I’ll summarize here for those who do not have time to read this, and please do include JC’s remarks in the comment section regarding payment of costs for people below poverty level to be better informed. What I found is that we are basically being sold catastrophic policies where we are on the hook for the first $6,350 of medical costs. If you have that much in costs, you can ignore all policy features except monthly premium. Go for the cheapest. The more expensive policies are an attempt to buy down the $6,350, but it’s a trap, as you end up spending more in medical expense plus premium than you would otherwise spend with a higher deductible and lower premium. If you have ongoing costs, go cheap.
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I was looking over the available policies on the Colorado Health Exchange, and it is very confusing, as it is designed to be. There are differing co-pays, co-insurance and deductibles. So I decided to do a side-by-side comparison, and selected twelve plans with varying monthly premiums, the low $430 (Kaiser) and the high $1,049 (Access Health Colorado). Bear with me here, as it will for a while seem confusing, but in the end be stone-cold simple.

There’s no way of anticipating what kind of health coverage anyone will need in a given year, so I decided to compare policies based on what might be typical for someone my age. I have an annual physical, blood tests, office visits, lab fees, an MRI and out-patient surgery, some physical rehabilitation after surgery, and ambulance and two ER visits, and a two-day hospital stay. I’ve done nothing but visit doctors for minor ailments (one knee surgery, outpatient) for decades, but am assuming that this year, SHTF. The total costs I imagined I would incur: $14,275.
Continue reading “It’s not complicated. It’s just deliberately confusing.” →

Since I am so familiar with it all, I think I talk over the heads of people as they muddle their way through the insurance exchanges looking for coverage. Here are some of the basics:

• Premium: the monthly rent paid to the insurance company in exchange for their coverage of your medical expenses. Continue reading “A primer on medical insurance in the new era” →

In ancient times courts employed fools and by the Middle Ages the jester was a familiar figure. In Renaissance times, aristocratic households in Britain employed licensed fools or jesters, who sometimes dressed as other servants were dressed, but generally wore a motley (i.e. parti-coloured) coat, hood with ass’s (i.e. donkey) ears or a red-flannel coxcomb and bells. Regarded as pets or mascots, they served not simply to amuse but to criticise their master or mistress and their guests. Queen Elizabeth (reigned 1558-1603) is said to have rebuked one of her fools for being insufficiently severe with her. Excessive behaviour, however, could lead to a fool being whipped, as Lear threatens to whip his fool. (Court Jester – The Full Wiki)

American liberals think themselves very smart because they have Jon Stewart and Bill Maher on their side, not realizing that in a state-controlled media there has to pressure-release valve. Stewart takes himself very seriously (as evidenced by his idiotic “Rally for Sanity), and does not understand why he is given seeming free rein. Maher is a little more modest, which I appreciate, but his problem can be summed up with remarks from last night’s show about Obama: Continue reading “Obama: “The Tea Party made me do it!”” →

Since we are forced by Obama now to buy insurance policies without a public option, I asked the agent if they covered attacks by bloodsuckers. She said no. Not covered.

Some additional points on the health care crisis and Obamacare:

• Access to health care has never been a problem in the upper reaches of our society, but the model, private insurance, is held together by government glue at its weak points, access by seniors and the poor, who are unprofitable.
• The free enterprise model, which only exists on chalk boards, cannot provide expensive products to poor people. In the muddled minds of its adherents, it has to be the fault of the poor, who are left to die.
• The same for us seniors, but we are mostly financially better off and white, and so have enough clout that Medicare came into being.
• Medicaid, the remedy for the poor, has always been under attack, and the fact that it even exists is a tribute to progressives of a bygone era.
• For so long as the poor are visible, Medicaid will exist. Most people have consciences.
• Obama was hired (in part) to rescue the private insurance system. He did so by the only possible means: protect it from competition (no public option), and subsidize it.

Will it work? Of course not. But more importantly, even as it does not work, will it continue to exist? For a time yes. Democrats, blinded by party politics, will see to that. And for so long as they do that, they will prevent us from solving our health care problems with the only workable solution: Single Payer.

