Princess Pander

It’s almost a year until the convention, but Saint Paul DFL gubernatorial candidate Erin Murphy’s campaign is already doomed.

Rep. Erin Murphy, doomed gubernatorial candidate

Perhaps with that in mind, she’s swinging for the (Metrocrat) fences, calling for single payer helathcare:

Murphy criticizes capitalist models of health care, saying that a for-profit model of any part of the health care system is bad for Americans. She tells a story of her dying mother’s struggle to get her insurance company to cover the care she needed for cancer treatments near the end of her life.

“We must guarantee health care for people who are sick, focus on the health of Minnesotans, and control health care costs,” Murphy wrote. “We must make strategic and difficult choices with valuable resources, putting the health of Minnesotans ahead of health insurance profit making.”

Asked how this plan would be paid for, Murphy responded “with golden coins borne down from heaven by unicorns [1]”

[1] Fake but conceptually accurate.

 

The Strib: Lowering Their Own Bar?

The Strib “reported”, after a fashion, about attitudes about Obamacare after an election where it was primarily responsible for ejecting the DFL from power in the Minnesota Senate.

DFLMinistryofTruthLARGE

And it’s either a masterpiece of selective fact, or some fairly incurious reporting:

Anxiety is greatest among Minnesotans with preexisting medical conditions. Before the ACA, insurance companies could simply deny them coverage.

Which is technically true.

After which, in Minnesota at least, they would get insurance from one of the state-subsizied high risk plans.

Before MNSure, 92% of Minnesotans were insured, via the private market, a public plan, or some combination.   It was the highest share in the nation.   Of the 8% who didn’t have insurance, the vast majority were people who didn’t want insurance – mostly young, mostly healthy.  There were exceptions – but they were few, rare, and mostly the product of poor information and a pre-Obama media who were actively pitching the “47 million uninsured Americans…” narrative.

Today, the state says half as many Minnesotans are uninsured – but networks have shrunk (in vast swathes of Minnesota, only one plan is available), premiums have skyrocketed for individual members (like me!),  people could not keep their doctor (The Lightworker’s promises notwithstanding…)

So why is the Strib story – a “Team Report” by Jeremy Olson, Christopher Snowbeck and Glenn Howatt, no less – either so slanted or uninformed?

To borrow a Glenn Reynolds phrase – if you treat them as DFL operatives with bylines, it all makes sense.

About Those Death Panels

As we’ve noted in this space in the past – while no health insurance provider has a room with the words “Death Panel” on an embossed brass plate on the door, the notion of allocation of services, including life-saving ones, to make sure scarce supplies of life-extending medicine and treatment go to the people who’ll gain the most usable lifespan, has been around for a long time.  It’s an integral part of the HMO business model.

In other words, if they’ve got one liver available, and one person on the transplant list is a 32 year old marathon-running woman who’s never smoked, and one is a 62 year old diabetic smoker, you can guess who’s going to get the liver, and who’s going on “palliative care” right?

And while that decision may not be made by people whose job title says “Death Panelist”, if you’re the 62 year old diabetic, it’s all tomayto tomahto, right?

Anyway – to those who thought calling the above the equivalent of a “death panel’ was overreach, I present this:

About one-year ago, Gov. Jerry Brown signed the state’s assisted-suicide bill into law. It fully went into effect this June, with the opening of the first clinic. While there is no data on the number of California assisted-suicides, Oregon recorded over 130 last year as part of their legalized physician-assisted death program.

Now, one young mother says her insurance company denied her coverage for chemotherapy treatment after originally agreeing to provide the fiscal support for it, but indicated it would be willing to pay for assisted suicide instead.

No, it’s not just one woman:

Packer attends meetings with others suffering from terminal illnesses. She indicates that the tone of those meetings have changed since the California assisted-suicide law was enacted.

“As soon as this law was passed – and you see it everywhere, when these laws are passed – patients fighting for a longer life end up getting denied treatment, because this will always be the cheapest option.”

