No, You Can't Keep Your Health Insurance

A new study by McKinsey suggests that as many as 78 million Americans could lose employer health coverage.

By Grace-Marie Turner

ObamaCare will lead to a dramatic decline in employer-provided health insurance—with as many as 78 million Americans forced to find other sources of coverage.

This disturbing finding is based on my calculations from a survey by McKinsey & Company. The survey, published this week in the McKinsey Quarterly, found that up to 50% of employers say they will definitely or probably pursue alternatives to their current health-insurance plan in the years after the Patient Protection and Affordable Care Act takes effect in 2014. An estimated 156 million non-elderly Americans get their coverage at work, according to the Employee Benefit Research Institute.

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Before the health law passed, the Congressional Budget Office estimated that only nine million to 10 million people, or about 7% of employees who currently get health insurance at work, would switch to government-subsidized insurance. But the McKinsey survey of 1,300 employers across industries, geographies and employer sizes found "that reform will provoke a much greater response" and concludes that the health overhaul law will lead to a "radical restructuring" of job-based health coverage.

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Another McKinsey analyst, Alissa Meade, told a meeting of health-insurance executives last November that "something in the range of 80 million to 100 million individuals are going to change coverage categories in the two years" after the insurance mandates take effect in 2014.

Many employees who will need to seek another source of coverage will take advantage of the health-insurance subsidies for families making as much as $88,000 a year. This will drive up the cost of ObamaCare.

In a study last year, Douglas Holtz-Eakin, a former director of the Congressional Budget Office, estimated that an additional 35 million workers would be moved out of employer plans and into subsidized coverage, and that this would add about $1 trillion to the total cost of the president's health law over the next decade. McKinsey's survey implies that the cost to taxpayers could be significantly more.

The McKinsey study, "How US health care reform will affect employee benefits," predicts that employers will either drop coverage altogether, offer defined contributions for insurance, or offer coverage only to certain employees. The study concludes that 30% of employers overall will definitely or probably stop offering health insurance to their workers. However, among employers with a high awareness of the health-reform law, this proportion increases to more than 50%.

The employer incentives to alter or cease coverage under the health-reform law are strong. According to the study, at least 30% of employers would gain economically from dropping coverage, even if they completely compensated employees for the change through other benefit offerings or higher salaries. That's because they no longer would be tethered to health-insurance costs that consistently rise faster than inflation.

Employers should think twice if they believe the fine for not offering coverage will stay unchanged at $2,000 per worker. "If many companies drop health insurance coverage, the government could increase the employer penalty or raise taxes," according to the new study, authored by McKinsey consultants Shubham Singhal, Jeris Stueland and Drew Ungerman.

The case for repeal of ObamaCare grows stronger every year. The massive shift of health costs to taxpayers thanks to the disruption of employer-sponsored health insurance will add further to the burgeoning federal budget deficit. Congress can and must develop policies that allow the marketplace to evolve and not be forced into ObamaCare's regulatory straitjacket.

Ms. Turner is president of the Galen Institute and a co-author of "Why ObamaCare Is Wrong for America" (Broadside/HarperCollins, 2011).

*Ai Insurance does not endorse the content provided within this blog. Content is strictly for informational purposes only.

Single-Payer Health Care Systems, Multiple Health Care Disasters

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Democrats have recently seized on a novel way of reducing health care costs — threats.

The Obama Administration’s Department of Health and Human Services (HHS) recently announced that any insurance company that wants to increase premiums more than 10% will have to get approval from the government. Congress didn’t pass a law mandating this draconian policy — HHS Secretary Kathleen Sebelius simply decreed it.

Meanwhile, at the state level, Vermont Gov. Peter Shumlin just signed a bill that will create a public insurance option within his borders. Advocates hope that the end result will be a “single-payer” system, in which the state pays for the health care of its residents directly.

Both Sebelius and Shumlin declared that they were only trying to rein in health costs and limit wasteful spending on insurance company profits. But cost control by fiat — whether through rate regulation or a state-run health care system — will fail not only to restrain spending but also to improve Americans’ health.



The facts suggest that most of the waste and inefficiency in our health care system is in the sectors dominated by government. The federal government loses as much as $60 billion a year in Medicare fraud alone. That’s five times more than the combined profits of the top ten health insurance companies in the Fortune 500.

