Monday, 7 January 2019

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So I get a phone call this past Friday from "Pam," who's looking for help with "personal health insurance." Turns out her husband's "idiot boss" had neglected to pay the group health insurance premiums, and as a result that plan had lapsed. At which point her "idiot husband" went on the Exchange (during Open Enrollment) and signed them up for a plan with Molina, to the tune of $2,100 per month (you know, 'affordable'). Pam was unhappy with both of these events (no kidding), and wanted to make some changes.

In the meantime, she had signed up for a UHC short term plan that will expire on the 20th.,

It should also be noted that Pam has a pre-existing shoulder injury for which she receives periodic treatment, and her "idiot husband" was recently diagnosed with a (thus far benign) thyroid nodule.

Hunh.

I explained that there really weren't a lot of insurance options here: since we're outside Open Enrollment, and I don't see any Special Open Enrollment triggers in her situation, there's not much we can do with ACA-compliant plans. Nor would another Short Term plan be advisable, since both her shoulder and now her "idiot husband's" thyroid condition would be pre-existing and thus excluded.

I then turned to some non-insurance (but ACA-compliant) options, and asked if she was familiar with Health Care Sharing arrangements; she was not. So I explained to her that, although I don't write these myself, I do know that there are a lot of folks who think they're pretty good (and also a lot who think they're a rip-off, of course). I also asked if she knew about Direct Primary Care (DPC) and, unsurprisingly, she did not. And so I explained how DPC worked, and how to use the DPC Frontier site to see if there's a nearby practice.

I also explained that many folks combine these two plans, and why that is often effective.

Keep in mind that I've now spent about 45 minutes with her answering questions and offering advice, and that since I wouldn't be selling her anything myself, this was completely uncompensated. On the other hand, The Sticker pretty much dictates this course of action.

At the end of the conversation, I asked if she had any other questions, and she said "no, I'm going to call the Exchange number and get my plan changed." And then she hung up.

Gee, Pam, you're quite welcome.

And rotsa ruck with that.


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Sunday, 6 January 2019

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Some 35 years ago, I had the pleasure of meeting a man who would become my boss, friend and mentor. Joe was the very definition of "larger than life." He passed away, peacefully, his family at his side, last night.

About 25 years ago, the local TV news did a report on laughter in the workplace, and the segment opened with a shot of our office from across the street.

You could hear Joe's laugh.

Joe's business model was pretty straightforward: do the right thing for our clients, always.

A devout and passionate Catholic, Joe organized a city-wide rosary prayer-a-thon that gained national attention.

Everyone knew Joe: I used to joke that if aliens ever landed here, the first thing they'd say would be "hey, where's Joe, I need insurance for my UFO."

He and the love of his life, Joan, were married for over 60 blissful years, and they have the kids, grandkids, and great grandkids to prove it.

He'd been in failing health for a while, and over the weekend preceding New Year's he was hospitalized. I was fortunate to visit them on Thursday morning, and had them all to myself for about an hour. He was still, well, Joe and I got to experience his trademark smile more than once.

He quizzed me about my girls, and even offered a (tremendous) suggestion for my youngest.

We're members of a synagogue in northern Cincinnati, about 35 minutes away. At services yesterday morning, I mentioned his name for the healing prayer list. After services, a friend came up to me and said, "I recognized Joe's name." Because of course he did. Why was I even surprised?

I will miss you, Joe, and your laugh, and your compassion, and your love of the Reds.

But mostly, I will miss your warmth, and love, and compassion.

Baruch Dayan HaEmet. Rest in Peace, dear friend.


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Friday, 4 January 2019

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Some time back, we had the opportunity to both buy and sell LifeLock ID Theft protection (we earned a modest commission on those sales). Eagle-eyed readers may have noticed that the LifeLock sidebar link has been gone for quite a while.

