Health Insurance Costs for Colorado Mountain Residents

There was a disturbing article in the Denver Post about the cost of health insurance in the Colorado high country. Health insurance premiums in one western Colorado region jumped 25.8 percent this year for people buying their own policies. That percentage increase sounds huge, but it seems small when quoting actual costs. One woman’s premium increased by more than $300 to $1828 per month, or nearly $22,000 per year. And it gets worse. The policy contains a $4,000 deductible for each her and her husband. Health care costs are significantly higher in the mountain communities compared to the metro areas and there are fewer insurers, which results in little if any competition.

Many people are obviously going to have to consider going uninsured, even though there are IRS penalties for being uninsured imposed by the Affordable Care Act, or “Obamacare.” The Act required the creation of geographical ratings within each state, and the mountain areas are locked into a high rating. Federal approval is required to revise them. One person is paying $1,590 a month for health insurance while an identical plan in Denver would cost $851. People are being forced to consider moving to Utah or Denver. Some are actually wishing they were older so they can be on Medicare. One woman commented, “It’s the first time I’ve heard 60-year-olds saying they wished they were 65.”

I didn’t find a proposed solution to the problem for people who don’t want to move or somehow find a way to quickly become 65. The term “Affordable” is misplaced for some of our citizens.

Another Unintended Consequence of Obamacare

The commentary posted last week was about the financial burden being placed on States by Obamacare. The article titled “Electronic care: Why doctors quit,” by Charles Krauthammer describes an even more important unintended consequence. Doctors who have small practices, often the doctors in rural communities, don’t have the financial resources or technology support to comply with the law. They are retiring because the law requires so much of their time is used for regulatory compliance rather than providing health care. According to the article, the law has created “…a deep erosion of their autonomy and authority, a transformation from physician to ‘provider’.”

The article says virtually every doctor expresses bitterness about the electronic health records (EHR) mandate that produces “…nothing more than ‘billing and legal documents’—and degraded medicine.” One doctor observed that “…introduction of the electronic medical record into our office has created so much more need for documentation that I only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.” Medical practices that hadn’t gone electronic by January 1st have had their Medicare payments cut by one percent. That penalty increases to three to five percent in future years.

What has Obamacare accomplished? Many more people have Medicaid, and that means it takes weeks or months to get an appointment at one of the few places that still accept it. Fifty year old women had their health insurance declared “non-compliant” because they didn’t have maternity coverage. Obamacare has accomplished spending $27 billion on “going paperless,” although the promised $77 billion in savings is nowhere to be found. None of this will make an impression on those who believe government should be in charge of our lives because we and those who have the archaic attitude that they want to own a profitable business can’t be trusted.

Unintended Consequences of Obamacare

This posting only focuses on one unintended consequence, but it is certainly important to the budgets of state governments. According to an article by Carala K. Johnson of the Associated Press, “A tax on health insurers is helping pay for President Barrack Obama’s health care law, but it’s proving costly to state governments—as much as $13 billion in less than a decade.” The Health Insurance Provider’s Fee was supposed be covered by insurance companies because they would earn a windfall from Obamacare.  Those who wrote the law believed those companies should pay for the expansion of coverage, but they apparently didn’t know how business works. The insurance companies raised prices to cover the costs of the new tax instead of just absorbing the cost. Businesses tend to continue to stay in business by making profits from their activities. Expecting the insurance companies to simply absorb additional costs was, to be kind, both naïve and silly.

The price increases passed on by the insurers affected state Medicaid programs, and they have had a huge impact. “State governments pay insurers for the tax; the insurers then pay the tax to the federal government. The federal government then reimburses part of the costs to the state. It might sound absurd, but it’s not amusing to state governments, which lose 54 cents for each dollar of insurance tax.” Another strange and detrimental impact of the law is that the health care tax is not deductible for insurance companies, so state governments must provide additional funds to cover that additional cost.

