INSURANCE NATIONAL

Aetna Will Probably Abandon the Individual Major Medical Market

noreply@blogger.com (sales) — Sat, 11 Dec 2010 08:28:00 -0800

Aetna has made another stupid move that will most likely cause them to abandon the individual major medical market in the next 18 months. Always a pain in the butt to deal with and customer service that is really cuss-tomer service.

Their latest move will put their very small block of individual major medical business into a death spiral.

Obamacare is taking its' toll on the individual health insurance market, leading to fewer choices and higher premiums. Parent's looking for children's health insurance have almost no options except to add them on as a dependent to their own plan.

Obamacrap has also killed the maternity benefit as an option in Georgia.

Last week Aetna sent a notice to agents that compensation will be cut drastically. New business comp is half what it was before. As if that wasn't enough, they also are cutting existing comp on in force renewal business by 70%.

The result will be agents will be forced to abandon Aetna as a resource for new business (no big loss there) and will move as many healthy clients as possible to new health insurance companies leaving Aetna with only the sick people.

Aetna's block of business will deteriorate to the point that premiums will be insufficient to cover claims, leading to larger and larger rate increases going forward. The policyholder's left behind will be held captive with no place to go and few options. Either they will have to pay the higher premium or drop coverage and go without for at least 6 months until they can get into Obama's PCIP program.

This is just another stupid carrier trick.

Healthcare Shortages Coming up: Thanks Lots, ObamaCare©! [UPDATED]

noreply@blogger.com (sales) — Fri, 10 Dec 2010 12:00:00 -0800

FoIB Bob D tips us to this interesting (if disheartening) news:

"(C)hildren’s hospitals are facing drug price hikes that will cost them hundreds of millions of dollars to supply needed medicine to children with rare diseases."

This is a direct, if unintended, consequence of the rush to get ObamaCare© passed before anyone actually, you know, read it. Because it was rammed through so quickly, but haphazardly, crucial wording that would have allowed the discounts to continue was omitted. Already, two major drug manufacturers have announced that these deals will be "suspended."

And lest you think this is heartless of "Big Pharma," remember whose perfidy caused this problem in the first place. Here's a hint.

But it's not just "the children" getting the short end of the stick; New York-based internist Dr Marc Siegel reports that, in a recent survey of 2400 practicing physicians, two thirds were against ObamaCare©. Worse yet, three fifths expected to "close or significantly restrict their practices to certain categories of patients." Almost as many acknowledged what we already knew: that they'd be required to spend less time with their patients. So much for "if you like your doctor, you can keep your doctor."

Thump, thump, under the bus you go.

Piling On: In case you thought Dr Siegel's piece was an outlier, here's this from Investor's Business Daily:

"Four in nine doctors responding to an IBD/TIPP poll sent out in August 2009 said they "would consider leaving their practice or taking an early retirement" if Congress passed what has become known as ObamaCare ... Now a Merritt Hawkins survey of 2,379 doctors for the Physicians Foundation completed in August has vindicated our poll. It found that 40% of doctors said they would "retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care"

Ooops.

Here's the bottom line: no matter how you slice it, ObamaCare© means less choice, less competition and higher health care costs.

And we all know what that means, right?

Cavalcade of Risk #120: Call for Submissions

noreply@blogger.com (sales) — Fri, 10 Dec 2010 06:55:00 -0800

Jason Shafrin hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 13th). Please remember to include:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

NB: The Cav is about risk, but not necessarily or exclusively about insurance. So feel free to think outside-the-box (e.g. driving and texting, the environment, vaccination, etc).

Better in the Great White North?

noreply@blogger.com (sales) — Thu, 9 Dec 2010 19:21:00 -0800

Uh, maybe not.

This Sceptered Isle Part LXIV

noreply@blogger.com (sales) — Thu, 9 Dec 2010 19:11:00 -0800

But of course if WE do it, it will work out better.