And the price controls the federal government plans to impose on insurers will simply result in the disappearance of private insurance options. For evidence, take a look at what happened after Massachusetts instituted heavy-handed price controls under its state health reform law — considered by the White House to be a model for ObamaCare.

Bay State officials initially denied 235 of 274 rate increases proposed by insurers last year. So insurers temporarily stopped offering new coverage.

The state government and insurers later compromised, but the state’s attempts to set insurance rates have resulted in a serious shortage of medical care. More than half of the state’s primary care practices are closed to new patients, and wait times for specialists range from 24 to 48 days, according to a survey by the Massachusetts Medical Society.

In Vermont, things will likely turn out much worse. The Green Mountain State’s new health care law creates a five-member board appointed by the governor with the power to set prices for all aspects of the state’s medical system — from routine tests to drugs.

The funding mechanism for the whole mess has not yet been set. But the law’s framers envisioned a 14% payroll tax paid by almost all workers and employers in the state. That’s on top of the Social Security, Medicare, and other taxes that Vermont’s residents and businesses already pay.

Again, we know how this scheme will play out. Vermont is just across the border from Quebec — which features a government-funded single-payer system of its own that relies heavily on price controls.

The francophone province’s health care system was implemented in the 1960s at the behest of a commission led by Dr. Claude Castonguay, the so-called “father of Quebec Medicare.”

Forty years later, in 2008, Castonguay was asked to review Quebec’s health care system again. He concluded that Canadian health care was in crisis. “We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it,” he said.

His prescription for Canadian health care? “We are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”

So just as Canada is running away from single-payer after decades of experience, Vermont is embracing it.

In 2010, residents of Quebec faced a median wait time of 18.8 weeks for surgical and other therapeutic treatments. According to The Fraser Institute, a Canadian think tank, average hospital wait times increased 96% in Canada between 1993 to 2010.

Not the sort of system most Americans would want to emulate.

Here in America, federal and state officials have promised to lower health care costs — and right quick. But forcibly regulating prices won’t do the trick. Americans — and Vermonters in particular — should hope that these experiments in health care reform are mercifully short.

Sally C. Pipes is President, CEO, and Taube Fellow in Health Care Studies at the Pacific Research Institute. Her latest book is The Truth About Obamacare (Regnery 2010).

Is Dental Insurance A Valuable Benefit?

 
By Carol Harnett

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The cost of twice-yearly dental care may be less than the cost of a dental-benefits plan, but HR leaders may want to consider carefully before changing their employees' coverage. It's a highly valued benefit -- plus it may drive down some healthcare costs as well.

