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Wednesday, November 30, 2011

Beneficiary? Don't Fuggedaboutit!

Although we blogged on the subject some time ago, our favorite Tax Blogger, Joe Kristan, has a timely reminder on why it's so important to periodically check - and, if necessary, update - the beneficiaries of your life insurance policies.

You do own some life insurance, right?

Philly Cheese Exchange

Pat and Geno probably won't be fighting over this one:

"After months of study ... [Pennsylvania is] moving forward with a key - and widely supported - option offered by the federal health-care overhaul: a state-run insurance exchange."

Of course, the authors of this piece offer no evidence demonstrating anything like "wide support" for the Exchanges (possibly because none such exists), but no sense letting a few facts get in the way of a good story, right?

The silliness doesn't end there, of course:

"Besides being a one-stop shop for health insurance, the exchange will be the only place where many of the people who will be newly eligible for insurance under the law ... can apply for the tax credits that are intended to make coverage affordable."

Well, sort of: it's true that, as this is a state-run Exchange, Keystone State citizens would be eligible for whatever tax "credits" may be available, and for as long as they're available. But since we know that ObamneyCare© will quickly generate huge deficits, it's a sure bet that this won't be for long. Especially since tax payers in states with federally-run Exchanges won't be eligible for these same credits.

What could possibly go wrong?

In the event, the Pennsylvania-run Exchange is scheduled to go on-line (literally) in 2014, and is expected to draw some 2 million people. How many of those will be eligible for tax credits is not mentioned, but one presumes that it will be a majority of participants.

Which leads to even greater deficits, and thus higher premiums.

More cheese!

Cavalcade of Risk #145: Insurance Fest edition

David Williams hosts this week's excellent round-up of risk-related posts, with an emphasis on insurance as risk management tool. Do check it out.

Also, we really need a host for the February 22nd Cav...Drop us a line for details.

Tuesday, November 29, 2011

RomneyCare for Seniors


Willard Mitt Romney wants to save Medicare. Nothing wrong with that, at least in principle. But what would he do to bring down the cost of health CARE?

As it turns out, nothing.

But no big deal. Obamneycare won't do anything to lower the cost of health care either.

The Boston Globe has this take on the Dick Clark of the Republican party.

Mitt Romney’s ambitious plan to rein in federal Medicare spending would give America’s seniors a choice: choose government insurance or use a federal voucher to buy medical insurance from private companies. The idea, according to Romney, is to drive down costs by introducing market competition.

That's his big idea?

Allow private industry to compete against a plan funded with unlimited taxpayer (and Chinese) dollars?

Private industry needs to turn a profit, or at least break even.

The bean counters in Washington never have to balance a checkbook or even worry about funding. They can promise anything and everything to everyone without ever considering how they would pay for it.

“Romney wants to privatize a program seniors depend on and end Medicare as we know it.’’

We already have a privatized Medicare program. Medicare Advantage plans give seniors a choice at low or even $0 premiums.

But in a way it is only partially privatized.

The government dictates the minimum coverage rules, tells the carriers how many docs and hospitals they must have in their network, defines the marketing rules, and decides how much they will pay the carriers to administer the plans.

And if DC decides to change the rules after the fact the carriers are penalized.

Yeah, that works real well.

But does it lower the cost of care?

No it does not.

Douglas Holtz-Eakin, president of American Action Forum and former director of the Congressional Budget Office, thinks the plan will achieve Romney’s goal of reducing Medicare costs.

“It will control the federal budget because it caps the taxpayers’ exposure,

True, but only if the seniors on Medicare do not pay taxes.

All this proposal does is shift the cost of care from Medicare to the patient. Items not paid by Medicare and Georgia Medicare supplement plans are paid by the Medicare patient.

This is nothing more than rearranging the deck chairs.

Barney, Fannie, Freddie and Death Panels

In his role as Congressional "Rabbi" for Freddie Mac and Fannie Mae, Barney Frank has been credited/blamed for many of our current fiscal problems. His recent announcement that he wouldn't be seeking a 17th term may be surprising, but it's his take on ObamneyCare© Death Panels that really hits home:

"Massachusetts Democratic Rep. Barney Frank announced on Tuesday his support for the repeal of the Independent Payment Advisory Board [aka Death Panels] ... became the 12th Democrat, and the 212th member of the House, to co-sponsor ... Rep. Phil Roe’s bill aimed at repealing the [them]."