Skin in the Game

noreply@blogger.com (sales) — Thu, 9 Dec 2010 07:04:00 -0800

A longstanding meme here at IB is that health insurance costs increase because health care costs increase; a corollary to this is that, because we are insulated from the true cost of health care, we have little or no incentive to demand its efficient delivery. That is, since the majority of (private) health insurance is subsidized by employers, we don't really know what it costs, and since most of us have some kind of co-pay plan, we don't know the true cost of the care we receive.

If, for example, your employer covered a third of your car payment, would you really know (or care much) what that payment is? And if your car insurance covered oil changes, would you know (or care much) what your mechanic charges?

Human nature suggests that the answer would be "no, not really." After all, if someone else is fronting the bill, we don't have much (or any) incentive to question it or look for a better "deal." We saw this most graphically in the lobster dinner allegory, and now Investors Business Daily puts hard numbers to the phenomenon:

"Nearly 60% of American adults are covered by an employer-based plan ... Because Americans who have employer-based coverage see little money coming out of their pockets when they visit a doctor or go to the hospital, they have little incentive to keep costs down."

Or, to put it more bluntly, "(a) primary reason why health care costs are soaring is that most of the time when people enter the medical marketplace, they are spending someone else's money," as Devon Herrick (of the National Center for Policy Analysis) notes.

There are certainly times, of course, when careful shopping is inappropriate: in the ambulance when suffering a heart attack, the CareFlight helicopter at the scene of the crash. But for the most part, and especially when it comes to routine and maintenance claims, why aren't we more involved?

Another example: the typical prescription drug card now carries a $15 co-pay for generics. But who pays $15 anymore? After all, (almost) all can be found for $4 at Walmart or CVS or Krogers (to name a few); yes, it may involve a little time and travel, but it's once a month (or every three months). Even at $3 a gallon, how far would you be willing to drive to save $11 per scrip? And if you're on several such meds, the cost is even less. So why aren't we using this model for other aspects of health care?

Here's why:

"According to Herrick, for every dollar of hospital care that is consumed, a patient pays only 3 cents. The rest is paid by a third party ... When a patient visits a doctor, less than 10 cents of every dollar of care consumed is paid by the patient. Again, a third party pays the balance."

That "third party" is, of course, one's insurance carrier. But even that's not completely accurate: for the most part, the routine claims are really just a transfer of one's premium to the provider; it's not the "house's money." Still, it obscures the actual cost of the care itself, which then further exacerbates the increase in those costs.

And, as IBD points out (and as we've noted), "Medicare and Medicaid have also had an impact on spending, as they too are third-party payers that ... hide from patients the true cost of medicine." These two schemes actually represent a double-whammy: the first (as IBD notes) is that they pick up the bulk of the tab, which hides the cost from the beneficiary. But that cost doesn't go away: a goodly portion of it is shifted to the private insurance sector, which must then recoup that cost by raising premiums.

So what's the solution?

Herrick takes a novel (and, I think, effective) approach: he considers the case of the plastic surgeon. In almost all circumstances, plastic surgery is elective, and thus not available for insurance reimbursement (and, as we've noted, ineligible for network discounts, as well). So the real cost is very easy to determine: it's what the doctor bills you. One would think that, since so few of these expenses are "outsourced," demand would remain fairly level (or even decrease as folks' disposable income plummets in this economy). But that's not the case:

"1.7 million cosmetic surgical procedures were performed in 2008, "more than 40 times the number performed two decades ago." Yet cosmetic surgeons' fees, he says, have remained relatively stable, rising only 21% from 1992 to 2008."

So there are two effects at work here: on the one hand, patients' demand is higher than ever, but the cost of the care isn't. Why is that? Well, it's pretty simple: when folks are spending their own money (as they almost certainly are in this instance), they have an incentive to find the best "bang for the buck." And since providers are truly at the market's mercy, there's an incentive to keep costs as low as possible. The key is that the patient, not a third party, is in control.

