Paul's Web Blog

Archive for September, 2011

Although the rain fell and floods came with Hurricane Irene, it was not quite on a Biblical scale, but it was certainly devastating to many communities that had never before believed it possible they could be the victims of flooding. Yet, in upstate New York and Vermont, entire communities have been introduced to a new reality of flooding and mudslides. No matter what you think about all these stories of global warming and climate change, there’s an underling reality you can’t deny. This has been a bad year for weather. Read any of the hard news sites and they will all tell you the same story. Property and auto insurance claims have already broken records this year. By the time we’re through December, the year 2011 will have gone into the books as the most expensive for weather-related insurance claims.

Perhaps not surprisingly, insurers have been receiving a lot more calls asking about flood insurance. Obviously, many homeowners have discovered their own policies exclude flood damage. In the hope of reducing future losses, they now ask what’s available and this is not good news. The majority of private insurers withdrew from covering floods some years ago. For a number of reasons, insurers have found they cannot make flood insurance profitable and they are not prepared to cross-subsidize from other types of cover. Most now only offer the Federal Flood Insurance Program which is funded out of tax revenues. As an aside, even this insurance may be lost if Washington fails to renew its funding allocation by the end of September 2011.

Assuming the Federal Program survives this budgetary crisis, it’s not really designed for the majority of homes. The first states that asked for federal help were on the Gulf Coast and the majority of properties built close to the sea don’t have basements. The cover for basements is therefore limited to the replacement of mechanical equipment like furnaces and water heaters, and the main cover only applies to the first story and above with a maximum of $250,000 for rebuilding. If you live further north, basements are common and rebuilding costs are higher. This suggests you will always need to top up the Federal Program cover. You will always need a basic home insurance policy to cover all the other ways in which your property can be damaged. The Federal Program limits contents claims to $100,000, so you will need a policy to increase the rebuilding and contents limits. The cost of this supplemental covers varies quite significantly depending on the weather patterns and geography of your state. It might surprise you to know there have been quite serious floods in Arizona, but they are quite rare. Where the risk of flooding is low, you can probably find additional cover for as little as $300 a year. In states where the risks are higher, the home insurance rates are likely to be between $600 and $800 a year. After a while, you will come to a hard decision. In states where the risk of flooding is actually quite small, how long will you pay the additional premium? According to the insurance industry, most people allow these supplemental policies to lapse within two to four years.

Thinking of where to make loans online can be frustrating. At some cases, we need to loan a big amount of money for our needs right away, but most of the banks or loan companies are too stingy to lend a bigger nominal of cash. Moreover, we still need to face the complicated processes and follow the terms and conditions that mostly make us feel difficult to fulfill. And of course, not all banks or companies easily give out the loan. That means, the customers need to wait a little longer until the bank or the companies verify the loan demand and give the money to the customers. It is a very long process and boring and hard and sometimes we are not even guaranteed to earn the money or in other words, our loan demand is rejected. But, now is the era of technology where we can use the internet in advantage. In the internet, there are many websites that provide easier loans to people. The benefits that you can get by using this online system of loan are, you can receive the money faster because they have the no fax cash advance system like TN payday loans online, it means at any time during the week or day, you can receive the money instantly, and then this system is also very suitable for the people who are limited on budget when they have to return the loan. This service is totally fast, convenience and accurate, definitely respecting the customers a lot. Once you make a loan request, you will have the money instantly, most of the time in one hour, in your savings account. This online loan system is very comfortable and very suitable for the people who need urgent fund for their daily needs and of course very helpful and friendly, because they really trust and appreciate their customers like what you can find in payday loans Arizona. There will be no regret if you deal with them.

Like everything written down, the Affordable Care Act sounds the perfect answer to all our problems. Except, of course, when it comes to turning the words into action, problems can emerge. One of the battlegrounds is turning out to be the insurance marketplaces or exchanges. These are supposed to make it easier and cheaper to buy insurance. They should allow people to compare prices, and discover whether they are entitled to any assistance like tax credits, Medicaid or the Children’s Health Insurance Program (CHIP). Every state is supposed to have one up and running by 2014. Should any state default, the federal government is apparently ready to step in and run one. The principle matches the mandate. If everyone is required to buy a policy, buying a policy should be made as easy as possible.

