Arthur Thompson's blog

Sports

Playing sports my whole life has given me a different perspective on how things work.  I understand how increasing the desire to succeed leads to success and achievement.

Writer's Block.......

How is it possible to have writer's block when you just want to write down your thoughts on a blog?  I don't know the answer to that, but I most definitely have it.  I can't write.  I sit here all day thinking great thoughts that I should be writing down somewhere for the rest of humanity to benefit from, and I can't write them.  I just can't.  I hear other people speak and I want to explain to them in great detail how they are either right or wrong, but I can't.  I read lots of articles, books, etc... and want to respond with my insight and brilliance, but I can't.  I watch tv and want to respond to the news or sit and begin writing a better script than the pathetic show I just saw on the tube, but I can't.

Why?

 

Can I See Some I.D. Please......

I like to think I am pretty laid back and tollerant, but I absolutely hate it when someone goes out of their way to put me in a spot.  I'm in one of those spots now.  The reason is that one of my sons has a new girlfriend.  This in itself is good news as he is as happy as I've ever seen him.  So what does this have to do with me?  Simple.  While my son is over 21 years of age, his new found love is not.  And since the drinking age here is 21, this presents a problem.  She, of course, must drink.  Like most kids, they believe that drinking alcohol is a right, a God-given right that can not be controlled or restricted by legislation of any kind.  They also believe that it is their duty to flaunt their drinking and sneer in the face of any authority that tries to restrict their right to drink.  And like all kids, they believe that everyone should have and use a fake ID when in public and the need to drink arises.

And that's where I have a problem.  I wouldn't let my own sons buy booze with fake ID in a bar right in front of me, so why must I sit tight and watch while some girl does it?  There are three laws being broken:  Underage drinking.  Serving alcohol to a minor.  Using a fake ID, which is fraud.  They are all pretty minor in terms of punishment, even for the bar serving the minor believe it or not.  But apparently, if it could be proved that I knew she was a minor as well, then I could be charged with a misdemeanor as well.  So in a sense I am a part of it as well.  But even if not, why do they have to snub their noses at me and commit crimes right in front of me?  In effect, daring me to turn her in, which I am supposed to do.

But I don't want to make that decision.  I want to listen to the music, dance with my wife, and enjoy the party.  I don't want to create an arguement with my son over something his girlfriend is doing.  Seriously, why can't the bartenders ask for some ID once in awhile and not serve minors without checking.  Did I mention that I later found out his girlfriend has a drinking problem?  Small wonder.

Tag, You're It.........

If you are wondering how the banks and credit card companies are going to recover the billions of dollars they lost over the last few years, then you will be interested in what is happening to me.  It started a little over a year ago when my wife and I were vacationing somewhere.  We went to make a purchase and they denied the credit card.  What????  Turns out they just wanted to talk to us and make sure it hadn't been stolen.  OK??  Seemed a bit strange at the time, but we had no idea where it was leading.  Later, my wife went to make a purchase and was denied again, this time being told that the bill hadn't been paid on time.  We assumed they were right and sent in a payment, late or not.

But it didn't stop there.  A few months later, I was denied the use of my Sears credit care.  Not in Sears, they did away with the old company credit cards long ago and made you replace them with a new Mastercard credit card that is provided by Sears just like a bank or whatever.  When I called them, they said that my payment was late and they wouldn't honor it, regardless of the limit, until the old balance was paid.  Since I only use this card as a backup for another one, I wasn't too bothered.  But I thought that the bill had been paid many days before, surely they would have received it by now.  So I looked up when I last paid the bill and sure enough, it had been sent out roughly a week before, plenty of time for them to have received  and posted it.  But that wasn't the part that surprised me.  Here it was the 25th of the month, Sears had denied the card on the 24th, and there, right at the top of the bill, it clearly stated that it was due by the 27th.   What???  Yep.  Sears was denying charges and cutting off customers that were paying their bills on time. 

I told my wife that we should think about changing cards (OK, she told me!), but we didn't do anything about it at the time.  Let's face it, changing credit cards is a big PITA!  But it happened again, this time my wife was denied locally for some trivial amount of less than $20.  They again said that she was late and we again checked and found it wasn't even due yet.  So we changed credit cards.  Sears, once a great company and convenient provider of many things over the years, will no langer get our credit business because it is operating dishonestly.

