Tag Archives: Health Insurance

Cognitive Weppner Dissonance

1 Oct

The big news Tuesday afternoon was that the first case of Ebola was diagnosed Stateside, down in Texas. By the late afternoon, we knew that the afflicted man had flown from Liberia (a former American colony) to Texas to visit relatives. 

Around 4:45 pm, walking, talking insult to your intelligence Kathy Weppner tweeted and posted this to the Bookface

I enjoy the anti-vaxxer weighing in with his idiot opinion, but I actually can’t fault Weppner here. We should deal with it medically and not politicize a disease, and we should be ensuring that the disease is not spread. The CDC worked last night to remind people that you can only catch Ebola by coming into contact with the bodily fluids of someone who has the disease. 

Yet just 30 minutes later – at 5:16 pm – Weppner asked this question on social media: 

Wait a cotton-pickin’ minute. I thought we were supposed to deal with this medically, not politically! But here we are, worrying not about containing the spread of this virus, but how much it’s going to cost and whether the person is here “illegally”.  

I’m guessing the fact that the person had traveled to a place other than Ireland, they must be – according to Klownshoes Kathy – likely illegals. Of course, when someone flies to the United States from Liberia, they need to apply for a visa, their passport is checked prior to departure and their identity transmitted to the US authorities to ensure that they’re not on any list. Upon arrival, the traveler must go through passport control at the port of entry, as well as a customs check. Just like any of the other millions of travelers who come to the U.S. annually from non-visa-waiver countries. 

But, you know, all brown people are probably illegals.

Weppner also inadvertently makes the case for Obamacare or some other universal coverage construct – who’s going to pay?! Who knows? Who the hell cares? Who paid for the American volunteers in Africa who caught Ebola and were flown on private jets back to the States to get treatment? I don’t give a crap, and neither should you.  I’m just glad they’re ok. Likewise, I hope our Liberian visitor gets the medical care he needs so that he can enjoy his family and go home healthy and safe. One Ebola Liberian isn’t going to bankrupt the Republic. 

If the person was Texan and didn’t have insurance, that means they’re either in violation of the Affordable Care Act’s coverage mandate, and possibly that they fell into the gap left by indictee-cum-Texas Governor Rick Perry’s refusal to expand Medicaid in the U.S. State with the lowest rate of people with health insurance. Texas refused federal money to ensure that people who make too much for Medicaid, but too much for Obamacare subsidies to render private insurance affordable for their incomes. It was a deliberate, political choice to do harm to the most vulnerable people in Texas society. Perry is the person who was feted last night by local thug Carl Paladino and the tone-deaf Erie County Republicans and fusion Conservatives. 

So, yes, Kathy – we should treat the Ebola patient with medical care, and not politicize it at all. 

It’s high time you asked Thug Paladino and the local Republicans and fusion Conservatives why they’re backing this abhorrent, repulsive candidate. 

American Health Care: Higher Cost, Worse Outcomes

8 Oct

I usually don’t click on videos that people post to Facebook, but in this case I thought that it was an interesting topic – why is health care so expensive in the US and what can we do about it?  This isn’t a paean to Obamacare. On the contrary, one could argue that it sets out the argument in favor of a single payer system, rather than an expansion and maintenance of our horribly inefficient and redundant private insurance scheme. In any event, it’s worth a look. 

The Obamacare Trainwreck

18 Jul

While freshman congressmen vote – yet again – to weaken or eliminate Obamacare, the news was actually quite good yesterday.

Good in a “it’s not Medicare-for-all, but it’s a vast improvement over the status quo” sort of way.

Yesterday, New York State revealed that rates for individual health insurance plans will plummet by over 50% next year, thanks to Obamacare. These are the “exchanges” you’ve been hearing about. If you can’t afford a plan, there will be a sliding scale of federal subsidies to help you pay for it. Why? Because it is far cheaper for the government to subsidize health insurance plans than to reimburse municipalities for unpaid bills resulting from uninsured people using the emergency room as a primary care facility. In the long run, prevention is cheaper than dealing with acute problems.

About 40 – 50 million Americans remain uninsured, and caring for their emergencies is something that we all subsidize. Our healthcare system is the most expensive in the world, and gets results that have plenty of room for improvement. For instance, Canada – with its socialized single-payer system – has lower maternal mortality than the US. Canada also spends a bit more than half on health care per capita than the US.

We’ll let Professor Krugman explain why this is going to work – and work spectacularly well.

