MVNHS© Winninng: A Story in Two Parts

Part 1:

North London NHS to stop hip replacements and tonsillectomies via @NewJournal https://t.co/VxQtmZGSHR pic.twitter.com/CJ41CmZfJV

— Sally Pipes (@sallypipes) March 14, 2019

This is what happens when a country turns its medical care over to government bureauweenies. As a result of consistent and increasing budget cuts, the Much Vaunted National health Service@ is "push[ing] more patients towards paying for treatment privately."

Wait, what?

"paying for treatment privately"

It's a not-so-closely guarded secret that even countries with government-run health "care" have huge markets for private insurance. As we reported 7+ years ago:

"Private Medical Insurance ... allows you to have complete reassurance of knowing that, should the need arise you and your family can receive medical treatment privately, without waiting for the NHS to treat you."

We wondered at the time about why this was necessary, given the free and widely available health care that is the MVNHS©. Now we know.

Part B):

One of our most enduring memes here at IB is the fact that health care ≠ health insurance. That is, what good is the coverage if there's no one to provide the care?

Well, our British Cousins are learning this lesson good and hard. From FoIB Rich W:

Over half of the doctors in the UK’s single-payer system are thinking about reducing hours or quitting due to low salaries and heavy caseloads.

Americans should fear the dangers of oppressive policies would enslave them to the gov. #ampFW via @sallypipes https://t.co/icvty74x1G

— FreedomWorks (@FreedomWorks) March 7, 2019

A lesson to be learned as we rush headlong toward #Medicare4All: Be careful what you wish for.

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*True* Junk Plans: A Retrospective

So big news on Capital Hill:

House Democrats sent letters to 12 insurance companies seeking information about short-term health insurance coverage. Companies that received letters include Anthem, UnitedHealth Group, Health Insurance Innovations and Cambia Health Solutions. https://t.co/NcyFsVPlBO

— ThinkAdv Life/Health (@TA_LifeHealth) March 14, 2019

What they really need to be reviewing are the true junk plans:

"Twenty percent of Ohio adults reported that they or a household member go without medical care because of the cost even though more than 90 percent of them have health insurance"

Hint: They're not talking about STM's....

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Blue Cross: Word Salad edition

So this morning, FoIB Jeff M emailed this item about the planned merger of Blue Cross Blue Shield of North Carolina "with Portland, Ore.-based insurer Cambia Health Solutions. The two not-for-profit organizations with combined revenue of $16 billion and more than 6 million customers said the alliance will make health care "simpler, better and more affordable."

Wait a minute: what does "simpler, better" actually mean?

Well, it depends. According to the official email announcement:

It might mean "Each company retains its current assets, such as its reserves and capital, and there is no change to the underlying business in our states."

On the other hand, it could be that "The companies will share services, which will cause some resources to shift."

On the gripping hand, perhaps it notes that "Our long-term goal is to make health care more affordable for the individuals and families we serve ... Our expertise, common management and increased resources will allow us to better address rising costs in the health care system by reinvesting shared savings, enhancing price transparency tool."

Okay, but why does all of that remind me of this?

In the end, one suspects that it means "business as usual," only with a bigger footprint.

And as Jeff notes, a look at their websiteseems to indicate that "they still think healthcare and health insurance are the same."

Yay?

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HIPAA, HIPAA Horray?

[click to embiggen]

So, FoIB Holly R sent us this:

"Just had a doctor's office tell me the doctor couldn't discuss test results over the phone because of HIPAA. This is false, and another reminder that medical facilities constantly use HIPAA as a bogus excuse for being opaque and difficult."

Interesting take, and one I've heard before. But is it true?

I reached out to co-blogger Kelley B, herself a medical office manager, for her reaction. She replied:

"The reality is that the doctor will be paid nothing to tell the patient his test results over the phone. Since this requires medical decision making on the doctor's part, he/she is entitled to be paid and that means that the patient has to come in for an appointment. The patients hate this because it costs them money.

Is it a HIPAA violation. It could be as you cannot confirm that the person on the other end of the phone is the patient. It is in the doctor's best interests not to give out results over the phone and have the patient come in."

That makes sense, although I would point out (before others do) that under the nascent DPC (Direct Care) model, that first point would be moot, since the doc's already been paid.

Interesting.

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The (New, Improved?) ACA is Working

Regular readers may recall that the current administration loosened a lot of the rules surrounding Short Term Medical (STM) plans, and the ensuing hue and cry from 'the usual suspects' about the world ending (or worse!) as a result.

Well, preliminary results are in, and guess who comes out standing tall (hint: it's not the naysayers):

Analysts at @eHealth asked participants who used their coverage to pay for care about their satisfaction levels. Here's what they said. https://t.co/v25rqIkVL1

— ThinkAdv Life/Health (@TA_LifeHealth) March 12, 2019

 

Turns out, folks who bought these plans are, for the most part, completely satisfied that they worked as promised; in fact, over 80% of buyers who actually had claims were either satisfied or even very satisfied.

Hunh.

And most of the folks who had claims also "said their policies covered what they thought the policies would cover."

Imagine that.

Were that ObamaPlan victims insureds were so satisfied.

Meantime, Colorado becomes the latest state to ban sales of STM plans altogether:

"The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has amended the regulation governing short-term limited duration health benefit plans, requiring these plans to provide many of the same protections afforded by Affordable Care Act (ACA) qualified plans."

In other words, no more short term plans for Centennial Staters.

Wonder why their leaders hate choice.

[Hat Tip: FoIb Lynne]

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Outstanding Vendor Tricks: Dental edition

Over the years, we've detailed any number of really stupid vendor tricks; the list of terrific one is, unfortunately, much smaller.

Well, that latter list just grew a little larger today, as Superior Dental Care joins that august group.

And why is that, you ask?

Well, because they are an absolute joy to work with. Case in point:

Recently, I was privileged to write a brand new small group (as in, they'd never had group health insurance before). A month or so later, they asked about adding voluntary dental ("voluntary" in this context means employee paid, no employer contribution). I don't do a lot of dental, but Superior Dental (SDC) is one of my two go-to's for it. Superior especially is a delight, because they just make things so easy. In this case, we were going for a March 1 effective date, and the employer mailed me the forms on February 27.

Except I never received that email. So I presumed that they had decided to either they'd changed their minds, or were opting for an April 1 start date. So last week I followed up to see if they were sill interested. They replied "of course, we sent you the paperwork last week!"

Oy.

So I called our SDC rep to see if there was any chance we could still get that March 1 effective date, even though it was already the 7th. And the answer was "of course," just send us the forms right away and we'll get that done for you.

So I called the client and they re-sent the forms, which I dutifully forwarded to SDC.And this morning, I received confirmation that the plan was activated on March 1, and that ID cards would be on he way shortly.

Doesn't get any better than that.

Kudos to Superior Dental Care.

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More MVNHS© #Winning

It’s working! Single Payer is working!! And better than expected. https://t.co/PvyHqoN2nq

— Rich Weinstein (@phillyrich1) March 10, 2019

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