As a small business owner, I wear many hats. One of my responsibilities includes making decisions about my benefits.
In theory, this should be an easy task for me. But, since I now pay the entire premium instead of receiving contributions from my employer, I find myself being more thoughtful about how I structure my benefits package.
Medical insurance was a no-brainer, as was setting up my retirement plan and making certain I provided for my survivors via a life insurance policy. Given my background working in and around rehabilitation medicine and disability insurance, I knew that updating my disability-insurance coverage was critical.
I found myself pausing, however, when I looked at dental insurance. You see, in the back alleys of the benefits world, experts often quietly discuss dental coverage as an overpriced benefit.
I started my analysis by looking at my plan design, my dental-coverage utilization and how much I paid in premiums, co-pays and deductibles.
My last group plan was a standard benefits design. After a $100 deductible, it paid 100 percent, 80 percent and 50 percent, respectively, for preventive, basic and major dental services. There was a maximum annual benefit of $1,500 and a lifetime plan maximum of $1,000 for orthodontic services. The insurance company had also negotiated discounts with the providers in its network.
The plan allowed me to seek preventive care twice every 12 months as long as I separated my appointments by 150 days. My annual premium was $600.
But, here's where my analysis got interesting. Historically, I sought preventive care twice a year like clockwork. My dentist and I worked out an intervention plan that included x-rays once a year.
When I reviewed my billing history, I noticed that the discount the dental carrier provided was only a few dollars less than my dentist's regular charges. And, when I looked at the total charges for the year, they were, on average, about $400.
Simple math led me to the conclusion that I "lost" approximately $300 annually.
Maybe my dental experience was atypical. But, it turns out that I'm not unusual. According to the American Dental Association, most people who seek treatment incur annual costs just below $300.
As a person who knows my way around insurance, I considered the risk I was insuring against. While I have never experienced a dental emergency, I was protecting myself, in theory, against unplanned dental issues.
But, if I ever had a dental emergency or needed major dental services, how much would my dental coverage help me? The answer: up to $1,500 per year.
Costhelper.com estimates that root canals and dental crowns range from $350 to $3,000 per tooth depending upon complexity, materials, location and the dentist's training and experience. Insurance would certainly help offset those expenses.
I would have to hope, of course, that my dentist's treatment and charges lined up with what my dental coverage established as "usual, customary and reasonable."
I decided to turn to my dentist, Robert Antmann, DDS, regarding his experience with dental care and insurance. Convery Dental, of which he is an owner, has been established for 99 years, so he has access to an unusual depth of history and perspective.
Dental insurance began sometime in the 1960s, Dr. Antmann says, and the benefit, at that time, had an annual maximum of about $1,000. The majority of his patients today have an annual maximum benefit of $1000 to $1,500. Not much has changed in 50 years.
Dr. Antmann's experience is not unusual, according to other sources -- which also project that the typical annual maximum, which was $1,500 in the 1970s, should have increased, via inflation, to $10,000.
So, there are some questions about the botton-line value of dental insurance. Why would employers offer it? A few reasons.
Most employee-benefits surveys find that dental insurance is the third most employee-requested benefit after medical and retirement benefits. The theory among industry experts is that employees believe this coverage is a tangible benefit they could potentially use every year -- unlike disability or long-term-care insurance.
A 2005 study published in the Journal of the American Dental Association reported that 63 percent of adults with dental insurance visited dentists regularly, compared to 40 percent of adults without coverage.
That may not be true, however, for the 12 percent of adults who have high dental anxiety. HR executives should consider a unique finding of the JADA study: Those employees with dental anxiety who have dental insurance were significantly less likely to visit dentists regularly than uninsured adults.
Overall, employed adults lose more than 164 million hours of work each year due to dental disease or dentist visits, according to the U.S. Surgeon General's 2011 report on Oral Health in America. The theory put forward by the National Association of Dental Plans is that employees without dental insurance are more likely to lose work due to untreated dental problems.
Dental treatment may also affect medical care, according to a recent longitudinal study by CIGNA (full disclosure: a client of mine), which sought to determine whether periodontal treatment affects the cost of medical care in diabetics. (Experts suggest there is a relationship between diabetes and periodontal disease -- and that both conditions may worsen if either is not properly care for.)
The results of the study indicate that ongoing periodontal treatment of diabetics lowered medical costs in 2008 by an average of almost $2,500. The effect was more pronounced in men than women ($3,200 vs. $735, respectively).
For HR leaders, the issue of whether dental insurance is a benefit that has kept up with the times may be a moot point. Dental coverage is a benefit that employees desire.
Added to that perceived value is the potential impact dental care may have on the healthcare costs of employees who are diabetic and, potentially, pregnant.
And, you can consider, too, that dental insurance is expanding its reach and services.
Gary Ballman, staff vice president at Anthem-owned Wellpoint Dental, says new enhancements in group dental insurance include international emergency treatment as well as dental analytics, which score providers by utilization and long-term economic value.
The American Dental Association offers some benefit-plan design alternatives to consider, such as a direct reimbursement plan, which may give your employees more coverage flexibility and maintain dental-benefit costs.
As for me, I've elected to forgo dental coverage this year. But, I'll keep my eye on how dental benefits evolve.

Windows 8 heavily focused on mobile devices; will it affect the desktop experience?

We all know that Windows 8 will be designed to run on tablets and according to some recent reports, the next version of Windows will put a heavy focus on mobile devices. Windows 8 will supposedly feature a welcome/unlock screen similar to the one found in Windows Phone 7, a new Ribbon UI for Windows Explorer and a document reader that uses a new packaged application model that “closely resembles Windows Phone 7 application packages.” These new features suggest that the operating system will be headed towards a more mobile-friendly interface than the previous versions of Windows. While this may be a good sign for users who want Windows on their mobile devices, it makes one wonder if the desktop version of the operating system will be streamlined similarly as well. After all, the desktop version of the Windows 7 is what makes it a great operating system and optimizing a desktop OS for the tablet/smartphone could have pretty drastic results.