Isn't it time we took control of our other health care needs, as well?

Health Wonk Review: Year-End Wrap-Up

noreply@blogger.com (sales) — Thu, 9 Dec 2010 06:30:00 -0800

Brad Wright hosts this year's final HWR, and it's a doozy. Lots of great posts, and some interesting illustrations to illumine them.

Obamacare and Single Payer

noreply@blogger.com (sales) — Wed, 8 Dec 2010 14:10:00 -0800

For some reason, many think they want a single payer health care system. What they don't know is, Obamacare has already created that in some situations.

I had a call today from a lady looking for health insurance with maternity coverage. I told her how her options were limited to one carrier. When she asked why, I said this was due to Obamacare.

She became annoyed and said this is why we need single payer so the carriers won't hold us hostage.

At this point I had no desire to give singing lessons, so I thanked her for calling and went back to the business at hand. But that got me thinking.

If you consider states like Maine that have intense regulation and mandates with regard to health insurance then it doesn't take long to figure out the only choice other than a government plan is Blue Cross.

If you don't like or don't qualify for the taxpayer funded plan you buy from Blue Cross . . . and you pay some of the highest health insurance premiums in the country.

Obamacrap has come to Georgia already in a sense. Last spring if you wanted maternity benefits you could pick from about a half dozen health insurance companies and different kinds of maternity benefits.

Thanks to Obamacrap, now you have one choice.

Blue Cross.

If you want maternity coverage in Georgia you buy from Blue Cross. The additional premium (in addition to the regular premium on this "Cadillac" plan) is about $200 per month. You must pay that premium for 12 months before you conceive and then you can start to access the benefits.

Over a two year period (your one year waiting period plus another 9+ months waiting on the baby) you will pay in over $2,000 in additional premiums. Once the baby arrives and the bill is totaled, your share of a normal delivery will be about $5,000 and Blue Cross will pay less than $1,000.

Once Obamacrap became law every carrier but Blue Cross pulled out of the maternity market making them, in effect, a single payer.

Many will remember the days of Ma Bell when you got your service from AT&T (or one of their subsidiaries) or you didn't have phone service. Your phone came in a basic black (although they later added different colors for the Princess line), but your choices were limited.

And everyone complained . . .

Now we have phone service in all sizes and packages, and people still complain, but at least you have a choice. If you don't like your current phone company you can go somewhere else.

But in Georgia, if you want maternity coverage you pick Blue Cross. If you don't like what they have to offer you do without because Obamacrap has made them a single payer when it comes to maternity coverage.

So for those who think they want single payer, how is this working for you?

(Military) HealthcareGates

noreply@blogger.com (sales) — Wed, 8 Dec 2010 06:00:00 -0800

A fundamental premise of ObamaCare© is that government is a more efficient manager of health care costs. As we've already shown, this is simply not the case. Medicare, though, is only one existing federal health care scheme; another, lesser-known one is the military's health care "system," known as "Tricare."

To give readers a sense of how out of control government-sponsored health care is, one need only consider the words of a retired Marine who chose to stay in that system despite the very nice benefits package available from his current employer:

"(H)e and his family remain on the military’s bountiful lifetime health insurance, Tricare, with fees of only $460 a year. He calls the benefit “phenomenal” ... It is so cheap compared to what Booz Allen [his current employer] has ... acknowledging that premiums called for by private employers can run many times greater."

No kidding! Could that be because that cost is borne not by himself or his employer, but by thee and me (i.e. the taxpayer)? And the situation continues to worsen, since so many of those who are eligible opt for the less expensive (for them) Tricare.

But is it really less expensive?

Well, it depends on one's perspective: it sure seems like a good deal for enrollees, but for those of us who actually foot the bill, not so much. It's gotten so bad, in fact, that Defense Secretary Robert Gates "is seriously considering whether to ask for Tricare fee increases in next year’s budget."

