Tuesday 29 October 2019
Monday 28 October 2019
Friday 25 October 2019
Thursday 24 October 2019
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In case you were wondering:
#Medicaid4All
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If you want government to take over healthcare, here’s what’s in store...— Kayleigh McEnany (@kayleighmcenany) October 24, 2019
➡️ wait times in some Canadian provinces average almost 1 YEAR
➡️ 4.4 million Brits waiting for treatment
➡️ 115k Brits got cancer diagnosis too late
MUST READ by @sallypipes ⬇️https://t.co/HfyoTAoVHp
#Medicaid4All
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So, did my annual training/re-certification for the individual Marketplace (aka 404Care.gov):
[click to embiggen]
On the one hand, they've actually streamlined the process for those of us with prior certification, which is nice.
On the other, they've really gone to town on codifying what behaviors are kosher (helping clients set up an account) and which are not (setting one up for them). This latter seems, well, stupid, but of course they aren't interested in feedback.
Which is probably just as well...
On the other, they've really gone to town on codifying what behaviors are kosher (helping clients set up an account) and which are not (setting one up for them). This latter seems, well, stupid, but of course they aren't interested in feedback.
Which is probably just as well...
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From FoIB Scott Olson, the REAL reason why older long-term care insurance policies have had such large rate increases:
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Wednesday 23 October 2019
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Children are society’s future. We have designed laws to protect children from harm, from fire proof pajamas to when a child is considered mature enough to make life altering decisions. As a Social Worker, my job was to protect children from unsafe home conditions. As a Medical Manger, my job is to protect both doctors and their patients from “never events”. A “never event” in Medicine is an event that, with proper safeguards, will or should never happen.In Texas a Custodial Court Case over the gender transition of a 7 year old male child is, in my Professional Opinion, a travesty in regards to what is best for the child. The full account of the trial can be read here: “BREAKING: Dallas Jury Grants Mother Sole Custody of Purported Transgender Child”.
The case revolved around divorced parents regarding the medical care of their 7 year old son. The mother, a pediatrician, is maintaining that the child is a female and is desirous of allowing him to transition, up to and including hormones. The father is maintaining that the child is happy being male. The case rested on two questions: "First, did they think that the current joint managing conservatorship should change to a sole managing conservatorship? Second — if they said “yes” to the first question — did they think Younger should be the sole managing conservator?”
The jury decided “yes” on the first question and “no” to the second, which results in the mother being the sole manager conservator.
Child rearing is the most difficult task a person can do, even in the best circumstances. Child rearing with an ex-spouse can add another layer of stress, especially if those opinions differ. In this case however, the issue is not whether or not the parents agree, but what is best for the child. An amicus attorney (one appointed by the court to be a neutral observer, recommended:
“Contending that both parents loved James, as acknowledged by everyone who interviewed both Younger (father) and Georgulas (mother), he asked the jury to choose for the parents to remain joint managing conservators, and leave the rights and duties of that custody agreement for the judge to rule on in a way that would address the concerns of the father.”
The attorney recommended a path that is considered the best plan for a child, whose parents are deemed appropriate to care for that child. In this decision, by allowing the mother full decision making powers, this child’s life could be permanently altered before he is mature enough to understand the consequences.
There are many things we do not let a 7 year old child do, that adults do, because these activities are either dangerous or beyond the comprehension of a child: driving a car, being alone for any length of time, voting, and - obviously - making medical decisions. It is a parent’s responsibility to keep a child safe and healthy, live in an environment where the child is allowed to grow, and nurture their personalities so that they become a functioning member of society.
As a Social Worker, I can attest that these tasks are not always performed by all parents, but that is why Social Work was created. Helen Northern noted that in the early 20th century in America, there were laws protecting Animals from abuse, but not children. From hers, and many other individuals, laws protecting children were enacted. A major premise of these laws is to protect children from danger, be it from society or from their family situation.
Based on these laws, it is not appropriate to make such a drastic, life altering change to a child when that child is unable to have a decision. Especially, when one parent does not agree.