Packer attends a support group for terminally ill patients. She said legally sanctioned suicide has changed the tone of the meetings, which used to be “positive and encouraging.” With patients under new societal pressure to kill themselves, she said meetings “became negative, and it started consuming people. And then they said, ‘You know what? I wish I could just end it.’”

There’s a website for patients concerned that insurance companies under price pressure  are trying to strongarm them into killing themeselves.

Yep.  It’s come to this.

So – you can’t keep your doctor, or the plan you like, your prices are going to rise, and if your life is inconveniently expensive for your insurer, it will try to kill you.

Thanks, Obama.

You Can Keep Your Doctor, Provided Your Doctor Is A Unicorn

Obamacare’s state exchanges are melting down – some faster than others, none faster at the moment than Tennessee:

Seventy-three out of Tennessee’s 95 counties will have only one insurer on the exchange, meaning no meaningful competition whatsoever. In regions where BlueCross BlueShield is pulling out, there will be two remaining major carriers, Cigna and Humana. The only large metro area with more options will be Chattanooga.

Then there are the premiums. State regulators have already approved the highest annual rise in the nation, a weighted average of nearly 56%, according to data at ACASignups.net. The rate increases authorized in late August include an average of 62% for BlueCross BlueShield, 46% for Cigna and 44% for Humana. The latter two companies could ask to revise their rates upward depending on how many former BlueCross consumers they pick up.

The idea that Obamacare is a conspiracy designed to fail, to leave only “single payer” government healthcare as a viable option, is looking less and less like a conspiracy theory.

Blind Squirrel

Governor Dayton admits Obama care is a flaming goat rodeo.

On its surface, the story is about one of the most left of center governors in America throwing Obamacare under the bus. And that’s all interesting, don’t get me wrong.

But the governor – and depressed it’s been covering for him for six years – is counting on you,or at least the mainstream Minnesota medias audience,forgetting a few things. He overrode the legislatures decision to get out of the Obama care exchanges. Then, he presided over one of the two or three most botched attempts to build an exchange. MNSure’s gestation was protracted, obscenely costly, and a technical nightmare. And for all that, the products that delivers – with soaring prices, ballooning deductibles and lower availability and choice – are worse.

The media coverage of the governors admission that the Minnesota state exchange, and Obamacare itself, has worked out very badly, tends to portray the governor as a kindly but well meeting fellowadmitting that his ministration’s signature product has had some teething problems.

It’s much, much worse than that.

Before Obamacare and MNSure, Minnesota had the best level of health insurance in the United States; between public and private plans, 92% of the states population was covered..

Proponents of the state/federal plans claim that number is up to 96%, today.  And that maybe true – but more and more people are hanging onto that insurance – policies much bigger than they need, with higher premiums, and deductibles that in many cases will bankrupt families  (What, you could pay her $12,000 a year deductible, along with 20% coinsurance?)

And people wonder why the media obsesses about things Donald Trump said on the TV 11 years ago…

This Is DFL Government

You, the DFL voter, wanted a government-managed healthcare market?  You got it!

And we’re all paying for it!

Health insurers are hiking premiums and limiting enrollment in Minnesota’s individual market next year, with regulators saying the emergency measures were needed to avert a market collapse.

The moves are a clear sign that the market for some 250,000 people who buy coverage for themselves is dysfunctional and needs reform, said Commerce Commissioner Mike Rothman during a Friday news conference.

While rate increases of more than 50 percent aren’t fair to consumers, Rothman said, things could have been worse. He described a period this summer when all health insurers in the state seemed prepared to abandon that segment of the market.

Elections have consequences; as former New York mayor Ed Koch put it, “the voters have spoken, and now they must accept the consequences”.

It’d be nice if those consequences didn’t botch up everyone else’s life.

