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The official blog of the National Center for Public Policy Research, covering news, current events and public policy from a conservative, free-market and pro-Constitution perspective.

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Tuesday
Sep302014

Can't Bloomberg Businessweek Reporters Do A Google Search?

At Bloomberg Businessweek, reporter John Tozzi recently linked to one of my blog posts in this sentence: “Americans sometimes accuse Britain’s single-payer system of rationing of health care.” More on that in a bit.

Tozzi’s piece focuses on the drug Sovaldi and Britain’s National Health Service (NHS).  The NHS’s National Institute of Clinical Excellence (NICE) decided to approve the use of Sovaldi, a “miracle” drug that can cure hepatitis C that is very expensive—up to $1,000 a pill.

After claiming that the NICE has decided that paying for the expensive drug now will save costs later on, Tozzi states:

That’s not the case in the U.S., where health care is paid for by a mix of employers, private insurers, and government programs such as Medicaid and Medicare. Hepatitis C can take 20 to 30 years to cause liver scarring that might require a transplant. An insurer paying for Sovaldi now is probably preventing an expensive treatment that would have ultimately been paid for by another part of the health-care system—most likely Medicare, the federal insurance program for Americans 65 and older. Insurers don’t have much incentive to do that, even if it would save the U.S. health system money in the long run. (Italics added.)

That second paragraph strongly implies that insurers in the U.S. aren’t paying for Sovaldi.  To check that, all you have to do is put the words “Sovaldi” and “insurer” into Google.  There you find articles—like this one in Reuters and this one in the Boston Globe—that describe the struggles of insurers in the U.S. to cover the cost of Sovaldi. But we also learn that by May “30,000 people have received hepatitis drug Sovaldi,” that the “drug contributed to a first-quarter financial loss at Partners HealthCare, the giant Boston system that runs Massachusetts General and Brigham and Women’s hospitals” and that “MassHealth, the government Medicaid program that insures many patients directly, spent about $10.8 million on the new hepatitis C treatment during the first three months of the year.”

Insurers, it seems, are paying for Sovaldi.  It would have been nice if Tozzi had done a bit of Google searching before he wrote his love letter to the NHS.

Here are a few other things he could search on Google:

1. The NHS, wait lists for treatment and cancelled surgeries. The Google search on this one is a bit tough, but one can eventually find the NHS’s own data showing that 3 million people on the wait list for surgery, 809,000 patients were waiting for a diagnostic test and 15,600 operations were cancelled at the last minute in the second quarter of 2014.

2. NICE and the drugs that it has declined to fund, such as Benlysta,” “Novartis,” “Sorafenib” and “Avastin.”  The first is a treatment for lupus while the last three can extend the life of cancer patients.  The Rare Cancers Forum notes that 16,000 patients annually could benefit from cancer drugs rejected by NICE.

3. What happens to patients in Britain who could benefit from a drug but must endure NICE’s approval process.  For example, put “Alice Mahon” and “Lucentis” into Google.  Mahon is a former Labor MP who was going blind in one eye because of macular degeneration. Lucentis is a drug that treats macular degeneration, but at the time Mahon needed it, NICE had not finished its approval process.  Mahon went blind in one eye because of the time it took for NICE to approve Lucentis. Mahon said, “I have been an ardent supporter of the NHS all my life, and now feel totally let down.”  (For more on Mahon and others like her, see National Center’s publication “Shattered Lives.”)

In short, all it takes is some Google searching to discover that rationing in the NHS is not a matter of “accusations.”  It’s well-established fact.

Friday
Sep262014

Danhof Defeats Hartmann in Radio Rumble Over GM Foods

Watch as Justin Danhof, director of the National Center’s Free Enterprise Project takes on and soundly defeats liberal talk radio host Thom Hartmann on the issue of labeling genetically modified foods.

Justin cited settled science and the obvious intent of the organic food industry lobby to demonize GM foods, while Hartmann said he thinks groups such as the American Medical Association that find no harm in genetically modified products are corrupt.

Justin recently attended the annual shareholder meeting of General Mills, where the Free Enterprise Project helped decisively defeat a shareholder proposal to mandate the removal of all genetically modified products from its inventory.

Friday
Sep262014

Refugee Status for Illegal Immigrants Rebutted

With the possibility that President Barack Obama may soon attempt to abuse federal refugee policy as a means of offering some sort of amnesty to illegal immigrants, Project 21 co-chairman Horace Cooper told One America News Network host Rick Amato that this potential action could hurt the prospects of legitimate refugees seeking relief in the United States from oppressive regimes and warlords in their home countries.

Speaking about a Project 21 data release on the issue of amnesty and refugee policy, Cooper said that a possible redefinition of refugee status by the Obama White House is unfair and probably unlawful:

Here’s some problems with that: One is [that] this isn’t going to allow for people like the Kurds in Iraq to be able to say, “Well, wait, ISIS is out of control.  We get to come to America.”  This isn’t gonna allow people in Nigeria, who are clearly persecuted by Boko Haram and other terrorist groups….