As a Medical Professional, there are two troubling aspects to this case, both of which revolve around the fact that the parent who wants the transition to be done is a Pediatrician.
In Medicine, it is considered unethical for a doctor to treat a family member. For example, a doctor cannot write a prescription for a family member or be the primary provider of a family member. This is especially important in regards to spouses, parents, and children. The reason is obvious: we as humans are not always objective when it comes to family members, and in the medical profession, it is necessary to be able to objectively make medical decisions. As a Social Worker it appears to be a clear conflict of interest, since the mother is a Pediatrician, between her medical decision making and parental love to give a child what they want. As a Medical Practice Manager, I view this as a doctor overly involved in a medical process with a family member. For the doctor who would perform the treatment, this could become a possible malpractice case by the child, or the objecting parent, over a “never event” being done.
Political correctness should never be a reason to overturn basic parental rights and responsibilities and standard Medical Ethical Guidance.
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Tuesday 22 October 2019
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On the other hand, at least this time the Much Vaunted National Health Service© isn't forbidding his parents from trying:
"The parents of a 10-month-old infant in the United Kingdom born with an extremely rare heart tumor plan to bring their son to the U.S. for surgery"
That's because Britain's government-run heatlh "care" scheme isn't capable of performing the surgery on the poor toddler. He'd been diagnosed with "a cardiac fibroma ... then fitted with a pacemaker" as a stopgap as his folks try to raise the necessary funds for a trip Across the Pond to "Boston Children’s Hospital for surgery, which is expected to cost $147,000."
Those so inclined can click here to help out.
"The parents of a 10-month-old infant in the United Kingdom born with an extremely rare heart tumor plan to bring their son to the U.S. for surgery"
That's because Britain's government-run heatlh "care" scheme isn't capable of performing the surgery on the poor toddler. He'd been diagnosed with "a cardiac fibroma ... then fitted with a pacemaker" as a stopgap as his folks try to raise the necessary funds for a trip Across the Pond to "Boston Children’s Hospital for surgery, which is expected to cost $147,000."
Those so inclined can click here to help out.
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So, a lot of folks buy their prescription drugs from Canada:
"We have found several reliable sources where you can get prescription drugs for a few dollars and in some cases, 100% free."
A lot of these folks also have either considered running the costs of these meds through their qualified plans, or have actually done so.
No harm, no foul, right?
Well, it's been kind of a gray area for a while, but thanks to our gurus of all things HSA/FSA/HRA at FlexBank, we seem to have some definitive guidance (of a sort):
"The Food and Drug Administration recently announced an action plan for allowing prescription drugs to be imported from Canada and other countries. However, employer plan sponsors and plan administrators must heed caution at this time as this is just the announcement that proposed rules are coming."
For now, one must weigh the tax savings of paying for these meds from one's HSA/FSA/HRA versus the potential tax consequences if the Federales decide to crack down before this rule is actually in effect.
#CaveatEmptor
"We have found several reliable sources where you can get prescription drugs for a few dollars and in some cases, 100% free."
A lot of these folks also have either considered running the costs of these meds through their qualified plans, or have actually done so.
No harm, no foul, right?
Well, it's been kind of a gray area for a while, but thanks to our gurus of all things HSA/FSA/HRA at FlexBank, we seem to have some definitive guidance (of a sort):
"The Food and Drug Administration recently announced an action plan for allowing prescription drugs to be imported from Canada and other countries. However, employer plan sponsors and plan administrators must heed caution at this time as this is just the announcement that proposed rules are coming."
For now, one must weigh the tax savings of paying for these meds from one's HSA/FSA/HRA versus the potential tax consequences if the Federales decide to crack down before this rule is actually in effect.
#CaveatEmptor
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Monday 21 October 2019
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Friday 18 October 2019
Thursday 17 October 2019
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Will you please help out by making a donation - any amount helps:
Thank you!!