While much of the focus has been on the (Evil) Mandate, the IPAB/Death Panel has managed to fly somewhat under the radar. Without it, though, there are few (if any) provisions in ObamneyCare© that directly address the cost of health care, not just the availability of health insurance.

Good times, good times.

Food Pyramid Update: Fat's Back!

According to a new study by universities in the Netherlands, the "dietary intake of saturated fatty acids (SAFA) is associated with a modest increase in serum total cholesterol, but not with cardiovascular disease."

Translated, that seems to be a green light for more saturated fats in our diet. The bad news is that we'll most likely need to hold off on carbs, especially those with "a high glycaemic index."

In other words, look for foods that haven't been processed so much (whole grain or sourdough breads are good choices), cut back on the taters, stock up on quinoa (which, by the way, is generally considered Kosher for Passover).

Yum!

[Hat Tip: Hunter-Gatherer]

Turning up the Heat on Allianz

Last week, we updated our readers on the efforts of Florida Congresswoman Ileana Ros-Lehtinen to resolve a decades-old dispute over life insurance proceeds due the families of those killed in the Holocaust.

Turns out, she's turning up the heat. To broil:

"[Congresswoman Ros-Lehtinen] is pressuring National Public Radio stations ... CNBC and others to stop airing sponsorships and advertising by a giant German insurer that collaborated with the Nazis ... has launched a letter-writing campaign aimed at blocking [Allianz] from advertising with any U.S. media until it pays off all Holocaust survivors' life insurance claims."

That's gonna leave a mark.

And in the "Adding Insult to Injury" Department, it turns out that in addition to insuring the lives of Holocaust victims, Allianz insured the means of their deaths, as well: "Allianz insured concentration camp facilities."

Full disclosure: I do not represent Allianz.

Monday, November 28, 2011

On Phones, Cars and Health Care

The Law of Unintended Consequences is cruel, and unforgiving: “every undertaking, however well-intentioned, is generally accompanied by unforeseen repercussions that can overshadow
the principal endeavor.”

We saw this with Cash4Clunkers. and are still reaping those consequences (don't believe me? Try finding a good deal on a used car). But there is, perhaps, an even better model: cell phones.

Ok Henry, now you've just gone off the deep end. What the heck do cell phones have to do with health care, or health insurance?

Just everything:

"Over 26,000 Ohioans abusing free cell phone plan ... Companies are flooding low-income households with free cell phones and minutes under a plan overseen by the federal government."

Let's tweak that a bit:

"Over 26,000 Ohioans abusing free or low-cost health insurance ... Carriers are flooding low-income households with free cell or almost-free health insurance phones, with immediate coverage for pre-exisitng conditions, under a plan overseen by the federal government."

And herein lies the problem: radio waves are essentially free, and limitless. Not so doctors, hospitals and medications. If the government can't keep a handle on handsets, how will it rein in the cost of hand surgeries?

But the cell phones are free, so what's the big deal?

Nothing is free:

"The program is paid for with fees mandated by the government and tacked onto most cellphone and home phone bills."

Again, a little plastic surgery (so to speak):

"The program is paid for with fees mandated by the government and tacked onto most insurance premiums and hospital bills."

'Nuff said?

Cash Baby


One of my clients is about to have their second baby without the benefit of health insurance. Parents and older siblings have health insurance but they opted out of maternity coverage some time ago due to the exorbitant cost and restrictions on coverage.

With some guidance from their agent, that would be me, they had baby number two at an out of pocket cost that was comparable to the discounted fee's charged by par providers if they had maternity coverage.

They took what they learned the last time and found ways to save even more on baby #3 (which is due any day now).

Hopefully you will find this site, and the information they are willing to share, helpful.



Dumping on MassCare

In the world of investing, the term pump-and-dump refers to a "scheme that attempts to boost the price of a stock through recommendations based on false ... statements. The perpetrators of this scheme ... sell their positions after the hype has led to a higher share price."

Put more simply, they get in, "use" the system, and get out, generally at a profit. This costs the company, and it costs the other shareholders.

But what, you may ask, does this have to do with health insurance?

