Insurance

The next shoe to drop in Obamacare involves providing health insurance for children from birth to age 18. As we have indicated in prior posts, some Georgia health insurance companies are no longer offering "child only" health insurance and at least one will no longer accept child only applications after 8/15/2010.

Now word comes that Blue Cross plans in two different states are taking a different approach. The Blues in Texas and Illinois have announced filing for approval of a new child only health insurance policy.

No details on rates or benefits but the announcement to insurance agents in those states includes this comment.

Blue Cross and Blue Shield of Illinois (BCBSIL) is committed to offering the broadest possible range of products for our members, as well as to maintaining its strong financial position. Thus, on Friday, July 16, 2010, it filed a new policy called Blue Pathway to provide coverage for children age 1 through 18 when the child is the primary insured (commonly called “child-only” policy) with the Illinois Department of Insurance (DOI).

This new coverage option responds to an Interim Final Rule that was issued by the Department of Health and Human Services (HHS) to implement several provisions of the Patient Protection and Affordability Act of 2010 (PPACA). In this Rule, HHS has determined that provisions limiting the application of pre-existing condition exclusions for children under 19 means that all children under 19 who apply for insurance for which they are eligible on or after Sept. 23, 2010, cannot be denied coverage—this is commonly known as “guaranteed issue.”

BCBSIL has long supported guaranteed issue as a way to ensure access to affordable, quality health care for all Americans, particularly children and young adults. However, that must be accompanied by an effective mandate for individuals to obtain coverage. PPACA itself recognizes the importance of pairing guaranteed issue with an effective mandate to ensure a sustainable insurance marketplace, with both being required in 2014. However, this Interim Final Rule addresses only guaranteed issue for children under 19, not any current requirements for them to have health insurance.

Without the mandate, it becomes too easy for people to buy insurance only when they feel they need services. This could be compared to allowing drivers to buy auto insurance once they have a fender-bender, and then drop coverage after their car repairs (financed by the insurance company and other insureds) are complete. This leads to what insurers term as “adverse selection,” which ultimately leads to unaffordable coverage for everyone. The Wall Street Journal recently published an article that demonstrates how this happened in Massachusetts, whose mandate has not proven as effective as originally hoped. This is based on a study commissioned by the Massachusetts Division of Insurance by the consulting firm Oliver Wyman.

Translation, the premium rates for this plan will start high and get even higher the longer the plan is on the market.

The lawyers that designed Obamacrap clearly had no idea what they were doing. This is not surprising given that most elected officials have never held a real job in the private sector. 

During the interim period while we are waiting for authorization to sell this new product, BCBSIL will temporarily suspend issuing new policies to children under 19 when the child is the primary insured. BCBSIL will stop quoting its current child-only policies on July 30, and the last assigned effective dates for those policies will be Sept. 15, 2010. Any application that has not been approved by Sept. 1, 2010, will be withdrawn from consideration.

The memo from Texas Blue Cross contains language that is virtually identical to BCBSIL.

So far BCBSGA has not given any indication they will follow suit. We will continue to monitor changes in the market place, particularly as they relate to Obamacrap, and keep our readers advised.

On Monday July 19, the Wall Street Journal ran a story on page A14 headlined “German Hospitals can Ill Afford End to Draft” [subscription required]

Huh?

Well, simple. Most German draftees apply for conscientious objector status, and most applications are approved. Germany permits military draft objectors to complete their service in civilian jobs and the majority choose hospitals, nursing homes and other social programs. The draftees perform these service jobs at military pay levels - below civilian wage levels.

Personnel officers at German Hospitals are worried because of the financial impact to them if the draft is curtailed or ended. That would mean - horrors! – their source of cheap, government-supplied labor would dry up. The hospitals would – gasp! - have to hire replacement workers at the prevailing wage. Specifically, at one hospital alone, “nearly 50 civilian servants perform basic nursing tasks and run errands, work that would otherwise need to be taken over by better-compensated employees . . . [that] would certainly drive costs up.”

And so we learn that one way Germany has contained its health care delivery costs has been forced labor at under-market rates. And all this time, I thought it was the magic of its nationalized health system. Come to think of it, that may be a good illustration of the “magic” of a nationalized health system. At least in Germany.

The government run health insurance plan for seniors continues to lose money every year and fraud continues unabated. The Miami Herald reports that  Florida has become the Medicare fraud capital of the United States.

Florida mental health clinics submitted $421 million in bills to Medicare last year -- about four times more than Texas and a whopping 635 times higher than Michigan, both also hotbeds of healthcare rackets, according to government records.

Florida rehabilitation facilities billed $310 million for physical and speech therapy -- 140 times more than New York and 10 times higher than California, records show.

 

With all the criticism heaped on health insurance companies I have never heard a single report on fraud that comes anywhere close to this kind of crime. Yet to listen to politicians and the lame stream media you would think a government takeover of health care is the best thing that could ever happen.