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From yesterday's post:
"I have ordered a new policy, which we will be mailing to you via UPS today. The tracking number is:Tracking Number: [REDACTED]Service: UPS Ground ServiceGuaranteed By: End of Day Wednesday, Oct 16, 2019 "
"I have ordered a new policy, which we will be mailing to you via UPS today. The tracking number is:Tracking Number: [REDACTED]Service: UPS Ground ServiceGuaranteed By: End of Day Wednesday, Oct 16, 2019 "
And because of course:
[click to embiggen]
[NB: It's unlikely that GTL bears any direct responsibility for this, just thought it was textbook ironic]
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Wednesday 16 October 2019
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I recently had occasion to write my first ever Critical Illness plan. For a number of reasons, we chose Guaranteed Trust Life (GTL) as the carrier: they had a good plan, at decent rates, and their underwriting was a good fit for this particular client.
We eventually settled on a plan design and completed and submitted the application. The underwriting process was unremarkable (that's a good thing) and the policy was issued in a reasonable time frame.
Kinda.
At the time it was approved, they sent me an e-version of the policy (.pdf), which was nice, but we were also told that we'd shortly receive the printed version, as well. On October 3rd, we received this in email:
"Hello Henry,
We mailed the policy to the agent as indicated on the application."
When a week or so went by with no policy appearing, I followed up, and received this:
"The policy was mailed on 10/8/2019."
Hunh?
Okay, so yesterday was the 14th, and I sent this to our GTL rep:
"According to this email, you first told me that you'd mailed the policy to me no later than October 3rd.
You subsequently told me that it had been mailed on the 8th.
It is now the 14th, and I still don't have it.
I am appalled at your company's lack of transparency and accountability.
One of my hats is insurance blogger. I will be writing a VERY negative post on this and will send you the link once it's live.
I often say that you only get one shot at a positive first impression, and GTL has failed this miserably.
I wish you well in your future endeavors, which will most assuredly not include me."
Pretty soon, I received an apology from the rep:
"Hello Henry,
I apologize for the inconvenience and the frustration. According to our systems, the policy was mailed on the 8th to the agent to the address we have on file for you. I have forwarded your email to our new business supervisor for handling. I am not sure why you have not received a copy of the policy yet but according to our notes, it was mailed on 10/8/2019."
Again, this fails to address why I was told that it had already been mailed a week or so before.
And then I received this from her supervisor:
"Good afternoon Henry,
I’m sorry to hear of the troubles we’ve had getting a policy delivered to you.
I have ordered a new policy, which we will be mailing to you via UPS today. The tracking number is:
Tracking Number:
[REDACTED]
Service: UPS Ground Service
Guaranteed By: End of Day Wednesday, Oct 16, 2019
I have also attached an electronic copy of the policy for you in the mean-time.
Please let me know if there is anything else I can assist with."
As I noted earlier, I'd long since received the e-version.
While I appreciate this last-ditch attempt to salvage some semblance of credibility, I see no indication that they've reviewed their processes to ensure that this doesn't happen in the future, nor that they intend to do so, nor that they even care if that happens. This tells me that this is not a carrier with which I should be doing business in the future: one needs to earn that second chance.
We eventually settled on a plan design and completed and submitted the application. The underwriting process was unremarkable (that's a good thing) and the policy was issued in a reasonable time frame.
Kinda.
At the time it was approved, they sent me an e-version of the policy (.pdf), which was nice, but we were also told that we'd shortly receive the printed version, as well. On October 3rd, we received this in email:
"Hello Henry,
We mailed the policy to the agent as indicated on the application."
When a week or so went by with no policy appearing, I followed up, and received this:
"The policy was mailed on 10/8/2019."
Hunh?
Okay, so yesterday was the 14th, and I sent this to our GTL rep:
"According to this email, you first told me that you'd mailed the policy to me no later than October 3rd.
You subsequently told me that it had been mailed on the 8th.
It is now the 14th, and I still don't have it.
I am appalled at your company's lack of transparency and accountability.
One of my hats is insurance blogger. I will be writing a VERY negative post on this and will send you the link once it's live.
I often say that you only get one shot at a positive first impression, and GTL has failed this miserably.
I wish you well in your future endeavors, which will most assuredly not include me."