But, instead, it’s going to attempt to redefine — we believe unlawfully — redefine the definition of persecution to say if drive-by shootings are happening, if high levels of drug activity are happening or other kinds of mayhem and you don’t like it, you get to come to America.

It doesn’t seem to me to be a strong argument that ultimately will bear out, and this is the kind of thing that will lead to litigation.  But it’s not the role of the President to even take on this kind of approach.

Horace is also given some time at the beginning of the segment to provide a concise description of the purpose and performance of the Project 21 black leadership network.

Friday
Sep262014

Project 21's LeBon Speaks (Separately) on Sharia Law, School Lunches

Cherylyn Harley LeBon, co-chairman of the National Center’s Project 21 black leadership network, has been active in pointing out the hypocrisy of liberal policymaking at both the federal and international level.

In early September, Cherylyn discussed the federal nutritional guidelines that are being imposed on schools on the Soul of the South network’s “D.C. Breakdown” program.  Pointing out that requirements for foods served in schools, such as whole wheat pasta that is unpopular with students and hard for cafeteria employees to make in bulk, Cherylyn focused on how federal mandates (especially these that are not phased in over time) are not always the best way to deal with children:

We have these federal bureaucrats who are coming up with these rules and, as a mom, I question, well, “Do you have children at home?  Do you realize that kids have very finicky palates?”  You know, you can’t just all of a sudden just force new food on children.

Cherylyn mentioned that forcing foods on kids that they may not like could have more harmful repercussions in poorer communities:

When we put these requirements — when we say “whole grain” and “fresh” — you know, what I worry about is we’re developing standards which may not fit for the entire population of the United States.  And, again, for low-income kids, if this is the only meal that they’re getting and they don’t like the whole grain pasta, they’re going home hungry.

It was also pointed out to host Angela Rae that pushing guidelines on food with the intention of fighting childhood obesity probably isn’t as effective as it could be as schools cut activities that get out and about:

It seems like a disconnect… On one hand, we’re trying to revamp the school lunches, but, yet, on the other hand, [First Lady Michelle Obama is] advocating “Let’s Move.”  But, yet, we see that the school districts across the country are reducing time — they’re reducing recess.  They’re reducing their [physical education] programs, and they’re reducing after school programs.

With the recent opening of the United Nations session, Cherylyn appeared on the “Rick Amato Show” on the One America News Network to expose how there are celebrities and activists who bring up seemingly trivial concerns regarding women despite a clear and present danger that religious extremism presents to women living under radical Islam.

Noting that movie star Emma Watson used her appearance at the U.N. to complain about description of women as “bossy,” Cherylyn noted there are life and death issues related to the imposition of Islamic sharia law that deprives women of their rights and even their lives aren’t discussed among these alleged advocates:

I find it very curious that, at the U.N., they are focusing on things like “bossy,” sexiness when — really — there are women suffering under radical Islam in the Middle East.  And there’s no discussion on how these women are really living under sharia law.

Cherylyn shared how the political left has had a deaf ear, and has even sometimes been hostile, towards stories of women such as Meriam Ibrahim — a woman who escaped persecution for her Christian beliefs and how some women still under radical Islamic rule are treated as sex slaves and cannot every receive formal education.  She added how this is not only discriminatory and a violation of human rights, such behavior also degrades society:

Women are the backbone of society.  They are the ones that give birth.  If you’re destroying women; if you’re destroying mothers; if you’re destroying those little girls by raping them and making them sex slaves, what do you think is going to happen to your population?  How do you think your society is going to function when these women and girls have been beaten and raped?  These women are going to be unable to function.

Friday
Sep262014

Zombie Apocalypse Or VA Cheating?

So Congress, how is that $17 billion in new funds you gave the Veterans Administration working out?  From FoxNews:

The family of a U.S. Marine is demanding answers after Department of Veterans Affairs records indicated that their son had canceled an appointment four days after his death.

Cpl. Jordan Buisman died on Nov. 26, 2012 while waiting for an appointment with a VA doctor in Minneapolis. The records indicate, however, that Buisman called to reschedule his appointment on Nov. 30. (Italics added.)

Let this be a warming to you:

 

Now that they’ve learned to speak and use phones, we are in big trouble!

Thursday
Sep252014

Project 21 Members on Obama’s Crusade Against ISIS

Three times over the past week, members of the National Center’s Project 21 black leadership network appeared on the One America News Network’s “Rick Amato Show” to discuss the resumption in the rise of Islamic terrorism and the Obama Administration’s pivot to a militarized response.

Interviews took place both before and after military action began, and dealt with many facets regarding the new Obama policy and the threat of religious extremism.

In discussing the threat of militant Islam before the missiles and bombs began to fly, Project 21 member Council Nedd II noted on 9/17/14 how “no one took [ISIS] seriously” a year ago.  Now, however, “everyone should be concerned” about the threat of ISIS and other rising militant groups.

