Category Archives: healthcare

“She Didn’t Ask”

Tennessee Gov. Haslam, who refuses to expand the state’s Medicaid program, preferring to let the state’s poor get sick and die (I suppose), while also claiming to have some kind of super-secret non-existent Tennessee plan that he’s supposedly “negotiating” (wink wink), and who recently was in the news asking HHS Secretary Kathleen Sebelius “to come up with a proposal that would give Tennessee more flexibility to expand Medicaid coverage,” could have asked Sebelius for an update on said plan today. Because today, Secretary Sebelius was in Nashville urging people to sign up for ObamaCare:

Sebelius was joined by Amy Speace, a 46-year-old singer-songwriter who was able to find insurance on the exchange for $30 a month with a $500 deductible, thanks to a tax credit. Speace said she did not at first think she would be eligible for insurance on the exchange because she already was covered by a high deductible plan through a musicians group. Despite that coverage, she nearly had to declare bankruptcy a few years ago when she developed laryngitis and ended up owing $5,000 in medical bills. She was only saved from bankruptcy by the help of a charity.

So, did Gov. Haslam meet with Sebelius for an update on that counterproposal? What do you think?

The governor told a reporter that he had no plans to meet with Sebelius when she came through Nashville on Thursday.

“She didn’t ask,” Haslam said.

I guess he just doesn’t give a shit.

Every day thousands of Tennesseans who lack health insurance face bankruptcy and worse. Gov. Haslam certainly doesn’t seem unduly concerned about those folks.

Good to know.

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Filed under Gov. Bill Haslam, health insurance, healthcare, Nashville, Obamacare

Best Healthcare In The World, V. Eleventybillion

Have you seen this video making the rounds?

When it comes to wait times for healthcare, I would just like to point out that not only is it correct that until Obamacare, millions of Americans died or sickened because they couldn’t get insurance and access the best healthcare system in the world, but also even ordinary, well-insured people such as myself have to deal with wait times. For example, today I called my doctor and was told her next appointment was at the end of May, over two months away. However, if I want to see her daughter, who is not a doctor but a nurse practitioner, I can get an appointment in April. That’s still a few weeks but it’s not a few months.

Let me remind everyone what happened last time I had to go to the doctor (and yes, I’m starting to think she’s avoiding me, foisting me off on her non-doctor daughter.)

Our system is not wonderful. Anyone who uses it knows that. My insurance company is now sending me quarterly marketing materials that look like warmed-over Cosmopolitan and Marie Claire magazine articles, reminding me to eat my vegetables and to exercise and get enough sleep. They even include recipes, as if the internet hasn’t been invented and I can’t find a damn recipe on my own.

This is what BlueCross BlueShield is spending its money on. But I don’t need that. I already know that stuff. I’d really prefer they stop with the patronizing PR/marketing bullshit. Let me be clear: the absolute last thing I want is a “relationship” with my insurance company. What I really want is for them to just basically do their jobs and otherwise leave me the fuck alone. That shouldn’t be too hard.

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Filed under healthcare

Obamacare Boosts Wages, Tennessee Proves

What’s that you say? It’s true, according to Dean Baker:

This is the “job loss” that has gotten opponents of the ACA so excited. But there is another aspect of this picture that should get other people excited. Back in intro economics we teach students about supply and demand. Other things equal, we expect a reduced supply – in this case of workers – to lead to a higher price or wage. In other words, a reduction in labor supply associated with the ACA might lead to some increase in wages.

We have an opportunity to test this proposition since Tennessee effectively did Obamacare in reverse, eliminating health insurance subsidies for low and moderate income adults without children in 2005. If the resulting change in labor supply has an impact on the market, then we would expect to see a drop in wages in Tennessee relative to other states.

That is in fact what we see. The figure below shows the median real wage for workers with high school degrees or less (the workers most likely to be affected) in Tennessee since 2000 compared to the workers without high school degrees elsewhere in the South.

btp-2014-02-20

Interesting idea. Also ironic that Tennessee kicked its low and moderate income folks in the teeth 9 years ago and saw a decline in wages as a result. It stands to reason that lifting up these folks will see a rise in wages. It’s sorta what people like Krugman have been saying since forever, but don’t expect the Republican’ts to start listening.