Miami Dade has about 250,000  residents. If the government can't control fraud in such a small population how will it ever prevent fraud when they take over health care for 320 million? This is a problem Ray Charles could see from a mile away.

In 2008, Medicare paid $520 million to Miami-Dade home healthcare agencies for treating diabetic patients -- more than what the agency spent in the rest of the country combined, according to federal authorities.

 

Why isn't this a red flag? It doesn't take a rocket surgeon to figure out there might be a problem. Even Forrest Gump would realize something is not right.

This tells you something about the level of incompetence in the Medicare system when obvious abuse is allowed to grow to this magnitude unabated.

Overall, Medicare fraud in South Florida costs taxpayers between $3 billion and $4 billion annually, according to experts. Nationwide, Medicare and other healthcare fraud is estimated to cost $68 billion annually -- about $18 billion more than the Obama administration plans to spend on education in the next fiscal year.

 

Teachers take note. When the government pisses away more money on fraud than it will spend on education this should be a warning. Where is the torch and pitchfork crowd? Why isn't someone demanding a halt to this kind of incompetence?

There are currently 40 million people on Medicare. Over the next 10 years the baby boomer generation will add 70 million participants. It is common knowledge that Social Security is flat busted and has been for years. This year Medicare will pay out more than it receives in tax collections for the first time ever. This problem will only get worse, not better, and it doesn't help when dollars are leaking out in the form of fraud.

Wasn't Obamacrap supposed to end this kind of fraud? A snowball has a better chance in Hell.

Baruch Atah Adonai Eloheinu Melech Ha-Olam Shehehchiyahnu vekiyamanu vehegianu lazman ha-zeh.

Blessed are You, Lord our God, Ruler of the universe, for giving us life, for sustaining us, and for enabling us to reach this season. Amen.

Wasn't this supposed to save us money???

The Outlook for Major Health Care Programs and Social Security

Growth in spending on health care programs remains the central fiscal challenge facing the nation. CBO projects that if current laws do not change, federal spending on major mandatory health care programs will grow from roughly 5 percent of GDP today to about 10 percent in 2035 and will continue to increase thereafter. (Mandatory programs are those that do not require annual appropriations; the major mandatory health care programs include Medicare, Medicaid, the Children’s Health Insurance Program, and the subsidies that will be provided through the insurance exchanges that will be established as a result of the new health care legislation.)

That estimate includes all of the effects of the recently enacted health care legislation. Although, CBO expects the legislation to reduce federal budget deficits over the first 10 years and in subsequent decades (through its effects on both revenues and spending), it is expected to increase federal spending in the next 10 years and for most of the following decade; by 2030, however, that legislation will slightly reduce federal spending for health care if all of its provisions are fully implemented, CBO projects. (The estimates for the health care legislation that are used in this report are unchanged from the ones that CBO and the staff of the Joint Committee on Taxation published in March, when the legislation was being considered.)

Under current law, spending on Social Security is also projected to rise over time as a share of GDP, albeit much less dramatically—from 5 percent to 6 percent of GDP. (Later this week, CBO will release a report on a number of different policy options for changing Social Security.)

All told, CBO projects, the aging of the population and the rising cost of health care will cause spending on the major mandatory health care programs and Social Security to grow from roughly 10 percent of GDP today to about 16 percent of GDP 25 years from now if current laws are not changed. (By comparison, spending on all of the federal government’s programs and activities, excluding interest payments on debt, has averaged 18.5 percent of GDP over the past 40 years.)

I guess not...

According to the HHS Sebelius, the Patient Protection and Unaffordable Health Care Act (Obamacrap) put's "women in control".

the Affordable Care Act is the best women's health bill since Medicare.

Given that Medicare is essentially broke, is this supposed to be a good thing?

under the Affordable Care Act it is illegal to charge women more for health insurance

This is true.

Once Obamacrap is fully implemented, everyone will pay more. Absent all the other goofball provisions of Obamacrap, if the only thing the law did was call for unisex rates, it would mean that men would pay more than under the prior system. The reason for the current rate differential is simple.

Women use health care more than men and typically have higher cost procedures. So the higher premium is justified based on utilization.

Charging men more for less usage is supposed to be an improvement?

Being a woman is no longer a preexisting condition!

It never was.

It will no longer be legal to deny coverage to children due to preexisting condition

This change goes into effect 9/23/10. In the interim carriers have floated suggestions that children's rates will double over current rates at a minimum and could easily triple.

I attended a meeting yesterday where one agent planned to visit a local children's cancer clinic on 9/23 with applications in hand. He said clinics like this, many of whom provide medical care at no charge or on a sliding scale will be glad to see this new law. They will take that opportunity to move children from charity care to the insurance companies.

You can bet that will happen in a heartbeat.

Increasing current children's rates by 300% will be totally inadequate. Obamacrap is a Pandora's box and the public will learn very soon that this is going to be a Private Benjamin moment.

"This isn't the health reform I voted for. I want the one with the lower premiums, and free care."

Smaller cars, bigger health insurance premiums, Poppa Washington.