Ai Insurance http://www.aiins.us recently made available a mobile (web-based) app to it's web users this weekend. Shortcuts includes "get a quote, locations, find an agent, and of course the Facebook link out. Try it out on your Droid or iPhone.

Tang was invented for the NASA space program

Myth: Tang was invented for the NASA space program.

       In fact, Tang was actually invented by chemist and occasional playwright William A. Mitchell in 1957 while he was working for General Foods. General Foods introduced Tang to the public in powder form in 1959, but it wasn’t popular initially.  Eventually, NASA decided to use it in 1962 during John Glenn’s Mercury flight and later in 1965 for the Gemini program.  In both instances, the Tang was used to improve the poor taste of the water from the life support system.
      The usage in the Gemini program particularly contributed to the previously unpopular drink mix becoming a huge hit.  Because most people were introduced to Tang for the first time through the space program, this lead to the misconception that it was invented for that program, rather than just a generally available product that NASA decided to use, as it was.
Bonus Factoids:

• Mitchell didn’t just invent Tang, he also invented Cool Whip, Pop Rocks, quick-setting Jell-O, powdered egg whites, and a popular Tapioca substitute, among other things (70 patents total).  In the non-food related field, Mitchell also helped invent a chemical process for developing the color green, while working for Eastman Kodak.
• The first major product Mitchell invented was a Tapioca substitute that was developed to get around the cassava shortage due to WWII, which is why Tapioca is sometimes called “Mitchell’s Mud”.
• Mitchell thought up Pop Rocks for a play he wrote about a boy who eats magical popping rocks.  In the play, every time the boy eats one of the rocks, he’s teleported to another world.  Later, when Mitchell was working for General Foods, he was attempting to come up with a way to make “instant” carbonated drink and accidentally invented Pop Rocks in the process, which he named Pop Rocks, referencing his play.  For how Pop Rocks Pop, check out this link.
• Project Mercury was the U.S.’s program to put a man in space for the first time.  Objectives of the program were to orbit a person around the Earth; investigate a human’s ability to function in space; and to bring that person home safely.  The program ran from 1958 to 1963 with all total NASA launching six manned flights.
• Tang was included in the menu for John Glenn’s 1962 Mercury mission where he orbited the Earth and experimented with eating in space.
• The Gemini program’s primary objectives were to test man’s ability to cope with long term flights in space; to maneuver a spacecraft in space, including docking with another spacecraft; train and prepare the flight and ground crews for the upcoming Apollo program; experiment with space walks; test out equipment and technologies that would be needed in the Apollo missions; and controlled re-entry.  The program included 19 total launches, only 10 of which were manned.
• According to an engineer who worked on the Gemini program, the reason Tang was specifically included in the astronaut’s rations was: “There was a particular component of the Gemini life support-system module which produced H2O (water) among other things. This was a byproduct of a recurring chemical reaction of one of the mechanical devices on the life-support module. The astronauts would use this water to drink during their space flight. The problem was that the astronauts did not like the taste of the water because of some of the byproducts produced, which were not harmful of course. So, they added Tang to make the water taste better.”
• It isn’t known exactly if Tang was used in the Apollo 11 mission.  The astronauts there decided to use a grapefruit-orange mix, which may have been a variant of Tang or may have been something else.  Both Buzz Aldrin and Neil Armstrong both have stated that they didn’t use Tang, but because Tang came in a variety of flavors and, during the missions, was labeled things like “Orange Aid” and the like, rather than Tang, so it may well have been Tang they were drinking.
• Methadone was once sold packaged with Tang, in an attempt by Philadelphia officials to stop people from injecting the drug into their bloodstream.  Unfortunately, they underestimated the addicts, who seemed to have no qualms with injecting the Tang/methadone mix, which obviously isn’t advisable.
• Tang, hydrogen peroxide, and hexamine were primary components of the explosive meant for the failed 2006 transatlantic aircraft plot.  These, and other components, were used to make HMTD (Hexamethylene triperoxide diamine), which is a fairly powerful homemade explosive.  HMTD was also going to be used in the failed 1999/2000 bombing of L.A. International Airport.