Well, before there was ObamneyCare©, there was MassCare. And an integral part of MassCare has been Guaranteed Issue, coupled with immediate coverage for pre-existing conditions. Or, as the Boston Herald's Frank Quaratiello reports:

"A gaping loophole in state insurance rules that lets freeloaders pick up coverage to pay for expensive surgeries — and then dump it once they’re treated — has cost taxpayers as much as $37 million a year"

There's even a term for this: "jumpers and dumpers.” Jump and dump, pump and dump; tomato, tomahto.

But that's just a Bay State problem, right?

Not so much, "according to a study that warns the same wrinkle in Obamacare could add a staggering $2 billion a year to the deficit-wracked federal budget ... similar provisions in the nation’s new health care plan could cost the government at least $1.9 billion a year starting in 2014 when Obamacare kicks in."

Ooops.

Glad we passed the bill to learn what's in it.

Supreme Court To Review Healthcare Reforms

West face of the United States Supreme Court b...
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The issue of health insurance seems to always be in the news in America, especially in the last couple of years as a result of the reforms which were passed last year.

The system is vastly different to the one in the UK, with almost all Americans required to have a health insurance policy or they will be fined through the tax system. The Supreme Court is set to rule next year on the recent reforms to ascertain if they are in line with the US constitution.

It has been a source of constant debate, with the majority of candidates in the recent presidential debates condemning the new laws, in particular the penalty aspect.

The conservative argument in favour of the reforms is that most responsible adults, in particular those with families, will get a health insurance policy. Either they will be covered though a business health insurancepolicy at their job or they will purchase it themselves. The cost of care is far too expensive for those who do not have insurance therefore the costs are outweighed by the benefits.

There are some people who will not be able to obtain a policy, perhaps those with high risk factors or pre-existing conditions, because the cost will be too high. Even some healthy individuals may find the cost of a policy too high. These are the people set to gain the most from healthcare reform, by either getting access to much more affordable health insurance or by being exempt from the penalties.

It will be interesting to monitor this situation in the coming months. It really makes the healthcare system in the UK seems far less complex. 

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Independent Contractor, Independent Work

As an independent contractor, you have certain obligations to clients. Your mistakes can be expensive thing for them. Your customers are the remedies and to seek justice for their economic losses. Agreement of the Agency will not protect you at all times. Professional liability insurance gives you the freedom of enterprise, if the requirements of customers big and small.

Working As An Independent Contractor

To work as an independent contractor, you must have liability insurance to meet the professional responsibilities and legal obligations. Today you will have noticed that customers ask for proof of professional liability insurance before the contract. If you work from home, abroad or on-site customers, you must ensure that their concerns and protection of Professional Indemnity Insurance.

Friday, November 25, 2011

I been workin' on the railroad (I mean for SEIU)

"If you're a parent who accepts Medicaid payments from the State of Michigan to help support your mentally-disabled adult children, you qualify as a state employee for the purposes of the Service Employees International Union (SEIU). They can now claim and receive a portion of your Medicaid in the form of union dues."

These deadbeat scab parents gotta be stopped. And our government is just the one to stop them.

Cavalcade of Risk #145: Call for submissions

David Williams hosts next week's CavRisk, and wants your risk-related post. Entries are due by Monday (the 28th).

NB: We're now using this submission tool: The BC WorkAround

Once there, you'll be asked to provide:

■ Your post's url and title
■ Your blog's url and name
■ Your name and email
■ A (brief) summary of the post ("Remarks")

At the bottom of the form, you'll see a drop-down menu; simply select "Cavalcade of Risk" then press "Submit" and you're good to go.

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

BTW: We REALLY need a host for January 25...

Thanks!

What ICD-10?

I love it when the government supports my theory. The theory in this case is that we will go metric before we go ICD -10. Towards that end the government announced on Thursday, November 17, 2011 that that first piece of moving towards ICD-10 has been delayed.

All physicians were to begin electronically billing using the new updated form, version 5010. That was to begin in Jan. 2012. It has been moved to March 2012.

As easy as running a four minute mile (no I do not know the metric equivalent, America never went metric).

Government Health Care

The VA (Veterans Administration) provides free and almost free health care to those who have served in the armed forces. These brave men and women have done something most of us have not in order to gain access to health care.

Most of us have health insurance paid for by employers or we do the responsible thing and buy it with our own money.

But our veterans voluntarily put themselves in harms way to preserve our liberty.

They deserve better than this.

