Saturday, December 28, 2013

Obamacare Schadenfreude - The Gift that Keeps on Giving

Don't you just hate the week after Christmas?  All the gifts are open.  The ones that are useful have already found their niche, the ones that aren't have been stashed some place for possible re-gifting. The wrapping paper is all cleaned up, but the tree, if it was once live, is starting to shed needles, and you're tired of all the blinking lights, but not yet motivated enough to take them down.  If you have relatives visiting (we don't), or are visiting relatives, the welcome is starting to wear thin. Even if you do have to go to work between Christmas and New Years, it's Saturday, and not much is going on.  But there's one gift that keeps on keepin' on: Obamacare Schadenfreude!
Low premiums may mean high out-of-pocket health costs

If you buy one of the less expensive insurance plans sold through the new health law’s marketplaces, you may be in for a surprise: Some plans won’t pay for doctor visits before you meet your annual deductible, which could be thousands of dollars.

“This could be the next shoe to drop, as people don’t realize that if they’re buying a bronze plan, they may have to pay $5,000 out of pocket before it contributes a penny,” said Carl McDonald, senior analyst with Citi Investment Research, speaking at a conference last month in Washington.
People who buy their own insurance have always had to pay a set annual sum, called a deductible, before policies begin paying their claims. But first-time insurance buyers may not realize they’re on the hook for those costs before benefits kick in, and might choose plans based solely on the monthly premiums.
Meeting the deductible before most coverage kicks in is common in the individual market, but it differs sharply from job-based health insurance. More than three-fourths of the insurance plans offered to Americans with coverage through their jobs pay a substantial chunk of the cost of doctor visits without the workers having to meet the annual deductible first, according to an annual survey of employers by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.)
In my mind, the high deductible insurance of the "bronze" plans is what insurance is designed to be; insurance that you can cover unexpected high cost medical, while you pay for routine, expected medical expenses (e.g. birth control, check ups, routine diagnostics; for which coverage is mandatory under Obamacare) out of pocket; it makes no sense to filter them through the overhead of an insurance company.  Car insurance doesn't normally cover the expenses of wiper fluid, air in the tires, oil changes, new tires, or alignments.

However, Americans have come to feel entitled to cradle to grave medical coverage, even those who would rather put their out of pocket money into smartphones.  They're going to be pissed. They thought someone else was paying for it.

Another Day, Another ObamaCare Lie Exposed
We’ve reached a point where, to any objective observer, it is clear that nearly every point made by Democrats to sell ObamaCare pre- and post-passage (and pre-implementation) was either a blatant lie or wishful thinking by people who had no idea what the law was going to do. The law is not affordable on a macro or micro level. No one was ever going to be able to keep their plan if they liked it, and there’s no way it is going to “bend the cost curve.”

Now we can add one of the more touchy-feely selling points made by Democrats. Courtesy of Nancy Pelosi:
...“You want to be a photographer or a writer or a musician, whatever — an artist, you want to be self-employed, if you want to start a business, you want to change jobs, you no longer are prohibited from doing that because you can’t have access to health care, especially because you do not want to put your family at risk,” she said.
Well, Nancy’s chickens have come home to roost:
Many in New York’s professional and cultural elite have long supported President Obama’s health care plan. But now, to their surprise, thousands of writers, opera singers, music teachers, photographers, doctors, lawyers and others are learning that their health insurance plans are being canceled and they may have to pay more to get comparable coverage, if they can find it.

They are part of an unusual, informal health insurance system that has developed in New York, in which independent practitioners were able to get lower insurance rates through group plans, typically set up by their professional associations or chambers of commerce. That allowed them to avoid the sky-high rates in New York’s individual insurance market, historically among the most expensive in the country.

But under the Affordable Care Act, they will be treated as individuals, responsible for their own insurance policies. For many of them, that is likely to mean they will no longer have access to a wide network of doctors and a range of plans tailored to their needs. And many of them are finding that if they want to keep their premiums from rising, they will have to accept higher deductible and co-pay costs or inferior coverage.

Train. Wreck.

The only consolation here is that most of these people supported ObamaCare and now have to live with their stupid decision. But millions of other people who didn’t want this monstrosity have to deal with it too. That’s sickening.
Now, that'se reale schadenfreude!

Meaningless Sentence of the Day 
This NY Times story on the middle class's struggle with the new healthcare law is generally pretty good, but this sentence struck me as comically meaningless:
Experts consider health insurance unaffordable once it exceeds 10 percent of annual income. . .
Probably what the sentence means is that people have become accustomed to spending less than 10 percent of income on health insurance and are unhappy when they have to spend more. But if healthcare costs keep rising as a share of national income, as many economists believe they will, then we will have to adjust our perceptions of what is affordable.
They say that if you don't have your health, for under 10% of your income, you don't have anything...

Obama’s accidental lesson for America
As the fifth year of the Obama presidency draws to a close, it may be time to examine the unspoken but powerful assumption behind the policies of the president and his party.

That is the assumption that in times of economic distress Americans would be, more than usual, supportive of or amenable to Big Government programs.

