Category Archives: healthcare

My Humana monthly statement left me twitched, bothered and bewildered in the quest for answers

The two thick envelopes arrive monthly for the wife and me, each 12 pages of lists of what drugs we bought that month, how much we paid, plus the amount Humana insurance contributed. If you just file this document, and don’t check the numbers, it may cost you a load of money.

I learned this when I reviewed my January 1 to 31 Humana recap for 2018, and found that the total for prescriptions in the year was about twice the total for the month. One month in the year expense should always equal the year-to-date total.

This same error appeared three times in my statement, and the higher annual total would take me into the Medicare prescription donut hole faster by nearly $400. The hole is where you pay 35% of the list price of drugs, rather than lower co-pays.

I decided to call Humana the Saturday I discovered this anomaly, and that’s when everything started going downhill.

A robot answers. It asks me for my date of birth, and the machine keeps telling me to repeat, because it doesn’t understand. I try using a Bombay accent, but still no luck. Finally, I get to a stage where I can enter birth date on phone number pad, and then I learn the bad news.

There is no phone customer service on Saturday or Sunday, only weekdays.

Can’t Humana afford someone to answer the phone on weekends? The company managed $4,100,000,000 in operating cash flow last year, including an expense of $148,000,000 for “charges associated with voluntary and involuntary workforce reduction programs.” Continue reading →

Should drug company execs get life in prison for their predatory pricing that endangers our lives?

Illegal drug dealers, who are designated as major suppliers, will face the electric chair or gas chamber if President Donald Trump has his way. Our sometimes alert members of Congress voice agreement, now suddenly aware that criminals who sell opioids, like heroin and oxycodone, deserve more than slap-on-wrist fines or jail time.

Don’t bet on the death penalty just yet for these creatures. With decades of litigation possible, it’s easier to prescribe life in prison.

Martin Shkreli, smug former CEO of Turing Pharmaceuticals LLC

And speaking of prescribing, when are we going to deal with the legal drug dealers, whose companies have priced life-saving medicine in the stratosphere, so that only the very rich, or those with golden health plans, are able to afford?

An illegal drug dealer who hooks 200 victims deserves their fate.

A legal drug dealer who ruins the lives of millions deserves no less a prison term.

Which brings me to the example of Hepatitis C and the story of Marsha Lecour, who contracted the condition when she was four, after open heart surgery that exposed her to contaminated blood. Lecour is a native of Canada, the only nation, other than the U.S., which doesn’t have government-provided prescription drugs, where there is national healthcare for everything else. Continue reading →

If all you want for Christmas is your two front teeth, it’s time to borrow $6,400 or pay 1/3 price in India

Visit Victoria Station while in Mumbai for implants

If our politicians ever make the effort to visit the “little people” – those neglected voters, who don’t live in gated communities and suck gin in the Capitol – our selected leaders will see smiles without front teeth. And that is just the beginning of their constituents’ dental problems.

Some 140 million Americans have no dental insurance, and for most who do pay premiums, the coverage won’t cover the cost of replacing those two front teeth with implants

Medicaid and Medicare will pay nothing.

If you search the web for how to afford dental implants, the usual answer is borrow the money. A few suggested contributing more to your Health Savings account (as if everyone has an account). One advised asking for charity on the Internet. I am surprised no one said: write a check or pay with cash. Continue reading →

How the “free market” in toilet tissue tricked you

Sometimes you have to cringe when a Capitalism fan praises the wonder of the “free market.”

For example, “free market competition lowers prices…”

Sounds great, but visit a store and compare the price of batteries from various companies – each one is within a penny of the other.

Listen to the CEO of a major airline who explains: “we no longer compete on price because that’s bad for profits for the entire industry.”

Or, be amazed when the generic drug you are prescribed is made by the same manufacturer as the brand name version and the price of both is nearly identical.

Ah…the “free” market. Some politicians salute this as the cure for rising middle class healthcare costs. Is medical services shopping fun as you put your heart attack on pause to consult with various institutions and learn they have no set price, just schedules of charges that all fall within a close range? Continue reading →

Americans suffer while drug companies make a fortune because FDA isn’t timely approving generics

The Food and Drug Administration (FDA) last year had 4,036 generic drug applications waiting for approval. In October 2012, there was a backlog of 2,868 drugs. It now takes a median 47 months to approve a generic drug by the FDA – nearly four years.

What does this mean to the healthcare consumer?

drugsalesFirst, it allows a drug company to continue selling their “brand name” drug because there is no replacement on the market. Brand name drugs are sold at incredible prices, pushed up by obscene profits, as well as constant advertising, plus promotion of drugs by medical professionals. To many in the health business, brand name drugs are the real money makers.

By comparison to the United States, the European FDA – the European Medicines Agency (EMA) – has just 24 generics awaiting approval. It takes about a year to get approval in Europe, one quarter the time of the U.S.

Why would it be faster to approve generics in Europe than here? The answer is that patients in America pay for their drugs, either directly or through health plan premiums. In Europe the government negotiates drug prices, because they are working to lower costs to benefit their citizens and reduce spending. It’s the difference between healthcare for profit or Continue reading →

Fracker’s friend frets that you might retire and get your Social Security, instead of working to death

When Libertarian Gary Johnson proclaimed that Americans should not get their Social Security until age 72, he was actually condemning many to death before receiving any of their “earned benefits.”

garygoofyThat’s because the average life expectancy of a Black male in the U.S. is 68 years, meaning death four years before Gary would grant retirement security. While the average life expectancy for men in general is 76.9 years, men in the middle and lower income levels die five years sooner, or at 71.9. With a 72 retirement age, most men would die before that first Social Security check.

