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Must-Reads Of The Week From Brianna Labuskes

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3 years ago

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Hello! This pandemic is going to have ramifications that unfold for years to come that we won’t be able to predict. But my money is, for sure, on all of us leveling up on our germophobe meters. This New York Times cough simulation burned itself into my brain when I saw it, while I’m trying desperately to erase the knowledge that speaking alone creates enough droplets to lead to potential exposure. (I’m dragging you all down with me!)

All right, on to my attempts to summarize years-worth of news that was somehow crammed into one week. Buckle up!

President Donald Trump released a three-phase plan that leans heavily on the idea that reopening the country should not be based on a one-size-fits-all mentality. Hot spots would keep their shutdown measures in place, while areas in the country that haven’t been hit could start slowly getting back to normal.

The guidance was quickly dismissed by critics as “vague and inconsistent.” And considering that governors are the final authority on when shelter-in-place orders are lifted (which Trump acknowledged, after previously drawing an outcry over claims that he alone would make that decision), it may not make a huge impact on what happens next.

Trump also announced his panel of advisers who will help him reopen the country — something that came as a surprise to some of the people he named. One of the first bits of advice to come from the business leaders? The United States is woefully behind in the amount of testing it needs to do to reopen the country. Meanwhile, conversations between Trump and his panel don’t have to be made public because only “formal outside advisory committees” fall under the transparency law requirements.

As Josh Gerstein, from Politico, notes: Notably, the White House avoided the term “committee” in its announcement.

Speaking of testing, saliva tests based on the 23andMe model are being touted as the answer to the country’s testing woes. But I think I’ve heard that promise before.

WHO became a new target in Trump’s efforts to shift blame from his own administration’s missteps in the early days of the crisis. After a few days of speculation, Trump announced he wants to cut funding for the international organization, going against the State Department’s advice that the move would be “ceding ground” to China.

Predictably, since the country is in the midst of a pandemic, the decision drew swift condemnation from Trump’s critics and the medical community. And though WHO’s response may not have been pitch-perfect, experts say, the organization consistently treated the contagion as the threat it was far earlier than some nations did.

Although Trump’s decision was based on his criticism of WHO’s early response to the current crisis, the funding cuts would be felt far beyond the organization’s efforts to fight COVID-19.

As all that was going on, many people were wondering where the CDC — once the preeminent disease-fighting body — has been in this current fight. The agency won high praise for its work helping fight AIDS, Ebola and Zika, and played a major role in eradicating smallpox, as well as the near-elimination of polio. But funding cuts beneath the Trump administration have rendered it a “nonentity.”

In an ironic twist of fate, the pandemic could shape Trump’s health care legacy into one that looks a lot like his opponents’ dream scenario. The administration has greenlighted plans that pump billions of government money into the health care system to help offset costs, including a taxpayer-generated fund for hospitals to use to cover patients’ care. (Ahem, does that sound familiar?) Anxiety is rippling through some conservative circles that Trump might oversee historic new levels of federal health spending.

In contrast to all that, though, Trump’s continued disdain for the health law could also hamper the administration’s response to the crisis.

And hospitals say that $100 billion pot allocated in the $2.2 trillion stimulus package is not only taking far too long to distribute, but also is woefully inadequate.

Thursday marked another deadliest-day record, with the death count rising by 4,591 in the span of 24 hours. Meanwhile, New York this week started counting “probable” COVID-19-related deaths, which sent its totals soaring past 10,000. The change highlights one of the issues with getting an accurate count of the nation’s losses. Not only are COVID-19 cases widely considered undercounted because of a lack of tests, some states are counting them using different criteria (while remaining adamant that their strategy is best).

There’s also been a worrisome spike in at-home deaths, which makes some experts think we’re just seeing the tip of the iceberg in the death toll.

In a nod to the fact that the coronavirus knows no state boundaries, governors in different regions are forming partnerships to create plans to reopen their states in the coming months. The coalitions so far: the Northeastern corridor, the West Coast trio of Washington, Oregon and California, and seven Midwestern states.

While the partnerships are in their early days, it seems the plans will rely heavily on testing and a slow rollout that takes into account more vulnerable populations.