Swimming Within an Hour After Eating is Not Dangerous

Myth: Swimming within an hour (sometimes stated 30 minutes) after eating is dangerous and can cause you to cramp up and drown.

     It is believed by many that you should not swim for at least an hour after eating, as it could be dangerous.  This old wives tale has been told to kids around the world and has become more or less a popular rule of swimming safety. Children in Cuba are even told not to swim for up to three hours after a meal!  The reasoning behind this myth is often stated to be that there is a possibility of severe muscle cramping when you swim on a full stomach and a risk of drowning because of it. But is swimming directly after eating actually dangerous?  It turns out, it is not at all.

     Similar to when exercising where your body requires greater blood flow to your limbs, food digestion requires greater blood flow to the stomach to help in the process of breaking down the foods.  This is why it is believed that digestion would divert the circulation of  blood toward the gut and, to some extent, away from the muscles, which could cause  cramping. The truth is though that we have enough blood to keep all of our parts supplied and most experts doubt that a full stomach could be the cause of cramps, should they occur while swimming, which of course is not that uncommon, whether you eat or not before swimming.

More to the point, not a single episode of drowning caused by swimming on a full stomach has ever been documented. Further, even if cramps do occur while swimming, which is common enough without eating, all a person has to do is  not panic and they’ll be fine.  Most cramps don’t last very long and the human body naturally floats; so the recipe for not drowning while experiencing cramping is just to stay calm and float it out.

     On top of that, few people, when choosing between drowning or continuing to swim with a painful cramp, will choose drowning, unless they panic.  So even if the experts are wrong and eating on a full stomach can increase the likelihood of cramping, the person who’s decided to eat and swim only need be told or remember not to panic, and to simply float until the cramp goes away.  Considering that cramps are fairly common when swimming anyways, most people have probably learned to deal with this in any event.  So even in the case of the experts being wrong about there being no connection between eating and cramping, there is no real increase in danger here.

     As far as the widespread belief that eating causes cramps, despite scientific evidence that states otherwise, this is just a clear instance of confirmation bias, where someone will eat and swim, then have a cramp and determine it’s because of eating. Later, when they think back on these instances, they only remember the times when they got a cramp after doing this set of actions and not all the other times when they didn’t nor do they correlate the number of times they got cramps after eating and swimming with the number of times they got cramps after not eating and swimming, which they’d find are shockingly similar percentages over a large enough sample size.  But because people don’t think like that and are naturally prone to confirmation bias, these instances of cramping or often stories they hear of someone drowning after eating then swimming just confirms the myth in their minds, even in the face of contrary evidence.  Then, naturally, as they don’t want their own kids to drown, they pass this little myth on to the next generation.

So while swimming, as with doing any exercise after a big meal, might not be the most comfortable  of things to do, particularly for out of shape adults, there is zero evidence that it is inherently dangerous.

Bonus Factoids:

• While many people are afraid to go swimming directly after eating for fear of drowning, most people are not afraid to drink and swim.  In the former case, as stated, there is no added danger, in the latter case, there are numerous people that drown thanks to combining drinking with swimming.  According to a recent study, alcohol was detected in the blood of up to 70% of adults who drown compared to the normal population attributable risk of 10%–30%, implying that alcohol does indeed play a large role in a large percentage of adult drowning.  So to recap: eating+swimming = no increase in danger; drinking+swimming = significant increase in danger.
• Interestingly this “water/eating” myth has spread not just to swimming, but also some people believe that you should not take a bath after eating as well, or you may drown.  How do they work this one out? The flawed reasoning behind this is that eating raises your overall body temperature and being in a really hot bath just after eating may cause you to overheat even more and faint. This again is not scientifically sound reasoning.
• Interestingly, while muscle cramps are extremely common, about 5% of people report having never experienced a single muscle cramp in their entire lifetime.
• It is estimated that about 1.2 million people die of drowning every year and about 10 million people partially drown, but are rescued at various stages of drowning process before death. About half of all the deaths or partial drownings are children.
• Interestingly, nearly 1/3 of all children who drown do so in very close to their own home, with many of these cases being emergency cases of flooding or the like.
• About 3/4 of all drowning victims did not know how to swim.
• The highest risk of drowning by age group is as follows:   0-5; 20-25; and 60 and above.  For the first age group, the majority of non-emergency type drownings occur in backyard pools or bathtubs when the children are left unsupervised.  It is theorized that the 20-25 age group drowns more often due to being more willing to take risks and particularly an increase in  excessive alcohol consumption during water activities.
• Nearly 40% of all non-emergency (non-flood/storm/etc) drowning victims  do so within 6 feet of the shore or edge of the pool.  In addition to that, nearly 25% drown in less than 3 feet of water.
• Finally, over 30% of all drowning deaths occur after dark, with an extreme spike in number of deaths that occur because of boating accidents.