Council — an archbishop with the Episcopal Missionary Church who is involved in ministry work in areas of the Middle East and Africa threatened by Islamic extremists — said these radical activists are “like a virus.”  And, when dealing with a virus, he noted that one cannot expect success when “giving it a sub-therapeutic dose of antibiotics… literally, the virus keeps getting stronger.”  Council’s prescription?  “We need to do something drastic.  We need to do something radical.  And it’s not going to be pretty.”  Simple things that Council suggested in the hours before Obama ordered military strikes included revoking someone’s citizenship if they chose to fight for ISIS and not buying or refining oil that comes from fields seized by ISIS and others.

Having already written two recent New Visions Commentaries on the need to contain and combat radical Islam, Council reiterated: “The fact is, unless we do something and unless we do something dramatic — unless we do something big in a big way — ISIS is just going to continue with their march toward Jerusalem and Spain and other places… Somebody needs to step up and say, ‘you know, this is ridiculous and we’re stopping you right here.’”

After military operations began, Project 21 member Hughey Newsome appeared on Amato’s show on 9/22/14 to discuss how Obama seems to have evolved in office regarding decisive action against terrorism.

Noting the difference between Obama as a senator and presidential candidate compared to his recent action as president, Hughey said “it’s night and day.”  He also noted that Obama continues to show that he has “no capacity whatsoever” to deal with Congress — even liberals such as Senator Barbara Boxer (D-CA).

He noted that Obama once had an overriding goal of getting American forces out of Iraq and Afghanistan at all costs, but now that goal-oriented agenda has come back to haunt the President.

Hughey noted how generals have said there is a possibility of needing “boots on the ground” to ultimately prevail against these terrorist networks — something that White House staff seem decidedly against.

“It might be the right thing to do.  Who knows?” Hughey noted.  “But, of course, putting politics first [and] effective policy second is the way the White House has gone… you need Congress to have some oversight.”

On 9/23/14, during Amato’s “grassroots citizens panel,” Project 21 member Kevin Martin, a Navy veteran, when commenting about the motivation of the extremists, said “[t]hese groups want notoriety.”  He added that “[t]hey look at al Qaeda and say ‘we’re gonna do it bigger and better.’”

But Kevin — who commented previously about the Obama military pivot in the war on terrorism — warned about the effectiveness of Obama’s work to build a coalition against the terrorists, saying “We cannot contract our national defense out to ‘moderates.’”  In particular, Kevin said it was valid to wonder about “who picks and chooses” who these alleged moderates are and whether they are working for the same goals as the United States.

Thursday
Sep252014

Health Care: Equity Vs. Efficiency

In my blog post yesterday arguing that health care is a commodity, I noted that Rashi Fein, one of the architects of Medicare, argued that health care needed to emphasize equity over efficiency.  I claimed that “a system that emphasizes equity over efficiency will end up with neither, while a system that emphasizes efficiency over equity will end up with a good deal of both.”

Here are some examples:

Medicaid: Equity over Efficiency.  One purpose of Medicaid is providing the poor with access to care similar to that available to the middle and upper classes.  But it doesn’t seem to be achieving this goal very well.

Among all physicians, nearly one-third are no longer seeing new Medicaid patients and that number may well be over 45 percent for some specialists. The most likely reason is that Medicaid’s reimbursement rates are among the lowest. This creates access problems.  Medicaid patients have more difficulty getting timely appointments with primary care physicians, specialists and ambulatory clinics than patients with private insurance.  

There is research showing that access to health care for Medicaid patients is as good as it is for those with private insurance.  However, if Medicaid patients didn’t have access problems to physicians and clinics, why do so many go to the emergency room for care versus patients with private insurance?  And, for the most part, they are going because they need the care, not because they are there for some minor ailment. 

Medicaid doesn’t come close to achieving care equitable with those who have private insurance. How does it do on efficiency?  Well, the U.S. spends over $415 billion on Medicaid, and according to the Oregon health experiment, Medicaid has no noticeable impact on patient health.  Other research suggests that children at hospitals that are more reliant on Medicaid funding have more adverse events, and that patients with Medicaid are more likely to receive a diagnosis of late-stage cancer than patients with private insurance who are more likely to receive diagnoses at earlier stages.  Such results probably don’t satisfy any reasonable definition of efficiency.

Minute Clinics: Efficiency over Equity.  Minute clinics are walk-in clinics, usually located in a pharmacy like CVS or Walgreens, that employ physician assistants and nurse practitioners to provide primary care.  (I’m using the term “minute clinic” generically here, even though that is what they are called at CVS.  Walgreens calls them Healthcare Clinics and Wal-Mart calls them Care Clinics.)  The companies that run minute clinics want to make a profit, and thus they were created with efficiency in mind—that is, to make it more convenient, in terms of both time and money, for patients to receive care. More patients increases the likelihood of profitability.

