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Sen. Hann Continues Assault On MNSure - But With Bogus Criticism

Category: Health Care
Posted: 10/04/14 23:44

by Dave Mindeman

Minnesota's Republicans get so frustrated when they aren't allowed to use their version of mathematics. It is almost embarrassing to watch the tantrums being thrown over how they want to play the game on MNSure.

They had a point when the MNSure exchange opened because the programming was awful and the exchange left people in a constant state of frustration. But since then, the GOP line is to continue to bad mouth the site and criticize Obamacare in general. And that line of attack has turned into a failure of credibility for their own part.

Continuing their version of how things operate, they are calling the recent data about rate increases of 4.5% totally bogus. And they say that based on how Senator David Hann thinks the numbers should be arrived at:

Senate Minority Leader David Hann says the calculation should have weighed how much of MNsure's market each plan had. And he said it should have included the largest and cheapest provider, PreferredOne, which is dropping out next year.

Here is why what Hann is saying is the actual bogus statement.

First, he says that the calculated increases should be "weighted" by current market share. Except it is CURRENT market share. When people again sign up for health insurance, they will be evaluating which policies are in their own best interest (remember, this is free market!) and the market share of each carrier WILL drastically change. In fact, the carriers that keep their premiums down will probably increase their own market share. So, the only way you can take an average insurance increase in premium is to take the carriers numbers as equal based on the new market they are now entering.

Secondly, he wants to include PreferredOne plans. Really? They removed themselves from the exchange - priced their policies for a different market - and will no longer be involved with Federal subsidies. How in the world could MNSure include them in the exchange averages, IF THEY ARE NOT PART OF THE EXCHANGE?

I understand the MN GOP's desperate need to find more fault with the MNSure exchange. The awful beginning was bad. But people did get health insurance and many people are actually happy with the result. And the electorate is starting to take a second look at the rates, the lower number of people who are uninsured, and the improvement in the exchange.

We still have more work to do, but "bogus" criticisms from Sen. Hann are more of a statement about his own credibility than actual problems with the MNSure exchange.
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The Mike McFadden "Solution" To Health Care

Category: Health Care
Posted: 09/27/14 10:34

by Dave Mindeman

Did you see Mike McFadden's health care "ideas"? A magical 6 pages (which you could fit onto one if you wanted to) of health care fixes. Oh why did we not do this before?

Truth is....we have tried all of this before....and it doesn't work.

Where do I begin.

He begins with a cost critique of Obamacare. His sources for the data come from the Manhattan Institute and the Freedom Foundation...both are right wing think tanks with slanted data.

He criticizes quality and lack of access by citing the New Hampshire exchange which had only one insurer - Anthem Blue Cross - in its network. But he doesn't mention that for next year, New Hampshire already has 5 carriers signed up and that all of the hospitals in the state will be involved with at least 3 of the 5 carriers.

Then he starts citing the old memes. He says 164,000 Minnesotans lost their health insurance. Again, let me repeat, all of those people got new insurance and it was better insurance. The bogus plans that were health care insurance in name only, had to be scrapped because they weren't close to the minimum standards required in Obamacare. Sure, the plans were cheap -IT WAS BECAUSE THEY DIDN'T COVER ANYTHING!

And I like this one.

"According to officials, 7.3 million people have enrolled in the Obamacare exchanges, a number far short of the 53 million uninsured prior to Obamacare."

You could put it another way. The uninsured population dropped 13% in one year with Obamacare. And let's be real factual and note that nearly 6 million more people could have been covered if Republican governors had just accepted the Medicare expansion!

Then we get the "plan" to lower health care costs....

1) Expand Health Care Savings Accts - Essentially this is making health care purchases tax exempt. You are still paying for it yourself, but you do get to use tax free money. McFadden thinks if he makes you purchase more of your own health care this way, then he can allow the insurance companies to cover less (like contraceptives). This was tried prior to Obamacare and costs were still escalating.

2) Increase Price Transparency - So, it is going to help that you can see the actual costs of things you could never pay for without insurance? I don't think we have to go deeper on that one.

