The Real Death Tax

It has always struck me as almost quaint that some conservatives get so worked up over what they call "the death tax". It will effect remarkably few of us (as in virtually none, unless academia pays a hell of a lot more than I have noticed, or books with Viking ships on the cover become best sellers). Here, on the other hand, is the real death tax that each and every person who reads this post has a good chance of paying. It's a real example from a reader asking Michelle Singleterry for advice at the Washington Post:

My mother has been at a wonderful nonprofit continuing care facility for almost 13 years. She is now 94 years old and although she had a mild stroke 10 years ago, she is in pretty good health and has all her marbles. First she lived in an independent apartment but two years ago, after a series of falls, we moved her into assisted living. She is now at Care Level 2 at a cost of roughly $84,000 per year. Here's the problem: she is running out of money. She will never hit zero because she has my father's pension and Social Security, totaling about $50,000/year. We have sold off most of her stocks (she was a very good investor when she was younger) to pay her bills and she has an annuity of about $240,000 she has held for many years. We will start tapping that but if she is raised to Care Level 3 or moves to the nursing home on the campus, that will be gone in as little as two or three years. The nursing home charges $12,000/month.

Meanwhile, the plan to starve the evil government goes forward. Hope you are feeling healthy as you age.

OK - someone's reputation improves

Doctors. Or at least some doctors. Or one: Sanjay Gupta. Yes, a media figure, and yes, I am cynical too (and I haven't seen any of the TV coverage).

Still, this seems to be what a doctor should be doing.

alright. That's it. Now it's back to cynicism and gloom.

North Carolina in the news

Here in the High Country we are represented by one of most loathsome politicians out there .... and I do mean out there.... Virginia Foxx. The reason I say that are legion, going from her reputation back in the days when she worked for the same school I do, to her pernicious role in every political enterprise she has been a part of, to rumors about the way she has become wealthy (funny how politicians do that).

Anyway, back to the topic on hand. Virginia has been busy burnishing the old Tar Heel State's reputation in Washington during our health care debate. Here is a sample from a blurb about her on the Washington Monthly site:

Rep. Virginia Foxx (R) of North Carolina has already contributed so much to the health care debate. It was Foxx, after all, who argued a month ago, "There are no Americans who don't have healthcare. Everybody in this country has access to healthcare." She added that reform would "give the government control of our lives."

A week later, Foxx insisted that health care reform would "put seniors in a position" in which they may be "put to death by their government."

And Thursday, Foxx was at it again, this time making a constitutional argument.

"The Constitution doesn't grant a right to health care, and most of us are living as much by the Constitution as we can. It also doesn't give the federal government the authority to deal with health care. As you may know, the 10th amendment, it says if it isn't mentioned in the Constitution to be done by the federal government, it's left to the states or the people."

ergo Medicare and Medicaid are unconstitutional.

I've always wondered if she is related to Redd.

Tort reform and medical reform

My friend Budweiser and I get together about every three months for deep discussions of politics, wars, cars, and a few other things (never gossip or family news, to Carmen's frustration). Budweiser, who is a legal aid lawyer, has a bee in his bonnet about tort reform and medical care: he hates trial lawyers like the late John Edwards who specialize in tort cases, especially medical malpractice.

I thought he was a bit irrational about it until I read this from a reader of Andrew Sullivan's site. He says that he is a liberal, working for an insurance company researching doctors and malpractice. If you take his self description at face value he knows what he is talking about and certainly seems to have the facts and figures. It's enlightening in several aspects. Here is just one:

As much as the trial lawyer lobby tries to dispute the facts, physicians did indeed flee Illinois in 2002 and 2003 after the judicial climate turned completely poisonous. There was a period in 2004 and 2005 where there were only 4 Neurosurgeons practicing in the entire state because several fled to Indiana, where there is an elaborate system of caps and state-funded malpractice insurance. The cost of malpractice insurance in Indiana is about 75% less than Illinois, and claims frequency and severity is a tiny fraction of Illinois'.

And here is another:

my company, after we initiated an elaborate Risk Management program a few years ago through which insureds could receive discounts for attending seminars, improving office procedures, electronic medical records, etc., claims frequency dropped by 28%. The program encourages fewer unnecessary tests and instead stresses improved record keeping, patient tracking, etc. Most "failure to diagnose" claims (the most common type) are the result of poor record-keeping, not failure to run additional tests.

So now I will listen to Budweiser with new respect the next time we meet at Tank's Taproom, down in that unnamed port city to the south.

I knew it! It's a health food!

Chocolate.

It's not just for self-indulgence anymore.

Carmen will be so happy - she's already had one heart attack so should take double the dose.

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Best Congress Money can Buy

This just in:

The Washington Post reports that the health care industry gave nearly $170 million to federal lawmakers in 2007 and 2008, with a narrow edge of 54% going to the Democrats -- increasing to 60% in the first quarter of this year, after the Dems expanded their majorities.

Hope you're feeling well.

I myself am feeling mighty puny.

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The Medical/Auto tie in

I had no idea that the medical business might be effected by the demise, or even the endangerment, of the automobile industry in America, but here is what one of Matt Yglesias' readers had to say in which Yglesias commented on the auto business:

“by which hundreds of thousands of jobs are now hanging isn’t very funny”

It’s not funny. I’m the medical industry, and we’re doing fine. You will always pay for medical treatment, even if you just lost your job. But many of our suppliers are tied to the auto industry. Few suppliers want to commit to the medical industry because of the high risk. What if the FDA decides you product is no good? Even worse, what if you get sued in faulty product litigation? For those reasons, our suppliers like to have some reliable auto business to keep them safe. But they sunk a lot of money into the machines needed to supply the auto industry. So what happens when those machines aren’t running? Well, they need to make up the costs by raising the price of my products. And we in the medical industry don’t take losses. We transfer the costs to you, because you’ll pay for your medical needs no matter what it costs. Are you laughing now? Didn’t think so. People rightly talk about how suppliers will be affected, but they don’t even know how far it goes.

Learn something new every day. Does anyone else out there know anything about this?

How to make money in Medical Insurance

First thing you do is write a lot of policies and collect a lot of money. Then if any of the policy holders get sick enough to require large payments, encourage your agents to find flaws in the original policy and dump them. Any little flaw.

This is a time honored business practice among the dishonest: sell a product or service and then don't deliver it.

After all, if you are caught, all you have to do is provide the service that has already been paid for. There was no extra cost, no punishment, and in a certain number of cases, the customer was dead anyway.

Until now.

You have to read the whole article to see just how sleazy Health Net, the insurance company, was in this case. Then think about something else the article implies: this is standard practice.

About those misquotes

[see last post]

A quote from a reputable medical article by reputable medical experts!

"Heartworm is an infectious life-threatening cardiovascular disease spread by misquotes."


Hmm. Think I'll go back and check all those quotes I have in my just-now finished article on the Master of the Temple. I didn't know being a writer could be so dangerous.