an insurer to cover a loss which has already taken place is welfare as John Stossell points out in this article. We have a very imperfect health insurance market today. Alas the world is still flawed. In the nirvana that many on the left imagine when everyone is covered by health insurance Pre-existing conditions would all be covered and indeed the insurance industry has agreed with this reform. Theoretically, the problem would be solved. Realistically, costs will increase as the risk pool absorbs individuals with chronic health problems that for many reasons, some within and some out of their control, today lack coverage. Realistically there will be individuals who ignore mandates to buy health coverage as there are today in Massachusetts.
So when insurers are demonized by Nancy Pelosi and other left wing fringe elements just remember no matter how hot the August heat gets no one likes to swim in a pool someones just peed in, or worse.
Tuesday, August 4, 2009
Monday, August 3, 2009
Sunday, August 2, 2009
Freespending Congressmen and President Obama need only look at Governor Scwarzeneggar's popularity and California's current budget deficit to get a vision of what their future holds.