MVNHS©: Dodging Bullets

With the incoming administration ostensibly Repeal-bound, perhaps we may avoid our own full-blown version of the Much Vaunted National Health System©:

"Nearly a quarter of patients waited longer than four hours at A&E last week with just one hospital hitting its target."

[ed: A&E being "accident and Emergency" care facility]

On top of that, there were almost 20,000 "trolley waits" (how long patients must wait for a hospital bed after being admitted in an emergency) of over 4 hours. The "target" is 4 hour (maximum), but only one hospital even ht that.

But hey, free!

[Hat Tip: FoIB Holly R]

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About that $2500 Savings...

Funny how I don't recall hearing this from 2008-2016.

-President Obama on January 6th, 2017 during an interview with Vox.com's Sarah Kliff and Ezra Klein

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Flatline: Lagniappe

Yesterday, Patrick's excellent post really pulled back the curtains on this year's Open Enrollment fiasco season, exposing just how poorly it really went. But it actually gets better (well, for certain values of "better"). A trusted source tells me that:

"Only 40% of the people who EVER bought on [404Care.gov]  kept coverage for 12 continuous months. 40%." Now that's a stable market"

[ed: Based on study done in Dec 2015 on data from Jan 2014 until then, but unlikely to be much different this go 'round]

What that means is that folks have figured out that gaming the system is quite easy, and lots of them have done so.

The challenge is that carriers incur acquisition costs for each policy they issue. This is pure overhead, before any claims (or, often, premiums) have been paid. If the majority of the policies issued are dropped by the client in that first year, that makes it even more difficult for carriers to make a profit. So, another reason so many carriers have dropped out of the market, leaving fewer choices and increase costs.

And there's this: many folks only buy ObamaPlans to help pay for a pre-existing condition, especially an acute or catastrophic one: insurance pays for the bulk of services rendered, then no longer needed. This results in a major loss for the carrier, and no way to recoup it (since Risk Corridors went away).

Another reason is to avoid the penalty fine tax itself, but of course for many that's nominal, and certainly a lot less than actual premiums.

Can you say "Death Spiral?"

[Hat Tip: @MikeBertaut]

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Flatline

Yesterday - with little fanfare - HHS released the Obamacare enrollment snapshot from week 9. This release is for the Federal exchange (healthcare.gov) from November 1st through December 31st and includes all plan selections (not paid plans) effective for January 1st as well as those who selected plans after December 15th that will be effective February 1st.

Other than a Sylvia Burwell tweet this uninspiring report got very little media attention (a Google search confirms it). This is because the numbers just aren't good. Compared to last year the increase in plan selections is a mere 154,123. Worse yet, all of the growth is attributed to renewals. New enrollment is down by more than 350,000 from last year.

That statistic should be troubling to ACA supporters. With a little over a month remaining in OE4 the prospects of hitting enrollment targets is next to impossible. Even when factoring in the state based exchanges there would need to be another 2 million or so NEW enrollments to hit the revised numbers.

There is little reason to rejoice in Obamaville this year. The signature achievement is showing it's true colors to a much broader swath of the general population at a much higher cost than we were promised. Medicaid expansion is way over budget and will soon be costing states who expanded billions in additional cost. Premiums are up significantly in the individual market, insurer participation is down, provider networks are razor thin, and benefits like deductibles are rising to unattainable levels. In the near future employer plans will also take a hit negatively impacting wages and benefits for middle class workers.

If the new Congress and President elect are smart (which is questionable) they would begin pointing out these flaws immediately. The narrative needs to be changed from an emotional viewpoint (see #makeamericasickagain) to a financial and practical viewpoint.

Then again, when has the Fantasyland known as Washington DC ever been fiscally responsible or practical? When one can only get reelected by playing on our emotions the answer is never.

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"You know better than to trust a strange computer!"

I've been making fun of home office folks for pretty much my entire career, so I should have seen this coming:

"Insurance firm Fukoku Mutual Life Insurance is making 34 employees redundant and replacing them with IBM’s Watson Explorer AI"

Followers of Jeopardy are familiar with the machine, which can sift through millions of data points instantaneously to quickly discern the correct answer. In this case, it appears that the machine will be replacing almost 3 dozen folks in the carrier's claims unit:

"The technology will be able to read tens of thousands of medical certificates and factor in the length of hospital stays, medical histories and any surgical procedures before calculating payouts"

Plus, it doesn't take coffee or smoke breaks, paid vacations or require health insurance benefits.

Win-win?

[Hat Tip: FoIB Jeff M]

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Yeah, about those $2500 rate decreases

Remember this?

Well, here's 1,000 words on how much ObamPlan premiums are going up in every state. :

 [click to embiggen]

 
[Hat Tip: Jason C]

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From the P&C Files in a Galaxy (Not) Far Away...

Over the weekend, my family saw the new Star Wars movie. It was bittersweet, of course: while the plot explains the events that lead up to the first Star Wars, it was only marginally about the Skywalker clan. Still, the recent passing of Princess Leia - Carrie Fisher - was on all of our minds.

Which brings up an interesting quandary: now that one of the principal characters is (apparently, although not necessarily) unavailable, what will happen to the series?

A few months ago, we discussed how rap star Kanye West's health issues, which forced cancellation of some of his shows, might be covered by a special events insurance policy. Such a plan was apparently also in place for the late Ms Fisher:

"[Disney] ... could receive $50 million thanks to an insurance policy the company took out in the event Fisher was unable to fulfill her three-film contract."

What's more, it's apparently "the largest single personal accident insurance claim payout ever" (although how one could possibly know that is unclear - I'd take it with a gran or two of salt). Still, it's obviously a lot of money; whether it will truly offset her loss on the big screen only time will tell.

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