Author: bill

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Is The $2.5 Billion Risk Corridor Shortfall A Reality Check For Insurance Companies?

Healthcare-LunchboxWhen I first heard about the $2.5 billion risk corridor shortfall in 2014 I was both happy and dismayed. I was happy because I did not believe the Congressional Budget Office estimate that the risk corridors would make the government $8 billion. It just did not make sense that the insurance companies would have excess profits from insuring enrollees who were generally older and sicker than anticipated. I was dismayed that the insurance companies would be confronted with two choices:

  1. Raise insurance rates for policies issued through the exchanges
  2. Get the middle class to pay for a bailout

Today I read an article, How Congress Stopped a Massive Obamacare Bailout, which said that Congress had looked at the “risk corridor” appropriation problem and decided last year that the risk corridor program would be budget-neutral for fiscal year 2015. Since Congress has already opted for the budget-neutral approach that makes it almost impossible to switch to a “risk corridor” appropriation method  in an election year without it looking like a bailout. That leaves insurance companies with only one alternative. They will have to raise rates to recoup their losses. Since 87% of the people in the exchanges have subsidized insurance, their cost is unchanged. It is the government and that 13% of the people who do not get subsidized insurance who will be hurt from the higher insurance rates. This is the first step of the death spiral. Maybe this is the reality check the insurance companies needed to get on board with either repealing or replacing the Affordable Care Act. It should be obvious to the insurance companies that the current system is not working and they were duped!

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Can Both Paul Ryan And The Freedom Caucus Win?

Although the media is particularly focused on demonizing the Freedom Caucus for the demise of Mr. Boehner, I think there are real opportunities for both Paul Ryan and the Freedom Caucus to come out of this mess as winners. Here are Paul Ryan’s requests for #moreReasonableSpeakerConditions.

  1. The Republicans must “move from being an opposition party to a proposition party.”
  2. The Republicans must “update our House rules so that everyone can be a more effective representative [including] fixes that ensure we don’t experience constant leadership challenges and crises.”
  3. The Republicans must “unify now” behind one Speaker.
  4. Mr. Ryan can forego fundraising travel to spend more time with his family.

His requests are not only reasonable but they also encourage the Republican party to evolve into a party that is better equipped to govern and be re-elected. The current political model is not working for either the Democrats or the Republicans. Democrats cringe at defending Ms. Clinton’s unforced errors. Did Ambassador Stevens death in Benghazi an unintended consequence of Democrat party politics run amok or incompetence? For every mother and father who lost a son in Benghazi are we to be consoled with the question, “What difference does it make?” Were there any adults in the room when Ms. Clinton said she wanted to set up a private email server? When you look at the Administration scandals over the last seven years there does not appear to be much in the way of accomplishments or accountability. Even though big government has become synonymous with government corruption Democrats have ceased to make any pretense they want our democratic process to make good decisions. It is no wonder that some people call the Democratic party the evil party.

Republicans on the other hand are not much better. Many Republicans ran advocating bipartisan change through the democratic process. They thought that if they proposed simple bills with bipartisan support such as the Small Business Healthcare Relief Act (S. 1697 and H.R. 2911) and Kate’s Law( S. 1762 and H.R. 3011) then there would be votes. Instead of votes the bills are locked up in Congressional hell. Republicans cringe at the thought they have successfully evolved from the opposition party to the do-nothing party so they should not be surprised that groups like the Freedom Caucus are demanding political changes.  The Republican establishment response to the Tea Party candidates in 2010 was “scorched-earth tactics” and all that did was piss the candidates off.  So instead of reconciling with the newly elected representatives Mr. Boehner went a step further and tried to marginalize them. Who would of thought that marginalized, pissed off representatives would respond by asking for a new Speaker of the House? Sorry Mr. Boehner, you own this problem and the stupid party moniker! If the Republicans truly want to evolve into a “big tent political party” they are going to need some adults in the room to reconcile Tea Party and Freedom Caucus issues. The time for demonizing is over. Avik Roy makes the same argument in the article, If The Freedom Caucus And Paul Ryan Agree, Here’s What The New House Speaker Will Do.

On the merits, reasonable decentralizing reforms could actually make the House function more smoothly. Backbenchers who now lodge protest votes out of frustration could have a stake in a legislative process that works, because their own bills could get passed. In The Federalist, Sen. Mike Lee (R., Utah) made this very case, that an “open-source” Congress might produce better legislation than the one we have now.

