Tag Archives: health care reform

Joining the 50 million

Our health insurance was canceled last month. We have joined the ranks of the uninsured. Collateral damage in health care reform and the race to parse the regulations, drive trucks of cash through the loopholes and squeeze every dollar out of every soul still breathing.

Payments were current. We had not made a claim that exceeded our deductible in a couple of years. Nothing had changed. And we weren’t even told until three weeks after it had happened. There’s no appeal. No reason required. No COBRA. It is just gone. And it was done on purpose.

Our business had used  Business Advantage, a PEO (Professional Employer Organization), to act as our “virtual employer” to provide Blue Cross group health care insurance. Technically, we worked for an LLC owned by Business Advantage for this purpose. According to Wayne Surman, National Sales Manager of Business Advantage*, “We decided to close that company because rates had gone up.” Business Advantage voluntarily shut down Near Northside, LLC because they didn’t think they were making enough money, which immediately canceled our policy and whomever else was in the plan. While failing to apologize for not telling us that we were going to be totally screwed, he did say we were welcome to “apply” for new coverage – coverage, subject to acceptance, with a new LLC and at new rates.

Responsible: Left to Right: Stanley R. Joseph, Wayne Surman and Jason C. Joseph of Business Advantage.

Were we just chumps? Hard to know so far. It seems pretty straight up for a business to fold a company and ruin the lives of anonymous customers when, in the owners’ judgment, it makes good business sense. The people behind Business Advantage, Stan and Jason Joseph, are well connected, and as far as I can tell, well thought of. Perhaps, they didn’t realize they were making a life and death decision in the lives of others? Perhaps, they needed the money more than we need health insurance? Perhaps, it had gotten to be too much trouble. All understandable these days. And it makes me hope there is a hell.

The CBO expects this to happen to 3 million others while waiting for health care reform to be fully implemented in 2014. Robert Woods Johnson research puts that number much higher. People who are employed. People who want coverage. People who won’t have it. People, like me.

While we will apply, no company is expected to take us on an individual policy because of preexisting conditions. Blue Cross has offered us a take or leave it conversion policy – take it and our rates will go up by $2,586.26 a month, plus, of course, a required payment for the month we had just lost and will never be able to use, a higher deductible and the expectation that rates will rise even higher.

A certificate of insurance was included with our cancellation notice. A certificate of insurance offers some federally required exceptions to preexisting condition exclusions if a policyholder is not without insurance for 62 days and is able to get back in an employee sponsored plan. It does not, however, give you squat protection for individual coverage. The 62-day clock on insurability had already ticked down to 42 days when we found out we needed it. We will apply, but acceptance and affordability is a serious concern. As is trust that it won’t happen again in a few months. Or next year. Or the year after.

By now, you must be asking yourself, “what about the health care reform bill, I remember reading on LikeTheDew.com that within 90-days of its passage, uninsured individuals who have a preexisting condition will have access to a state or federal high risk insurance pool?

There will be no Georgia pool. Georgia goobernatorial candidate and Insurance Commissioner John Oxendine has written US Health and Human Services Secretary Kathleen Sebellus saying of the fully funded federal program, “I cannot commit the state of Georgia to … a scheme which I believe the Supreme Court will hold to be unconstitutional, leads to the further expansion of the federal government, undermines the financial security of our nation, and potentially commits the state of Georgia to future financial obligations.” (Source: AJC) Georgia joined 17 other states refusing to participate (including almost all Southern states).

The federal high risk pool will be funded beginning July 1st. Details of the process and eligibility are still being developed, but the law requires that individuals be uninsured for six months – perhaps, this will save us next fall. The cost benefit is extraordinary: it is capped at $11,900 a year including all out of pocket costs. Easily $25,000 less than a private plan.

We could take the chance and bet we’d be healthy for six months to wait for the federal program, but what if we were wrong? Or, we could bet that we could pay the huge price increase even if we had nothing left to use it — which is what they want: pay as much as you can possibly afford and be too broke to ever use it.

In complete candor, the medical history questions on the forms make me apoplectic – the fear of the costs rob my sleep –  the fear of an insurance need limited by a preexisting condition is cruel, but in America, hardly unusual.

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* Feel free to contact Wayne Surman, Business Advantage Program Employee Leasing, 11175 Cicero Drive, Suite 100, Alpharetta, GA 30022, Office: 678.242.5277,  Fax: 678.242.5241, Cell: 678.480.5200, email: [email protected] or [email protected] – Linkedin: http://www.linkedin.com/pub/wayne-surman/13/478/a14 or Stanley R. Joseph, President & CEO of Business Advantage, Inc. – Linkedin: http://www.linkedin.com/pub/stan-joseph/5/73b/954, Jason C. Joseph – Linkedin: http://www.linkedin.com/pub/jason-joseph/0/915/100, Co-Founder and Executive Vice President. The Josephs are also involved in  X1 Capital Partners, LLC, Hibernian Pacific Holdings, LLC and Fog City Blue Entertainment, LLC who do business at the same address as Business Advantage, Inc., but, of course, those businesses could close at any time without warning.