Their efficiency is partially reflected in how much they have grown. The first one was launched in 2000 by CVS and there were 1,400 by 2012.  Accenture anticipates that (1) the number will grow to 2,800 by 2015 due to increased demand brought on by ObamaCare and (2) they will save the health care system about $800 million.

But are they making care more equitable?  Well, prices are relatively cheap, with most visits at CVS costing $79-$99 with some going as low as $59.  At Walgreens they are about $60 and at Wal-Mart some visits are as low as $40.  Those are prices that are affordable, even for many low-income people.  (Also see this study on the costs of more involved health care cases—minute clinics still were the cheapest.)

Minute clinics reduce another cost that is a barrier for the poor: time.  As a recent article from Health Affairs shows, poor people often have a big “time cost” in getting to a physician’s office—taking time off work, setting up transportation, etc.  Minute clinics reduce that cost by offering evening and weekend hours, something that physicians offices don’t do, at least not with the frequency of minute clinics.  Moreover, easier access to such care results in fewer emergency room visits.

In short, minute clinics are creating a great deal of both efficiency and equity.

Wednesday
Sep242014

We Have No Liberty: Now the Government is Coming for Our Hobbies

California lawmaker wineThe state of California has fined a hobbyist winery $115,000 because some of the people working at the --- let me use this word again -- HOBBYIST winery were volunteers.

National Center Senior Fellow R.J. Smith, who knows as much about wine as he does about the benefits of liberty (and that's saying something), has this comment:

Outrageous example of out-of-control government tyranny. Just what California needs, fewer wineries and small businesses. One of the great joys of wines has been the ability to volunteer during harvest season and also grape stomping. All over the world. Widely spreads the enjoyment and love of wine. And sometimes interests young people in a career in wines.

So the government says we can't have volunteers and interns any longer. Who are they to say?

What was that that Mr. Jefferson wrote in 1776 -- about the people facing a government that is no longer protecting life, liberty and property: "...it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security."

Say a prayer for [Westover & Palomares Vineyards President and Winemaker] Bill Smyth -- his wife, family, employees and volunteers.

The state of California, which opposes liberty, has made it illegal for business to accept the help of volunteers. Across the board.

So if you love model trains and want to hang about a California-based model train shop on Saturday afternoons, answering kids' questions, don't. That's illegal.

If a California business seeks volunteers to transport food to a community event or food pantry, don't volunteer. It's illegal.

If a someone in your California church or synagogue is confused about how to do the tax forms for his small business, don't help unless you charge him. You'd be breaking the law.

Heck, by the standards of this law it is illegal to drive your own daughter to her babysitting job, unless you charge her. The law doesn't have exceptions for family members.

As R.J. (and T.J.) noted, we have a duty to throw off governments such as this.

It's difficult to imagine who the idiotic lawmakers who voted for this thought they were helping. Do they really presume hordes of Californians are going to persuaded to work for free for multitudes of businesses, unless they think it is worth their while? And if it is worth it to them, then why should government stop them?

Sadly, even if California lawmakers wise up, the story ends unhappily for this winery, which will close this year, thanks to the state of California. And lest you think, good, these people were taking advantage of their volunteers to make money, be aware: This winery did not sell its wine in stores. It served it to visitors. This was a place where people socialized, picked grapes, made wine and had fun.

Until the government we should overthrow said they couldn't.

More news stories here and here.

Wednesday
Sep242014

Health Care IS A Commodity

Rashi Fein, one of the most important people in the development of Medicare and Medicaid, passed away two weeks ago Monday.

Via his obituary, I discovered that he had written the following in the New England Journal of Medicine back in 1982:

A new language is infecting the culture of American medicine. It is the language of the marketplace, of the tradesman, and of the cost accountant. It is a language that depersonalizes both patients and physicians and describes medical care as just another commodity. It is a language that is dangerous.

Unfortunately, Fein’s view has infected much of health care policy in the last 30-plus years.  That type of wrongheaded thinking leads to removing health care from the discipline of market processes and into the control of government.

But the fact is, health care is a commodity.  Health care, like all commodities, is a marketable item produced to satisfy wants or needs.  

Given that, the only question is in what type of system will a commodity be produced and consumed?  Do we want health care to be bought and sold via markets or via government?  

Fein also urged physicians to “be more vigorous spokesmen for the human values in medicine.”  Medical care, he claimed, wasn’t measured just by the number of treatments administered “but also by the amount of comfort, concern, and compassion provided.”

It’s hard to see how treating health care like a commodity is inhumane.  Subjecting health care to markets is what will reduce its cost while improving its quality.  Making health care more affordable and better for everyone is indeed a very humane result.

Finally, Fein complained that physicians had adopted the language of “a narrow economics the emphasizes efficiency more than equity,” and encouraged them to “speak the language that addresses the unfinished agenda of equity and decency in the distribution of health care.”