“The very first time I went to the Nashville VA hospital, I had made my appointment and waited my two months. I showed up and I waited in the lobby for about an hour and 45 minutes — almost two hours — before I just left,” Betts said.
Is this what most of us have to look forward to when Obamacare adds 18 million to Medicaid rolls and the rest are subject to government designed plans?

Primary Care Trusts Banning Approved Medication


Some medications approved by the NHS are being banned by some health trusts as they are too expensive. Medicines blacklisted include treatments for asthma, diabetes, epilepsy, cancer and heart disease despite being approved by the National Institute for Health and Clinical Excellence (Nice).

An investigation carried out by GP newspaper found that round 25% of trusts have banned the use of Nice medications. A freedom of information request found that 33 of the 71 primary care trusts had a blacklist, with 18 of those including medications on the Nice list.

If a doctor deems a drug approved by Nice to be clinically appropriate then according to the NHS constitution the patient has the right to receive it. The care trust lists contains medications which are classed as “not prescribable” or not effective enough.

The Department of Health say there is no excuse for PCT’s to be denying patients access to medication if their doctor thinks it is necessary.

Those not wishing to be at the mercy of the NHS have been looking at private health insurance, with the sector continuing to perform well. While there is often a cap on the amount companies will spend on medications they are far more flexible when it comes to prescribing certain medications. 

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Thursday, November 24, 2011

Captain Kirk vs Tom Turkey

If you've never had the pleasure of tasting deep-fried turkey, you're missing a real treat. But unlike conventionally-cooked birds, preparing one of these can be both daunting, and dangerous:



Be careful, and have a GREAT Thanksgiving!

[Courtesy of our friends at State Farm]

What Is The Coverage Line

A Professional Indemnity Insurance covers claims against professional negligence, breach of contract, copyright infringement, theft of data and any other. The amount of risk is limited to the area of ​​professional work and politics can be taken according to the wishes of professionals. For example, hiring a lawyer to defend if you are charged in a dispute. Under his guidance, illegal or service that you lose the case and have to endure a great loss. As a result, you can continue with the professional to recover the losses caused to you by request compensation. You can also file a complaint to express their pain to get adequate compensation to recoup their losses. So here is the attorney needs an insurance policy to protect its intellectual property rights / interests. In one case, if a customer calls, professionals paid by your insurance policy and avoid any unpleasant situation.

Wednesday, November 23, 2011

CMS Head Berwick Resigns

CMS Director Donald Berwick, lover of rationed health care for all, has resigned rather than go through a Senate confirmation hearing.

Readers may recall Berwick was appointed to the position while Congress was in recess, thus allowing him to assume the position on a temporary basis.

Obama circumvented the Senate confirmation process, appointing Berwick while Congress was in recess in July 2010.

The move, which hardened GOP opposition, meant Berwick had to step down by the end of this year.

Looks like the American public got an early Christmas present and something more to be thankful for tomorrow.

Wal-Marting of Health Care in America Continued

In 2009 I wrote a paper titled “The Wal-Mart”ing of Health Care in America”. The premise of the paper was that consumer driven healthcare was paving the way for clinics in places like Wal-Mart. Over the past several years mini-clinics have been popping up in grocery stores and strip malls across the country. In March of that year, an article announced that “Wal-Mart will partner with its Sams Club division with Dell and eClinicalWorks to begin offering low-cost electronic health record systems to physicians”. Well Wal-Mart did not go forward with the EMR, but instead is going straight to the mini med clinic with the headline: “Wal-Mart wants to be your MD: Retailer seeks to use medical services to lure shoppers, boost traffic."

In that 2009 paper I observed that “America has been facing a crisis in a shortage of primary care physicians. For the past few decades the number of graduating medical students going into family and general practice has been steadily declining. According to a study published by the American Osteopathic Association, in 1984 56.4% of all graduating D.O.’s chose family practice. That number has dropped to 42.6% while general internal medicine has significantly jumped from 4.7% to 9.5%. It seems that Wal-Mart “now wants to dominate a growing part of the health care market, offering a range of medical services from basic prevention to management of chronic conditions like diabetes and heart disease, according to a document obtained by NPR and Kaiser Health News.” First, general practice is not a growing part of health care, thus there is no domination. Wal-Mart “intends to build a national, integrated, low-cost primary care healthcare platform.” Isn’t this what Obamacare is all about? So what's wrong with Wal-Mart doing it sooner and cheaper?