As we come in the Fall, ten states have already passed the necessary enabling legislation and are on their way toward getting their exchanges in place. Seven more states have bills pending. Legislation has failed in sixteen states. The rest of the states have either decided to take their time or are flatly refusing to make progress. Such is the world of politics with the Republican party dead-set against exchanges. Some GOP governors have sworn oaths on a stack of Bibles they will never sign an enabling bill into law. Yet this is not necessarily good politics.

Because the federal government will impose an exchange if the state refuses to act, the arrival of an exchange is unavoidable. Some GOP governors are therefore interested in negotiating terms. If they have no choice, they might as well try to influence the outcome to their advantage. So this September, health officials from the majority of the states will be attending a conference organized by the Department of Health and Human Services. Most GOP governors are prepared to talk about a partnership approach to give them some political leverage. Equally, if the states actually do less of the work, the budget requirements will be lower. For example, some states are offering to run local call centers to guide people through their choices. This is fairly uncontroversial. More problematic are the offers of some states to run outreach and education programs to bring their citizens into the exchanges. If staff hostile to the notion of the exchanges are involved, the exchanges may not get the expected number of applicants.

When the dust settles at the end of all the negotiations, we can hope for a health insurance exchange or marketplace in every state where citizens can be guided between federal and state aid, and the private section plans. With supportive staff working in the call centers, everyone should end up with the level of cover appropriate to their individual needs. Significantly, the exchanges are also intended to help small and medium-sized businesses navigate the new laws. Many business people are as confused as ordinary citizens. If everything works as it should, we should all find access to affordable covered significantly easier. However, with their opposition to the central principles of Obamacare undiminished, we can expect the GOP to find a whole new set of ways to slow down this health insurance reform. Your vote in the next election will help decide matters.

In the long-distant past, the law of the land was directly administered by the rulers. They sat as judges on all major disputes and dispensed justice as they saw fit. It was not until civilization spread a little that we saw anything like today’s courts and lawyers emerged. This was a law-and-order strategy. Before courts, people used to resort to a little self-help to get what they thought they were owed. Blood feuds and riots were therefore quite common. Giving people “independent” judges to decide matters defused the violence and kept the peace. All we had to wait for was the inevitable corruption to die away. In theory, today’s judges are to recuse themselves if they know any of the parties or have a financial interest in the outcome. Yet there’s still great unhappiness with our legal system, many people blaming our law of tort for many of our economic ills. Attorneys are routinely attacked for distorting the legal system in order the maximize their profit rather than to protect the interests of their clients.

The real problem comes from the simple rule in tort that, if you cause loss or harm to another, you should pay money to that other to make good the loss. This sounds a great idea. It’s financial responsibility in action. In a shop, if you break it, it’s yours. The only problems are the delays in getting a case decided and the cost. There are too few judges to deal with all the cases efficiently. Months can therefore pass before it’s your turn again to move forward a little. Then attorneys seem to think they can charge you for breathing the same air as you. So, to cut out all the delay and reduce costs, some twenty-four brave states decided to abandon the tort system in favor of no-fault. In effect, everyone in those states is self-insured. If you’re injured in an accident or you need to repair your vehicle, your own insurance company pays out no matter who’s to blame. The only question when you submit a claim is whether the amount you ask for is a reasonable estimate of the loss. This can usually be agreed quite quickly and life goes on.

In other countries, the no-fault system has produced major savings. With the need to pay attorneys almost completely removed and staff levels in the insurance companies reduced to a minimum, everyone enjoys excellent value for money. Unfortunately, our wise law-makers decided to add in a few zingers which have conspired to keep the premium rates among the highest in the land. As a result, we’re down to only twelve no-fault states today plus Puerto Rico. It’s a case of a good idea largely sabotaged in the implementation.

However, when it comes to pricing the car insurance rates, the measures and classifications are basically the same. No matter what the legal system for resolving claims, the insurers are still estimating the number of accidents and the total amount of losses. Once they have those numbers, the total is divided among their policy holders, they add their administration costs and profit margin, and there you have the final rate. Car insurance may sound like rocket science but it a Model T rocket.