What would Pat Robertson say?

Goldman SucksLet’s take a quick look at recent legislative initiatives and the relationship of opposition-killing news events:

  • Health care reform – dead in the house and frozen in the senate until Anthem/Blue Cross announces billions in earnings along with huge policy price increases and the tea party takes the Kennedy senate seat.
  • Wall Street reform – seemingly dead in the Senate, then record-breaking Wall Street profits, revelations of sinister-sounding, but all too routine conflicts and manipulation, then Goldman Sachs was indicted.
  • Immigration reform – no one thought this could get a breath of political air during this partisan election season, then along comes Arizona’s xenophobic immigration law.
  • Energy bill – not a hope in hell for Senate action this year and, boom, BP/Transocean’s Gulf oil platform explodes, drill-baby-drill turns to spill-baby-spill and the oil-version of Katrina makes landfall.

Acts of god? A conspiracy of the non-working liberal press? Greed and hubris metastasizing naturally? Or, is Rahm, just that good?

Incredibly high fictitious cost of health care

Health care reform doesn’t go into effect for 3 more years, so why is it costing really really big businesses so much right now? In the last month, company after company has announced quarterly earnings and included huge accounting charges for health care costs.

Companies announcing charge offs for health care costs
“Why? For what? And should we be scared shitless?” Glad you asked. First off, except for exercising their Supreme Court given right to paid free speech, which resulted in hundreds of millions of dollars being spent on lobbyists to fight the health care reform bill, it hasn’t cost big business a nickel. Nothing. Nada.

Here’s what has happened. Way back in 2003, under Bush/Cheney, the brain trust in charge of our government at the time, decided to add a prescription drug benefit to those on Medicare. You probably wondered at the time, “what the hell do Republicans care about seniors?” Me, too. I knew they were having a difficult time squandering the Clinton budget surpluses so they could begin starving the states, so the states, in turn, could begin starving the poor. Plus, Bush Inc. had already paid off the campaign money they’d gotten from the super rich, the oil cartels, defense contractors and Wall Street. But they still owed big health insurance, big pharma and big business and thought they might be able to buy some senior votes in Florida, so they hatched this scheme: establish a huge new subsidy to create a private for profit prescription drug insurance plan industry to buy hundreds of billions of dollars of pharmaceuticals at non-negotiable retail and provide a tax subsidy to big business to help them get rid of workers at or nearing retirement age (Medicare Part D) – a real win-win. Even got Ted Kennedy to vote for it. Except for the donut hole, a diabolical stroke of campaign genius that must have Lee Atwater wish he could have come back from hell to enjoy it. But I digress.

The 2009 law gave big business a 28% tax deduction on retiree, or early retiree drug benefits, but it was more than just another corporate tax loophole. It was a tax-free treatment of the government subsidy to pay for companies providing the equivalent of Medicare Part D – the law gave them a subsidy and let them also deduct it from their taxes. Technically, accountants, lawyers and Adam’s house cat* refer to this as “double-dipping.” Republicans and the Chambers of Commerce refer to this as “pro-business.” When the new health care reform law goes into effect in three years, the subsidy will continue, but the tax deduction big business got for spending the subsidy will end.

snake oil“Then the tax deduction was worth billions of dollars?” you might ask. No, not by a long shot. In fact, the loss of the deduction will have almost no affect at all on company valuation or profit, but they’d like us to think it does. The explanation of how they came up with such extravagant numbers and why now, is a wee bit technical. Here goes: accounting rules require companies to recognize the present value today of future cash costs for as long as they offer the drug benefits and make this adjustment by writing down the deferred tax asset balances. Another way of saying it would be, they can pick any number they want and they can do whenever they want. These announcements are big businesses’ way of attempting to influence the off-year elections with the hope that the next Congress will give them back the deduction, which they don’t really use, doesn’t have any impact on jobs, but they are greedy and like to have more of whatever they want than they would ever need and don’t mind scaring the bejesus out of us as sport.

“But these tax deductions were real, so there’s a real cost to the companies’ investors, right?” In most cases, no. Big companies don’t pay taxes in America . That’s why we have those island governments just off our shores. According to the GAO’s most recent data (why it is so old, I have no idea, but I’m guessing that it has something to with providing political cover to those who write tax law), shows that two-thirds of US corporations paid no federal income taxes from 1996 through 2005 (those include the Clinton boom years) and 94% paid less than 5%.