In my opinion, Wal-Mart will succeed because Medicine is a business. Back in 2009, I wrote that “physicians, like all technicians, understand the art of medicine, that is their training, and they are effective in their art. However, medical schools do not teach physicians how to relate to the enterprise of medicine or to the business of medicine.” Wal-Mart will succeed because they appreciate the patient and they can offer low prices; prices lower, in fact, than the standard family practice physician. Physicians become their own worst enemies by constantly micro managing their practices and their staff; as a result, they will be unable to compete with Wal-Mart.

"Maybe Walmart can deliver a lot of this stuff more cheaply because it is an expert at doing this with other types of widgets, but health care is not a widget and managing individual human beings is not nearly as simple as selling commercial products to consumers," says Ann O'Malley, a physician and senior health researcher at the Center for Studying Health System Change, a nonpartisan Washington think tank.” Unfortunately, this is incorrect: in a recent post, I noted that medicine has already moved to a standardized format and consumers want simple medicine.

Health care leaders will need to deal with many issues if they want to maintain supremacy (or at least market share) in Health Care in America over Wal-Mart. There are many barriers standing in their way to achieve the change necessary to stay viable. One is the culture of the current state of how medicine is managed here. If physicians are making the decisions without input from the administrative people and medical ancillary personnel working in the health care field, then there is a 50-80 percent chance of failure. Norma Hagenow, President of CEO Genesys Health System Source stated that “Culture eats strategy every day of the week. Culture is people. You can set up the best strategies in the world, but if you do not have the hearts and souls of the people behind that enterprise, it’s nothing.”

Back in 2009, these were my concluding thoughts: “The Health Care perfect storm has been brewing for several decades, since the failures of HMO’s in the 1970’s, Phil Donahue lambasting against health care in the 1980’s, the Clinton initiative in the 1990’s and now Wal-Mart has entered the picture. At each time of conflict the physicians clung to their culture and refused to work towards change. As a result, change will come to them in the form of Wal-Mart clinics, consumer driven healthcare and electronic records. Based on all evidence, physicians will not address the changes and as all failed organizational structures, the current physician driven medical system will fade into oblivion.”

It seems the future is now.

The MVNHS© Gets Down

Down Syndrome, that is.

So what is Down Syndrome?

It's a "set of mental and physical symptoms that result from having an extra copy of Chromosome 21 ... Usually, mental development and physical development are slower in people with Down syndrome than in those without the condition."

Although DS isn't curable (yet), those afflicted with it can, with training and time, "live productive lives well into adulthood."

Well, maybe just folks who aren't subject to the Much Vaunted National Health System©:

"A man with Down’s syndrome was locked in a one-bedroom flat and deprived of his basic human rights for ten months until his death ... Detained against his will by health and council officials ... David Parsons was denied regular contact with his wife and family and ‘abandoned’ by those caring for him."

At age 53, he had plenty of life left, time he could have spent with his wife and other family members. A few years ago, MVNHS© physicians declared that he "had developed dementia and epilepsy," but Mr Parsons' family disputes this. Regardless, he and Mrs Parsons (who apparently has similar developmental issues) were locked away in a "residential care home for the elderly."

Well, there ya go: "Out of sight, out of mind, we're the MVNHS©"

Tuesday, November 22, 2011

No, they're not

Of all the stupid things I've read recently about SCOTUS and ObamneyCare©, this takes the cake:

"The insurance industry is terrified that the Supreme Court will strike down the individual mandate to buy insurance next year while leaving the rest of the healthcare reform law intact."

The truth is, carriers know that ObamneyCare© is simply the next step towards a nationalized system, and every one of the major players wants to be the one (or among the ones) who actually administers that system.

Afraid of it?

Heck no, they're rooting for it.

Great News, LexisNexis edition: Tax Update blog named to Top 20!

FoIB and All-Around Good Guy Joe Kristan has been named one of the Top 20 Tax Bloggers of 2011.

Which is great in and of itself, but there's more: the Update's also in the running for Top Tax Law blog. And no one deserves it more than Joe - the Update is consistently interesting and entertaining, informative and snarky. That's no mean feat for a blog about taxes.

So, click here to vote for the Tax Update Blog for LexisNexis Top Tax Law blog, 2011 edition [NB: Make sure you vote for "Roth Tax Update Blog"].