"Seriously considering?" Are you kidding me?! At a time of unprecedented national debt, with unemployment consistently hovering around 10% (or, more accurately, 17%, as measured by the more accurate U-6), why is this even a question?

Here's why:

"The battle over Tricare pits the efforts of the Pentagon to contain the exploding cost of health care for nearly 10 million eligible beneficiaries against the pain and emotions of those who say they have already “paid up front” with service in uniform."

While I certainly respect and appreciate that service, not all (or even many) of those "10 million eligible beneficiaries" were front-line troops; in fact, many (most?) are the families of those who served. Yes, they made a sacrifice, but almost all of the service-members were volunteers. But even that's beside the point: the key phrase here is "exploding cost of health care." Now where have we heard that phrase before?

Oh, yeah.

So the Fed's are having no more success containing the cost of health care under Tricare as Medicare, yet we're supposed to believe that adding tens or hundreds of millions more folks to those programs will somehow magically solve the cost problem?

Sure.

Risk Management Gone Horribly, Horribly Weird

noreply@blogger.com (sales) — Tue, 7 Dec 2010 12:30:00 -0800

On the one hand, we've cataloged the unusual things that people seek to insure, and certainly protecting one's "money maker" (so to speak) is high on the list.

But this is just, well, creepy:

The Obama Waffle House

noreply@blogger.com (sales) — Tue, 7 Dec 2010 10:28:00 -0800

If you like the health insurance plan you have you can keep it, as long as you work at the Waffle House and have friends in Washington. It seems HHS Secretary Shebullshits is at it again, handing out exemptions from Obamacare like they are going out of style.

We are now at 222 groups that don't have to play by the Obamcrap rules like the rest of us and the number is likely to continue to rise. Among the new inductee's into the Obamacrap walk of fame is Georgia's own Waffle House. That means the almost 4,000 workers at Waffle House will be able to continue their mini-med

This begs the question, how many have asked for waivers and been denied, as well as how many more are awaiting approval?

Tax Carnival; Stocking Stuffers edition

noreply@blogger.com (sales) — Tue, 7 Dec 2010 10:00:00 -0800

This is a new one for us: the Tax Carnival is a monthly round-up of tax-blog posts. We're obviously no CPA's (although I understand Bob plays one on the radio?), but our post on new HSA rules made the cut. I apologize for being a bit tardy with the announcement: it actually went "live" yesterday but I just saw it today.

Do check it out.

Grand Rounds: Impact of Healthcare "Reform"

noreply@blogger.com (sales) — Tue, 7 Dec 2010 06:07:00 -0800

Over at Highlight Health, Walter Jessen presents this week's extensive round-up of medblog posts, focusing on the effects of "reform" not just today, but moving forward.

Mike and Bob on Medical Loss Ratios

noreply@blogger.com (sales) — Mon, 6 Dec 2010 13:04:00 -0800

Recently, I was privileged to observe a really interesting email exchange regarding the new Medical Loss Ration (MLR) rules which go into effect next month, and which promise to further erode the value of health insurance. The conversation was a result of an email I'd received from Cigna, and which I forwarded to Bob, who then forwarded it on to Mike. The email said, in part:

"On November 22, 2010, the Departments of Treasury, Labor, and Health and Human Services jointly announced Interim Final Regulations for the Patient Protection and Affordable Care Act’s (PPACA) Medical Loss Ratio (MLR) provision.

The provision states that beginning in 2011, insurers and HMOs must annually calculate their MLR and provide rebates to policyholders if their MLR (percent of premium revenue spent on claims/medical care) is less than 85 percent for large groups and 80 percent for small groups or individuals.

MLR applies to insured plans only, regardless of grandfathered status."

It also mentioned that "Non-U.S. insurance companies do not file MLR."

