Friday, 28 June 2013

Hunger Games and the MVNHS©

Sometimes, the headline really is the story:

Nearly 1,200 people have starved to death in NHS hospitals because 'nurses are too busy to feed patients'

On the one hand, this apparently took place over four years, so that (presumably) "only" about 300 Brits per year were killed off this way. Still, death by starvation is no treat:

"Pain in the stomach often quickly develops, then can turn into digestive and waste-related syndromes such as severe and painful constipation followed by uncontrollable diarrhea. Early symptoms of starvation include faintness, weakness, and dizziness. Thirst may also rapidly increase."

Oh, and apparently starvation isn't the only problem facing patients victims of the Much Vaunted National Health Service©:

"[F]or every patient who dies from malnutrition, four more have dehydration mentioned on their death certificate."

No big deal, really: just think of it as a very dry Liverpool.

And speaking of the MVNHS
© and pools, the good news for "aspiring glamour model" Josie Cunningham is that she'll be a knockout in a bikini. That's because the rocket plastic surgeons at the Much Vaunted National Health Service© gave the go-ahead for her "upgrade" to 36DD (and no, that's not her seat number).

The bad news is that these same folks took a pass on "upgrading" 2-year old aspiring walker Oliver Dockerty. Apparently the boobs in charge at the MVNHS
© found Ms Cunningham's case more, ahem, compelling. After all, why would any two-year-old want to walk?

Obamacare Stress Relief

The Obamacare exchange opens October 1, 2013 but will it be ready to roll?

Probably not . . .
That process is complex enough by itself. How much coverage do you want? What deductible? Are family members on the plan? Do you need an asthma program? Do you want to keep your current doctor? What about dental?
Kaiser Health News

That's getting ahead of yourself.

Before selecting a plan, if you go through the exchange you need to know if you qualify for a subsidy. That is a 45 minute process.
Like other filtering software, Connecture’s program is a multi-step search engine, screening out inappropriate options (based on your input) to deliver a manageable menu. After getting past the basics (Stripped-down “bronze” plan or high-benefit “platinum”? High deductible or low?), the program asks if it’s important to keep your current doctor.
“Based on our research, the choice of doctor was probably the No. 1 and No. 2 [features] of what people are looking for in a plan,”
Good luck on that.
It may be almost impossible to find "your" doc on the exchange plans.
Need to see if your drugs are on the formulary?
Fat chance
To try to reduce sticker shock, Connecture shows your net premium price — after the tax credits are applied — early in the shopping process. But perhaps the most important feature is the one estimating the total cost of coverage, including deductibles and co-pays, based on your reported health status. Without that information somebody with a chronic condition requiring lots of care could choose a plan based only on a low premium, not realizing the total expense could be substantially reduced by paying a larger premium up front.
How is this working for you so far?
Might need to chill out a bit.

Friday Morning Updates

Updates on a couple of yesterday's items:

■ Unlike Aetna and UHC, Anthem will not be sending out rebate checks to Buckeye State insureds. Via email:

"On June 1, 2013, Anthem filed the required MLR report with Health and Human Services for the 2012 calendar year and met the required loss ratio for all lines of business for 2012. This means no notices will be sent and no rebates will be issued."

Good for them!

■ Hobby Lobby, much like Beckwith Electric, gets a reprieve on implementing the birth control convenience item mandate (Hat Tip: Hot Air):

"The 10th Circuit Court of Appeals moved to reverse a lower court's decision to deny Hobby Lobby Stores Inc.'s quest for an injunction against part of the Affordable Care Act that requires it to cover the cost of emergency contraceptives for some of its employees."

It's not a done deal, though: the case now goes back to the lower court for another round.

Still, some good news heading into the weekend.

Stuck in Folsom Prison

RIP Johnny Cash. Yes, he did spend time in prison but fortunately for him he had a trade to fall back on once he got out.

Perhaps the same is true for today's felons.
Republican senators slammed the Patient Protection and Affordable Care Act’s navigator program Thursday arguing that the rule is so lenient that a convicted felon could qualify as a navigator and get access to consumers’ confidential health information.
“The standards proposed by your Department could result in a convicted felon receiving federal dollars and gaining access to confidential taxpayer information," the letter stated. "The same standards allow any individual who has registered with the exchange and completed two days of training to facilitate enrollment, as if the decision to purchase health insurance is similar to the decision of registering to vote." 
Life Health Pro

and time keep dragging on . . .