But other credit cards are using some of the same tactics.  Several, including but not limited to Sears, have taken to mailing your bills out with a back-dated postage mark.  What does this mean, you ask?  It means that they will be complying with the LETTER of the law that goes into effect soon requiring credit card companies to provide a minimum amount of grace time, I think it is three weeks, but in practice squeezing it down to less than two by delaying the bill and back-dating the metered mail.  Next time you receive a credit card bill, notice how long it alledgedly took to travel to you.  Some of my credit card statements are taking as long as a week, even longer to arrive.  I have very little time to pay them, as little as 9 days in one case, before it is overdue.  And remember, that includes the time the post office takes to deliver it from me back to them. 

Check your credit cards folks, they are messing with you.

Catch 22.....

I support health care reform.  I really do.  I think that the only feasible reform that we can implement right now would be to reduce the Medicare eligible age down to 60.  That might be pretty expensive for now, I would consider a starter movement of 62-63 with a promise to go further after the effects of the initial expansion are known.

But the proposed bills by both the House and Senate are DOA.  Neither has any real reform in them, neither is remotely feasible, neither can help the country.  I am a poor writer and it is difficult for me to express myself on paper.  So rather than try to answer questions that no one has asked, I am asking questions that I haven't heard answered yet either.

1.  Why would any healthy UN-insured person elect to enroll in a public option (PO) plan if it is going to cost them money to do so?

2.  If offered to employees as a choice, why wouldn't each employee choose the program that gives them the most healthcare for the least cost?

3.  If the "Pre-Existing Condition Exclusion" clause is removed from all private healthplans, why would ANYBODY enroll in a program BEFORE they need coverage?

Answer those questions for yourself.  They will help you understand why the programs will fail if implemented as proposed.

Now let's do some simple math.

IF the healthcare expenditures for this coming year are projected to be roughly $2.2 Trillion and roughly 15% of the population is currently not insured (but included in the costs, I'm assuming), THEN the cost of insuring the current uninsured is roughly 15% x $2.2 Trillion = $330 Billion per year. There would be administrative costs in addition.

I'm assuming these are average risks and that we are either collecting from them now in a self pay program or they are being subsidized by any of several means, i.e., Medicaid, indigent programs, subsidies from the hospitals, etc....

If they are not currently included, or they are greater than average risks, then the cost will be much greater.

Who will pay?  Seriously.  No taxes or program "cuts" are anywhere close to getting us that kind of money.  Who is planning on paying for the program?  I think the answer is you and me.

I'm sorry.  I can't support bills that are rediculously inflationary and have no tangible means of funding.  I still think extending Medicare down in small increments is the only logical answer.

The Pre-Ex......

Included in every health insurance and HMO contract is a clause known in the industry as the Pre-Ex clause.  This is short for "pre-existing condition exclusion" clause.  The pre-ex is designed to hold down anti-selection against insurers by excluding any health care need or "condition" that is thought to have existed before you sign up for coverage with that carrier.  It is a great "gotcha" in the insurance industry, because many times, people sign up for coverage without realizing they won't be covered for the very reason (condition) for which they are enrolling.

Have angina?  Not covered.

Diabetes?  Not covered.

Cancer?  Not covered.

The pre-ex applies to any condition you can think of, and all those you can't.  It applies to everything.  But you probably won't realize this until you go in for treatment and the HMO or insurance company denies your claim.  What?  Yep, they simply reject your claims or send you a bill, either way, you pay.  And that is for life.  And nothing is worse than paying for insurance that doesn't cover anything.  Which can happen.  Take diabetes for example.  If you are pre-exed for diabetes, then have to have treatment for loss of vision or leg injury, it will very likely be denied because of the pre-ex and the assumption that any treatment is for a diabetes "related" cause.  Hence, not covered.

There are a lot of people out there that have run into this clause.  It simply applies to anyone that, while not insured, acquired a healthcare condition that could possibly require treatment sometime in the future.  If the condition ever requires medical care or treatment, you are on your own.  It won't be covered.

The reason for this clause is to prevent people from not enrolling with an HMO or insurance plan  while still healthy.  If there were no pre-ex clauses, everyone would wait until they had an illness or injury and THEN decide what coverage they wanted and which doctor they wished to see about it.  They would have contributed nothing financially to the insurance program and the costs for their medical treatment would not have been averaged across a large group of insured members.  So the insurance companies said that while they would love to have you sign up for insurance now and start paying premiums for the coverage (or collect from your employer on your behalf, same thing), they are not going to cover medical conditions that were present before you signed up.  Hence you can't wait until you are sick to start looking for insurance, because of the pre-ex clause.