As the general shutdown effort enters its second month, though, tensions are simmering to a boiling point for some. Protesters, driven by economic and civil liberty concerns took to the streets this week to demand governors lift specific shutdown orders. But even as they voiced complaints, cases started to spike in the very states that hadn’t seen the need to shelter in place.

And those of us who have been social distancing laughed a little nervously (without humor) at a new study that suggests it could be needed until 2022. For what it’s worth, that seemed like a worst-case-scenario projection that didn’t account for a possible vaccine or increased capacity in hospitals.

It’s so rare these days that I get to talk about good news, but today is the day! There are hopeful signs coming out of a study on Gilead’s antiviral remdesivir, the drug that’s been a front-runner since the early days of the crisis. But, a warning: The good news comes with a huge helping of salt in that there was no control group used in the study, so the patients might have been getting better on their own.

Meanwhile, studies are going forward on a drug that calms the immune system, targeting the deadly “cytokine storms” that seem to be at the root of younger patients’ deaths. But fears remain that suppressing a patient’s immune system in the midst of a battle against the virus could backfire.

While the global science community has dropped everything to race for a cure, the scattershot, all-hands-on-deck method might actually be doing more harm than good, with researchers working at cross-purposes, duplicating efforts and failing to communicate outside of their realm.

Speaking of hopeful signs, there’s also a lot of movement with Moderna’s development of a vaccine. The company is set to get an infusion of cash and expand its trials with hopes that something can get pushed to the public far earlier than the original 12- to 18-month timeframe. Even Dr. Anthony Fauci (who has been on the extra-cautious side) has said that he thinks it might be possible to have a safe and effective vaccine as early as mid- to late winter.

In the meantime, some observers wonder if the general immune boost that comes with an old TB vaccine might help bridge the gap during the long wait for a coronavirus vaccine.

And, so far, the big names in the anti-vaccination movement have not changed their tunes, even as many in the country are looking to a vaccine as the one true exit strategy from the pandemic.

In a man-our-health-system-is-complicated moment, UnitedHealth Group is actually reporting an increase in profits during the pandemic. That’s because the extra coronavirus costs have been offset by the cancellations of other procedures.

Hospitals and states where the virus has not yet struck are growing ever more frustrated with FEMA “redirecting” (or “poaching,” for the more critically inclined) equipment it needs to brace for any potential surges. Over the past few weeks, the federal government’s response to equipment distribution has been blasted as somehow too chaotic and too controlling at the same time, which seems to be a real feat.

In another attempt to address some of the shortages in hot spots, the Trump administration announced a voluntary exchange program, in which hospitals in “cold spots” send their unused ventilators to places in need.

And all this demand is driving up costs across the board. A protective mask that used to cost $0.38 now rings up for $5.75. Isolation gowns went from $0.25 to $5. (You get the picture.)

If you expected quick, bipartisan action (haha!) out of Congress during these high-stakes times, you might have to take off the rose-colored glasses. The small-business fund allocated through the $2.2 trillion stimulus package ran out this week, and even in the face of overwhelming requests, Congress can’t seem to shake the shackles of partisan disputes.

Meanwhile, a staggering 22 million Americans have filed for unemployment in the past four weeks, sending the country into an economic nosedive that is drawing apt comparisons to the Great Depression. Images of lines of cars miles long might be our generation’s bread-line pictures, with food banks struggling to deal with the onslaught of needy Americans.

Experts say the stress from the pandemic revealed underlying vulnerabilities that suggest the booming economy might not have been all that strong to begin with. “We built an economy with no shock absorbers,” said Joseph Stiglitz, a Nobel Prize-winning economist.

Meanwhile, whatever details shake out about the reopening of the economy, one thing is certain: It will be fragile, partial and slow.

We know that health care workers represent a high number of coronavirus cases, but a new CDC report puts hard (though still undercounted) numbers on it: As of April 9, 9,282 health care professionals had contracted the virus and at least 27 had died from it.

On that note, KHN and The Guardian are documenting the lives of U.S. workers who succumbed during the crisis. If you have a story to share, please contact us here.