Thursday, 27 June 2013

Obamacare Whether You Like it or Not


They're baaaack: ObamaWaiver Mania

In fairness, this first item isn't so much an ObamaWaiver as a court-ordered time-out:

"A Largo high-tech engineering firm doesn't have to offer emergency contraception under its medical plan while its case challenging part of the federal health care law is pending in court"

The company's owner is a "devout Southern Baptist" whose religious beliefs [ed: remember when those were protected under the First Amendment? Good times, good times], prohibit abortifacients. Timing is everything, which seems to be working in Mr Beckwith's favor: since his "insurance plan was up for renewal this month, Beckwith could have been required to start covering the contraceptives while the case was under review. U.S. District Judge Elizabeth Kovachevich granted Beckwith a reprieve, saying the company may be due religious protections under federal law."

Whew!

There's no denying, though, that this one is a full-bore ObamaWaiver:

"The Obama administration on Wednesday broadened an exemption for American Indians from the new health care law's [Evil Mandate] ...  tribal advocates are pleased that the administration added an exemption for Native Americans who are eligible for services through an Indian health care provider."

Um, guys? Be careful what you wish for. You might just get it.

MLR: More Loony Results

And the hits just keep on comin'. Last week, LifeHealthPro's Allison Bell reported that "insurers did a better job of meeting the new federal minimum medical loss ratio (MLR) targets in 2012 than in 2011, and they will end up paying fewer rebates to a smaller number of people."

Maybe so, maybe not:

■ FoIB Jeff M tips us that "North Carolina health insurance consumers will receive close to $10 million in [MLR] rebates"

But how will the other 57 states fare?


Via email, we learn that "[b]eginning in June and by August 1st, Aetna is scheduled to mail rebate notices and checks to policyholders and subscribers whose plans are due a rebate ... In this second year of MLR reporting, Aetna's rebates represent 0.2 percent of the premiums we collected"

That's down quite a bit from last year (the first for which MLR "rebates" were due), which the carrier interprets as indicating that they've met their pricing goal.


United Healthcare is also rolling out their 2013 MLR rebate initiative. Via email we learn that:

"In the second Medical Loss Ratio (MLR) Reporting Year, UnitedHealthcare’s results show that 83 Aggregation Sets in total (group and individual combined) qualified to receive premium rebates totaling $149,861,252 for 2012."

That's also down from last year; in fact this year's rebates are less than half of last year's.


  Interestingly, both carriers indicate that the checks will be going to the group (employer) for distribution. Chalk that up as one more accounting and tax headache for businesses.

Guess who pays for that?

Wednesday, 26 June 2013

Punchline: RomneyCare vs The ObamaTax


"A very interesting ACA development is taking place in Massachusetts today as the state that “inspired” Obamacare tries to reconcile its current law with the new federal law ... The amendment that was filed would force President Obama’s good friend Governor Deval Patrick (D), and his Administration, to seek a waiver from certain elements of Obamacare." [emphasis added]

Too. Funny.

Cavalcade of Rick #186 now on line....

Van Mayhall hosts this week's grand collection of risk-related posts, covering everything from the new Insurer Provider Fee to the FHA's stance on mortgage insurance cancellations.

And a friendly reminder to newbies and regulars alike that, while it's not mandatory to give a link back, it’s the way that carnivals work best. If your submitted post has been included in the Cav, please remember to post about it on your blog because it helps us all.

OH! Still looking for a host for the July 10th Cav - how 'bout it?

Because it's Better Than Drinking Alone

The folks who are responsible for policing Obamacare are already celebrating on our dime.
Poor oversight by the Internal Revenue Service allowed workers to use agency credit cards to buy wine for an expensive luncheon, dorky swag for managers' meetings and, for one employee, romance novels and diet pills, an agency watchdog said Tuesday.
Two IRS credit cards were used to buy online pornography, though the employees said the cards were stolen. One of the workers reported five agency credit cards lost or stolen
Breitbart

Billy Joel was right.

The Obamacare Reality Show

Just when you thought it was safe, it seems the folks who gave us Obamacare have moved beyond jokes on late night TV and is now moving towards reality entertainment.