Clearly Fein favored equity over efficiency.

But to crib a little from Milton Friedman (at 28:09), a system that emphasizes equity over efficiency will end up with neither, while a system that emphasizes efficiency over equity will end up with a good deal of both.

Are there examples of this?  Yes, but that will be tomorrow’s blog post. 

Tuesday
Sep232014

Health Care Odds & Ends

1. Did ObamaCare Increase The Number of Uninsured?  The American Enterprise Institute’s Joe Antos has a great piece on both the recent health insurance surveys from the Center for Disease Control (CDC) and the Census Bureau.  According to Antos the CDC survey “received a great deal of attention [and] said there were 3.8 million fewer uninsured. The other, which was hardly noticed, found that there were 1.3 million more uninsured.”  So why, possibly, did the number of uninsured rise?  The most likely explanation is that of the 4 to 6 million people who lost their insurance last year, about 1 million of those have not bought new insurance. More on this in a later post.  

As for the lack of media coverage of the Census Bureau survey, I’m at a loss to explain it. No, really.

2. Visual Aid.  Phil Kerpen put this image together comparing the 2013 Census Bureau Survey with the one for the first quarter of 2014:

The number of uninsured rose from 13.4 percent to 13.8 percent, which is roughly 1.3 million people.  The 2013 Census Bureau survey is here and the Q1 2014 is here.  

3. Another Reason ObamaCare Is Cancelling Your Plan.  If you don’t understand the concept of “actuarial value,” you should because it can result in the cancellation of your health insurance.  Thankfully, there is this video from the Mercatus Center that explains it all in layman terms:

 

4. A Rant, But A Pretty Good One.  Bruno Korschek goes through the ObamaCare insured vs. uninsured numbers and then gives an update on some of things that have gone wrong with ObamaCare recently.  If you have some time, give it a look.

5. Something Non-Health Care:  Catfish Crony Capitalism.  The FDA already regulates Catfish, but buried in the 2008 farm bill was a new regulatory program to be carried out by the USDA.  As the Daily Signal reports:

The program actually is a protectionist scheme for domestic catfish farmers. Foreign exporters won’t be able to sell their catfish that Americans already consume until the USDA works with other countries to establish an equivalent regulatory system. This could take several years, assuming other countries even decide to move forward with such a system.

Monday
Sep222014

ObamaCare's ACOs Saving Medicare A Pittance

Accountable Care Organizations (ACOs) are supposed to be one of the great innovations in ObamaCare that will save money for Medicare and improve quality for beneficiaries.  There are two ACO programs under Medicare, the Pioneer Program and the Medicare Shared Savings Programs (MSSP).  Under these programs, ACOs that generate enough savings for Medicare also get to share in some of the savings.  Thus far, 360 medical organizations have signed up to be ACOs covering about 5.6 million beneficiaries.

Last week the Department of Health and Human Services released the results for 23 Pioneer ACOs and 220 MMSP ACOs, and despite the triumphant tone of the press release, the results are underwhelming.  These ACOs “generated over $372 million in total program savings,” according to the release.  That seems like a lot of money, but it’s a pittance when compared to Medicare’s total $492 billion budget in 2013.  $372 million is about .08 percent of that.

It isn’t much better if we assume that ACOs would generate that same rate of savings even if all beneficiaries were in an ACO.  There are about 4.1 million beneficiaries* in the 23 Pioneer and 220 MMSP ACOc.  If $372 million in savings is generated for 4.1 million beneficiaries, then a rough calculation shows that $4.7 billion in savings would be generated if all 52.3 million Medicare beneficiaries were in an ACO.  That’s about one percent of Medicare’s total budget.  

Then there is the question of whether future ACOs would save at the same rate of the current ACOs.  It’s possible that the organizations that entered the program early did so because they figured they had the right patient mix needed to generate savings.  If that’s the case, then ACOs that join later might not generate much savings.

Regardless, it’s unlikely that one percent in savings is going to make much of a dent in Medicare’s $37.4 trillion unfunded liability.

*Here is how I determined that there are 4.1 million beneficiaries in the 23 Pioneer and 220 MSSP ACOs (actually, HHS determined it for me—thanks for the help.)  Anyway, there are 5.6 million total beneficiaries in ACOs.  To get the total number of enrollees in Pioneer ACOs, subtract the total number of enrollees in ACOs, 5.6 million, from the number in the MSSP ACOs, 4.9 million, which equals 700,000.

Next, there are 338 MSSP ACOs in total.  118 of those began earlier this year, and enrolled 1.5 million.  So, the number in the other 220 MSSP ACOs are 4.9 million – 1.5 million which equals 3.4 million.  And 3.4 million plus 700,000 is 4.1 million.

Friday
Sep192014

How Many Are Still Enrolled In The ObamaCare Exchanges? People Who Care About The Truth Would Like To Know

Here is one of my not-so-good predictions:

[Various] factors will cause the eight million figure [of enrollees in the ObamaCare exchanges] to be revised downward as the year goes on.