3) Allow Small Business Pooling - Actually Obamacare addressed that but the implementation has been delayed. It is complicated to create a pool for this purpose and the same problems that have delayed it with Obamacare, would be a problem for McFadden. (He just doesn't know enough about it yet to understand that). And his assertion that small business owners with no employees (he says 78% of small business) need to have their own pool is odd. They HAVE their own pool - it is called the Obamacare Exchange.

4) Allow Individuals to Purchase Across State Lines - It's funny. One of the main assertions for McFadden's critique of health care is that the states should have more control. States do have control - they control the criteria for minimum standards that their own citizens have for health care. I could purchase much cheaper insurance in Mississippi, but it wouldn't have the same mandatory coverage or network access that I have in Minnesota. The Republicans put this option out there all the time without ever explaining the problems with that kind of implementation or the reasons that it is not allowed in the first place.

5) Reform The Tort System - A Republican favorite. Protect corporations from the trial lawyers. Actually, I cannot imagine putting limits on tort liability in the health care industry. Countless health care best practices have come from public lawsuits that pointed out the problem. Sure, it might save a little money on malpractice insurance for providers, but would that benefit the general public? Nope.

And then there is McFadden's attempt to take the popular aspects of Obamacare and just add them to the healthcare mix - AFTER he gets Obamacare repealed.

Really?

Covering Pre-Existing conditions. Children on parents insurance to age 26. Keep the ban on lifetime limits. Make subsidies optional state by state. Make oral contraceptives available over the counter.

McFadden waves his magic wand and all of that can happen. Wow.

There is a reason that those options were not part of health care prior to Obamacare. The insurance industry had to use them to keep their premium costs down. It was the only way to keep the sickest people off the roles.

The only way to implement those "benefits" was to incorporate them into a larger plan (Obamacare) that would absorb the costs and allow the system as a whole to make it all work together. Obamacare did all of that and still lowered the general cost to the consumer.

But McFadden thinks it is easy-peasy to just say "Poof!", let's do it.

And let me say something about over the counter birth control, because that seems to be the new Republican solution to appease their "religious objectors".

Yes, you could probably switch oral contraceptives to an OTC status. It has been discussed before Hobby Lobby and was probably going to happen at some point. But here are some things to consider:

- 15% of women take oral contraceptives for other medical reasons. OC's can regulate a troublesome menstrual cycle and ease painful cramping during that cycle. In these cases, oral contraceptives are medically necessary and should be a covered medical expense.

- Over the counter purchases are still purchases. They will cost less when they are OTC but it will still be a very significant cost. Retail prices can vary from $10 to $15 a month for uncomplicated generics, up to $120 to $200 per month for specialty brand products. Under Obamacare, they would be 100% covered. No cost to the consumer. McFadden's "solution" just cost you more money.

So, again, when you hear Republicans talk about health care "solutions", please realize that they really aren't solutions to anything. They are just more corporation protecting, higher out of pocket, band-aids which should never see the light of day after an election.

Health care does NOT, I repeat NOT, have a market based solution. And as McFadden always says - he's a business guy.

Don't let Mike McFadden give you the "business".
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Regarding PreferredOne - Nobody's Fault, Just Business

Category: Health Care
Posted: 09/17/14 14:43

by Dave Mindeman

(Forgive me if this gets a little lengthy, but I wanted to cover it all)

I guess the GOP thinks that the latest news about Preferred One pulling out of MNSure is worth a whole bunch of media time. So I guess I hate to disappoint them when I say the Preferred One pullout is no big deal.

I will try to explain this and I will speak slowly for all you conservative bloggers on the True North site.

Let's evaluate this based on facts...(we all remember those I hope) and along the way, let me point out the myriad of GOP criticisms that have never panned out.

First, these are the current total enrollments in MNSure - 327,154

I think we should remember that the GOP was blasting those numbers at the beginning, believing we would never meet projections. But we did.

Second, of those enrollments we have 54,646 that are qualified health plans or individual sign ups. That is what we are talking about here. And the GOP had a somewhat valid point that this part of the roll out was somewhat low. Since the site is paid for by a percentage of premiums in this group, there was a lot of criticism that MNSure would have to tap into general funds. That, again, did not happen.