The Obamacare question regarding subsidy eligibility seems innocuous enough.
The ACA requires Medicaid, CHIP and tax-subsidized exchange coverage to use Modified Adjusted Gross Income (MAGI) to determine eligibility for most individuals.
Statereforum

Until you scroll down a bit and view the comments.

MAGI Training Materials for States - Check this Out!Louisiana - ever a font of creativity - has created this really ingenious and funny email training materials called MAGI Monday directed to eligibility workers. Using a "real life" case study of the Kardashians, the missives walk workers through how changes in household, income, and custody might impact how the eligibility determination is implemented and whether and who is eligible for Medicaid. The state is using this tool to help get their line staff acclimated to new concepts and rules before the in-depth trainings get underway. Susan Wright in Louisiana has kindly shared these so other states can use them or be inspired to create their own serials. We will be posting these weekly so you can keep current with all the twists and turns in the MAGI saga. Enjoy!

Just another MAGI Monday . . .


Flopping and Obamacare

HHS is reaching out to the major sports leagues in hopes of partnering to promote the Patient Protection and Affordable Care Act. So far they have engaged with the NFL and the NBA.

For the NBA this partnership could have mixed outcomes. While it hits a significant part of their fan base, it is also a controversial law that could alienate the part of it's fan base who happen to be the drivers of the financial spend for tickets, concessions, and merchandise. For now.

More importantly it will impact their players. According to data listed on ESPN.com there are 534 players who received compensation during the 2012-2013 season. Of these, 492 earned more than $250,000. This is the magic number for paying the additional Medicare tax of 0.9% when filing as joint married. (I know some players are single but just bear with me)

Total salaries for all players over the threshold come to $2,021,287,266 which means that NBA players will be paying $17,086,835 in new Medicare taxes this year just on their salaries.

When PPACA flops will Joey Crawford be there to make the call? If so, what can the NBA fine HHS and President Obama for their efforts? If so, my guess is it won't come close to $17 million.

Good idea to buy Health Insurance for your support staff

Good idea to buy Health Insurance for your support staff.

Nikhil Dwivedi has done a good thing by buying Health Insurance for his employees as well as families. He has got good appreciation for his gesture.
Times of India is leading a campaign with focus on Compassion.

“Make Compassion your passion on 28th June” is a good theme. On that day or nay other day in the year you as an individual can do something for your support staff (Servant, Maid Servant, Driver, Mali, Gardener, Chowkidar or Guard) by giving them gift of insurance policy.

All these efforts deserve appreciation.

Insurance Foundation of India a Not for Profit Organization is doing good work in spreading the message of Insurance among masses (www.ifingo.org) and has been  making NGO’s aware of Micro Insurance & Social Insurance. Recently a Conference was held in Delhi in association with PHD Chamber of Commerce, where large number of NGO’s attended the conference.

What we have to say is that :

1. Nikhil Dwivedi
2. Times of India
                
or any one else who is giving Health Insurance or any other insurance policy to his/her support staff deserves appreciation.

Tuesday, 25 June 2013

Oh Good Lord!

Is this really the face they want to put on The ObamaTax?

"General Electric (GE) has enlisted Agent Smith, the villain from "The Matrix" trilogy, to tout its health care technology in a new ad campaign."

Actually, that might make more sense than you'd think, given this:

"[Soon to be former] Sen. Max Baucus ... asked HHS to provide "a complete list of agencies that will interact with the Federal Data Services Hub."

Regular readers may recall that the "data hub -- in laymen's terms, a huge digital warehouse capable of sending information to other online servers -- plays a crucial role in the exchanges"

That innocuous-sounding phrase "sending information to other online servers" actually means more, a lot more. The Hub will be sending information to, and receiving information from, Ms Shecantbeserious and her minions, the IRS, Immigration, even Homeland Security. And of course all of this previously private health care information will be completely secure.

Trust us (they said).

Y'know, if you're going to enlist a villain to promote your evil scheme, I say go big or go home.

Give me your tired, your....uninsured

A few weeks ago, Bob pointed out that, under the pending Senate immigration bill, newly "legalized" immigrants will "have to wait at least 13 years to be able to obtain full citizenship, and it isn’t until then that they could qualify for [the ObamaTax benefits]."