“You Can Keep Your Doctor” Update

Next year, if all proceeds as expected,  one out of six Americans will have exactly one option in their Obamacare exchange:

According to an analysis done for The Upshot by the McKinsey Center for U.S. Health System Reform, 17 percent of Americans eligible for an Affordable Care Act plan may have only one insurer to choose next year. The analysis shows that there are five entire states currently set to have one insurer, although our map also includes two more states because the plans for more carriers are not final. By comparison, only 2 percent of eligible customers last year had only one choice.

The conspiracy theory that Obamacare was intentionally designed to wreck the system to make single-payer inevitable looks less and less far-fetched every day.

MNSure: All Is, Naturally, Proceeding As Predicted

The Blues are eliminating scads of individual plans.

In response Gov. Mark Dayton highlighted gains in enrolling more Minnesotans in health insurance plans since the implementation of the Affordable Care Act. He also acknowledged the BCBSM departure reflects the instability in the market for individual and family coverage.

In other words, as people have been squeezed out of the private plans they originally chose, they are dribbling in to MNSure’s more expensive plans with higher deductibles and more-constricted networks.

He thinks has been told to think it’s a win.

“This creates a serious and unintended challenge for the individual market: the Minnesotans who seek coverage there tend to have greater, more expensive health care needs than the general population,” said Dayton. “Blue Cross Blue Shield’s decision to leave the individual market is symptomatic of conditions in the national health insurance marketplace.

University of Minnesota health economist Roger Feldman called the Blues’ departure a major blow to Minnesota’s already troubled individual market.

“What this says about the individual market is that it is very unstable and it has been disrupted by a number of events and we still don’t know whether it will recover or not from those disruptions,” said Feldman.

Apparently we have to cripple healthcare before we can save it.

Pass

My mom worked at a nursing school. My niece is a NICU nurse.  I have quite a few nurses among my closest friends.  

So it’s hard not to say “I have all the sympathy in the world for the nurses that are striking at the various Alina hospitals”.

So I will let Larry from “Very Angry Bird” say it for me:

Normally, I am very sympathetic to anyone who is affected by the treachery and deceit of ObamaCare. The only ones who escape by shoulder to cry on are union types who supported ObamaCare when it was first being hatched. Since most unions are Democratic strongholds, the nurses union all supported ObamaCare. To put it in old west terms – they now know what it is like to be shot with their own gun.

nurses are wonderful people – but the nurses union is as hard left as the SEIU. The union jumped up and down and did cartwheels for Obama, and Obamacare, eight years ago.

Now, as the “Affordable Care Act” makes healthcare I’ll truly unaffordable for millions – exactly as predicted – the union is trying to insulate itself and its members from the policies that the union supported, worked for, and donated its members ‘money to.

Sorry, nurses. You lost me on this one.

Crawling From The Wreckage

By every rational measure, Obamacare is a complete failure – a fraternity-rush-week of terrible assumptions and economic ignorance that have turned a sixth of this nation’s economy into a hapless dumpster fire.

Kevin Williamson takes stock of the failures – and, in this notable passage, breaks down the “why” of how we got here:

The architects of Obamacare are deeply distrustful of the role of for-profit companies in the health-care business because, in their nearly pristine ignorance, they falsely believe profits to be net deductions from the sum of the public good rather than measures of the creation of real social value. So they created incentives to set up co-ops, nonprofit enterprises that would administer Obamacare plans in particular states and jurisdictions. It was obvious from the beginning that if Obamacare’s perverse incentives created insurance pools that were older and sicker rather than younger and healthier, these co-ops wouldn’t be economically viable: You need lots of young, healthy insurance subscribers to offset the costs associated with your older, sicker subscribers. Many of us — myself included — assumed that the federal government under President Obama would simply write these co-ops huge checks to keep them afloat. We were half right: The government is writing them huge checks, but they are failing anyway, so fundamental is their economic unsustainability. Half of the co-ops have gone belly-up already, including large, prominent, splendidly subsidized ones in Kentucky, New York, Louisiana, and South Carolina. Hundreds of thousands of customers have lost their coverage as a result. Hundreds of millions of dollars in taxpayers’ money has been poured into these enterprises, to no avail. Almost all of Obamacare’s basic promises have failed, it is an economic shambles, and it is a political mess .

