Archive | March, 2010

Health insurance claim denials, what is going to change under the Patient Protection and Affordable Care Act

31 Mar


The reality and expectations of claim denial and review may be wide apart.

The health care reform law adds these requirements:

Insured plans will have to satisfy external review requirements mandated by the state, which will be binding, or by the Secretary, but only if the state doesn’t have procedures 

Self-funded group health plans must implement an external review process in accordance minimum standards to be created by the Secretary of HHS

The above is effective the first plan year after six months following enactment of the law, generally January 1, for most plans.

Self-funded plans routinely use independent medical evaluations to settle many disputed claims when it comes to medical necessity or clinical questions.  We won’t know the full impact of all this on cost, or administrative complexity until regulations are issued but there is a good bet it will mean more cost and work for employers.

I know removal of this tattoo is not covered but it is giving me a great deal of emotional stress and I think it should be covered

In my experience insurance companies do create problems at times.  A customer service representative gives out wrong information, or incorrectly approves or denies a pre-certification.  Perhaps the administrator drops the ball and it takes far too long for a decision to be made. Maybe a claim is denied and it turns out the physician used the wrong code causing the denial of what was a legitimate eligible service.  It happens, errors are made because like all organizations including government, insurance companies are made up of people and let’s face it, on occasion people do dumb things.

But there is another side of the story.

The Wall Street Journal today contains an article about the provision of the new health care reform law that prohibits insurance companies from denying coverage to children with a pre-existing conditions, a rare occurrence by the way.  There was a picture of a women and her daughter who was denied coverage by a Blue Shield plan.  The child has multiple sclerosis and was denied payment for a drug that costs $1,000 a month.  Pretty bad stuff, right?  After all why do you have insurance anyway?

However, it turns out that the drug in question has not been approved by the FDA for use by children.  Now who is right?

For over forty five years I listened to employee complaints and heard claim appeals and in all that time I learned one thing.  Never accept what you hear on face value especially when it involves a health care claim.  People are prone to leaving out bits of the story, outright lying, or basing their case on the perceptions that (1) the doctor is always right and (2) their insurance should pay for anything and everything.

I once had the wife of an employee tell me she was going to hold me responsible for the death of her children because our plan did not cover vaccinations for Lyme Disease.  Her children were eight and ten, but the vaccine even if we did cover it could not be given to children under thirteen.  Besides, it cost $60.00 hardly a financial hardship, especially if you felt your child was at risk.  When I pointed that out, she said, ” You expect me to pay for it?”

I recall the case of a child who was being treated for months on end with IV medication for Lyme Disease, treatment after treatment did no good we were told and the plan should keep paying the $3,000 per treatment.  We sent the case out for an independent medical review and the report came back indicating there was no clinical evidence that the child actually had Lyme Disease.  The was an additional comment to the effect that what they were doing to this child bordered on child abuse.

Time after time when we obtained an independent medical review there would be questions as to the legitimacy of the treatment or the diagnosis.  Serious back surgery was denied because there were no indications it was necessary, but the patient wanted it anyway.  Many claims were related to high fees. The patient went to a non-participating doctor which generally means the fee is going to be high, the plan paid it’s normal liability based on reasonable and customary allowances and the patient wanted more paid when the doctor billed for thousands of dollars above the 90% range of other doctors for the same service.

One employee filed a claim appeal and later legal action because the plan denied a procedure to reverse a voluntary vasectomy.  All this despite the fact the plan clearly stated that this service was not covered and the employee admitted he knew that before having the procedure.  One can only wonder why the fully voluntary original vasectomy was a covered expense. The insurer who administered this plan was not acting as an insurance company because this was a self-insured plan and yet the perception would be that Blue Shield was denying claims to save money.

The point is don’t believe every horror story you see on television or read in the paper, there is always more to the story.  In addition, don’t expect much to change under the new law because the assumption that health insurance plans randomly and frequently deny claims in violation of legitimate criteria is false.  In addition, there will be an ongoing need for valid claim review because if there is not, health care costs will become even more unaffordable as benefits are expanded to millions more Americans.



Independent Medicare Advisory Board- unemployed employee benefit managers wanted

31 Mar


Let’s say you were just hired as the benefits manager for a large organization.  Your first job is to help the firm control health care costs, whatever you come up with will be negotiated with the union.  Sounds like a tough job to me, even with all the help you just received from Congress.  A lot is a stake here, the company’s earnings are suffering, dividends are at risk and something serious has to be done.