Selfless vs Selfish

Last night I happened to catch the premiere of a new game show with a pretty cool premise: all the winnings would go to the contestant's best friend "Because She Deserved It." To introduce the deserving single mother of three, we were treated to a quick bio, which included the fact that her late husband was selfish and irresponsible.

Of course, they didn't couch it this way, but consider the facts: he (apparently) had no life insurance, and decided to go scuba diving alone - at night - leaving a young widow and three fatherless daughters. Mom struggles to pay the bills, and lives in constant fear that she or her daughters will become ill. Why is that? Because he also didn't arrange for them to have health insurance.

Having had enough of that, I hit the remote and was treated to this outstanding commercial from State farm:



Yes, it's funny, but it's also illustrative of a father who does care about his family. That's how responsible dads operate.

Suit Against Insurer Must be Served through S.C. Department of Insurance


Post by Pete Dworjanyn
The South Carolina Court of Appeals has issued an opinion that lawsuits against insurance companies in South Carolina must be served through the South Carolina Department of Insurance. The opinion was premised on two code sections. S.C. Code § 38-5-70 Appointment of Director as Attorney for Service of Process provides that every insurer shall appoint in writing the director [of the Department of Insurance] to be its lawful attorney upon whom all legal process and action or proceeding against it must be served.  S.C. Code Section § 15-9-270 Service on Insurance Companies provides that the summons and any other legal process in any action against it must be served on an insurance company as defined in Section § 38-1-20 by delivering two copies of the summons or other legal process to the Director of the Department of Insurance.

In White Oak Manor v. Lexington Ins. Co., 394 S.C. 375, 715 S.E.2d 383 (August 10, 2011) the South Carolina Court of Appeals reversed the circuit court’s entry of default against Lexington Insurance Company where the plaintiff had failed to serve the insurer through the Department of Insurance. The court also held that inclusion of a service clause in the policy did not constitute a waiver of the insurance company’s right to insist on statutory service of process. Lexington had disputed that process was effective even under the service of suit clause in the policy. Lexington also argued the circuit court erred in failing to set aside the entry of default.  As the Court of Appeals concluded that the code sections referenced above are mandatory in their requirement of service of process on the Department of Insurance, the court did not address Lexington’s other challenges to the circuit court’s rulings.  White Oak Manor has filed a petition for writ of certiorari in the South Carolina Supreme Court, which is currently pending.  We will update this entry when the Supreme Court rules on that petition.     

- Pete  

Frustrating Carrier Tricks: Medicare vs Group

Basic rule: your group is under 20 lives, Medicare is "primary."

But what does that mean?

In simple terms, it means that if you're on Medicare, but still actively at work and on the group insurance there, your group plan becomes a sort of supplement to Medicare. Not so difficult in theory, but in practice, well, sometimes carriers make it too hard.

Take, for example, Anthem (please!).

One of my small groups has a simple plan: $30 office visit co-pays, a $5,000 deductible and some co-insurance for big-ticket items, and a prescription drug benefit. Next March, their employee Mary will turn 65, and Medicare will become the primary health insurance on her claims.

Mary's employer asked me how that would work, and requested that information in writing from Anthem. Seems pretty simple to me. Anthem knows how Medicare works, they know that it's primary for this group, and they know this group's benefits structure.

Piece of cake, right?

Well, no.

After repeated phone calls and emails, further and further up the Anthem food chain, this is what I got in email today:

"... I did hear back from customer service who confirmed we do not have something like this. You are correct that there would be too many variances with how the claims will process. We will need to see the Medicare EOB & then determine which policy is the primary. The claims area will then key the claim into the system ... they will input the information from Medicare. All of this information is taken into account, while viewing the members benefits. I hope this helps."

No, Tracy, it does not help. This is very simple: Anthem insures the group, and knows exactly how and what it will pay. This should not be a deep, dark state secret.

Cough. It. Up.

Grand Rounds: In Gratitude edition

FoIB Amy T hosts a Thanksgiving-themed collection of medblog posts, and we're grateful to have been included.

Monday, November 21, 2011

Protection with Pi insurance for your freelance business

If one of your clients suffer damage or economic loss due to an error, omission or negligence caused by you, the professional liability insurance to register and comply with their litigation costs. Suppose you are an employer and put a computer error by accident, while the software development. This may delay the delivery and the customer can claim substantial compensation to you. It can operate independently if you have professional liability insurance. But it can defend its case against a resolution IR35. Moreover, the premiums paid by permitting it against the tax.