 

Obamacare’s partisans were confronted with the economic facts long before the law was even passed, and their answer was: “Never mind the economics, we’re the good guys, and you want poor people to die.” Democrats argued that Republicans literally wanted to kill poor people, that their plan was for the poor to “die quickly.” This is a habitual mode of discourse among progressives: Reality doesn’t matter; only the purity of Democrats’ motives matters. Obamacare is what it is: Another damned five-year plan based on wishful thinking and very little else.

Read the whole thing.

And if you haven’t read Williamson’s The End Is Near, And It’s Going To Be Awesome, get out to Amazon and do it.  Now.

Passive-Aggression

Joe Doakes from Como Park emails:

Obama-care is the federal program, but Minnesota Democrats rushed to set up our own parallel Minnesota Care system so every Minnesota family could easily find affordable health insurance.  But insurance companies are dropping out of Minnesota Care to avoid administrative hassles and taxes to reduce overhead, and that makes their plans even more affordable than the Minnesota Care plans.

The Democrats’ proposed solution?  No, not decrease administrative hassle or lower taxes to make Minnesota Care competitive.  Certainly not.  No, the proposed solution is to impose administrative hassles and taxes on insurance companies who are NOT participating in Minnesota Care, so that everybody is equally hassled and taxed.  The name of the guy proposing that – Jim Schowalter – may sound familiar.  That’s because he was Mark Dayton’s Commissioner of Budget who oversaw setting up the Minnesota Care system at a cost of half-a-billion dollars, now he’s the chief lobbyist for the insurance companies in the system.

I say there’s something fishy about this story.  It’s all about people losing their plan and paying more for it.  But if you like your plan, you can keep your plan and every family saves $2,500 – we know this because The Light-bringer told us so.  There’s something not right about this new story.

Joe Doakes

It’s the Minnesota way.

We Interrupt The All Trump, All The Time…

…menu in the mainstream media for an actual substantive policy argument among Republicans.

Walker’s concept:

Walker’s proposal would repeal all of ObamaCare, dismantling its federal healthcare exchanges and eliminating the tax credits now provided for people to buy health insurance policies. It would replace them with a system that doles out federal dollars based on an individual’s age, instead of income.

For example, a person between the ages of 18 and 34 would receive $1,200, while a person between the ages of 50 to 64 would receive $3,000. The tax credits would only go to people without employer-sponsored coverage.

Unlike ObamaCare, his plan would also allow groups, such as small businesses or farmers, to band together to negotiate lower rates and allow all individuals to purchase coverage across state lines.

James Capretta at NRO runs down the details of the Walker, Jindal and Rubio plans.

For those who’d rather talk policy than combovers.

“It’d Be A Shame If Your Insurance Company Were To..Break, Or Something”

The reason Preferred One – provider with all of the least-expensive plans in the MNSure exchange – left the exchange last month, giving most of its subscribers a 60+% increase in rates to keep a MNSure plan, was that they were basically strong-armed into providing the unsustainable low rates to begin with:

Sometime after the insurer PreferredOne submitted its proposed rates for the first year of the MNsure exchange, state regulators asked the company to consider lowering the numbers.

Ultimately, the insurer responded with “a total rate decrease of 37 percent”, according to a July 2013 letter from an outside actuary to the company.  Those final rates were the lowest in the Twin Cities – and across the country, in many cases – and helped PreferredOne to grab nearly 60 percent of the MNsure business.

 

Now, those subscribers face an average premium increase of 63 percent if they stay with PreferredOne — a yo-yo scenario that health policy experts say points to the challenge in setting prices under the federal health law. The big swing also suggests that the low prices were out of step with the reality of the business.