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Filed under healthcare, Obamacare, Tennessee, wages

Yet Another Anti-Obamacare Story Falls Apart

The Tennessean committed an act of journalism and actually looked into the claims of Emilie Lamb, a Tennessee woman who has become the “national posterchild” for the anti-Obamacare crowd, appearing in Americans For Prosperity ads and mentioned in an op-ed by that harpy Marsha Blackburn.

Like every other one of these stories, it doesn’t add up:

Her beef? The health coverage she had received for years — and liked — under a state program known as CoverTN ended last year because it was deemed substandard under the health care law. Now she pays seven times more for a plan she says is more than she needs.

Supporters of the law who have examined CoverTN say the coverage Lamb had under the state plan was the very kind of junk policy the health care law was meant to replace.

There were restrictions on the number of times she could see a doctor or specialist. Emergency room visits were limited. Financial help for prescriptions was capped. But the real danger of CoverTN, they said, was that it covered a maximum $25,000 in medical bills a year— an amount a moderate hospital stay could easily eat up.

Even BlueCross BlueShield of Tennessee, which administered the program for the state, warned consumers on its website that CoverTN benefits “are very limited compared to traditional insurance.”

[…]

Advocates for the health care law say Lamb was lucky to avoid financial ruin under her old plan, especially because of the long-term expenses associated with lupus.

And they said she could have opted for a much less expensive option that covers hospitalization — including a plan costing $159 per month — among the 37 plans offered on the federal HealthCare.gov health exchange serving Tennessee residents.

Basically, Lamb is an idiot. As I wrote last November,

If you liked insurance that is basically ripping you off then you’re a moron. You’re probably one of those people who thinks a Nigerian prince wants to send you a million bucks. Guess what, that’s a scam, too.

Okay, it’s not fair to say CoverTN was ripping people off but let’s remember who and what it was designed for: it was a program Gov. Bredesen created to cover all of those people who were uninsured because of pre-existing conditions and those who got kicked off TennCare, our state Medicaid program. It was,

[...] designed to offer stripped-down medical coverage to the uninsured at a steep discount.

Denying coverage because of pre-existing conditions is now against the law — remember, this is the part of the Affordable Care Act everybody likes — so you can see how an insurance program designed to cover a group of people who no longer exist might be a tad superfluous.

CoverTN was also created for the unemployed and self-employed — it was designed for portability. Again, this is a key part of the Affordable Care Act (and the part that the media completely missed when it erroneously reported the “Obamacare kills 2.5 million jobs” lie): with health insurance tied to your employment, people didn’t have the freedom to leave jobs, retire, stay home with the kids for a while, start a new enterprise, be self-employed, etc. etc. If you, your spouse or child had a health condition, you were trapped in your job by your need for health insurance. Under Obamacare this is no longer the case. As a self-employed person let me say: this is wonderful.

Also, CoverTN was created for low-income people who made too much money to be eligible for TennCare but not enough money to be able to afford traditional insurance. Emilie Lamb paid $52 a month, but that was just one-third of the actual premium’s cost: the rest was paid by employers ($50) and the state ($50). Seems like if Gov. Haslam would get off his ass and accept the federal help to expand Medicaid here, people like Lamb wouldn’t be complaining.

And finally,

The entire Cover Tennessee plan will “sunset” in 2010, at which time it will be re-evaluated by the legislature.

It was going to go away anyway.

CoverTN was created as a stop-gap measure for a marketplace which no longer exists. People are no longer denied insurance for pre-existing conditions. The unemployed and self-employed no longer have limited options for obtaining health insurance. Low-income people — at least, those in states which don’t have recalcitrant Republican governors who’d rather hurt the poor than defy the Tea Party — have expanded state Medicaid programs to turn to.

I just can’t take Emilie Lamb’s complaints seriously.

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Filed under health insurance, healthcare, Tennessee

Rand Paul Is Lying

Stop the presses: Rand Paul claims when his son signed up for Obamacare, he was “forced” onto the Kentucky Medicaid rolls:

The senator briefly flashed a blue-and-white insurance card before launching into a diatribe about his son’s travails: “We didn’t try to get him Medicaid…They automatically enrolled him in Medicaid,” Paul said. “For a month they wouldn’t talk to us because they said they weren’t sure he existed. He had to go down to the welfare office, prove his existence, then, next thing we know, we get a Medicaid card.”

Paul then extrapolated from his son’s experience to make a general point about Kentucky’s health exchange: “Most of the people in Kentucky are getting automatically enrolled in Medicaid.”

Paul is lying.