If you are covered by Professional Indemnity Insurance for your business freelance contract now, you should not worry about the past to defend the claims made against you or future damages incurred and paid by you.

And awaaaaay we go !

Secretary of Health and Human Services Kathleen Sebelius is urging Pennsylvania-based Everence Insurance to abandon its plan to raise rates by an average of 11.6 percent in the small-group market.

And will this be more entertaining than Jackie Gleason?

Well, probably not.

But still good.

Government Price Controls

A doctor, now retired from the health care rat race, decided to offer his opinion on top down, government rationed health care. His observations were published in the Dominion Post.

A brief excerpt follows.

In short, Dr. Iammarino (retired pathologist) had a rapid heart beat, went to the ER for diagnosis and treatment. The doc is covered by Medicare and opted to have ablation surgery to correct the issue.

His total bill was $53,252.75.
I am a longstanding health professional (an M.D.) and I knew this charge was way over the top. I asked for an itemized bill. There were many examples of excesses. To me, the most outstanding was $48 for one 100mg dose of Zoloft. At the local pharmacy, a generic form of the drug costs well under $1. The hospital does have legitimate extra charges, but nowhere near $47. It went on and on.

I wanted a second opinion. Another cardiologist came to WVU, relieving the shortage well after my procedure was done. He had been in private practice. I asked what the charge of my procedure would have been in the area of West Virginia where he had practiced. He said it would have been around $10,000. In my case, Medicare paid $8,318.33.
OK, and your point is?
Had I been a private-pay patient, I’m sure the $53,000 plus would have been what I had to pay.
Can you say out of touch?

No one pays "sticker price" and those without health insurance usually pay almost nothing for their care. Hospitals are lucky if they collect 15 cents on the dollar from the uninsured.

His rant continues.
Around 1980 and since, Managed care groups (Health Maintenance Organizations — HMOs) became very popular. We were told that they would save money.

HMOs built on venture capital, saw health care as a low-risk, highprofit industry. We have seen medical care turn into a profit making business — mostly privatized with shareholders and highly paid CEOs.
Health care has NEVER been a low risk, high profit business. Apparently this doc spent way too much time in the lab and the fumes got to his brain.
Getting old has some advantages, but one disadvantage is recalling the government stepping in to establish price controls and fighting against price fixing when confronted with outlandish charges
Too bad his memory fails him when it comes to price controls. When the government regulation stopped and the free market returned prices and inflation when through the roof.

Thanks to Henry Stern for this tip.

Holocaust insurance settlement: Update

It's been over 4 years since we've had any news about efforts by survivors in their efforts to collect on Holocaust-era life insurance benefits. At the time, Florida Congresswoman Ileana Ros-Lehtinen had introduced legislation to help move those efforts along.

Skip ahead 4 years, and Ms Ileana Ros-Lehtinen is holding hearings in Congress aimed at enabling survivors and their families to "sue European companies such as Allianz AG, a German insurance giant, in state courts for unpaid life insurance policies sold before World War II."

The seemingly insurmountable problem, of course, is that life insurance companies require death certificates in order to adjudicate claims. Obviously, these are not going to be forthcoming in the cases of those massacred in the Holocaust. As Congresswoman Ros-Lehtinen asks, "[c]an you imagine anything more outrageous than asking for a death certificate for someone murdered in Auschwitz?"

Indeed.

Of course, there's a twist here:

"[T]he American Jewish Committee, the Anti-Defamation League, B'nai B'rith and the World Jewish Congress ... argued at a 2010 congressional hearing that the International Commission on Holocaust Era Insurance Claims was created to address worldwide claims, and that re-engaging in court could unrealistically raise the expectations of survivors."

I'm reminded of that classic punchline: "what could it hurt?"

Online clinic on prostate disease

Do you know all you should about the risks of prostate disease?

Running from 25th November until 1st December - TalkHealth in conjunction with prostate Action, AXA PPP healthcare, and NHS Choices - are running an online clinic on prostate disease, where a team of experts will be on hand with advice on everything prostate related - from prevention of prostate disease, to managing prostate conditions.

