Continuing Education: An Ethical Conundrum

In addition to selling and writing about insurance, I'm also a licensed Continuing Education instructor for Ohio, Kentucky and Indiana. These states require (as do, to the best of my knowledge, all states) licensed insurance agents to have a certain amount of updated knowledge of our industry and the laws and agencies which regulate it. The number of hours vary, but they are not insubstantial.

Other industries have similar requirements: lawyers have CLE, accountants must take CPE courses, and physicians have CME classes.

Costs for these courses vary, depending on industry and subject matter. But it can get expensive: I recently complained about the $100 charge for an 8 hour long term care course I was required to take. That is, until I asked my better half (a certified Project Management Professional) how much her courses cost, and was told that $30 an hour was a "good deal." And my surgeon brother-in-law told me that CME can run $100 (or more) an hour.

But that's only if you pay for it.

Many industries allow (encourage?) vendors to sponsor CE classes, at no charge to the actual licensee (doctor, lawyer, agent, whatever). So one might have BMW pay for lawyers' CLE classes, or Anthem pay for insurance agents' (this is more ubiquitous than you might have thought).

Or Pfizer paying for doctors' CME courses.

Apparently, that last is too much for the nanny-statists at the American Medical Association. I received an email (not sure why) that "actions are in motion by the American Medical Association’s Council on Ethical and Judicial Affairs (CEJA) and proponents to eliminate commercial support of certified CME."

The Council's concern is that there's an inherent conflict of interest when a vendor pays for CME for a physician. I'm not sure I buy that, unless the vendor is also the instructor. The email went on to inform me that "the Accreditation Council for Continuing Medical Education (which accredits providers of CME) found ‘no evidence to support or refute the assertion that support biases CME’." Granted, that's lukewarm, at best. Far more telling were the results of a recent poll claiming that "92% of physicians disagreed with the Committee’s call to end commercial support of CME." Of course, these doc's have a vested interest: free CME beats $100 an hour CME every time.

So what's this got to do with insurance?

Well, as I mentioned above, I teach CE myself, and we're paid (directly and indirectly) by carriers to do so. That is to say, the agents who take our classes don't pay anything, our fees are picked up by carriers. And as regular readers know, I don't carry any insurance company's water. So how does that work?

Well, it's pretty simple: a carrier wants to present itself in a positive light to its customers (agents), and so it offers "free CE." It's not really "free," of course: the company pays us so that the agent doesn't have to. And the company chooses the topic (from a rather extensive "catalog" of courses). We're the licensed providers, and we write and develop and file - and teach - the courses. The carrier's involvement stops at the classroom door, and then picks back up when we present our bill.

So where's the conflict of interest?

And why would that be any different for doctors, or lawyers, or accountants?

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Continuing Education: An Ethical Conundrum

In addition to selling and writing about insurance, I'm also a licensed Continuing Education instructor for Ohio, Kentucky and Indiana. These states require (as do, to the best of my knowledge, all states) licensed insurance agents to have a certain amount of updated knowledge of our industry and the laws and agencies which regulate it. The number of hours vary, but they are not insubstantial.

Other industries have similar requirements: lawyers have CLE, accountants must take CPE courses, and physicians have CME classes.

Costs for these courses vary, depending on industry and subject matter. But it can get expensive: I recently complained about the $100 charge for an 8 hour long term care course I was required to take. That is, until I asked my better half (a certified Project Management Professional) how much her courses cost, and was told that $30 an hour was a "good deal." And my surgeon brother-in-law told me that CME can run $100 (or more) an hour.

But that's only if you pay for it.

Many industries allow (encourage?) vendors to sponsor CE classes, at no charge to the actual licensee (doctor, lawyer, agent, whatever). So one might have BMW pay for lawyers' CLE classes, or Anthem pay for insurance agents' (this is more ubiquitous than you might have thought).

Or Pfizer paying for doctors' CME courses.

Apparently, that last is too much for the nanny-statists at the American Medical Association. I received an email (not sure why) that "actions are in motion by the American Medical Association’s Council on Ethical and Judicial Affairs (CEJA) and proponents to eliminate commercial support of certified CME."

The Council's concern is that there's an inherent conflict of interest when a vendor pays for CME for a physician. I'm not sure I buy that, unless the vendor is also the instructor. The email went on to inform me that "the Accreditation Council for Continuing Medical Education (which accredits providers of CME) found ‘no evidence to support or refute the assertion that support biases CME’." Granted, that's lukewarm, at best. Far more telling were the results of a recent poll claiming that "92% of physicians disagreed with the Committee’s call to end commercial support of CME." Of course, these doc's have a vested interest: free CME beats $100 an hour CME every time.

So what's this got to do with insurance?

Well, as I mentioned above, I teach CE myself, and we're paid (directly and indirectly) by carriers to do so. That is to say, the agents who take our classes don't pay anything, our fees are picked up by carriers. And as regular readers know, I don't carry any insurance company's water. So how does that work?

Well, it's pretty simple: a carrier wants to present itself in a positive light to its customers (agents), and so it offers "free CE." It's not really "free," of course: the company pays us so that the agent doesn't have to. And the company chooses the topic (from a rather extensive "catalog" of courses). We're the licensed providers, and we write and develop and file - and teach - the courses. The carrier's involvement stops at the classroom door, and then picks back up when we present our bill.

So where's the conflict of interest?

And why would that be any different for doctors, or lawyers, or accountants?

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The Grift of the Magi?

The (unfortunate) headline reads like a convoluted novel:

Feds go after Christ, 3 others, charging kickback scheme

The good news, such as it is, is that this is not a hit piece on organized religion. Rather, it's a report on the (alleged) shenanigans of some local health care providers. It's an insight, as well, on how "the system" works:

"The suit seeks damages from Christ Hospital, the Health Alliance of Greater Cincinnati, Ohio Heart and Vascular Center and the now defunct Medical Diagnostic Associates for an alleged kickback scheme in which Ohio Heart and Christ Hospital traded referrals for patients whose services were billed to Medicare and other federal programs."

What's interesting (frightening?) about this is that there's no indication of actual monetary damage. No allegation that Medicare was billed for fictitious services, or that patients were treated for non-existent maladies. It seems that the appearance of impropriety is enough to warrant legal action.

In some ways, this is not unexpected.

About a year ago, we reported that Christ Hospital had actually parted ways with the Cincinnati-based Health Alliance. The news account mentions that the (alleged) violations occurred over a seven year period, ending in 2004; this would certainly jive with the date of the "break up." During that time, the feds say, physicians were "rewarded" for throwing business to the alliance and its hospitals.

We've talked before about the inherent conflict of interest when physicians have ownership in various other medical-related industries. Doctors are human, after all, and subject to the same temptations as the rest of us mortals. It appears that the Health Alliance took advantage of this fact (and I didn't see anything in the story indicating that they had to force the doc's to participate), and ended up profiting from it (as did the doc's, apparently). The good news is that at least one physician, a Dr Harry Fry [ed: how ironic is it that a cardiologist is named Fry?], warned the Alliance that the practice was illegal, but was apparently ignored.

