Category Archives: Health Insurance

Fallout of the End of ACA Subsidies

Joe Paduda today gave a very succinct and clear-minded assessment of the fallout of the ending of the ACA subsidies, also known as Cost-Sharing Reimbursement (CSR) payments.

Here is Joe’s article.

It makes perfect sense that what the Orange man said yesterday will do more damage to health care than his false and misleading pronouncements of the past year that the ACA is failing and doing harm.

It is you, sir, who are doing harm. To the poor, to minorities like those in Puerto Rico despite your morning mea culpa, to African-Americans and Latinos,  to women, to international agreements and organizations,  and to our credibility with our allies and adversaries.

 

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ACA Subsidies to End

Here is the New York Times article tonight which will appear in tomorrow’ paper.

The Orangutan is blowing up the health care law, and with it, the health care system.

Cutting off subsidies to cover low-income individuals and signing an Executive Order that will create chaos and uncertainty is dangerous, reckless, and despicable.

Not even Gru is that mean-spirited and inhumane.

The Roman Senator Cato the Elder ended his speeches by declaring that “Carthago delenda est”. which means Carthage must be destroyed.

We need a modern Senator to declare that “Trump sit remotus”, means Trump must be removed.

Executive (Dis)order

The signing this morning of an executive order by the Orangutan will have, in the opinion of some of the bloggers and politicians, spell disaster for the nation’s health care system.

It will, if carried into action, likely siphon healthy people from the Affordable Care Act-compliant market, continuing a pattern of regulatory actions under the Trump administration that have undermined the ACA.

The rationale for such a move that has been given is that since Congress has not been able to repeal and replace the ACA, an executive order will, piece by piece.

Coupled with the recent budget move to eliminate the CHIP program for children’s health (New York State faces dire consequences if Congress does not act on CHIP), and cut backs to Medicare and Medicaid, the intent here is to privatize health care for some, and eliminate it for others, and to get government out of health care providing altogether.

There are provisions in this order for greater competition, short-term coverage, and lower premiums with less coverage. Why this is better is beyond me, unless the Orangutan is seeking to destroy health care so that single-payer will be the only option.

Cutting healthy people out of the ACA means leaving sick people to struggle with a health care law that many say needs to be fixed, not repealed and replaced. But because the Tea Party ranted and raved before it was enacted, and the Orangutan and the GOP campaigned on getting rid of it, they had no choice but to sabotage it if they could not do so through legislation.

I predict that we will soon see the total collapse of our health care system thanks to this stupid, overreaching, and ill-advised Executive Order. I even read today that the Vice President had to remind the Orangutan to sign the darn thing, something that almost slipped what is left of his so-called mind.

Welcome to Crackerbox Palace.

The Wisdom of Solomon?

You all know the story of King Solomon in the Bible where he was called upon to settle a dispute between two women, each claiming to be the mother of a baby. Solomon’s “solution” was to order the baby be cut in half, so that each mother would have half a baby. But when she realized what this would mean, the real mother spoke up and spared the child from being split in two.

Well, something posted today on LinkedIn, sort of reminded me of that story. Rather than paraphrasing it, I am posting the item here for you.

Trump plans to split Obamacare in two

President Trump plans to sign an executive order this week that takes aim at the Obama-era Affordable Care Act, according to sources. Among the changes, the order would give individuals and small businesses in association health plans more options to opt in for lower-cost — albeit less comprehensive — plans not allowed under the ACA, leaving older and sicker individuals with fewer options and pricier premiums. It would also provide short-term insurance for up to a year, reversing the three-month deadline put forth by the previous administration. If the order is signed, the market could divide in two, adding more difficulties to traditional markets under the ACA while opening the door to new types of insurance.

It seems the Orangutan now fancies himself with the wisdom of Solomon in regard to dealing with the “problem” of getting rid of the ACA. Like the two women in the story, the two parties in Congress each claim their own view of health reform, and since neither side is getting their way, the Orange King is doing it for them by signing an Executive Order.

And like the proverbial baby, splitting health care in two solves nothing. But don’t let that stop the Orangutan. He’s the wisest person there ever was, or didn’t you know that?

“Yes, We Have No Humana”

Have you ever gone into a store looking to purchase an item they are supposed to carry because that is the kind of store they are, and been told that it is not available in your area?

For example, if I walked into a shoe store and wanted to buy a certain kind of very nice, but not too expensive shoe, and was told that shoe is not available in this area, I would feel that the act of buying shoes from a shoe store was somewhat disorganized and complicated. Especially if the store sells under their name (remember Florsheim?).

This is what happened to me today when I tried to get a Medicare Advantage plan for my medical condition from, you guessed it, Humana.

As my readers well know, I’ve been critical of Humana before due to issues with my late mother. However, after learning about Special Needs Plans from CMS, my agent informed me that Humana does not offer a Medicare Advantage plan for people with my condition in my area.

So, to use my shoe store analogy above, Humana does not sell Special Needs Plans (certain kind of nice, but not too expensive shoe) under their name in my area of the country.

How stupid is that?

Why shouldn’t everyone be able to buy the same shoe no matter where they live?

Naturally, if you wanted to buy sandals, and lived in Alaska during the winter, you wouldn’t, but all things being equal, you should.