It makes sense from the viewpoint of the insurance companies and HMOs, but it is still a great big "gotcha".

The Public Option......

The "Public Option" (PO) health care plan being formed and proposed in Congress is going to fail if it is ever passed and signed into law.  Here is why.

It is designed to cover those people in the U.S. that don't have any form of health care coverage now.  Those people are:

a. People who can not afford any healthcare coverage but have too much money or property to be eligible for Medicaid.

b. People who have fallen into one of the many cracks in employer sponsored coverage, i.e., changing jobs, lost job, pre-existing condition, needed treatment that has been deemed "medically un-necessary" or "experimental", or something that requires long-term care, etc...

c. Healthy people that don't have employer paid coverage and don't want to pay for individual insurance.  These tend to be young and want to save their money now for other expenses.

Think about this for a moment (I wish Congress would).  If you can not afford healthcare now, what price can we put on the proposed "Public Option" ?  That's correct...ZERO!  If they can't afford healthcare, no program or proposal is going to interest them if it costs money, because they can't pay now.  They might try to do something goofy like they do with Medicare, which is to have a small cost (or "premium" in the industry lingo) paid for by the covered person, but that will actually keep some of the healthy people from signing up, yes, even $25-50 per month.  So if they want to cover everyone, the net cost to the recipient will almost have to be nothing, it will have to be free.

But what about the ones who "can't" get coverage because they have health needs and are excluded by one of the insurance companies exclusions (and there are many)?  They would certainly be willing to pay something, pretty much whatever they can afford, for the chance to get coverage and have someone else, anyone else, assume the financial burden of paying those bills.  They will be rushing as fast as they can to sign up for the PO if it doesn't exclude them.  Price be damned.  Let someone else pay for my daughter's cystic fibrosis, my prostate cancer, my wife's kidney transplant, my son's mental illness.

I don't know how many of the 40-50 million uninsured people can afford to pay for insurance but can't get it and how many simply don't want to pay for it.  Pretty much everyone falls into one of the two situations.  "Want it" being the variable, everyone wants it if it is free, fewer want it if it costs them money.  But that is the conundrum Congress faces right now with the PO: Do we charge for it? Or do we provide it free?  If you have ever watched "Who wants to be a millionaire?", then you already know that large groups generally choose the correct answer collectively.  By choosing what is best for them individually, they select the option that is best for them collectively as well.  Hence, incredible cost selection enters into the decision to offer a PO plan. 

So there you have it.  No matter what form the PO takes or what benefits are included, everyone will read it over and decide if they feel that the PO offers benefits that are worth the cost to them.  If so, they sign up.  If not, they don't. 

So does Congress offer a PO plan to people that already have coverage from employers?  Particularly those that have to pay part or all of the premiums now?  A good question, because if they do, then all of the 100+ million people in the U.S. will make the same decision as the uninsured.  They will decide whether or not the PO is a better cost-benefit choice than their current plan.  If it is, then they sign with the PO.  If not, then they stay with their current program.  Same question is presented to those on Medicare.

So obviously Congress can't make the PO free to everyone.  Someone has to pay.  How do you make it affordable to those you want to sign up and not make it attractive to those you don't?  You can't.

Can you make it unavailable to those that are already insured by their employer?  They say that is not the way they are going to do it.  Do you make the covered benefits less attractive than Medicare?  You have to if you don't want all of the retired old folks signing up.

And what about the "pre-existing conditions" clause?  Do you waive that for the uninsured?  What about everyone else?  Why should I sign up now for even, say, $25/mo for insurance if I can wait until I am diagnosed with something expensive and THEN sign up?  What stops me from saving my money now and signing up for coverage later?  Uh.. nothing. 

This is called "anti-selection" in the insurance industry and is what scares the insurance companies and the employers so much.  They fear that a low cost, high benefit plan offered in competition with theirs will attract the younger, healthier members of their program and ultimately drive their costs up, leading to higher prices and driving more of their members to the PO plan.  The result being the feared "death spiral" to insurance companies, their plans get more and more expensive, driving more and more of the better risks to the PO and ultimately costing them so much money they just shut it down and pull out of the market.  This doesn't occur if the program is offered at no cost to the employee, because he would have no financial incentive to choose a cheaper plan, but it would definitely occur if it were to be offered to employers who only pay for part of the healthcare coverage now.