To understand what’s happening in New York, you have to start with what almost everyone at least pretends to believe: Americans shouldn’t find it impossible to get health insurance because of pre-existing conditions that aren’t their fault. Two decades ago, New York tried to deal with this by imposing community rating: insurance is available to everyone, and the price doesn’t depend on your medical history.

The problem was that this created a death spiral: young, healthy people didn’t buy insurance, worsening the risk pool, driving up premiums, driving out more relatively healthy people, etc., until you were left with a rump of very ill people paying very high rates.

How do you deal with this? Well, ideally, Medicare for all. But since that wasn’t going to happen, you improve the risk pool by requiring everyone to buy insurance — the individual mandate. And since some people won’t be able to afford that, you also offer subsidies. Voila! ObamaRomneycare!

Where does the money for the subsidies come from? Partly by reducing corporate welfare: reducing overpayments for Medicare Advantage, reducing tax breaks for very generous insurance plans; partly with new taxes on the wealthy.

And while a few people will be hurt — young, healthy individuals too affluent to qualify for subsidies, wealthy taxpayers, etc. — a much larger number of people will be helped, some of them enormously.

Does this amount to “redistribution”? Well, yes — not as an end in itself, but yes, a lot of people will be made better off at the expense of an affluent few.

The reason why Obamacare will be popular? People who are happy will stay happy, while people who are uninsured will become happy with their new coverage.

Implementation won’t much affect the 78 percent of Americans currently covered through Medicaid, Medicare, or employer group health plans,” and among the remaining 22 percent, the predominant effect will be to get some subsidized health insurance.

Because the Obama administration decided to postpone the employer mandate for health insurance on businesses with over 50 full time (over 30 hrs/week) workers, congressional Republicans – who have a pathological, partisan, political vested interest in the failure of universal health insurance – voted yesterday to delay the implementation of the individual health insurance mandate, which is Obamacare’s quid for the insurers’ pro quo of guaranteed coverage for people with pre-existing conditions. That mandate is why rates are going down in New York next year.

Among the people voting to postpone affordable insurance for millions of Americans was Chris Collins (NY-27), who has taken it upon himself as a clout-free congressional freshman to demonize Obamacare at every step.

The failure of Obamacare is a particularly acute need for Collins because he believes that he defeated Kathy Hochul on that issue alone. If the people in the 27th district suddenly have access to cheap, subsidized, quality health insurance, and discover that Obamacare isn’t the Stalinist Kenyan train wreck Collins has sold, they may very well turn on him and demand to know what his problem is.

Collins constantly talks about all the people who write to him, explaining that they will lose their hours at work thanks to Obamcare’s employer mandate. So, if he’s so concerned about these people, why doesn’t he sponsor legislation to protect those workers from that sort of thing? Could you imagine? Chris Collins sponsoring a worker protection law? I know, it’s a ridiculous notion because Collins exists only to protect business owners and the very wealthy. The idea of individual people having the government meet a need that private industry can’t or won’t is anathema to Collins and his conservative cohorts.

So, you’ll see Collins and other congressional Republicans constantly refer to Obamacare as a “trainwreck”, a catchphrase likely forged by Frank Luntz in the fires of Mount Doom. When Obamacare is implemented, and people begin to benefit from it, the conservatives will be exposed for the lying frauds they are.

The best part about this is that Republicans are so short-sighted and beholden to political expediency that they don’t realize that their constant “trainwreck” language is lowering the public’s expectations of Obamacare. If they are made to think it’s a disaster, and it doesn’t become a disaster, they’ll all look like idiot chicken littles.

Medicare Part D and the Children’s Health Insurance Program … got through their rocky implementations in large part because benefits obtained with bureaucratic difficulty are better than no benefits at all. He’s right, and this is why conservatives are “magnanimously” offering to delay implementation of Obamacare. They realize that once people have guaranteed access to health coverage, they won’t want to give it up, even if there are implementation problems.

The political landscape is already dire for those who still hope to repeal Obamacare, and they’re actually making their position worse by talking constantly about what a nightmare implementation is going to be. This fall, as the exchanges come on line, tens of millions of people are going to find they can get health coverage they never could before. They are likely to be quite happy about that, especially if they’ve been hearing for months in advance that it will be a mess.

So, when Obamacare is implemented and people are happy about it, I hope the voters take Collins’ scare tactics and throw them back in his face.

As an aside, I have asked Collins and his people numerous times in various media whether he holds health insurance through the federal government for himself and his family. I will conclude from the deafening silence that he does, and that excellent, federally subsidized health insurance is something to which he and his family are entitled – but you and I are not.

