Tuesday, May 14, 2013

Filling Out the Obamacare Forms

The agenda-pu$hing media that helped it through and says you all love Obamacare so far is only because none of the costs have come due. When America sees this monstrosity come online at the end of this year Democrats might as well kiss the Senate goodbye (that's assuming the dumbed-down, drug-addled public will even be able to do it).

"Filling out the application is just the first part of the process, which lets you know if you qualify for financial help. The government asks to see what you’re making because Obama’s Affordable Care Act is means-tested, with lower-income people getting the most generous help to pay premiums. Consumers who aren’t applying for financial help still have to fill out a five-page form. Once you’re finished with the money part, actually picking a health plan will require additional steps, plus a basic understanding of insurance jargon.... 

I've already had enough. Why can't we get the health plans Congress gives to themselves? You know, the ones taxpayers are paying for?

Consumers must provide a snapshot of their finances. That potentially includes multiple sources of income, from alimony to tips to regular paychecks. On the list: unemployment, pensions, Social Security, other retirement checks, and farming and fishing income. Individuals will have to gather tax returns, pay stubs, and other financial records before filling out the application....

Related: Dr. Obama's Anal Probe

Pretty much -- and I'm told you love it, America.

Consumers who underestimate their incomes could be in for an unwelcome surprise later on in the form of smaller tax refunds....  

But banks are too big to jail.

Identification, citizenship, and immigration status, as well as income details, are supposed to be verified in close to real time through a federal ‘‘data hub’’ pinging Social Security, the Homeland Security department, and the Internal Revenue Service."

Caring about your health somehow turned into tyranny, huh? 

And shouldn't it be PATIENTS, not con$umers? Makes me feel like they want to make and keep you $ick.

"Simpler forms for health care coverage debut" by Ricardo Alonso-Zaldivar  |  Associated Press, May 01, 2013

WASHINGTON — The ease or difficulty of applying for benefits takes on added importance because Americans remain confused about what the health care law will mean for them. A Kaiser Family Foundation poll released Tuesday found that 4 in 10 are unaware it’s the law of the land. Some think it’s been repealed by Congress.

And it’s a mandate, not a suggestion. Virtually all Americans must carry health insurance starting next year, though most will just keep the coverage they now have through jobs, Medicare, or Medicaid....

Filling out the application is just the first part of the process, which lets you know if you qualify for financial help. The government asks to see what you’re making because Obama’s Affordable Care Act is means-tested, with lower-income people getting the most generous help to pay premiums. Consumers who aren’t applying for financial help still have to fill out a five-page form.

Once you’re finished with the money part, actually picking a health plan will require additional steps, plus a basic understanding of insurance jargon....

While the first drafts of the applications were widely panned, the new forms were seen as an improvement. Still, consumers must provide a snapshot of their finances. That potentially includes multiple sources of income, from alimony to tips to regular paychecks.

On the list: unemployment, pensions, Social Security, other retirement checks, and farming and fishing income. Individuals will have to gather tax returns, pay stubs, and other financial records before filling out the application....

Administration officials expect most people to apply online. The process will route consumers to either private plans or Medicaid. Identification, citizenship, and immigration status, as well as income details, are supposed to be verified in close to real time through a federal ‘‘data hub’’ pinging Social Security, the Homeland Security department, and the Internal Revenue Service.

Under Obama’s overhaul, insurers will no longer be able to turn away the sick or charge them more. The pitfalls of giving the wrong answer to a health care question will be gone, but consumers who underestimate their incomes could be in for an unwelcome surprise later on in the form of smaller tax refunds.

One section eliminated in the new form asked applicants if they also wanted to register to vote. Some congressional Republicans had criticized that, calling it politically motivated.


The new forms that REPLACE NO FORMS are better, yeah. 

So HOW MUCH is all this going to CO$T US?

"Six million may face penalties under health care law" by Alonso-Zaldivar Ricardo  |  Associated Press, September 20, 2012

WASHINGTON — Nearly 6 million Americans, most of them in the middle class, will face a tax penalty for not carrying medical coverage once President Obama’s health care overhaul law is fully in place, congressional budget analysts said Wednesday.

The new estimate amounts to an inconvenient fact for the administration, a reminder of what critics see as broken promises.

