Tag Archives: Healthcare

Business, Health, US

Goldman Sachs Questions Whether Curing Disease is Economically Sustainable

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New York, NY— Goldman Sachs, in an April report to clients, addressed an ethical conundrum facing pharmaceutical and biotechnology companies in regard to futuristic cures based on cutting edge gene therapy: “one shot cures,” rather than the model of continuous treatment, could be difficult for some “medicine developers looking for a sustained cash flow.”

In a report entitled “The Genome Revolution” Goldman Sachs analyst Salveen Richter asked, “Is curing patients a sustainable business model?”

“The potential to deliver ‘one shot cures’ is one of the most attractive aspects of gene therapy, genetically-engineered cell therapy and gene editing. However, such treatments offer a very different outlook with regard to recurring revenue versus chronic therapies,” analyst Salveen Richter wrote in the note to clients on April 10. “While this proposition carries tremendous value for patients and society, it could represent a challenge for genome medicine developers looking for sustained cash flow.”

Richter highlighted the case of Gilead Sciences’ treatments for hepatitis C, which reportedly achieved cure rates of over 90 percent, as a cautionary tale.

“GILD is a case in point, where the success of its hepatitis C franchise has gradually exhausted the available pool of treatable patients,” the Goldman Sachs analyst wrote. “In the case of infectious diseases such as hepatitis C, curing existing patients also decreases the number of carriers able to transmit the virus to new patients, thus the incident pool also declines … Where an incident pool remains stable (eg, in cancer) the potential for a cure poses less risk to the sustainability of a franchise.”

CNBC reported that in 2015 the company’s U.S. sales for hepatitis C treatments peaked at $12.5 billion but have fallen each following year. Goldman has estimated that U.S. sales of these treatments in 2018 will be under $4 billion, according to the report.

The report proposed three possible solutions for biotech companies:

“Solution 1: Address large markets: Hemophilia is a $9-10bn WW market (hemophilia A, B), growing at ~6-7% annually.”

“Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.”

“Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.”

The issues addressed in the report essentially means that mega-profits will be reduced to extremely large profits— but for more rare diseases, however, there is a concern that due to reduced potential income there may not be enough profits for biotech firms to justify the cost of research and clinical trials, usually at the cost of at least $1 billion.

Featured, Government Accountability, Politics

Senate Passes Bill Repealing Obamacare Provisions, Defunding Planned Parenthood

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The United States Senate passed a budget bill on Thursday that aims to repeal several key provisions of the Affordable Care Act and seeks to halt funding to Planned Parenthood.

HR 3762, the “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015,” would overhaul Obamacare provisions such as the requirement for most people to obtain healthcare coverage, the expansion of Medicaid, and the taxes imposed on income, insurance policies and medical devices that were required to fund Obamacare.

The bill would also put an end to the nearly $450 million given to Planned Parenthood annually. While the Senate did vote on over a dozen amendments to the bill, they rejected two amendments that would have given money to Planned Parenthood.

[RELATED: Federal Court: Obamacare Contraceptive Mandate Violated Religious Freedom]

The Senate also blocked proposals for increased gun control that were pushed after a mass shooting in San Bernardino, California, on Wednesday.

Although President Obama has promised to veto the bill, it marks the first time legislation of its kind could make it to the president’s desk without being prevented by Democrats in Congress.

Needing 51 votes to pass, the bill passed in the Senate 52-47, and will go on to the House of Representatives where it is expected to pass, as a similar bill was passed on Oct. 23.

Senate Majority Leader Mitch McConnell (R-Ky.) said the bill presents Obama with a choice that could lead to “better care” for Americans with his consent.

“President Obama will have a choice,” McConnell said. “He can defend a status quo that’s failed the middle class by vetoing the bill, or he can work toward a new beginning and better care by signing it.”

Healthcare spending topped $3.03 trillion in 2014, up 5.3 percent from 2013, which marked the highest growth since 2007.

In terms of GOP presidential candidates, the bill received the approval of Sens. Ted Cruz (R-Tx.), Marco Rubio (R-Fl.) Rand Paul (R-Ky.). Democratic presidential candidate Sen. Bernie Sanders (I-Vt.) did not vote.

Health, Politics

Obamacare Forces 2016 Insurance Premiums To Skyrocket

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October 27, 2015– Insurance premiums across the country are about to skyrocket yet again thanks to President Obama’s Affordable Care Act, more commonly known as Obamacare.

Former Tennessee Medical Association board member and current Emergency department director Dr. Omar Hamada says that he expects Obamacare will force insurance premiums to continue climbing for the foreseeable future.

“I see no end in sight for increasing insurance costs as long as Obamacare is the law of the land. Since becoming law, Obamacare has forced costs to skyrocket every single year,” said Hamada. “In Tennessee, the Obamacare co-op is shutting down because costs were catastrophically high and insurance premiums will climb again in 2016.”

Hamada says that Tennessee’s 2016 insurance rate hike is one of the highest in the nation.

“In 2014, Tennessee’s benchmark plan was $188 a month. In 2016, the plan will cost at least $250,” said Hamada. “By 2017, I expect the plan will be nearly $300. On average, premiums will cost at least 23 percent more in 2016.”

In Utah, those who buy healthcare insurance through brokers or the HealthCare.gov Obamacare exchange will see rate hikes up to 44 percent. The price of an average insurance plan for a 21-year-old will go up 13 percent to nearly $165 per month in urban Salt Lake County. Meanwhile, a 21-year-old living in rural Rich County will see a substantial 44 percent price hike to nearly $228 per month.

Oklahoma will see a 35.7 percent increase; Montana will have a 34.5 percent increase; Alaska will have a 31.5 percent increase; New Mexico will have a 25.8 percent increase; and South Dakota will have a 24.7 percent increase.

