Coming to Newstand Near You

Have you Heard Our Government is planning a comic book to explain Health Care Reform to its citizens.

A new comic book to explain President Obama's health-care reform is coming! It's being written by Jonathan Gruber, the MIT economist behind many of the reform's concepts!
We're talking in exclamation points because we hope the comic book borrows from the over-exclamation of such hallowed comics as Rex Morgan, MD and Mary Worth!
OK, the new venture may not go that far, says a Pulse report in the Boston Herald, but the idea of a 2,400-page document being reduced to splashy-colored panels with captions ought to amuse -- no matter on which side of the aisle you sit.
Gruber promises lots of pictures and text. That's because it's a graphic novel, a long-form comic book. But that doesn't mean it's a novel-novel, as in fiction. Gruber says he'll be using facts to tell the tale.
It already has a catchy title: Health Care Reform: What It Is, Why It's Necessary, How It Works

Pretty sure (NSFW Satire in following links)  Robot Chicken may have some fun with this during Adult Swim but I digress. Psst here is my favorite comic about the constitution.

Failure Of Central Planning Via HHS

It is indeed a positive trend to notice increasingly cogent reporting coming from the media and blogosphere with respect to Obamacare. Its about time!

 The media is finally reporting on trends average Americans know all too well in the season of open enrollment; Namely, that health insurance premiums are exploding to unaffordable levels particularly for child coverage under group plans. Worse yet, consumers have lost their ability to go to the individual market for child only coverage since insurers are want to write new business individual policies that will be completely unprofitable.

Merrill Matthews writes in Forbes of The Heavy Hand of Katherine Sebellius.

Jeff Jacoby writes in the Boston Globe of Obamacare Blowback.

John Stossell points out that HHS cannot Repeal The Laws of Economics. Quotes from Mr Stossell are below.

When Obamacare was debated, we free-market advocates insisted that no matter what the president promised, the laws of economics cannot be repealed. Our opponents in effect answered, "Yes, we can."
Well, Obamacare has barely started taking effect, and the evidence is already rolling in. I hate to say we told them so, but ... we told them so. The laws of economics have struck back.
Health insurers Wellpoint, Cigna, Aetna, Humana and CoventryOne will stop writing policies for all children. Why? Because Obamacare requires that they insure already sick children for the same price as well children.
That sounds compassionate, but -- in case Obamacare fanatics haven't noticed -- sick children need more medical care. Insurance is about risk, and already sick children are 100 percent certain to be sick when their coverage begins. So if the government mandates that insurance companies cover sick children at the lower well-children price, insurers will quit the market rather than sandbag their shareholders. This is not callousness -- it's fiduciary responsibility. Insurance companies are not charities. So, thanks to the compassionate Congress and president, parents of sick children will be saved from expensive insurance -- by being unable to obtain any insurance! That's how government compassion works.
In 2014, the same rule will kick in for adults. You now know what to expect.

Of Course Mr Stossell is 99% correct. his article points out that Obamacare has already precipitated Principal Financial Group from exiting the group medical market. Principal has arranged for United HealthCare to assume all group medical policies over the next 3 years. One minor point Mr Stossell is that Principal insures 840,000 group health policyholders totalling over 5,000,000 members. Most of these policyholders are small businesses. Many are carve-out plans covering salary only members. I spoke to one such policyholder  yesterday who due to business conditions will likely be dropping health coverage as of November 1, 2010. Do you think those employees will be happy when they vote November 2, 2010?

It should further be noted that everything coming to pass with Obamacare was completely predictable. The sad truth is that we used to have major medical coverage that covered hospitalization. People paid out of pocket for office visits and routine care including prescriptions. Then came Medicare introducing relative value reimbursement and co-pays. Then came the HMO Act of 1973 which normalized low co-pays for routine office visit, pharmacy coverage and deductibles for all health care. Health care inflation exploded. The consumer driven movement in Healthcare that began early in this decade was beheaded by Obamacare because HHS and the exchanges have deemed these plans innappropriate for consumers.

