Maggie's Farm

For over twenty years, I’ve been a scrupulous, multi-credentialed independent health care consultant and broker. I and others who actually know anything from the experienced, practical and studied perspective have warned that the medical loss ratios built into ObamaCare are dangerous to the quality and costs of medical insurance.

Medical loss ratio measures the percentage of premiums paid out in claims and for quality improvement. Just paying out more on claims does not reduce costs nor improve quality. Duh!

I wrote about this last April, that the CBO (Congressional Budget Office) said that ObamaCare’s medical loss ratios were within 5% of nationalizing the health insurance industry, so the Congressional Democrats who rammed ObamaCare through kept the medical loss ratios just below the 90% at which the multi-trillion dollar costs of outright nationalization would have to be counted by the CBO. What we got is a sham, nationalization masquerading – bad enough – as a highly regulated utility.

The CBO and the American Academy of Actuaries both pointed out that medical loss ratios are both misleading and can easily be contradictory to restraining costs or improving quality. This is particularly so when the formula is drawn too narrowly or ignorantly. Politicians' soundbites and regulator rampagers fit those categories of malpractice.

The largest insurance companies were at least half-way in bed with ObamaCare, looking to their own preservation, but now both they and brokers and the public are impregnated with a problem baby.

As during the HillaryCare debates, health care consultants and brokers are in the lead in trying to get sense into the examining room. We are virtually the only organized groups really fighting to keep government quackery away from your health. Sure, our already low commissions are in play, but so is your ability to have knowledgeable, independent guidance through the thickets of medical insurance and coverage.

The Council of Insurance Agents and Brokers, the Independent Insurance Agents and Brokers of America, the National Association of Health Underwriters, and the National Association of Insurance and Financial Advisors  have joined to plead to state insurance commissioners and medical insurance companies:

But “we fear the adoption of a narrow and static definition will adversely impact spending on certain important health plan activities,” the groups say.

In many cases, moves to reduce costs improve quality, and moves to improve quality reduce costs, the groups say.

“The definition of ‘activities that improve health care quality’ should be crafted in a way that recognizes this,” the groups say.

Activities now shut out of the definition include utilization review, fraud prevention activities, and network management, and those activities “are essential to maintaining and improving the quality of health care that clients of our members receive on a daily basis,” the producer groups say.

“Our members know firsthand that less utilization review, fraud prevention, and network development means lower quality health care for their clients – in addition to higher costs,” the groups say.

But, hey, ObamaCare is not really about reducing costs or improving quality; it’s primarily about grossly enlarging government and its control of the economy and our lives.

If you care to weigh in on drawing the formula for medical loss ratios in ObamaCare to be more reasonable, you can write to Ethan Sonnichsen, the National Association of Insurance Commissioners (the umbrella for the states' insurance commissioners) Director of Government Relations at his email  esonnich@naic.org .

Oh Yeah: This Mass. pre-experience of ObamaCare should help increase the medical loss ratio, pay large claims for those who dip in to coverage then stop paying premiums.

The number of people who appear to be gaming the state’s health insurance system by purchasing coverage only when they are sick quadrupled from 2006 to 2008, according to a long-awaited report released yesterday from the Massachusetts Division of Insurance.

The result is that insured residents of Massachusetts wind up paying more for health care, according to the report. …

My local newspaper has the following this morning. Rulers rule, people suffer.

-- South Africa sees jump in circumcision deaths:

…39 young men died in the last month after undergoing the rite of passage into manhood….and that more than 120 young men are in hospitals nursing their botched wounds….The procedure is performed outdoors by a traditional leader who uses a spear to remove the foreskin. – Associated Press

Well, Duh!

At my younger son’s bris (that’s the Hebrew word for the Jewish circumcision) 8 days after birth performed by a mohel (that’s the religiously trained and vetted circumcisor), who was also a pediatrician, our guests included several Gentiles. I wish I had a camera aimed at them, as they all together scrunched their eyes and reached for their groin area.

I was walking down the main street in town looking for a watch repair shop. Finally, I saw a store with old watches hanging in the window. I entered, but the man there said he didn’t fix watches. “I’m a mohel. What do you expect me to hang in the window?”

-- Street peddlers eyed in inflation battle:

Venezuela’s government said Tuesday it will make street vendors freeze their prices, threatening violators with fines, confiscations and even jail.

Marxism in the streets of Venezuela is hardly like “power to the people”!

Chavez probably lost at three-card monte.

-- Supreme Court nominee faces another day of questions:

…But we get no answers from her.

Sorry, but the only illustrations I could find are too disrespectful. Two wrongs don’t make a right, but they do make a Supreme Court justice.

P.S.: Thanks to the kind reader who just sent me this illustration:

New York State is typical of spendthrift states teetering on the hole they've dug of big deficits, looking for more taxes to fill the hole into which tax dollars are thrown.