Recent news would seem to confirm not only that, but its implications:

"Those placed on provisional status would become the nation's second-largest population of uninsured, or about 25 percent ... research shows that the older you get, the sicker you become, so these people will be sicker and will be more expensive on the system"

Great.

But at least there's some good news to soften the blow, right?

Um, not so much:

"Immigrants with provisional status may obtain insurance through employers, but many ... tend to work low-wage jobs at small businesses that don't have to provide the benefit under the [ObamaTax]."

And then one has to consider what happens when these larger employers figure out that they can hire these "provisionals" who are not subject to the [Evil] Mandate. How many American citizens will lose their jobs in favor of employees who aren't required to be covered?

Ouch.

Monday, 24 June 2013

99 Bottles of Aspirin on the Wall

It’s hard to understate the enormity of the task at hand for the Obama administration. It will be orchestrating the largest expansion of private health insurance in the country’s history. That means there’s a huge amount of work to be done over the next few months. There are at least 99 things that need to happen between now and October


Here they are:
1. Health and Human Services must certify that 17 states will be able to launch their own marketplaces. While these states currently have conditional approval, none have the final go ahead to launch their exchange.

2. Washington State must launch a health insurance exchange
3. Oregon must launch a health insurance exchange
4. California must launch a health insurance exchange
5. Idaho must launch a health insurance exchange
6. Hawaii must launch a health insurance exchange
7. Colorado must launch a health insurance exchange
8. Minnesota must launch a health insurance exchange
9. Kentucky must launch a health insurance exchange
10. Exchange list interruption: The federal government likely needs to work on the fact that 42 percent of Americans don’t know that the health-care law is a law at all.

Child Labor

It's 10 o'clock. Do you know where your children are?  

The Los Angeles Unified School District will use a state grant to train teens to promote ObamaCare to family members. Covered California, the state's health insurance exchange, announced grants of $37 million on May 14 to promote the nationally unpopular law.
LAUSD will receive $990,000. The district listed as a primary outcome for its project, “Teens trained to be messengers to family members.”

Obamacare Babel

Obamacare kicks off in 99 days. DC is still selling the health insurance plan that almost nobody wants.  

The Department of Health and Human Services reportedly asked professional sports leagues to help them promote the law’s benefits. The leagues reach a wide audience, especially the young and healthy crowd the administration is trying to court so premiums on the exchange do not soar from an influx of older, sicker patients.
HHS Secretary Kathleen Sebelius said Monday the NFL has been “very actively and enthusiastically engaged” in the discussions, according to The Hill.
Give me an O . . .
But wait. There's more.
The government’s revamped website, healthcare.gov, features sleeker graphics than its prior iteration and features a “Start Now” button that guides users through the law’s benefits. There is a Spanish-language version of the site, at www.cuidadodesalud.gov, and the government’s call center will accommodate 150 languages through interpretation services, HHS said.
Press 1 for English, press 2 for Spanish . . . press 150 for . . .

Exchange News

Now that we're at less than 100 days until the Exchanges (allegedly) open for business, here's the latest from a select few of the 58 states:

■ First up, New Hampshire  has "achieved a dubious distinction," one that has some folks pretty concerned:

"It is the only state so far with just one health insurer that plans to sell its products in the new online marketplace."

It will surprise no one that that carrier is Anthem Blue Cross/Shield.

■ FoIB Jeff M tips us that North Carolina's public Exchange is faring little better:

"Individuals buying health insurance coverage on new online exchange marketplaces beginning this fall will be choosing from products from only two or three carriers"

And businesses in the Tar Heel State will have similar lack of variety in the small group Marketplace: thus far, only the ubiquitous Blues are on-board.

■ We're doing a bit better here in the Buckeye State:

"Lt. Governor Mary Taylor, who also serves as the Director of the Ohio Department of Insurance, has announced that 14 companies filed 214 products intended to be sold on the federally facilitated insurance exchange in Ohio"

That's the good news. The bad is that these new plans represent "an 88 percent increase over the average cost in 2013"

Ooopsies.