This was primarily as a result of this news last summer:

"Identity theft protection firm LifeLock — a company that’s built a name for itself based on the promise of helping consumers protect their identities online — may have actually exposed customers to additional attacks from ID thieves and phishers."

In the event, we discontinued our association at that time, and removed the link from the sidebar.

But we still had a need for the protection, and a good friend (and colleague) recommended Zander Insurance Group as a helpful and more economical alternative. In fact, their package includes all the features that we had appreciated from LifeLock, at a fraction of the price.

Of course, "cheaper" often means "lower quality" but that hasn't been the case at all: Recently, our primary credit card (from which our Zander ID plan premiums were charged) was hacked and we had to get replacement cards (and numbers). This in turn generated an email from Zander when our premium "bounced." So I called up the customer service number, and was almost immediately connected to a delightful young lady named Elizabeth. Not only did she offer great service with a smile, she also recognized that I had inadvertently set up a duplicate account and was being double charged. She immediately cancelled that second, unnecessary account, and arranged for a full refund of the fees.

It just doesn't get much better than that.

Thanks, Elizabeth!


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Thursday, 3 January 2019

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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

In which its adherents fall into the same trap as those who conflate health insurance and health care.

Look, I have long been a fan of the Direct Primary Care (DPC) model: in fact, we were among the first to interview one of its pioneers, way back in Aught 12.

There is much positive to be said about DPC: it satisfies the ObamaTax mandate (which may or may not matter for this year), and offers the opportunity for better clinical outcomes based on more patient-focused care.

Unfortunately, it seems that its advocates think a lot more highly of the model than is actually justified. For one thing, it is literally a blip on the health care radar: there are about a quarter of a million primary care doc's in the US, and less than 1,000 of them are DPC (that's about 4/10's of 1%). As I recently pointed out to one of the more outspoken DPC folks, it's not that DPC is a bad thing, it's just not a thing. And the idea that it can be easily or quickly (or realistically) scaled up to meet a meaningful number of patients' needs is, frankly, laughable.

And of course, we've discussed numerous times (here for example) how DPC folks continue to make the fallacious argument that it makes economic sense for patients*. Until true Catastrophic medical plans are allowed once again (they're currently illegal under ObamaCare), then one of two things will continue to be true:

1) That folks will be double-paying for primary care (since it's already covered under ObamaPlans) or

2) They'll drop their major med plans in favor of DPC only, leaving themselves exposed to potentially massive catastrophic claims.

Sigh.

So what's your point here, Henry? Or are you just blowing off steam?

Good question - mostly the latter.

And there's this, from FoIB Michael Bertaut (an economist with Louisiana Blue Cross):

"Insurance carriers depend on primary care docs with a free flow of patient health data via EHR's to keep patients healthy. A huge slice of care coordination (especially post-discharge) and much of predictive modeling, both of which are now big contributors to keeping claims costs down, require in-network, EHR sharing PCP's. To me this makes the idea of carving out primary care not only counter-intuitive, but bad for the patient and his healthcare costs overall."

A good point, although I do see a role for DPC here, if only to provide timely access and more patient-centered care.

Still, a conundrum.


*To be fair: Many (most?) DPC practices do offer discounted rx options, which has the net effect of lowering the subscription cost.


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Wednesday, 2 January 2019

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But just what makes this development so troubling?

Well:

"Thanks to NICE guidelines, millions of British citizens are on waiting lists at any given time for procedures, hundreds of thousands are waiting for basic diagnostic tests, and thousands of operations are regularly cancelled."

Opening soon here.



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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

Shot:

"Had a patient today who had a skin cancer on her nose. 6 month wait for Mohs surgery removal in Toronto and no pathway for Facial Plastic Surgery nasal reconstruction following. She went to the US and was treated the next day."

Regular readers know that situations like this are a common occurrence under Canada's state-run health "care" system. Unfortunately, those who advocate such a system here seem to be, well, oblivious (or just don't care).

Chaser (courtesy of our friends at OOC):



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