Bob immediately glommed on to that last bit:

"Go back 20+ years or so when self funded plans with stop loss insurance was becoming popular in groups less than 1000 lives. Because US based health insurance carriers were prohibited from offering such plans (stop loss) foreign companies, most notably Lloyds, were major players along with Swiss Re, NRG (Netherlands Reinsurance Group), Sun Life, Manu Life and a few others. Even saw Tokio Fire and Marine on some risks.

P&C companies quickly figured out the ban was on US health insurance companies so carriers like Safeco, Travelers and some minor players got in the game.

This makes me wonder if this opens the door for foreign companies to get in the game and spoil the market? They can apparently skate on the MLR issue but the plans themselves would have to comply with other issues (mandated benefits) or else the insured is subject to a fine."

I had focused on the way MLR will be calculated, but Bob immediately noticed something "under the radar."

Mike then responded:

"I've attached two paragraphs that I found in the preamble to the regulations, together with a full copy of the preamble & regulations. (The preamble is 230 pages long, the regs themselves 78 pages long. In effect, HHS takes three pages to explain each page of their regulation - think that will be enough?)

Anyway, it seems to me that the main thing is whether a health insurance policy is approved by any state, and only secondarily whether the health insurer is domestic or foreign. Therefore I think the CIGNA comment does not fully explain the situation and probably has raised a lot of questions.

As to stop-loss insurance, I don't find where the preamble addresses it. I think that's because the insurance reform law deals with health insurance policies and benefits, not stop-loss insurance. So I assume that none of this applies to stop-loss insurance because it's not "health insurance" and I doubt there will be any disruption in stop-loss insurance markets, whether the insurer is a US insurer, or not."

Which is at once comforting and disturbing: comforting to know that the stop-loss insurance market (a vital component for self-funded plans) is probably going to be alright. But disturbing because, well, as Bob points out:

"Let me see.

Obamacrap is 2200 pages, give or take.

Regs are 78 and preamble 230 pages.

And let's factor in the numerous exceptions (over 100 companies and counting) and this thing will make the tax code seem like a Readers Digest article.

So frustrating to see what they have done, and how they are seemingly clueless about, well, just about anything dealing with the real world."

Just so.

Obamacare - Radio Interview

noreply@blogger.com (sales) — Mon, 6 Dec 2010 08:25:00 -0800

How has Obamacare impacted the citizens of Georgia? How many HEALTHY children can no longer obtain health insurance on their own? How many women cannot purchase maternity coverage? How have rates and choices been impacted already by the implementation of Obamacrap?

As a result of Obamacrap, no child left behind has become all children left behind when it comes to health insurance.

Women of child bearing age who want to purchase health insurance to cover the cost of maternity have only one choice.

Prior to Obamacrap about a half dozen health insurance companies offered maternity benefits, now there is one. If you want maternity coverage you have to buy the plan a year before conception and pay an additional premium (roughly $200 per month on top of your regular health insurance premium). Once you become eligible for maternity benefits you will have to satisfy your major medical deductible (typically $2500) before anything other than office visits are covered.

That means most pre-natal testing is paid for by the mother, not the insurance company, until she reaches her deductible. A woman who conceives in the summer will have to satisfy two deductibles. One for the current year then a new one the following year.

In addition to the outpatient pre-natal care the mother is required to pay the first $3,000 of the hospital bill.

All thanks to Obamacrap.

On Tuesday, December 7, 2010 (Pearl Harbor Day) Rob Johnson of WGST AM640 in Atlanta will interview me live on the air at 7:50AM. You can listen on the radio or by clicking the link.

Wish me luck!

Your (Benefits) Package has arrived

noreply@blogger.com (sales) — Mon, 6 Dec 2010 06:22:00 -0800

Our friend Evan Falchuk has started a new, bi-weekly "carnival" highlighting developments and issues in the world of "benefits;" that is, the folks on the front lines who have to deal with the everyday tasks of deciphering and implementing what Congress has wrought and insurers offer.