■ And, finally, it looks like Iowa may be tied with New Hampshire for "first/last" place (depending on one's perspective):

"The Iowa state insurance commissioner is urging carriers to get into the exchange while there are still lots of potential policyholders ... However, [insurance commissioner] Gerhart has seen only one carrier — and not even the first- or second-largest — sign up for the partnership exchange"

And that one has chosen - ominously - to remain anonymous.

Wonder why.

This just in...

Via email:

"Effective immediately, Aetna is temporarily suspending new business sales for Aetna Advantage Plans for Individuals, Families and the Self-Employed in Ohio."

These are the carrier's individual major medical plans (PPO, HSA, etc). The email does not say why they're suspending sales, but one can't help but wonder if the ObamaTax holds some clues.

More as this develops.

Another MVNHS© Scandal

Regular readers will be familiar with the on-going shanda at the Much Vaunted National Health System© facility in Mid Staffordshire:

"Almost 3,000 people may have died unnecessarily in just one year at the 14 NHS trusts whose excessive mortality rates were reviewed in the wake of the Mid Staffordshire scandal"

This particular facility has been in the news (and not for its outstanding reputation for delivering quality health care) for quite a while. So one might be forgiven for thinking that the folks who run the MVNHS© might be sensitive to any whiff of impropriety as regards care "Across the Pond."

Unfortunately, it just keeps getting worse:

"[A]fter the revelations of the cover-up over deaths from negligence at Morecambe Bay hospitals, we learned just what happened to Kay Sheldon, a non-executive director at the CQC [Care Quality Commission], when she tried to bring to light failings at the regulator which were putting patients’ lives at risk."

Ms Sheldon made the mistake of believing that the folks who run the Service actually care about the folks they ostensibly serve. This was, of course, a mistake:

"When Ms Sheldon tried to air her concerns that the CQC wasn’t up to the task of uncovering bad practice in hospitals and care homes, her messages to chief executive Cynthia Bower and other board members were not answered, or were stonewalled."

Remember, this is one of the platforms on which the ObamaTax is based, so it's a pretty significant peek into our own future. And it's not pretty:

"As a result, the CQC’s chairman, Dame Jo Williams, wrote to then Health Secretary Andrew Lansley asking him to sack her."

Shoot the messenger! The challenge, of course, is that this won't make the problem go away, and it certainly won't save any lives. But then, that's not the real purpose of the Much Vaunted National Health System© (or the ObamaTax), as can be clearly seen here:

"The ensuing debacle was not just the result of a botched merger: it reflects an NHS culture which is profoundly, systemically and almost certainly irredeemably rotten." [emphasis added]

And it is, in fact, that culture which has been transplanted here. How else to explain the that Donald Berwick was, at one point, in charge of the agency in charge of implementing our train wreck?

And make no mistake, this culture is what leads to:

"[N]eglect and cruelty reached such a pitch that patients drank from flower vases to relieve their thirst ... these failings are not being addressed; because what rules in the NHS, from top to bottom, is a culture of ruthless unaccountability in which the buck stops nowhere."

Ah, that magic phrase: "culture of ruthless unaccountability." What does that remind us of?

[Hat Tip: FoIB Holly R]

Why a Sales Pitch?

Why? More than 3 years after the legislation that no one read was signed into law, why is the government still trying to sell the public on the greatness of Obamacare?  


Why? Almost a year after the Supreme Court ruled that Obamacare was a tax and the mandate was legal, why does DC still have to use non-sequestered taxpayer dollars to promote a plan that only a third of the nation supports?

Why? If Obamacare is supposed to create a windfall in new revenue and profits to health insurance carriers, create more demand for prescription drugs and medical supplies, and minimize cash flow concerns of medical providers (especially hospitals), then why must we still be SOLD on how wonderful life will be?
The nonprofit group with ties to the president's team is poised to become the president's unofficial Obamacare marketing team, announcing this week that it will put its message in every corner of American life.
Its new campaign is called "Get Covered America," and the aim is to provide an easily understood set of reasons and directions to Americans who either don't have health insurance or have inadequate coverage to sign up.
"Get Covered America will engage you at your churches, schools and community events," said Enroll America President Anne Filipic in a YouTube video pitch announcing the plan.
One wonders if the folks behind "Get Covered America" is a non-profit organization and if the IRS delayed their application for 501(c)(3) status.
If Obamacare and the exchange is so wonderful, why are so many health insurance carriers opting out? Is this really the way to stimulate competition and lower prices?