By the way, the company already tried wellness programs, HMOs, preferred provider organizations, flexible spending accounts, high deductible health plans, prescription drug managers, promoting generic drug use and has redesigned the plans several times in the last ten years to no avail.

In addition, there are certain things you cannot do in your quest to save money.  You cannot attempt to ration health care, raise premiums, increase employee cost sharing (including deductibles, coinsurance, and co payments), or otherwise restrict benefits or modify eligibility criteria. 

You gotta be kidding!  I’m outta here, how am I supposed to control company’s health care costs?   

Frankly, I don’t know why you are so upset, if the federal government can do it why can’t you?

If those criteria sound familiar, they should because they are the same as what applies to the Medicare Advisory Board:

The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria. 

But you have one disadvantage, you do not have the ability to simply say what you will pay for health care and the consequences be damned.

Leanr more about the Board here.

Student loans are the symptom-Why college costs are no different than health care costs, both rise at more than twice the cost of living

30 Mar


Do you get your money’s worth from all the health care you receive, do you get your money’s worth from a college education?  The answer is who knows, and to a large extent both depend on the involvement of the individual.  Likewise, both are considered essential by many people and both are purchased without a second thought as to the costs. 

Since 1980 college costs have risen at twice the rate of the cost of living .  I don’t recall an outcry over these costs except perhaps over the kitchen table (or granite breakfast bar) as parents try to figure out how to finance these costs.  Why do college costs go up so fast, I suspect there are many reasons which include to some extent government involvement insulating people from the cost, a great deal of inefficiency at colleges, dare I say million dollar administration salaries (na, that’s not fair) and an inability for parents who want the best for their children to be objective.  Here is more from someone more knowledgeable than I.

The Obama administration is approaching the college cost issue the same way it did health care by attacking the symptom and not the problem.  Under the just passed changes in the student loan program within the reconciliation act repayment of student loans is capped at no more than 10% of annual income.   This logic further insulates the student from costs and gives her less reason to object to cost increases.  Why don’t we question the cost of a college education, the rate of increase and the salaries of college administrators and professors, many of whom essentially have part time jobs?

This attitude of trying to help people by giving them more from the hard work of other people is pervasive in the current administration.  The goal of helping people afford college is a good one as is expanding health insurance, but the way to do both is not to subsidize flawed systems where costs continue to outstrip inflation, but to bring the costs in line.  If this is done, the need to subsidize will be reduced and the goal of making both college and health care affordable can more realistically be achieved.

And so it begins…benefits are insufficient, cost may be understated, and we may have to look at some of the provisions of health care reform

29 Mar


Contained within health care reform legislation is something called the CLASS act, a program similar to long-term care insurance that provides assistance in the home for seniors unable to perform the normal functions of daily living.  The program is voluntary and about ten million seniors are expected to sign up over the next decade.  Monthly premiums have been bandied about from $65.00 per month to $123.  Once you enroll in the program, you have a five-year waiting period before collecting benefits.  This delay in benefit payments is one of the controversial aspects of deficit reduction because Congress claimed $70 billion from this program to offset health care reform despite the fact that the $70 billion will eventually have to pay the accumulated claims.  The Congressional Budget Office has predicted that eventually this program will add to the deficit and already it is being projected that the program will cost more than estimated. Democrats claim the premiums will always be self-sustaining which means of course that premiums will rise as the participation and utilization rise.  Let’s hope the premiums never get to the level of “unaffordable.”   Surely, I jest.

Early Retiree Reinsurance

Another aspect of health care reform is a $5 billion reinsurance program for early retirees.  Under this program an employer can be reimbursed for certain health care expenses if those payments are used to lower costs for the retiree health benefits plan.  Already we are hearing that the $5 billion may not be enough money (not sure how one comes to that conclusion since this is a windfall designed to keep employers in the health care game for early retirees).  At least one member of Congress has indicated they will monitor the program and evaluate the need for more money.   Perhaps they can extend the five-year wait on the long-term care insurance to seven years and get more money from Peter to pay Paul.

These early hints simply emphasize what those of us who are critical of this version of reform have been saying.  The costs are understated or unknown and unfunded and most important Congress will never be able to keep hands off and not adjust the costs even higher during the next ten years. Both of the above examples are new entitlements, one for all Americans and one for corporations with direct transfer to Americans age 55 to 65.  

Find somewhere else to put that thing, and don’t raise my taxes while you are at it

People do not want a high voltage power line running through their backyard even if it means more reliable and cheaper electricity and they do not want to lose a new entitlement even if it means more debt and higher obligations and taxes for their children and grandchildren.