They have broken so many we are jaded.

The numbers from the nonpartisan Congressional Budget Office are 50 percent higher than a previous projection by the same office in 2010, shortly after the law passed. The earlier estimate found 4 million people would be affected in 2016, when the penalty is fully in effect.

That’s still only a sliver of the population, given that more than 150 million people currently are covered by employer plans. Nonetheless, starting in 2014, virtually every legal US resident will be required to carry health insurance or face a tax penalty, with exemptions for financial hardship, religious objections, and certain other circumstances. Most people will not have to worry about the requirement because they already have coverage through employers, government programs such as Medicare, or by buying their own policies.

Given the jobs crisis in this country that is no assurance.

A spokeswoman for the Obama administration said 98 percent of Americans will not be affected by the tax penalty, and suggested that those who will be should face up to their civic responsibilities.


So, WHEN are you going to FACE UP TO YOURS?


I didn't see an e$timate, did you?

Also see:

Mass. health law thrown a curve by Obamacare
Slow Saturday Special: Obamacare Makes Massachusetts Mad 
Mass. push offers lesson on selling Obamacare
Health costs in Mass. are heading upward

And we are the model.

Darden tries expanding part-timers

It's to avoid Obamacare, as was predicted. 

"Insurers apt to pass $63 health care fee to workers" by Ricardo Alonso-Zaldivar  |  Associated Press, December 11, 2012

WASHINGTON — Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new $63-per-head fee to cushion the cost of covering people with preexisting conditions under President Obama’s health care overhaul.

The charge works out to tens of millions of dollars for the largest companies, employers say. Most of that is likely to be passed on to workers.

But you are going to love it!

Chantel Sheaks, an employee benefits lawyer, calls it a ‘‘sleeper issue’’ with significant financial consequences, particularly for large employers.

‘‘Especially at a time when we are facing economic uncertainty, [companies will] be hit with a multimillion dollar assessment without getting anything back for it,’’ said Sheaks, a principal at Buck Consultants....

The insurance fee had been overlooked as employers focused on other costs in the law....

The fee will be assessed on all ‘‘major medical’’ insurance plans, including those provided by employers and those purchased individually by consumers. Large employers will owe the fee directly. That’s because major companies usually pay upfront for most of the health care costs of their employees. It may not be apparent to workers, but the insurance company they deal with is basically an agent administering the plan for their employer.

Oh, I think it will be -- unle$$ it is hidden in the fine print of the form.

The fee will phase out in 2017 — unless Congress decides to extend it.

I'm sure a fee will be extended (and increased) by this government, just as a tax break for business or the wealthy would be added or extended.


Who el$e can they fined?

"Medicare to fine hospitals for readmissions; Penalties per facility average about $125,000" by Ricardo Alonso-Zaldivar  |  Associated Press,  October 01, 2012

WASHINGTON — Medicare patients who have been hospitalized recently may have noticed extra attention when the time came to be discharged, but there’s more to it than good customer service.

As of Monday, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications.

Can anyone predict the outcomes of medical procedures with certainty? WTF?

The penalties are part of a broader push under President Obama’s health care law to improve quality while also trying to save taxpayers money.

I'm all for that, but try it on Wall Street and the Pentagon! 

About two-thirds of the hospitals serving Medicare patients, or some 2,200 facilities, will be hit with penalties averaging about $125,000 per facility this coming year, according to government estimates.

Data to assess the penalties have been collected and crunched, and Medicare has shared the results with individual hospitals.

Medicare plans to post details online later in October, and people can look up how their community hospitals performed by using the agency’s ‘‘Hospital Compare’’ website.

It adds up to a new way of doing business for hospitals, and they have scrambled to prepare for well over a year.

They are working on ways to improve communication with rehabilitation centers and doctors who follow patients after they are released, as well as connecting individually with patients....

Still, industry officials say they have misgivings about being held liable for circumstances beyond their control.

They also complain that facilities serving low-income people, including many major teaching hospitals, are much more likely to be fined, raising questions of fairness....

Obama $hould be a$hamed of him$elf.

Consumer advocates say Medicare’s nudge to hospitals is long overdue and not nearly stiff enough....

Dr. John Santa, director of the Consumer Reports Health Ratings Center, said,  ‘‘Should we be surprised that industry is objecting? You would expect them to object to anything that changes the status quo.’’ 