The Affordable Care Act allowed states to automatically add residents who already receive other social services, such as food stamps and other health programs, to the Medicaid rolls. But Kentucky chose not to take advantage of that provision of the law. The state is notifying some residents of their eligibility for Medicaid, but Paul’s son would have needed to actually apply for Medicaid in order to receive a Medicaid card.

Midkiff couldn’t discuss the Paul family’s specific troubles due to confidentiality laws. But her general description of the state’s exchange clearly contradicts Paul’s story. When a Kentuckian visits Kynect, the state’s health insurance website, she’s asked to provide basic information about herself—age, location, income, number of dependents, etc.—to determine whether she qualifies for the Medicaid expansion or other insurance subsidies. The website is designed to encourage people who are eligible for Medicaid to apply, but it doesn’t force anyone onto the Medicaid rolls. The applicant would still have to actively choose to enroll in a specific Medicaid plan.

Rand Paul is lying.

Of course, it wouldn’t be the first time.

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Filed under health insurance, healthcare, Rand Paul

The Reason We Call It Gun Control

[UPDATE]:

Lessons For Gun-Owning Parents is a must-read.

———————————————

Last year after another horrible accidental shooting made headlines, someone pointed out that “we don’t want to control your guns. We want YOU to control your guns.” It’s a line I’ve parroted here many times because it’s so true. The fact that we have so many gun accidents, mass shootings, gun crime with stolen weapons, etc. is proof that gun owners cannot control their own guns.

Case in point: this good piece on the absence of responsibility and gun safety from our national conversation on guns. This quote from Ladd Everitt, of the Coalition to Stop Gun Violence, resonates:

“There’s no reasonability and no discussion about what one’s responsibility should be. It’s long past due to have a serious discussion about the responsibilities that come with these Second Amendment rights.”

I don’t understand why this has been ignored. It’s all “mah rahts!” and full stop. The gun loonz shout over anyone who dares point out that not all gun owners are the most responsible ever, and even the most responsible gun owner has moments of being irresponsible. It’s as if merely owning a gun makes them “one of us” and they don’t need to be accountable for their behavior, ever.

There’s a reason a lot of these gun accidents happen: human nature. So to Winter Haven Police Chief Gary Hester, I have two words for you: wake up:

Winter Haven Police Chief Gary Hester said most gun accidents happen for one reason: human error.

“Firearms aren’t the problem,” he said. “Firearms don’t kill people; people kill people.”

In Ruby Bing’s death, her mother was not handling the pistol in a safe and appropriate manner, Hester said. He said Adele Bing told police she had the weapon as protection, but her misuse of it led to a deadly shooting.

Right, well, what the hell do you expect? A woman thinks her boyfriend is coming to kill her, and she’s not thinking “am I operating my gun safely.” She’s thinking, “holyfuckingshitI’mgonnadie.” The rational mind is not operating in these situations. This is a no-brainer, and the cliche that “guns don’t kill people, people kill people” is pretty much null and void when you remember in the majority of these situations, people are not in control, the gun is. Put a loaded gun in the hands of a two-year old and what do you expect to happen? The gun is in charge of that situation, not a rational, adult person.

Everitt points out that incidents of negligent gun behavior are not sufficiently prosecuted. I would add that they are not fairly prosecuted, either.

The only way this is going to change is to start prosecuting these incidents of negligence and mandatory liability insurance for gun owners.

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Filed under gun control, healthcare

Most Expensive Healthcare In The World

[UPDATE]:

I was glad to see this story discussed on today’s “Morning Joe.” Interestingly, their healthcare “specialist” was a doctor who had until recently practiced at California Pacific Medical Center — the facility called out in the Times piece for gross upcharges. Her rationalization? It’s expensive to operate a hospital in California because of earthquake retrofitting!

Blaming earthquake retrofitting for an $18 aspirin? Um, no.

————————————-

This is how folks like the Frist family got rich:

A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to the International Federation of Health Plans, a global network of health insurance industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures — closing a wound with a needle and thread — typically leads to bills of at least $1,500 and often much more.

Just three stitches cost $2,229.11? Sealing a wound with skin glue, for $1,696? This is a national disgrace. In all of the haranguing about healthcare, little attention has been paid to the actual cost of simple procedures like this. When Republicans go on TV and tell everyone that we do have universal healthcare — at emergency rooms — and you see hospitals turning their ERs into “profit centers,” you’ve gotta wonder what the hell is going on. If I’ve said it once I’ve said it a million times: where there’s shit there’s always flies.