Both Mr. Ryan and the Freedom Caucus can win if they keep their eyes focused on making the House function more smoothly and bring some of the law making back to the House. The Freedom Caucus requests are simple and Mr. Ryan will look presidential if he handles their issues like an adult. If they are successful they may be surprised to find that the Republican Party has become attractive to Black and Hispanic candidates who want to make a difference for their communities. That is what I call a Win-Win-Win!

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Things that make me go hmm… Medicare Cannot Fix Email Problems Without A Medicare Number

Today I tried to convince Medicare to stop sending me emails that should be going to a different person. I called them on the phone and they were apologetic but they said that they cannot do anything with MyMedicare.gov accounts without the Medicare number. That is a strange way to run a web site. Since I am not interested in hacking into his account and none of his emails has his Medicare number on it, I guess I need to grin and bear it.

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Why Does Medicare Cost More Than My Health Insurance?

I was reading the latest Thoughts From The Front Line newsletter, Unhealthy, Not Wealthy, and Far from Wise, and could not help wondering whether Medicare costs more than my health insurance. My wife and I are 61 years old and our health insurance premium is $479.  According to the Medicare website the 2015 “Part B” premiums is $209.80 per month for a couple earning less than $170,000. That looks nice but it is only the part of the total health care bill. According to the Medicare NewsGroup in “2011, Medicare spent a total of $549.1 billion on health care coverage for 48.7 million beneficiaries” or about $11,275 per person. This is considerably higher than what we are paying for private insurance, $4,764 per person. It sure looks like the vaunted cost efficiency of single-payer health care systems is more sizzle than steak and you have to wonder how many of these services were necessary!

John Mauldin goes on to say that Medicare costs are going to get much worse.

In July, the Medicare trustees issued a report estimating that next year’s Part B premium will have to rise 52% in order to keep the system solvent. That’s right, 52%. This will be an increase of $50 to $175 per month, again depending on your income. So much for 2% inflation.

Some supporters will agree that Medicare has not done a good job of controlling costs but then say at least it is not dysfunctional. I think they are sorely mistaken. Nothing describes how dysfunctional Medicare has become than Health and Human Services Secretary Sylvia Burwell pledging that 70% of Medicare enrollees will be exempt from the rate increase. Now I am beginning to dread the day I become eligible for Medicare because health care costs are growing faster than Social Security Cost of Living Adjustments and I will be part of the 30% who will bear a disproportionate burden of the cost increases. Someday we will have to start thinking outside of the box about cost cutting because this is not a revenue problem. Both the single-payer health care systems and the health insurance exchange rely too much on wealth redistribution. Without intelligent cost cutting to temper our health care abuses and inefficiencies,  the system continues to get more dysfunctional.

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My Grandfathered Health Insurance Plan Is Alive!

I was sure that this was the year my grandfathered health insurance plan would die. Some people have had their plan canceled twice. Yesterday I got a letter telling me that the 2016 premium would be 14% higher than last year. The consolation prize is that my grandfathered health insurance plan is better and cheaper than getting health insurance from the exchange. Although we were leaning toward going without health insurance in 2016, we opted to go another year of grandfathered health insurance to build up our health savings account.

I am puzzled why my grandfathered health insurance plan is still alive. When I see a report of a $2.5 billion risk corridor shortfall in 2014, I wonder what went wrong and how the insurance companies and our government officials are going to make the middle class pay for their mistakes. Since health insurance from the exchange does not become affordable for me until I earn $146,850 a year, I assume insurance companies have given up trying to entice healthy people to buy unsubsidized insurance from the exchange.  To avoid the dreaded adverse selection scenario the only solution left is to force these healthy people into the exchange by canceling their grandfathered health insurance plans. That will not be pleasant and may have an unintended consequence. When health insurance goes over 10% of a family’s budget, self insurance looks pretty attractive for pissed off, healthy people.

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Can Ms. Clinton Be Convicted Of Manslaughter?

l_201_300_thumb.pngWhen I looks at the facts that the Clinton email server contains about 5% confidential information, some of the emails would be very helpful to someone planning an attack on the consulate, and there was very little email security, you have to wonder whether a Secretary of State can be convicted of manslaughter. The Wikipedia definition says:

Criminally negligent manslaughter occurs where there is an omission to act when there is a duty to do so, or a failure to perform a duty owed, which leads to a death.