Each time that happens in the coming months, the media will hark back to the President’s victory dance.  For a public that doesn’t much trust Obama on health care, each revision will likely erode that trust a little further.  They will also provide his political opponents with more opportunities to claim Obamacare isn’t working as well as the President claimed.

Oops.

Unfortunately, I didn’t count on the Obama Administration stopping the enrollment reports once the open enrollment period was over.  And I don’t really have any excuse since I had previously noticed how fast-and-loose the Administration had played with the data.  It makes perfect sense, though, since it allows ObamaCare supporters and other assorted nitwits to continue using the 8 million enrolled as a talking point through November:

But yesterday we learned from the Administration that enrollment is down to 7.3 million. According to The Hill, the 7.3 million enrollees “reflect those who had paid their premiums through Aug. 15.”

But is it really 7.3 million?  The first reason to be skeptical is the folks in the Administration have always used a slippery definition of enrollee.  During the open enrollment period, they defined enrollee as someone who had signed up for a health insurance plan, while insurance companies didn’t count someone as an enrollee until the first premium had been paid.  The Administration’s definition, of course, let it inflate the numbers.

So what definition are they using this time?  Since enrollees aren’t dropped until they have failed to pay their premiums for three consecutive months, does paid through Aug. 15 really mean that it also includes people who last paid on June 15?  Who knows?

Another reason to be skeptical:  In August, Jed Graham of Investor’s Business Daily reported that Aetna, the “nation’s third-largest health insurer[,] had 720,000 people sign up for exchange coverage as of May 20, a spokesman confirmed to IBD. At the end of June, it had fewer than 600,000 paying customers.” 

So, of the 700,000 who have dropped out of the exchanges, 120,000 of them—17 percent—are accounted for by one company?  That dog won’t hunt.  Either the Administration is playing with the numbers or Graham got it wrong.  Since I worked with Graham at IBD for over four years and will gladly vouch for his integrity and competence, my money is on the Administration.

Finally, the drop of 700,000 does not yet include the 115,000 exchange “enrollees” who have not yet confirmed their immigration status nor the 360,000 who have received subsidies but have not confirmed their income. This is not a criticism of the Administration since these people still have until the end of this month to get the requisite information to the government.  We don’t yet know how many of those people will end up losing or dropping coverage.

But we can guess as to when the Administration will tell how much those factors impacted enrollment.  If the number is in the 50,000 range, they will release it in mid-October.  If it is 250,000 or more, the best bet is after the November election.

Thursday
Sep182014

Until Now, I've Been Sneezing In My Hands And Touching Every Doorknob I Could Find

Thanks goodness for our elected officials!  Without them, we’d be so much more unsanitary!

At a press conference yesterday, Senator Dean Heller (R-NV) and Majority Leader Harry Reid (D-NV) reminded us to wash our hands.

“It’s amazing how such a small thing can make such a big difference,” Senator Heller said.

Yes it is!  I’m sorry that my mom never told me to do that.

Senator Reid added his two cents: “The fact is, simply washing your hands can cut down the transmission of flu, for example, by 50 percent. If you wash with water, it’s better than nothing, but it’s not as good as if you have soap.”

With soap?!  Ah, now I get it.

With all of the annoying distractions that Senators face, like the massive deficit, sluggish economy, unaffordable entitlements and a president who has made a mess of foreign policy, just to name a few, it’s good to see that they have time to spend on really pressing matters like informing the great unwashed about proper hygiene.

I also have to wonder if those evil Koch brothers intentionally DON’T wash their hands.  I’m sure Senator Reid will let us know soon.

Tuesday
Sep162014

Meet Pam Hopmann--ObamaCare Made Her Coverage Worse

I followed up my study on the quality of policies on the ObamaCare exchanges with an op-ed in RARE.  It began with the story of Pam Hopmann:

Like millions of Americans, Pam Hopmann of Chesterfield, Missouri received a notice cancelling her insurance in September 2013. Her experience after that is a textbook example of the problems caused by Obamacare late last year.

“My husband and I started trying to sign up for insurance on the exchange,” she said of her experience in getting a new plan, “but we never got through. We ended up using an insurance agent.”

Then came the rate shock. The plan she chose had a higher premium—$544 per month versus $400 for her old plan. Her new plan also required more cost-sharing. Her old plan had a deductible of $1,000; the new one had a deductible of $1,750.

She would soon experience the phenomenon that became known as the “skinny network.”

“In the fall of 2013 I started receiving letters from my physicians, including my ob/gyn and cardiologist, saying that they wouldn’t be taking insurance on the exchange because the reimbursement rates were too low,” Pam said.

“I just really feel like it was shoved down our throats—like I had no choice. Obama said we could keep our plans and keep our doctors, and I couldn’t do either of those. I think that’s wrong because if you had something you liked, you should have been able to stick with it.”