Pretty soon, I received an apology from the rep:
"Hello Henry,
I apologize for the inconvenience and the frustration. According to our systems, the policy was mailed on the 8th to the agent to the address we have on file for you. I have forwarded your email to our new business supervisor for handling. I am not sure why you have not received a copy of the policy yet but according to our notes, it was mailed on 10/8/2019."
Again, this fails to address why I was told that it had already been mailed a week or so before.
And then I received this from her supervisor:
"Good afternoon Henry,
I’m sorry to hear of the troubles we’ve had getting a policy delivered to you.
I have ordered a new policy, which we will be mailing to you via UPS today. The tracking number is:
Tracking Number:
[REDACTED]
Service: UPS Ground Service
Guaranteed By: End of Day Wednesday, Oct 16, 2019
I have also attached an electronic copy of the policy for you in the mean-time.
Please let me know if there is anything else I can assist with."
As I noted earlier, I'd long since received the e-version.
While I appreciate this last-ditch attempt to salvage some semblance of credibility, I see no indication that they've reviewed their processes to ensure that this doesn't happen in the future, nor that they intend to do so, nor that they even care if that happens. This tells me that this is not a carrier with which I should be doing business in the future: one needs to earn that second chance.
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Tuesday 15 October 2019
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So yesterday we noted that the American VA medical system continued circling the drain:
"Atlanta VA hospital suspends routine surgeries amid ... shortages in sterilized equipment and sutures, staff not showing up on time."
It's worth noting that the VA is a prime example of gocvernment-run health "care;" no less so than that "enjoyed" by our Neighbors to the North©, who are quickly following suit (or have lead the way - tomayto, tomahto:
"Federal government cuts reimbursements for military health care, hospitals on the hook for millions ... The federal government has quietly rolled back what it pays hospitals to take care of military members."
Oh, goody.
#MedicaidForALL
"Atlanta VA hospital suspends routine surgeries amid ... shortages in sterilized equipment and sutures, staff not showing up on time."
It's worth noting that the VA is a prime example of gocvernment-run health "care;" no less so than that "enjoyed" by our Neighbors to the North©, who are quickly following suit (or have lead the way - tomayto, tomahto:
"Federal government cuts reimbursements for military health care, hospitals on the hook for millions ... The federal government has quietly rolled back what it pays hospitals to take care of military members."
Oh, goody.
#MedicaidForALL
[Note from HGS: Please excuse the light posting - we've had a family medical emergency and things are pressed here. Thanks for understanding!]
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Monday 14 October 2019
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Last month, co-blogger Kelley told us about some of the issues surrounding health care for our vets:
"She said that after spending two hours at the hospital without any change, two doctors advised her to go home and come back when she was five centimeters dilated."
Compassion: how does it work?
Well, that was then, and this is now:
It's what you get when the government is in charge of health "care."
#Medicaid4All
"She said that after spending two hours at the hospital without any change, two doctors advised her to go home and come back when she was five centimeters dilated."
Compassion: how does it work?
Well, that was then, and this is now:
"Atlanta VA hospital suspends routine surgeries amid ... shortages in sterilized equipment and sutures, staff not showing up on time...." https://t.co/wFFp4pTBxy— AssocAmerPhys&Surg (@AAPSonline) October 12, 2019
It's what you get when the government is in charge of health "care."
#Medicaid4All
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Thursday 10 October 2019
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They say a picture's worth 1,000 words.
Well:
Remember: Coverage ≠ Care
[Hat Tip: FoIB Ed S]
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Well:
ACA facts=hard pills to swallow.— Kris Held,MD (@kksheld) October 9, 2019
Per @SeemaCMS -premiums on individual market have doubled,even tripled in some states since Obamacare regulations took effect. Thus a new group of uninsured was created (who used to have Ins plans they liked)-working Americans.Forgotten Patients. pic.twitter.com/VsYcj5M58e
Remember: Coverage ≠ Care
[Hat Tip: FoIB Ed S]
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Wednesday 9 October 2019
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Kudos to Cigna!