Forget about health care reform, everyone else has…for now

28 Mar


Somebody is carrying the load, it's no free lunch

The fog is descending, the memory of health care (oops, health insurance) reform is fading.  Many of the people so opposed to this legislation are about to become reconciled and complacent.  Oh heck, it’s over and there is nothing to do but to live with it.  How is that possible?  Well, there is always hope there is something in it for me. 

As one letter to the Editor in a New Jersey paper put it:

March 21 marked an historic moment when Congress passed the health care bill. To those who opposed its passage, guess what? The sky didn’t fall. Get over it. Let’s move on and deal with other issues.

 Hey, it will be years before anything substantial happens. That is not completely true, one thing substantial will happen today, health care costs will continue to rise annually well beyond inflation and the average American will continue to be oblivious to health care costs.  Why should they care, if someone else is paying your electric bill do you holler at your kids for leaving the lights on? If  your employer is paying the bulk of your premiums and those payments are tax free to you, what the heck, reform all you want all it means is I get more. 

Talk of repeal is nonsense, it is never going to happen the American people will not stand for it.  What is that you say, people want this health care reform?  In fact, some polls are showing just that, support for this legislation is growing. Over the next several months we will hear stories about children who can obtain coverage, seniors who received $250 for prescription drugs, adult children who lost coverage and now have it again and that one person in a million who did not exceed the limit on her benefits because there is none.  In other words, it all sounds quite appealing even seductive. 

My favorite unanswered or should I say unasked question is this.  If health insurers and health insurance premiums are the problem, why have large employers who can design their benefits any way they like, do not use insurance and cover about 70,000,000 Americans struggled with the cost of health care for decades?  You lie Mr. President!   Oops, sorry about that I was caught up in the moment. 

I am not sure if liberals are smarter, but they sure understand human nature better than folks who profess to approach these issues with common sense and a long-term practical view.  Nobody is elected to office by taking away a goody from the voters no matter how responsible it was to do so.  

I will never forget what a Democratic staffer in the House told me a few months back.  “We know this will mean rationing of health care at some point to control costs, my member knows it too, but we can’t say that to the American people.”  He is right you know, some form of what most people call rationing will be necessary. In fact, this expansive entitlement virtually guarantees it.  Actually, that should have happened years ago and perhaps we would not be headed for the cost crisis in health care that is still on our horizon. In many cases, less is better in health care, but an American public besieged by drug advertising, conditioned to expect a myriad of tests and more tests and expecting the latest in technology to treat acne ain’t buying the less is more scenario.  Another staffer told me flat out that as soon as the legislation passed they would get to work on changes. Congress likes to tinker. 

We accept that insurance companies and their premiums are the cause of our woes, they are abusive, they discriminate, they deny us care (still trying to figure out how that works) and their salaries and profits are exorbitant.  On the other hand, when the politicians tell us about the $500 billion they are going to save by removing the waste and fraud from Medicare, nobody asks, “Hey, I thought a government system was efficient, how is there $500 billion in waste and fraud, who is minding the store?” 

When all the provisions kick in many people will see how this legislation affects them, some will be pleased, some will perceive no changes, some Americans will have less, everyone will pay more than they do today and more than they would without reform (except those Americans receiving government subsidies).  Eventually all Americans will see higher taxes and fees to pay for this change.  No doubt, there are those who see that as the price of progress. 

However, we could have done it a better way and while we may grow accustomed to health insurance reform, we still need to accomplish health care reform and that is going to hurt.

The DNC tells me of the accomplishments of health reform legislation (and wants $5.00), let’s hope you like the ones affecting you

26 Mar


Hey, you have an extra five bucks, your health care is affordable now

I received this e-mail recently; I thought you would like to see it. Perhaps you have $5.00 or more you would like to donate. I on the other hand, have decided to save my $5.00 because I may need it if I lose my retiree prescription coverage or to help someone else pay off his mortgage.

Isn’t it comforting to know that after all this time dealing with the health care issue one of the major accomplishments is:

“we beat the insurance companies”


Richard –

We knew that power concedes nothing. So did President Obama. So did the members of Congress who courageously voted for reform, knowing that the special interests and the extreme right wing would retaliate swiftly.

The attacks are fierce. Deceptive ads are hitting the airwaves in swing districts. GOP lawmakers are pushing to repeal reform — and preventing the Senate from performing basic functions.

A few Republican attorneys general have launched a baseless attack to overturn the legislation. But that’s not even the worst of it.

