Search the KHIT Blog

Tuesday, October 25, 2016

Election Day 2016 can't come soon enough

Cheryl and I already voted, by mail-in ballots (and it wasn't for you-know-who). I am so ready for this campaign to be over.

The news getting major play this week.
Obamacare premiums are going up 25 percent. So what happens next?

OBAMACARE PREMIUMS ARE GOING UP 25 PERCENT. SO WHAT HAPPENS NEXT? — HHS on Monday confirmed that benchmark premiums on will dramatically jump next year, re-injecting Obamacare into the political debate just two weeks before the election.
It's the latest bad headline for Obamacare in a series this fall, with major insurers dropping out of the exchanges and Democrats acknowledging the law needs fixes. But the 25 percent rate hike is especially eye-catching: Average prices for the second cheapest silver-level plan — used as the benchmark to determine premium subsidy levels — had increased by just 7.5 percent on average in 2016 and 2 percent in 2015, Pro's Rachana Pradhan reports....
From the HHS release:

Interesting piddly side note. I just got a Humana notice apprising me that my 2017 Medi-Gap high-deductible Plan F Supplemental premium is going up 13.25% relative to the current cost. I'll be paying them $727.08 for the year, -- as a true insurance hedge against something really big, bad, and expensive happening.
Below: the Donald Trump Campaign official health care reform proposal, verbatim as of today:
Healthcare Reform
Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. 

Since March of 2010, the American people have had to suffer under the incredible economic burden of the Affordable Care Act—Obamacare. This legislation, passed by totally partisan votes in the House and Senate and signed into law by the most divisive and partisan President in American history, has tragically but predictably resulted in runaway costs, websites that don’t work, greater rationing of care, higher premiums, less competition and fewer choices. Obamacare has raised the economic uncertainty of every single person residing in this country. As it appears Obamacare is certain to collapse of its own weight, the damage done by the Democrats and President Obama, and abetted by the Supreme Court, will be difficult to repair unless the next President and a Republican congress lead the effort to bring much-needed free market reforms to the healthcare industry. 

But none of these positive reforms can be accomplished without Obamacare repeal. On day one of the Trump Administration, we will ask Congress to immediately deliver a full repeal of Obamacare. 

However, it is not enough to simply repeal this terrible legislation. We will work with Congress to make sure we have a series of reforms ready for implementation that follow free market principles and that will restore economic freedom and certainty to everyone in this country. By following free market principles and working together to create sound public policy that will broaden healthcare access, make healthcare more affordable and improve the quality of the care available to all Americans.
Any reform effort must begin with Congress. Since Obamacare became law, conservative Republicans have been offering reforms that can be delivered individually or as part of more comprehensive reform efforts. In the remaining sections of this policy paper, several reforms will be offered that should be considered by Congress so that on the first day of the Trump Administration, we can start the process of restoring faith in government and economic liberty to the people. 
Congress must act. Our elected representatives in the House and Senate must:
  1. Completely repeal Obamacare. Our elected representatives must eliminate the individual mandate. No person should be required to buy insurance unless he or she wants to. 

  2. Modify existing law that inhibits the sale of healthinsurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up. 

  3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it. 

  4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be particularly attractive to young people who are healthy and can afford high-deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.
  1. Require price transparency from all healthcare providers, especially doctors
    and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure. 

  2. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources. 

  3. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. Allowing consumers access to imported, safe and dependable drugs from overseas will bring more options to consumers.
The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation. 

Providing healthcare to illegal immigrants costs us some $11 billion annually. If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.

To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs. 

Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support. 

To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country. These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again. 
More detail than that which The Donald proffered on the Dr. Oz show. Oh, and The Donald says be sure to get out and vote.

OK: Recall from my prior post? (scroll to the bottom)
"The finest clinical capability on earth is of nil utility if it's increasingly out of reach financially."
BTW, I posted on the Clinton position back in July, here: "The Clinton campaign health care policy position."

I'll have more to say about this shortly, after helping my daughter finish moving.

Until then, how about a song?


And then there's this music, from the Socialist Hellhole of Scandinavia (Sweden, specifically) that crushes all human initiative and creativity (while providing universal health care with excellent outcomes).

We got to see these astonishing young gentlemen live in a club in San Francisco (Slim's). They were even better live. Hard to believe. Google 'Dirty Loops." Unreal.


From The Incidental Economist:
Why the U.S. Still Trails Many Wealthy Nations in Access to Care
Aaron Carroll, MD 

Many are still unhappy with Obamacare.

The main intent of the Affordable Care Act was to expand the safety net (Medicaid), regulate the non-employer-based private insurance market (the insurance exchanges) and help people buy that insurance (subsidies) in order to reduce the number of Americans who are uninsured.

On those metrics, it appears to be succeeding.

First and foremost, Obamacare was about improving access to health care. While it did improve access to insurance, in many, many other ways the United States is falling short. Things are likely to get worse before they get better.

