Friday, April 20, 2018

The MVNHS© Giveth, and the MVNHS© Taketh Away

A few weeks ago, we reported that the Much Vaunted National Health Service© had granted not-quite-two-years-old Alfie Evans a (temporary) reprieve:

"Alfie Evans’ Life Support Won’t be Switched Off, Delayed After Pope Francis Intervenes on His Behalf"

And it's critical to remember that his parents were willing to foot the entire health care bill themselves (likely with a little help from their friends).

Well, it seems that the poor toddler's time has, in fact, now run out:

"UK Supreme Court declines appeal from parents of ill toddler"

And so the plug will be pulled, and little Alfie will be gone (but certainly not forgotten by anyone with a heart).

Here's the thing: while reasonable folks could disagree about the utility of further treatment (he's "in a "semi-vegetative state" as the result of a degenerative neurological condition"), and it could further be argued that public health care dollars pounds would be wasted, in this case it's actually cost the MVNHS© more money to fight his being flown elsewhere for treatment at his parents' expense.

But hey: Free health "care."

Case Study: Life plus LTCi

So, working on an interesting case for a long-time client. Doris is in her early 60's, has an existing Universal Life policy but is looking at replacing it with a new plan that would include both life and long term care coverage (please don't ask why she's replacing a perfectly good UL plan; she apparently has her reasons).

After some discussion, we've narrowed things down to 2 (well, technically 3) options. All include $250,000 of life insurance and $5,000/month of long term care benefits:

Option 1: Term life + Stand-alone Long Term Care (LTCi) plan

15 Year term + LTCi = $4,551/year, or
20 Year term + LTCi = $5,189/year

The stand-alone LTCi plan offers 3% inflation protection and is Partnership-compliant; benefits payable for up to 48 months.

Option 2: Hybrid Guaranteed Universal Life/LTCi has a 50 month benefit period, and is built on an indemnity chassis (no receipts or invoices to submit past the initial claim form). On the other hand, it has no inflation protection and is not Partnership-compliant. On the gripping hand, the life insurance pays someone if there's no long term care claim (to her age 120!). The annual premium for this plan is $5,000 (Thanks to commenter Scott O who pointed out this omission - Mea culpa!)

There are a few other details, of course, but that's the gist.

So which option will she pick? I have no idea, but would be interested in our readers' prognostications (and feel free to explain why in the comments section below):

Thursday, April 19, 2018

Spring has Sprung!

And so has this month's Health Wonk Review, with a wonderfully fresh variety of posts on health care wonkery.

Louise Norris hosts, offering items ranging from "rumblings at CMS" (yay Silver plans) to the horrendous opioid crisis, not to mention the state of Medicaid (oops, mentioned!).

Do head on over for a great bouquet of interesting topics.

Wednesday, April 18, 2018

Tort reform, MVNHS©-style?

As previously noted, government-run health care schemes like the Much Vaunted National Health System©  have never really managed to rein in health care costs:

"It's kind of funny that their data actually shows real socialized medicine (UK NHS) has annualized cost growth higher than that in the US."

But co-blogger Mike tells us that they're at least trying (for certain values of "try"):

"Health leaders have written to Justice Secretary David Gauke urging him to reform the payout system for negligence claims against the NHS."

Seems that all those (costly) mistakes (such as leaving patients "dying prematurely in corridors") have begun to add up. A pound here, a pound there, and pretty soon you're talking real money:



[click to embiggen]

Yikes!

Monday, April 16, 2018

HHS makes its move

Via email from our friends at Cornerstone regarding next year's individual health insurance market:

The Bureauweenies in DC
© have published their "Notice of Benefit and Payment Parameters for 2019," which includes another reprieve for Transitional ("Grandmothered") plans for another year, as well as info on:
• Qualified Health Plan (QHP) Certification Standards
• Exemptions
• Risk Adjustment
• Advance Premium Tax Credit (APTC) Program Integrity
• Special Enrollment Periods (SEPs)
• Medical Loss Ratio
Among other items. There's also additional guidance on those underwhelming SHOP plans (oh, goody).

Interested (or insomnia-stricken) readers may click here for the not-so-gory details.

Friday, April 13, 2018

Rich Man, Poor Man

It was the best of times, it was the worst of times.