The online clinic is easy to use, so why not head across and find out more about this important subject. Prostate disease is actually a lot more common than many of us realise, so if you'd like information, advice or guidance - head on over. If you're a concerned partner and the man in your life is too shy to discuss the subject - no problem - just log in and find out more on his behalf!

More info here - http://experts.axappphealthcare.co.uk/


Saturday, November 19, 2011

An Easy Life And Secure Awoesome

The coverage of Professional Indemnity Insurance is responsible for the damages done to the professional negligence or breach of duty of care the professional commitment in the course of providing services to a client. In addition, all legal expenses of the combination are also covered by the insurance company. The insurer may choose between a blanket, which makes payments which are then reimbursed by the insurance company where you can go for a "pay on behalf" in which the insurer is responsible for all payments and associated documents him.

Friday, November 18, 2011

Lamenting the Demise of Medicine in America

Two physicians from Beth Israel Deaconess Medical Center, Pamela Hartzband, MD and Jerome Groopman MD, write in the Oct. 13 edition of the New England Journal of Medicine that medicine has become industrialized. In their view, the medical exam given by a doctor to his patient has become an encounter between a provider and a consumer. Their lament is correct but a little late in coming. When I was working on my MBA, I researched the business of medicine and discovered that the process that these physicians lament has occurred over the past 6 decades. The insurance structure that exists today came about as a result of wage freezes during World War II.

As employer-sponsored health insurance become more popular, the revenue cycle of medical care changed. Instead of the patient paying for the entire service at the time of treatment, the patient would pay a small amount of the medical bill and the insurance would pay the rest.

And then:
…insured patients began to request that the [medical offices] bill their health insurance before making payments on their accounts. [The patient] agreed to pay the balance due after the carriers determined the insurance portion of the claim. Each insurance company had a unique set of billing requirements. The complexity of the new billing procedures greatly increased paperwork and practices had to, therefore, increase the size of their billing staff [or add a billing staff which had heretofore never existed in the medical practice]
These changes dramatically affected how Americans viewed health care. First, by not paying the premium, they no longer had the knowledge of the true cost of those premiums. Secondly, by not paying for the medical care at the time of service, they no longer had the knowledge of the true cost of health care. The organizational culture of healthcare changed and the organizational memory has been lost by the American populace.

The Deaconness folks weigh in:
“We are in the midst of an economic crisis and efforts to reform the health care system have centered on controlling spiraling costs. To that end, many economists and policy makers have proposed that patient care should be industrialized and standardized.”
Patient care became standardized when insurance companies began telling physicians how much their services are worth. No longer is a physician paid based on the financial needs of the physician’s business, but instead on a government produced fee schedule based on a formula called RVU’s. Physicians have not had a raise in their fee schedule from Medicare in over a decade, and the docs are so appreciative that each year the fee is not cut that they don't realize that they did not receive any increase.

The Deaconness Duo adds:
“The problem ... is that the special knowledge that doctors and nurses possess and use to help patients understand the reason for and remedies to their illness get lost in a system that values prepackaged, off-the-shelf solutions that substitute "evidence-based practice" for "clinical judgment."
What Hartzband and Groopman do not understand is that the patient does not want to pay for the physician to develop an evidence-based plan of care. Today’s exam averages 15 minutes. A physician cannot do the type of work that Hartzband and Groopman want in 15 minutes. That is the reason that more and more medicine is pre-packaged, and it works for the majority of the population. For the minority of patients that need the more protracted appointment and care, there is resentment that they should have to pay more for their care than someone else.

More from Boston:
“Even more troubling ... is the impact of the new vocabulary on future doctors, nurses, therapists and social workers who care for patients. Recasting their roles as providers who merely implement prefabricated practices diminishes their professionalism.

Reconfiguring medicine in economic and industrial terms is unlikely to attract creative and independent thinkers with not only expertise in science and biology but also an authentic focus on humanism and caring.”
Here, Hartzband and Groopman are correct: individuals who desire to make a contribution to society, and to be rewarded for this contribution financially, will steer away from medicine. Since insurance companies pay the inadequate physician the exact same as the extraordinary physician, what is the incentive to become a physician?

While I applaud Doctors Hartzband and Groopman for their impassioned plea to return to medicine of old, that ship has sailed. Modern medicine is dictated by a labyrinth of regulations, economics, and government oversight that has forever changed medicine in America.

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