Congress hasn't addressed this yet.  It is a tough question and difficult to structure so that the anti-selection doesn't occur.  Their goal of wanting to cover the uninsured seems to be in conflict with their other goal of wanting to offer the PO to employees that already have coverage through the employer.  We will see how this plays out down the road, but some compromises will definitely have to be made.

Art 

What is the Healthcare Debate About?.....

I have just finished reading yet another article about healthcare and President Obama's efforts to implement change.  As I read the article, which mentioned nothing about Obama's legislative efforts, it occurred to me that I didn't know what exactly people were referring to when they talk (or write) about healthcare reform.  The reason I often don't know what they are referring to is a result of the speaker (or writer) not knowing what they are talking about.  Seriously.  I just read an article by a columnist on the Yahoo finance page about why the public is not supporting the proposed legislation for reform.  The author made some good points and added a few huge misunderstandings as well.  Truly, he doesn't know.

The debate usually breaks down into two sides, Republican and Democrat, rather than focus on providing healthcare.  The Republican political position is that while we would like to improve the current healthcare system to be more efficient, cost less and cover more of the population, ....this is not the time to make those changes due to the current economic environment.  They also feel that any change to the existing system may threaten their personal doctor-patient relationship, which they feel would be a disaster.  The Democrats feel that now is the time for change, since they have control of both the White House and Congress.  They also feel that coverage needs to be extended, by either offer or mandate, to everyone living in the country, citizen or not.  I confess, I don't have the details of the proposal at this time.  Cost be damned.  President Obama has said that the additional costs for covering the additional people will be covered by raising taxes on the wealthy.  We will discuss that later.

Who am I?

I spent about 15 years working in the healthcare industry, starting out as a Group Life and Health Underwriter for the largest insurance company in the U.S. and ending up as a Vice President of Underwriting for the largest HMO in the country.  I am not a doctor, nor a politician.  My job was to analyse risk, price the risk, price the products and manage the risk/pricing to earn a specific profit for the insurance company/HMO.  I have since moved on and have not been involved in the business for almost 18 years, a lot of my knowledge is old.  But I am still an underwriter at heart, I still analyse and think about issues before I decide.  I wish politicians did that.

So what are the issues in the debate about healthcare?

Clearly, cost is one of them.  Change always involve cost, and in this case, that cost is tax money.  So taxes and reform are joined together.  Coverage is another.  It is universally agreed that there are millions of people wandering around the country with no coverage at all.  What isn't agreed is how many, exactly, are we talking about, and how much it will cost to cover them.  Then there is the age old issue of "quality of care".  This is my favorite issue, because it means whatever anyone wants it to mean.  To some people it means we can't change because we already have the best care possible, to others it means we must change because this country is falling behind others in quality of care and is no longer the best in the world.

Cost.

Coverage/access.

Quality.

Those appear to be the issues at the heart of the debate in Congress.  They are big issues and anyone that attempts to answer or inform you of all the nuances of the issues in a single column or two is unlikely to succeed.  I will try to write about them in a series of articles over the next few days.  Perhaps I can at least help inform some people.

Satchmo Had It Right........

I like to listen to music.  I often read reviews about a song or a group and realize I just don't care about the nonsense that people spew on blogs and paper.  But I do like music.  And so I thought I ought to mention five songs that I have always believed everyone should listen to at least once in awhile.  They aren't necessarily my favorites, just songs that speak a message we ought to hear occasionally.  No particular order:

 

1.  Won't Get Fooled Again  (The Who) It doesn't matter what political party you belong to, or whether you are a conservative or liberal, the message remains spot on....."meet the new boss, same as the old boss"  The more things change, the more they stay the same.  Real change takes hard work, not an election.

 

2.  Kicks  (Paul Revere and the Raiders) There are a million pro drug songs, this is one of the anti-drug songs.  Old, but holds up well. 

 

3.  Cat's in the Cradle  (Harry Chapin) This song only applies to parents.  As soon as you have kids old enough to talk, you need to listen to this song once in a while.  It's not a great song musically, I didn't enjoy listening to it when it came out and was a hit, but it flat out makes you a better parent.  A must.

