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Monday, 9 July 2018

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While we've never been fans of the (Evil) Individual Mandate, we've recognized that it's limited in how draconian its enforcement is allowed to be. Worst case scenario, a big check to Uncle Sam (and even that's difficult to actually enforce).

But as terrible as the (Evil ) ObamaCare Mandate is, it pales in comparison to the new iteration recently passed by the Rocket Surgeons in the District of Columbia:

"DC Passes Law Requiring People To Buy Health Insurance Or Have Their Property Seized"

So, "nice house you've got there, be a shame if something happened to it because you passed on buying health insurance."

Worse yet, it doesn't appear that there's no carve-out for Direct Primary Care or Health Care Sharing Ministries (as there is in the ACA).

Yikes, indeed.

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We try not to get too political here at IB, so I want to be careful in how I characterize the subject of this post. First, one needs to know that the Cost Sharing Reduction (CSR) mechanism was designed to help offset the higher claims anticipated as a result of implementing ObamaCare. There's some dispute as to their legality (or, rather, how they were actually aid for). Regardless, carriers counted on them when determining rates, and for "cleaning up" their books at the end of a given plan year.

These funds have now been cut off by the folks in charge (ie President Trump's CMS). Now, whether or not this is a good idea is, of course, debatable. What's not at issue, it seems, is the effect this will have on premiums going forward. As FoIB Michael Bertaut has noted, carriers have been counting on these reimbursements (from the 2017 plan year) in their 2019 rate calculations. Absent these funds, rates are going to go even higher.

On the other hand, FoIB Jeanne Bodine calls them "insurance company bailouts."

Contrariwise, co-blogger Patrick says that they're not bailouts, but promises to carriers.

I think that there's room here for everyone, and that the most accurate description is "bribes."

So, you may ask, what's the difference between a "bailout" and a "bribe?"

Well, a bailout is something that occurs after an event, whereas a bribe is an inducement towards a given behavior or action. And there is zero doubt that insurance companies were big proponents of the idea of ACA (hey, the government's going to make people buy my product? Count me in!) but not so much fans of the promise of guaranteed issue and immediate coverage of pre-existing conditions. The CSR's were a bribe to get (and keep) carriers "on board;" if they go away, what then?

Well, it's not as if there's currently a plethora of carriers available, so look for even more market tightening.

And, since there aren't a lot of variables left for carriers to rein in costs, look for narrower networks and more restrictions on prescription drug coverage.

Oh, and the idea that this some kind of "sabotage" by the Trump administration?

Well, not so fast there. As Christopher Jacobs (CEO of a well-regarded policy consulting firm) notes, this actually lays at the feet of one Andrew Slavitt, also well-known but hardly someone to be admired. Mr Jacobs writes:

"The Trump administration took actions to comply with a federal court order that vacated rules promulgated by the Obama administration—including rules CMS issued when Slavitt ran the agency. If Slavitt wants to denounce the supposed “sabotage” of Obamacare, he need look no further than the nearest mirror."

In other words, Mr Trump was simply following the law.

Not that there's anything wring with that.

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Thursday, 5 July 2018

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Pitch perfect:

Disagree. Why can't savvy shoppers be allowed to manage their own level of risk? This is INSURANCE after all, not healthcare. We let them manage their own auto risk, homeowners risk, death risk. Why not healthcare risk? Afraid of market forces in healthcare? Hmmm..... https://t.co/gUizCBhmPv
— Michael Bertaut (@MikeBertaut) July 5, 2018

Perhaps doubly so, given the similarity between auto/home insurance and health insurance (or, rather, what health insurance used to be),

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Insurance Tips and trik auto insurance, auto insurance quotes, auto insurance companies, auto insurance florida, auto insurance quotes online, auto insurance america

At an acquisition cost of $200,000 per enrollee? https://t.co/f68fBEM0QC
— John Chamberlain (@misterchambo) July 4, 2018

This is a great point: imagine how much more efficient and effective health care financing and delivery could be if instead of throwing all this cash at a few, selected carriers offering "one size fits all" (or none) policies, folks could choose the plan they want (if any), including Direct Primary Care and other options like true catastrophic pans.

One wonders, though, what one would call this system?

I'd voucher for it, though!

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Tuesday, 3 July 2018

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First, our heartfelt condolences to Stefanie Schaffer, a young woman who recently lost both legs in a tragic boating accident while on a cruise in the Bahamas when the boat she was on exploded.

To make matters worse, Ms Schaffer was an aspiring dancer.

And to pile on, she apparently had neglected (declined?) to purchase travel medical insurance. Assuming this was a week-long cruise, a $1million dollar plan with a $1,000 deductible from our friends at Global Underwriters would have set her back a measly $15.

A small price to pay in comparison to the $50,000 she's hoping to raise through GoFundMe.

A painful, and expensive, lesson learned.

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Monday, 2 July 2018

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First, from our Neighbors to the North (ie CanuckCare©). Our friend Holly R tips us to this interesting tidbit:

"Ontario’s government will no longer offer free prescriptions to kids and young adults with private coverage"

Wait, what??

Government-run health care is free in Canada, so what's this about "private coverage?" Well, regular IB readers already know that dirty little secret. As we pointed out 13 years ago:

"The Supreme Court on Thursday struck down a Quebec law banning private medical insurance"

In the event, Canadians savvy enough to buy their own coverage, and also forced to pay for the gummint-run one, can no longer benefit from the latter. Actually, this isn't all that different from ObamaPlans, where men are forced to pay for women's health care with no corresponding coverage for themselves.

Next up, Across the Pond to the Much Vaunted National Health System© where, thanks to Sally Pipes, we learn that:

"Tens of thousands of protesters [took] to the streets of London [yesterday] as they mark the 70th anniversary of the National Health Service by marching to Downing Street."

Wait, we've been constantly reminded about what a great deal the MVNHS© represents. How can this be?

Well:

"The march is part of a larger movement of pressure on the government for increased funding and staffing for the NHS, as well as a protest against privatisation."

Heh.

So again, if it's such a rousing success, why is it losing money hand-over-fist, and why do its advocates feel so threatened by alternatives?

(To be fair, one could ask the same of ObamaCare proponents here in the US)

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Medicare can be confusing. Where can you find answers to ALL your Medicare questions? One minute video addresses your questions.

You have questions.

We have answers.

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