Posts archived in Health Care


Health Care!

I love reading the AMG reaction to health care. They are suggesting people confront Justice Roberts when he visits Maine next, and yell at him. Or something. I guess he has a house here.

It is the end of the world… the end of the world…. Again, as always.

And I’m also watching Senator Rubio on Fox saying that because the 2009 Senate said they were passing a penalty, but it was actually a tax, he hopes the current Senate leaders will be nice and politely agree to hold the vote again. A redo, to make sure they get the word right.


He must think the people he is talking to have the intelligence of four year olds.

And also on AMG, Woodcanoe thinks this is a win for Republicans because they will get angrier and, like the dark side of the force, anger makes them more powerful!

Did you know you can comment on the Maine GOP website?

It is moderated, unfortunately, so no one is ever likely to see what you write, but if you wish to vent your anger at the absurdity of the modern Republican party you could, say, go to the list of State Committee members and write a comment like this:

It may be of interest to some readers that Committee member Roger Ek, Penobscot County, opposes the President’s compromise on ensuring access to birth control because, Roger notes, woman have had access to fish bladder condoms for thousands of years and can have an abortion anytime they want by jamming a stick into their uterus.

I’m not making this up.

Will it ever see the light? Who knows. But I found it a useful release in a moment of Roger Ek inspired annoyance.


AMG hates sluts.

On birth control, “johnw” is somehow the voice of reason.

I haven’t written about johnw before, because he is so incredibly dull. He posts long Ron Paul-enque rants that even people like me can’t go through without our eyes rolling into the back of our heads. But somehow, on birth control, he is concise and logical.

Here is what he says:

I work in an office where there are 30+ women….. some of them pretty darn conservative.
The prevailing attitude is why shouldn’t insurance pay for birth control if they choose to use it whether you agree with it or not.
These women vote , they pay for insurance and they believe that they should receive services they deem necessary……I had one standing in front of my desk yesterday telling me if our insurance policy pays for Viagra….. a drug that helps get women pregnant it sure as hell should pay for things that prevent it…… .

Other AMGers, however, they’ve still got the crazy flowing uninterrupted. Here are some of my favorites:

Maine State Republican Party Committee member Roger Ek:

Contraception has been around for thousands of years. Air bladders from fish were used back then as condoms and an old lady with a stick was used to perform abortions. The issue today is whether citizens’ tax dollars should be used to pay for these products and services.

Let me say that I am wholeheartedly in agreement with Roger in standing against taxpayer subsidies for fish bladders. And ‘old lady with a stick’ abortions. One-hundred percent with you there, Roger.

And then there is the resident conspiracy theorist, Mackenzie Andersen:

Extrapolating into the future as we continue down the course we are headed:

Phase One: in order to advance its population control agenda, the authoritarian totalitarian government issues free contraceptives.

Phase Two: The contraceptives that the government is issuing are revealed to be sterility pills. If one wants to conceive, one must get the antidote pill but to get that one must apply to the government for permission
Phase Three: New “advances’ in genetic engineering are made.

Phase Four: Genetic engineering mandates.

Wow. Phase Two is a plot twist I’d expect on the sci-fi channel at 2 a.m. I like where you’re going with this, Mackenzie. Put it in 45 pages of script form and I’ll see what the network brass thinks.

And finally, more Mackenzie. Doubling down.

I know the opening scenario sounds like it couldn’t happen here but as the second post in this discussion brought up- it is consistent with the views oi some of Obama czars, who ill continue to hold power if Obama is re-elected. These czars have already expressed a belief in public sterilization as a solution to the population problem. Science is always discovering unknown side affects of new drugs. Sterilization could be marketed as an either unknown side effect or an accidental contamination of the drugs- at least in the first phase of phase two, The antidote could be said to be in short supply and so must be regulated by the government.

Yes I know it sounds unlikely but so did everything that is happening today seem unlikely a short four years ago,

First of all, birth control is not a new drug. Well, unless you are on the Roger Ek geologic timescale, comparing hormonal pills to fish bladders, but you get my point. Five decades is not a short time.

Second, what a complete moron. The woman, Sandra Fluke, who testified and set off the whole Rush Limbaugh “slut” debacle was not talking about sex. She told the story of a woman who needed hormonal birth control pills not for birth control, but to prevent a progressive loss of fertility and the eventual disabling of one of her ovaries. She wanted to prevent sterility. She wanted what civilized people might call medicine. But she couldn’t get it, because the Affordable Care Act didn’t exist. Soon, people with her problem will not have to lose their fertility because of idiots like you, Mackenzie.