I suspect that, ultimately, the real issue will turn out to be "who was harmed?" There's a lot of finger-pointing going on right now; we'll let you know how it ends up.

[Hat Tip: Holly Robinson]

Read More

The Grift of the Magi?

The (unfortunate) headline reads like a convoluted novel:

Feds go after Christ, 3 others, charging kickback scheme

The good news, such as it is, is that this is not a hit piece on organized religion. Rather, it's a report on the (alleged) shenanigans of some local health care providers. It's an insight, as well, on how "the system" works:

"The suit seeks damages from Christ Hospital, the Health Alliance of Greater Cincinnati, Ohio Heart and Vascular Center and the now defunct Medical Diagnostic Associates for an alleged kickback scheme in which Ohio Heart and Christ Hospital traded referrals for patients whose services were billed to Medicare and other federal programs."

What's interesting (frightening?) about this is that there's no indication of actual monetary damage. No allegation that Medicare was billed for fictitious services, or that patients were treated for non-existent maladies. It seems that the appearance of impropriety is enough to warrant legal action.

In some ways, this is not unexpected.

About a year ago, we reported that Christ Hospital had actually parted ways with the Cincinnati-based Health Alliance. The news account mentions that the (alleged) violations occurred over a seven year period, ending in 2004; this would certainly jive with the date of the "break up." During that time, the feds say, physicians were "rewarded" for throwing business to the alliance and its hospitals.

We've talked before about the inherent conflict of interest when physicians have ownership in various other medical-related industries. Doctors are human, after all, and subject to the same temptations as the rest of us mortals. It appears that the Health Alliance took advantage of this fact (and I didn't see anything in the story indicating that they had to force the doc's to participate), and ended up profiting from it (as did the doc's, apparently). The good news is that at least one physician, a Dr Harry Fry [ed: how ironic is it that a cardiologist is named Fry?], warned the Alliance that the practice was illegal, but was apparently ignored.

I suspect that, ultimately, the real issue will turn out to be "who was harmed?" There's a lot of finger-pointing going on right now; we'll let you know how it ends up.

[Hat Tip: Holly Robinson]

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UHC and OhioHealth: Update

About a month ago, we learned that United HealthCare had pulled a little faux pas (literally, fox's paw) by (erroneously) notifying some 176,000 insureds that their provider of choice, OhioHealth, would no longer be in-network. To say the least, they chose poorly.

Now, though, it's time to pay the piper, to the tune of a quarter of a million dollars (or, as insurers call it, petty cash). That's a heck of a fine for some letters, especially since the two parties eventually inked a deal.

The fine itself amounts to $150,000; the balance is for unspecified "administrative costs". I bet.

[H/T: Industry Radar]

Read More

UHC and OhioHealth: Update

About a month ago, we learned that United HealthCare had pulled a little faux pas (literally, fox's paw) by (erroneously) notifying some 176,000 insureds that their provider of choice, OhioHealth, would no longer be in-network. To say the least, they chose poorly.

Now, though, it's time to pay the piper, to the tune of a quarter of a million dollars (or, as insurers call it, petty cash). That's a heck of a fine for some letters, especially since the two parties eventually inked a deal.

The fine itself amounts to $150,000; the balance is for unspecified "administrative costs". I bet.

[H/T: Industry Radar]

Read More

Car 54, Where Are You (and how's your insurance)?

A few months ago, we reported on efforts by some insurers to link data from folks' GPS systems to their insurance rates. The idea is that by monitoring where insureds traveled (and how long it took them to get there), and other data, the carrier could more accurately assess (and rate for) the risk. On its face, this seemed innocuous enough.

But there are also privacy concerns, and worry over just how this data will be used. And, over course, there's a "slippery slope" from insureds voluntarily submitting this data to legislation mandating that it be supplied.

Progressive Insurance (headquartered here in the Buckeye State), has introduced a new program that sort of straddles that line:

"A high-tech monitoring device makes it possible to reduce insurance premiums for drivers who avoid jackrabbit starts and slam-on-the-brakes stops...The catch? Bad drivers who take a chance on the program may wind up paying a surcharge instead."

To some extent, this makes sense. For one thing, auto insurance employs many of the same principles as health insurance: stop-and-go driving, peeling rubber, and such might be likened to smoking or high fat diets. All of those indicate a higher risk, and should generate a higher premium to offset it. And the program is voluntary: Progressive "has begun offering its drivers the chance to cut their costs based on how they actually drive."

So far, they're not requiring it.

But that could change: I recall some years ago that at least one insurer sent out an innocent-looking survey to its customer base, asking (among other things) whether that person owned a radar detector. Those who answered in the affirmative saw a spike in their auto premiums, even though they'd had no accidents or tickets.

And Progressive's not alone in looking for "creative" ways to re-underwrite risks: GMAC Insurance has linked data from the auto manufacturer's OnStar program to ostensibly offer discounts to safer drivers. That program also is voluntary. For now.

As we noted back in February, though, those who "watch the watchers" are somewhat skittish about the whole concept. There's a real fear that once companies start collecting this data, it may be difficult to control:

"Charles Samuelson, executive director of the American Civil Liberties Union of Minnesota...has worries about privacy.

We see this as kind of a creeping abduction of people's data," he said. "Basically, once they collect that data, it belongs to the insurance company. That's a big problem."

Maybe. Risk management is always at odds with behavior: what people should be doing is very often not reflected in what they actually are doing. And it does seem fair to reward those who practice good risk-management techniques (e.g. careful driving) while penalizing those who don't.

Personally, I'd also like to see this data used to target folks who are almost as dangerous as speeders: slow-pokes. Fair's fair, and if we're going to penalize those who break the speed limit, we ought to be having a talk about folks who drive dangerously slow, as well.

Read More

Car 54, Where Are You (and how's your insurance)?

A few months ago, we reported on efforts by some insurers to link data from folks' GPS systems to their insurance rates. The idea is that by monitoring where insureds traveled (and how long it took them to get there), and other data, the carrier could more accurately assess (and rate for) the risk. On its face, this seemed innocuous enough.

But there are also privacy concerns, and worry over just how this data will be used. And, over course, there's a "slippery slope" from insureds voluntarily submitting this data to legislation mandating that it be supplied.

Progressive Insurance (headquartered here in the Buckeye State), has introduced a new program that sort of straddles that line:

"A high-tech monitoring device makes it possible to reduce insurance premiums for drivers who avoid jackrabbit starts and slam-on-the-brakes stops...The catch? Bad drivers who take a chance on the program may wind up paying a surcharge instead."

To some extent, this makes sense. For one thing, auto insurance employs many of the same principles as health insurance: stop-and-go driving, peeling rubber, and such might be likened to smoking or high fat diets. All of those indicate a higher risk, and should generate a higher premium to offset it. And the program is voluntary: Progressive "has begun offering its drivers the chance to cut their costs based on how they actually drive."