Sunday, 23 June 2013

Stopping Bank Crises Before They Start

This is a Wall Street Journal Oped 6/24/2013

Regulating the riskiness of bank assets is a dead end. Instead, fix the run-prone nature of bank liabilities.

In recent months the realization has sunk in across the country that the 2010 Dodd-Frank financial-reform legislation is a colossal mess. Yet we obviously can't go back to the status quo that produced a financial catastrophe in 2007-08. Fortunately, there is an alternative.

At its core, the recent financial crisis was a run. The run was concentrated in the "shadow banking system" of overnight repurchase agreements, asset-backed securities, broker-dealers and investment banks, but it was a classic run nonetheless.

The run made the crisis. In the 2000 tech bust, people lost a lot of money, but there was no crisis. Why not? Because tech firms were funded by stock. When stock values fall you can't run to get your money out first, and you can't take a company to bankruptcy court.

This is a vital and liberating insight: To stop future crises, the financial system needs to be reformed so that it is not prone to runs. Americans do not have to trust newly wise regulators to fix Fannie Mae and Freddie Mac, end rating-agency shenanigans, clairvoyantly spot and prick "bubbles," and address every other real or perceived shortcoming of our financial system.

Runs are a pathology of financial contracts, such as bank deposits, that promise investors a fixed amount of money and the right to withdraw that amount at any time. A run also requires that the issuing institution can't raise cash by selling assets, borrowing or issuing equity. If I see you taking your money out, then I have an incentive to take my money out too. When a run at one institution causes people to question the finances of others, the run becomes "systemic," which is practically the definition of a crisis.

By the time they failed in 2008, Lehman Brothers and Bear Stearns were funding portfolios of mortgage-backed securities with overnight debt leveraged 30 to 1. For each $1 of equity capital, the banks borrowed $30. Then, every single day, they had to borrow 30 new dollars to pay off the previous day's loans.

When investors sniffed trouble, they refused to roll over the loans. The bank's broker-dealer customers and derivatives counterparties also pulled their money out, each also having the right to money immediately, but each contract also serving as a source of short-term funding for the banks. When this short-term funding evaporated, the banks instantly failed.

Clearly, overnight debt is the problem. The solution is just as clear: Don't let financial institutions issue run-prone liabilities. Run-prone contracts generate an externality, like pollution, and merit severe regulation on that basis.

Institutions that want to take deposits, borrow overnight, issue fixed-value money-market shares or any similar runnable contract must back those liabilities 100% by short-term Treasurys or reserves at the Fed. Institutions that want to invest in risky or illiquid assets, like loans or mortgage-backed securities, have to fund those investments with equity and long-term debt. Then they can invest as they please, as their problems cannot start a crisis.

Money-market funds that want to offer better returns by investing in riskier securities must let their values float, rather than promise a fixed value of $1 per share. Mortgage-backed securities also belong in floating-value funds, like equity mutual funds or exchange-traded funds. The run-prone nature of broker-dealer and derivatives contracts can also be reformed at small cost by fixing the terms of those contracts and their treatment in bankruptcy.

The bottom line: People who want better returns must transparently shoulder additional risk.

Some people will argue: Don't we need banks to "transform maturity" and provide abundant "safe and liquid" assets for people to invest in? Not anymore.

First, $16 trillion of government debt is enough to back any conceivable demand for fixed-value liquid assets. Money-market funds that hold Treasurys can expand to enormous size. The Federal Reserve should continue to provide abundant reserves to banks, paying market interest. The Treasury could offer reserves to the rest of us—floating-rate, fixed-value, electronically-transferable debt. There is no reason that the Fed and Treasury should artificially starve the economy of completely safe, interest-paying cash.

Second, financial and technical innovations can deliver the liquidity that once only banks could provide. Today, you can pay your monthly credit-card bill from your exchange-traded stock fund. Tomorrow, your ATM could sell $100 of that fund if you want cash, or you could bump your smartphone on a cash register to buy coffee with that fund. Liquidity no longer requires that anyone hold risk-free or fixed-value assets.

Others will object: Won't eliminating short-term funding for long-term investments drive up rates for borrowers? Not much. Floating-value investments such as equity and long-term debt that go unlevered into loans are very safe and need to pay correspondingly low returns. If borrowers pay a bit more than now, it is only because banks lose their government guarantees and subsidies.