[Hat Tip: FoIB Beverly G]
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Nice to see @Cigna educating about the #HSA opportunity.— HealthyHive (@Hiveaway) October 8, 2019
Now no one can ever accuse us of never saying anything good about a health insurer! pic.twitter.com/M0XkJOwbsX
[Hat Tip: FoIB Beverly G]
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Tuesday 8 October 2019
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This evening marks the beginning of Yom Kippur, which we've come to call The Day of Atonement. Like Rosh HaShannah (New Year's) this Holy Day is commanded of us in the Torah in Vayikra (Leviticus):
"And this shall be to you a law for all time: In the seventh month, on the tenth day of the month, you shall practice self-denial; and you shall do no manner of work, neither the citizen nor the alien who resides among you."
We generally fast from sundown this evening until sundown tomorrow, and spend this time in contemplation and prayer.
If you observe, may your fast be meaningful.
L'shannah tova!
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Monday 7 October 2019
Friday 4 October 2019
Thursday 3 October 2019
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For once this is really just one of those unhappy coincidence type stories, but it's a good illustration of how things outside of our control can have a big impact.
Got a call this morning from the admin for one of my group clients. She told me that "Larry" had initially waived coverage on their plan because he was covered under his spouse's employer's group plan. Okay, no big deal, how may I be of assistance?
Well, seems that Larry's wife took a new job, and this one doesn't offer spousal coverage at all. So, can he still get on their plan, or must he wait for Open Enrollment?
The good news is that losing coverage is a "trigger" for enrolling on his employer's plan, no problem. Here's the kicker: his termination form the wife's plan isn't until the end of November.
The reason this is such a big deal is that it means that he'll be (potentially) subject to 3 deductibles in 32 days: his 2019 deductible for his current coverage until November 30th, then his own group's 2019 deductible for December, and then his group's 2020 deductible come January 1.
Yikes!
Now granted, the odds of him having to satisfy all of these in essentially a month's time is pretty slim, but I'd be taking a lot of time off and staying in bed.
Got a call this morning from the admin for one of my group clients. She told me that "Larry" had initially waived coverage on their plan because he was covered under his spouse's employer's group plan. Okay, no big deal, how may I be of assistance?
Well, seems that Larry's wife took a new job, and this one doesn't offer spousal coverage at all. So, can he still get on their plan, or must he wait for Open Enrollment?
The good news is that losing coverage is a "trigger" for enrolling on his employer's plan, no problem. Here's the kicker: his termination form the wife's plan isn't until the end of November.
The reason this is such a big deal is that it means that he'll be (potentially) subject to 3 deductibles in 32 days: his 2019 deductible for his current coverage until November 30th, then his own group's 2019 deductible for December, and then his group's 2020 deductible come January 1.
Yikes!
Now granted, the odds of him having to satisfy all of these in essentially a month's time is pretty slim, but I'd be taking a lot of time off and staying in bed.
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Wednesday 2 October 2019
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Oh goody, another wonderful innovation" from the Feds:
"Today, the Centers for Medicare & Medicaid Services (CMS), released an informational bulletin announcing the opportunity for 10 states to apply to participate in a wellness program demonstration project for their individual market."
Actually, it gives insurers in those 10 states the opportunity to increase premiums with little effort, and even less actual cost.
How is that, you ask?
Regular readers already know:
"Workplace Wellness Programs Don’t Work Well."
But I'm sure it just wasn't tried by the right folks....
"Today, the Centers for Medicare & Medicaid Services (CMS), released an informational bulletin announcing the opportunity for 10 states to apply to participate in a wellness program demonstration project for their individual market."
Actually, it gives insurers in those 10 states the opportunity to increase premiums with little effort, and even less actual cost.
How is that, you ask?
Regular readers already know:
"Workplace Wellness Programs Don’t Work Well."
But I'm sure it just wasn't tried by the right folks....
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Seriously good news:
It's surprising primarily because it's under the radar.
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Health Savings Accounts Linked to Increased Care Access in Cancer Survivors https://t.co/tsQRor792V— AssocAmerPhys&Surg (@AAPSonline) September 18, 2019
It's surprising primarily because it's under the radar.
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