For the first time since becoming law, the Obama administration publicly acknowledged that those purchasing health insurance will be paying more to do so during Monday’s announcement.

Election, Featured

Paul Hits Trump On Socialized Healthcare And Support Of Clinton

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United States Senator and presidential candidate Rand Paul (R-Ky.) is doing something no other Republican candidate or party official is willing to do– throw down the gauntlet on Donald Trump.

Trump has said that he would run 3rd party if he doesn’t win the GOP nomination, which has led some insiders believe that Trump could be working with the Clintons to ensure a victory for Hillary.

In the first GOP debate, just as he refused to dismiss the idea of a 3rd party run, Paul slapped Trump with his support of the Clinton family by saying that Trump was hedging his bets because he is used to buying politicians.

Paul’s latest ad showcases Trump’s support of the Clinton family, socialized healthcare, and the Democratic Party in general.

Trump has since come out and said that he is considering rescinding his refusal to not run 3rd party and issued a lengthy response to Paul’s campaign ad.

Follow Michael Lotfi on Facebook, Twitter & LinkedIn.

Business, Economy

New IRS Regulation Threatens Small Businesses With Fines For Helping Workers With Health Costs

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A new regulation that went into effect on July 1 threatens small businesses with fines from the Internal Revenue Service of up to $36,500 a year per employee, if the businesses help their employees with health costs by reimbursing them for the cost of their healthcare premiums or by paying for their health costs directly.

The National Federation of Independent Business (NFIB) reported that the new regulation, which is not part of the Affordable Care Act, states that employers who compensate their employees for health costs, rather than offering a group health plan, “can be fined $100 per day, per employee,” which adds up to “$36,500 per employee up to $500,000 in total.”

Gracie-Marie Turner, the founder of the Galen Institute and a contributor to Forbes, noted that this new regulation is more than “18 times greater than the $2,000 employer-mandate penalty under Obamacare for not providing qualifying health insurance for employees,” and while employers with fewer than 50 employees are exempt from the employer-mandate penalty under Obamacare, they are not exempt from this penalty from the IRS.

“The rule appears nowhere in the Affordable Care Act but was developed by the Obama administration’s regulation writers at the IRS,” Turner wrote. “The rule punishes small businesses for providing the only health insurance support many can afford – a contribution to help employees pay premiums for their individual or family health insurance policies or to help finance direct payment for medical services.”

Kevin Kuhlman, NFIB’s policy director, called the new regulations the “biggest penalty no one is talking about.”

“The penalty for compensating employees for healthcare-related expenses is enough to destroy most small businesses,” Kuhlman said. “Reimbursing employees for the cost of insurance or medical services is a way for small businesses to help their workers without the administrative headaches of setting up a costly group plan.”

In response to the regulation, Rep. Charles Boustany (R-La.) introduced H.R. 2911 in the House and Sen. Charles Grassley (R-Iowa) introduced S.1697 in the Senate. Both bills are labeled as “Small Business Healthcare Relief Acts” and are awaiting congressional action.

Government Accountability, US

SCOTUScare: Texas Rep Introduces Bill To Force Supreme Court To Enroll In Obamacare

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Following the Supreme Court decision on Thursday to uphold Obamacare subsidies, Rep. Brian Babin (R-Texas) introduced the “SCOTUScare Act of 2015,” a bill that would force each of the Supreme Court justices and their aides to sign up for Obamacare.

In the case of King v. Burwell, the Supreme Court ruled, 6-3, that federal subsidies can be paid to customers throughout the United States, not just in the states that have established their own insurance exchanges under the Affordable Care Act (ACA).

Babin said that he created the “SCOTUScare Act” as a way to make the Supreme Court justices and their employees “see firsthand what the American people are forced to live with,” by removing their exemptions and making them join the national healthcare law’s exchanges.

[pull_quote_center]As the Supreme Court continues to ignore the letter of the law, it’s important that these six individuals understand the full impact of their decisions on the American people. That’s why I introduced the SCOTUScare Act to require the Supreme Court and all of its employees to sign up for Obamacare. By eliminating their exemption from Obamacare, they will see firsthand what the American people are forced to live with![/pull_quote_center]

The term “SCOTUScare” was used by Justice Antonin Scalia on Thursday, in reference to the Supreme Court’s decision on Obamacare.

In his dissent, Scalia said that while the Act that Congress passed makes tax credits available on an “Exchange established by the State,” this Court “concludes that this limitation would prevent the rest of the Act from working as well as hoped.”

“So it rewrites the law to make tax credits available everywhere,” Scalia wrote. “We should start calling this law SCOTUScare.”

Health, Politics, US

Obama Defends Obamacare, but Does Not Address the “Stupidity of the American Voter”

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On Sunday, President Obama spoke out in defense of the Affordable Care Act, after comments from its original architect, Jonathan Gruber, called the bill’s transparency into question.

As previously reported, a video of Gruber saying that Obamacare was made to appeal to the “stupidity of the American voter,” with “lack of transparency” being a “huge political advantage,” in its creation, was released recently.

According to Reuters, Gruber’s comments were “quickly picked up” by Republicans in Congress, “who are committed to repealing or dismantling parts of the healthcare law.”

USA Today reported that Obama addressed Gruber’s comments while at a news conference after the G-20 Summit in Brisbane, Australia, and insisted that the bill was “extensively debated,” before it went into law in 2010.

“The fact that an adviser who was never on our staff expressed an opinion that I completely disagree with in terms of the voters is not a reflection on the actual process that was run,” Obama said.

Although Gruber was not a member of the staff, Politico reported that he was a  “paid consultant whose models were used to help assess the impact of various policy changes being considered as part of health care legislation,” and that “official logs show he visited the White House about a dozen times” from 2009 to 2014.