Despite the claims of some the law’s supporters, there are real people who suffer because of ObamaCare.

Read the entire op-e here.  More on Mrs. Hopmann in the study.

 

Monday
Sep152014

ObamaCare Has Harmed The Quality Of Insurance

Most of you remember late last year when millions of people were losing their insurance plans in the individual market.  At the time, many ObamaCare apologists, including the president himself, tried to excuse the cancellations by saying that the health plans that people were losing were “substandard.”  MSNBC host Ed Schultz referred to the lost plans as “crappy” but only because he couldn’t “use the S-word.” 

However, ObamaCare supporters never produced a shred of evidence that plans in the individual market in 2013 were inferior in quality to the plans on the ObamaCare exchanges.  The study we are releasing today shows that plans on the ObamaCare exchanges are in fact inferior in quality when compared to the plans on the individual market via eHealthinsurance.com and Finder.healthcare.gov.

Entitled “Despite ObamaCare Supporters’ Claims, Health Insurance Plans Prior to ObamaCare Exchanges Were Neither ‘Crappy’ Nor ‘Substandard, it compared the cost-sharing — i.e., the deductibles and the out-of-pocket maximums — of plans on the individual market in 2013 and on the ObamaCare exchanges in ten major metropolitan areas for a 27-year-old single person and a 57-year-old couple. It also examined the provider networks, comparing the number of health maintenance organization (HMO) plans to preferred provider organizations (PPO) plans in the individual markets and ObamaCare exchanges.  

Here are the highlights:

  • There was an average of 33 plans in each area for a 27-year-old on the individual market that had lower premiums and lower or equal deductibles and out-of-pocket maximums than the cheapest plans on the ObamaCare exchanges. Milwaukee, Wisconsin had the most such plans with an average of 68.

  • For a 57-year-old couple there was an average of 10 policies in each area that had lower premiums and lower or equal cost-sharing in the 2013 individual market than the cheapest plans on the ObamaCare exchanges. Louisville, Kentucky had the most with an average of 26. 

  • The ObamaCare exchanges had many more of the restrictive HMO networks in their plans relative to the individual market, an average of 16 more HMO plans for both 27-year-olds and 57-year-olds.

  • The less restrictive PPOs were more common in the individual markets, with an average of 32 more plans with PPOs for 27-year-olds and 25 more for 57-year-olds.

While “quality” is often a very subjective concept, this study focused on cost-sharing and provider networks because they are the least subjective dimensions of quality of health insurance plans. Regarding the relationship of the premium to the deductible and out-of-pocket maximum, few people, if any, would consider it good value for the money to change to a policy with a higher premium and a higher deductible and out-of-pocket maximum than a policy they previously owned. In other words, looking solely at the aspect of premium relative to out-of-pocket costs, almost no one would rationally consider it an improvement in quality to pay a higher premium and get less out-of-pocket coverage. 

The quality of the network of physicians, hospitals and other health care providers available through an insurance plan is a bit more subjective.  While HMOs are more restrictive than PPOs, there are HMOs like Kaiser Permanente and Group Health Cooperative that get high marks from consumers. Nevertheless, data from the employer-based market shows that people tend to prefer less restrictive networks. The Kaiser Family Foundation shows that at the height of HMO coverage in 1996, about 31 percent of employees with employer-provided health insurance were in an HMO plan. By 2013, that had dropped to 14 percent. At the same time, PPOs grew from 28 percent to 57 percent of covered employees. Based on actual consumer choice, most of those consumers appear to consider the less restrictive networks of PPOs to be higher quality than HMOs. 

Unfortunately, as this study demonstrates, quality has declined in these areas in the plans on the ObamaCare exchanges.  This is due to the regulations that ObamaCare places on exchange plans, such as the benefit mandates.  Those regulations cause premiums to increase.  To keep premiums anywhere close to reasonable on the exchanges, insurers had to skimp on cost-sharing and provider networks.

There is nothing wrong with doing that—provided that’s what consumers want.  Yet consumers no longer get to make that choice. They no longer have the option of foregoing some benefits for lower out-of-pocket costs and broader networks.

So, not only has ObamaCare reduce insurance quality, it has reduced our choices as well.

Saturday
Sep132014

Thank you, Oklahoma Daily, for Sowing Discord and Inaccuracy

RacistBraUnderwearLingerieDFC AMR

How much whining should the world have to put up with?

This article, by the editorial board of the Oklahoma Daily, complains that calling a bra's color "nude" is "racist."

Please, people. In other countries, children are being buried alive by Islamist radicals, starved to death by North Korean's evil dictatorship, dying of curable diseases because of ignorance and superstition, married off in childhood to ancient putrid lechers -- we all know I could go on and on.

If this rises to the level of a problem in your life, get on your knees and thank God for your good fortune.

Furthermore, Oklahoma Daily: Lazy reporting is inexcusable. As a commentator to your own article had to point out for you, "nude" bras are called "nude" because they can't be seen through light-colored shirts. This is true regardless of the skin tone of the woman.