I wanted single-payer.


If General Motors and Toyota issue warranties for their vehicles, hospitals should have some similar obligation when a patient gets a new knee or a stent to relieve a blocked artery, Santa contends. ‘‘People go to the hospital to get their problem solved, not to have to come back,’’ he said.

Well, I agree there. We all want them to perform the operation as it should be. Unfortunately, horror stories abound in AmeriKan health care.

Excessive rates of readmission are only part of the problem of high costs and uneven quality in the health care system....

Under Obama’s health care overhaul, Medicare is pursuing efforts to try to improve quality and lower costs. They include rewarding hospitals for quality results, and encouraging hospitals, nursing homes and medical practice groups to join in ‘‘accountable care organizations.’’


Dozens of pilot programs are under way. The jury is still out on the results.

They will render the verdict when they get the forms. No one is going to want to do it.


At least the care is good, right?

"Medicare paid $5.1b for poor nursing home care" by Garance Burke  |  Associated Press, March 01, 2013

SAN FRANCISCO — Medicare paid about $5.1 billion in taxpayer dollars to nursing homes that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services’ inspector general, said one out of every three stays in nursing homes in 2009 were in facilities that failed to follow basic care standards laid out by the federal agency that administers Medicare.

In some cases, the conditions were dangerous and neglectful, the report said.

The elderly and other patients who need daily help from a nurse or therapist typically are sent to skilled nursing facilities, which can get reimbursed by the government for much of the care they provide.

By law, they need to write up care plans specially tailored for each resident, so doctors, nurses, therapists, and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental, and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people’s health, the report concluded.

The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation’s sweeping health care overhaul.

And this isn't making me feel any better about it.

The review prompted sharp criticism Thursday from the head of the Senate Special Committee on Aging.

‘‘Spending taxpayers’ money on facilities that provide poor care is unacceptable,’’ said the committee’s chairman, Senator Bill Nelson, Democrat of Florida. ‘‘The government must do a better job of ensuring Medicare beneficiaries receive the highest quality of care.’’



Milton doctor, others charged in Medicaid kickback
91 charged in $429m Medicare fraud
Newton man ordered to pay $700,000 for kickback scheme
Policy shift likely to allow more home health care access
Shortage of doctors spreading throughout US

"Medicare premiums are going up $5 a month in 2013, the government said Friday. It’s less than expected, but still enough to eat up about one-fourth of a typical retiree’s cost-of-living raise next year. Advocates for the elderly didn’t see much to cheer about, particularly since Medicare cuts are on the table in budget negotiations....

And now Obama wants to chain the CPI so your standard of living will drop even more.


RelatedMedicare premiums could rise for many retirees

More than $5 a month?

"Medicare payment changes draw fire; Neurologists rip lower test fees" by Chelsea Conaboy  |  Globe Staff, November 26, 2012

Neurologists in Boston and nationwide are objecting to a plan that would pay them less for certain diagnostic tests, a change meant to cut Medicare costs and direct more money to primary care physicians whose pay is widely seen as inadequate even before they take on more work under the national health care overhaul.

The neurologists are asking federal regulators to reconsider the plan and argue that the cuts, made under a provision of the Affordable Care Act, could undermine patient care and limit access to neurology services.

The debate highlights the short-term pain and pressure expected from changing the way health care is paid for, a process certain to produce winners and losers....

I was told we were all going to be winners.


At least costs are coming down, right?

"Health insurers still seek steep premium increases; Rates going up fastest in states with weaker rules" by Reed Abelson  |  New York Times, January 06, 2013

NEW YORK — Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

Or pay tax. 

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of their policy holders, according to the insurers’ filings with the state for 2013.

The rate requests in California are all the more striking after a 39 percent increase sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed two years ago.

In other states, such as Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies....

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy....

But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

‘‘This is business as usual,’’ Jones said. ‘‘It’s a huge loophole in the Affordable Care Act.”

Now I am feeling sick.



GOP governors walk fine line on health care law
Pennsylvania won’t set up health exchange, governor says
Tennessee will not expand Medicaid

Can you blame them?