With each passing day, scientists are learning more about the coronavirus. Some news from this week includes a link between obesity and severe cases, as well as good news for asthma patients.

And as the coronavirus upends some ironclad medical traditions, doctors talk about what they wished they’d known about how the illness presents a month ago.

In an extremely grim snapshot of the devastation that’s hitting nursing homes across the country, an investigation following an anonymous tip found a makeshift morgue in one New Jersey facility that was housing 17 bodies.

I hate to leave you on that terrible note, so have a picture of three extremely adorable KHN dogs that will surely brighten your day, if only a little. Have a restful and safe weekend!

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By: Brianna Labuskes
Title: Must-Reads Of The Week From Brianna Labuskes
Sourced From: khn.org/news/friday-breeze-health-care-policy-must-reads-of-the-week-from-brianna-labuskes-april-17-2020/
Published Date: Fri, 17 Apr 2020 18:17:22 +0000

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At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections

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3 months ago

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July 6, 2023

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A new report has provided the first national count of Americans who rely on health care sharing plans — arrangements through which people agree to pay one another’s medical bills — and the number is higher than previously realized.

The report from the Colorado Division of Insurance found that more than 1.7 million Americans rely on sharing plans and that many of the plans require members to ask for charity care before submitting their bills.

The total membership numbers are likely even higher. The state agency collected data from 16 sharing plans across the U.S. but identified five other plans that did not report their data.

“These plans cover more people than we had previously known,” said JoAnn Volk, co-director of the Center on Health Insurance Reforms at Georgetown University.

Under the arrangements, members, who usually share some religious beliefs, agree to send money each month to cover other members’ health care bills. At least 11 of the sharing plans that reported data operated in or advertised plans in all 50 states in 2021.

Sharing plans do not guarantee payment for health services and are not held to the same standards and consumer protections as health insurance plans. Sharing plans are not required to cover preexisting conditions or provide the minimum health benefits mandated by the Affordable Care Act. And unlike health insurance, sharing plans can place annual or lifetime caps on payments. A single catastrophic health event can easily exceed a sharing plan’s limits.

In Colorado, at least 67,000 people were members of sharing plans in 2021, representing about 1 in 4 Coloradans purchasing health care coverage on their own. That rate concerns Kate Harris, a chief deputy commissioner of the Colorado Division of Insurance, which she said regularly receives complaints from sharing plan enrollees.

“What we hear from consumers is that when they purchase one of these, they do think there is some guarantee of coverage, for the most part, despite the disclaimers on many of the organizations’ websites,” Harris said.

The Colorado report found that health sharing arrangements often require their members to seek charity care or assistance from providers, governments, or consumer support organizations before submitting sharing requests. Those costs are then shifted to other public or private health plans.

Katy Talento, executive director of the Alliance of Health Care Sharing Ministries, which represents five of the largest and longest-operating sharing plans in the country, said sharing ministries encourage members to act like the uninsured people they are. Such requirements to seek charity care reflect a desire to be good stewards of their members’ money, Talento said.

“Think about it like a soup kitchen,” she said.

Fourteen sharing plans reported that Colorado members submitted a cumulative $362 million in health bills in 2021, and nearly $132 million of those requests were approved. The remainder, sharing plan executives told the division, reflected duplicative bills, ineligible charges, negotiated discounts, and the members’ agreed-upon portion of medical bills.

“It’s not like every claim line on a health care sharing request is going to be eligible for sharing,” Talento said. “They have to submit the whole bill. They can’t just pull out a piece of it.”

But consumer complaints to the Division of Insurance and to consumer assistance programs, such as the Colorado Consumer Health Initiative, show that members do not always realize what sharing plans will cover.

“We have seen firsthand the risks that people face when they sign up for these arrangements without recognizing the magnitude of the risk that they’re assuming for their health care costs,” said Isabel Cruz, the initiative’s policy director.

Talento disputed the notion that members don’t know the parameters of their sharing plans.

“That’s just suggesting that our members are dumb,” she said. “Is it likely that somehow our people are going to be willy-nilly jumping blindly into something?”