So tomorrow when you read, “Company X earnings down due to health care reform costs,” just smirk and turn (or click) the page.

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*A variation of “Adam’s off ox.” The form commonly used is ‘not to know one from Adam’s off ox,’ meaning to have not the slightest information about the person indicated. The saying in any form, however, is another of the numerous ones commonly heard but of which no printed record has been found. But in 1848 the author of a book on ‘Nantucketisms’ recorded a saying then in use on that island, ‘Poor as God’s off ox,’ which, he said, meant very poor. It is possible that on the mainland ‘Adam’ was used as a euphemistic substitute. The off ox, in a yoke of oxen, is the one on the right of the team. Because it is the farthest from the driver it cannot be so well seen and may therefore get the worst of the footing. It is for that reason that ‘off ox’ has been used figuratively to designate a clumsy or awkward person.” From “A Hog on Ice” by Charles Earle Funk (1948, Harper & Row).

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Note: the post was edited on 4/23/10 to correct a stupid error of fact in paragraph 3. The original post, referred to “George Herbert Walker Bush” which was fortunately caught by alert reader/writer/commenter, Cliff Green.

Senate Plans to Order More Chickens

fox_hen_house

With so many Americans now unable to afford health insurance, the private insurance industry is facing a catastrophic problem: how to keep profits high, executive compensation exorbitant and campaign contributions excessive?

Fortunately, $200 million in lobbying and campaign contributions have convinced a majority in the senate (41 members) that the problem is not the fox or the hen house, the problem is the shortage of chickens. Agreeing with the house, the Senate will force every chicken-livered American above the poverty line and below the retirement age to get back in that hen house and act happy about it – 30 to 40 million of us.

The hen house will still be run by private, for-profit corporations not responsible to anyone (no public option, no Medicare buy-in, no co-op chicken coop in the Senate bill). Sure, insurance companies will no longer be allowed to deny you coverage because you are old or sick or male or female, but they will charge you up to 3 times what others pay. Sure, there are a lot of wonderful little rule changes that will get us on the road (roads in Iraq are safer) to real reform. Sure, individuals and tiny businesses might get the chance to enter the hen house at rates similar to groups. Sure, a few years from now there will be some subsidies to help you afford health insurance until you are poor enough to qualify for Medicaid. Sure. We’re totally screwed.

There’s a tiny chance something good could happen in conference. Or, some of the Republicans purchased by the insurance lobby would accept a bigger bribe from Obama & Company. Or, maybe, they’ll just go home for holidays and forget all about it. Personally, I think I have a better chance free range.

It is a tough time to be anything

believe_0001It is an awful time to passionately believe in something. Be it liberal, conservative, or independent. No one is happy.

For all our freedom, America is a lousy place to be a zealot. Sure, you can talk the talk almost as loud as you wish. You can carry signs, march, demonstrate, blog, tweet, harangue, chant, argue, and pontificate – but in the end, it will be decided by politicians, pollsters and lobbyists.

  • Anti-war? 30,000 more troops are going to Afghanistan. We’ll assess the situation on the ground before bringing our troops home and it will take at least 3 years after that.
  • A hawk on defense? We are only sending 30,000 more troops to Afghanistan and we’re getting out in 18 months.
  • Health care reform with or without public option? It won’t be a true public option and we’ll spend more because of it, but actually pay for it less. There is something in it for everyone to love and everyone to hate.
  • Immigration reform? We’re still building a wall with Mexico. There’s no path to citizenship for people who are here illegally, but we still pay for their emergency health care and now provide alternatives to detaining those who are caught.
  • Wall Street regulation? Tough regulation is planned, but it will take another meltdown to get it out of committee.
  • Deficit reduction? In this tough economy, we can’t cut spending or raise taxes – or won’t. The deficit doesn’t matter – or it does.
  • Unemployment and the economy stupid? We’ll extend the benefits for those who get unemployment; provide some food stamps, but little else for others unemployed or underemployed; give trillions to the banks so they’ll make loans which they won’t; spend hundreds of billions on works projects that are subverted by states to help their budgets; and do nothing to re-capitalize small business.
  • Alternative energy and domestic production? We bailed out GM. Wasted billions then abandoned Chrysler. We provided incentives to buy cars that get “at least 22 mpg,” continue to subsidize oil with taxes, but created no new tax or incentive to reduce consumption. We have provided some, but not much, stimulus money for alternative energy, conservation and light rail.
  • Equal rights and discrimination? We are still “studying” don’t ask, don’t tell. It is still okay to discriminate based on sexual orientation except where it isn’t. You cannot hire or fire someone because of their race, age or gender, but it is fine to do so if you can make up some other reason. Racial, religious and ethnic profiling is wrong, but okay if it protects us.