Eleven Ways To Save Money Every Month

How to Save Money Every Month

1. Cut cell phone service down to minimum. Talk to your current provider about reducing your monthly minutes, or eliminating features you just don’t use that often. We recently asked our cell phone provider to tell us the average paid minutes we used over the last six months and discovered it was well below the next smallest plan from our current arrangement. Dropping plans shaved $20 a month off our cell phone bill.

2. Shop for cheaper car insurance using tools such as Ai insurance  (free quotes available). We saved quite a bit just by switching carriers. If you have a solid emergency fund in place to easily cover deductibles, it might make sense to increase those deductibles on your auto insurance policy.  Raising deductibles from $250 to $1,000 can save you a few hundred dollars on insurance–just be sure you can afford that $1,000 in the event something bad happens.

3. Consider dropping home telephone service. Just about the only people who call us these days are telemarketers. Most friends and family have cell phones and those that are “in network” can talk to us for free for an unlimited amount of time.  Even if you don’t cancel your home telephone service, you can probably save some by cutting back on extras like call waiting, caller ID, etc.  Since you are not using the land-line that much, you won’t miss the features.

4. Reduce the temperature setting on your hot water heater.  This one does require a little effort, especially if your water heater is in an out-of-the-way place.  Set the temperature to around 120 degrees.  You can count on about a 5 percent reduction on energy bills for each 10 degrees you drop the water.  While you are at it, consider a thermal blanket to insulate your water heater, particularly if it is stored in an uninsulated location that gets cold in the winter (garage, utility room, etc.).

5. Run your ceiling fans in the winter. I know, it sounds crazy. By changing the blade direction on your ceiling fan to create an updraft, you can help recycle heat throughout a drafty room. Most fan models have a switch on the base of the unit that allows you to change direction.

6. Use microwaves in the summer, and ovens in the winter.  During the dog days of summer, cranking up an oven can put an air conditioning system into overdrive.  However, in the winter the warmth of an oven can lessen the load of your heating system.  Your monthly utility bill will thank you.

7. Divide credit card payments in half.  If you are already paying $100 a month on your credit card, half the amount and schedule two payments with the first coming about half way through the billing cycle.  Since interest is calculated using the card’s average daily balance, you’ll be reducing that balance earlier in the month by paying a little bit of the balance off, instead of waiting the full month to make a single payment.

8. Switch to generic prescriptions. Talk to your health care provider about switching to generic prescriptions, and be sure to check out places like Walmart and other grocery store pharmacies that now offer 30-day supplies of many popular generic prescription medicines for only a few dollars a month.

9. Disconnect electronic devices when not in use.The easiest way to do this is to plug devices into a single power strip and then unplugging the power strip when the items are not in use.  Electronic items continue to pull small amounts of power continuously even when powered down (this phenomenon is often referred to as “vampire power,” probably because it is sucking the life out of your finances!

10. Improve your car’s gas mileage by replacing the air filter.  I know I said these would be effortless, but this one is so easy you can do it in less than five minutes.  Stop by a parts store and ask for a new air filter.  They will need to know your vehicle’s make, model, year and maybe the engine size (six-cylinder, eight-cylinder, etc.).  All this information should be listed in your owner’s manual, or on the inside of your driver’s side door panel.  Following the directions in your owner’s manual, which include locating the filter’s housing, removing a few screws, and swapping out filters, only take a few minutes of time.

11. Use a drying rack for heavy linens. If you aren’t up for hanging a clothesline (or your neighborhood frowns on their use), consider buying  a simple drying rack to hang heavy towels and jeans over.  When the clothes are nearly dry, toss them in the dryer for a couple minutes with a fabric softening pad to freshen them up a bit and remove most of the wrinkles.