Minimal Obamacare Schadenfreude

I've been out erranding, so this is late. It's a good thing yesterday was a slow day Obamacare Schadenfreude land, so I can get this over with, and get out and enjoy a gorgeous day.

Another turn of the "Death Spiral" Yep, early ObamaCare enrollees are sicker than average

Tantalizing circumstantial evidence about the demographic mix in the new ObamaCare exchange risk pools. The more those pools are dominated by the old and sick, the higher premiums will have to be next year to cover the cost of their expensive treatments. The X factor here, though, is that the study includes data only from people whose coverage was in effect in January and February. All the sign-ups in March before the deadline are missing from the picture, an important detail since it’s widely assumed that lots of healthy young “knuckleheads” waited until the last minute to enroll. If that’s true then the early crush of sick people might be manageable; premiums paid by twentysomething latecomers who don’t need much medicare care will simply be applied to paying for the sick, easing costs next year. If it’s not true, premiums are headed up, up, and away, and O-Care’s in trouble.
. . .
Here’s a quickie two-page breakdown from Express Scripts of their key findings. Note the table comparing conditions for which ObamaCare customers sought treatment to conditions treated among all other insured. Contraceptives are notably lower for O-Care users than for the rest of the population, a clue about the average age of the exchange risk pools circa March 1. More comparison details from Kaiser:

-More than 6 in every 1,000 prescriptions were for an HIV drug, a rate four times that of employer plans.
-HIV/AIDS drugs Atripla and Truvada ranked in the top 10 for total amounts spent on drugs but did not hit the top 10 in spending among the comparison group.
-Sovaldi, an $84,000 treatment approved in December to treat hepatitis C, came in second for total spending, while it ranked No. 8 in the comparison group.
-The volume of pain medication was 35 percent higher; drugs to control seizures were 27 percent higher and antidepressants were 14 percent higher. Conversely, birth control prescriptions were 31 percent lower.

The Hepatitis C drug, in particular, is fantastically expensive at $1,000 per pill; the number of Americans with the disease is upwards of three million.

So, on average, Obamacare signups are less likely to be worried about contraception and pregnancy, and more likely to be worried about HIV, Hep C and getting free pain meds than the general population...  Oh goody.

Another rube self-identifies: Medicaid Patients Realize They Can’t Find a Doctor

A supporter of Obamacare finds that access to health insurance does not automatically turn into access to health care:

“I’m sorry, we are no longer accepting that kind of insurance. I apologize for the confusion; Dr. [insert name] is only willing to see existing patients at this time.”
As a proud new beneficiary of the Affordable Health Care Act, I’d like to report that I am doctorless. Ninety-six. Ninety-six is the number of soul crushing rejections that greeted me as I attempted to find one. It’s the number of physicians whose secretaries feigned empathy while rehearsing the “I’m so sorry” line before curtly hanging up. You see, when the rush of the formerly uninsured came knocking, doctors in my New Jersey town began closing their doors and promptly telling insurance companies that they had no room for new patients.

Writer Danielle Kimberly notes that doctors lament that Medicaid reimburses them far too little money for their treatment. However, doctors also lament that reimbursement takes way too long to arrive and that the paperwork and bureaucracy are far too frustrating.

And not really Obamacare Schadenfreude, but certainly related to the whole health care debacle:
Menendez crony got $21 million from Medicare in 2012

Remember Salomon Melgen? Over a year ago, the FBI raided his opthalmologic practice offices shortly after his connection to Senator Robert Menendez’ travel and prostitution habits surfaced. The FBI later opened a probe of Menendez, which went to a grand jury a year ago, and charged Melgen with Medicare fraud last August. CMS released its figures on total compensation from 2012 on Medicare and Medicaid claims, and guess who topped the list?

Medicare paid a tiny group of doctors $3 million or more apiece in 2012. One got nearly $21 million.
Those are among the findings of an Associated Press analysis of physician data released Wednesday by the Obama administration, part of a move to open the books on health care financing.
Topping Medicare’s list was Florida ophthalmologist Salomon Melgen, whose relationship with Sen. Robert Menendez, D-N.J., made headlines last year after news broke that the lawmaker used the doctor’s personal jet for trips to the Dominican Republic. Medicare paid Melgen $20.8 million.
AP’s analysis found that a small sliver of the more than 825,000 individual physicians in Medicare’s claims data base — just 344 physicians — took in top dollar, at least $3 million apiece for a total of nearly $1.5 billion.
AP picked the $3 million threshold because that was the figure used by the Health and Human Services inspector general in an audit last year that recommended Medicare automatically scrutinize total billings above a set level. Medicare says it’s working on that recommendation.

Give AP credit for both mentioning Menendez and his political affiliation — and in the third paragraph, no less. Bloomberg never bothers to mention Melgen’s Beltway connections, which led a commenter to ask: “Why no mention that the florida $21 Million doctor is a benefactor to NJ Senator Menendez?” That’s a good question — as is the question of the status of the probe into Menendez.

As the article hastens to point out, a large volume of medicare reimbursements is not proof of fraud, but it is certainly a possibility to consider. But how did he get looked at; isn't that why you pay Congressmen?  To help keep you out of the limelight?

'Shut Up' Is No Argument

"The debate over repealing this law is over," President Obama declared last Tuesday in reference to ObamaCare. April Fool! By the end of the week some of Obama's most loyal media supporters were proving him wrong--by repeating his arguments.

"Is there any accountability in American politics for being completely wrong?" demanded the Washington Post's E.J. Dionne in his Thursday column. "Is there any cost to those who say things that turn out not to be true and then, when their fabrications or false predictions are exposed, calmly move on to concocting new claims as if they had never made the old ones?"

It won't surprise you to learn that Dionne did not demand accountability from Obama and the other politicians who sold ObamaCare on the fraudulent promise "if you like your plan, you can keep your plan." Rather, he asserted that the administration's claim of having "hit its original goal . . . of signing up more than 7 million people through its insurance exchanges" was a definitive refutation of any notion that ObamaCare is "doomed."

What about insurance cancellations, narrow networks, high deductibles, blown deadlines, work disincentives, adverse selection and the law's continuing political unpopularity? Dionne dispenses with all these problems in one sentence: "To be sure, the law could still face other problems, blah, blah, blah."

When it's all you have, it is.