Now of these 54,000 QHP's, Preferred One, (and this is important - a new entry into this type of insurance), got over 50% of the signups. The actual number is somewhere between 29,000 and 33,000.

This is my favorite quote from Jeff Johnson....

"This is yet another example of everyday, middle-class Minnesotans paying the price for Mark Dayton's incompetence. Six out of 10 people who've purchased insurance through MNsure will now have to go through the nightmare process of purchasing another plan all over again--thanks to Mark Dayton.

That is a terribly misleading statement. Six out of Ten sounds like a huge issue, but let's have a reality check. This is affecting about 30,000 Minnesotans which is 1 out of 10 people on the exchange. And if you think that punching in your data into MNSure and selecting another option is a nightmare than you must be depending on having some very placid dreams. And lastly, I would like to know how Mark Dayton has anything at all to do with it. Preferred One made a business decision (which I will go into more shortly) and they did not confer with Dayton - as far as I know.

OK, so let's discuss Preferred One.

Preferred One has never gone big into the individual health insurance market.....

For years, PreferredOne has been a small player in Minnesota for individuals who purchase coverage without help from an employer. The company had just 2 percent of the $688 million market in 2012 -- a sliver that was dwarfed by the 65 percent share held by Eagan-based Blue Cross and Blue Shield of Minnesota.

If you are going to venture into this type of market you would have to go big because adding a few new individual clients is bad for the pool. So, they decided to low ball the price and grab a big share. It worked. But still an addition of 30,000 to a small individual market pool put them at risk.

But their entry did a couple of things. It made the Minnesota market look like the best priced deal in the country. Preferred One's pricing was very attractive, but, in hindsight, wasn't realistic long term.

Personally, I think that Preferred One wanted a big presence to avail themselves of the new small business mandate. That is where their expertise lies and if these businesses went to the exchange, they would match up well. However, the small business portion was delayed by President Obama, which put more pressure on Preferred One's decision.

Here's another relevant fact....

In the individual market, PreferredOne sells only in Minnesota.

Preferred One doesn't have a national presence. So these 30,000 individual plans is all they have from the exchanges. So, if they are losing money on them, it is probably a good business decision to pull out now before too much is invested.

OK, so now we know the basis and why the decision was made. I guess if you are the GOP and you are invested in a MNSure failure then this is the kind of thing you need to seize upon and distort. And they are.

But how is this really going to play out. Well, when you have an open exchange, there will always be players coming and going. Preferred One gambled and lost on their pricing scheme, but the more experienced individual market players are still there and they, of course, will pick up the slack - being available when these 30,000 people reapply.

There will be some unhappy people in those 30,000....their rates will probably increase somewhat but as I understand it, their networks will almost surely broaden to include more physicians and clinics. It isn't like these things don't happen with regular employer based insurance. Your employer is constantly shopping around and change plans often. Before I retired I used to have health care changes at least 2 out of every 3 years.

So, Minnesota will probably not be the lowest in the nation for premiums anymore, but double digit increases????....I doubt it. The market will take a few years to stabilize and then hopefully, prices will too.

Last year we had the "woe is me" mantra of 140,000 Minnesotans not being able to keep their health care. Well, they still got health care...not the same plans, but probably better plans with better coverage. The prices were more reflective of a real market, so they probably cost more, but they didn't go back to these high deductible policies in which you paid a small premium but never filed a claim. Paying the insurance company a stipend to have your name on a contract.

Preferred One is a reputable company. A good insurance company and the policies they sold were excellent. But they gambled on the price and lost. You conservatives should be familiar with that - free market capitalism and that sort of thing.

Really, this system was molded by Republican insistence. Had to have a market based system. No public option to fall back on. Subsidies based on a complicated evaluation system. That's your mark on a lot of it.

You can criticize this all you want. (and you are) You can even try to label Mark Dayton incompetent regarding it. (and you have). And you can put MNSure in there as the culprit (and again, you have). But the truth of the matter is that this was a business decision pure and simple. Frankly there are no bad players in this. This is just how business works sometimes.

You GOPers remember business don't you?
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