This is a fascinating story, one which shouldn’t be relegated to the inner depths of the health section of the newspaper, but should be on the front page and topic one on every cable news show. The fact that we’ve barely discussed why everything costs so damn much in American hospitals is very telling. By all means, let’s continue to “debate” phantoms like death panels and socialized medicine while the real issues go ignored.

Even as the cost of Obamacare plummets, much to the GOP’s dismay, our for-profit hospitals continue to fleece the American people with stuff like $2,000 stitches, while the rest of the developed world gets their bumps and scrapes taken care of without breaking the bank. Hell, maybe we all need to take basic First Aid classes and just do this shit ourselves at home.

This is something we can change, easily. All we need is the political will. There is no reason for us to pay more for this stuff except the greed of the healthcare sector:

The main reason for high hospital costs in the United States, economists say, is fiscal, not medical: Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market.

Rising costs of drugs, medical equipment and other services, and fees from layers of middlemen, play a significant role in escalating hospital bills, of course. But just as important is that mergers and consolidation have resulted in a couple of hospital chains — like Partners in Boston, or Banner in Phoenix — dominating many parts of the country, allowing them to command high prices from insurers and employers.

Sutter Health, California Pacific Medical Center’s parent company, operates more than two dozen community hospitals in Northern California, almost all in middle-class or high-income neighborhoods. Its clout has helped California Pacific Medical Center, the state’s largest private nonprofit hospital, also earn the highest net income in California. Prices for many of the procedures at the San Francisco hospital are among the top 20 percent in the country, according to a New York Times analysis of data released by the federal government.

“Sutter is a leader — a pioneer — in figuring out how to amass market power to raise prices and decrease competition,” said Glenn Melnick, a professor of health economics at the University of Southern California. “How do hospitals set prices? They set prices to maximize revenue, and they raise prices as much as they can — all the research supports that.”

Couple this with the vast amounts of cash pouring in to steal our elections and it’s easy to see why this country has been torn apart over a Libertarian, market-based, modest regulating of the healthcare markets.

Anyway, follow the link and give the article a read. It may raise your blood pressure, but if it leads to action, that’s a good thing.

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Filed under healthcare

Identity Theft Memory Hole

It’s very amusing that people have suddenly discovered the identity theft issue, but it’s really annoying that they only seem to care about it in relation to Healthcare.gov. It’s not like your private insurance company doesn’t have all of this same information, folks, and it’s not like they are any less vulnerable to theft than Obamacare.

Let’s take a trip into the memory hole and go waay back to 2009. Oh lookie here: BlueCross BlueShield of Tennessee had 57 hard drives containing unencrypted client identity information stolen from a closet at its Chattanooga office.

Or how about back in 2007, when thieves stole laptops containing the Davidson County voter rolls — which include everyone’s social security numbers?

We’re always hearing about data breaches at places like Amazon.com and PayPal. I need look no further back than October 2013 when the State of Tennessee, which processes my paychecks, lost all of my information — not just social security number and passport number but also my freaking bank account number, because I signed up for direct deposit. All of it … gone. Not only did I not get paid for an entire month but now I have to worry about what the hell happened to this sensitive information. Probably nothing, but should I take this risk?

Wingers are going nuts about the Obamacare website exposing people to identity theft, but it’s not like everyone’s information isn’t available to thieves in a thousand other ways, too. Identity theft isn’t new, and it isn’t something Obamacare has brought on.

I find this incredibly annoying.

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Filed under Blue Cross, health insurance, healthcare, Obamacare

Things That You Can’t Buy Anymore

John Cole nailed it last night:

I find this whole “Obama lied” about keeping your plan nonsense to be quite distressing. The only reason people are not able to keep their plans is that insurance companies no longer offer them. This may because the companies have decided they needed to alter the plans to be more competitive with other plans, or if the plan was so shitty that it covered nothing and the ACA requires the plan to actually do something. That’s it. Obama isn’t running around kicking people off their insurance for shits and giggles, it’s that people can’t keep their insurance plan because the companies ARE NO LONGER OFFERING IT.

There are a ton of things that used to exist that I would love to have back. The original Boomslang Razer, for example. But it doesn’t exist, because the company NO LONGER MAKES IT, so I can’t have what I believe was the best feeling mouse ever. I’m not blaming Obama for that, either.