I find the false economics isn’t the saddest part of the story. One of my doctors made the comment that insurance provided by Medicaid “is a myth.” He explained that people think they have Medicaid insurance, but find that a limited and shrinking number of medical practices accept Medicaid patients. The result is that a person with Medicaid coverage must wait many weeks or even months for an appointment. Not a good thing if you have a medical need. The outcome is that people who have Medicaid aren’t getting health care and the States are paying penalties. Maybe we should be thinking about a better way of solving the problem. Maybe businesses that have a reputation for finding competitive solutions to problems could be lured in by the promise of profits.

As an aside, I’ve heard one of the best parts of Obamacare is the allowing children to remain on their parent’s plans until age 26. If that’s such a great idea, why not 36, 56, or until the parents are no longer around? (Just kidding, maybe?)

“Let’s Kill All the Psychiatrists!”

anatomy-of-an-epidemicL. Ron Hubbard was one of the most prolific writers in history, authoring more than 1100 books. He was also the founder of the Church of Scientology, arguably one of history’s most controversial quasi-religious organizations. Many of the tenets upon which Hubbard based his church are inarguably crackpot, but after reading Robert Whitaker’s latest offering one could easily conclude that at least one of Hubbard’s paranoid beliefs, that psychiatric drugs and the doctors who prescribe them are the tools of the Devil, may contain a grain of truth.

Whitaker’s book, Anatomy of an Epidemic:  Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America, examines two related issues.  The first is the astronomical increase over the last 60 years in the number of Americans who have been diagnosed with anxiety, depression and bipolar disorders, and schizophrenia.  These conditions, now being diagnosed in as many as 850 adults and 250 children per day, often are so debilitating that sufferers are unable to hold a job and so become dependent on Social Security Disability Insurance (SSDI) to survive.  The exploding number of mentally disabled being granted SSDI is threatening to bust the agency’s budget as early as 2016.

In 1955, around the time that the first psychotropic drugs like Thorazine were discovered, there were 355,000 people in the US under diagnosis for psychiatric conditions.  Almost all were housed in state or county hospitals as was then standard practice.  This number represented one in 468 Americans.  By 1987, with the closing of most mental hospitals and the treatment of affective disorders well into the age of Lithium and Prozac, one in 186 Americans was on the mental patient rolls. Since then, in spite of the promises made by the psychiatric profession and Big Pharma that Selective Serotonen Reuptake Inhibitor (SSRI) drugs were the cure for America’s mental ills, the numbers are still going up.  Continue reading

Explanation for how the Affordable Care Act (AKA Obamacare) Became Law

Charles Krauthammer wrote an editorial describing how recently released videos of MIT professor Jonathan Gruber, an architect of Obamacare, describing how Obamacare was written deceptively to allow it to become law. Gruber explained, “Lack of transparency is a huge political advantage. Basically call it the stupidity of the American voter or whatever, but basically that was really, really critical to getting the thing to pass. Gruber also explained that the authors of the bill realized they had to manipulate the nonpartisan Congressional Budget Office that is responsible for issuing cost estimates on any legislative proposal. “This bill was written in a tortured way to make sure CDO did not score the mandate as taxes. If the CBO scored the mandate as taxes, the bill dies.” The President even insisted in his speeches in favor of the law that what must be paid to the government if you fail to buy health insurance was not a tax. We all know that the Supreme Court declared the law constitutional because it was a tax.

There were numerous broken promises. One that was repeated on numerous occasions by the President was that “If you like your doctor, you can keep your doctor. Period. If you like your insurance, you can keep your insurance. Period. Then people learned their doctors often weren’t included in the government-approved coverage. People who had shopped for tailored health insurance were told they could not keep their insurance because it was substandard. Thus a fifty year old woman with no children remaining at home was told her insurance did not meet government standards because it did not include maternity benefits or pediatric dental coverage. Continue reading

Efforts to Protect Rocky Flats Retiree Benefits

[Note: My first newsletter, which was recently sent to Rocky Flats retirees, dealt with upcoming changes to Rocky Flats retiree benefits and contained some of the content of the following posting.]