The assumption was widely shared, and not just by Democrats. And it has pretty well been disproven, insofar as any abstract proposition can be disproven, in the five years of the Obama presidency. . .
The Obamacare rollout in particular has been a valuable lesson in why wisdom is separate and distinct from intelligence, and why it's not always a good idea to put the self-proclaimed smartest person and his henchpeople in charge.

A ghost of Christmas future?  Which Is Having A Worse Year, Obamacare or NHS?
The bureaucrats at the Dept. of Health and Human Services and those at Great Britain’s National Health Service should consider getting together to compare notes on 2013.

I don’t know who would come out the winner in the pity competition, but at least the ObamaCare exchanges aren’t abandoning 1 in 4 women who are giving birth:
One in four new mothers were left alone by midwives when they were in labour, the NHS watchdog has revealed.

Some were forced to give birth on the floor in waiting rooms, having earlier been told not to come in as they were ‘not in enough pain’.
"Bad Apple" Insurance issued by the Federal Government?
The NY Times outs another "bad apple" insurance plan offering sub-standard benefits:
Vista Workers Told Their U.S. Health Plan Fails Test

WASHINGTON — The Obama administration has told Vista volunteers and other AmeriCorps workers that their government-provided health coverage does not measure up to the standards of the new health care law, and that they may be subject to financial penalties unless they obtain insurance elsewhere.
Will Insurers Ever Say Enough’s Enough To Obamacare?
So when Obama came along with an offer to require all Americans to buy their products, it was an offer they couldn’t refuse. Especially when the products he had in mind were comprehensive, cover-everything health plans. No more bank involvement. We’ll really be in the catbird seat now!

The naivety I had witnessed during the Clinton Wars was still in force. Many of us tried to warn the industry that they would regret this arrangement. Yes, they might be assured of modest profits, but the cost of sacrificing their autonomy would be far too high. They would become little more than public utilities. They would lose all control over benefit design, marketing practices, and rate setting. They would have no idea of the risks they were enrolling and would have to set premiums blindly.

It has become much, much worse than I ever imagined. Obamacare is not even fully in effect yet and already we are seeing the President playing with the carriers like a toddler plays with toy trucks –
  • Employers will be mandated to buy your policies for 2014
  • (Oops, employers are angry)
  • Employers won’t be mandated until 2015 – if then
  • Small employers will give workers a choice of health plans through the SHOP program in 2014
  • (Oops, we can’t get the web site ready in time) . . . (a long list follows). . .
How can anyone run a business this way? This is worse than being a federal agency. No federal agency would be expected to stop and start on a personal whim like this. These aren’t rules, they aren’t regulations, they are dictates based on nothing more than Kathleen Sebelius’ momentary feelings.

These are only the “glitches” that have been made public. God knows what orders and threats are being issued in closed-door meetings.

How long will the insurance industry abide being treated like shoe shine boys? Mr. Obama will not be in office forever. His regime is already coming to an end. What will these companies do then? He will no longer be around to grant or withhold bailout (“risk corridor”) money. No other president, Democrat or Republican, will ever be as arrogant or irrational.

It is well past time for the industry, supposed Titans of Wall Street, to grow some spine and start thinking about the best interests of their customers and shareholders.
It's kind of late for that.  They forgot the old  saw about supping with the devil.

Big rush on ObamaCare, but how many will be insured?
As anyone could have predicted, the deadline for ObamaCare enrollment has prompted a surge in traffic to and state exchange websites. Mandate compliance will tend to focus attention, especially when the IRS could end up breathing down your neck for non-compliance. CBS News reports that record numbers of people signed up for insurance on the exchanges over the past week, but no one’s really sure if they actually will have insurance after January 1:

CBS calls these “enrollments,” but that’s actually the question. As CBS notes, insurers aren’t sure that the sign-ups will equate to actual enrollments for a number of reasons. Two of those reasons don’t get a mention in the report. First, the federal exchange and perhaps some of the state exchanges still have issues with their 834s, the electronic report that transmits enrollment data to insurers. The failure rate, by the administration’s own admission, is at least 10%. If the insurers don’t get the proper data, then they can’t enroll the customers. Second, the back-end subsidy payment system isn’t even in place, although the Obama administration’s workaround will be to have the insurers bill CMS for subsidy payments and to issue them without confirmation for a while. If enrollment data gets confused, customers might find their insurance cancelled even if they have been making their partial payments — unless insurers really want to go out on a limb and into the red on provider payments with short revenue.
Virtually guaranteeing that Obamacare will be in the news for months, and not it good way.

Finally, a little light new, a  liberal fuck self-identifies:
Ethan Krupp, the little man who played “Pajama Boy” in a widely mocked Obamacare ad, once characterized himself as a “liberal fuck.”

Krupp, an Organizing for Action (OFA) content writer who became the face of progressive America while wearing a onesie pajama suit, also remarked that gays “are all liberal fucks” and criticized a “conservative gay prick” on his now-deleted WordPress blog, entitled “Not Being Creative.”

“I am a Liberal Fuck,” Krupp wrote in one post. “A Liberal Fuck is not a Democrat, but rather someone who combines political data and theory, extreme leftist views and sarcasm to win any argument while make the opponents feel terrible about themselves. I won every argument but one.”

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