According to the Washington Post, Gruber’s comments should be taken seriously, due to the fact that he is “well-known in health-care circles as one of the intellectual godfathers of Obamacare,” and because he received “nearly $400,000” from the Obama administration for his contribution to the Affordable Care Act.

Obama went on to insist that if there were any questions, every press outlet present should “pull up every clip and every story,” that was written on the bill.

“I think it’s fair to say there was not a provision in the health care law that was not extensively debated and was fully transparent,” said Obama. “It was a tough debate.”

Among the controversial comments made by Jonathan Gruber, at an academic conference in October 2013, he also claimed that Obamacare was “written in a tortured way,” in order to ensure its approval from the Congressional Budget Office (CBO).

“This bill was written in a tortured way to make sure the CBO did not score the mandate as taxes,” said Gruber. “If CBO scored the mandate as taxes, the bill dies.

According to the New York Times, while the Obama administration officials and congressional Democrats who were writing the law had “strong political incentives to ensure that the individual mandate they proposed would fit the CBO’s definition of things that don’t have to be counted on the federal government budget,” it is important to note that “the versions of Obamacare that received public discussion and debate never broke from that goal.”

Politico reported that although Obama had a “dismissive tone toward Gruber,” he has previously acknowledge that “some of his own statements about the law were ill-advised,” such as his “repeated promises that if Americans liked their health care plans they could keep them.”

Economy, Health, Politics, US

Obamacare Has Raised Healthcare Premiums by Up To 78 Percent

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On Tuesday, a study revealed that under the Affordable Care Act, rather than decreasing the cost of healthcare, some groups have experienced raises by as much as 78% in insurance premiums.

The study, conducted by HealthPocket, a nonpartisan health insurance research company, compared the average healthcare premiums before Obamacare was enacted in 2013, to the current average premiums in 2014.

According to the Washington Times, the study 23-year-olds experiences the greatest increase in insurance premiums, with men “seeing an average 78.2 percent price increase before factoring in government subsidies, and women having their premiums rise 44.9 percent.”

The study also found that 30-year-olds experienced a dramatic increase, with men paying 73.4 percent more, and women paying 35.1 percent more.

The head of research and data at HealthPocket, Kev Coleman, said that the study was “very eye-opening in terms of the transformation occurring within the individual health insurance market.”

“I was surprised in general to see the differences in terms of the average premiums in the pre-reform and post-reform markets,” said Coleman. “It was a higher amount than I had anticipated.”

The Daily Caller reported that the major increase in insurance premiums for men can be explained by the fact that “Obamacare bans insurers from charging women more,” and by the fact that insurers are required to cover a plethora of services, even if the customers don’t want them, such as “maternity and newborn coverage,” for both men and women.

According to the Washington Times, the major increases among younger insurance buyers “could be a problem for Obamacare’s long-term solvency given that young people are needed to offset the higher costs associated with older policyholders.”

 

Health, Polls

Scheduling an appointment with a Psychiatrist is not as easy as it sounds

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WASHINGTON, October 20, 2014 – Nearly 93,000 licensed psychiatrists are listed in the United States, yet a new study conducted in several metropolitan U.S. cities found that it is very difficult to secure an appointment with one of them, regardless of insurance or ability to pay for services.

The study was conducted in Boston, Chicago and Houston and included 360 office that investigators, posing as patients in search of psychiatric services, reached out to. Investigators claimed to have health insurance or expressed a willingness to pay for the cost of care out of pocket in their phone calls, yet only secured appointments with around 25% of the doctors. Of appointments scheduled in the study, the average wait time for the first visit was a 25 day period.

Investigators made two attempts to contact each psychiatrist. Cold calls in the study found that 16% of the offices in the sample had incorrect listings with the major private insurer database. Nearly one third of the offices contacted failed to return the investigators’ phone calls.

The findings of the study confirm what many professionals and activists in the mental health community have known for quite some time, and that is that the mental healthcare system in America is inadequate.

According to the CDC, 25% of all Americans live with a mental illness, while nearly 50% of Americans will experience a mental disorder at some point in their lives. Yet, less than 40% of Americans receive the mental health services they seek according to a survey conducted by the Substance Abuse and Mental Health Services Administration.

The Affordable Care Act of 2008 expanded mental health benefits to 32 million people by enforcing rules that forced private insurers to reimburse mental health services in the same manner as physical health care. However, this expansion of health insurance does not seem to have had any substantial impact on the availability of mental health care in the U.S.

Dr. J. Wesley Boyd, the senior author of the study and an assistant clinical professor in the department of psychiatry at Harvard Medical School spoke with WebMd concerning the study’s implications and stated, “One message from this is that having insurance, even good insurance, is not enough to guarantee that you can get the mental health care you need.”

Several contributing factors contribute to the lack of accessible mental health care in America. A 2013 study found that psychiatrists were less likely to accept private insurance than doctors in other fields. The study also found that psychiatrists accepted other insurance plans, such as Medicaid and Medicare at significantly lower rates than other doctors.

Access to psychiatrists is also very limited in many parts of the United States. A report in 2009 by the Center For Rural Affairs found that over 85% of the 1,669 federally designated “mental health professional shortage areas” were rural locations. The report stated, “Only in rural America did the National Advisory Committee on Rural Health find entire counties with no practicing psychiatrists, psychologists, or social workers.”

The ability to meet with a doctor and develop a comprehensive plan to manage mental disorders is imperative for those who suffer from mental illness. The consequences of an individual not receiving treatment for mental illness in a timely manner can be staggering and include substance abuse, loss of job, homelessness and suicide. The risk of suicide increases 300% for those struggling with a mental illness according to the University of Washington’s School of Social Work.

“It’s all the more poignant for those who are profoundly depressed or anxious, because for them it may really be just too much to be able to make enough phone calls and endure all the hurdles in their way before actually being able to secure an appointment.” Boyd stated.