So far, they're not requiring it.

But that could change: I recall some years ago that at least one insurer sent out an innocent-looking survey to its customer base, asking (among other things) whether that person owned a radar detector. Those who answered in the affirmative saw a spike in their auto premiums, even though they'd had no accidents or tickets.

And Progressive's not alone in looking for "creative" ways to re-underwrite risks: GMAC Insurance has linked data from the auto manufacturer's OnStar program to ostensibly offer discounts to safer drivers. That program also is voluntary. For now.

As we noted back in February, though, those who "watch the watchers" are somewhat skittish about the whole concept. There's a real fear that once companies start collecting this data, it may be difficult to control:

"Charles Samuelson, executive director of the American Civil Liberties Union of Minnesota...has worries about privacy.

We see this as kind of a creeping abduction of people's data," he said. "Basically, once they collect that data, it belongs to the insurance company. That's a big problem."

Maybe. Risk management is always at odds with behavior: what people should be doing is very often not reflected in what they actually are doing. And it does seem fair to reward those who practice good risk-management techniques (e.g. careful driving) while penalizing those who don't.

Personally, I'd also like to see this data used to target folks who are almost as dangerous as speeders: slow-pokes. Fair's fair, and if we're going to penalize those who break the speed limit, we ought to be having a talk about folks who drive dangerously slow, as well.

Read More

Fast Food Police

[Welcome Time readers!]

(Sirens, lights, To Catch a Predator film crew . . .)

"Excuse me officer, but was I driving too fast?"

"No son, but you are about to enter a fast-food-free zone."

It seems the folks in la-la land have determined that low income families are no longer entitled to two-all-beef-patties-with-special-sauce-on-a-sesame-seed-bun and triple Whoppers.

The Los Angeles City Council has approved a one-year moratorium on new fast-food restaurants in a low-income area of the city.

The moratorium unanimously approved Tuesday is a bid to attract restaurants that offer healthier food choices to residents in a 32-square-mile area of South Los Angeles.

And the reason is?

Councilwoman Jan Perry says residents at five public meetings expressed concern with the proliferation of fast-food outlets in the community plagued by above-average rates of obesity.

Well there you go.

I guess they will have to start "brown bagging" their Happy Meals.

Let's just hope there aren't any strip searches.

Read More

Fast Food Police

[Welcome Time readers!]

(Sirens, lights, To Catch a Predator film crew . . .)

"Excuse me officer, but was I driving too fast?"

"No son, but you are about to enter a fast-food-free zone."

It seems the folks in la-la land have determined that low income families are no longer entitled to two-all-beef-patties-with-special-sauce-on-a-sesame-seed-bun and triple Whoppers.

The Los Angeles City Council has approved a one-year moratorium on new fast-food restaurants in a low-income area of the city.

The moratorium unanimously approved Tuesday is a bid to attract restaurants that offer healthier food choices to residents in a 32-square-mile area of South Los Angeles.

And the reason is?

Councilwoman Jan Perry says residents at five public meetings expressed concern with the proliferation of fast-food outlets in the community plagued by above-average rates of obesity.

Well there you go.

I guess they will have to start "brown bagging" their Happy Meals.

Let's just hope there aren't any strip searches.

Read More

The MVNHS© Strikes Again!

War hero, and NHS victim, Jack Tagg wanted nothing more than the sight restored to his right eye. Mr Tagg, a sprightly 89, was in danger of losing that sight due to macular degeneration (MD), a function of his advancing years.

Fortunately, a med called Lucentis held promise: it's an injectable drug that blocks abnormal blood vessel growth and leakage (which cause macular degeneration). Although it's not cheap (it can run $15,000 or more), it's apparently quite effective. And it's also one of the few effective treatments available.

In the event, Mr Tagg dutifully contacted the MVNHS©, believing that the service would quickly approve the treatment, and he could go on about his daily life. Obviously, poor Mr Tagg hasn't been reading IB, else he'd know that this was but a pipedream:

"Tagg's local health board rejected his request for NHS funding, saying they wouldn't pay the high price of Lucentis unless the disease hit his second eye."

Well, that makes sense, doesn't it? Can't really help him until he's truly blind, don't you see?

The misinformed former pilot even thought he could just pay for the treatment himself:

"Tagg was astonished. "I would have gone blind, unless we could have sold the house and got some money," he says."

Sadly, no; as we've seen, this course of action could prove even more costly.

Fortune was smiling on Mr Tagg, though, in the form of his neighbor, Dr. Martin Rankin. The good doctor went online, soliciting contributions to help defray the cost of the medication. He collected hundreds of checks, which he and Mr Tagg hand delivered to 10 Downing Street, press in tow. The Prime Minister wasn't having any of this, however, and returned all the checks.

Then our hero's own Member of Parliament stepped up to the plate, and demanded answers from the MVNHS©, which intervened on Mr Tagg's behalf, pressuring the local representatives to make an exception (and/or stop the bad press). But fighter that he is, Mr Tagg demurred unless and until the service offered the same treatment to everyone with MD.

And that's apparently exactly what's happened:

"In fact, NICE now says local health boards shouldn't wait for the first eye to go blind, they should pay for Lucentis right away in situations where it's warranted. Officials at NICE say it wasn't a result of Tagg's activism, but a scheduled reconsideration of the data."

Not "a result of Tagg's activism." But of course.

One might be tempted to say that this demonstrates how flexible the NHS can be when its back is to the (metaphorical) wall. But that's most assuredly not the lesson here; rather, it's that when something's "free," you can bet that there will be strings attached.

Read More

The MVNHS© Strikes Again!

War hero, and NHS victim, Jack Tagg wanted nothing more than the sight restored to his right eye. Mr Tagg, a sprightly 89, was in danger of losing that sight due to macular degeneration (MD), a function of his advancing years.

Fortunately, a med called Lucentis held promise: it's an injectable drug that blocks abnormal blood vessel growth and leakage (which cause macular degeneration). Although it's not cheap (it can run $15,000 or more), it's apparently quite effective. And it's also one of the few effective treatments available.

In the event, Mr Tagg dutifully contacted the MVNHS©, believing that the service would quickly approve the treatment, and he could go on about his daily life. Obviously, poor Mr Tagg hasn't been reading IB, else he'd know that this was but a pipedream:

"Tagg's local health board rejected his request for NHS funding, saying they wouldn't pay the high price of Lucentis unless the disease hit his second eye."

Well, that makes sense, doesn't it? Can't really help him until he's truly blind, don't you see?

The misinformed former pilot even thought he could just pay for the treatment himself:

"Tagg was astonished. "I would have gone blind, unless we could have sold the house and got some money," he says."

Sadly, no; as we've seen, this course of action could prove even more costly.