I say “only.” Some systems, like Britain’s and the VA, are government-owned and run. They work well, though Britain’s is under unrelenting attack from it’s right wing. Only it’s mass support keeps it running. Switzerland, which uses private insurance, is workable, but only because their insurance companies are so heavily regulated that they are virtual slaves to the system. So single payer is not the only solution, but in the US, the only workable one because it can be embedded in our patchwork private care system, as are Medicare and Medicaid.

Both of those systems are strained, as they cannot control outside costs imposed by an unworkable private care system with its hundreds of cost-shifting mechanisms, everyone running around trying to dump their costs on others. (VA is exempt from that, and so is remarkably efficient.) So single payer, when it comes to the US, will not be a shining model of efficiency. It will take decades to rid this system of its internal contradictions.

But this needs to be understood: we need to build a platform on which our society can function and where families, especially our young people, have a fighting chance. That platform will guarantee everyone two things: access to health care, and access to education. That’s what they do out there in the civilized world.

Those two societal functions are being eaten alive by the scavengers of the so-called free enterprise system. Until we cage them, we are nothing but chattel. Our youth, those who have jobs, are chained to their desks by student loans and the need for health care, and so are virtual slaves to employers.

We are not a free people. But the remedies are before our eyes. If real leaders step forward, and if the CIA doesn’t murder them, we can fix these problems.

Today, October 1st, is a sad day in our history, the day the “insurance exchanges” open, three months shy of the day that the private mandate part of “Obamacare” goes into effect. Typically, the Democrats are out there spouting its wonders, clueless as ever. Their party leaders are depending on the power of suggestion to make it seem that this AMC Pacer is a Cadillac. But Cadillac’s (in other countries called “basic health care”) will soon be illegal.

Yeah, I’m kind of bitter. It is hard to watch people get sucked into perception management games while having their pockets picked. Is anyone really paying attention to anything? Anyone?
Continue reading “Black Tuesday” →

This was another “Duh!” moment I had recently – it has to do with private health insurers eliminating coverage of office visits from their policies as we move into ACA, or “Obamacare.”

ACA instituted requirements for basic care, but they are minimal – certain tests and an annual physical. That part went into effect a couple of years ago. I had coverage through Anthem Blue Cross at that time, and after I got the physical learned that they would not pay for the office visit portion – the majority of the cost of the physical. I questioned them about this, thinking that “annual physical” would naturally include going to a physician’s office. No, they said, read the contract. They do not cover office visits.

Continue reading “Serving two masters” →

David Crisp of the Billings Outpost wrote this article, Unveiling Obamacare, as a journalistic piece. It brought to mind Krugman’s comment about how journalists would deal with a flat earth if powerful people disagreed: “Shape of the earth: views differ.”

First, Mr Crisp: He is an accomplished man, a scholar. He can write on a host of topics and be interesting and insightful. Anyone who has met him will tell you that he is sincere and nice and unassuming. This is not about him.

However, in reading this piece, along with so many others put out by our journalists, I wonder why the rules of their game forbid being insightful. The piece in question does what they claim to be their only job: bring us the facts, let us decide.
Continue reading “Shape of Obamacare: Views differ” →

I am getting notices in the mail now from my health insurance carrier, Cover Colorado, a state program based on adverse selection – that is, Cover Colorado can only offer insurance to people who have been deemed potentially unprofitable by private insurers

What a country.

In October we are going to be faced with a decision – we will have many policies to choose from, offered by private insurance companies. That’s how it is framed for us. More accurately, we will be forced to choose from a wide range of crappy policies from the insurance cartel within which competitors are friends and customers are the enemy.

What a country.
Continue reading “Thanks Obama, for a royal screwing” →

Imagine the following scenario: A married couple has health insurance through his employer. Having just married, she had before carried her own insurance as a private individual, but in a gesture of friendliness, his boss suggested that she be added to his policy. But his was a small company, and costs were mounting, so that the cost of his insurance was approaching $10,000 per year. In the meantime, she had a bout with melanoma, and a couple of surgeries had probably saved her life.

He is called into the executive suite one day, and told that the health insurance policy is cancelled, and that each employee now must obtain insurance in the private market. But, he says, my wife had melanoma. She can’t get a policy anymore! The company was not aware of this, but the decision was made, the results final.
Continue reading “Free market magic in health care” →