Theresa Brilli, a small-business owner in Longmont, Colorado, said she and her partner signed up for a direct primary care plan in 2017 that covered primary care visits for $179 a month. Direct primary care plans are payment arrangements between patients and providers for receiving health services without billing insurance. The plan had an arrangement with Liberty HealthShare, a Canton, Ohio-based sharing plan with more than 131,000 members nationwide, to cover additional services like preventive screenings, emergency room care, and hospitalizations for $349 a month with a $1,000 deductible. The rates increased to $499 a month, with a $1,750 deductible, in 2020, Brilli said.

But Brilli said getting payments was a major hassle.

“It took about four to eight months to get reimbursed,” she said. “It was a fight, every bill.”

When she heard about enhanced subsidies for ACA marketplace plans in 2022, she decided the hassle was no longer worth it and switched to a Kaiser Permanente plan for $397 a month.

“I will never go back to Liberty Health or a health care sharing plan,” she said. “I didn’t agree with the whole ministry thing. They made you sign off saying you believed in God, which was like, ‘Whoa, I guess that’s what I have to do to get my health insurance.’”

Laura Murray, 49, of Aurora, Colorado, said she signed up for a Liberty HealthShare plan in 2017 as a more affordable alternative to her husband’s employer-based plan.

“We kind of felt we were cutting out the middleman in a way, and it was a helping-out-your-neighbor sort of deal,” she said.

But when she became pregnant unexpectedly, she had trouble getting her health bills paid. Initially, Liberty paid only a portion of the tab, and her bills got sent to a collection agency. It was only through multiple calls that she learned she needed to send the bills to a third party that would negotiate with the providers.

“It took years to get it cleared up,” she said.

Timothy Bryan, Liberty’s vice president of marketing and communication, disputed many of the details of Brilli’s account and attributed some of the delay in payment to her “failure to submit the required supporting documentation.” Murray’s payments, he said, were delayed more than 10 months because she had failed to provide the required pre-notification.

Mike Quinlan, 42, of Denver, turned to a health sharing ministry in 2014 after the birth of his first child cost him more than $17,000 out-of-pocket, on top of nearly $24,000 in premiums that year, under an employer-sponsored health plan. He said the births of his three youngest children were covered in full by Samaritan Ministries International, a Peoria, Illinois-based sharing plan with 359,000 members, to which he contributes $600 a month. When he incurs large health expenses, he receives a slew of $600 checks from other members, he said.

Every year, Quinlan attests that he is a Christian and identifies the church he attends.

“This is a group of like-minded people who have said voluntarily we’re going to trust each other to cover each other’s health costs,” he said.

The rules differ from plan to plan. Some sharing plans require members to pledge to abide by Christian principles, and some exclude payment for out-of-wedlock births or health issues that arise from drug use. Many sharing plans exclude coverage of contraception, mental health services, and abortion, often with no exceptions for rape or safety of the mother.

Regulators in Colorado and other states have also expressed concerns that health sharing arrangements are paying brokers much higher commissions for signing up members than health plans do. That could create financial incentives to push sharing plans over health insurance without adequately educating consumers about the differences.

In 2019, Covered California, the Golden State’s ACA marketplace, instituted a requirement that its certified agents who sell both sharing plans and health insurance provide consumers with a list of disclosures about sharing plans and show them the subsidies they could receive for buying traditional health insurance coverage.

“It’s really important that consumers understand what these arrangements are, and what they are not,” said Jessica Altman, executive director of Covered California.

Harris said the Colorado Division of Insurance is investigating multiple health sharing arrangements based on consumer complaints but declined to name them.

Colorado officials are also concerned that health sharing arrangements might appeal primarily to people who don’t expect to use many health services. That could increase the proportion of sicker and more expensive patients among enrollees in traditional health insurance plans, driving up premiums.

Harris said many consumers can get a health plan for less than the cost of a sharing plan, particularly with increased federal and state subsidies put in place in recent years. State officials are also working to inform consumers of the financial risks associated with health sharing arrangements, some of which have gone bankrupt in recent years.