 

“This was the first year of a new market, so no one knew what they were bidding on,” , said Gary Claxton, a vice president with the California-based Kaiser Family Foundation. “That means it was hard to create the rates, and it was hard to review them.”

 Here’s the deal:  as Representative Zerwas pointed out on a morning radio show today, Preferred One is keenly aware that the MNSure board – a political board, composed (per statute) of absolutely no people from the  healthcare or health insurance industries – can decide who does and doesn’t get to participate in the exchange. 

Which gives them a lot of power when, for example, they tell a company like Preferred One  to kick the tires on an unsustainable rate structure. 

 

 

Chanting Points Memo: “Only 4.5%!”

A friend of mine on Facebook (who admits he based it on a statement by Senator Michelle Benson, on the Dave Thompson show) notes the wierdness of the state’s math in arriving at the “4.5% increase in MNSure Premiums” number that the media is trumpeting.

He put it this way:  If a fast food restaurant serves 500 customers and has $5,000 in the till at the end of the day, that’s an average of $10 per person. 

If a coffee shop next door has 5 customers and makes a grand total of $25, they averaged $5 per sale. 

So what was the average amount spent by customers to those two stores?

  1. $7.50 – the average of $10 and $5?  Or…
  2. $9.95 – $5,025 in total receipts divided by 505 customers?

If you’re a Democrat, you picked “1” – which is the average price of two items, but is not the average amount spent by the customers  If you undestand economics, you picked “2”. 

What the state has done – and the media has reported more or less uncritically – is tell us the average price of the plans (that are still on the market).  Not the average amount customers will have to spend to stay in the exchange – which includes nearly 2/3 of all MNSure customers who lost their lower-priced Preferred One plans, and who will be paying at least 20% more. 

The state’s spin is dishonest.  The media uncritically running the spin is an abdication of their purported job of keeping government honest.

More Sunshine Blown Up Minnesota’s Skirt, Part III

I went into a chain diner the other day.  I had a bowl of soup.  I promptly felt ill, and before long came the projectile vomiting, and then the projectile diarrhea.

I went to the manager after I cleaned up to complain.

“Yeah” said the manager, “we’ve had a lot of that today with the soup.  OK – actually every person who’s eaten the soup today has gotten sick.  But in our defense, people eating the soup at all our other stores have gotten even sicker.  You should feel pretty good, all in all!”

——–

MNSure – the state’s Obamacare exchange – has been a bulgarian goat rodeo from the very beginning.  Between the cataclysmic botch of the rollout, to the Director’s corrupt canoodling with the state’s Medicad director, to the technical review that indicates this year’s open enrollment could be worse than last year, to Preferred One – the provider with the best value for most younger, healthier people – dropping out, it’s been an ordeal to watch a pretty typical example of government control of any product or service.

But now – in the wake of yesterday’s price hikes – MNSure, the DFL and the media (ptr) are trying a new tactic; the bizarre non-sequitur; I’m adding emphasis:

Even with the premium increases for 2015, the cost of a mid-level benchmark policy on MNsure for a 40-year-old will be about $182 per month, state officials said. That’s less than the rate for comparable plans in 16 other metropolitan areas, according to figures published in September by the Kaiser Family Foundation, which is based in California.

On Wednesday, the Commerce Department supplemented the foundation’s analysis with preliminary and current rates from more than two dozen other metropolitan areas, and concluded that rates in the Twin Cities are the lowest.

When you compare Minneapolis and St. Paul to every metropolitan region throughout the country, Minnesota has the lowest rates in the nation,” Commerce Commissioner Mike Rothman said during a news conference near the State Capitol.

Ah.  So Minnesotans’ rates are rising – rising by a lot for the people on the lower end of the market – but they’re higher elsewhere?

Ahem:

SO WHAT?

Minnesota had a system that covered 92% of Minnesotans – the highest rate in the country – with everything from cadillac government union plans to UCare to company health plans to inexpensive “catastrophic care” plans (now illegal!).

And it did all that for even less!