A conservative blogger posted the home address of Congressman Tom Perriello, urging tea partiers to “drop by.” Other members have had death threats. Democratic offices have been vandalized.

Please chip in $5 or more to defend health reform — and those in Congress who fought to make it possible.

Showing support for reform and those who fought for it is our number one priority right now. We’re going all-out, organizing grassroots events around the country, running supportive ads on the air, and making sure that every American knows the truth about the historic legislation that representatives voted into law.

Members of Congress know that reform would not have passed without all of your incredible work. But we also know that it would not have passed without their courage.

Together, along with President Obama, we beat the insurance companies and brought affordable coverage to 32 million without it, reduced costs for families and small businesses, and created the toughest patient protections in history.

A few weeks ago, we made a simple promise to these representatives: You fight for health reform, we’ll fight for you. It’s time to hold up our end of the deal.

Please donate $5 or more:



Mitch Stewart
Organizing for America

Paid for by Organizing for America, a project of the Democratic National Committee — 430 South Capitol Street SE, Washington, D.C. 20003. This communication is not authorized by any candidate or candidate’s committee.

Contributions or gifts to the Democratic National Committee are not deductible as charitable contributions for income tax purposes.

Putting five million retirees at risk for higher health care costs – why changing the status of the Medicare Part D rebate to employers is a bad idea

26 Mar


As companies take the accounting charge related to the loss of the tax deduction for prescriptions drugs under the Medicare Part D rebate, the Administration is spinning the issue as no big deal. Well, yes it is a big deal because five million retirees may lose their company prescription benefits or see them reduced. If they are forced into Medicare Part D drug coverage these retiree’s out of pocket costs for prescription drugs will rise and they will lose the safety net of having their former employer manage their benefits and provide assistance when necessary.

This rebate was crafted not as a windfall for corporations as some in Washington now claim, but to encourage them to keep the coverage and to save the federal government money on Part D subsidies.

The White House press secretary recently said they were just closing a loophole. What nonsense, it is a pure revenue raiser for health care reform. However, keep in mind that the cost of this rebate is less than half of the governments cost per person for Part D. In a joint letter to Sen Harry Reid in December 2009, the American Benefits Council and the AFL-CIO pointed out: 


Independent calculations show that if as few as 24 percent of retirees are dropped from employer plans and obtain coverage through Medicare Part D, then Section 9012 will be a net revenue losing provision. 


This alert was dismissed out of hand as were many others pointing out the likely unintended consequences of reform as then conceived and now the law of the land.

During the Fall of 2009 I and several colleagues from other companies  met with dozens of House and Senate staffers on this issue trying to explain the impact of the change, it’s implications for retirees and the potential increase in government costs. Not one person we talked to knew about the issue or was aware it was even in the legislation. Several expressed shock, some asked that we talk to other staffers and to budget staff members.

As you can see, the result was simply ignoring all they were told.  Today the White House and others in Washington blame employers for overreacting, who will they blame when retirees lose their prescription coverage…as if we had to ask.

Myths surrounding health care reform

25 Mar


We did it, we fixed health care. It's "affordable."

I’m reading an op- ed in the New York Times, The Fight Is Over, the Myths Remain By BRENDAN NYHAN.  He talks about the myths of end of life counseling, free care for immigrants and subsidized abortion.  Indeed these are myths that have circulated about the health care reform legislation just signed into law. However, they are the insignificant myths.  The real myths are the ones that came with the legislation and which will form the basis for not only disappointment, but deep fiscal concerns.

Here are some of the real myths:

  • We have reformed health care
  • We have made health care affordable
  • If you like the plan you have, you can keep it
  • The legislation will reduce the deficit
  • The legislation will lower the cost curve for health care
  • Health insurance companies are the cause of rising health insurance premiums 

Some of you reading this will say, ha, more sour grapes from someone opposed to health care reform.  Not so, I was never opposed to health care system reform.  But the reality is that we have not done that, we have not even addressed some of the very basic problems that left unaddressed will sink the desirable goal of health insurance for all Americans. To solve our problems, we must be able to afford the solution lest we create another larger problem.  Sadly, that is exactly what we have done.  Think of it this way, you have a credit card that is out of control and you want to get out from under the debt so you pay off that card by transferring the balance to a new card…problem solved.