‘‘I have never seen an industry with more gaping security holes,’’ said Avi Rubin, a computer scientist and technical director of the Information Security Institute at Johns Hopkins University. ‘‘If our financial industry regarded security the way the health care sector does, I would stuff my cash in a mattress under my bed.’’ 

That's the best place for it considering the deposit grab by the banks. 

At least the faulty $ecurity is $aving you money, right?

"Electronic health records yet to deliver, study finds" by Reed Abelson and Julie Creswell  |  New York Times,  January 11, 2013

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corp.

At least $ome high-tech companies got healthy.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,’’ said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric Co. and Cerner Corp., that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, from $1 billion to a projected $3 billion in 2013.

The report predicted that widespread use of electronic records could save the US health care system at least $81 billion a year, a figure RAND now says was overstated.

The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

More $timuloot. 

Also see: Administration Telling the Truth About Stimuloot

That's a first.

Many soecialists say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money.

Making that more efficient!

Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records.

Technology ‘‘is only a tool,’’ said Dr. David Blumenthal, who helped oversee the federal push for the adoption of electronic records under President Obama and is now president of the Commonwealth Fund, a nonrofit health group. ‘‘Like any tool, it can be used well or poorly.’’

While there is strong evidence that electronic records can contribute to better care and more efficiency, Blumenthal said, the systems in place do not always work in ways that help achieve those benefits.



"Health care tax hikes for 2013 may be just start" by Ricardo Alonso-Zaldivar  |  Associated Press, December 26, 2012

WASHINGTON — New taxes are coming Jan. 1 to help finance President Obama’s health care overhaul.

Most people may not notice, because the taxes are aimed at the health industry and high-income taxpayers. But they will pay attention if Congress starts taxing employer-sponsored health insurance, one option in play if lawmakers can ever agree on a budget deal to reduce federal deficits.

The tax hikes already on the books, taking effect in 2013, fall mainly on people who make lots of money and on the health care industry. But about half of Americans benefit from the tax-free status of employer health insurance.

Workers pay no income or payroll taxes on what their employer contributes for health insurance, and in most cases on their own share of premiums as well.

It’s the single biggest tax break the government allows, outstripping the mortgage interest deduction, the deduction for charitable giving, and other better-known benefits. If the value of job-based health insurance were taxed like regular income, it would raise nearly $150 billion in 2013, according to congressional estimates.

You just got a "rai$e," American.

By comparison, wiping away the mortgage interest deduction would bring in only about $90 billion.

Which goes mostly to the wealthy. I'm not saying it should be taken away from average Americans because that is often the only thing they have of significant equity, but that is fact. 

‘‘If you are looking to raise revenue to pay for tax reform, that is the biggest pot of money of all,’’ said Martin Sullivan, chief economist with Tax Analysts, a nonpartisan publisher of tax information.

It’s hard to see how lawmakers can avoid touching health insurance if they want to eliminate loopholes and curtail deductions so as to raise revenue and lower tax rates. Congress probably would not do away with the health care tax break, but limit it in some form. Such limits could be keyed to the cost of a particular health insurance plan, the income level of taxpayers, or a combination.

Many economists think some kind of limit would be a good thing because it would force consumers to watch costs, and that could help keep health care spending in check. Obama’s health law took a tentative step toward limits by imposing a tax on high-value health insurance plans. But that does not start until 2018.

The way I watch costs? I don't go.

Next spring will be three years since Congress passed the health care overhaul but, because of a long phase-in, many of the taxes to finance the plan are only now coming into effect.

That's why we are told Americans love Obamacare so far. Wait until they get a load of this.

Medicare spending cuts that help pay for covering the uninsured have started to take effect, but they also are staggered.

The law’s main benefit, coverage for 30 million uninsured people, will take a little longer. It does not start until Jan. 1, 2014.

The biggest tax increase from the health care law has a bit of mystery to it.

We don't want to see that.

The legislation calls it a ‘‘Medicare contribution,’’ but none of the revenue will go to the Medicare trust fund. Instead, it’s funneled into the government’s general fund, which pays the lion’s share of Medicare outpatient and prescription costs, but also covers most other things the government does.

That's how they stole social security.

The new tax is a 3.8 percent levy on investment income that applies to individuals making more than $200,000 or married couples above $250,000. Projected to raise $123 billion from 2013-2019, it comes on top of other taxes on investment income.