When Ms. Clinton set up her private email server there was a duty for her to use a secure server because 5% of her emails would eventually be classified as confidential. Even if we concede that she was allowed to set up a private email server, her failure to secure the server to the same standards as State Department email servers is an omission to act. She was not exempt from the State Department email security standards and ignorance of the standards is not an excuse. When I connect the dots I see a combination of one of the worst national security mistakes in my lifetime coupled with gross incompetence that led to the deaths of four men. Maybe we cannot convict her of manslaughter but like the late Senator Kennedy she definitely does not have the right stuff to be President.

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Things that make me go hmm… Medicare Drumming Up Business For Health Care Professionals

Since I am not enrolled in Medicare and my birthday is in March I was surprised to get this email a few days ago. Obviously Medicare does not follow the best practice used in the business world of verifying email addresses by using a Double Opt-in process. I guess I will continue to get the other Mr. Huber’s Medicare emails until he notices that he is not getting emails from Medicare. Arghhh!

What I found particularly interesting in the email is the fine line between preventive care and what looks like Medicare going the extra yard to drum up business for the health care industry.  I am really curious whether this strategy will achieve different results than the Oregon Medicaid Experiment which showed no statistically significant impact on physical health measures despite increased use of health care services.

 

Dear WILLIAM H HUBER,

Happy Birthday from Medicare! We wish you well in the upcoming year and want to remind you of the preventive services Medicare offers to help you stay healthy.

Our records show that you have not taken advantage of some of the preventive services which are available to you now or in the future and listed in the table below. Please talk with your doctor to decide which ones are right for you.

Name Eligibility Date
ANNUAL WELLNESS VISIT 10/01/2016
ALCOHOL MISUSE SCREENING 10/01/2015
ABDOMINAL AORTIC ANEURYSM 10/01/2015
CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) 10/01/2015
HIGH INTENSITY BEHAVIORAL COUNSELING 10/01/2015
OBESITY COUNSELING 10/01/2015
DEPRESSION SCREENING 10/01/2015
COLORECTAL 10/01/2015
PSA 10/01/2015
PROSTATE 10/01/2015
PPV 10/01/2015
DIABETES 10/01/2015
CARDIOVASCULAR 10/01/2015
PHYSICAL 10/01/2015

To see more details of the services you are eligible for, visit www.MyMedicare.gov and select “Preventive Services” under the “My Health” tab. Or, talk to your doctor for more information.

Remember, Medicare is your partner in health.

Sincerely,
Centers for Medicare & Medicaid Services.

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Jazzed Up Meatloaf

Jazzed Up Meatloaf

This photo is of a jazzed up version of the Allrecipe Easy Meatloaf recipe I made recently. I wanted something with more flavors and it just so happened that I had some spicy Italian sausage and Poblano peppers in the fridge. So I replaced half of the ground beef with the sausage and added some sauteed Poblano and banana peppers. The peppers and sausage did not make the dish spicy but they did enhance the flavors over the standard recipe.

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John Kasich Renews Push For Strict “Green Energy” Mandates

As an Ohio resident I am upset that my electrical rate has gone up at a 5.1% annual rate since 2011. It is not like we have a shortage of electrical power generation or any of its fuels. I did my fair share of improving my carbon footprint but rate increases overwhelmed all of my cost savings from improved insulation and LED light bulbs. The renewable lobby has over promised the cost savings and new jobs for years and the middle class has been stuck with the bill. Last year the Ohio legislature finally said we need to pause the renewable energy mandates and take a close look at why this program has consistently under-performed. Hurray! A group of legislators who actually did their job!

For middle class people whose salaries have been stagnant, the “Green Energy” mandates reminds us of the Affordable Care Act since the only thing worse than my electrical rate increases has been the 11.7% annual increase in my health insurance premiums. For those middle class people who balance their budget on a regular basis we are getting slapped in the face by our “friends” in government trying to help us. If this is helping the middle class, I want less help. Both of these programs share the same management style that encourages government incompetence and cronyism at the expense of the middle class.

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5 Rabbit Yodo Con Leche

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The name of this beer, Yodo Con Leche, translates as iodine with milk but the brewers say the Spanish slang translation is a coffee that is strong and dark. I was expecting this imperial porter to be somewhat bitter with a strong coffee flavor so I was surprised that the bitterness and coffee flavor were more muted than expected. Since I am not a big fan of IPA beers, I am not complaining. The combination worked for me and I enjoyed sipping this beer.