Big changes in dependent coverage as adult children remain in employer health plans

24 Mar


In recent years, employers have embraced the idea of dependent audits in an attempt to ferret out ineligible dependent children from health benefit plans. Most plans cover dependent children to age 19 and age 23 or 25 if the child is dependent and a full-time student.  Under the new health care law, that is all out the window and hundreds of thousands, perhaps millions of adult children are now eligible to be enrolled in their parents health plan.  In fact, in many cases there will be a strong incentive for the child to remain on the parents plan. 

It does not matter if the child is a dependent, if the child is attending college or even if the child is married.  The only exception for group plans is if the child is eligible to enroll in another employer’s coverage (but only for plan years beginning before January, 2014).  The Senate bill required the child to be unmarried but the reconciliation bill removes that language.  The law also contemplates employer contributions because there is a clear statement that such contributions will be included as income to the child unless he or she is a dependent of the employee.  However, it appears that the intent for this employer contribution not to be imputed income and changes are being made in the Reconciliation legislation. Generally speaking, the intent was to cover these children just as any younger child is covered under the employer plan.

For group health plans this change can be significant as new children come under plan coverage.  Employers who recently audited such coverage may be required to notify their employees that dropped children can be reinstated as of January 1, 2011.  In order to avoid what may be a financial hardship for workers employers may want to consider initiating this process in advance of 2011.  In addition, this will change the scope of COBRA as previously COBRA beneficiaries are returned to the active group.

These provisions are effective for plan years that begin after six months from enactment of the law – January 1, 2011 for most employer plans. 

As usual, all sections of the legislation will be subject to new regulations and employers can expect millions of pages of those over the next several years. 

Senate Bill 


(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child (who is not married) until the child turns 26 years of age. Nothing in this section shall require a health plan or a health insurance issuer described in the preceding sentence to make coverage available for a child of a child receiving dependent coverage.

Reconcilation Act

‘‘(ii) ADULT DEPENDENT COVERAGE.—For plan years beginning before January 1, 2014, the provisions of section 2714 of the Public Health Service Act (as added by this subtitle) shall apply in the case of an adult dependent with respect to a grandfathered health plan that is a group health plan only if such dependent is not eligible to enroll in an eligible employer-sponsored health plan (as defined in section 5000A(f)(2) of the Internal Revenue Code of 1986) other than such grandfathered health plan.’’. 

(b) CLARIFICATION REGARDING DEPENDENT COVERAGE.—Section 2714(a) of the Public Health Service Act, as added by section 1001(5) of the Patient Protection and Affordable Care Act, is amended by striking ‘‘(who is not married)’’.

What health care reform does and does not do

23 Mar


I guess it makes us feel good to say we have expanded coverage to all Americans, we have taken the insurance companies to task, we are making health insurance (but not health care) more “affordable, (that is, we are subsidizing coverage for some Americans)” and the wealthy and corporations pay for most of these changes. However, none of that changes the facts.

Let me first say what did not happen on the night of March 21.

The most important thing that did not happen was that we did not address the problem of rising health care costs (or much else in the delivery and payment systems). These costs are likely to continue to escalate at 8% or more a year and perhaps higher once the expanded coverage goes into effect. We also did not lower the deficit.

You wanted change, you got it!

One key assumption in the CBO calculations is that provider payments under Medicare are reduced by $250 billion dollars over the next ten years as contained in the Senate bill. That includes a 21% reduction in physician payments. The White House has already indicated it will not let this happen and in the past Congress has routinely stopped similar cuts. If the cuts do occur, there is a good chance that many physicians will no longer accept Medicare patients. This becomes more feasible because of the expanded number of insured Americans promised beginning in 2014. If the cut in payments does not occur, then this legislation easily increases the deficit.

Money is cut from Medicare Advantage Plans to keep insurance companies in line and curb excess profits. However, nobody told the eleven million Medicare beneficiaries enrolled in these plans what those cuts will mean to them. The Congressional Budget Office estimates that the changes in Medicare Advantage Plans will cause a decrease in the number of enrolled Americans. The CBO is projecting  that Medicare Advantage enrollment under the new law will decrease to 8.9 million by 2019 versus the 2009 level of 10.6 million. The Medicare Advantage program was expected to grow to 13.9 million by 2019. So much for “if you like the plan you have you can keep it.” Think of it this way, the government puts tariffs on many products from China and Wal-Mart customers are baffled. Everything is connected.

