Tick, tock...
Rabu, 14 Desember 2016
Going Bare: Making the Case
As we've long noted (here, for example), some (many?) folks have made the perfectly rational decision to forgo ObamaPlans (or health insurance of any kind). For one thing, the fine penalty tax is nominal (particularly in comparison to non-subsidized premiums). Recently, FoIB Dr Gerard Gianoli tipped us to this well-researched and written article expanding on the idea:
"There are necessities of life, but insurance is not one of them."
That's Dr Jane Orient's opening salvo, and it gets even better from there:
"It might be a ticket to get you into certain medical facilities, but in these days of narrow networks, it will keep you out of others."
This in reference to how restrictive networks have become; I'd add that there's another dimension, as well: HMO vs PPO models.
Until this year, many (most?) plans were built on the PPO (Preferred Provider Organization) chassis. That is, one got the best bang for their premium bucks by staying in-network for care, but there was still a safety net for out-of-network claims. This is no longer the case: all the plans I've seen (in this market) are for HMO model plans; that is, zero coverage for non-emergency non-network expenses.
So what's the big deal? Well, what if your oncologist is out of network?
I particularly appreciated this observation:
"If most bills were paid directly instead of through a third party, medical care would cost far less. Wouldn’t that be better for everybody?"
This comes as she makes the case for a return to truly catastrophic coverage, which she favors as the best O'Care alternative.
As they say: Read the whole thing. You'll be glad you did.
"There are necessities of life, but insurance is not one of them."
That's Dr Jane Orient's opening salvo, and it gets even better from there:
"It might be a ticket to get you into certain medical facilities, but in these days of narrow networks, it will keep you out of others."
This in reference to how restrictive networks have become; I'd add that there's another dimension, as well: HMO vs PPO models.
Until this year, many (most?) plans were built on the PPO (Preferred Provider Organization) chassis. That is, one got the best bang for their premium bucks by staying in-network for care, but there was still a safety net for out-of-network claims. This is no longer the case: all the plans I've seen (in this market) are for HMO model plans; that is, zero coverage for non-emergency non-network expenses.
So what's the big deal? Well, what if your oncologist is out of network?
I particularly appreciated this observation:
"If most bills were paid directly instead of through a third party, medical care would cost far less. Wouldn’t that be better for everybody?"
This comes as she makes the case for a return to truly catastrophic coverage, which she favors as the best O'Care alternative.
As they say: Read the whole thing. You'll be glad you did.
Selasa, 13 Desember 2016
Wing, Prayer, Healthcare
It's long been my belief that there's a direct, intrinsic connection between prayer and healing. Although the healing prayer group in which I'd participated for so many years is now defunct, I continue to believe in the healing power of those prayers. And of course I'm far from alone in this.
Recently, FoIB Holly R sent along this interesting article that discusses the link between health care and spirituality:
"Dr. Christina Puchalski is familiar with death ... Several years ago, [she] went into a checkup with a patient previously diagnosed with a terminal illness ... We’d gotten to the heart of the visit, and it wasn’t about the medication or the pain. The real issue was the bereavement and the fear of losing each other.”
And it's not really about religious faith, per se: the focus is primarily on one's “search for ultimate meaning.”
I recall a few years ago, a dear friend (who, perhaps not coincidentally, was the founder of our own healing prayer group) was scheduled for a procedure. Like me, he was also Jewish, and his Christian doctor asked if it would be alright if they could pray together. Of course my friend immediately agreed, and everything went well (which may or may not have had anything to do with the prayers, but they certainly did no harm).
In fact, this practice appears to be more widespread than one might believe:
"In 1998, the Association of American Medical Colleges (AAMC) published a report called the Medical School Objectives Project, which included sections on spirituality."
Kudos (and prayers sent).
Recently, FoIB Holly R sent along this interesting article that discusses the link between health care and spirituality:
"Dr. Christina Puchalski is familiar with death ... Several years ago, [she] went into a checkup with a patient previously diagnosed with a terminal illness ... We’d gotten to the heart of the visit, and it wasn’t about the medication or the pain. The real issue was the bereavement and the fear of losing each other.”