In this thread we learn that the state of Maine has, inexplicably, spent $10 million dollars from it’s $6 b-b-b-billion dollar budget on prescriptions meant to help people get off of heroin.

Whoa, we better stop that right away!

We wouldn’t want people getting off heroin and onto the worst addiction of all: the government gravy train.

Besides just being generally astoundingly stupid, this thread is specific example of that conservative ideological phenomenon known as the Unless-It-Happened-To-Me principle: “Government spending is bad, and government spending recommended by experts who have spent years gaining knowledge about a subject is even more bad, UNLESS I had one personal experience in this area and saw it benefit me or someone I love, in which case that particular thing is GOOD but everything else is still bad.”

User “Woodcanoe” sums this up: his wife had an addiction problem. She used a prescription to help break the addiction. Hey, he says, maybe treating people is better than the inevitable incarceration or death that happens from untreated drug problems.

Well, at least he values his wife’s life more than tax cuts. Sometimes on AMG I question whether this is true for most posters.

Unfortunately other personal experiences come into play, and they are negative, and are equally determinative despite all expert opinion.

For instance, “Ugenetoo” says that someone he knew was “suckered” into joining a methadone program and his doctor seems intent on keeping him on it.  Wow, that’s some damning stuff. You’ve got the story as interpreted by an admitted heroin addict versus some doctor guy who probably, like, went to school and has treated hundreds of patients. I’d definitely go with the heroin addict.

News flash: Sometime drug addicts try to avoid treatment. Sometimes a doctor wants to keep a person on a prescription because the drug works best when the patient is on a gradual reduction plan, and suddenly cutting off the prescription leads a situation where a desperate addict overdoses on heroin in his bedroom a few days later.

But hey, maybe I’m just crazy- here I am taking the expert’s view, versus this anonymous poster’s anonymous heroin addict friend. I’m going to lose that argument on AMG every single time.

“Jeepn” has a similar story about a family member who was told to stay on methadone and “give it time.” Yeah, you think maybe doctors have done studies on this? Nah, they just want to sell more government drugs. They must be evil. There are tax dollars involved!

And because it is impossible to read a thread without Naran saying something stupid, it is impossible for me to comment on the stupidity in a thread without saying something about Naran. Her basic problem seems to me that the doctors are prescribing two different drugs, one of which is more expensive. And they’re both for the same thing: heroin addiction! So, obviously Dr. Naran thinks Mr. Actually-A-Real-Doctor should only prescribe the cheaper drug. She laments:

– isn’t it amazing, that the longer the new administration has a chance to explore the murky state funding cesspool, the more of these sordid albatrosses float to the surface?

So there you have it. Naran is against government getting between a patient and their doctor, unless that doctor thinks the more expensive drug does the job better. Than Naran is ready to jump out from behind the nurse’s station, spoon in hand, to yell “No suboxone! As the angry old lady of Kennebunk, I demand you prescribe something else for this patient I’ve never met! I am the good and the holy! Obey me!”

I am only slightly exaggerating about Naran on this one. She probably wouldn’t yell the “angry old lady” part.


Rep. McKane’s Fuzzy Math

Last night on AMG, Republican Representative Jon McKane (R-Newcastle) published a lengthy, straight-forward defense of the new insurance regime enacted by the legislature.

It is well written and persuasive, as long as you don’t think too hard about the math.

Ready to enter Republican math land? Grab a handrail and hold on.

I’ll let Rep. McKane explain the quasi-high risk pool created by the new law. It is called the “Guaranteed Access Plan.”

Part B creates the Guaranteed Access Plan (GAP). This is similar to a “high-risk pool” but differs in some significant ways. First, those who need chronic care and are in the GAP will be offered the same policies as anyone else. Also, they will not be charged a higher premium. The difference for the cost of their care will be made up by the insurers and by a maximum $4 per month fee on enrollees. The addition of this new fee will be more than offset by the elimination of the 2.14% tax on claims that supports the Dirigo program.

The idea is this: people who are sick and have very high health care costs will be in the same plans as everyone else and pay the same premiums, as if by magic. How, you ask? There will be a tax (oh, excuse me Rep. McKane, a fee) of $4 per month per person to pay for the higher costs of these sick people.

But how much money does it actually cost to take care of the sickest people? Rep. McKane gives us some facts:

It is important to remember that 1% of those who have health insurance account for 40% of the claims paid. By moving this 1% out of the general insurance pool and continuing to cover their health care expenses, there will be less pressure to raise rates for healthier individuals.

