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The world is often a confusing place and nowhere is the confusion likely to be so complete as in the tax system. Here we have the best brains in the Government taking on the best brains in the private sector. The Government wants the maximum tax take. The private sector wants to arrange things so that no one with money ever has to pay any tax. Somewhere in the middle the two world-views collide and, usually, some tax is paid. Anyway, when President Obama signed the healthcare reform bill into law, some of the largest employers in the US let out a collective sigh of pain. As an example, Caterpillar is the world’s largest manufacturer of excavators and bulldozers. The day after the President’s signature, Caterpillar announced it was taking a charge of $100 million to earnings over an expected loss of tax benefits. A number of other influential corporations have also made allowances in their accounts. The reason is that the healthcare reform ended a tax break given to cover the cost of supplying drugs to early retirees. Read the rest of this entry »

There are times when you get an overview and then it hits you, “Somethings just don’t add up.” Well, you remember Wellpoint, don’t you? This is the friendly company that, around January or February, announced it was going to increase premium rates by up to 39% in a number of states around the Union. President Obama got himself all worked up, citing them as the real reason why all the Democrats in Washington should band together and take a stand against the insurance industry. Then, sure as eggs is eggs, there was a stampede to get the healthcare reform bill to the President for him to sign it into law. Those Democrats sure did have fun beating on Wellpoint. So the big question is what happened next? Here’s one of the largest corporations in the insurance market demanding premium increases. Did it get its way?

The answer starts off in California where the maximum rate of 39% was due to take effect. The state referred the proposed increase to independent auditors for an opinion. The answer came back negative. It seemed Wellpoint couldn’t add up. Well, that’s oversimplifying things a little. But the reality is that the numbers Wellpoint offered to support their premium increases were based on some very shaky mathematical assumptions. When news of the report became public, Wellpoint withdrew the proposed increase. Acting on this, Kathleen Sebelius who is Secretary of the Department of Health and Human Services sent out a letter to all state insurance commissioners encouraging them to review every proposed premium increase. This is the first sign that the balance of power is shifting against the insurance industry and in favor of the consumer. For too long, insurance companies have hidden behind complicated mathematical explanations and gamed the system. With the Affordable Care Act now law, Sebelius is encouraging every state to give itself the power to approve rate increases. The first sign of continuing good news for consumers comes out of Connecticut where Attorney General Blumental forced an audit of Blue Shield and Anthem Blue Cross, both Wellpoint subsidiaries. Connecticut’s Insurance Commissioner Sullivan rejected these companies requests for increases last year. It seems likely the same thing will happen this year. Read the rest of this entry »

Looking at the title of this article again, it seems a little strange. Surely it goes without saying that having a company insure your health is a good thing? How can it not be good? Surely people who are insured have better health and live longer? One of the more interesting things about the so-called scientific method is that everyone knows how it is supposed to work. You have to start with a hypothesis. In this case, it would be: people with health plans enjoy better health. You then devise an experiment involving a statistically significant number of people. One group, drawn randomly from the population have health plans. The other group (the control group) do not have health plans. Researchers then monitor their health for, say, ten years. Data is collected and analyzed. Results are published in a peer reviewed journal. Human knowledge is increased. Except, the US has been running this experiment for decades. Millions of people across the age range and with differing levels of health are uninsured. Millions more pay for private coverage. The remainder have plans provided by their employers. The data over the years shows that uninsured people have a lower life expectancy. In fact, the poor on average die seven years earlier than the rich. By a coincidence, many of those without insurance are poor. Now that is bad news for this research. There are many factors contributing to death. They are directly related to the social class and lifestyles of the individuals involved. In this, lack of access to medical care is not a major contributing factor. Put another way: there has never been any research to answer the question posed in the title to this article.

We need to consider two contradictory statements: when they fall sick, the poor go to an emergency room and, if they are lucky, receive treatment that keeps them alive; when they are insured, the rich receive care that gives them better health. Except the international statistics show the US has higher mortality rates than most of the other developed countries. To help you understand, we need a comparison with Europe where there is a completely socialized healthcare service and better life expectancy. Both at a European and individual state level, there are panels of experts who decide what treatments and which drugs represent good value for money. States will only pay for treatment proven effective and safe, and will not pay drug companies the retail price they claim. Instead, the states will only pay for approved drugs at prices agreed in negotiations. In the US, insurance companies happily pay for a battery of medical tests and procedures even though there is no evidence any of this work is effective. This adds to the irony. Sometimes the rich die young even though they have received multiple treatments. This is because their expensive treatments are ineffective. Read the rest of this entry »