The collaborative care model is a practice that is gaining traction among professionals in the mental health community, the model “expands across the entire health care process, including diagnosis, treatment, surveillance, health communications, management, and support services, and allows families to make their own health care decisions.”

Many in the mental health care field believe this approach offers solutions for some of the problems plaguing the field. Former American Psychiatric Association president Dr. Jeffrey A. Lieberman stated in his Everyday Health column that the “collaborative care model could ensure parity for mental ailments that have been stigmatized for decades.”

Lieberman also stated, “Collaborative care can help solve the shortage problem. This approach brings together mental and physical health services for patients, so that psychiatric and primary care doctors are working in close coordination with each other and with care managers. The combination of better mental health coverage through the Affordable Care Act, an increase in accountable care organizations and patient-centered medical homes, and long overdue national attention to mental illness mean this is a life-changing time for so many Americans who have been stigmatized and denied equality in health coverage and benefits.”

Follow Michael Lotfi on Facebook & Twitter.

Featured, Politics, US

As Scottish vote for independence, more Americans think of secession

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As the Scottish vote to secede from the UK failed, the idea of secession has been picked up by almost a quarter of Americans who say they would be open to the idea of their respective state leaving the Union.

A new Reuters poll, which took place between Aug. 23 and Sept. 16, found 23.9 percent of Americans strongly support the notion of their state breaking away from the larger US.  However, on the other side of this argument, of those polled, 53.3 percent strongly opposed the idea.

The idea to secede seems to be split down party lines too, as more Republicans, 29.7 percent of those polled, support their state standing on its own, while 21 percent of Democrats who were polled supported the idea for their state.

Many Republicans cited their dissatisfaction with the way the Obama administration has handled various issues as to why they liked the idea of secession.  These issues range from the current administration’s handling of ISIS in the Middle East, to the healthcare reforms put in place recently.

Others said they don’t believe Washington gets anything done, and they feel if their state would break away, things would be better off.  Roy Gustafson, 61, of South Carolina, told the Sun Sentinel, “I don’t think it makes a whole lot of difference anymore which political party is running things. Nothing gets done… The state would better off handling things on its own.”

One state that has taken the idea of secession seriously is Texas, where a group known as the Texas Nationalist Movement has been looking into ways to leave the US behind in hopes of establishing their own nation.

Daniel Miller is the director for the TNM who was excited for the Scottish vote to breakaway from the UK.  Miller said, according to USA Today, “We’re excited that they are able to have a voice, to be able to go to the polls and voice their political will on the issue of self-determination…”

Interviews, US

Exclusive: Libertarian Candidate Wants To Stop Vermont’s Single-Payer Health Care

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If you thought that Obamacare was intrusive, just wait until you hear what’s going on in Vermont where the government there is trying to create a single-payer healthcare system, like Canada.

Libertarian Dan Feliciano, who is running for governor, has stopping the single-payer healthcare system as one of his campaign tenants.

“I have a deep understanding in healthcare, the single payer solution does nothing, absolutely nothing to drive the primary cost of healthcare down,” said Feliciano.

If Vermont goes single-payer they will be the most taxed state in the Union and that fact isn’t lost on Feliciano.

Feliciano told Benswann.com’s Joshua Cook, “The first thing we need to do is get all the tax structure under control. Vermont is a great place to live, but we pay some of the highest taxes in the nation,” he said.

“So the key issues that I’m going to talk about are reducing spending and cutting waste,” he added.

He’s looking to this campaign as an opportunity to raise awareness for the Libertarian party: “This is an incredible opportunity for us, especially the Libertarian Party in Vermont. I mean, we have a really great party and we are really looking forward to this campaign.”

Feliciano said that he is a problem solver and he knows how to fix Vermont’s biggest issue: Healthcare. “I have over 20 years of experience and deep expertise as a business improvement consultant and strategy and change consultant. The problems we face as a state I have seen before and I know what it takes to fix them,” said Feliciano.

Feliciano faces incumbent Democrat Peter Shumlin in November, along with several other contenders.

Here is a video from his website:

Politics

Democratic Senator: If You Want Your Doctors Back– Pay More

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WASHINGTON, February 4, 2014– US Senator Jeanne Shaheen (D- N.H.) said in an interview last Friday that the millions of people who have lost their doctors due to Obamacare may be able to get their doctors back. However, there’s a catch. “They have to be willing to pay more,” she said.

Wasn’t the point of the “Affordable Care Act” to cut the costs of medical care? On average, premiums have skyrocketed 44% due to Obamacare. In many cases, premiums have even tripled. According to Shaheen, the solution is to simply pay even more for healthcare.

“At least for people who are willing to pay more, that they have that option of going to their doctor and hospital no matter what their insurer does,” Shaheen stated.

Here, Shaheen attempts to shift blame on the insurance companies. However, the healthcare law prohibits insurers from offering many plans. As a result, millions lost their health insurance and doctors respectively.

“Welcome to New Hampshire’s shiny new two-tier healthcare system. You can keep your doctor and access the best hospital for you, but only if you are willing to pay more –much more. Does Senator Shaheen really think she’s off the hook because she voted for Obamare, but did not write it,” said Republican challenger Jim Rubens.

Shaheen told supporters at a private event that Obamacare was having a positive impact. In contrast to Shaheen’s claims, major insurance providers have dropped at least ten hospitals in New Hampshire, and now tens of thousands of women in the state are without care providers due to Obamacare.

In the interview, Shaheen even admits that there is a serious lack of doctors and hospitals accepting the new healthcare plans under Obamacare. However, she refused to answer whether or not she’d vote for it again if given the chance.

Follow Michael Lotfi on Facebook & on Twitter:  @MichaelLotfi

 

Health, US

Obamacare: Beware the Invisible “Glitches”

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I recently wrote an impassioned article about the philosophy that underlies the Obamacare and the way in which it was sold to the nation.

