Peter Schiff Blasts “The Website Is Fixable, Obamacare Isn’t!” | Zero Hedge

Wait, wait, this was supposed to bend the cost curve Down…

It is also ironic that high-deductible, catastrophic plans are precisely what young people should be buying in the first place. They are inexpensive because they provide coverage for unlikely, but expensive, events. Routine care is best paid for out-of-pocket by value conscious consumers. But Obamacare outlaws these plans, in favor of what amounts to prepaid medical treatment that shifts the cost of services to taxpayers. In such a system, patients have no incentive to contain costs. Since the biggest factor driving health care costs higher in the first place has been the over use of insurance that results from government-provided tax incentives, and the lack of cost accountability that results from a third-party payer system, Obamacare will bend the cost curve even higher. The fact that Obamacare does nothing to rein in costs while providing an open-ended insurance subsidy may be good news for hospitals and insurance companies, but it’s bad news for taxpayers, on whom this increased burden will ultimately fall.

via Peter Schiff Blasts “The Website Is Fixable, Obamacare Isn’t!” | Zero Hedge.

Lack of skin in the game.

Assessing the Exchanges | National Review Online

Read and weep. My comments in [brackets]:

…[interviews with medical insurance policy-type reps in Washington]

One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game and loads up the site to get coverage—the dream consumer so essential to the design of the exchange system—will not keep trying 25 times over a week if the site is not working [1]. The person with high health costs and no insurance will [2]. The exchange system is designed to enable that sick person to get coverage, of course, but it can only do that if the healthy person does too [3]. The insurers don’t yet have a clear overall sense of the risk profile of the people who are signing up, but the circumstantial evidence they have is very distressing to them [4]. The danger of a rapid adverse selection spiral is much more serious than they believed possible this summer [5]. They would love it if the administration could shut down the exchange system, at least the federal one, until the interface problems can be addressed. But they know this is impossible [6].

via Assessing the Exchanges | National Review Online.

A terrifically scary article (read it all ™), but this paragraph has so much implied information in it it jumped out as needing some amplification.

1: Why would he? He’s actuarially bulletproof, and has as much need of medical insurance as he does a 401k (unemployment joke), but seriously: this youngster is the basis for paying the ACA bills. If the young and healthy and unlikely to need medical insurance don’t sign up the ACA insurance house of cards collapses (see next):

2: Why wouldn’t they? This is the group the ACA is aimed at, those who can’t get insurance at all, or who have it (Cobra, etc), but for this group insurance is prohibitively expensive. Were I in their shoes I’d be hitting this site 18 hours a day and not quitting until I got insurance and a subsidy. Hint, this group is very to horrifically expensive, and require their costs to be spread far and wide for insurance to work.

3: To belabor the point, insurance companies don’t print money to pay bills, they transfer money from the payments of those paying for insurance who don’t wind up using it to the bills of those who do. Therefore not enough insured paying (but not using) the insurance company runs out of money, then the insured aren’t insured when the company goes broke. That’s ungood.

4: Insurance companies understand medical cost risk like no other group, and were this good news for them (non-distressing news) they’d be singing this to the heavens/news, as a way to sign up the [1] group. Then it’d be ‘cool!’, which would cascade into more young/well signups.

5: This is inexplicable. Insurance companies abhor risk, this was a completely foreseeable risk in an unknown situation, unless there were some significant assurances from On High that Nothing Can Go Wrong. Which they would be dumb to just swallow whole. This part of the mechanism of bargaining still bugs me, as I don’t have an explanation for why an entire, smart and profitable industry would buy into a scheme that could destroy it quickly and painlessly. Remember this, they walked into the ACA eyes wide open.

6. It’s hard to stop a process bought into under a combination of duress and greed, either objection draws credibility into question.

No secret, I’m totally against (and aghast at) the ACA. That said, it’s more than curious a nation that put men on the moon with slide rules cannot make an insurance marketplace with roughly a half a billion dollars and a three year head start.

Interesting times.

 

 

 

 

Hill averts Obamacare mess

Know how you know the ACA is a disaster? Everyone who can is pulling strings to avoid it:

Lawmakers and staff can breathe easy — their health care tab is not going to soar next year.

The Office of Personnel Management, under heavy pressure from Capitol Hill, will issue a ruling that says the government can continue to make a contribution to the health care premiums of members of Congress and their aides, according to several Hill sources.

via Hill averts Obamacare mess – John Bresnahan and Jake Sherman – POLITICO.com.

We’re all second class citizens outside the beltway.

Is Obamacare too much work for the Obama administration?

I particularly like the graphic…

By the end of this week, states must decide whether they will build a health-insurance exchange or leave the task to the federal government. The question is, with as many as 17 states expected to leave it to the feds, can the Obama administration handle the workload.

“These are systems that typically take two or three years to build,” says Kevin Walsh, managing director of insurance exchange services at Xerox. “The last time I looked at the calendar, that’s not what we’re working with.”

via Is Obamacare too much work for the Obama administration?.

Frankly, it’s too much work for any administration. Absurd to think it’s workable given any timeframe.

The Truth About SwedenCare – Klaus Bernpaintner – Mises Daily

Required reading.

As a Swede currently living in the United States, with actual experience of Swedencare, I must reply to the delusions propagated by professor Robert H. Frank in his June 15 article in the New York Times, titled “What Sweden Can Teach Us About Obamacare.”

It is surprising to read something so out of line with basic economic theory from an economics professor. But theory aside, it would have sufficed for professor Frank to have taken a field trip down to the nearest public emergency room to have his illusions irreparably shattered. The reality is that Swedish healthcare is the perfect illustration of the tragedy of central planning. It is expensive and — even worse — it kills innocent people.