The debut edition of The Benefits Package features posts on mini-meds from FoIB David Williams and an exhortation from Dan Buckles ("The Group Guy") on why employee well-being is so critical, not to mention our own Mike Feehan's post on Medicare and Medicaid cost-shifting, and much more.

The Benefits Package promises to be an interesting, and potentially important, resource for folks interested in the real-world application of health care policy.

Our (Current) System isn't "Broken"

noreply@blogger.com (sales) — Sun, 5 Dec 2010 10:04:00 -0800

Mike sends along this video, admonishing us to "remember this the next time some ignorant yahoo bleats that the US medical care system has "failed:"

The Game of Life

noreply@blogger.com (sales) — Fri, 3 Dec 2010 11:55:00 -0800

In the past two weeks, I've had the privilege of helping the families of two clients who have passed away. I say "privilege" because it means that we were able to help grieving loved ones with something more tangible that condolences and more lasting than a casserole (which is in no way meant to minimize the value of either). Long after the flowers have wilted and the cookies are gone, the cold, hard cash that is the ultimate result of a life insurance policy will be there to help pay the mortgage, fund a son or daughter's college education, and pay off hospital bills.

The first of these two folks had been a client for many, many years. He lived a reasonably long life, passing away at age 81. His wife, also a client, knows that any expenses left behind will be taken care of, and she and her children and grandchildren will benefit from his legacy for years to come.

The other is more tragic: cut off at the painfully young age of 53, she leaves behind a grieving husband and three daughters, one of whom is to be married in a few short weeks. As a labor and delivery nurse, she was responsible for helping to bring life into this world; as a matter of fact, she helped to deliver our youngest. How does one console the family of one taken so young?

The other day, my good friend Bill M sent along an email he'd received, with the provocative title "Sue thanks God Greg had life insurance:"

"Tuesday, October 18th was one year to the day that my friend and client Greg Murphy died suddenly. He left behind a wife and two children. He was only 52 years of age ... Sue, Greg's wife, is one of the fortunate ones. Greg left her a substantial amount through a life insurance policy. If he had not, their family would be doubly devastated; emotionally and financially."

The scary part came a bit later:

"Statistics show that 34% of Americans have no life insurance [and] 48% don't have enough life insurance for proper family protection."

But that's just one email, right?

Turns out, there's more. A lot more. According to today's McPaper:

"The percentage of U.S. households with life insurance coverage is at its lowest in 50 years, leaving millions of families without a safety net, industry experts say ... Only 44% of households have an individual life insurance policy, and 30% have no individual or employer-provided life insurance."

Professionally, I discount group-based life insurance because it is specifically designed not to be in force when it's most needed. Nonetheless, it's arguably better than none at all. What's so mind-boggling is that, from a simple cost standpoint, life insurance rates are at historical lows.

As always, there's a raft of excuses for why folks keep putting off that purchase. Personally, I think the internet has a lot to do with it: there's so much information, and so many quote-sites vying for attention, that information overload sets in, and the decision-making process grinds to a complete halt. Which is a shame, because it means that there are going to be a lot of un (and under-) protected families out there.

Don't be one of them.

And another (Symbolic, but still Awesome) Step Forward

noreply@blogger.com (sales) — Fri, 3 Dec 2010 07:01:00 -0800

A few days ago, we noted the faltering steps toward derailing ObamaCare©. Today brings news that South Carolina's new governor, Nikki Haley, stood up to PresBo, virtually demanding him to repeal ObamaCrap. When he (of course) refused, she then requested (a la McDonald's) a waiver for the Palmetto State. It's doubtful, of course, that this will be forthcoming (although she says he promised to consider it, who would bet on it?), but it's heartening to see the pushback from newly-elected leaders against this train-wreck.

Kudos, Nikki!