Its argument stands, but I have just learned that that article included an error – an error made because of problems with the WA Health Exchange site through which I purchased my plan.

My conscience requires me to write this follow-up – not just because I don’t want to be knowingly peddling half truths, but also, and rather more urgently, because my discovery of the error leads me to believe that thousands of families may be paying massively more than they have to for their insurance under Obamacare or may be unnecessarily going without health insurance altogether.

The sentence in my previous article that I have to revisit is this one.

A slightly worse policy [than the one I had before the ACA was implemented] (which I have purchased) costs me 20% more – presumably somewhat “subsidized” on account of my modest income.

It was wrong on two counts. First, the policy I bought under Obamacare was not slightly worse than the one I had pre-Obamcare – it was much worse. Second, that higher price I was paying for that policy included no subsidy whatsoever, despite the fact that I am, as I supposed, eligible for such a subsidy on account of my income.

Here’s why.

Some time after my former health insurance provider cancelled my policy last year – and then informed me that the price of their nearest equivalent policy under Obamacare was so much higher that I could not afford to buy it – I reluctantly ventured onto the Washington State Health Insurance Exchange website and entered my details … and selected the cheapest policy available, which was, as per my earlier article, 20% more expensive than the one that had been cancelled.

My first premium payment cleared my account last month and I was enrolled in my new healthcare plan as of 1 January.

Although I figured I was eligible for a subsidy, when I purchased my new policy, the WA site provided no information about the amount of that subsidy, instead giving me just my final policy premium.

Three weeks later, I wrote my recent article on Obamacare. I sat on it for days while I made multiple attempts to call “customer service” at the State exchange to find out the exact amount of the subsidy I had been eligible for. Every time I called (I stopped counting after the fifth attempt), I would get a recorded message that told me that they’d “been receiving a large volume of calls” and that I should call back another time. Rather than wait any longer, I published the article.

But I remained curious about the exact amount of that subsidy – and continued to try to get through. (I even sent an email but no reply as yet.) However, in one of my attempts to pull the exchange’s website, I obviously made some error in the search field, and clicked on the site of an insurance broker with a similar URL.

Assuming that I was just on a newly updated version of the WA state exchange site, I called the number on the page. When I got through, I expressed surprise to the gentleman who picked up the phone and, realizing after a few seconds that something strange was afoot, I asked if I had gotten through to a private company accidentally.

I had. And it turned out to be the best mistake I have made since, well, Obamacare.

Vernon, my accidental new health insurance agent, was able to pull up the original application I had made through the state exchange website and answer my question, at last: the total subsidy that had been applied to my health insurance premium was … zero. But he could also see that I was eligible for a subsidy based on income, and quickly worked out why it had not been applied.

The reason is shocking because of its implications.

I had made the “mistake” of correctly answering two questions in my application as they were asked – but not as they were meant.

The first question was whether anyone in my household had any other insurance policy. I answered affirmatively since at the time of applying, I had a privately purchased policy. In fact, said Vernon, the system took an affirmative answer as indicating that I had an employer-provided policy, which makes me ineligible for the subsidy.

The second question was whether I had a passport. I answered affirmatively and entered the required details. Despite the fact that I had already told the system that I am a legal permanent resident (which makes me eligible for a subsidy), another glitch in the system, Vernon informed me, caused it to make me ineligible because my passport is not American.

It turns out that what the system really needed was my greencard number – but it never asked for that.

This is frightening: if it weren’t for the fact that I was a curious political writer who wanted to know exactly what subsidy I had been eligible for; that I had not been put off by the many times I had tried to get through to the exchange to find out that information, and that I typed in a wrong URL somewhere along the line and gotten through to a private health insurance broker, I would never have known that I didn’t have to pay anything close to the amount that I had already begun paying for my healthcare. Vernon sorted it out for me – but how many other Americans, I wondered, have failed to have the subsidy to which they are “entitled” applied to the cost of their premium? These are not small amounts.

But it was just as well that I didn’t enter a state of shock – because I probably wouldn’t have been able to get treatment for it under my new plan, as Vernon went on to explain.

As far as I could understand, the plan I’d chosen on the state exchange is administered by the same organization that provides Medicaid coverage, which pays doctors 25 cents on the dollar for their work. Most doctors and hospitals don’t want to deal with this so they refuse patients with coverage from this organization. Therefore, the policy that I was paying over-the-odds for has an extremely limited range of doctors, hospitals and treatment options. I knew my new policy was worse (in terms of deductibles etc.) than the cheaper one that had been cancelled – but I had no idea that the quality of care I could receive under it was significantly poorer than that supported by any other policy I could have chosen, including some only very slightly more expensive.

None of that critical information about the policies, obviously necessary to making any informed decision, was available on the State site. I ventured to Vernon that the whole thing was outrageous. He agreed, and told me that you shouldn’t expect the State to be able to broker healthcare.

Touché.

Whether someone buys a policy on the State exchange, and then takes the subsidy that may enable them to undo the increase in cost of the policy under the Affordable Care Act, is up to him or her to decide, and I have been public about my philosophical issues with the whole thing. Nothing I say here changes my earlier argument – but a system that drives the cost of a product up, and then mandates purchasing it, is surely even worse if it fails to enable some people to enjoy the financial remedy to which the same system “entitles” them.

I know now that problems with the State and Federal exchanges are much more than glitches. They are serious errors that are causing unsuspecting individuals and families to pay massively more than they are legally required to pay for something they are forced to buy. And faced with this unnecessarily high premium, some families will decide not to carry insurance at all. This puts lives at stake.