And it's not really about religious faith, per se: the focus is primarily on one's “search for ultimate meaning.”
I recall a few years ago, a dear friend (who, perhaps not coincidentally, was the founder of our own healing prayer group) was scheduled for a procedure. Like me, he was also Jewish, and his Christian doctor asked if it would be alright if they could pray together. Of course my friend immediately agreed, and everything went well (which may or may not have had anything to do with the prayers, but they certainly did no harm).
In fact, this practice appears to be more widespread than one might believe:
"In 1998, the Association of American Medical Colleges (AAMC) published a report called the Medical School Objectives Project, which included sections on spirituality."
Kudos (and prayers sent).
Senin, 12 Desember 2016
About Those ACA Signups (GIGO)
As the first phase of Open Enrollment v4.0 winds down, it may be helpful to get a sense of how successful the whole effort's been thus far (for certain values of "success"). ObamaCare proponents like to boast that the train-wreck insured some 20 million Americans.
But is this really accurate?
It will come as no surprise to IB regulars that the answer is a resounding 'No:'
"The Department of Health and Human Services claims that 20 million people have gained health coverage ... 17.7 million people gained health insurance from Obamacare’s first open enrollment period."
Which is all well and good, except that these numbers are based entirely on survey data, not actual, verified enrollment numbers. When one examines those, a very different picture emerges:
"Just over 14 million people gained coverage from the end of 2013 to the end of 2015. Of those 14 million, 11.8 million gained their insurance through Medicaid."
So roughly 85% of those being counted are not, in fact, insured: they're enrolled in Medicaid, which is not insurance. So less than 15% of the folks who ACA proponents claim became insured under the ObamaTax actually did so.
Of course, they'll never admit this, because: #Narrative.
But is this really accurate?
It will come as no surprise to IB regulars that the answer is a resounding 'No:'
"The Department of Health and Human Services claims that 20 million people have gained health coverage ... 17.7 million people gained health insurance from Obamacare’s first open enrollment period."
Which is all well and good, except that these numbers are based entirely on survey data, not actual, verified enrollment numbers. When one examines those, a very different picture emerges:
"Just over 14 million people gained coverage from the end of 2013 to the end of 2015. Of those 14 million, 11.8 million gained their insurance through Medicaid."
So roughly 85% of those being counted are not, in fact, insured: they're enrolled in Medicaid, which is not insurance. So less than 15% of the folks who ACA proponents claim became insured under the ObamaTax actually did so.
Of course, they'll never admit this, because: #Narrative.
Kamis, 08 Desember 2016
Another One Bites the Dust
Last we looked, there were only a handful of Co-Ops still fogging a mirror (metaphorically, of course). And that list just got shorter:
"Evergreen Health Cooperative Inc. (“Evergreen” or “company”) will not be issuing or renewing individual health benefit policies ... Evergreen Health plans are not available on Maryland Health Connection for the 2017 plan year"
This means that folks currently insured by the faltering carrier will have to choose a new one, and they have just about a week to do so (if they want to remain insured come January 1). Now, if they'd purchased their current plans through the Old Line State's Exchange (Maryland Health Connection), they'll be automatically "transitioned" into a comparable plan with another carrier. If they don't wish that to happen, then they'd best get crackin'.
Those who bought off-Exchange are on their own.
Still, I'm a bit puzzled as to how this can be happening. After all:
[Hat Tip: FoIB WeirdDave]
"Evergreen Health Cooperative Inc. (“Evergreen” or “company”) will not be issuing or renewing individual health benefit policies ... Evergreen Health plans are not available on Maryland Health Connection for the 2017 plan year"
This means that folks currently insured by the faltering carrier will have to choose a new one, and they have just about a week to do so (if they want to remain insured come January 1). Now, if they'd purchased their current plans through the Old Line State's Exchange (Maryland Health Connection), they'll be automatically "transitioned" into a comparable plan with another carrier. If they don't wish that to happen, then they'd best get crackin'.