While it applies to profits from home sales, the vast majority of sellers will not have to worry since another law allows individuals to shield up to $250,000 in gains on their home from taxation. (Married couples can exclude up to $500,000 in home sale gains.)

Investors have been taking steps to avoid the tax, selling assets this year before it takes effect. The impact of the investment tax will be compounded if Obama and Republicans cannot stave off the automatic tax increases coming next year if there is no budget agreement.

High earners will face another new tax under the health care law Jan. 1. It’s an additional Medicare payroll tax of 0.9 percent on wage income above $200,000 for an individual or $250,000 for couples. This one goes to the Medicare trust fund.

Donald Marron, director of the nonpartisan Tax Policy Center, says the health care law’s tax increases are medium-sized by historical standards. The center, a joint project of the Brookings Institution and the Urban Institute, provides in-depth analyses on tax issues.

They also foreshadow the current debate about raising taxes on people with high incomes. ‘‘These were an example of the president winning, and raising taxes on upper-income people,’’ said Marron. ‘‘They are going to happen.’’

That debate faded away quick, right after the election.

Other health care law tax increases taking effect Jan. 1 include a 2.3 percent sales tax on medical devices used by hospitals and doctors. Industry is trying to delay or repeal the tax, saying it will lead to a loss of jobs. Several economists say manufacturers should be able to pass on most of the cost.

Related: Budgeting My Posts 

Mission accomplished.

Also taking effect is a limit on the amount employees can contribute to tax-free flexible spending accounts for medical expenses. It is set at $2,500 for 2013, and indexed thereafter for inflation.

Efforts to save the nation from going over the year-end ‘‘fiscal cliff’’ of automatic tax increases and budget cuts were in disarray as lawmakers left Washington for their Christmas break. ‘‘God only knows’’ how a deal can be reached now, House Speaker John Boehner declared.

Related: Sunday Globe Specials: Fiscal Cliff Fraud

The tax increase was actually a tax cut?

Obama, on his way out of town for a vacation in Hawaii, insisted a bargain could still be struck before Dec. 31. ‘‘Call me a hopeless optimist,’’ he said.

If Congress and the president fail to meet the deadline, some scary fiscal forces come together at the start of 2013.

They include about $536 billion in tax increases, touching nearly all Americans, because various federal tax cuts and breaks expire at year’s end. About $110 billion in spending cuts would be divided equally between the military and most other federal departments.

With the military money restored.


Anything el$e hidden in the fine print?

"Some health care taxes, fees will debut on Jan. 1" Associated Press, December 26, 2012

Starting in 2014, President Obama’s health care law will expand coverage to some 30 million uninsured people. For most people, the law will not mean sending more money to the Internal Revenue Service. But the wealthiest 2 percent of Americans will take a hit, starting next year.

And roughly 20 million people eventually will benefit from tax credits that start in 2014 to help them pay insurance premiums.

A look at some of the major taxes and fees, estimated to total nearly $700 billion over 10 years.

■  Upper-income households. Starting Jan. 1, individuals making more than $200,000 per year, and couples making more than $250,000 will face a 0.9 percent Medicare tax increase on wages above those threshold amounts. They will also face an additional 3.8 percent tax on investment income. Together these are the biggest tax increases in the health care law.

■  Employer penalties. Starting in 2014, companies with 50 or more employees that do not offer coverage will face penalties if at least one of their employees receives government-subsidized coverage. The penalty is $2,000 per employee, but a company’s first 30 workers do not count toward the total.

■  Health care industries. Insurers, drug companies, and medical device manufacturers face new fees and taxes. Companies that make medical equipment sold chiefly through doctors and hospitals, such as pacemakers, artificial hips and coronary stents, will pay a 2.3 percent excise tax on their sales, expected to total $1.7 billion in its first year, 2013. The insurance industry faces an annual fee that starts at $8 billion in its first year, 2014. Pharmaceutical companies that make or import brand-name drugs are already paying fees; they totaled $2.5 billion in 2011.

■  People who do not get insurance. Nearly 6 million people who do not get health insurance will face tax penalties starting in 2014. The fines are estimated to raise $6.9 billion in 2016. Average penalty in that year: about $1,200.

That's to start.