There will be yet others who made the other mistake I made – of choosing a policy that looked like all the others on the website, without having any idea that when they need it, they’ll get massively worse care than they would have if they had spent just a few bucks more. They will make that mistake because the state site on which they buy their insurance is missing critical information. This state of affairs is frightening because a non-expert could never know what pertinent information is missing.

Consider this a public service announcement.

Please, for the sake of your family’s physical and financial health, do not do what I originally did and simply visit the website of your state exchange, buy a plan, and assume everything is fine. Find your own Vernon – an experienced private health insurance agent who is authorized to help you buy a plan, on the exchange if you so choose. He knows more about the glitches in the system and the plans on offer than you do.

Somewhat ironically, that’s because he’s had to compete in a real marketplace and would already be out of business if he couldn’t.

Politics, US

Obamacare Group Gets $1M To Pitch “Obamacare Success Stories” To Media

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MSB

By Michael Lotfi,

The President’s landmark legislation has been anything but successful. Premiums have skyrocketed, millions have lost their doctors and their insurance, three twenty-year-old college kids built a better website in a few days than the Obama administration could construct with hundreds of millions of dollars and years to do so, and polls show that the majority of Americans flat out want the law totally axed.

Step in the  Robert Wood Johnson Foundation. The liberal healthcare foundation is paying Families USA, a non profit healthcare advocate organization, $1 million to plant the media with pro-obamacare success stories.

According to TIME, Ron Pollack, Executive Director of Families USA, says that the donation will significantly expand the story bank, which will be delivered to various news media outlets. Pollack says there are more than 900 stories with more to come.

The Obama administration and supporters are working overtime to turn public opinion on the Patient Care Act. Negative association with the name “Obamacare” has even prompted the administration to no longer use the term and only refer to the healthcare law as the Patient Care Act. The $1 million grant is sure to help redirect the negative attention away from the failures of the President’s healthcare law.

Follow Michael Lotfi On Facebook & Twitter

Interviews, US

Exclusive: Hospitals Using DHEC to Shut Down Natural Birth Centers in SC – UPDATE

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 See update below…

Hospitals are losing millions to natural birth centers and want to use government regulation to eliminate their competition.  According to an employee of a Fort Mill center, Obstetricians from Rock Hill sent an email to a S.C. Department of Health and Environmental Control (DHEC) board member in order to shut down the center.

They succeeded. In September, the license for a Fort Mill birth center was suspended pending an investigation by DHEC.

According to the Charlotte Observer, the center released a statement saying it is appealing the suspension, which stemmed from “a birth with a bad outcome.”

Benswann.com’s Joshua Cook reached out to one of the midwives who works at the center to get more details.

Christine Struther from Carolina Community Maternity Center states, “we been suspended since September 2nd because of two citations. One was thrown out because they were saying that we didn’t have an agreement with EMS which we do. That wasn’t a valid citation. The other one was regarding a policy statement that we changed and got resolved.”

“So the only reason why we are still suspended is this “physician on call” statute that they are enforcing now. They are able to keep us closed. We are appealing this in court now,” said Struthers.

But this reinterpretation of the statute doesn’t effect just the Fort Mill center. DHEC now requires all birth centers throughout the state to be supervised by physicians or be suspended.

“South Carolina has over 80 percent of physicians working for hospitals already and cannot work for a birth center even if they want to,” said Struthers.  “DHEC is not giving birth centers time to comply with this new interpretation of the law, and Birth centers are now being told that they have 15 days to comply or they will be shut down.”

Lesley Rathbun, owner and director of the Charleston Birth Place, told Charleston City Paper that “the state agency is reinterpreting its regulations for birth centers and could end up shutting down non-hospital birthplaces across the state.”

“We’re really concerned about what’s going to happen to the consumers,” says Rathbun. “They do about 30 births a month here, and similar numbers in the other birth centers,” Lenehan says. “These people, as you can see, are looking for a really different product than they’re going to get in the hospital, and they’re not going to be able to get that elsewhere. This is safe, it’s cost-effective, and it’s what the customers desire. So what’s going to happen to all these mothers who are due in three weeks?”

Joshua Cook asked Struthers why expecting mother choose to deliver at natural birth centers?

cozy room“Our birth center is beautiful and people love it. I had people literally come into a tour and cry because they want to be here because it’s that nice. They get to be with the same person. If I’m your client, I’m with you the whole time,” said Struthers.

Citizens are outraged that they may lose the freedom to choose where to birth their children because of crony capitalism. 

A licensed Midwife, Brandy Brandfass states, “H. 3731 is nanny-state legislation at its worst. South Carolinians have historically placed great value on the freedoms we have. When we leave families without access to trained professionals, we eliminate their option to decide among varied, highly-educated maternity care providers. It is restraint of trade, and an attempt to medical monopoly.”

Struthers concurs with Brandfrass and believes that there is a financial motivator behind this audacious move to shut down birth centers. “If you go into a hospital it will cost you over $11,000, and a cesarean section is double that. In S.C. the cesarean section rate is around 34% and last year our cesarean section was about 2%  … that’s a lot of money these hospitals are losing.”

 

Struthers is encouraging people to join them in a protest this Monday, Demonstrate DHEC – Rock Hill Rally, and supporters of birth centers have created an online petition with over 2,400 signatures so far.

 

We just received this breaking new from the South Carolina Birth Coalition and from a local birth center. There will be an official press release that we will publish here.

Read the South Carolina Birth Coalition message via Facebook.

Post by South Carolina Birth Coalition.

 

Politics, US

Bunny Ranch Prostitutes Say They Love Obamacare

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The legal prostitutes at the Bunny Ranch brothel in Nevada say they love Obamacare.

In interviews conducted by KRNV-TV, multiple prostitutes expressed full support the new healthcare law.”I’m really for Obamacare, I’m excited,” gushed “working girl” Taylor Lee.