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Signup for Newsletter

Firstly, I want to mention that readers can signup to have future RockyFlatsFacts.com (RFF.com) newsletters on RF benefits and other issues sent directly to your email by typing your email address into the box in the upper right sidebar of this website’s landing page (just below, “Get RFF.com Newsletter”), and clicking the “Subscribe” button. You will receive an email asking you to confirm your subscription – which you need to reply to – in order to complete the signup process. (Of course, I won’t spam you or give your email address to others, and you can unsubscribe at any time, no hard feelings.)

I’m unsure at this point how many future RFF.com newsletters might be forthcoming since it will depend both on the availability of new information and the level of reader interest. There’s only about a month remaining until RF retirees should receive details of the new 2015 RF benefit plans by mail and that announcement will be followed by about six weeks until (Nov. 30, 2014) retirees are required to sign up…or lose health insurance coverage.

I mentioned in a recent commentary on this website that I was alerted to some efforts to reverse the recent move by the Department of Energy (DOE) to reduce medical insurance benefits for Rocky Flats retirees and/or their spouses who are 65 and older. I have received messages about efforts to forestall these retiree benefits changes. One message contained a link to a letter to Congress asking for exemption from the new changes for people who retired from Rocky Flats prior to 1995.

However, I have since received a personal email message that “…our letter seems to be falling on deaf ears. Politicians don’t seem to have much interest in an election year…We have also contacted an attorney and discussed legal action but don’t feel there are sufficient grounds to do so.” Don’t lose your health insurance waiting for someone to stop this! Perhaps something can still be done, and I’m certain many people are thinking of what that might be. Be prepared for the likely outcome that such efforts will fail and make certain you complete the sign up requirements ahead of the deadline.

I’m well aware that some retirees won’t be helped by a decision to defer or eliminate the benefits changes for pre-1995 retirees: I happen to be in that group. I had the “pre-1995” benefits until I returned to work at Rocky Flats as a “second-tier contractor.” I was required to forego my no-cost medical insurance benefits to be able to return to work at Rocky Flats. I still remember how upset I was. I expect many pre-1995 RF retirees may feel that same anxiety being forced to cope with this current benefits change.

I will once again recommend that affected Rocky Flats retirees review the new health insurance options carefully and be prepared to sign up for a “less generous” (i.e., higher upfront cost) medical insurance coverage. The no-action alternative is to lose all Rocky Flats benefits if retirees don’t sign up before the November 30, 2014 deadline. The letter in the above link does a fine job of expressing the feelings of many pre-1995 retirees.

On a contrary note, I have also received email comments to this weblog from pre-1995 Rocky Flats retirees who believe that the retirees should not be “complaining.” Their opinion, in brief, is that pre-1995 RF retirees have enjoyed many, many years of benefits far more generous than those of most retirees in the “private sector.” I mention this in the interest of fairness and diversity of opinion. Remember that I have no official capacity on this subject and am only attempting to be a conduit for information and community feedback on this challenging issue.

Important endnote: Please be aware that I’m not providing any legal, financial, or retirement planning advice nor do I profess any special expertise and am not acting in any official capacity to disseminate Rocky Flats retiree benefits information. Please conduct your own due diligence in this matter and consult your attorney or financial planning professional, as needed, before making important benefits decisions.

The Immortal Life of Henrietta Lacks

This is another book recommended to me by my wife. Her recommendation once again led me to read a fascinating book. However, she continues to recommend books that don’t have a happy story or ending.

This book by Rebecca Skloot introduced me to a subject I hadn’t read about before. The book begins by describing how a doctor treating Henrietta’s cervical cancer shaved samples from cancerous and noncancerous areas. He gave the samples to George Gey, who had built a laboratory out of spare parts and had worked unsuccessfully for years to grow malignant cells outside the body. The cells were taken without Henrietta Lacks knowledge or permission and were labeled “HeLa.” Cells from the cancerous tumor began to replicate at an enormously rapid rate. When Gey finally determined that his lab had grown the “first immortal human cells” he began sharing samples with colleagues. The word spread and Gey was sending samples all over the country and then the world. A huge medical research industry was developed to grow cells and use them in experimentation that has resulted in the cure to many diseases. There is no way of knowing how many of Henrietta’s cells have been grown but it is estimated that there are several tens of metric tons. Continue reading