Fortune was smiling on Mr Tagg, though, in the form of his neighbor, Dr. Martin Rankin. The good doctor went online, soliciting contributions to help defray the cost of the medication. He collected hundreds of checks, which he and Mr Tagg hand delivered to 10 Downing Street, press in tow. The Prime Minister wasn't having any of this, however, and returned all the checks.

Then our hero's own Member of Parliament stepped up to the plate, and demanded answers from the MVNHS©, which intervened on Mr Tagg's behalf, pressuring the local representatives to make an exception (and/or stop the bad press). But fighter that he is, Mr Tagg demurred unless and until the service offered the same treatment to everyone with MD.

And that's apparently exactly what's happened:

"In fact, NICE now says local health boards shouldn't wait for the first eye to go blind, they should pay for Lucentis right away in situations where it's warranted. Officials at NICE say it wasn't a result of Tagg's activism, but a scheduled reconsideration of the data."

Not "a result of Tagg's activism." But of course.

One might be tempted to say that this demonstrates how flexible the NHS can be when its back is to the (metaphorical) wall. But that's most assuredly not the lesson here; rather, it's that when something's "free," you can bet that there will be strings attached.

Read More

Cavalcade of Risk #57: Up and Running!

Richard Eskow got a head start on this week's Cav, and it's a good thing he did: it's chock full of interesting and spot-on posts. Take a chance and head on over.

And don't be afraid to risk hosting a Cav yourself. It's fun and easy, and we have slots available for early fall. Just drop us a line to claim yours.

Read More

Cavalcade of Risk #57: Up and Running!

Richard Eskow got a head start on this week's Cav, and it's a good thing he did: it's chock full of interesting and spot-on posts. Take a chance and head on over.

And don't be afraid to risk hosting a Cav yourself. It's fun and easy, and we have slots available for early fall. Just drop us a line to claim yours.

Read More

Gamer Awards: Ennie Voting: UPDATE

UPDATE: Tom just sent me this:

Looks like they had a voting snafu yesterday. If you voted for Fat Dragon Games in the ENnie Awards before 7am TUESDAY morning, you need to go back and recast your vote. Sorry and thanks again!

Last year, in its first year of eligibility, Fat Dragon Games was nominated for two industry awards, winning one (against stiff competition).

This year, they're in the hunt again: Fat Dragon's been nominated in the "Best Miniature Product" category. Please cast your vote* for this outstanding young entrepreneur - whether you're a "gamer" or not.

Voting starts today (July 28th) and runs through August 6th. To vote, please click here*.

*To vote, scroll down to "Best Miniature Product" Click on "Choice #1" and then click on "Dragon Tiles: Forest Adventures, Fat Dragon Games" (You can also scroll down a bit further, to "Fan Choice Best Publisher" and click on "Fat Dragon Games")

The remarkable thing about FDG is that, in an industry dominated by "the big boys," it's a one-man show, the brainchild (and dream) of its founder, Tom Tullis. A true entrepreneur, Tom's carved out a great niche, and provides gamers (young and old) with affordable gaming items.

Thanks!

Read More

Gamer Awards: Ennie Voting: UPDATE

UPDATE: Tom just sent me this:

Looks like they had a voting snafu yesterday. If you voted for Fat Dragon Games in the ENnie Awards before 7am TUESDAY morning, you need to go back and recast your vote. Sorry and thanks again!

Last year, in its first year of eligibility, Fat Dragon Games was nominated for two industry awards, winning one (against stiff competition).

This year, they're in the hunt again: Fat Dragon's been nominated in the "Best Miniature Product" category. Please cast your vote* for this outstanding young entrepreneur - whether you're a "gamer" or not.

Voting starts today (July 28th) and runs through August 6th. To vote, please click here*.

*To vote, scroll down to "Best Miniature Product" Click on "Choice #1" and then click on "Dragon Tiles: Forest Adventures, Fat Dragon Games" (You can also scroll down a bit further, to "Fan Choice Best Publisher" and click on "Fat Dragon Games")

The remarkable thing about FDG is that, in an industry dominated by "the big boys," it's a one-man show, the brainchild (and dream) of its founder, Tom Tullis. A true entrepreneur, Tom's carved out a great niche, and provides gamers (young and old) with affordable gaming items.

Thanks!

Read More

Grand Rounds (and it really is!)

Edwin Leap jumps into this week's 'Rounds, offering an amazing variety of interesting posts. It's built around the question of "why do we do it?" and he explains in a sort of prologue his own drives and concerns. It's an impressive debut.

As a coffee drinker, I certainly appreciated this item from Highlight Health: apparently, coffee can help lower the risk of liver disease. Yay!

Read More

Grand Rounds (and it really is!)

Edwin Leap jumps into this week's 'Rounds, offering an amazing variety of interesting posts. It's built around the question of "why do we do it?" and he explains in a sort of prologue his own drives and concerns. It's an impressive debut.

As a coffee drinker, I certainly appreciated this item from Highlight Health: apparently, coffee can help lower the risk of liver disease. Yay!

Read More

Oh, Oh, Oregon!

[Welcome Industry Radar readers!]

About a month ago, we reported that Oregon's state-run "health" plan made Barbara Wagner "an offer she couldn't refuse:"

"State officials have offered a lung cancer patient the option of having the Oregon Health Plan, set up in 1994 to ration health care, pay for an assisted suicide but not for the chemotherapy prescribed by her physician."

Turns out, it was considered more cost effective for her to, um, "go away" than to pay for life-extending meds.

And now the compassionate bureaucrats in the Beaver State have apparently decided to make that wonderful option more readily, and easily, available to even more desperately ill citizens:

"Since the spread of his prostate cancer, 53-year-old Randy Stroup of Dexter, Ore., has been in a fight for his life. Uninsured and unable to pay for expensive chemotherapy, he applied to Oregon's state-run health plan for help.

Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide."

Sound familiar?

The "health" plan won't pay for treatment, but has no trouble coming up with the funds for doctor-assisited "suicide." Of course, this makes perfect sense, when one considers that "state officials reported a new emphasis on preventive care and cost effectiveness." What could possibly be more effective than euthanasia? It's guaranteed to provide a complete and permanent resolution to the problem, without all that expensive medicine and stuff.

Who knew Dr Jack would be in-network?

Read More

Oh, Oh, Oregon!

[Welcome Industry Radar readers!]

About a month ago, we reported that Oregon's state-run "health" plan made Barbara Wagner "an offer she couldn't refuse:"

"State officials have offered a lung cancer patient the option of having the Oregon Health Plan, set up in 1994 to ration health care, pay for an assisted suicide but not for the chemotherapy prescribed by her physician."

Turns out, it was considered more cost effective for her to, um, "go away" than to pay for life-extending meds.

And now the compassionate bureaucrats in the Beaver State have apparently decided to make that wonderful option more readily, and easily, available to even more desperately ill citizens:

"Since the spread of his prostate cancer, 53-year-old Randy Stroup of Dexter, Ore., has been in a fight for his life. Uninsured and unable to pay for expensive chemotherapy, he applied to Oregon's state-run health plan for help.