There is nothing economically mysterious about health care — it is just another service. Like any other it can be plentifully provided on a free market at affordable prices and constantly improving quality. But like everything else, it breaks down when the central planners get their hands on it, which they now have. To claim that the problems are due to a “market failure” in health care is like saying that there was a market failure in Soviet bread production.

via The Truth About SwedenCare – Klaus Bernpaintner – Mises Daily.

Others have been down this path, do we have to do it in the typically American governmental (expensive, borderline incompetent) version? Can’t we just jump to the free market?

A Few Questions for the AMA | The Redheaded Pharmacist

Sing it!

The American Medical Association AMA just concluded their Annual Meeting of the House of Delegates in Chicago on Wednesday, June 19th. And it seems as if the profession of pharmacy was a topic of conversation. According to the AMAWire, one of the points of discussion for the delegates this year was pharmacist inquiries with practitioners to verify controlled substances. This is the statement they released in response that you will find on the AMA’s website: The AMA delegates “Issued a warning against “inappropriate inquiries” from pharmacies to verify the medical rationale behind prescriptions and diagnoses, calling them unwarranted interference with the practice of medicine.” Forgive me for being a bit confused about the last part of that statement. I’ve always been under the impression that the duty of a pharmacist was to ensure prescriptions were written for a legitimate medical condition in the course of a practitioner’s normal scope of practice. If we are being accused of interference, shall we then be relieved of all responsibilities toward ensuring the best interests of our patients? Are we not the drug expert profession that is the last stop in the chain of treatment from provider to the patient?

via A Few Questions for the AMA | The Redheaded Pharmacist.

All health-care systems have ‘death panels’ of one sort or another | Full Comment | National Post

Via @medskep on twitter:

Many scoff at the term “death panel” — Sarah Palin’s morbid, if misleading description of the powers contained in U.S. government health-care legislation back in 2009. Yet there was a grain of truth in that infamous noun phrase. The fact of the matter is that all health-care systems have “death panels” of one sort or another. It’s just a question of who sits on them — bureaucrats, insurers or doctors — and what label we put on their functions.

via All health-care systems have ‘death panels’ of one sort or another | Full Comment | National Post.

There’s the truth, let’s not act like it isn’t.

Health-Care Costs: A State-by-State Comparison – WSJ.com

Nice graphs of spending by state, then another breakdown of where the money goes per state. Click through and enjoy the graphics.

Health-care spending in the U.S. averaged $6,815 per person in 2009. But that figure varies significantly across the country, for reasons that go beyond the relative healthiness, or unhealthiness, of residents in each state.

via Health-Care Costs: A State-by-State Comparison – WSJ.com.

An open letter to UnitedHealth Group CEO Stephen Hemsley about my family’s canceled COBRA insurance | Mike Holden’s blog

It’s stuff like this that makes even trying to support the idea of private insurance untenable.

Mr. Stephen Hemsley:

I made an honest mistake, wasn’t given a fair opportunity to correct it and now my family’s COBRA coverage has been canceled by your company.

via An open letter to UnitedHealth Group CEO Stephen Hemsley about my family’s canceled COBRA insurance | Mike Holden’s blog.

UnitedHealth, fix this!

Obamacare Incompetence | TIME.com

I link to Ezra Klein approvingly about one a decade, so…

Let me try to understand this: the key incentive for small businesses to support Obamacare was that they would be able to shop for the best deals in health care superstores — called exchanges. The Administration has had three years to set up these exchanges. It has failed to do so.

This is a really bad sign.

via Obamacare Incompetence | TIME.com.

NYC painkiller poster

From NPR:

Doctors who follow the advice will consider alternatives to opioids and prescribe only a few days’ worth of the drugs, if they decide that’s the best course for short-term pain relief. They’ll also avoid starting patients on long-acting opioids, like Oxycontin, and will refrain from replacing lost, or allegedly lost, opioid prescriptions without lots of due diligence first.

painkiller-poster_vert-41d783296ca44c5e35a435dd8c25bf5217907c5e-s3

 

I like it.

Press Ganey, meet Wong-Baker

For those not actively engaged in the practice of medicine, this will mean nothing to you. For those of us in the trenches:

IMG_0847

I cannot wait for the day the government realizes this misguided effort is costing them Billions (and harming patients and providers).

 

IRS: Cheapest Obamacare Plan Will Be $20,000 Per Family | CNS News

“Affordable” Care act.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

The IRS’s assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.

“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.

via IRS: Cheapest Obamacare Plan Will Be $20,000 Per Family | CNS News.

Unbelievable. Enjoy the Sticker Shock.

Feds get specific on ACA individual mandate rules  : ACEP NEWS

After years of legal wrangling and a showdown in front of the Supreme Court, the federal government has finally begun to implement the Affordable Care Act’s controversial individual insurance mandate.

Starting on Jan. 1, 2014, Americans will have a choice: Buy basic health insurance, qualify for an exemption, or pay a penalty when filing federal income taxes, according to proposed regulations issued Jan. 30 by the Treasury Department and the Health and Human Services Department.

via Feds get specific on ACA individual mandate rules  : ACEP NEWS.

Go and read all the exclusions. For an incredibly intrusive and expensive mandate there sure are a lot of people that still won’t have to be covered.

Health Insurance Brokers Prepare Clients For Obamacare Sticker Shock – Forbes

(emphasis added):

By Dr. Scott Gottlieb, M.D.

A California insurance broker, who sells health plans to individuals and small businesses, told me that she’s prepping her clients for a sticker shock. Her local carriers are hinting to her that premiums may triple this fall, when the plans unveil how they’ll billet the full brunt of Obamacare’s new regulations and mandates.

via Health Insurance Brokers Prepare Clients For Obamacare Sticker Shock – Forbes.

You. Don’t. Say.  Thanks, Obamacare!