Another prostitute, Caressa Kisses, said that her profession has caused her to be considered “high risk” for STDs by insurance companies. This makes her insurance rates very high, she claimed.

Kisses said, “They equate us to illegal working girls, who have very high STDs and AID rates. We have none of the above — we’re legal, licensed prostitutes. I see the doctor every week, it’s state mandatory. We’re tested weekly and monthly for blood.”

“We’re independent contractors, so we have to get our own insurance,” she continued. “[Obamacare] is really a blessing. We hope that the kinks are worked out and that affordable healthcare for all happens.”

But, like many Obamacare supporters, these girls might not know exactly how the healthcare bill will affect them.

These girls will be able to get insurance thanks to Obamacare. However, what they probably do not know is that healthcare will likely cost them a lot more under Obamacare than it does now. This is because most of the prostitutes at the Bunny Ranch make too much income to qualify for government subsidies, meaning they’ll have to pay the full price.

In most states, individuals may only receive subsidized healthcare if their income puts somewhere near the poverty level.

In other words, if you make around or more than the average American income (which is about $50,000), you receive no government help with healthcare costs. Subsidy eligibility may be determined using the Kaiser Calculator.

According to Dennis Hoff, the owner of Bunny Ranch, almost all of his “working girls” make much more than $50,00o per year — in fact, he has claimed that his most popular prostitutes can make that much in just one month.

This means that the prostitutes are far from qualified for any subsidy.

One can only wonder what these girls will be saying when they find out exactly how much Obamacare will actually cost them. There is little doubt they will experience sticker shock.

 

Follow Kristin on Facebook and Twitter.

Politics, US

Big Unions May Get Their Obamacare Exemption After All

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The President has been under increased pressure from unions, which are seeking any possible exemption they can from his healthcare law. However, the President assured America that no one was getting an exemption– not even labor.

On Sept. 11, the last day of the AFL-CIO quadrennial convention was held in Los Angeles. Here, prominent labor leaders attacked provisions of the health care law, warning that if left intact they would devastate union-backed health plans that were decades in the making. Terry O’Sullivan, the International Union of North America General President, addressed the convention,“We’ll be damned if we’re going to lose our health care plan because of unintended consequences.”

Unions are in an uproar because the Patient Care Act does not allow them to receive premium tax credits under multiemployer union health plans and forces them to pay the reinsurance tax. In a resolution, labor also demanded that the ACA excise tax, reinsurance tax and other taxes to be nullified  for collectively bargained plans, union administered plans and other various plans that cover union-represented workers.

Robert Scardelletti, president of the Transportation Communications International Union/International Association of Machinists (TCU/AIM), estimates that  under current ACA rules, his union’s multiemployer health fund will have to pay $27 million in taxes. He’s not happy about it.

At the convention, labor said that if their demands weren’t met, then the Affordable Care Act should be repealed.

Three days after the convention the Obama administration told labor– no exemptions. It was not legally possible.

However, those exemption requests by labor are now coming to fruit. Last week the Obama administration released hundreds upon hundreds of pages worth of new rules and regulations for the healthcare law. Inside, a new loophole for unions was discovered. A disclosure exists that the administration will propose exempting “certain self-insured,  self-administered plans” from the laws reinsurance tax. Such a description applies to the majority of the Taft-Hartley union healthcare plans, which act as their own insurance company and claims processors.

Eliminating this specific fee was one of the key parts of the resolution adopted by labor at the convention. According to a report by Kaiser Health, labor most likely just got their exemption.

Piece by piece Obamacare  is being chipped away at via exemptions, which are all against the law. However, unions have proved a point that perhaps all opponents of Obamcare should take note of. When organized, Obamacare can be defeated.

To read more about how Obamacare is not a law, but a new 3-letter agency read my op-ed.

Follow Michael Lotfi On Twitter: @MichaelLotfi

 

Politics

Obama’s Trick Or Treat: “I Just Lost My Doctor”

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“We will keep this promise to the American people. If you like your doctor, you will be able to keep your doctor. Period,” President Obama (2009). It was repeated again, again and again all over the country. It was, in fact, the propagandized phrase that sold the health care bill. That, and “This is not a tax!” …Oh, but it is.

Moments before the clock struck midnight to usher in Halloween one woman saw first hand– It was all a trick. Whitney Smith, a Tennessee citizen, arrived home from work to see a letter from her insurance company. After ignoring the letter for a while to settle in at home, as many of us do, she finally opened it.

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What she saw didn’t shock her. “I’m shocked… not,” says Smith. Her doctor is no longer a provider with her Aetna insurance group. Smith tells us that her doctor is leaving the insurance group to opt for cash only practice because of Obamacare. The plan that the doctor provided didn’t meet the requirements of Obamacare.

Smith says she was more than happy with their family doctor. “He was extremely affordable, I could see him fast and easily get a referral.” says Smith. The insurance plan was provided under Smith’s husband, a firefighter for a local city

Reports surface every day of doctors no longer accepting health insurance and moving to cash only practices. (Video Below)

Other doctors are simply being dropped from insurance providers, which is causing thousands of people to be left out in the cold without their doctors. Smith’s situation seems to be a combination of both. (Video Below)

 

The go to retort for Obamacare proponents is that the health care law says nothing about insurance prices going up, people losing their doctors, or their health care plans being dropped. Of course the law doesn’t say that. What these proponents fail to account for are the tens of thousands of pages of regulations, which generate countless negative economic externalities in the health care industry.

-Happy Halloween

Follow Michael Lotfi on Twitter: @MichaelLotfi

US

Obamacare Website Company Contributed to Obama Campaign

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Have you heard of CGI Federal? It’s the company that received a $678 million no-bid contract to develop the disaster that is healthcare.gov. It is also the company whose officials are now coming under scrutiny for the roll out of the Obamacare exchange web portal. But it also seems like those officials are also buddy-buddy with the Obama administration.