In yesterdays post I pointed out Marc Siegels prescient explanation here but what I did not quote then is relevant and is included below;

None of this is terribly surprising. I mean, imagine if your car insurance covered every scratch or dent. Wouldn't you expect your premiums to rise to meet the expanded coverage? And wouldn't you expect your auto repair shops to become clogged with cars that didn't really need to be repaired, competing for time and space with other cars with broken transmissions or burnt-out motors?
If we want lower insurance premiums, we will need to return to a system that favors high deductible, high co-pay catastrophic-type insurance with a built-in disincentive for overuse, such as the kind that some employers have provided as an option up until now. Patients could pay for office visits from health savings accounts or other flexible spending tax shelters. More than 10 million Americans already have such accounts.
Unfortunately, the new law is taking us away from the kind of insurance that compels patients to have more skin in the game. As a result, we'll all pay in the long run — both financially and with less efficient, perhaps even lower quality, care.


The kind of insurance the new law mandates will, over the years, wear out the health care system in the same way that overuse in orthopedics wears out an elbow or knee joint. This won't be fun for doctors or, most important, for patients.

Marc Siegel is an associate professor of medicine and medical director of Doctor Radio at NYU Langone Medical Center.

U.S. Health Care Versus England and Canada

Very interesting. Just so everyone can comprehend what President Obama means when he say's we will go broke without health care reform. This is the rationing he has in mind and what Harry Reid has placed under your Christmas Tree

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:
U.S. 65%
England 46%
Canada 42%
Percentage of patients diagnosed with diabetes who received treatment within six months:
U.S. 93%
England 15%
Canada 43%
Percentage of seniors needing hip replacement who received it within six months:
U.S. 90%
England 15%
Canada 43%
Percentage referred to a medical specialist who see one within one month:
U.S. 77%
England 40%
Canada 43%
Number of MRI scanners (a prime diagnostic tool) per million people:

U.S. 71%
England 14

Canada 18%
Percentage of seniors (65+), with low income, who say they are in "excellent health":
U.S. 12%
England 2%
Canada 6%
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."

Mitch McConnell and Olympia Snowe on Obamacare

Some truth from your minority America.

“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.”

Spreading New Yorks Bad Medicine

The NY Post has an excellent op-ed column providing insight into what you can expect if the current Health Care Reform proposals are enacted into law.

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

Lies, Damn Lies and Statistics II

Secretary of  Health & Human Services Kathleen Sebelius has issued a fact sheet outlining the benefits of Health Reform for Business quoting CBO as the source for the claims below.

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:

 

Lower administrative overhead. 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. The exchange centralizes what is otherwise a process that is extremely duplicative, streamlining administrative costs and lowering premiums.

 

Greater competition. 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.

 

Administrative simplification. 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]

 

Here we have the former Kansas State Insurance Commissioner, who ought to know better, telling some Orwellian whoppers such as;
 

•  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"?
  

So there you have it. Unemployment will be solved by all those new jobs in the exchange. But wait how does one reconcile the apparent 1-4% savings under reform with this statement?

• 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.”

 

Recently I spoke with the CEO of a large insurer with a significant presence in the U.S. individual health insurance marketplace. The CEO told me the average policyholder the firm covered would experience a 23% increase premiums due to the inclusion of mandates the government requires be in their plans. These are policies people purchased for catastrophic coverage the government has now decreed as inadequate. So ultimately its the healthy prudent Americans who secured their own catastrophic coverage who will pay dearly when some bureaucrat decides the appropriate premium ratio is 2-1 for those over 50 to those under 30 years of age. Theres your change suckers.

 

Health Care Reform

Harry Reid thinks he knows whats best for you. He's back with the public option again.

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.