As the commentator said:

As someone who used to work in a high end lingerie store, let me explain to you the point of a nude bra. It's really quite simple and has absolutely nothing to do with skin color. A nude bra is made in a light beige color because it's the only color that won't show through a lightly colored shirt. A white bra, for example, will show through a white shirt, so of course a dark colored bra would show through a white shirt. I sold nude bras to women of every skin color, because they understand the purpose of owning one. A nude bra is simply about making sure a woman's outfit is what's on display, rather than her undergarments.

The example of "racism" was ridiculous even if it had been true, and it wasn't even true.

Another banner day for the nation's media, sowing discord and inaccuracy and making the world a worse place than it found it.

Thursday
Sep112014

Never Forget

Today is the 13th Anniversary.

 

Tribute here.

Wednesday
Sep102014

Project 21's Kevin Martin: "The Strategy Laid Out by the President is Nothing New"

Kevin Martin

Project 21's Kevin Martin has some strong thoughts about President Obama's ISIS speech tonight:

The strategy laid out by the President is nothing new outside the application of United States air power.

President Obama and former Secretary of State Hillary Clinton, Senators McCain and Graham were advocates of arming so-called 'moderate Muslims' inside Syria back in 2010 over the objections of conservative voices, who factually stated that there more radical elements within the opposition forces to Syrian President Bashar al-Assad. These radical elements were allowed to gain power and influence within the opposition before breaking with them and forming what we know as ISIS today.

I find it difficult to accept the President's plan to arm these so-called moderate forces when it failed the first time and produced ISIS, a group of radicals that now have nearly a billion dollars in assets. These assets include military equipment looted from the governments of both Syria and Iraq, including heavy weapons, MANPADS and aircraft. This makes the policy of limited airstrikes inside Syria a difficult task.

As a veteran, I find it most difficult to support the President's strategy of arming these supposed moderates in light of the fact that the White House cannot confirm if these same moderate forces within Syria sold American Journalist Steven Sotloff to the forces of ISIS that later beheaded him.

It is time for the President to go before the American people and Congress to put forth a real strategy that completely destroys ISIS and does not create another Son of Al-Qaeda by contracting out our national security to so-called 'moderates.'

Kevin Martin is a member of the National Advisory Council of the Project 21 black leadership network. An environmental contractor in the Washington-Baltimore area and a long-time public policy commentator, Kevin frequently appears on the Fox News Channel and typically is interviewed by radio talk shows over 70 times each year on behalf of Project 21.

Monday
Sep082014

Great Moments In Single-Payer Health Care

1. Will It Be A Best Seller? Angela Johnson, president of Medical Confidence, Inc., has just released a new book entitled “Step by Step Guide to Navigating your way through Canada’s Health Care System and Minimizing Your Wait Time.”  The press release states that the book is “a first of its kind and must read for Canadians, providing them with 14 valuable tips to overcome these issues and minimize their wait times.”  I wonder if the book instructs patients to go to this website for British Columbia that enables people to see wait times for surgery by clicking on a body part?

2. The Psychiatrist Will Not See You Soon.  In Canada’s capital, Ottawa, “1,195 children and youth are waiting for mental health outpatient and outreach services at CHEO and the Royal, up 10 per cent from 1,082 a year ago,” according to an article in the Ottawa Citizen.  The wait time for mental health treatment could be up to a year.  Young people are recommended to plan their bouts of depression in advance.

3. A Cancerous System.  Britain’s National Health Service (NHS) recommends that no cancer patient should wait more than 62 days to start treatment.  Yet the Daily Mail reports just over 9,900 British cancer patients waited longer than that in the first six months of 2014.  It would be interesting to know just where the NHS came up with the 62 day standard, because the longer one waits for treatment, the odds increase that the cancer will recur.  According to an article in the journal Radiotherapy and Oncology, for breat cancer there is an “increase in the risk of recurrence of 1.0% per month of delay” and for head and neck cancer there is an “increase in the risk of recurrence of 3.7% per month of delay” (p. 12).

4. Records Are Made To Be Broken! The Daily Mail reported last month that the “number of patients languishing on NHS waiting lists for operations is at its highest for six years…There are 3.2 million people awaiting surgery – a rise of 700,000 compared with 2010.”  Not only are there 3.2 million people on the wait list for surgery, 809,000 patients were waiting for a diagnostic test and 15,600 operations were cancelled at the last minute in the second quarter of 2014. To top it off, these numbers may be an undercount due to errors and incomplete records.

Friday
Sep052014

9 + 6 = Our Friend '10' Because 6 Is 1 + 5 And If You Take The 1 And Add It To 9 You Get 10 And Then Add In That 5 = 15

Is that headline a wee bit confusing?  Welcome to Common Core math!  Enjoy the decline of our education system:

Hat tip: Townhall.com