“It might look cheaper on its face, month to month,” Harris said. “But if they do really actually need their costs covered, there’s a real risk that they may not be.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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By: Markian Hawryluk
Title: At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections
Sourced From: kffhealthnews.org/news/article/health-sharing-arrangements-ministries-protections-risks/
Published Date: Wed, 14 Jun 2023 09:00:00 +0000

 

 

 

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Retirement Planning

Give Yourself the Perfect Retirement Gift

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3 months ago

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July 5, 2023

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Give Yourself the Perfect Retirement Gift

From day one, everyone looks forward to retirement, that day where they can finally let go of the stresses of the daily grind and spend their leisurely days traveling, reading and basically having fun. As compared to previous generations, we have longer life spans so we all expect our golden years to be fulfilling and rewarding.

Instead of waiting for people to help you plan your retirement, you should do it yourself. Although retirement planning is probably one of the most draining activities where one spends loads of time perusing over financial and brokerage statements, benefits brochures and insurance policies. One does this in terms of the benefits of long term planning: if one retires earlier, he/she will think and anticipate less on government-funded plans which only gives a pittance of a pension and focus more on the beauty of life.

Why Retirement Planning is Necessary

Obviously, retirement planning isn’t all about numerous hours of stress by chugging down numbers and analyzing mutual funds: it’s about fixing and deciding how you will live the final years of your life. If one can balance financially and plan fully on a retirement plan, rest assured that your future is secure.

But remember that retirement planning isn’t a singular activity. It is something that stretches forth to decades, spanning your 30s, 40s and 50s. In every decade, one must rethink their strategies since you are inching closer and closer to retirement, thus one must forgo risky investments and go to bonds and reliable mutual funds as the years pass by.

Build the Right Retirement Plan

A retirement plan must be suited to your risk tolerance and apparent need for cash when retirement comes. If you prefer a general 401(k) that has a good balance of everything, you may go for equal amounts of low-risk bonds and riskier stocks or you may also opt for an assortment of mutual funds that both have high-risk and low-risk funds.

Generally, risk tolerance is congruent to one’s age. If you are on your 20s or early 30s, you may opt for a more stock-saturated mutual fund in the hope of getting a good return because of the added risk stocks give. If ever the worst comes and you face some declines in the stock market, you still have a good 20 to 30 years to compensate for the losses.

On the other hand, if one is teetering on the 40s or 50s, it is necessary that one must go low-risk in his/her investments. One’s mutual funds must now be concentrated more on low-risk government bonds, which virtually assure no losses and minimum gain, if there will be no huge political crisis, of course.

If one follows this general age/risk rule, then one has better chance that one has an ample amount of cash to spend on the pleasures of life when retirement age finally comes.

Conclusion

One has always dreamt of traveling the world, playing golf all day and enjoying the best life can give. But one cannot do all that while working away in the office. Therefore one must give importance to the rising necessity of building a retirement plan.

It is probably as stressful as work itself, but if you can carry all that heap of information and mix it into the delicacy that is a finely tailored retirement plan, then rest assured that your dream of tasting and relishing the best of life is definitely reachable by 65.

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Retirement Planning

Ends-of-the-World Every Year Since 1970

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3 years ago

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August 14, 2020

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There always has been and always will be a reason not to invest or not to stay invested. This is all the mainstream media reports to us. Below you will find a list of some of the worst global events each year since 1970. I have some commentary to follow.