This is exactly right, and it’s annoying the shit out of me that the news media is picking up the whole “people were kicked off their plans” language. This is what we call technically true but collectively bullshit. If your health insurance was so crappy it doesn’t pass the minimal standard, then you will need to get another one. Cry me a fucking river. Because Congress decided it’s not in the national interest for you to saddle the rest of us with your medical debt because your “insurance” is really just a scam and doesn’t cover jack when you actually need it. That’s the fucking point, people.

If you liked insurance that is basically ripping you off then you’re a moron. You’re probably one of those people who thinks a Nigerian prince wants to send you a million bucks. Guess what, that’s a scam, too.

And can I tell you how annoying I find this national pearl-clutching over what Obama said about people who like getting ripped off by their health insurance company? Jesus effin’ Christmas Tree, people, where the hell was this national pearl-clutching and word-parsing when Bush-Cheney-Rummy et. al. told us Saddam Hussein had weapons of mass destruction and we invaded and occupied Iraq and then it turned out he didn’t have them after all? My God, this “but he said it!” bullshit is gonna give me an aneurism.

The discourse in this country is so fucking annoying. Why is it Democratic presidents are always held to a higher standard than Republican ones? So President Obama said if you like your health insurance you can keep it, and then the insurance companies no longer offer these plans, and Obama is a liar and impeeeeach??! Grow the fuck up, people.

Okay, end rant.

There are a lot of things that have gone the way of the dinosaur which I miss. For example:

1- Free matchbooks at restaurants. I loved those things. I loved them as souvenirs of places I visited, restaurants I liked. I used them, too, because I love matches (not lighter wands) for things like candles and incense. I love that smell of sulfur as you light a matchstick. But no one offers them anymore because people don’t smoke anymore.

2- Public laundromats. I don’t know about where you live, but pretty much every public laundromat in Nashville has closed its doors. I use public laundromats for washing dog beds and large quilts. I don’t know what I’m going to do when the last one near me closes (which is going to be soon, I hear).

3- Liner notes. It was bad enough when liner notes shrunk down to microscopic levels to fit in CD jewel boxes. You needed a magnifying glass to read them, but they at least existed. But now with digital music, you just don’t see them at all. I miss that.

4- Neighborhood speed humps. Metro Nashville Public Works used to put them on residential streets to keep the damn speeders from roaring through our neighborhoods but now that we really really need them on my street I’m told they aren’t building them anymore. Not only that, they’re actually ripping out ones they’d already built. That kinda pisses me off.

These are things I liked and, dangit, I can’t keep ‘em. Whaah. What are yours?

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Filed under health insurance, healthcare

Julia Hurley Lost Her Insurance

That’s pretty much all you need to know about the former Republican state rep/dog surfer, who has written an Obamacare op-ed (excerpted here).

In it, Hurley states that since she lost her job and got dumped by her insurance company, she is rethinking Obamacare. As so often happens with Republicans, all bets are off once the plight of the plebes lands on their doorstep. Suddenly the social safety net isn’t the “hammock” they thought it was.

Hurley makes one good point:

I am a conservative Republican who believes in providing a future for myself without government involvement. I have been unemployed for nearly 14 months. Unable to collect unemployment and unwilling to take government assistance, I have spent nearly all my savings and, unless an employment option arrives, soon will be spending my retirement savings as well.

[...] If the Republican Party continues to fight Obamacare without offering an alternative, I fear the failure of my party is inevitable. The expectation of personal responsibility is being outweighed by the overwhelming number of unemployed voters, uninsured voters and, to be honest, voters without hope who are tired of being told to just hang in there a little longer because things will get better.

Well, join the club, honey. Yes, we’ve all been dying to know what the Republican healthcare plan is. Cue the *crickets*, right?

Then she says this:

If the Democratic Party continues to provide everything for a voter without encouraging some personal responsibility, I fear a gap between taxpayers and beneficiaries will open so wide that our government will not be able to repair the financial damages.

While I do not support the premise of Obamacare, I can fully understand the frustration of the unemployed, uninsured American. I cannot judge those who choose to use the program, for I know exactly what it is like to need it.

Gosh, I’m so old, I remember when Republicans sold the individual mandate as a “personal responsibility provision.” I mean seriously, Julia?

I still think Julia Hurley is an idiot, but she’s the kind of idiot who’s slowly starting to realize that Obamacare sure beats “I don’t care.”

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Filed under health insurance, healthcare, Tennessee, Tennessee politics