[Hat Tip: RedState]

December Wikio Health Rankings

noreply@blogger.com (sales) — Fri, 3 Dec 2010 06:22:00 -0800

Once again, we've been asked (exclusively!) to post the new Wikio Health blog rankings. Although we've slipped a couple spots, we're still in the Top 20 (which still amazes me):

1	Well
2	Kevin, M.D. - Medical Weblog
3	Respectful Insolence
4	Science-Based Medicine
5	In the Pipeline
6	Pharmalot
7	The Health Care Blog
8	Dr. Wes
9	Better Health
10	John Goodman's Health Policy Blog
11	The Last Psychiatrist
12	Age of Autism
13	Health Beat
14	Gary Schwitzer's HealthNewsReview Blog
15	Healthcare Economist
16	White Coat Underground
17	ScienceRoll
18	Running a hospital
19	Health Care Renewal
20	InsureBlog

Ranking made by Wikio

National Health Care

noreply@blogger.com (sales) — Thu, 2 Dec 2010 20:28:00 -0800

More than 45 million Americans go without health care. At 14% of the gross domestic product, national health care spending is at an all time high. Health care issues and prescription drug costs continue to gain increasing attention during election campaigns, and many Americans are calling for the need to provide national health coverage as a universal service to all residents.

The government already provides healthcare to 28% of Americans. Medicaid programs cover medical treatments for people who are of low income and limited resources. Medicare provides health care coverage to U.S. citizens over the age of 65, and to certain people under the age of 65 with specific disabilities. While neither of these systems are perfect, advocates call for the expansion of similar national health care products to service all U.S. citizens. Although 61% of Americans have private health insurance, usually through a group employer, proponents of national health care coverage believe that only government reforms and mandates can control rising health care costs and make coverage available to all citizens.

Among physicians who support a national health care system, a single-payer system is seen as the only solution capable of providing coverage to the uninsured or underinsured, while also controlling the skyrocketing health costs due to drug pricing, malpractice suits, and long-term care. Under a single-payer system, the government would finance health care, but delivery of services to the consumer would be managed by private parties. How to integrate this in a cost-efficient manner, without breaking our current system, continues to be a source of much debate.

The call for a universal health care system began under the Theodore Roosevelt administration, and was a major issue and topic of debate during the Clinton administration. During this time, First Lady Hillary Clinton was appointed by President Bill Clinton to head the Task Force on National Health Care Reform, making national health care her primary concern. The system reforms she proposed were too complex for many Americans to understand and they were defeated in Congress. In 2003, President George W. Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act. This was done to overhaul and expand a system which had become antiquated.

Despite this, many experts believe Medicare will run out of money as the baby-boomer generation requires greater, more intensive health care, and suggest national health insurance as the only solution. Many proponents of national health care point to the face that the United States, which is vastly rich in its resources, should be capable of providing the same type of national health care coverage that is universally offered in other modern, industrialized nations. National health care systems have been in practice for some time in many European nations. Those systems don't provide the same independence of choice that individuals in the U.S. demand.

Auto Insurance Nationwide - Many Different Choices For Consumers

noreply@blogger.com (sales) — Thu, 2 Dec 2010 20:28:00 -0800

To get solid coverage, consider the following items when browsing national auto insurance companies. This may be difficult, as there are plenty of national auto insurance companies out there. To be able to easily look for the right coverage that fits your needs, you have think for answers to your questions.

What is the age and value of the vehicle you are looking to insure? If you carry a comprehensive insurance policy for your old car you may be eligible for a lower insurance rate. It will require you to may more money before they insurance will pay their portion, if there is an accident.

The price of auto insurance companies in many countries may vary with the age of the people is guaranteed, the value and type of car insurance. Please remember, your insurance will change when you experience new life situations. Included are getting married (you then add your spouse to the policy of interest), purchasing another car, and moving across state lines. Different states have varying laws on policy requirements.

Consider that insurance companies compete amongst one another, so the rates they provide may differ. There are some substantially cheaper companies when looking at the cost. Therefore, you should shop around before deciding on a specific company. You can purchase an insurance policy where you live or online. The steps are easy. Simply choose what coverage you'd like and print out your temporary proof of coverage until your insurance cards arrive in the mail.