1970: War: US troops invade Cambodia.
1971: Civil Unrest: Anti-war militants march on Washington.
1972: Political: Start of Watergate Scandal.
1973: Economic: OPEC raises oil prices in response to US involvement abroad.
1974: Political: Nixon resigns as President of the United States.
1975: Political: Multiple assassination attempts on President Ford.
1976: World: Ebola virus.
1977: Political: Government shutdowns.
1978: Market: U.S. Dollar plunges to record low against many European currencies.
1979: World: Iranian militants seize the U.S. embassy in Teheran and hold hostages.
1980: Economic: Inflation spiked to a high of 14.76%.
1981: Political: President Reagan assassination attempt.
1982: Economic: Recession continues in the U.S. with nationwide unemployment of 10.8%.
1983: Economic: Unemployment in the U.S. reaches 12 million.
1984: Economic: 70 U.S. banks fail during the year.
1985: World: Multiple airplane hijackings around the world.
1986: World: Chernobyl Nuclear Power Station explodes.
1987: Market: DOW drops by 22.6% on October 22.
1988: Environment: Awareness of global warming and the greenhouse effect grows.
1989: Environment: Exxon Valdez dumps 11 million gallons of crude oil into Prince William Sound.
1990: World: Persian Gulf War starts.
1991: World: Mass shooting in Killeen, TX.
1992: Human Rights: Los Angeles riots following the death of Rodney King.
1993: Terrorism: World Trade Center bombing.
1994: World: Mass genocide in Rwanda.
1995: Terrorism: Oklahoma City bombing.
1996: Terrorism: Olympic Park bombing.
1997: World: Bird flu.
1998: World: Multiple U.S. embassy bombings.
1999: World: Columbine shooting.
2000: Economic: Start of the Dotcom Market Crash.
2001: Terrorism: Terrorist Attacks in NYC, DC & PA.
2002: Economic: Nasdaq bottomed after a 76.81% drop.
2003: World: The U.S. invades Iraq.
2004: World: The U.S. launches an attack on Falluja.
2005: World: Hurricane Katrina
2006: World: Bird flu.
2007: Economic: Start of the Great Recession.
2008: Economic: Great Recession continues.
2009: Economic: S&P bottomed after a 56.8% drop.
2010: Market: Flash crash.
2011: Market: Occupy Wall Street and S&P downgrades U.S. Debt.
2012: Political: Fiscal cliff.
2013: Political: Taper tantrum.
2014: World: Ebola virus.
2015: World: Multiple mass shootings.
2016: Political: Divided U.S. Presidential election.
2017: World: North Korea testing nuclear weapons.
2018: Economic: U.S. & China trade war.
2019: Economic: Student loan debt reaches an all-time high of $1.4 trillion.
2020: World: COVID-19.

While many of these events were undoubtedly terrible (and there are certainly others not named here that were worse), most of these were broadcast as end-of-the-world events for the stock market. Despite that attention, it is worth noting that these were, for the most part, one-time events. In other words, most faded into the newspapers of history. We moved on.

Obviously, some caused monumental shifts in the way the world works. Just think about how much air travel continues to be impacted by the events of 9/11. But, outside of the resulting inconveniences (if we want to call safety protocols inconveniences) associated with air travel, flying is safer than ever before.

Take a look at just about any of the events and you will find there are many that people will hardly remember. My point here isn’t that these events are to be ignored or that they were easy to stomach at the time, but that they have become a distant memory.

I want to also make the point that we should expect these types of negative events. As investors, we know these types of crises, economic catastrophes, and global phenomena are going to happen.

But in almost all cases, here is what we can say in the next breath – this too shall pass.

Will there be legal, humanitarian, economic, or some other aid required as a result of these events? Almost certainly the answer is yes, but that doesn’t mean it they won’t eventually fade into history.

Lastly, what’s worth noting is how the market has performed over these last 50 years despite the continual advertisements of the world crashing down around us. On January 2, 1970, the Dow Jones stood at 809 and the S&P at 90 -> those are not typos. These same indexes have grown (not including dividends) to 26,387 and 3,232 respectively. Amazing, no?

Perhaps what gets overlooked more than anything else is what separates the above one-time negative events from the positive stories that go largely ignored over our lifetimes. And that is a story worth telling. See the companion post below:

Unheralded Positive Events Every Year Since 1970

Stay the Course,
Ashby

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The post Ends-of-the-World Every Year Since 1970 appeared first on Retirement Field Guide.

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By: Ashby Daniels, CFP®
Title: Ends-of-the-World Every Year Since 1970
Sourced From: retirementfieldguide.com/ends-of-the-world-every-year-since-1970/?utm_source=rss&utm_medium=rss&utm_campaign=ends-of-the-world-every-year-since-1970
Published Date: Tue, 04 Aug 2020 13:26:19 +0000

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