As Rep. McKane says, one percent of insured persons require 40% of total claims paid because they have cancer, a chronic condition, high prescription costs, or some other serious malady.

Those people are the one percent that will be covered under the Guaranteed Access Plan, which will be funded by the $4 fee paid by everyone else.

But think about this: will $4 be enough? How do you pay 40% of claims with a $4 fee, all while not reducing coverage or increasing premiums?

Answer: You don’t. It doesn’t add up. I doubt you could even pay half a percent of claims with a $4 fee. If an extra $4 was all insurance companies needed, why didn’t they raise their rates by $4?

Answer: Because they were too busy raising them by hundreds of dollars just to keep up with health care costs.

Let me break it down: there is no free lunch. There is no clever scheme that can reduce health insurance cost without dealing with health care costs. Health care costs in Maine are higher than average because we, as a state, are one of the oldest in the nation. Older people need a lot of health care and it isn’t cheap.

No. Free. Lunch.

$4 is not going to change anything. It will not cover the costs, and Republicans will need to raise the fee dramatically or reduce coverage to balance the sheets. Which do you think they will choose?

Rep. McKane ends his essay with some reassuring talking points:

The concepts are not experimental or bold but have been used successfully around the country to create stable yet competitive health insurance markets. Over the next few years, Maine will be put back on the road to health insurance normalcy.

No, Rep. McKane. Other states have kept insurance costs a bit lower than in Maine by having a younger population and covering fewer peple. The sickest people drop out first. They just happen to be the most expensive to cover.

Maine covers much more of it’s population but it costs money, because there is no free lunch.

I can’t wait to see how Rep. McKane votes when the first bill comes forward to reduce coverage, raise deductibles, and reduce prescription reimbursements for the “Guaranteed Access Plan.”

Remember hearing how nearly half of potential Republican primary voters thought Obama wasn’t born in the United States? Talk about misinformed.

Well, if you needed it, here is further evidence that Republican primary voters might not have all their gears turning. According to PPP, 61% percent of New Hampshire GOP primary voters say they would not vote for someone who ever supported a health insurance mandate, even if that mandate was at the state level.

So who is the leading candidate?

Among just those 61% who would never, ever vote for a guy who supported an insurance mandate, Mitt Romney is the heavily preferred candidate. He gets almost twice a many nods as the next closest guy.

I guess a winning smile really does go a long way!


Health Care in Idaho

Maine Republicans are remodeling Maine’s health care system after the one in Idaho.

They are adopting the Idaho model of paying health insurance companies reimbursements for any costs on a policy above a certain amount. Taxpayers foot that bill.

But there is one thing Maine Republicans are not adopting: The Idaho catastrophic care fund.

This fund pays for the emergency health care of people who can’t afford insurance. As others have noted, the percentage of uninsured persons in Idaho is higher than that of Maine.

But there is a problem: the fund is running out of money. And not by a small amount.

So we Mainers are going to adopt health reforms that, in Idaho, pushed people to use that state’s catastrophic care program in ever increasing amounts.

Except that Maine doesn’t have a catastrophic care program. So what will Mainers do?

I’m no health policy expert. But I can read a bill and here is what I see about the taxes that will fund the high risk pool:

There is a $4 per person/month tax to fund the high risk pool.

That section is here:

Section 3597(2). Maximum assessment.  The board shall assess each insurer an amount not to exceed $4 per month per covered person enrolled in medical insurance insured, reinsured or administered by the insurer. An insurer may not be assessed on policies or contracts insuring federal or state employees.

But the $4 maximum appears meaningless. In fact, the tax rate may be higher if the high-risk pool loses money.

Section 3597(5). Assessments to cover net losses.  In addition to the assessment described in subsections 1 to 3, the board shall assess insurers at such a time and for such amounts as the board finds necessary to cover any net loss in accordance with this subsection.
A.  Before April 1st of each year, the association shall determine and report to the superintendent the association’s net losses for the previous calendar year, including administrative expenses and incurred losses for the year, taking into account investment income and other appropriate gains and losses and an estimate of the assessments needed to cover the losses incurred by the association in the previous calendar year.
B.  Individual assessments of each insurer are determined by multiplying the absolute value of net losses, if net earnings are negative, by a fraction, the numerator of which is the insurer’s total premiums earned in the preceding calendar year from all health benefit plans, including excess or stop loss coverage, and the denominator of which is the total premiums earned in the preceding calendar year from all health benefit plans.
C.  The association shall impose a penalty of interest on insurers for late payment of assessments.

Republican voted for an open-ended, unlimited tax increase on anyone with insurance.

To me, this is absolute proof that they did not read the bill.