The larger national companies provide different discounts depending on your individual situation and insurance needs. Certain safety features installed in your vehicle may qualify you for a discount. Having more than one vehicle insured in the same policy qualifies for another discount with some participating auto insurance companies.

Remember that the insurance business you select should be reputable. They used to have a look on all your debt accounts and unexpected happenings in turn you can also do the same on them. Try to choose a company that has a good reputation and is trustworthy. The Better Business Bureau will have all needed information about an insurance company. You can find out if and how many complaints have been filed against the company and also if they have been resolved.

It's important to choose a plan you can afford, so as to keep it current. Insurance is inherently costly, and even more so for drivers who are still in their youth. But, if you intend to drive, it is a necessity. Most states have severe penalties for uninsured drivers. Naturally, the national insurance companies are required to comply with state laws and are well-equipped to do so.

Most national auto insurance companies offer different payment schedules so that you can choose the one that fits with your unique financial situation. You have the option of monthly, every four months, or yearly. It's good to have the security of insurance, even though you hope to never use it.

UK National Insurance Contributions

noreply@blogger.com (sales) — Thu, 2 Dec 2010 20:27:00 -0800

National Insurance contributions (NICs) are paid to build up a person's entitlement to certain state benefits, including the State Retirement Pension. The amount that an individual is liable to pay depends on their own personal circumstances.

Who pays National Insurance?

National Insurance is payable by all UK individuals aged over 16 that are either employed or self-employed and their earning are above a certain level. If you are an employee and reach the state retirement age you are no longer required to make NICs. Similarly if you are self-employed and reach the state retirement age you immediately are no longer required to make class 2 NICs, and from the tax year following the year you reached the state retirement age you are no longer required to make class 4 contributions.

The various classes of National Insurance contributions are detailed below:

Class 1 - paid by employees, sometimes politicians have referred to this as "an employment tax" or "a tax on Jobs". Two elements to class 1 contributions which are employee's contributions are deducted from an employees pay. Employer's contributions are paid by employers when they pay employees.

Class 2 - this paid by self employed people. It is a flat rate regardless of earning (provided that the self-employed person has earning over a certain level, if earnings are lower than this level then a "small earning exemption" may be applied for). These are normally paid either quarterly via a bill from HMRC or monthly by direct debit.

Class 3 - These are voluntary National Insurance Contributions, in certain circumstances some people may wish to make these. For example, but not limited to, you have not made sufficient contributions in the year or perhaps you are living abroad but want to maintain your potential UK state benefits. It is highly recommended that you speak to an experienced professional prior to making such contributions.

Class 4 - These are payable by self-employed people in addition to Class 2 contributions, if their income is above a certain level. The level of these contributions are dependent on earnings. Class 4 National Insurance contributions are normally payable with income tax calculated on an individual's Self-assessment tax return.

If you have any concerns about your National Insurance payments or record we suggest you contact a suitably qualified and experienced professional such as a Chartered Accountant.

$3 Million Seersucker Suit

noreply@blogger.com (sales) — Thu, 2 Dec 2010 11:51:00 -0800

With emphasis on the "sucker" part:

"The federal government spent $3.1 million on TV ads in which actor Andy Griffith touts the new health care law, but a non-partisan watchdog group says those ads are misleading."

Well, it's not just the "watchdog group" (FactCheck.org) who made that call; we "fisked" the former Mayberry star's infomercial in August, pointing out, for example that:

"as a senior citizen, he's about to see his own Medicare benefits - including choice of doctors - severely curtailed."

We were off the mark, though, in one aspect: we understood that the effort cost less than a million dollars. Turns out, it actually cost about 4 and a half times that.

That's more than Floyd charges for a perm!

Happy Chanukah 2010/5771

noreply@blogger.com (sales) — Wed, 1 Dec 2010 15:11:00 -0800

The Festival of Lights begins tonight. Enjoy!