Lane Individual Practice Association (LIPA), which administers the Oregon Health Plan in Lane County, responded to Stroup's request with a letter saying the state would not cover Stroup's pricey treatment, but would pay for the cost of physician-assisted suicide."

Sound familiar?

The "health" plan won't pay for treatment, but has no trouble coming up with the funds for doctor-assisited "suicide." Of course, this makes perfect sense, when one considers that "state officials reported a new emphasis on preventive care and cost effectiveness." What could possibly be more effective than euthanasia? It's guaranteed to provide a complete and permanent resolution to the problem, without all that expensive medicine and stuff.

Who knew Dr Jack would be in-network?

Read More

Double Cross

Certainly you can trust your insurance carrier to keep your medical history secret, right? I mean, we have all these privacy laws that come with heavy penalties for breaching a confidence.

So what can happen when your medical records fall into the wrong hands?

It could affect your ability to get a job, a promotion or even a loan. There is also the possibility you could be a victim of medical identity theft.

So what happens when your carrier sends information on your medical health, complete with your Social Security number, to 202,000 people who are not you and have no right to your information?

The error occurred statewide and affected both employer and individual health benefit plans. The company has many state employees and schoolteachers as members, as well as large and small corporate customers. Blue Cross declined to identify large employers that it serves.

This may not be the only breach.

A thick stack of paperwork from Blue Cross of Georgia arrived at the Portland home of a KOIN News 6 employee. Many national and international corporations are based in Georgia, some of which have branches in Oregon, but provide insurance from Georgia-based insurance companies.

It is possible the two are related, but we cannot tell at this point.

Oxendine said he ordered the company to provide free credit monitoring for affected patients for one year. Blue Cross also must give written notice to policyholders whose names were on the EOBs and compile a list of names of those who erroneously received the forms.

While a noble gesture, I am not sure the credit bureau's track medical identity theft.

Read More

Double Cross

Certainly you can trust your insurance carrier to keep your medical history secret, right? I mean, we have all these privacy laws that come with heavy penalties for breaching a confidence.

So what can happen when your medical records fall into the wrong hands?

It could affect your ability to get a job, a promotion or even a loan. There is also the possibility you could be a victim of medical identity theft.

So what happens when your carrier sends information on your medical health, complete with your Social Security number, to 202,000 people who are not you and have no right to your information?

The error occurred statewide and affected both employer and individual health benefit plans. The company has many state employees and schoolteachers as members, as well as large and small corporate customers. Blue Cross declined to identify large employers that it serves.

This may not be the only breach.

A thick stack of paperwork from Blue Cross of Georgia arrived at the Portland home of a KOIN News 6 employee. Many national and international corporations are based in Georgia, some of which have branches in Oregon, but provide insurance from Georgia-based insurance companies.

It is possible the two are related, but we cannot tell at this point.

Oxendine said he ordered the company to provide free credit monitoring for affected patients for one year. Blue Cross also must give written notice to policyholders whose names were on the EOBs and compile a list of names of those who erroneously received the forms.

While a noble gesture, I am not sure the credit bureau's track medical identity theft.

Read More

Randy Pausch

ABC News tribute.

Randy's last lecture. . .

Read More

Randy Pausch

ABC News tribute.

Randy's last lecture. . .

Read More

Amigo? No Gracias!

And yes, that is how one says "no, thanks" in Spanish. And what's the reason behind our bilingual foray? I'll answer that question with another question.

What's wrong with this picture:

Dear Henry,

Recently I emailed you information on our LOW cost “Amigo” Short-Term Life...You may recall this is the short-term [plan] that

· Has only a $50.00 deductible at any Urgent Care Facility

· Has NO Proof of Citizenship

· GREAT Rates

[From email]

Catch that? "Has NO Proof of Citizenship."

Anyone else have a problem with that?

Okay, as an insurance guy, my first thought is supposed to be: "Great, a vast new untapped market. And now illegal aliens will have access to insurance products to help pay for health care, thereby reducing my costs."

And there's obviously merit in that position.

But I take a different view: Why are we promoting and enabling folks who are here illegally to become "part of the system?" Isn't there a greater issue here? Shouldn't we be focusing on folks who are here legally, by rewarding them for playing by the rules (i.e. following the law), rather than those who flaunt them? And if someone is willing to break one set of laws, then why would we suppose that any answers on an application would be truthful? And just so we have no doubts about the point of this excercise, or the target market, the website immediately offers "Click Here for a quote in Spanish."

I am appalled.

[H/T to Hannah S for the Spanish lesson]

Read More

Amigo? No Gracias!

And yes, that is how one says "no, thanks" in Spanish. And what's the reason behind our bilingual foray? I'll answer that question with another question.

What's wrong with this picture:

Dear Henry,

Recently I emailed you information on our LOW cost “Amigo” Short-Term Life...You may recall this is the short-term [plan] that

· Has only a $50.00 deductible at any Urgent Care Facility

· Has NO Proof of Citizenship

· GREAT Rates

[From email]

Catch that? "Has NO Proof of Citizenship."

Anyone else have a problem with that?

Okay, as an insurance guy, my first thought is supposed to be: "Great, a vast new untapped market. And now illegal aliens will have access to insurance products to help pay for health care, thereby reducing my costs."

And there's obviously merit in that position.

But I take a different view: Why are we promoting and enabling folks who are here illegally to become "part of the system?" Isn't there a greater issue here? Shouldn't we be focusing on folks who are here legally, by rewarding them for playing by the rules (i.e. following the law), rather than those who flaunt them? And if someone is willing to break one set of laws, then why would we suppose that any answers on an application would be truthful? And just so we have no doubts about the point of this excercise, or the target market, the website immediately offers "Click Here for a quote in Spanish."

I am appalled.

[H/T to Hannah S for the Spanish lesson]

Read More

ER Tragedy: Update

Earlier this month, we saw horrific video of a woman literally dying on the floor of a Brooklyn hospital, as uncaring hospital staff stood idly by. Esmin Green died at the relatively young age of 49, killed as much by an apathetic health care provider as her pulmonary embolism.

And while the circumstances of her actual death are horrible to contemplate, there's an even scarier sub-text: why she had the embolism in the first place. Ms Green had been waiting -- sitting -- for so long that blood had begun to pool in her legs, perhaps because of a shortage of inpatient beds.

Whoa, Henry, what's the one got to do with the other?

Well, turns out that "(a) major cause for E.R. crowding is the hospital practice of boarding inpatients in emergency departments... If there are no inpatient beds in the hospital (or no extra inpatient nurses on duty that day) then the patient stays in the E.R. long past the completion of the initial emergency work."

It could be worse, of course: the MVNHS© routinely parks its ER patients in the (actual) parking lot, waiting aboard the ambulances which brought them.