Now I understand why in some counties there are only one exchange to purchase insurance, but again that is like saying there is only one shoe store in a certain county where you can buy shoes.

Totally wrong and bad for business. This is why we need Medicare for All, and should stop denying coverage to anyone, anywhere in the country, for whatever reason. If I buy that certain shoe in New York, I should be able to buy it also in California, Kansas, or anywhere else in the country.

To do anything less only makes the system worse.

So, “yes, we have no Humana, we have no Humana today.”

The “Curse” of For-Profit Health Care

Recently, Vermont Senator Bernie Sanders introduced a Medicare for All bill into the U.S. Senate, and many Democratic Senators signed on as co-sponsors of the bill.

Earlier yesterday morning, on his way to a photo-op in Naples, Florida to see the damage from Hurricane Irma (why didn’t he go to the Keys), the Orangeman tweeted that Senator Sanders’ bill would visit a curse on the U.S.

This from a man who said that he preferred the Canadian system, and told the Australian Prime Minister to his face, and the cameras, that they had a better health care system than the US.

What are we to make of someone who likes other countries health care systems as long as it is not our system? What do we do when the elected leaders of this country are dead set against providing the best health care system to their constituents, and in fact, are determined to take away what little health care they already have?

I find it rather odd, and callous that the Orangutan calls Sen. Sanders’ plan a curse, when millions of Americans are cursed everyday with not having any health care, or minimal care at best.

No, what is a curse are families going broke paying for medical care, individuals forgoing needed care because it costs too much, doctors and nurses burned out because they are overworked, underpaid (in some cases), and trying to work in a broken, bureaucratic, sclerotic, and byzantine system.

The American “health care” system is the curse. The cure, or rather the silver bullet for this vampiric monster, is single-payer. Maybe Sen. Sanders’ bill won’t pass this time, with this Congress and this President, but it or something like it should in the future.

Our curse as a nation is in our slavish devotion to making everything conform to the will and whim of the free market. We have seen that the free market is great for the production and selling of goods and services, but health care is not a consumer good. It is a right of every man, woman, and child.

The Canadians, the Australians, the British, and many other nations are not so slavishly devoted to the free market as we are when it comes to providing health care to all their citizens, and they cannot be called “Socialist” or “Communist” in any way, shape, or form.

Only because of the greed of a few insurance companies, Wall Street players and their investor clients, as well as very wealthy Libertarian brothers from the energy sector do we continue to be cursed with the worse system for providing health care.

Finally, the ultimate curse this nation has is the individual who said single-payer would be a curse. And like Dracula, only the light of day will stop him.

Single Payer Supported by Majority of Physicians

A shout-out to Dr. Don McCanne for posting the following article from Merritt Hawkins.

Merritt Hawkins
August 14, 2017
Survey: 42% of Physicians Strongly Support a Single Payer Healthcare System, 35% are Strongly Opposed
By Phillip Miller
A plurality of physicians strongly support a single payer healthcare system, according to a new survey by Merritt Hawkins.
The survey of 1,033 physicians indicates that 42 percent strongly support a single payer health care system while 14 percent are somewhat supportive. Over one-third (35 percent) strongly oppose a single payer system while six percent are somewhat against it. The remaining three percent neither support nor oppose single payer.
The results contrast with a national survey of physicians Merritt Hawkins conducted in 2008, which indicated that 58 percent of physicians opposed single payer at that time while 42 percent supported it.
In Merritt Hawkins’ experience, there are four reasons why a growing number of physicians are in favor of single payer. First, they are seeking clarity and stability. The fits and starts of health reform and the growing complexity of our current hybrid system are a daily strain on most doctors. Many of them believe that a single payer healthcare system will reduce the distractions and allow them to focus on what they have paid a high price to do: care for patients.
Second, it’s a generational issue. The various surveys that Merritt Hawkins has conducted for The Physicians Foundation in the past show that younger doctors are more accepting of Obamacare, ACOs, EHR, and change in general than are older physicians As the new generation of physicians comes up, there is less resistance among doctors to single payer.
Third, there is a feeling of resignation rather than enthusiasm among some physicians about single payer. These physicians believe we are drifting toward single payer and would just as soon get it over with. The 14% of physicians surveyed who said they “somewhat” support single payer are probably in this group.
Fourth, there is a philosophical change among physicians that I think the public and political leaders on both sides of the aisle now share, which is that we should make an effort to cover as many people as possible.
However, while single payer has gained acceptance among some physicians, it remains strongly opposed by over one third and strongly or somewhat opposed by over 40 percent. It is still a polarizing issue among physicians and is likely to remain so for the foreseeable future.
So, if a majority of physicians support single payer, and they are the ones we should listen to when it comes to taking care of our health, and if a growing majority of Americans are coming around to this idea, then the only ones standing in the way are our politicians.
POTUS, the Secretary of Health and Human Services, Mitch McConnell, Paul Ryan, Rand Paul, and the medical-industrial complex of insurance companies, drug companies, and medical device manufacturers are all opposed and are preventing this nation from joining the rest of the developed world in providing health care to ALL its citizens.
And there is one more obstacle in our way: Wall Street investors and their clients who are funding insurance and medical companies, engaging in adverse selection and determining who lives and who dies. Who gets covered and who goes into bankruptcy.
They need to removed from the equation.