I could go on, but let me just ask: is there any issue anyone outside of Washington is happy with?

Mindlessness must be the route to happiness. Things are great as long as you don’t care. Stay away from the news and just watch another survivor or gossip show (or anything on television). Grey is the new black. Grey is the new white. We know the economy is making a comeback because fewer people lost their jobs last week. President Obama accepts the Peace prize the same week he announces escalation of the war.

“A good compromise, a good piece of legislation, is like a good sentence; or a good piece of music. Everybody can recognize it. They say, ‘Huh. It works. It makes sense.’” – Barack Obama

“All compromise is based on give and take, but there can be no give and take on fundamentals. Any compromise on mere fundamentals is a surrender. For it is all give and no take.” – Mohandas Gandhi

“So then because thou art lukewarm, and neither cold nor hot, I will spue thee out of my mouth.” – Revelation 3:16 (King James)

“Don’t worry, be happy” – Bobby McFerrin Bobby McFerrin - Best of Bobby McFerrin - Don't Worry, Be Happy

Hold your nose and swallow

medicinekidsClose your eyes. Hold your nose. Open your mouth. Now swallow. – That’s how my mom tried to keep me from gagging when taking medicine. That’s what our Democrat leaders are telling us now about health care “reform.”

Another gigantic example of big event legislation. A massive bill way too big to fail – or read – or understand – or debate. Chock full of things for just about every special interest so Dems can finally deliver a health care bill.

  • No insurance? We’ll give it to you.
  • Can’t afford insurance? We’ll help you.
  • Uninsurable? No longer.
  • Have insurance? We’re not going to change a thing.
  • On medicare? We’ll close the prescription donut hole.
  • Own insurance or pharma stocks? We’ll increase your markets and your profits.
  • A health care provider? We won’t set prices.
  • Against a woman’s right to choose? Us, too.
  • Against expanding Medicare? Us, too.
  • Against a public option? It will be in name only.
  • Anti-deficit? It’s paid for with savings and new taxes.
  • Anti-health care reform? Your state can opt out.
  • Anti-Obama? Won’t go into effect until after the next presidential election.
  • Anti-immigrant? Us, too.
  • Own a business? Have we got some loopholes for you.
  • Middle class poor with lots of debt? Okay, nothing for you, but didn’t we just pass a tax cut and credit card reform?
  • Healthy and just starting out? There are no jobs anyway, go for Medicaid.
  • Work on K Street? You’ll make your bonus.
  • An accountant or lawyer? Consider it a bailout.

H.R.3590 – Service Members Home Ownership Tax Act of 2009 (this is the actual name of Senate health care bill which is an amendment of a bill already in the cue to speed it up – aka: The Patient Protection and Affordable Care Act) runs some 2,074 pages containing 327,911 words (War and Peace has 561,893 words). It is the poster child example of the preferred way to govern these days: one gigantic omnibus bill that no one authors (or is to blame) and no one really knows who (or what lobby firm) added or compromised what that ends up in it. Bills that can be labeled, branded, lobbied, spun and base-rallied pro or con. Legislation to do everything, will last forever and we’ll fix down the road, depending upon who is in the majority down the road. This type of legislation is the reason politics is so partisan. And, this is what I hate about health care reform.

Dew_BillWordCounts

Note on the numbers in the chart: I downloaded the documents (transcripts of the older document) and used Microsoft Word’s word count tool. Some of the documents included signers, secretary notes, enactment dates, and other information that may cause count to vary slightly.

Couldn’t we have broken out a few things that we all believe in? Small, understandable bills that could be bipartisan? Simple language to solve some basic problems that simple people could believe government could actually accomplish? Incremental reforms to fix what we all might agree is broken?

  • Why do we have to debate the public option to get rules changed so preexisting conditions don’t prevent people from getting insurance?
  • Why do we have to debate whether every business will be forced to offer – and every individual will be forced to have – insurance in order that individuals and mom and pop businesses are allowed to join group plans at a reasonable cost?
  • Why do we have to agree not to negotiate prescription prices in order to have higher penalties for people who commit Medicare fraud?
  • Why do we have to debate subsidies for the uninsured, just so we can get rid of subsidies of private insurance companies offering Medicare (or at least require them to report quality of care results)?
  • Why do we have to debate changes in tort so that we can pass legislation to cover newborns who don’t have insurance?
  • Or require reporting on the effectiveness of drugs, medical tests and procedures? Or require electronic reporting? Or remove lifetime limits? Or limiting waiting periods? Or insurance plan transparency? Or transparency of physician ownership and investments? Or investments in primary care provider training? Or nursing student loans? Or funding for a National Health Service Corps? Or a national and state background checks for facilities and providers? Or medical bankruptcy prevention? Or improvements in access to immunizations? Or addressing childhood obesity? Or hospice reform? Or chronic disease prevention? Etc.