As an aside, male life expectancy in this country, where we work so long and hard, is ranked 32d in the world, behind such places as Costa Rica, Chile, Greece, Slovenia and Korea, as well as most members of the EU. We did tie with Cuba – for what that’s worth.

David Barton, another Johnson/Tea Party type, personified the big business view of Continue reading →

Gary Johnson wants to cut 43% from Medicare and the Defense Dept., end the senior drug benefit, eliminate student loans, and stop taxing the rich

GoofyGary

Is the grass always greener?

It was a simple question to Gary Johnson in a 2012 interview, while running for President as the Libertarian candidate: How do you stop the deficits and out of control spending?

The answer from Johnson, who is currently managing 6% to 10% voter support in national polls:

A: Well, cutting $1.675 trillion from the federal government. You got to start out by talking about (cutting) Medicare and Medicaid by 43 percent. They could block grant the states, 50 laboratories of innovation. Give it to the states to deliver health care to the poor and those over 65 and do away with the strings. Do away with that regulations; let states handle it. There would be best practices emerge. Other states would emulate the best practices. They’re be failure. States would avoid the failure.

Johnson also wants to eliminate the Federal Income Tax, which would require huge program cuts in the federal budget to pay for it. His revenue solution would be a national 23% sales tax, plus virtual elimination of the earned Medicare benefit (now paid for by workers with a payroll tax). Continue reading →

How a Medicaid divorce can save you millions.

Leave it to the scions of Washington D.C. to break up middle class marriages.

Under current law if your spouse enters a nursing home, both of you are obligated to pay for care. With an average Social Security check at about $14,000, the cost of a nursing home is impossible to pay out of current income. Most folks dip into savings.

But even a family with say, $400,000 saved over a lifetime, will see that money rapidly disappear because nursing home care is not covered by Medicare. You have to pay 100% of the costs.

To give you better sense of these expenses the states with the most expensive median annual rate for a single person’s private room bed in a nursing home:

  1. Alaska – $259,515
  2. Connecticut – $158,775
  3. Massachusetts – $139,430
  4. New York – $136,510
  5. Hawaii – $135,050

The states with the least expensive median annual rate for a single person’s private room bed in a nursing home:

  1. Oklahoma – $60,225
  2. Missouri – $60,955
  3. Louisiana – $62,050
  4. Kansas – $65,700
  5. Arkansas – $65,700

Double all the above numbers for two persons.

The table below shows the range of costs by state in 2015 of the daily rate for a private room. Continue reading →

Heritage hates Obamacare – plans “Impoverishcare”

Healthcare.gov has my email address, because I once searched for plan information on the site, and now the artificial intelligence – or just perhaps an algorithm – has decided to pester me to sign up or pay a penalty. Having fooled the system (because I can’t get Obamacare since I passed my 65th birthday), I checked some prices to see the cost of  plans for my neighbors, assuming a family of two parents and two teenage children.

Cruz-at-Heritage-Foundation

Rafael Edward “Ted” Cruz

It’s not a pretty picture. Without premium subsidies, all of the so-called Obamacare Bronze plans cost about $900 a month, or $10,800 a year. All of them have a deductible of about $12,000, which adds up to a total cost of $22,800 – before you receive one penny of health insurance. It’s all on you – just put pennies in the jar each January and set aside 2,280,000 as your personal Copper plan. Actually, someone should call the coppers for allowing such a ripoff junk health plan.

The missing ingredient in this analysis is that the government (middle class taxpayers) provides a subsidy to our average $50k-a-year household of four, amounting to $800 or so per month. That money goes directly to the insurance company. You pay the difference in premiums and you also pay all that $12,000 deductible. It seems insanely expensive – between contributions from taxpayers and subscribers – and some might say a windfall for insurance companies, a deal that was negotiated by Chicago’s current mayor under assault, who is also a former investment banker.

The Democrats may have bowed to the healthcare industry, prostrated their principles, humiliated party members, destroyed the President’s legacy and may even made Valerie Jarrett unhappy, but things might get even far worse.

Enter the GOP and its brainiacs at the Heritage Foundation. They have a plan that makes Obamacare look like heaven with 72 virgins (persons, of course) and unlimited six packs of Continue reading →

Medicare age hike to 68 is Heritage GOP plan

With the exceptions of Mike Huckabee and Donald Trump, all of the Republican candidates for President want to change Medicare so that it costs you much more, but guarantees profits for campaign-funding insurance companies.

The details are in the Heritage Foundation plan to replace Medicare with a “premium support” plan in which you buy Medicare on the open market and the government reimburses you, based on the lowest price from solicited private bids:

During the first five years of the premium-support program, the government’s contribution is based on the weighted average premium of the regional bids of competing health plans. After the first five years, the government contribution is based on the lowest bid of competing plans in a region.

Last week, I blasted the foundation for its miserable plan for Social Security. Their suggestions for Medicare are just as bad. What would such a plan cost, and what would be gop-no-ideas2its benefits to seniors? An examination of a typical Obamacare plan for a single 64-year-old may reveal some answers.

We couldn’t compare plans for 70 or 85-year-olds, because Obamacare won’t allow them for anyone past their 65th birthday. Since someone in their 90s requires more care than the average 64-year-old, whether Heritage blends rates (one rate for all) or age adjusts like Obamacare, premiums could easily be twice as much. What’s the difference, you might ask, if the government pays all the premium cost? Keep reading and learn why.

The cheapest (Bronze) Obamacare plan in Montgomery County, PA this morning was $533 a month for a single person, or $6,396 a year. Under the Heritage plan for Medicare this seems like a likely low-ball comparison – many co-pays, no dental or hearing aids, etc. In addition, there is a

Continue reading →

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