Not only that, but he will work tirelessly to prevent you and me from being guaranteed quality health insurance. Who goes into public service to screw the public?

 

The 47% and Irony

26 Sep

Let’s personalize Mitt Romney’s denigration of the 47%. 

Cindy Nerger went to her local Kroger’s to pick up groceries for her family. She paid using her food stamps, but the cashier and then the store manager said that she still owed $10. Ms. Nerger replied that this was not possible, because she knew that food stamps covered everything she had bought. To this, the store manager replied, “Okay, just give it to her.” Nerger said, “see, I told you it was covered by food stamps,” to which the manager replied, “excuse me for working for a living and not relying on food stamps!'”

Granted, it was likely one of the few times the manager of a Kroger’s in the middle of Georgia was able to lord it over anyone else, but still.

When the manager insulted her in that way, Nerger turned and saw the other people in line, felt humiliated, and left the store in tears. 

Moocher. 

But here’s the thing

Nerger said she started receiving food stamps, formally known as the Supplemental Nutrition Assistance Program, when she became eligible for Medicare and Social Security Supplemental Income because of kidney failure in 2008. While she waits for a kidney transplant, she cannot work because of daily 12-hour dialysis treatments. Her husband runs a carpentry business. “If he doesn’t get a call [for a job] we don’t have any extra money for the month,” she said.

Food stamps have been a hot issue in the presidential campaign, with Republicans labeling President Barack Obama the “Food Stamp President” and charging that Obama has deliberately increased dependency on government. The Great Recession and its aftermath have pushed SNAP enrollment to 46.6 million, up from 34 million at the same time in 2009.

Heartbreaking, right? Well, here’s the other thing:

However much the campaign issues might resonate in her personal life, Nerger said she doesn’t have cable and hasn’t been following politics or the presidential election. Still, she doesn’t think much of either Obama or his Republican opponent, Mitt Romney.

“They’re all gonna kill us,” she said. “Most of the people that we have to choose from — Obama with his spending and his health care reform, and then Mitt Romney, he just wants to let poor people die, so either way we’re doomed. So I don’t see any point in voting.”

Scroll back up to the part where she’s a Medicare recipient. She is a beneficiary of a federally run single-payer health insurance program and denigrates Obamacare and “spending”.

WTF, people. 

$1.6 Million Missing From Possible Cancer Cure

5 Sep

This article from the Telegraph is somewhat heartbreaking. Sitting in a freezer in the middle of Sweden is a virus that has been proven to target and kill cancer cells – and cancer cells only. The only side-effects are mild flu-like symptoms

It is a fact of human biology that healthy cells are programmed to die when they become infected by a virus, because this prevents the virus spreading to other parts of the body. But a cancerous cell is immortal; through its mutations it has somehow managed to turn off the bits of its genetic programme that enforce cell suicide. This means that, if a suitable virus infects a cancer cell, it could continue to replicate inside it uncontrollably, and causes the cell to ‘lyse’ – or, in non-technical language, tear apart. The progeny viruses then spread to cancer cells nearby and repeat the process. A virus becomes, in effect, a cancer of cancer. In Prof Essand’s laboratory studies his virus surges through the bloodstreams of test animals, rupturing cancerous cells with Viking rapacity.

Unfortunately, the man behind this discovery needs – and doesn’t have – about $1.6 million to handle the health and safety regulatory paperwork needed to start human clinical trials. 

Swedishly uninterested in profiteering, devoted only to the purity of science, Magnus and his co-workers on this virus have already published the details of their experiments in leading journals around the world, which means that the modified virus as it stands can no longer be patented. And without a patent to make the virus commercial, no one will invest. Even if I could raise the £2 million (I want only the best version) to get the therapy to the end of phase II trials, no organisation is going to step forward to run the phase III trial that is necessary to make the therapy public.

‘Is that because pharmaceuticals companies are run by ruthless plutocrats who tuck into roast baby with cranberry sauce for lunch and laugh at the sick?’ I ask sneerily.

‘It is because,’ Kjell corrects me, ‘only if there’s a big profit can such companies ensure that everyone involved earns enough to pay their mortgage.’

If you donate $1.6 million, you can have the potentially historic cancer-killing virus named after you. If you want to donate against that sum, donations are being accepted at The Oncolytic Virus Fund, Box 256, SE-751 05 Uppsala, Sweden. 

