Front and Center

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Tag Archives: Insurance

About Granting “exceptions” and Free Contraception

I saw a piece regarding President Obama and the uproar caused by saying church-sponsored institutions have to provide contraception to employees.  Today, he reversed course and said that insurance companies would be forced to provide it for free to the employees of such institutions.    What’s funny is, it still means the institutions will pay for it, because typically a company will pay for part of the benefits package provided to their employees.  So, they will still pay.  Remember, there is no such thing as a free lunch!

While reading said piece, I found something in the comments section that I found to be very interesting, and spot-on:

There is a deep and very troubling issue being missed in not only this debate, but permeating the entire Obama administration. See today and also  recall yesterday  just how often the word “exception” is now used in edicts from Obama and his administration. In manufacturing, banking, education, health care by-passed senate confirmations and now religion, we get word from Obama that “we have granted an exception”. Granting  exceptions requires one be in absolute authority over those seeking relief from an onerous government imposed obligation. We are no longer being governed with our consent, but are in fact ruled by edict through Obama’s consent. Obama has not yet superseded  that authority which the Declaration of Independence plainly says  our individual rights come from and Obama must be told that in plain and simple words.

It makes me wonder if folks realize that–if you have to grant exceptions to a rule, then maybe, your rule should be changed?

I also wondered about “free” contraception.  Why should contraception be free?  Or Viagra?  Why should the government be involved in it?  Maybe there is a good reason, but its not coming to me right now.

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I Said We All Lose With the Budget Deal; It’s Worse Than I Thought

In my last post, I explained why I thought we all lose out in the end when it comes to the budget deal agreed on last week.  Well, now that they put out the details of the agreement, many people are realizing that it’s worse than we thought.  In many cases, “cuts” aren’t cuts at all.

So, what constitutes a “budget cut?”

Many of the cuts appear to have been cuts in name only, because they came from programs that had unspent funds.

For example, $1.7 billion left over from the 2010 census; $3.5 billion in unused children’s health insurance funds; $2.2 billion in subsidies for health insurance co-ops (that’s something the president’s new health care law is going to fund anyway); and $2.5 billion from highway programs that can’t be spent because of restrictions set by other legislation.

About $10 billion of the cuts comes from targeting appropriations accounts previously used by lawmakers for so-called earmarks – pet projects like highways, water projects, community development grants and new equipment for police and fire departments. Republicans had already engineered a ban on earmarks when taking back the House this year.

Republicans also claimed $5 billion in savings by capping payments from a fund awarding compensation to crime victims. Under an arcane bookkeeping rule — used for years by appropriators — placing a cap on spending from the Justice Department crime victims fund allows lawmakers to claim the entire contents of the fund as “budget savings.” The savings are awarded year after year.

For those keeping count at home, that block of funny money amounts to $24.9 billion of the $38 billion in budget cuts! Yes, the shutdown drama was over about $13 billion in actual cuts, which amounts to a miniscule percentage of the overall budget. Oh, and they managed to find time to tell D.C. how they can and can’t spend their money, too.

This is the type of tomfoolery we have to put up with. Both sides should be ashamed. But we know its just business as usual.

Healthcare Reform–What is MLR and how it may affect you

Healthcare Reform.  A topic that dominated the airwaves for months as President Obama and the Democrats attempted (and succeeded) to passing major legislation changing the way we do health care in America.  Later, we will discuss how what was passed wasn’t as much healthCARE reform as much as it was healthINSURANCE reform, but we’ll discuss that later.  For now, lets discuss MLR.

MLR, or medical loss ratio, is the amount of each dollar an insurer takes in that much be used to pay for medical coverage.  The concept is simple:  when you the insured pays a dollar of premium to, say, United Health Care, UHC is required to spend a certain amount of that dollar on things related to patient care.

Currently, that ratio is all over the map and depends on carrier as well as individual state mandates.   One may find that one carrier’s ratio may be in the 70s, while another carrier may be in the 90s.  But that is about to change.  New rules will require all carriers to have a MLR in the 80% to 85% range.    If a carrier is found to have a ratio exceeding that, they will be require to pay a rebate or refund to plan participants.  So, consumers are definitely going to get more bang for the buck, right?

Maybe.  Maybe not.

There are at least 2 ways that the new provision will most likely negatively affect consumers.  First, there are already carriers that are getting out of the major medical insurance business because they will not be able to comply.  “Big deal!” most will say.  But we all know what happens when we have fewer providers to pick from.  The amount we as consumers spend goes up because each carrier gone reduces competition.  Second, carriers are going to begin cutting commissions to insurance brokers and agents.  For many, that’s not a big deal and they could care less about it.  But there are a significant number of consumers who prefer the ability to deal with an agent who is available to explain plans and coverages as opposed to calling a particular carrier’s customer service line.  When those agents disappear, consumers will find themselves on their own in regards to figuring things out.

All this isn’t to say MLR is a bad thing.  But knowing how it may affect you is a GOOD thing!