■  Indoor tanning devotees. The 10 percent sales tax on indoor tanning sessions took effect in 2010. It is expected to raise $1.5 billion over 10 years. Tanning salons were singled out because of strong medical evidence that exposure to ultraviolet lights increases the risk of skin cancer.

But they look so good!


"Health insurers to report all hikes to government" by Robert Pear  |  New York Times, March 04, 2013

WASHINGTON — The Obama administration says it will require health insurance companies to report all price increases, no matter how small, to the federal government so officials can monitor the impact of the new health care law and insurers’ compliance with it....

Insurers object to the requirements. The federal government ‘‘is creating a hugely burdensome and expensive reporting system’’ that duplicates what most states already require, the Blue Cross and Blue Shield Association said....

A fierce debate has erupted over the impact of President Obama’s health care law. Insurers and employers predict it will drive up premiums, especially for healthy people under 35. The White House disputes that prediction and says that many factors will lead to lower prices....


The law guarantees coverage for people regardless of preexisting conditions, prohibits insurers from charging women more, and limits their ability to charge higher rates to older people.

Insurers now often divide consumers into groups. Premiums are often higher and rise faster for less healthy individuals and groups.

By contrast, the new law requires insurers to pool the claim costs of all their customers when setting rates in the individual market in a state. Likewise, insurers must consider the claims histories of all their small-business customers when setting rates for them. Premiums for each product are supposed to reflect the combined experience of all products in the market.

Federal health officials said they needed to know the prices of all insurance products so they could determine whether insurers were complying with these requirements.

If an insurer wants to increase rates for any product, it ‘‘must submit a rate filing justification for all products’’ in the same market, the rule says. ‘‘Products can no longer be reviewed as completely unique,’’ but must reflect the experience of the entire market.


"Health care costs increase slightly again; Respite provides potential for tighter controls" by Ricardo Alonso-Zaldivar  |  Associated Press, January 08, 2013

WASHINGTON — Americans kept health care spending in check for three years in a row, the government reported Monday, an unusual respite that could linger if the economy stays soft or fade like a mirage if job growth comes roaring back.

The nation’s health care tab stood at $2.7 trillion in 2011, the latest year available, said nonpartisan number crunchers with the Department of Health and Human Services. That is 17.9 percent of the economy, which averages out to $8,680 for every man, woman, and child, far more than any other economically advanced country spends.

Still, it was the third straight year of historically low increases in the United States. The 3.9 percent increase meant that health care costs grew in line with the overall economy in 2011 instead of surging ahead as they normally have during a recovery. A health care bill that grows at about the same rate as the economy is affordable; one that surges ahead is not.

The respite means President Obama and lawmakers in Congress have a window to ease in tighter cost controls this year, if they can manage to reach a broader agreement on taxes and spending. Health care spending is projected to spike up again in 2014, as Obama’s law covering the uninsured takes full effect, before settling down to a new normal.

That term means you are getting $crewed.

‘‘Economic, income, and job growth in 2011 was modest and less than might normally be expected during an economic recovery,’’ said the report from the government’s National Health Expenditure Accounts Team. ‘‘This fact raises questions.’’

Yeah, a hell of a lot of them!

The slowdown in health care spending has been widely debated. Some experts see it as an echo-chamber effect of a weak economy. Others say cost controls by government and employers are starting to have an effect. Many believe costs need to be squeezed more.

‘‘I think it’s a big opening,’’ said Ken Thorpe, a professor of health policy at Emory University in Atlanta, who served in the Clinton administration as a senior adviser. ‘‘If we have a debate on entitlement reform this year, we need to come up with ideas for pulling costs out of the system.’’

Cutting payments to hospitals and doctors won’t solve the problem, said Thorpe. The challenge is to slow the spread of chronic illnesses such as diabetes while also finding ways to keep patients healthier and out of the hospital.

The numbers back up Thorpe’s observation. Health care spending is highly skewed toward the sickest people. Five percent of patients account for nearly half the total spending in any given year.

Then let's just kill them or let them die. Isn't that the point of the panels that will decide who gets the rationed care this is all leading to?


RelatedHealth costs could spike by 32%

But Obama says.... (sigh). 

UPDATE: Insurers predict 100% to 400% Obamacare rate explosion 

Who do you think is going to pay for it, taxpayers?