More or less wherever you look, you will find the GOP propaganda machine churning out articles warning you that rationing is coming if the Affordable Care Act is fully implemented. The latest scare stories surround the entirely reasonable proposal to appoint an Independent Payment Advisory Board to recommend cost-saving changes to the reform program. This is a return to the death panel debate where a panel was going to sit to decide who should get treatment and who should be allowed to die. The GOP point to the British who have a panel called the National Institute for Health and Clinical Excellence (NICE) which often rejects expensive drugs, e.g. for the treatment of cancer including leukemia. In fact, NICE does quite often reject drugs, but only when there are cheaper alternates and there’s no evidence to show the more expensive drugs produce better results. Inevitably, some of these decisions are considered controversial by the British themselves but, so far, NICE has done a good job in keeping British healthcare service reasonably affordable to the taxpayers. For those of you who’ve forgotten, Britain has socialized medicine funded by the state.

Anyway, the GOP is convinced our new panel will decide the really ill, the elderly and the disabled will not be eligible to life-saving drugs and they will all be allowed to die. This will be rationing with intent to kill. All of which leads us to ask whether we have rationing now. As you may also have seen or read in the media, some 52 million Americans are without medical insurance. In simple terms, they cannot afford to buy a private health plan. So the current reality is that we have rationing today, but instead of it being based on patient need, it’s based on the patient’s ability to pay. Turning it around, those with the money in hand can afford to buy health cover. Everyone else either falls into a federal safety net or is left to fend for themselves.

As an example, let’s think about a young couple living together, both earning and producing just enough income to fall outside the Medicaid limits. They take no precautions and she now discovers her pregnancy. Instead of this being a time of joy, it’s a catastrophe. Assuming no complications, the pre-natal care and delivery usually costs about $20,000. With bad luck, this can double with some complications. It will cost her about $600 for an abortion. The comparison with Britain is instructive. If she lived there, both the birth or the abortion would cost her nothing. Whatever she chose would be free. Yes, their income tax as a couple would be higher but, averaged out over a lifetime of work, they would be better off. No matter what criteria you pick: access to care, the quality of care delivered, the efficiency of the services, the fairness of the decision-making and the general health of the nation, Britain comes out ahead of us.

So, given rationing already affects our health insurance services, survival depends either having the money to pay the premium rates or staying healthy. We would benefit from a universal system, but the GOP is determined to frustrate any move in that direction. Republicans believe our health insurance provision is not broken and needs no fixing.

When you have a leaking faucet, you always ask the plumber for a price before you agree he should come. It’s routine to haggle when you are dealing with a range of people who supply services. Every dollar you save in these tough economic times helps pay for the next meal. Indeed, as a consumer, you should always take the initiative to get quotes from several potential suppliers and then set one off against the other. Everyone needs work and flexibility on all sides keeps the suppliers in work and you with a few extra dollars in your bank account. So how come doctors have managed to pull this trick so we feel uncomfortable if we start haggling about the cost of treatment? Do you remember, last year, Sue Lowden, the Republican Senate candidate for Nevada, suggested the next time you go see your doctor, you take a chicken with you. She remembered a time when people would trade services for treatment. A country doctor could always find someone to rewire his home or paint the walls. No matter how you feel about trading livestock for treatment, the underlying message is sound.

If you don’t protect yourself in these hard economic times, you can be dragged into bankruptcy by medical bills. Indeed, the national statistics show about 16% of all those seeking treatment can’t afford to pay the billed price. So even though you may find the idea embarrassing, you should negotiate with doctors before agreeing treatment. You never know, you might find you can make big savings.

The best time to talk to doctors is when you’re healthy. If you can walk away without endangering your own health or the health of your family, you’re in a good position. Did you know doctors have an ethical duty to consider your financial situation? If you don’t say anything, why should they care? So if you spend two minutes explaining your problems, you can set a framework for future treatment. Once the doctor knows you have problems, he or she can avoid the most expensive options and focus on the most urgent steps offering the best value for money. Once the need arises, get prices in writing before you start treatment.

If you are caught in an emergency and have no time to negotiate, you can be hit by a big bill you have no chance of paying. Although it may sound too late, you should sit down with the hospital and find out how the bill came to be so high. There are websites giving national price guidelines for the standard treatments. Look for any mistakes in the math and for costs that are significantly above the national guidelines. Never assume you can’t change a bill after the fact. Even if the price remains unchanged, you can still negotiate terms for payment. The hospital does not want you to enter bankruptcy. That makes it difficult for them to get anything. So most will give you time to pay by installments. This approach also endears you to your health insurance providers. They like you to save them money. If you don’t have a health insurance plan, protect your bank account in the same way you deal with plumbers who ask too much for that leaking faucet.