Wouldn’t it seem more civilized to pass specific bills that we agree on rather than bundling those we agree on with a bunch of controversial issues forcing our representatives to vote up or down on the whole package – or, God forbid, break with their party?

Why can’t we have a separate debate/vote on a public option or expanding Medicare? And a separate debate/vote on allowing insurance companies to compete in national markets? And a separate debate/vote on requiring everyone to have some form of coverage?

What is really going on here? Our leaders just don’t have much faith in us. They act as if they believe that the only way they can build a constituency to pass a bill is to make the issue seem to have epic proportions. To frame a debate as one that threatens our existence or our way of life. To excite the base, shake out the campaign contributions, get TV face time and get reelected. They did this to invade Iraq (Vietnam, Korea, Philippines, Mexico, Indian Wars, etc.). To bail out Wall Street (protect many other industries). And now, to pass health care “reform.”

We need our health care industry reformed. We must find ways to stablize costs. We must become more efficient and more competitive. We must do better in preventive care. We must discuss as a society, how the poor, the unfortunately sick and the innocent should receive health services. We also must find common ground, or we may lose more in the process than gained by any victory or defeat of the bill.

This bill is not about really about “reform” – I sincerely wish it were since I hear and read so much about it. Don’t get me wrong – there is a lot of great stuff mixed in the 2,074 pages – important, life-improving and life-and-money-saving stuff. But much of this bill and almost all of the cost, is about expansion of health care insurance for those who can’t afford insurance, don’t choose to buy it (preferring, in most cases I suspect, to eat or have shelter), or have been denied it. Reform is mostly packaging.

As a result, we’ll probably get a compromise of a “reform” law. A compromise of a benefit for the uninsured. Certainly a more divided country. And, we’ll probably have to do it all again some day soon because many of the real issues won’t have been honestly included, debated in daylight, voted on, or made sustainable.

On the other hand, what an historic achievement to get it this close. Maybe it really does take this cynical, scare-the-hell-out-of-everyone, Rahm Emanuel-pit bull-but-open-to-compromise-approach to get something done? Please weigh-in with your comments.


Suggested Reading:

Tell Congress to Go to Hell

fuck-youWednesday’s Democrat victory / compromise / cave-in is a harbinger. A public option won’t be able to negotiate for lower costs. Hmmm. Who benefits. Hospitals? Check. Big pharma? Check. Insurance companies? Check. People, sick or otherwise? Wonnnnnk. The smart money on Wall Street has been betting we’d be screwed and they’d get richer. Enough to make me hope nothing passes.

Not. Can’t go there. This is the most important thing this Congress and this President can do for about a hundred million of us who duck doctors and hospital bill collectors while we wince in pain. Not the most important thing this year … they’ve already shafted us on that — the stimulus (aka: bailout for the gloriously happy rich). No, this is life and death and they have chosen profits and to pretend (CNN wants you to believe that, too) that Wall Street mirrors America.

All to save a hundred billion over ten years? Sure. There is not a human being on the planet that believes any of it. Many trillions to make sure Ben Bernanke’s friends stay super-wealthy and the US government needs to screw me and my hundred million peers? F-them..

As God is my witness (oops, God left on the last train to the coast and is now on a slow-boat to China where they bailed-out people instead of banks), I will spend every moment I can afford (Hah! When this is passed, I won’t afford anything) working to defeat every single-sniveling-cowardly-corrupt-lobby-sucking-dickhead-congress-person I can find. I’ll march. I’ll picket. I’ll write. Email. You-tube. Twitter those [expletive deleted by editor] assholes the rest of my life. (Note to the Secret Service: strictly metaphorical threats.)

Folks, this ain’t over, but it will be soon.

I know. I know. I know. We just need to pass health care reform and will fix it in post (a video and audio production term that allows you to record something really badly and use various computer techniques — like Photoshop —  to make it seem better when people see it). Not this time. We’ll be dead broke and mostly dead before they take the power out of the cold live hands of the lobbyists.

I don’t have any power except to write you. If you can reach out and touch one, just one of the cretins we called leaders, please do it for me — or for one of the hundred million others who are more likeable.