"Hospital charges bring a backlash; Patients objecting; state adds scrutiny" by Liz Kowalczyk  |  Globe Staff, March 11, 2013

Patients, angered by surprise surcharges that hospitals tack on bills for doctor visits, are increasingly challenging these fees — sometimes even refusing to pay.

Hospitals say the charges cover their overhead, but the fees are sometimes added to the bill even when patients are treated in offices miles away from the medical centers.

The fees can reach hundreds of dollars, and some resistant patients end up being pursued by collection agencies. Others, such as Wendy Frosh, are dropping longtime caregivers in favor of physicians not employed by hospitals.

Tufts Medical Center charged Frosh a $500 “facility fee’’ for a routine 20-minute exam in an adjacent office building — on top of roughly $250 a surgeon billed for his services, she said. After complaining in vain to Tufts, Frosh switched to a new doctor.

“I am willing to spend my money for my doctor — I am getting expert care,’’ said the New Hampshire resident. “I am not willing to pay $500 to sit in a waiting room.’’

State officials have taken notice of the uproar. The Health Policy Commission, a newly created agency that monitors health care costs, decided to examine these so-called “facility fees” after the Globe published a story in January about a patient charged $1,525 in operating room and facility fees for a minor skin procedure.

Related: Massachusetts Hospitals Are $ick

And a spokesman for Attorney General Martha Coakley said last week her office is reviewing the practice after receiving complaints from consumers....

Related: The Massachusetts Model: The AG's Amnesia 

Yeah, everyone knows what is driving up co$ts and everyone acts like they don't know.


Also seeKey health panel left without funds

Maybe there is still hope.

"Health law component to be delayed" New York Times, April 02, 2013

WASHINGTON — Unable to meet tight deadlines in the new health care law, the Obama administration is delaying parts of a program intended to provide affordable health insurance to small businesses and their employees, a major selling point for the health care legislation.

The law calls for a new insurance marketplace specifically for small businesses, starting next year. But in most states, employers will not be able to get what Congress intended: the option to provide workers with a choice of health plans. They will instead be limited to a single plan.

This choice option, already available to many big businesses, was supposed to become available to small employers in January 2014. But administration officials said they would delay it to 2015 in the 33 states where the federal government will be running insurance markets known as exchanges. And they will delay the requirement for other states as well.

The promise of affordable health insurance for small businesses was portrayed as a major advantage of the new health care law, mentioned often by White House officials and Democratic leaders in Congress as they fought opponents of the legislation.

Supporters of the health care law said they were disappointed by the turn of events.

The delay will ‘‘prolong and exacerbate health care costs that are crippling 29 million small businesses,’’ said Senator Mary L. Landrieu, a Louisiana Democrat and chairwoman of the Senate Committee on Small Business and Entrepreneurship.

In the weeks leading up to passage of the health care legislation in 2010, Landrieu provided crucial support for the measure, after securing changes to help small businesses.

The administration cited ‘‘operational challenges’’ as a reason for the delay. As a result, it said, most small employers buying insurance through an exchange will offer just a single health plan to their workers next year.

Health insurance availability and cost are huge concerns for small businesses. They have less bargaining power than large companies.

The 2010 law stipulates that each state will have a Small Business Health Options Program, or SHOP exchange, to help employers compare health plans.



"The experience here doesn’t fully comport with President Obama’s recent assertion that the new law is “working fine.” Massachusetts’s experience, after all, isn’t an isolated one. According to The New York Times, a number of anxious Democratic senators expressed frustration with Obamacare’s implementation at a recent meeting with White House officials. The White House should take heed. When even supporters start raising red flags, it behooves the president and his administration to pay closer attention."

They haven't so far, so why now?

Also seeAnother round for the House on 'Obamacare' 

Sadly, it is on life-support which will be taken away in the Senate via neglect. I hold Chief Justice Roberts culpable for this monstrosity as well since it is well known he bowed to pressure after deciding against it; however, one also sadly looks at the House as the last backstop against Obama. Looking like the Senate goes that way next year so that will help to a certain, slim degree. The whole program is the same, but the best thing is to have bickering and inertia before they make things worse (as they always do when they try to fix things, I mean, a tax increase on the rich that is a cut?