Benjamin Hynden had an abdominal pain and made an appointment to see his doctor. During the examination his doctor suggested a CT scan to look for abnormalities.

The radiologist didn’t see anything wrong on the images, and Ardesia didn’t recommend any treatment.
A few weeks later, Hynden, who has a high-deductible health insurance policy with Cigna, got a bill for $268. He paid it and moved on. -
KHN

Three months later the pain returned. This time Dr Ardesia wasn't available so he saw a nurse practitioner. The NP, fearing possible appendicitis, told Benjamin to have a CT scan at the hospital.

The triage nurse told him the problem wasn’t his appendix, but she suggested he stick around for some additional tests — including another CT scan — just to be safe.
 “It was the exact same machine. It was the exact same test,” Hynden said.
The results were also the same as the October scan: Hynden was sent home without a definitive diagnosis.

But what happened next was a complete shock.

Total Bill: $10,174.75, including $8,897 for a CT scan of the abdomen

Things such as this happen every day. So how can you protect yourself?

Follow this link for the rest of the story.

It was the age of wisdom . . . .

#CTScan #MedicalPriceGouging  #Medicare  #ProviderNetworks


Wednesday, April 11, 2018

Does Medicare Pay For Dental Work?

What kind of dental coverage is included with original Medicare? Does Medicare pay for routine care like exams, cleaning and X-rays? Or crowns and bridges.

The answer is no.

No basic dental coverage. No routine exams. No cleanings or X-rays.

The next question is . . . why not?

Auto insurance doesn't cover routine items like tires, brakes and oil changes. Why do people THINK they need dental insurance to see a dentist?

I have no idea.

But maybe this will help.

The retail cost of dental and oral health care services varies widely, from practice to practice and from one geographic region to another. But according to one consumer website, a standard cleaning typically costs between $70 and $200. Dental X-rays can cost $250 or more. - Insurance News Net

Split the difference in $70 vs $200 and call it $185 for a routine exam and cleaning. With twice a year cleaning that works out to a little more than $30/month, stuffed in your mattress, to cover the cost of routine dental care.

Why does someone need insurance to "help pay for" something you could pay from petty cash?

Most individual dental insurance plan premiums run $25 - $45 per month. Almost all require you to use participating network dentists. They have annual limits of $1,000 - $1500. Major work like crowns, bridges and root canals are not covered until you have had the plan 6 to 12 months.

Does it make sense to pay $500 - $600 per year for a dental insurance plan you can only use with maybe 15% of the dentists in your area? When you finally do get to use it for major work it may only pay 30% of what the dentist bills.

You decide.

#Medicare #DentalCare #DentalInsurance



More Rocket Surgery from the MVNHS©

So, underscoring once again that ("free") coverage ≠ care, the Brits' Much Vaunted National Health System©, FoIB Sally Pipes tips us to this item:

"Megan flew to Istanbul for private surgery late last year, having been told she faced long delays for an operation to fix the deformation of her spine, which was causing her problems breathing."

As we know, the bureauweenies who run the MVNHS© aren't too keen on the next generation, so I was actually surprised that the young lady was allowed to travel elsewhere for potentially life-saving treatment. Perhaps this was due more to the fact that she's Irish, not English.

And adding insult to injury, we learn that these kinds of national health care schemes don't actually rein in costs:



Ooops.

Monday, April 09, 2018

Told ya so!

Back in late '16, we pointed out that "going bare" had begun to make sense since health insurance had become too expensive to use:

"It might be a ticket to get you into certain medical facilities, but in these days of narrow networks, it will keep you out of others."

Believe it or not, it's gotten worse:

"Obamacare is now so expensive it keeps patients away from their doctors"

And, I would add, their hospitals and specialists, as well.

As Heartland Institute's Justin Haskins points out:

"In a recent survey ... 47 percent of those surveyed said they chose within the past 12 months not to see a doctor or dentist for a routine checkup ... because of the high costs associated with healthcare."

But how could that be; after all, annual physicals are "free."

Well, except for that whole pesky thousands-of-premium-dollars-later thing.

And then there are the non-routine costs, with additional out-of-pockets in the thousands (often tens of thousands) of dollars.

The point, of course, is that the ultimate end-goal of ObamaCare has always been  Single Payer; by that metric, these unworldly prices are features, not bugs.

Definitely click through to read the whole thing.

[Hat Tip: FoIB David Fluker]