Saturday 2 October 2010

Health Wonk Review: In the Here and Now

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I continue to be impressed with the quality of wonkery displayed by the folks whose submissions you'll see below. Looking back at the first 'Review I ever hosted, I was struck by how many wonk-bloggers [ed: is that even a word?] have left the 'sphere, but quite pleased to see names I recognize as still active: the Health Business Blog's David Williams, my favorite econ-blogger Jason Shafrin, and Workers Comp guru Jon Coppelman (all of whom appear in this edition, as well). I also noticed how short that review really was. I'm all for brevity when appropriate, but there's also no shame in piling on, especially when you read this week's entries.

In keeping with my newfound penchant for minimalism, posts appear in order of submission:

Rita Schwab has the sad tale - and important lesson - of little Taylee Blischke, who died at the hands of survived despite the efforts of incompetent, and unrepentant, physicians.

■ Bradley Flansbaum (aka The Hospitalist Leader) shares his comparison of The Great Emancipator and (what we at IB call) ObamaCare©. Guess who wins?

■ Peggy Salvatore uses an old (but timely!) joke to demonstrate the folly of government-supported EHR initiatives.

■ Rich Elmore at Healthcare Technology News reports on the Tiger Team on security and privacy recommendations on handling of personally identifiable health information. Important stuff.

■ Joanne Kenen's post is about how CareOregon, a medicaid managed care plan, has created patient-centered medical homes and adapted to its own population a successful care coordination program for patients with multiple and/or complex chronic disease. Interesting.

■ HWR co-founder Joe Paduda weighs in on the cost of voluntarily forgoing necessary health care. While I disagree with his reasoning (high deductibles and/or co-pays ate to blame), he makes a valid point:: delaying or forgoing primary care will increase future health care costs

■ Uber-wonk Dr Roy Poses posits that maybe - just maybe - having health care leaders' incentives actually aligned with patients' and the public's needs, and not so large as to elevate the leaders into the "Superclass" might work out better in the long run.

My favorite health care economist - Jason Shafrin - examines key provisions of ObamaCare@ from (you guessed it!) an economist's viewpoint.

■ Boston's Tinker Ready talks about "e-patient" Dave, and the contrarian's view of "positive thinking."

■ What does Joe's suddenly accelerating Camry have to do with HWR? Well, you'll have to click through to newcomer Michelle Woods' post on HIT (Health Information tech).

■ Austin Frakt, The Incidental Economist, believes that Rep. Ryan's plan for Medicare is unlikely to control costs because it is too much like the current [ed: but soon to be "late"] Medicare Advantage program.

■ Maggie Mahar takes a look at former HCA honcho - and current Florida gubernatorial candidate - Rick Scott and finds him wanting.

■ Ken Terry sings the Motown Blues, taking to task the waste of dollars being thrown at Detroit's hospitals. Stop, in the name of...common sense!

■ Workers Comp Insider's Jon Coppelman reports on the case of Americans with Disabilities versus the Occupational Safety and Health Administration. Who wins? Guess you'll have to read the post.

■ Jay Norris, of the Colorado Health Insurance Insider blog, writes about the newly-created Early Retiree Reinsurance Program, which enables federal funding to help pay for retirees’ health insurance.

■ Avik Roy, of The Apothecary (and a featured NRO blogger, as well), takes the contrarian viewpoint in defending the FDA's position i the recent Avastin kerfluffle.

■ Over at the Health Access Blog, Anthony Wright points out that California was the first state in the nation to have its legislature pass a bill to set up a health insurance exchange under health reform.

■ Dr Jaans Sidorov compares and contrasts this Administration's most recent spins with academic writings that "say it ain't so."

■ The eponymous John Goodman's Health Policy Blog reports that the The NCPA [ed: National Center for Policy Analysis] has released an evenhanded consumer’s guide to health care reform, focusing on both new benefits and costs, in a helpful Q&A format.

■ At the Health Affairs Blog, Michael O’Grady and Jennifer Baxendell Young propose an automatic adjustment mechanism in which federal Medicaid financing would increase for states suffering economic hardship, without the need for special Congressional legislation. Left unanswered: why only Michael's picture is on the post.

The Health Business Blog's David Williams interviews one of my favorite med-bloggers: Dr Evan Falchuk. What makes him a fave? Here's a sample: "We connect with people because we’re talking about real stuff." Trust me, this guy is important.

■ And finally, our own Bob Vineyard puts the smackdown on all the "wonderful" changes promised by ObamaCare©, including the fact that we now have fewer choices at higher costs.

That wraps up this week's episode of Health Wonkery. Please be sure to tune in again on the 16th when Jay's better half, Louise Norris, hosts the next edition.