The latest:

Many nonprofit organizations in New York are deeply concerned they will lose significant contributions from wealthy donors if a pending state budget proposal becomes law. The proposal would reduce the charitable-contribution deductions allowed for individual donors who are “high earners.”

Gov. David Paterson and the state legislature are in a bitter battle as they try to finalize a budget during the bad economic times, but they apparently have agreed on a proposal that would allow the approximately 3,500 New York taxpayers who earn more than $10-million annually to deduct on their state tax returns only 25 percent of their charitable contributions rather than the current 50 percent.

Yes, there’s this, for many donors, self-promotion ranks above helping the needy:

In New York, Arts Trump Social Causes for Philanthropic Recognition: Large donations to institutions such as the Lincoln Center, the Metropolitan Museum of Art, and the New York City Ballet are well covered in the press, and serving on major arts boards can raise members’ social standing and improve business ties, Crain’s writes. By contrast, when the New York investment managers Fiona and Stanley Druckenmiller, who focus on medical and economic charities, ranked No. 1 on the latest Chronicle of Philanthropy list of top givers, “many in the city's nonprofit world wondered, 'Who?’”

Experts say the city's elite put great value on major arts institutions, and gifts to such organizations garner public attention because they are often landmarks frequented by residents and tourists, unlike new hospital wings or university buildings.

Yet, as the official tabulation of income taxes paid in New York shows, (page 5) of $29.6 billion in personal income taxes collected in 2007, 49% came from those with income above $500,000, about 1% of taxpayers, and their deductions were 8% of the tax deductions claimed by all taxpayers.

The well-to-do are more than contributing their part to the NYS government largesse with taxpayer funds.

But, according to the tabulation of the top US contributors to charities for 2008,due to the economic downturn their charitable contributions have fallen:

[T]he number of wealthy people making big gifts has shrunk. A donor needed to part with just $16.2-million in 2009 to qualify for The Chronicle’s list. In 2008 that number was $30.5-million; and in 2007 it was $39-million.

So, tell me why and how New York State driving its golden geese out of state will benefit the needy or the art-starved in New York State.

So, tell me how higher taxes will incent the most productive to invest more or earn more just in order to have more taken away.

So, tell me why higher taxes will not lead to lowered prosperity and thus to lower tax collections and charitable contributions, most of which goes to help the real and supposedly needy.

So, tell me whether adding more government-sector workers, at higher pay and benefits than among private-sector workers, the private-sector workforce shrinking, is really the priority of liberal nest-feathering politicians.

Instapundit Glenn Reynolds posts:

HOPE: Consumer Confidence Plunges In June. “Recovery Summer, or Recovery Bummer? Economists are beginning to wonder whether we’re heading into a double-dip recession, or whether the first one ever really ended.”

To which this bottom-line economist adds:

Glenn Reynolds added this bit of observation:

Anecdotage: A woman who works at a local used bookstore told me they’re not selling nearly as many hardbacks as they used to — people won’t spring for them any more, even at the reduced prices. That doesn’t sound like a recovery to me.

Posted by Glenn Reynolds at 12:52 pm

Perhaps better marketing would help:

My former wife worked in fancy dinner houses for decades. She had the best economic indicator: the size of tips. She also received better tips with an extra blouse button open.

Which would you rather see, Jack Nicholson's man-tits or his playmate's?

A. Jack's

B. Playmate's

C. None of the above. (In which case, take a lesson from the Buddha, below.)

Ron Radosh, as well as other knowledgeable or honest critics, recognize the “travesty” of “Oliver Stone’s new documentary,  South of the Border, his ode to Hugo Chavez and South and Latin America’s new quasi-Marxist and not so quasi dictators.”

For some background into useful idiot Oliver Stone’s “standard far-left narrative that is part of a long line of propaganda films, a modern American version of the old agitprop”:

From the BBC report and from Robert Service’s bio of Trotsky, will the real Chavez and Trotsky please stand up or be excused by ignorant fantasist rationalizers of tyranny?

This morning I saw my son off to sleepaway camp. The mother of my son’s seatmate on the bus and I met and spoke briefly. It turned out we have family (all Jewish) and other friends in common back East.

She was in law school with Obama at Harvard.

She says that Obama was not particularly “political” at that time. [My thought: probably unnecessary as most there likely agreed on most things.]

She says that Obama is not an anti-Semite. [My thought: So what if he hires “court Jews”, hangs out with real anti-Semites, and even for – in his opinion – the best of reasons weakens Israel.]

She says that Obama is a good listener. [My thought: So what, if he only listens to those who agree with him.]

She is an Obama-loyalist, only offering the criticism that he is “indecisive.” [My thought: Only indecisive while trying to figure out how to get away with weakening allies or national security, or propel the US into further debts, enlarge government intrusion into and control over our lives, and undermine free enterprise.]