EppsNet Archive: Insurance Companies

Spot the Fake News: Obamacare Subsidies

16 Oct 2017 /

I read four news stories on the same topic — the end of Obamacare subsidies to insurance companies.

The Wall Street Journal plays it straight down the middle:

President Donald Trump’s executive order on health care issued Thursday marks the first major salvo in what the White House promises will be an extensive, targeted campaign to unravel the Affordable Care Act administratively.

As does Bloomberg:

President Donald Trump said he is moving “step by step” on his own to remake the U.S. health care system because Congress won’t act on his demand to repeal Obamacare.

The Trump administration took its most drastic measure yet to roll back the Affordable Care Act Thursday evening, announcing it would cut off a subsidy to insurers hours after issuing an executive order designed to draw people away from the health law’s markets.

See if you can spot the fake news in the Politico version:

President Donald Trump plans to cut off subsidy payments to insurers selling Obamacare coverage in his most aggressive move yet to undermine his predecessor’s health care law.

Politico imputes an ulterior motive, i.e., Trump is not trying to make life better for anyone, he just wants to undermine Obama. That is fake. You can’t know why someone did something. I don’t even know why I do half the things I do.

Surprisingly to me, CNBC, which I expected would have an impartial, businesslike report, went completely off the rails:

Obamacare bombshell: Trump kills key payments to health insurers

The Trump administration will immediately stop making critically important payments to insurers who sell Obamacare health plans, a bombshell move that is expected to spike premium prices and potentially lead many insurers to exit the marketplace.

Where to start on this . . .?

1. The word “bombshell” doesn’t belong in a news story. Even to call something a “surprise” or an “unforeseen event” raises the question of who exactly was surprised by it.

In this case, nobody was surprised. Everyone knew that there was no appropriation for the subsidies, meaning that they are not accounted for in the federal budget.

When Obama was president, he didn’t care that the payments were off budget, but when Trump was elected, everyone had an inkling that the payments would stop.

2. What’s the difference between a payment, an important payment and a critically important payment? “Critically important payment” is not a fact, it’s an opinion. It’s fake news.

If you want to make a case for critical importance, lay out the facts and let the reader decide.

3. “Increase” is a better word than “spike” in a news story. Using words like “spike,” “bombshell” and “kills,” especially in a story about healthcare, creates a manufactured sense of danger, fear and imminent fatality.

Also: premium prices have already gone up. Insurance companies raised the premiums in anticipation of the subsidies being stopped, despite CNBC’s characterization of the stoppage as a “bombshell” (see #1 above).

4. There’s no information in saying that something will “potentially” transpire. How many insurers did you talk to? None? One? More than one? How many said they would exit the marketplace?

Every major insurer has already partially or completely left the Obamacare marketplace.

 

There’s a taxonomy of fake news. It’s not (necessarily) fabricated. It’s more often misleading content or false context, as seen above.


25 Concepts to Facilitate Judicious Use of Psychiatric Drugs

20 Sep 2015 /

I’m not a doctor, nor do I play one on TV, but I did stay at a Holiday Inn Express last night . . . I also took a Colgate University class on medicating for mental health and judicious use of psychiatric drugs.

Pills
  1. A psychiatric medication is only one useful tool among a collection of useful tools. Remember to also consider non-drug options for therapy.
  2. The benefits of psychiatric medications are always accompanied by risk. Become familiar with the potential risk of your medication. Be alert to potential risks that might be intolerable to you.
  3. Establishing a diagnosis is a difficult and imperfect task, but it establishes the starting point for determining which treatments are appropriate.
  4. Engage your physician or a psychologist in a dialogue regarding the structure of your treatment program. Be an active participant in establishing the structure of that program. Having confidence that your treatment program will work is important for its success.
  5. Become familiar with the vocabulary of psychopharmacology and with some basic principles of psychopharmacology. It will improve your ability to communicate with your physician or therapist.
  6. Be forthcoming and candid with your physician or therapist when working to establish realistic goals for your use of psychiatric medication. These goals should include the meaningful improvement of symptoms and side effects that are acceptable to you.
  7. A treatment program should aim to not only produce meaningful improvement of symptoms but also should include a plan to prevent relapse.
  8. A psychiatric medication is limited in its effectiveness for improving a problem that has biological, psychological, and social characteristics.
  9. Ask whether the use of your recommended psychiatric medication is supported by published evidence or is an off-label prescription based upon educated guesswork. If your prescribing physician doesn’t know the answer to that question tell him or her to find out for you.
  10. Remind yourself that a psychiatric medication will alter the neurochemistry of your brain and that the effects of medication on the brain can persist and may be permanent.
  11. The ideal dosage of a psychiatric medication is the smallest dosage that is able to provide meaningful relief of symptoms.
  12. Fulfill your responsibilities for ensuring the success of your treatment program. Be fully cooperative regarding instructions for using medication and for taking the advice of the therapist.
  13. Remember that counseling, psychotherapy, or behavioral therapy may enhance the effectiveness of a psychiatric medication.
  14. Remember also that a psychiatric medication may enable counseling, psychotherapy, or behavioral therapy to be more effective.
  15. Newer psychiatric medications are often more expensive medications despite the fact that those newer drugs may not be more effective than older medications.
  16. Newer psychiatric medications have been used for a shorter period of time and by fewer people than older medications. This fact increases the likelihood that newer medications might bring unpleasant surprises.
  17. Herbal remedies and dietary supplements may or may not be effective or safe and very few of those remedies have been studied in well-designed experiments to evaluate their effectiveness and their relative safety.
  18. If possible, avoid using multiple medications in order to minimize the possibility of harmful drug interactions.
  19. Direct-to-consumer advertising of psychiatric medication is principally intended to get you to buy a product. That product may or may not be in the best interest of your own physiological, emotional and psychological well-being.
  20. Be aware that your health insurance provider may structure costs to you, the patient, in a way that provides some incentive to use one drug instead of some other drug or to use medication instead of psychotherapy. If possible, try to make the principal goal of your therapy to be the relief of symptoms, not the lowest cost of treatment.
  21. The elderly present special vulnerabilities for psychiatric medications — for example, enhanced sensitivity, likelihood of polypharmacy, or increased risk of falling.
  22. Exposing the young, still-developing brain of a child or adolescent to a potent psychiatric medication risks creating problems for those brains when they reach adulthood.
  23. The recent trend is to rely more upon psychiatric medication than upon non-drug therapies to treat psychopathology. Resist that trend when you are not convinced that medication is the best choice for you or for a member of your family.
  24. The study of brain and behavior is a frontier science. Thus the use of drugs that alter brain neurochemistry to treat psychopathology is based upon an incomplete understanding of brain and behavior.
  25. Because our current understanding of brain and behavior is incomplete, contemporary psychiatric medications are imperfect tools that are clinically useful until we learn enough to develop better tools.