Even with Obamacare, the United States still ranks poorly among comparable countries in insurance coverage. Even in 2016, when the rate of insured is the best it has ever been in the United States, Americans still have a greater percent of the population uninsured than pretty much any other industrialized nation in the world...
From The New Yorker (may be paywalled):
By John Cassidy

It has long been clear that many of the health-insurance companies offering policies through the public exchanges set up under the Affordable Care Act of 2010 were losing money. Some big operators, including Aetna, Humana, and United Health Care, have withdrawn from a number of the exchanges, and those insurers that remain have been indicating their intention to raise prices sharply for 2017. “The reality is the Affordable Care Act is no longer affordable,” Mark Dayton, the Democratic governor of Minnesota, said earlier this month. So it shouldn’t have come as a surprise when the Obama Administration this week formally acknowledged that prices will go up for plans purchased on the exchanges.

But this is an election season, and Donald Trump and other Republicans used Monday’s news as an opportunity to denounce Obamacare as a hopeless failure. “It is blowing up,” Trump told Fox News. “It is out of control. It can’t be saved.” As usual, the G.O.P. candidate was exaggerating greatly.

In some ways, the Affordable Care Act is working as planned. Figures from the Census Bureau show that between the start of 2014, when the major provisions of the law went into effect, and the end of 2015, the percentage of Americans without insurance fell from 14.2 per cent to 9.1 per cent. That drop of 5.1 percentage points is the largest on record. Among groups that the Affordable Care Act particularly targeted, such as poor families and non-elderly adults, the numbers have been even more dramatic.

Since the Affordable Care Act’s expansion of Medicaid, the government insurance program that serves the poor, more than fifteen million Americans have joined its rolls. If Republicans in nineteen states hadn’t refused to go along with the expansion, this number would be considerably higher. Other elements of the law, such as forcing insurers to cover people with preëxisting conditions and allowing young people to stay on the their parents’ plans until the age of twenty-six, have proved enormously popular.

The issue is the publicly-run exchanges, where people who don’t receive health insurance through their jobs can buy plans on an individual basis...
...For people who don’t qualify for subsidies, the costs of buying insurance through the exchanges can be very high. Take a family of four living in Brooklyn and making a hundred thousand dollars a year. Since their income is more than four times the federal poverty threshold, they wouldn’t qualify for any subsidies. On, a Web site that lists the insurance policies offered on the New York state exchange (and others), the cheapest “silver”—that is, mid-level—2017 family plan I could find for such a family was from EmblemHealth, and it cost $1,432.78 a month, or $17,193.36 for the year. The family deductible was $11,600, as was the out-of-pocket maximum.

Figures like these are disturbing. Until policy-holders have covered their deductibles, they have to pay for the full cost of most of the medical services they receive. “I can’t afford to get sick after paying for the health insurance,” Laura Schlett, a forty-four-year-old woman from Brandon, Mississippi, told the Times’s Robert Pear this week. Many people feel the same way...

See my August post "ObamaCare in trouble? Coverage, cost, access problems..." See also my July 2015 review of "ObamaCare is a great mess."

Again, the finest clinical delivery workforce and systems, and the finest clinical science are problematic if access is out of reach financially.


Ian was a recent Health 2.0 Conference Keynoter, recall?

Making a killing under Obamacare: The ACA gets blamed for rising premiums, while insurance companies are reaping massive profits

...While Americans continue to fork out more money, insurers are doing great.

On Thursday, Aetna reported $734 million in profit on $15.8 billion in revenue for the three months ended Sept. 30. The nation’s third-largest health insurer by revenue handily beat Wall Street estimates for the quarter. Chief Financial Officer Shawn M. Guertin cited “solid performance” in its core health insurance business that offset “pressure” from its business under the Affordable Care Act. “Pressure” here refers to the fact that, while Aetna has reaped an ACA windfall, it can’t make money insuring the sicker and costlier undesirables desperately trying to access affordable care by seeking coverage on the ACA exchanges.

Aetna’s earnings report came a week after UnitedHealth reported a 12 percent jump in revenue to $46.3 billion for the three months ended Sept. 30 compared to the same period the previous year. The company collected $36.1 billion in insurance premiums, 11 percent higher than the year-ago quarter, while profits increased 29 percent to $1.98 billion as the company signed up 955,000 more health insurance customers through its employer and individual plans. (Anthem, Cigna and Humana will report their latest quarterly earnings next week.)

Investors are reaping major rewards as well. In the first nine months of the year, UnitedHealth spent $1.1 billion in share repurchases and $1.7 billion in direct dividend cash payments to shareholders, according to its quarterly filing. Between 2012 and 2015, UnitedHealth spent $12.6 billion in buybacks and dividends. Because most revenue for health insurers comes from insurance premiums, any cash doled out to shareholders essentially behaves as a transfer of wealth from a consumer’s health care budget to an investor’s annual capital gains income...

More to come...

No comments:

Post a Comment