The problem here is that, if there's no place for admitted patients to go, then they're going to begin stacking up somewhere, and that somewhere is often the ER. This is especially becoming the case for those hospitals serving poorer communities [ed: Hello! Grady, anyone?]. It's called "boarding," and it's a growing problem.

Simply put, boarding is when a hospital, knowing that it has finite bedspace, looks toward filling that space with insured or other private pay patients, as opposed to the indigent. It's sort of a balancing act between EMTALA and the bottom line. The problem is, the folks who end up on the wrong end of that balancing act may be the ones who need care the most.

The challenge is that there's really no ideal solution. As noted above, it's just as much a problem for gummint-run health care systems as our own. More beds means less waiting, but it also means higher costs. And of course higher health care costs leads to higher health insurance costs [ed: just had to get that in there, didn't you?].

None of which excuses the unconscionable treatment afforded the late Esmin Green. Unfortunately, it's too late for her.

Read More

ER Tragedy: Update

Earlier this month, we saw horrific video of a woman literally dying on the floor of a Brooklyn hospital, as uncaring hospital staff stood idly by. Esmin Green died at the relatively young age of 49, killed as much by an apathetic health care provider as her pulmonary embolism.

And while the circumstances of her actual death are horrible to contemplate, there's an even scarier sub-text: why she had the embolism in the first place. Ms Green had been waiting -- sitting -- for so long that blood had begun to pool in her legs, perhaps because of a shortage of inpatient beds.

Whoa, Henry, what's the one got to do with the other?

Well, turns out that "(a) major cause for E.R. crowding is the hospital practice of boarding inpatients in emergency departments... If there are no inpatient beds in the hospital (or no extra inpatient nurses on duty that day) then the patient stays in the E.R. long past the completion of the initial emergency work."

It could be worse, of course: the MVNHS© routinely parks its ER patients in the (actual) parking lot, waiting aboard the ambulances which brought them.

The problem here is that, if there's no place for admitted patients to go, then they're going to begin stacking up somewhere, and that somewhere is often the ER. This is especially becoming the case for those hospitals serving poorer communities [ed: Hello! Grady, anyone?]. It's called "boarding," and it's a growing problem.

Simply put, boarding is when a hospital, knowing that it has finite bedspace, looks toward filling that space with insured or other private pay patients, as opposed to the indigent. It's sort of a balancing act between EMTALA and the bottom line. The problem is, the folks who end up on the wrong end of that balancing act may be the ones who need care the most.

The challenge is that there's really no ideal solution. As noted above, it's just as much a problem for gummint-run health care systems as our own. More beds means less waiting, but it also means higher costs. And of course higher health care costs leads to higher health insurance costs [ed: just had to get that in there, didn't you?].

None of which excuses the unconscionable treatment afforded the late Esmin Green. Unfortunately, it's too late for her.

Read More

The Carnival of Personal Finance is up

Hosted this week at You Need A Budget, this week's compilation of finance-related posts is punctuated by some interestong and pithy quotes from the world of finance, both high and low.

With all the recent news of problems in the banking world, My Wealth Builder asks (and answers) a pretty important question: "Are my bank deposits insured?"

Read More

The Carnival of Personal Finance is up

Hosted this week at You Need A Budget, this week's compilation of finance-related posts is punctuated by some interestong and pithy quotes from the world of finance, both high and low.

With all the recent news of problems in the banking world, My Wealth Builder asks (and answers) a pretty important question: "Are my bank deposits insured?"

Read More

About Those 47M Uninsured . . .

We have posted on this before. Eye opening stats on the uninsured.

The 47,000,000 who are uninsured.

The upcoming election has once again focused a light on the uninsured, and the prospective candidate's plans for fixing what is wrong with America.

So how will "universal coverage" affect the uninsured?

Well according to the Phoenix Business Journal it won't include illegals.

Obama's plan to save us will not include 8.3 million illegals.

Thirteen percent of American citizens do not have health insurance compared to 69 percent of illegal immigrants in Arizona

There goes the Hispanic vote . . .

Read More

About Those 47M Uninsured . . .

We have posted on this before. Eye opening stats on the uninsured.

The 47,000,000 who are uninsured.

The upcoming election has once again focused a light on the uninsured, and the prospective candidate's plans for fixing what is wrong with America.

So how will "universal coverage" affect the uninsured?

Well according to the Phoenix Business Journal it won't include illegals.

Obama's plan to save us will not include 8.3 million illegals.

Thirteen percent of American citizens do not have health insurance compared to 69 percent of illegal immigrants in Arizona

There goes the Hispanic vote . . .

Read More

Rethinking Genetic Testing

Over the years, I've come down pretty hard on the use of genetic testing, especially as it regards insurance underwriting. Until now, I've felt that the dangers outweighed the benefits, and that there were other, more unobtrusive, means to accomplish the stated goals.

But I'm beginnging to rethink that position:

"Researchers from Oxford have discovered that a common gene variation is a major cause of a rare side-effect of the cholesterol-lowering drugs, statins."

Turns out, some folks are genetically predisposed toward a potentially fatal complication that can arise through the use of statins (kind of a "the operation was a success, but the patient died" kind of thing). Since statins continue to be a front-line weapon in the war on cholesterol, it seems to me that this new development merits some new thinking on my part, as well.

In addition to genetic factors that could lead some folks to higher "bad" cholesterol levels, despite diets and excercise, it may be that its treatment could also elicit some dangerous problems as well, and if a genetic screening could help lower that risk, then it seems to me to be worthwhile awaiting further developments.

This impacts insurance in two areas. First, from an underwriting standpoint, where I'm still ambivalent. But from a claims standpoint, as well: what if the med that the doctor prescribes (and that the insurer subsidizes or outright pays for) causes major problems for the insured?

Definitely something to consider.

Read More

Rethinking Genetic Testing

Over the years, I've come down pretty hard on the use of genetic testing, especially as it regards insurance underwriting. Until now, I've felt that the dangers outweighed the benefits, and that there were other, more unobtrusive, means to accomplish the stated goals.

But I'm beginnging to rethink that position:

"Researchers from Oxford have discovered that a common gene variation is a major cause of a rare side-effect of the cholesterol-lowering drugs, statins."

Turns out, some folks are genetically predisposed toward a potentially fatal complication that can arise through the use of statins (kind of a "the operation was a success, but the patient died" kind of thing). Since statins continue to be a front-line weapon in the war on cholesterol, it seems to me that this new development merits some new thinking on my part, as well.

In addition to genetic factors that could lead some folks to higher "bad" cholesterol levels, despite diets and excercise, it may be that its treatment could also elicit some dangerous problems as well, and if a genetic screening could help lower that risk, then it seems to me to be worthwhile awaiting further developments.

This impacts insurance in two areas. First, from an underwriting standpoint, where I'm still ambivalent. But from a claims standpoint, as well: what if the med that the doctor prescribes (and that the insurer subsidizes or outright pays for) causes major problems for the insured?