Finally, given the tenor and content of the health insurance debate in this country, this should not go unnoticed: 

…Uppsala University Hospital, a European Centre of Excellence in Neuroendocrine Tumours. Patients fly in from all over the world to be seen here, especially from America, where treatment for certain types of cancer lags five years behind Europe.

Sweden has a redistributive socialist universal health care system – among the best in the world.  It is a point of pride for the country that equal access to health care ensures a healthy population. The United States can’t even agree on that goal yet, much less the means with which to attain it. 

Happy Birthday, Romneycare!

16 Apr

Six years ago, Massachusetts’ then-Governor Mitt Romney signed the Commonwealth’s universal health insurance act into law. Try as Romney might, there is no doubt whatsoever that Obamacare directly descends from Romneycare – it is the Massachusetts plan writ large and federalized. Six years is the half-life, apparently, where a conservative path towards universal coverage becomes socialism. 

But Romneycare has resulted in an almost 100% coverage rate in Massachusetts, and though not perfect, has been dubbed a success story

Yet the 2012 model of Mitt Romney has nothing whatsoever to say about Romneycare on its sixth anniversary in the middle of a Presidential campaign. It’s his most significant and marketable achievement, and he’s painted himself into a rhetorical corner to avoid drawing attention to the similarities between Romneycare and Obamacare.  They’re almost identical. 

Romney’s argument in 2012 is that he’s proud of Romneycare, but disagrees with the notion that every state be required to follow one particular model. It’s the cowardly Republican’s disingenuous argument – when in doubt, go with state’s rights. The problem is that the crisis – really the shame – of uninsurance and underinsurance is a national one, one that requires a national response. The problems of medical bankruptcies (handled exclusively in federal courts), and of the uninsured using emergency rooms for primary care, the cost of which is then shunted onto taxpayers are national, federal issues. 

If Mr. Romney even believes these things to be problems needing solving, he should present a plan to fix them. If he wants to be true to his supposed 10th Amendment feelings, the federal government could simply mandate that states reach universal health insurance coverage, and let them each come up with their own ways to do so. 

I eagerly await President Obama to call Mr. Romney on this particular bluff. 

Well, Happy Birthday, Romneycare. Thanks for setting up the system that the federal government modified to apply to the entire country!

 

Common Council Approves Domestic Partnership Benefits

30 Mar

At the regular meeting of the City of Buffalo Common Council held today, the Council voted unanimously to approve an ordinance amendment sponsored by Council Members David Rivera and Michael LoCurto establishing Domestic Partnership Benefits for city employees.

After a thorough review of the potential costs associated with the domestic partnership benefit, the Council Members voted to approve the amendment with the following stipulations:

  • Both domestic partner members are of the same sex
  • Both persons currently share or have shared a common residence for at least six months as evidenced by proofs of residency required by the City’s medical insurance provider
  • Both persons are financially interdependent as evidenced by proofs of financial interdependence required by the City’s medical insurance provider.

This legislation extends to the registered domestic partner and eligible members of the families of city employees health, medical and dental benefits, and will take effect in 30 days.

(From a Common Council Press Release)

The Immediate Changes

24 Mar
A Medicare card, with several areas of the car...
Image via Wikipedia

From Nancy Pelosi’s blog:

IF YOU ARE A SMALL BUSINESSES OWNER:

  • SMALL BUSINESS TAX CREDITS—Offers tax credits to small businesses to make employee coverage more affordable. Tax credits of up to 35 percent of premiums will be immediately available. Effective beginning for calendar year 2010. (Beginning in 2014, small business tax credits will cover 50 percent of premiums.)

IF YOU ARE A SENIOR:

  • BEGINS TO CLOSE THE MEDICARE PART D DONUT HOLE—Provides a $250 rebate to Medicare beneficiaries who hit the donut hole in 2010. Effective for calendar year 2010. (Beginning in 2011, institutes a 50% discount on brand-name drugs in the donut hole; also completely closes the donut hole by 2020.)
  • FREE PREVENTIVE CARE UNDER MEDICARE—Eliminates co-payments for preventive services and exempts preventive services from deductibles under the Medicare program. Effective beginning January 1, 2011.
  • HELP FOR EARLY RETIREES—Creates a temporary re-insurance program (until the Exchanges are available) to help offset the costs of expensive health claims for employers that provide health benefits for retirees age 55-64. Effective 90 days after enactment.