Those who bought off-Exchange are on their own.
Still, I'm a bit puzzled as to how this can be happening. After all:
[Hat Tip: FoIB WeirdDave]
Rabu, 07 Desember 2016
Obamacare Conflict: Losing The Personal Touch
I've been fielding a lot of questions from individuals looking for health insurance lately. They wonder why I tell them up front that it's unlikely I will have time to personally meet with them on their needs - especially considering many of them are losing their plans. So, in an effort to explain my situation here is what I'm sharing.
Hi Jane,
I'm sorry our affiliate isn't able to suit your needs. Unfortunately the ACA forces everyone to renew their plan January 1st which makes a personal touch almost impossible to achieve. Also unfortunate is most of my professional colleagues that have true knowledge and understanding of the industry aren't willing to work in this market. This is because they are astute business people and know that most of the insurers participating don't value our personal touch. We know this because many of them have completely eliminated our compensation and others have dramatically reduced our compensation. I hope you understand that we simply can't work for free.
Hi Jane,
I'm sorry our affiliate isn't able to suit your needs. Unfortunately the ACA forces everyone to renew their plan January 1st which makes a personal touch almost impossible to achieve. Also unfortunate is most of my professional colleagues that have true knowledge and understanding of the industry aren't willing to work in this market. This is because they are astute business people and know that most of the insurers participating don't value our personal touch. We know this because many of them have completely eliminated our compensation and others have dramatically reduced our compensation. I hope you understand that we simply can't work for free.
If you are looking for a personal touch I can tell you that you do have options available.
The first are Navigators. Navigators are unlicensed people that have been hired by non-profits who received government funded grants to help you through the process. Unfortunately these folks aren't able to advise you on specific plan choices or make any recommendations. Of course why would you take their advice since they are not licensed to sell insurance and haven't had any formal training. Not to mention, they are unable to service your account throughout the year.
The second option is to head on over to your local WalMart. You will need to find the person standing up by the checkout lines behind a table with a "health care" banner next to it looking bored out of their mind. This person is licensed to sell health insurance and can walk you through the process. I'm sure they will have time to meet with you.
If you would still be interested in a phone consultation and my recommendations please let me know. I'd be happy to assist you - if I can.
Attaboy, ObamaCare Style
So you've just spent several hours helping a client navigate Open Enrollment v4.0, sifting through the various options, checking to see which (if any) of his doc's are in-network, helping to determine whether or not he's eligible for a subsidy, helping him set up an account and verifying his identity at 404Care.gov. How do you think you should be compensated? Well, co-blogger Bob V tells us that the Rocket Surgeons in DC© have just the thing:
"[T]he Centers for Medicare and Medicaid Services (CMS) is offering health insurance brokers who enroll 20 or more individual consumers or 20 or more employers through the marketplace the opportunity for a “gold star” in the form of membership in the Healthcare.gov Circle of Champions."
Gosh, who wouldn't prefer this kind of recognition to icky commission dollars?
As we've pointed out, many agents have bailed on this season because carriers have drastically reduced or, in some cases, done away with agent compensation. As Ronnell Nolan, president/CEO of Health Agents for America points out, it's really just "throw ‘em a bone but not pay any money.”
And stay tuned: Co-Blogger Patrick has a very personal experience to share coming up shortly.
#ObamaCareWinning!
"[T]he Centers for Medicare and Medicaid Services (CMS) is offering health insurance brokers who enroll 20 or more individual consumers or 20 or more employers through the marketplace the opportunity for a “gold star” in the form of membership in the Healthcare.gov Circle of Champions."
Gosh, who wouldn't prefer this kind of recognition to icky commission dollars?
As we've pointed out, many agents have bailed on this season because carriers have drastically reduced or, in some cases, done away with agent compensation. As Ronnell Nolan, president/CEO of Health Agents for America points out, it's really just "throw ‘em a bone but not pay any money.”
And stay tuned: Co-Blogger Patrick has a very personal experience to share coming up shortly.
#ObamaCareWinning!
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