 

4.  War! (What is it Good For?)  (Edwin Starr)  Like Kicks, this song is both old and holds up well.  Call me a peacenik, anti-war, pacifist, whatever.....but this song says it simply and directly ....."War! What is it good for?  Aaaaabsolutely nothing!"  We have yet to solve anything by killing other people,  I would have hoped that both Vietnam and Iraq would have shown people that, but I would be wrong.

 

5.  Wonderful World  ( Louis Armstrong)  OK, this is one of my favorites.  I have this as the last song I listen to on any tape I make, cd I burn or playlist I create.  It is positive and upbeat, warm and soothing and I just like to listen to it.  If I had the technical ability, I would put it on this blog for sure.

Dear President Obama....

I am writing to you because I think there are a few things that need to be addressed quickly now that you are in office.  You are trying to work on the economy and I assume there is a list of other projects you will tackle immediately after.  That's great, but I want to mention a few ideas that perhaps your advisors haven't considered.

1.  Send about $100 billion or so of that bailout fund over to Fannie Mae and Freddie Mac with instructions to start lending it out tomorrow to anyone with a home that is in default.  Lend it out at 4.5% for 30 yrs, fixed, no points, no origination fees, etc.  Post a few 1-800 numbers on the web and get going.  We originally created Fannie and Freddie  for exactly that purpose.  Perhaps they could stop buying crap mortgages that someone else sold without checking credit worthiness and start  issuing solid, fixed rate paper tomorrow.  Tell the thousands of emplyees that work there that their new job is to answer the phone and start making new loans and refinanacing old ones until the problem is solved.  Oh yeah, be prepared to put more money into this idea.

2.  There, we fixed your problem with bad mortgages and shakey financing.  Now lets look at the auto industry.  Why are you lending or giving billions of dollars to an industry that is trying to commit suicide (see GM and Ford)?  Why not take at least $1 billion and give it..... er...lend it to Tesla Motors and tell them to start pumping out the gol darned electric roadster it claims to be manufacturing.  It still claims it can put one on the road, but this isn't ready, and that isn't working.  Can they make the darn thing or not????  Get on this now. Give them the financing, take more than half the stock, and make them sell the dang things for about $50K.  Anything more than that is a rip off and we all know it.  Pollution problem fixed, check.  California emission standards met, check.  Gas and oil consumption reduced, check.  Fun toy car available for Hollywood celebrities like Jay Leno and Tim Allen, check.  Oh yeah, and if they need plants, equipment and workers to manufacture the cars?  I think GM and Ford have a few extras they aren't using.  If Tesla manufactured and sold as few as 100,000 the first year it would go a long way toward establishing a viable industry that could do so many things for the environment.

3.  We need you to quickly begin restoring basic human rights to the citizens of this great country. The Writ of Habeus Corpus needs to be restored.  The Geneva Convention standards need to be honored.  Proper bench warrants for any wire taps or electronic surveillance of any sort must be obtained.  Rights to fair and speedy trials need to be restored, rights to attorneys need to be restored.  Let's correct the huge mistakes made with the UN patriot acts I and II.

4.  Sorry to harp on this subject, but along the same lines, some rules for the appropriate use of Eminent Domain need to be implemented as well.  It is rediculous that governments, whether federal, state, county or city, can come along, point to someone's property, and just take it for any purpose whatsoever.  Compensation to be haggled out in court later.  There are times when Eminent Domain is needed to build roads, bridges, etc...,but taking private property for the private business use of someone else is wrong and shouldn't be allowed.  Allowing Costco to just take private land that the owner doesn't want to sell, or let a developer take land on which to build a shopping mall, etc.., is just wrong.  Fix this too.

5.  If you want to insure the uninsured in this country the best thing to do would be to extend Medicare down to age 60.  Do it now.  When the program has shown it can handle that age group, keep dropping the age down in reasonable increments until everyone is covered.  There, national healthcare.  At five year age increments every year, you could do this in about 8 years.  Get it started.  But you would have to address the real issue in attempting to do something for healthcare, i.e., you would have to prevent the physicians from refusing to provide treatment to patients as they do now.  Best way to do that?  Probably have a law that says no physician can refuse patients treatment, period.  Will there be abuses of that?  Of course.  But right now, Medicare patients are being refused treatment simply because they are on Medicare.  That simply can't be allowed either.  Drop the age and force the docs to treat everyone.

That should get you started.  Let me know when you've knocked these out, because I've got more if you need them.

Sincerely Yours,

Art