In the 19th century, private banks issued currency. A few crises later, we stopped that and gave the federal government a monopoly on currency issue. Now that short-term debt is our money, we should treat it the same way, and for exactly the same reasons.

In the wake of Great Depression bank runs, the U.S. government chose to guarantee bank deposits, so that people no longer had the incentive to get out first. But guaranteeing a bank's deposits gives bank managers a huge incentive to take risks.

So we tried to regulate the banks from taking risks. The banks got around the regulations, and "shadow banks" grew around the regulated system. Since then we have been on a treadmill of ever-larger bailouts, ever-expanding government guarantees, ever-expanding attempts to regulate risks, ever-more powerful regulators and ever-larger crises.

This approach will never work. Rather than try to regulate the riskiness of bank assets, we should fix the run-prone nature of their liabilities. Fortunately, modern financial technology surmounts the economic obstacles that impeded this approach in the 1930s. Now we only have to surmount the obstacle of entrenched interests that profit from the current dysfunctional system.

Obamacare 100 Days and Counting

In 100 days the Obamacare health insurance exchanges will open for business . . . in a manner of speaking. In addition to shoppers hoping to stock up on sale prices for health insurance no doubt many will have questions.  


Who will answer them?

A company called Vangent.
The Department of Health and Human Services estimates that Vangent's call centers will receive 42 million calls about the federal marketplaces this year, a daily average of up to 200,000; plus answer 2,400 letters and 740 e-mails, and host 500 Web chats daily. Customer service representatives will take consumers through the process -- from shopping for a plan to enrolling.
Kaiser

Never heard of Vangent?

They are the same folks that answer the phone at 1-800-MEDICARE.
"The number of calls they are likely to get will probably dwarf anything they saw in Medicare."Vangent declined requests for interviews.
Currently averaging 60,000 calls a day that is expected to spike to 200,000 daily.
No problem.
But these folks will be trained, right?
An HHS official said call-center representatives would "undergo extensive training" about the health law and basic insurance issues but could not provide more details. 
Top secret.
Wonder if the NSA will be monitoring calls?
 Employment ads  for the call centers' "temporary customer service representatives" seek applicants who have a high school diploma or equivalent and six months of telemarketing or secretarial experience.
An HHS spokeswoman said that customer service representatives will answer questions by reading from HHS-approved scripts and provide state-specific information. However, she would not provide examples of the scripts or say whether they were tested with consumers.
Six months experience OR a high school degree.
Reading answers from a script.
What could possibly go wrong?

Friday, 21 June 2013

Making Bernie Madoff Proud

By golly this minimum loss ratio thingy sure is working well, said every liberal journalist and health insurance company.

CMS released figures yesterday touting that the minimum loss ratio (MLR) requirements under the Patient Protection and Affordable Care Act saved consumers $500 million that must be paid back in the form of rebates. 8.5 million consumers will each receive a portion of the rebate checks which works out to an average of roughly $60 per person. This is down from $1.1 billion that was paid out last year. If hearing this news gives you the "warm and fuzzies" all over then you probably should stop reading here. For the brutal truth please continue.

This is how PPACA planned for MLR to work. Insurance companies must spend 80% of premium dollars they collect on medical claims. The other 20% goes towards operating costs and profit. If the percentage is less than the required amount then the insurance company must rebate customers the difference. If the percentage is higher then the insurance company simply loses out and has to cut their profit margin.

In 2011 the average single premium for health insurance was $5,222 according to the Kaiser Family Foundation. 80% of this figure, $4,178, must be spent on medical claims meaning the insurance company would retain $1,044. For 2012 this number increased to $5,616. 80% equals $4,492 which gives the insurance company $1,124. So, because of MLR, insurance companies were able to retain an additional $80 per insured person in 2012 versus 2011.

The latest figures available (2010 census) state that 195.9 million people are insured through the private market in the United States. Simple math: 195.9 million x $80 = the insurance industry was able to increase their bottom lines by $15,672,000,000!!!

So, why are we celebrating $60 being returned to 8.5 million people when 195.9 million people paid $80 more?

Only in Congress would this be kind of accounting be considered "savings".