Scam or Implementation?

When I saw this headline, "Scam alert issued on new health care law" I immediately thought "good, someone's finally called ObamaCare© what it really is." But alas, it's a hit piece on some poor, hard-working individuals looking on the bright side of our new health care financing system:

"Some of the [entrepreneurs] are going door to door claiming there's a limited open-enrollment period to buy health insurance now."

Which is, after all, quite true: once the new law is in full effect, there will be limited types of plans and providers, and most insurance policies are likely to be quite unaffordable.

The article says that "Health and Human Services Secretary Kathleen [Shecantbeserious] said Tuesday she's writing state officials about a proliferation of scams involving the new health care law." Not sure why she'd do that; seems to me that she should be directing her correspondence to Sens Nelson and Landrieu (to name just two), since they're primary instigators of the scam writ large.

Perhaps she'll get to that, eventually.

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An Insurance Mandate in Action

Thanks to a pointer at National Review Online, I found this article in the Boston Globe Sunday April 4:

"Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses." . . . "The typical monthly premium for these short-term members was $400, but their average claims exceeded $2,200 per month."

Ouch - but there's more:

"The problem is, it is less expensive for consumers — especially young and healthy people — to pay the monthly penalty of as much as $93 imposed under the state law for not having insurance, than to buy the coverage year-round. This is also the case under the federal health care overhaul legislation signed by the president, insurers say."

. . . also the case under federal health insurance overhaul legislation. Swell. What can possibly go wrong?

But, the people are pretty smart huh? We figure this stuff out. How's come the legislators don't figure this out? They had actuaries and insurance experts advising them. Don't the legislators pay attention? Who DO they listen to? What were they thinking by making the penalty so much less than the premiums? Did they think they were doing some kind of big favor for people who still couldn't afford insurance?

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Oy Canada! Runaway Costs Coming Home to Roost

So our "broken system" needed a mutli-trillion dollar fix, based at least in part on the "success" of Canada's?

Not so fast there, pardner:

"The light bulb has gone on and the Ontario government has finally realized that the current method of financing health care in this province is not sustainable ... Premier Dalton McGuinty warned that if serious reforms are not implemented soon, health spending will consume 70 cents of every provincial dollar spent in 12 years. Not only would this increase government rationing of health care services, it would also crowd out other critical public services."

A couple of key points here:

■ What exactly comprise "serious reforms?" Is the Premier perhaps hinting at returning to a privatized system?

■ I found this little throw-away particularly delicious: "increase government rationing of health care services." In fact, this is a profound admission that the Canadian system is, in fact, based on rationing health care, and they still can't hold down costs.

Boy, I'm thrilled we've chosen that route, too.

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ObamaMath and ObamaPools

Where can you purchase a $200 item for $100?

In ObamaWorld.

HHS Sebelius has released some guidelines for the new medical risk pools that will hit the streets in 90 days. We already addressed some of the potential problems in an earlier post.

Now it seems others are catching on as well.

The N Y Times makes these observations.

State high-risk pools, all of which operate at a loss, paid a total of $1.9 billion in claims in 2008, according to a recent report by the Government Accountability Office, an investigative arm of Congress. The average claims per person totaled $9,437 in that year. Premiums paid by beneficiaries accounted for 54 percent of the money used to operate the existing high-risk pools. Assessments collected from insurance companies accounted for 23 percent of the total, while state general revenues and other taxes accounted for most of the remainder.

Currently risk pools charge 125 - 200% of standard rates, but the ObamaPool has a different math book.

Premiums in the new program will be set at “standard rates,” based on the average premiums charged by private insurers for similar coverage in the individual market.

“If I have cancer, my rate cannot vary based on my having cancer,” said Jeanne M. Lambrew, director of the Office of Health Reform at the Department of Health and Human Services.

For those of you playing along at home, see if you follow this.

Rates currently charged by risk pools are higher than the ObamaPool and those premiums are insufficient to cover the claims. But the ObamaPool uses new math to come up with better benefits and lower premiums.

Must be magic.

Or ObamaMath (like those 57 states he visited and the 3000% premium reductions that were promised).

Dr. Lambrew said the new program would “build on what works.”

I guess you need to define the word "works".

A plan that covers really sick people but does not charge enough to cover their claims would only work in Obamaworld. In the real world, that would be a plan that doesn't work.

So using ObamaMath to set up an ObamaPool in ObamaWorld makes perfect sense.

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Healthcare and the oPad

ObamaCare© in easy-to-follow format:



[Hat Tip: Lucianne]

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Drive By Health Insurance

Drive by health insurance is killing the health insurance market in Massachusetts and will do the same when Obamacare goes live.

Thousands of consumers are gaming Massachusetts’ 2006 health insurance law by buying insurance when they need to cover pricey medical care, such as fertility treatments and knee surgery, and then swiftly dropping coverage, a practice that insurance executives say is driving up costs for other people and small businesses.

Gosh, who could have seen that coming?

The typical monthly premium for these short-term members was $400, but their average claims exceeded $2,200 per month.

That's better than playing the lottery.

the phenomenon is likely to be repeated on a grander scale when the new national health care law begins requiring most people to have insurance in 2014

No kidding.

The problem is, it is less expensive for consumers — especially young and healthy people — to pay the monthly penalty of as much as $93 imposed under the state law for not having insurance, than to buy the coverage year-round. This is also the case under the federal health care overhaul legislation signed by the president, insurers say.

Well yeah, but Obamacare is going to create a budget surplus which will save us from going bankrupt.

In February, (Gov. Duval) Patrick filed legislation that would give his administration sweeping authority to cap rates charged by insurers and medical providers. The bill included a provision that would restrict enrollment for consumers who are buying insurance on their own to two annual periods — in June and December — but includes exceptions for people facing life changes, such as loss of workplace insurance or the birth of a child.

Let's see. Wait until a child is born then buy health insurance. Yeah, that worked so well for the folks in Texas.

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