Definitely something to consider.

Read More

Better Than Any Commission Check

When they ask, I tell people I am driven, not by money, but by a strong desire to help people.

So, would I do it for free?

If I could, I would, but the folks I owe money to might not feel the same way.

I got a renewal letter on a small employer that has been a group health insurance client for almost 2 years. This employer was a bit of a pain at first, and I almost walked away from it.

Their prior agent had lied, or was simply mistaken, and had promised that certain medical conditions would be paid by the carrier.

As it turned out, that simply was not the case.

The result was, it cost the owner of the company over $10,000 to pay a claim he felt should have been the carrier responsibility. The agent who made these promises was a long time friend and I was a total stranger to the owner.

Still, I made my presentation which received (to put it mildly) a cool reception. The owner put me through the ringer, asking for financial information on the carrier, a copy of the policy and other things that are out of the ordinary.

After reviewing the information he asked what Blue Cross would charge for a similar plan. He was comfortable with the "brand" and felt he would be better served by a big company vs. the one I suggested.

I gave him a copy of the Blue proposal and pointed out their rates were about 40% higher for essentially the same benefit, but if he insisted, I had no problem using Blue.

He finally agreed to apply for coverage with the carrier I recommended.

Last years renewal went well but there was some resistance.

This year is a different story.

They are facing a 34% rate increase.

I received an advance copy of the renewal letter. A summary of the financial's follows.

Total premiums paid to date, $25,114.

Total claims paid to date, $83,546 (including $22,818 in Rx claims).

Total claims denied, $0.

This is what insurance is all about.

This is what drives me.

Finding ways to make coverage more affordable and delivering on a promise to pay.

Read More

Better Than Any Commission Check

When they ask, I tell people I am driven, not by money, but by a strong desire to help people.

So, would I do it for free?

If I could, I would, but the folks I owe money to might not feel the same way.

I got a renewal letter on a small employer that has been a group health insurance client for almost 2 years. This employer was a bit of a pain at first, and I almost walked away from it.

Their prior agent had lied, or was simply mistaken, and had promised that certain medical conditions would be paid by the carrier.

As it turned out, that simply was not the case.

The result was, it cost the owner of the company over $10,000 to pay a claim he felt should have been the carrier responsibility. The agent who made these promises was a long time friend and I was a total stranger to the owner.

Still, I made my presentation which received (to put it mildly) a cool reception. The owner put me through the ringer, asking for financial information on the carrier, a copy of the policy and other things that are out of the ordinary.

After reviewing the information he asked what Blue Cross would charge for a similar plan. He was comfortable with the "brand" and felt he would be better served by a big company vs. the one I suggested.

I gave him a copy of the Blue proposal and pointed out their rates were about 40% higher for essentially the same benefit, but if he insisted, I had no problem using Blue.

He finally agreed to apply for coverage with the carrier I recommended.

Last years renewal went well but there was some resistance.

This year is a different story.

They are facing a 34% rate increase.

I received an advance copy of the renewal letter. A summary of the financial's follows.

Total premiums paid to date, $25,114.

Total claims paid to date, $83,546 (including $22,818 in Rx claims).

Total claims denied, $0.

This is what insurance is all about.

This is what drives me.

Finding ways to make coverage more affordable and delivering on a promise to pay.

Read More

SSDI Logjam

Is the Social Security Disability Income program, which is the only Social Security trust fund that is currently solvent, looking for a scapegoat?

It would seem that way, as the Senate "is investigating whether insurance companies are forcing able-bodied people to apply for Social Security disability benefits, worsening a severe backlog in the government program while increasing their own profits."

Forcing able-bodied folks to apply.

I suppose that is one way to say it.

Of course if they are able-bodied, why are they currently collecting disability? Carriers are not benevolent organizations that freely dole out monies to folks who are able to work.

Sick and injured people must often wait more than a year before their claims can be decided by one of Social Security’s administrative law judges, a delay Mr. Grassley called “abominable.”

“The last thing those who rely on Social Security need is for insurance companies to be clogging up the system by forcing ineligible applicants to apply,” he said.

Waiting a year before being awarded the benefit. Many times SSDI applicants must hire an attorney to appeal earlier denials.

If carriers acted in the same manner they would be strung up by their Gucci heels.

The Social Security Administration defines “disabled” much more narrowly than insurance policies typically do, so many people who qualify for insurance benefits do not qualify for Social Security.

It is true that the SSDI definition of disability is much more stringent than carrier language. It is also true that if carriers tried using the same language in their contracts would be tarred and feathered for denying claims to folks who were not "disabled enough" to qualify.

Senator's calling carriers on the carpet for trying to legally manage their business while ignoring their own shortcoming.

This must be an election year.

Read More

SSDI Logjam

Is the Social Security Disability Income program, which is the only Social Security trust fund that is currently solvent, looking for a scapegoat?

It would seem that way, as the Senate "is investigating whether insurance companies are forcing able-bodied people to apply for Social Security disability benefits, worsening a severe backlog in the government program while increasing their own profits."

Forcing able-bodied folks to apply.

I suppose that is one way to say it.

Of course if they are able-bodied, why are they currently collecting disability? Carriers are not benevolent organizations that freely dole out monies to folks who are able to work.

Sick and injured people must often wait more than a year before their claims can be decided by one of Social Security’s administrative law judges, a delay Mr. Grassley called “abominable.”

“The last thing those who rely on Social Security need is for insurance companies to be clogging up the system by forcing ineligible applicants to apply,” he said.

Waiting a year before being awarded the benefit. Many times SSDI applicants must hire an attorney to appeal earlier denials.

If carriers acted in the same manner they would be strung up by their Gucci heels.

The Social Security Administration defines “disabled” much more narrowly than insurance policies typically do, so many people who qualify for insurance benefits do not qualify for Social Security.

It is true that the SSDI definition of disability is much more stringent than carrier language. It is also true that if carriers tried using the same language in their contracts would be tarred and feathered for denying claims to folks who were not "disabled enough" to qualify.

Senator's calling carriers on the carpet for trying to legally manage their business while ignoring their own shortcoming.

This must be an election year.

Read More

HIPAA, HIPAA, Hooray!

Two years ago, I wrote that I was "puzzled, bordering on angry, that, (i)n the three years since Americans gained federal protection for their private medical information, the Bush administration has received thousands of complaints alleging violations but has not imposed a single civil fine and has prosecuted just two criminal cases."

Be careful what you wish for:

"WASHINGTON - The Department of Health and Human Services has levied a $100,000 fine on Seattle-based Providence Health and Services for alleged violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules."

According to its web site, Providence isn't an insurer, per se, but a "not-for-profit health system" which includes hospitals, clinics, physicians, even a university. They both provide and finance health care, so make of that what you will.

In the event, Providence was cited for a number of violations, including "unprotected backup tapes, optical disks and laptops, [which] compromised the protected health information of more than 386,000 patients." That's a lot of PHI.