There is an approximate $10 billion a year to implement all the changes including the establishment of over one hundred new government agencies of various sizes. This amount is not even part of the CBO calculation. In addition, there is an assumption of a $70 billion revenue amount from the new long-term care premiums for a new government run insurance that workers will be automatically enrolled in upon hire. While premiums begin when the coverage starts (costing each worker about $65 per month), benefits cannot be claimed for five years. Therefore, rather than use the premiums to pay the eventual claims under the program, they are counted as assumed revenue. This is like a company claiming pension trust earnings as revenue and ignoring the accumulated pension obligations. If an insurance company did this with premiums it would be accused of abuse and end up in court.

Many other things happened whose ultimate impact is years away. For example, more very low income people will be covered by Medicaid, lower middle income Americans (families earning up to $88,000 a year) will be entitled to government subsidies on the cost of their coverage (but they will be shocked when they see their cost for the coverage they are required to purchase). The impact of going from an income of $88,000 with subsidized coverage to an income of $89,000 without subsidized benefits means many Americans will go backward before they can go forward in net income growth.

Employers who provide prescription drug coverage to their retirees will now be taxed on the rebate they receive for continuing such coverage and not requiring these retirees to enroll in Part D.  This taxation also changes accounting and will cause major income issues for these companies.  The result is that millions of retirees may lose their company coverage and thus see their individual out of pocket costs rise.

This legislation will present an entirely new set of challenges. Americans are likely to be surprised when they learn all the details of what is in this massive legislation, the true cost, who will pay and perhaps most important, how “affordable” is defined.

What do you expect from health care reform?

22 Mar

Now that it is a done deal, what do you expect from health care reform? What do you think will be the real impact on you personally?

Let’s have your comments, let’s take a practical look at real life.

Before you jump for joy over the CBO’s estimates for health care reform read the Directors Blog

22 Mar


The press is filled with the estimated savings from the health care reform reconciliation legislation.  Proponents are touting the deficit reduction aspects of the bill.  In short, you are hearing all the good stuff and not the reality.

The CBO by all accounts is a very reputable group of professionals who are constrained by the reality of what they are given to evaluate.  For example, they must assume that every aspect of the legislation will be enacted as written even if a provision is eight years into the future and left untouched by future Congresses.  That possibility is close to zero as history shows us repeatedly.

There is a great deal of uncertainty in these estimates.

You should read exactly what the Director of the CBO says about all this on his Blog   

Be careful what you wish for…you are about to get it.

21 Mar

Here is part of a message I just received from

“Richard —

Today, we can extend coverage to millions. We can end insurance-company abuses forever. We can finally give Americans control over their own health care.”

Remember these promises and consider how this massive legislation will give you more control over your health care.

And, if you think that insurance company “abuses” are what ails the health care system, watch what happens as these so-called abuses impact your premiums.

Hopefully, coverage will be extended to more Americans sometime in the future, but you should also hope that between now and then something happens to truly manage health care costs for all Americans because we are launching a massive new entitlement that will quickly consume more and more of declining national resources.

$250 for seniors, now you see it now you don’t. Is anyone serious about managing the Federal deficit?

21 Mar

Last year the President (irresponsibly) proposed providing each Social Security recipient with $250 because the formula under Social Security did not provide for an increase in Social Security benefits as a result of very low inflation.  This unnecessary spending was rejected by Congress, or so we thought.

Now we see that as part of the health care reform package that seniors are being given a $250 credit toward the cost of their prescription drugs in 2010 as part of the process to phase out the donut hole in the Part D benefit.

Hey, $250 spent is $250 spent is it not?   Perhaps not in the world of Washington accounting.  It is amazing that we hear of the benefits of health care reform in lowering the deficit and yet the legislation is filled is nice to do, but affordable goodies especially for the more important voting blocks.  Forget wellness, I think we need to promote integrity.

Health care on the verge, the weekend of March 21

20 Mar

Sadly, what should have been one of the most carefully considered debates in the history of the Country has turned out to be little more than meeting the demands of a screaming two year old.

Health care reform is critical to the United States, meeting the ideological needs of a relatively few is not. Controlling costs is essentially, blaming insurance premiums is nonsense.

Assuring every American has access to an efficient health care system is paramount, making that system efficient is the road to success.

Within the next several hours 216 people are likely to change the health care face of America forever. They are not doing so with the best interests of Americans in mind nor are they considering the economic interests of the Country. They are marching to political orders and in many cases have no idea exactly what they are voting for.

As with all entitlements good or bad once in place they stay forever. This one with it’s budget and deficit game playing will haunt the Country for decades.

Americans will be dissappointed with the results, costs will continue to rise uncontrolled and fifty years from now pundits will be saying, “what were they thinking?”

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