According to The Daily Caller, Toni Townes-Whitley, a senior vice president at CGI Federal, is a Princeton classmate of First Lady Michelle Obama. Townes-Whitley and Mrs. Obama are both members of are both members of the Association of Black Princeton Alumni.

As reported by the Washington Examiner in early October, the Department of Health and Human Services reviewed only CGI’s bid for the Obamacare account. CGI was one of 16 companies qualified under the Bush administration to provide certain tech services to the federal government. A senior vice president for the company testified this week before The House Committee on Energy and Commerce that four companies submitted bids, but did not name those companies or explain why only CGI’s bid was considered.

According to Federal Election Commission Records, Toni Townes-Whitley gave $500 in 2011 and 2012 to Obama’s reelection, and another $1,000 to the Obama Victory Fund.

The Washington Examiner reports that senior officials at CGI Federal had White House access. Before being granted the no-bid contract, CGI Federal officials attended several invitation only addresses by President Obama. White House visitor logs show that “CGI Federal President Donna Ryan visited the White House six times prior to her company being selected to do the IT design work behind the high-profile website.”

Two of the meetings attended by CGI executives were with Vivek Kundra, Obama’s chief information officer. Kundra was a key figure in Obama administration information technology initiatives across the government.

Ryan met Kundra on June 21, 2010, in the latter’s Old Executive Office Building office, according to the White House visitor logs.

In addition to the $88 million contract awarded to CGI Federal for the health-insurance exchange website, the company has received a total of $422 million in contracts related to Obamacare since the legislation was signed into law, according to Bloomberg News.

Fox News reported a number of occasions in which the company had failed to meet deadlines or experienced botched launches similar to that seen with the launch of healthcare.gov.

“In projects stretching from Canada to Hawaii, parent company CGI Group and its subsidiaries ran into complaints about its performance,” Fox reported.

“The morning I heard CGI was behind [Healthcare.gov], I said, my God, no wonder that thing doesn’t work,” said James Bagnola, a Texas-based corporate consultant who was hired by the Hawaii Department of Taxation (DOTAX) in 2008, to Fox News.

Bagnola suggested that CGI has been shrewd politically, giving to both Democrats and Republicans at both the state and federal levels. In the case of Hawaii, Bagnola said the company was able to continue to work on the DOTAX contract despite repeated complaints from management and a “corrosive” environment in which government employees felt pitted against CGI staff. This was noted in the final 2010 audit.

“I don’t have an ax to grind here, except I was just trying to do my job for this team and stop the state of Hawaii from being ripped off,” he said.

According to campaign records at OpenSecrets.com, CGI Group contributed $345,600 to federal candidates and parties — both Democratic and Republican — during the 2011-12 cycle. Some $147,000 went to the Republican Governors Association; and $35,000 to the Democratic Governors Association. The company spent $400,000 in lobbying expenditures between 2011 and 2012.

Opinion, US

Is Your Health Insurance Going Up? Readers Respond

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Is your health insurance rate going through the roof?

President Obama told the American public that the Affordable Care Act would save them approximately $2,500 in insurance premiums. But, many Americans are finding that not to be the case. They’re finding that their rates are going up and up.

We asked readers to share their stories. Here are some of those disenfranchised stories from our readers at Benswann.com:

“In New Hampshire 12 of the 26 hospitals will not take anyone with ACA insurance. My hospital is one that will not take ACA insurance, which means if I buy into the market place I will lose both my doctor and my hospital of choice.” (see article Telegraph)

 

“Obamacare is going to kill entrepreneurs like myself and put many small business owners on the streets. My family and I had our own plan independent of my employer from Humana.  It was a high-deductible plan where only regular check-ups were covered.  Everything else required to be paid out of pocket up to $10,400 annually.  It cost us $256 a month. Humana has informed us that this plan is no longer eligible under the Affordable Care Act.  Instead of going to Healthcare.gov, I went to eHealthInsurance and looked up plans available there.  Humana now offers another plan, which costs about $444 a month.  It is similar to the high-deductible plan I had with them with a little extra coverage. Oh, and the annual out of pocket limit is around $12,000 now. So my only option is to go with a plan that is worse for both me and my family or pay a fine.  Many friends on Facebook can’t believe this is happening when I announced it to them.  They seem to believe that Obamacare is not responsible for me losing my health insurance and having to spend more money for it.”

 

“My husband and I are the parents of 6 children.  We have been insured through Blue Cross Blue Shield of NC on a catastrophic plan with a premium of $256 per month.  We just received our premium increase.  Our new premium is now $1,170 per month!  That is for the Bronze plan, with a $5,000 deductible per person or $11,000 for the family.  I have been trying for days to finish finding what it will really cost me through the health.gov website.  It took hours to fill out the application when I finally got through to the site, and then I could not finish the process and have tried since last Friday to get through to find what this will really cost us.  Still no luck.  Depressing, to say the least.  Even if I don’t have to pay the full amount because of my income, I despise the thought of someone else covering that on my behalf.  It is SOOO immoral!”

 

“I just got word from Kaiser Permanente that my premium is going up 77.2%.  This is a plan that I purchase entirely on my own without any assistance.  The monthly fee increase is $108.83.  I haven’t looked at the coverage to see if I’m better or worse.”

 

“With so many people’s premiums and deductibles going up, I find it hard to believe that the ACA is nothing more than a bailout for the insurance companies and a transfer of wealth from the working middle class, entrepreneurs, and small business to the mega insurance corporations.”

Last week we posted a poll entitled What Is Obamacare Costing You? Below are the results.*

 

obamacare-poll

 

 

*This is not a scientific poll. The results are based on the respondents that required an email address and was IP specific. Thanks for those who participated.