If you'd like to see a copy of the agreement itself, just click here.

What I found to be even more interesting was this little factoid:

"The OCR [Office for Civil Rights] and the Centers for Medicare & Medicaid Services report they have successfully resolved more than 6,700 HIPAA Privacy and Security Rule cases." I recently had my own experience with a carrier and PHI, and ended up filing such a claim (which was later resolved to my satisfaction), and it surprised me that the process itself is generated from the OCR website. And, as noted above, it looks like the gummint's been a bit more proactive in cracking down on these violators.

And that's a good thing.

[H/T: Regular Reader Fred W]

Read More

HIPAA, HIPAA, Hooray!

Two years ago, I wrote that I was "puzzled, bordering on angry, that, (i)n the three years since Americans gained federal protection for their private medical information, the Bush administration has received thousands of complaints alleging violations but has not imposed a single civil fine and has prosecuted just two criminal cases."

Be careful what you wish for:

"WASHINGTON - The Department of Health and Human Services has levied a $100,000 fine on Seattle-based Providence Health and Services for alleged violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules."

According to its web site, Providence isn't an insurer, per se, but a "not-for-profit health system" which includes hospitals, clinics, physicians, even a university. They both provide and finance health care, so make of that what you will.

In the event, Providence was cited for a number of violations, including "unprotected backup tapes, optical disks and laptops, [which] compromised the protected health information of more than 386,000 patients." That's a lot of PHI.

If you'd like to see a copy of the agreement itself, just click here.

What I found to be even more interesting was this little factoid:

"The OCR [Office for Civil Rights] and the Centers for Medicare & Medicaid Services report they have successfully resolved more than 6,700 HIPAA Privacy and Security Rule cases." I recently had my own experience with a carrier and PHI, and ended up filing such a claim (which was later resolved to my satisfaction), and it surprised me that the process itself is generated from the OCR website. And, as noted above, it looks like the gummint's been a bit more proactive in cracking down on these violators.

And that's a good thing.

[H/T: Regular Reader Fred W]

Read More

Treating a Captive Audience

Remember Charles Manson? The Helter Skelter killer and his gang made infamous for the slaying of Sharon Tate and others in 1969.

Most of his "family" are still in jail, including Susan Atkins.

Her story has taken a different twist of late. Seems she has brain cancer which has paralyzed her right side and led to the amputation of a limb.

So how much has her treatment cost so far?

About $1.4 million.

That's $1.4 million in taxpayer dollars.

"I dare say that apart from the president and the members of Congress, the people with the best health care in this country are inmates," said Dr. Joshua Atiba, the medical director and CEO of Newport Oncology and Healthcare, which delivers cancer treatment to inmates in prisons in California.

I can't say if that is a subjective comment or not. Regardless, this situation is eye opening.

Atiba said that much of the cost can be attributed to the $10,000 daily cost of a bed in the intensive care unit, along with the money needed for guards. According to Thornton, two guards are with Atkins at all time to prevent family members from helping her escape and to keep her from being harmed by members of the public.

The woman is paralyzed and missing a leg. She is 60 years old. How much of a threat is she if she does escape?

No, I am not minimizing her crime. But rather I am simply stating a fact based on the economics of the situation.

Now here is an oddity.

While all of Atkins' health-care costs are paid for by the state, she cannot receive any experimental treatments while in custody, says Atiba. As a prisoner, she cannot give consent.

"They have no autonomy," he said.

Brain cancer patients in the general public, on the other hand, may have the option to receive such experimental treatments.

Probably some kind of prisoner's rights thing.

But there is a positive.

According to the UCLA Hospital System, the total medical bill for a person in the general population who had a diagnosis of brain cancer would be $2.2 million over the same time period.

I'm sure the California taxpayers are relieved to hear that.

Caplan also noted that while many speculate that some people will commit crimes to get better health care, he hasn't seen any evidence that this is the case.

"People are interested in health care, but they're not interested in getting it as a prisoner," he said.

They are not interested in becoming a prisoner to receive health care, but they are willing to become a prisoner of a government run, universal health care system.

What is wrong with this picture?


Caplan predicts the problems we now confront about prisoners may eventually become discussed more widely as health care costs rise.

"We have a hard time saying no, even with prisoners," he said, noting that the questions applied to them will become more widespread with time.

"Why are we doing things that are basically hopeless when they cost a lot of money? We don't spend much on prevention, but boy, do we spend money to rescue people."

And so it goes . . .

Read More

Treating a Captive Audience

Remember Charles Manson? The Helter Skelter killer and his gang made infamous for the slaying of Sharon Tate and others in 1969.

Most of his "family" are still in jail, including Susan Atkins.

Her story has taken a different twist of late. Seems she has brain cancer which has paralyzed her right side and led to the amputation of a limb.

So how much has her treatment cost so far?

About $1.4 million.

That's $1.4 million in taxpayer dollars.

"I dare say that apart from the president and the members of Congress, the people with the best health care in this country are inmates," said Dr. Joshua Atiba, the medical director and CEO of Newport Oncology and Healthcare, which delivers cancer treatment to inmates in prisons in California.

I can't say if that is a subjective comment or not. Regardless, this situation is eye opening.

Atiba said that much of the cost can be attributed to the $10,000 daily cost of a bed in the intensive care unit, along with the money needed for guards. According to Thornton, two guards are with Atkins at all time to prevent family members from helping her escape and to keep her from being harmed by members of the public.

The woman is paralyzed and missing a leg. She is 60 years old. How much of a threat is she if she does escape?

No, I am not minimizing her crime. But rather I am simply stating a fact based on the economics of the situation.

Now here is an oddity.

While all of Atkins' health-care costs are paid for by the state, she cannot receive any experimental treatments while in custody, says Atiba. As a prisoner, she cannot give consent.

"They have no autonomy," he said.

Brain cancer patients in the general public, on the other hand, may have the option to receive such experimental treatments.

Probably some kind of prisoner's rights thing.

But there is a positive.

According to the UCLA Hospital System, the total medical bill for a person in the general population who had a diagnosis of brain cancer would be $2.2 million over the same time period.

I'm sure the California taxpayers are relieved to hear that.

Caplan also noted that while many speculate that some people will commit crimes to get better health care, he hasn't seen any evidence that this is the case.

"People are interested in health care, but they're not interested in getting it as a prisoner," he said.

They are not interested in becoming a prisoner to receive health care, but they are willing to become a prisoner of a government run, universal health care system.

What is wrong with this picture?


Caplan predicts the problems we now confront about prisoners may eventually become discussed more widely as health care costs rise.

"We have a hard time saying no, even with prisoners," he said, noting that the questions applied to them will become more widespread with time.

"Why are we doing things that are basically hopeless when they cost a lot of money? We don't spend much on prevention, but boy, do we spend money to rescue people."

And so it goes . . .

Read More