By Way of Explanation

14 Aug 2014 /
Bed

I was yelling this morning and I scared the dog. I wasn’t angry at him or at anyone in the house, I was angry about a whole life insurance scam we got in the mail. (That’s redundant, isn’t it? “Whole life insurance scam”?)

Anyway, the dog got scared and crawled under the bed. His joints, especially in his back legs, are not too good anymore and once he got under the bed, he couldn’t get back out. I had to crawl under there myself, roll him on his side, which he didn’t like, and then slide him out.

That’s in case you’re wondering why I showed up late for work this morning looking like I just crawled out from under a bed . . .


People Who Don’t Want Me to Know Things

12 Jul 2014 /

What I want to know is why there are so many people who don’t want me to know things . . .

Trudeau's book Natural Cures Updated Edition

And that doesn’t even include all the things that people “won’t tell me.”


Thomas Jefferson on Why Your Health Insurance Premium is Going Up

11 Jan 2013 /
Thomas Jefferson

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

That headline should not read “DESPITE new health law,” it should read “BECAUSE OF new health law.”

But we were going to get things for free! We were promised better things at a lower cost!

In my day, most of the citizens were farmers or merchants or tradesmen. They lived by their hands and their wits. They had horse sense and they knew when they were being sold a bill of goods.

Of course, that was before television.

Americans today are unfortunately rather stupid. Most of them don’t know anything about economics, science, history, government . . . as George Carlin says, “Think of how stupid the average person is, and realize half of them are stupider than that.” George is here in heaven now. He breaks me up, he really does.

Your president and Congress have decreed that every American will have health insurance whether they want it or not. They have further decreed that a lot of Americans will not have to pay for their own health insurance, which means that the cost of their health insurance has to be paid by the rest of you. That’s one reason why your health insurance premium is going up.

Another reason your premium is going up is the “guaranteed issue” provision. “Guaranteed issue” means that no one can be denied health insurance because of pre-existing conditions.

Funny story: My friend Paul Epps, his wife has an insurance agency in Southern California. It’s an area that’s susceptible to wildfires in the summer months. When a fire breaks out, people who live near the fire actually call this woman wanting to buy a homeowners policy.

Of course, she doesn’t sell it to them. Insurance companies are a little bit smarter than that.

Buying a homeowners policy when your house is already on fire is analogous to “guaranteed issue” health insurance: Hello, I’d like to buy some health insurance. Oh by the way, I have cancer, but the doctors think that with lengthy and expensive treatment, I have a chance to pull through.

This is not even insurance anymore. Insurance is something you pay for now to protect against the risk of having to pay a lot more later. In these cases, there IS no risk. The bad news has already happened. It’s a dead loss for the insurance company and they have to spread the cost of that loss to other policyholders. That’s another reason your premium is going up.

This isn’t even economics, folks, it’s just common sense.

Thomas Jefferson


Thomas Jefferson on Obama’s Healthcare Speech

13 Sep 2009 /

My fellow Americans —

Perhaps it was unfair of me to be critical of President Obama’s healthcare speech without having heard it. There’s not much to do on a Saturday night when you’re dead, so I read the transcript:

Thomas Jefferson

We’ve estimated that most of this plan can be paid for by finding savings within the existing health care system, a system that is currently full of waste and abuse. . . . The only thing this plan would eliminate is the hundreds of billions of dollars in waste and fraud, as well as unwarranted subsidies in Medicare that go to insurance companies . . . Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan.

And how much money are we talking about, sir?

Now, add it all up, and the plan I’m proposing will cost around $900 billion over 10 years.

WTF?!

I will not accept the status quo as a solution.

OK — cut the bullshit, my friend. Your “plan” vs. “the status quo” is a false choice. You’ve just said so yourself. If you’ve figured out how to eliminate $900 billion in waste and inefficiency from the current system, GO AHEAD AND DO IT! Why are you tying that to 1,000 pages of unrelated “reforms” that no one has even bothered to read?

If you can eliminate hundreds of billions of dollars in waste and inefficiency — I don’t believe that for a second, but let’s say you can — you will have no greater supporter than old Tom Jefferson. AND — you will have acquired so much credibility that you’ll be able to pass any reforms you like.

Don’t present false choices to us like we’re a nation of fools. Cut the bullshit and DO something.

— Tom