Mid-Week Linkage Roundup

■ From the "Everything Old is New Again" Department: My late mother had Post-Polio Syndrome, a result of childhood exposure, but (thankfully) she never had the full-blown version of the dread disease. A common treatment for those that did was the so-called "iron-lung." Fortunately, we've long since eradicated polio, but FoIB Allison Bell warns that we may have to dig those old machines out of mothballs:

"Zika May Be Polio All Over Again ... the CDC concluded, “after careful review of existing evidence,” that “Zika virus is a cause of microcephaly and other severe fetal brain defects” in newborn infants."

Heads' up.

■ Co-Blogger Mike thinks that Belgium might be catching up to Sweden in the Bizzaro World medical tourism race:

"Euthanasia tourists are flocking to Brussels to get a lethal dose. Doctors at hospitals and clinics at Belgium’s capital are seeing an increase in number of euthanasia tourists who are travelling from across the world"

Supply and demand.

■ FoIB Jeff M first alerted us to troubles brewing for North Carolina's Blue Cross franchise back in May. Today he shares this update in the continuing saga:

"The N.C. Department of Insurance announced Monday it will broaden its investigation into Blue Cross and Blue Shield of North Carolina, citing “disagreements” with the insurer."

At issue are continuing IT and claims processing issues.

Gotta love the tech.

■ And finally, via FoIB Holly R, this sad (and highly unusual) case from Great Britain (and for once, it's not about the MVNHS©):

"[A] 61-year-old British bagpipe player who developed a dry cough and breathlessness that worsened over a period of seven years ... He died several weeks after entering the hospital"

Turns out, several different - and deadly - fungi had taken up residence in his bagpipe, which he had neglected to clean. Truly sad, but perhaps a helpful warning to fellow pipers.

Death by Amazing Grace?

Tick-Tock: Welcome to the Walmart Marketplace

As we noted earlier this month, agents have the opportunity to sell ObamaPlans at Walmart stores around the country. But the window for signing up to do so is closing.

From email:

"Tomorrow (August 31) is the last opportunity for agents and brokers to sign up to enroll consumers in Marketplace plans in Walmart stores.

In order to participate in this Walmart event, you must hold a valid state license and be trained and registered to participate in the Marketplace for 2017."

Interested? Then click here to get started. And any readers that do choose to participate are encouraged to let us know what you think of the experience.

MVNHS© circling the drain?

Earlier this month, we noted the financial difficulties facing the Much Vaunted National Health Service©, and observed that if you're a government-run health care system and you're going broke, that's a problem. But it's not the only problem - lack of self-awareness is also strong:

"Yet oddly, rationing is not entirely dead. It is alive and well and making a comeback in our “precious” National Health Service." [emphasis added]

Just now noticing that, Jeremy? Had you been a regular IB reader, you'd have seen examples for years. Better late than never, one supposes. And he does, in fact, make an extraordinarily brilliant point:

"In a tax-funded health care system, the normal, self-limiting rules of supply and demand don’t apply."

Which is exactly right, and we're already seeing signs of it here, with only a partially government run health care scheme:

"A majority of new enrollees are considered high risk, meaning insurers will have to spend more money on people in poor health and requiring expensive  care."

Mr Warner goes on to point out three "new elements" that have entered the picture: mass communication, an aging society, and ever-growing, ever-changing tech. Notice the elephant in the room that he doesn't mention?

[Hat Tip: FoIB Peter K]

History Can Be Fun

Shortly after ACA was enacted into law in 2010, Senate Finance Chairman Max Baucus, whose Committee wrote most of it, "tried to calm an angry Montana voter by saying this: “Mark my words, several years from now, you’re going to look back and say, “Well that wasn't so bad after all”. 

Senator, we did mark your words.
 
It’s now been several years. 

It's pretty clear the average person today would NOT say: “Well, that wasn’t so bad after all”.  

In fact, a great many Americans are still looking for a good reason to calm down about Obamacare.

I think perspectives like these help explain why history can be fun.

Now in fairness to Senator Baucus, he had begun to change his opinion of Obamacare, in fact had become a critic, within a couple years of its passage.  Not necessarily because he disagreed with Obamacare's goals; more likely because the Administration's fumbling, bumbling, and rumbling threatened to prevent the law from accomplishing its goals.