If your rates are rising 20% – and if you were a Preferred One customer, 2/3 of MNSure’s customer base, they are – on top of the higher rates you’re already paying (because MNSure replaced the catastrophic-care-only plan you may have had two years ago with a plan that includes mental health, preventive and, for the guys, OB-GYN services), why do you care what people are paying in Newark?

Are their plans rising 20%?  If yes, then that proves the point.  If no, then what is Minnsota doing wrong?

More Of That “Blowing Sunshine Up Minnesota’s Skirt” Thing…

I read yesterday’s headlines about the new, Preferred-One-Free MNSure rates, and got ready to write.

Then, I got an email from a friend who works in the Healthcare industry, which explains it much better:

The headlines on MNSure saying premiums rose only 4.5%.  This reminds me of an old story.

A friend of mine was flying a helicopter in the fog in downtown St. Paul and his radio and navigation equipment failed suddenly.  He knew he was in the midst of the downtown and going any direction could mean an immediate crash.  He stayed put hovering for a few minutes, inching lower.  When the fog lifted he was right outside the MN Dept. of Commerce.  Not recognizing the building he grabbed a piece of paper and a big sharpie.  He wrote in big block letters “Where am I?” and put it put it on the outside of his windshield.  A commerce employee saw the helicopter’s predictament and wrote a note back and placed it in the building window.  “You’re in a helicopter.”

Technically correct and absolutely meaningless.

That’s my take of this headline.  The real problem is that the low cost insurer, Preferred One, dropped out.  Maybe the remaining plans only increased by 4.5% but to the 60% who were on Preferred One, the real story is that their premiums are rising about 20%.  Minnesotans will understand that if they take time to read the full story.

Which the DFL is counting on people not doing, naturally, as they relentlessly pound away with that “4.5%” number on ads around the state.

Recent history shows it’s not hard to fool Minnesotans.

There Will Be No SwissSure

What’s the difference between Switzerland and Minnesota?

  1. The Swiss don’t have a football team – but if they did, they’d be better than the Vikings
  2. The Swiss are too smart to socialize their healthcare system:

And it wasn’t even close:  62 percent, mostly German, voted to tube the proposal to socialize Switzerland’s healthcare system.

Hey, speaking of Minnesota – does any of this sound familiar?

“Our health system is among the top performers in the world. Competition between health insurers and freedom of choice for clients play a major role in this,” it added.

Going public would have been a major shift for a country whose health system is often hailed abroad as a paragon of efficiency, but is a growing source of frustration at home because of soaring costs…

And how are the costs soaring?

…”Over the past 20 years in Switzerland, health costs have grown 80 percent and insurance premiums 125 percent,” ophthalmologist Michel Matter told AFP.

That’s bad.  Nothing like the US healthcare system, between the past ten years and Obamacare, but it’s certainly a problem. 

Still – what do the Swiss know that we – and by “we” I mean “a plurality of our Democrat neighbors” – don’t?

So It Appears Preferred One Aren’t The Only Ones Wrong For Minnesota

The Minnesota Association of Health Underwriters is worried about MNSure – for the same reason Preferres One bailed:

[MAHU chair Alycia] Riedly says there is no computerized renewal system in place, and if it is not functional by the next MNsure open enrollment, Nov. 15, it could affect tens of thousands of people who are already enrolled through MNsure.
Riedl says it will severely limit their access to information if they want to change their policies in any way and could create lengthy delays for MNsure consumers.
“The renewals would literally have to be done by hand, and that will take a long time, creating a backlog that hurts consumers who want to make better choices, and it will hurt MNsure’s bottom line if it isn’t taken care of soon,” Riedl said.

The private sector systems that MNSure bullied into submission have been doing this successfully since, well, health insurance existed.
So by all means, Twin Cities media – let’s talk about hanky-panky in vacant houses and crazy people chopping up garages.
This is serious business. Therefore, the DFL wants to focus on silly.
And so we will get a lot of silly between now and November.