IF YOU HAVE PRIVATE HEALTH INSURANCE:

  • NO DISCRIMINATION AGAINST CHILDREN WITH PRE-EXISTING CONDITIONS—Prohibits health plans from denying coverage to children with pre-existing conditions. Effective 6 months after enactment. (Beginning in 2014, this prohibition would apply to adults as well.)
  • NO RESCISSIONS—Bans health plans from dropping people from coverage when they get sick. Effective 6 months after enactment.
  • NO LIFETIME LIMITS ON COVERAGE—Prohibits health plans from placing lifetime caps on coverage. Effective 6 months after enactment.
  • NO RESTRICTIVE ANNUAL LIMITS ON COVERAGE—Tightly restricts new plans’ use of annual limits to ensure access to needed care. These tight restrictions will be defined by HHS. Effective 6 months after enactment. (Beginning in 2014, the use of any annual limits would be prohibited for all plans.)
  • FREE PREVENTIVE CARE UNDER NEW PLANS—Requires new private plans to cover preventive services with no co-payments and with preventive services being exempt from deductibles. Effective 6 months after enactment.
  • NEW, INDEPENDENT APPEALS PROCESS FOR NEW PLANS—Ensures consumers in new plans have access to an effective internal and external appeals process to appeal decisions. Effective 6 months after enactment.
  • MORE FOR YOUR PREMIUM DOLLAR—Requires plans to put more of your premiums into your care, and less into profits, CEO pay, etc. This medical loss ratio requires plans in the individual and small group market to spend 80 percent of premiums on medical services, and plans in the large group market to spend 85 percent. Insurers that don’t meet these thresholds must provide rebates to policyholders. Effective on January 1, 2011.
  • NO DISCRIMINATION BASED ON SALARY—Prohibits new group health plans from establishing any eligibility rules for health care coverage that have the effect of discriminating in favor of higher wage employees. Effective 6 months after enactment.

IF YOU DON’T HAVE HEALTH INSURANCE:

  • IMMEDIATE HELP FOR THE UNINSURED WITH PRE-EXISTING CONDITIONS (INTERIM HIGH-RISK POOL)—Provides immediate access to insurance for Americans who are uninsured because of a pre-existing condition – through a temporary high-risk pool – until the Exchanges up and running in 2014. Effective 90 days after enactment. (Beginning in 2014, health plans are banned from discriminating against all people with pre-existing conditions, so high-risk pools would phase out).
  • EXTENDING COVERAGE FOR YOUNG PEOPLE UP TO 26TH BIRTHDAY THROUGH PARENTS’ INSURANCE – Requires health plans to allow young people up to their 26th birthday to remain on their parents’ insurance policy, at the parents’ choice. Effective 6 months after enactment.

GENERAL REFORMS:

  • COMMUNITY HEALTH CENTERS—Increases funding for Community Health Centers to allow for nearly doubling the number of patients served over the next 5 years. Effective beginning in fiscal year 2010.
  • MORE PRIMARY CARE DOCTORS—Provides new investment in training programs to increase the number of primary care doctors, nurses, and public health professionals. Effective beginning in fiscal year 2010.
  • HEALTH INSURANCE CONSUMER ASSISTANCE—Provides aid to states to establish offices of health insurance consumer assistance to help consumers file complaints and appeals. Effective beginning in FY 2010.
  • A NEW, VOLUNTARY, PUBLIC LONG-TERM CARE INSURANCE PROGRAM—Creates a long-term care insurance program to be financed by voluntary payroll deductions to provide benefits to adults who become functionally disabled. Effective on January 1, 2011.

And in 2014, once the exchanges have formed, more insurance reforms go into effect, including:

  • NO DISCRIMINATION AGAINST ADULTS WITH PRE-EXISTING CONDITIONS
  • BAN ON HIGHER PREMIUMS FOR WOMEN
  • PREMIUMS BASED ON AGE CAN ONLY VARY BY A MAXIMUM OF 3-TO-1 RATIO
  • CAP ON OUT-OF-POCKET EXPENSES for private health plans

Good Thing

23 Mar

Last week, the polls may have shown that more Americans didn’t want health care passed than did.

But now that it’s passed, more Americans are happy that it did than aren’t.

What a difference a day, a win, and a little momentum make.

Physicians Payments Sunshine Act

23 Mar

Why, it’s as if the ghosts of Marx, Lenin, and Mao came back to life to bring us this:

…hospitals will have to post prices. Insurance products will be presented with standardized information, consumer ratings and quality measures. The payments physicians take from drug and device companies will be in a public database. There will be independent funding for research on the relative effectiveness of different treatments. Some of these changes are small and some are big, but put together, the system is going to become a lot more visible in the coming years.

Consumer protection and information? The horror.