Centralizing Healthcare

“The proletariat will use its political supremacy to wrest, by degree, all capital from the bourgeoisie, to centralize all instruments of production in the hands of the state… Of course, in the beginning, this cannot be effected except by means of despotic inroads on the rights of property”


— Karl Marx

Another Aspect Of Baucus Plan

From the Senator Baucus's press release

Responsibility for Employers – The Mark would not require employers to offer health insurance. However, effective January 1, 2013, all employers with more than 50 employees who do not offer coverage will have to reimburse the government for each full-time employee (defined as those working 30 or more hours a week) receiving a health care affordability tax credit in the exchange equal to 100 percent of the average exchange subsidy up to a cap of $400 per total number of employees whether they are receiving a tax credit or not.

 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?

America’s Health Future Act; Don't Drink The Kool-Aid

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.

Americans who like their health insurance and want to keep it can do so.

Unfortunately you will not be able to keep your own health insurance if you like it. You see with this bill existing health insurance will be grandfathered. That means the insurance companies will not have any new customers in those plans after 1/1/2013. How many companies would stick with a product when by law they could not offer the product to new customers? Would you? If I told a customer this at best I would be guilty of an error of ommision--the failure to mention a material fact--and at worst I would be lying. The only plans insurers can sell after 1/1/2013 are those whose rates and benefits conform with an as yet uncreated health exchange whose edicts on rate setting will be enforcable or the grandfathered plans that have no growth prospects. But have no fear the government will be using the internet to make it easier for you to buy coverage they have defined through their newly created exchange.If you like Medicare.gov and find it and the 1-800-medicare a bastion of information staffed by knowledgable call center personell who are unfailingly polite and extrardinarily helpful you are in luck.They should have trotted out the Guinness Guys for the Press conference. Brilliant! Politicans who missed the hundreds of thousands of Americans protesting on 912 in DC must think the average American has stupid painted across their forehead. Read for yourself from the press release.

 

Individual Market Reforms – The Mark would require insurance companies to issue coverage to all individuals regardless of health status; insurers would no longer be allowed to limit coverage based on pre-existing conditions. Limited variation in premium rates would be permitted for tobacco use, age, and family composition. Variation in rating would be allowed between geographic areas, but would not differ within a geographic area.

Small Group Market Reforms – Rating rules for the individual market would also apply to the small group market, as defined by states. This would include groups of one to 50 employees, but could include companies with up to 100 employees, depending on current state law.

Health Insurance Exchanges – The Mark would make purchasing health insurance coverage easier and more understandable by using the Internet to present consumers with available plans. The Mark would create state-based web portals, or “exchanges” that would direct consumers purchasing plans on the individual market to every health coverage option available in their zip code. The exchanges would offer standardized health insurance enrollment applications, a standard format companies would use to present their insurance plans, and standardized marketing materials. The exchanges would have a call center for customer support. The exchanges would also enable users to determine whether they are eligible for health care affordability tax credits or public programs and would enable consumers without access to the Internet to enroll through the mail or in person in a variety of locations.

Small Group Purchasing Through SHOP Exchanges − Under the Chairman’s Mark, small businesses would have access to state-based Small Business Health Options Program (SHOP) exchanges. These exchanges – like the individual market exchanges – would be web portals that make comparing and purchasing health care coverage easier for small businesses.

Transitioning to a Reformed Insurance Market – Once the insurance market reforms take effect, people who want to keep the insurance they have today can do so. Plans would be allowed to continue to offer the coverage they offer today and this coverage would be grandfathered. These grandfathered plans would only be available to those people who are enrolled today or, in the case of a small employer, to new employees and their dependents. People who qualify for the health care affordability tax credits in the reformed market would not be able to use the credits to purchase grandfathered plans. Tax credits would be offered only to purchase plans created in the reformed market that meet the new benefit standards.

 

Transitioning for Rating Requirements − Federal rating rules for the individual market (other than for grandfathered plans) would take effect by January 1, 2013. Federal rating rules for the small group market would be phased in over a period of up to five years, as determined by each state, with approval from the Secretary of HHS

Teddy Roosevelt on Reform

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.

COBRA Elections and Costs Accelerating

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.