The Washington Post reported Senator Baucus' changing opinion during 2013.   Early that year,  the Senator told HHS Secretary Kathleen Sebelius, “I just see huge train wreck coming down. You and I have discussed this many times and I don't see any results yet.” Later that year, the Post reported Senator Baucus commented (about the health-care exchanges and the government enrollment Web site) "Let's just see how much of this can be put together, how much Humpty Dumpty can be fixed, in the next month."

Well, hmmm.  Mmmaybe it WAS so bad, after all?  Even my Magic 8-Ball replied "It is decidedly so".  

I suspect Senator Baucus' deteriorating confidence in the success of Obamacare may have been a factor in his decision to retire from the Senate at the end of his term in 2014.  I also wonder if Senator Baucus' public criticism of Obamacare, especially his use of the descriptions "train wreck" and "Humpty-Dumpty," was a factor in prompting Mr. Obama to name him an Ambassador in 2014 and get him out of the country.  China, to be exact.

I think questions like these also help explain why history can be fun.

EpiPen: The EpiLogue

The other day, I linked to David Williams' insightful post countering the conventional EpiPen narrative. Turns out there's even more fallout:

"Mylan, said that the generic EpiPen would be available in several weeks and be identical to the existing product, which is used to treat severe allergic reactions. But it would have a wholesale list price of $300 for a pack of two, compared with just above $600 for the existing product."

As a friend noted today on Twitter, it's unclear on how they're going to compete with themselves and still come out ahead.

Not my monkeys, not my circus.

[Hat Tip: Co-Blogger Bob V]

Healthcare is Different. Real Different.

Modern Healthcare has released its list of the top 100 most influential people in healthcare.  It's an annual list.

It's worth your time to scan the whole list.  As you do, don't overlook the fact that not one of the top 25 is a physician.

Not one.

Plenty of politicians, lawyers, MBA's, and accountants. Couple of nurses. A phys Ed. Major. Not one physician.

President Obama is #1. (Modern  Healthcare doesn't really say whether it distinguished between positive or negative "influence" assembling their list.). You'll also notice Loretta Lynch, Paul Ryan, John Roberts, even Bernie Sanders.  But not one physician.

Can anyone imagine the automotive industry's 25 most influential people not including even one senior mechanical engineer?  Or the 25 most influential construction executives not including even one experienced building contractor?  Or the 25 most influential American military figures not including even one general or flag rank officer?

But it's all good, because, you know, "Healthcare is different".

Bad News for Obamacare in Ohio

Ohio’s individual health insurance market is failing. In less than 12 months we have seen HealthSpan, InHealth, United Health Care, and Aetna exit the Obamacare Marketplace. Another insurer local to Northwest Ohio, Paramount, is reducing its footprint for their HMO products. Now comes official word that Medical Mutual will be eliminating all PPO products and will no longer participate in 65% of the state.

For people living in 19 counties choice is no longer an option. Anthem will be the sole insurer they can purchase a plan from. In 28 counties there will only be two insurance carriers to choose from – Anthem and one other. These 47 counties make up more than half the state of Ohio. This is a far cry from 2016 when Ohio boasted of having at least four insurers in every county.

MMO’s PPO plan elimination is even more important for those it will still serve. Their largest number of insured members were enrolled in a PPO product. The PPO network was very robust and allowed members to utilize several hospital systems and specialists. That choice is gone. Going in to 2017 the remaining insurers all utilize narrow networks. For consumers in some counties this means that they cannot have services from the local community hospital that serves them. For others it means that they will have to find new cardiologists or oncologists. This will be especially problematic for outlying communities.

The bad news doesn’t stop there. In addition to less choice, rate increases are estimated to rise nearly 13%. As the only statewide insurer, Anthem is seeking a 9.9% average increase for their plans. Overall this is less than the average but it is relevant to point out that they already had some of the highest rates in the state. Other insurers such as Medicaid managed care providers Caresource and Premier are seeking increases of 13.5% and 39% respectively. Now they will be taking on the additional risk coming from insurers who are losing their shorts in the Obamacare marketplace.

Higher rates, less insurers, and fewer providers. Exactly the opposite of what Obamacare promised.