Friday 1 October 2010

Mid-Week ObamaCare© Implementation Update

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First up (and as previously noted but now confirmed), Aetna will no longer write so-called "child-only" plans. These have been useful in, for example, divorce situations and some group-based scenarios, and are now off the table insofar as Aetna's individual medical plans are concerned. While this may not seem to be a big deal, it's a further erosion in the choices available in the (previously) open market.

This change is effective October 1st for Kentucky and Indiana, and November 1st for Ohio.

If you're tuning in late, these changes are a direct result of ObamaCare©'s careless and destructive assaults on basic risk management principles. For example, the new regs prohibit underwriting on "children" 19 years and under, which, according to the folks at Aetna, "have the potential to significantly increase the cost of premiums and make coverage unaffordable." Quite so.

On the other hand, Medical Mutual is poised to pick up at least a few of Aetna's minors:

"Medical Mutual will continue to accept applications and provide quotes for plans with effective dates of September 23, 2010, through October 31, 2010, for children under the age of 19 (either as a stand-alone product or as part of a family)."

Of course, no one really knows what's going to happen going forward from October. As the folks at MMO told us in email, "the Company reserves the right to withhold final approval based on clarification of state and federal regulations on individual plans or not issue a policy at all."

How's that for Hope and Change?

UPDATE: And this just in from United Healthcare's Golden Rule:

"In previous communications, we had informed you of an impending change to the coverage effective date that would take place on September 1, 2010. Due to broker feedback, this date has been moved to September 6, 2010."

Interesting that they received, and acceded to, what must have been fairly intense pressure from agents.

So beginning with new applications received on or after next Monday:

"Coverage effective dates for Golden Rule renewable health plans will be the later of 30 days after an application is received or the date requested by the customer (but no greater than 60 days)."

Glad they cleared that up.

Oh No She Din't!

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(That's not a typo - it's yours truly trying to be "hip")

Maybe she just can't help it, but HHS Secretary Shecantbeserious just doesn't quite "get" why those of us who oppose the train-wreck that is ObamaCare© might take some slight umbrage at this:

"So, we have a lot of reeducation to do" [emphasis added]

For those historically-challenged readers, here's why it's so offensive, and telling:

"The re-education camp remained the predominant device of social "control" in the late 1980s. It was used to incarcerate members of certain social classes in order to coerce them to accept and conform to the new social norms."

Looks like Kathy let the ol' mask slip.

BlogRoll Update

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I've been meaning to add Andrew Garland's entertaining and enlightening blog for some time, and am pleased as punch to have finally done so. You'll see the Easy Opinions link about 5 spots down from the top (look for the "NEW!" tag), and I heartily recommend clicking through.

You'll be glad you did.

Health Insurance Bridge to Nowhere

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The folks in Washington that gave us the "bridge to nowhere" have done it again, this time with health insurance. ERRP (Early Retirement Reinsurance Program) as announced by HHS is supposed to make it easier for employers to provide health insurance to early retirees. Congress authorized $5 billion of money they did not have to fund this program until 2014.


Most expect that will not be enough to support the program, but then, what else is new? According to Sunshine News:



Sixty-nine Florida businesses and government entities have been accepted into a new federal program designed to help employers and unions maintain health coverage for early retirees not yet eligible for Medicare.


The Early Retiree Reinsurance Program is designed to be a $5 billion bridge to the new federally mandated health insurance exchanges that begin in 2014.


But U.S. Rep. Bill Posey said the program looks more like a shell game, and it could come up short financially.



Rep. Posey is not the only one with this concern.



"The timing of this announcement by the administration is interesting because earlier this month Medicare trustees issued a report noting on page 183 that the new health-care law will result in nearly 6 million retirees losing their prescription drug coverage from their former employers -- a fact that went largely unreported," said Posey, R-Cocoa.


Posey added, "Nowhere in today’s HHS release is there a reference to HHS’ own warning to retirees that this program is largely unfunded -- by perhaps tens of billions of dollars.



Probably just an oversight . . .



The White House said immediate action was needed to bridge the health-care gap for early retirees, noting that the percentage of large firms providing retiree coverage dropped from 66 percent in 1988 to 29 percent in 2009.



Does the White House actually believe they can magically reverse a trend of the last 20 years when they can't reverse the unemployment and foreclosure trend of the last 2 years? Or do they only care if the voters believe this garbage?


The folks at EBRI, who have a pretty good handle on health insurance costs, have estimated the money for ERRP will run out in 2 years.


Just another stupid government trick from the folks who brought you Obamacrap.