July 29, 2014

Tuesday's Number: $604,020

Tuesday is the day my local paper, the Syracuse Post-Standard, publishes the weekly business section. In addition to special features, tips from stock experts, budgeting advice and the like, we get the judgment and bankruptcy listings.

Each week, I track health care related filings. I include anything that is clearly a debt owed to a hospital, nursing home, physician or physician group, medical supplier, and so on; I do not include filings by insurance companies, many of which are so diversified it would not be a fair assumption that the filing is related to medical care or health insurance.

·         This week, there were 28 new judgments to hospitals, doctors, or other medical providers totaling $573,049.

·         There were no satisfied judgments.

·         There was one healthcare related bankruptcies listed, for $18,533.

New this year, I’m tracking filings for each of the four Syracuse hospitals. Here’s the breakdown for this week:

·         Crouse had five, totaling $108,133
·         St Joe’s had four, totaling $113,549
·         SUNY Upstate had twenty, for $382,338
·         Community General, a part of Upstate, had none

The paper publishes only those accounts of at least $5,000.

July 26, 2014

Thoughts on the New House Tax Credit Bill

A couple hundred House Republicans and five handfuls of Democrats passed a tax bill yesterday. The bill tinkers with the federal child tax credit, in part by eliminating the marriage penalty, which means that couples with children can earn more money and still qualify for this kind of credit.  According to Mother Jones, the bill would cost the federal government some $115 billion over 10 years, which even in Washington is not chump change.

According to House Speaker Boehner, on the other hand,
Making the tax code simpler and fairer is good for jobs and economic growth, and for American families barely treading water in the Obama economy. The child tax credit legislation we passed today supports working families by eliminating the marriage penalty and better aligning the tax credit with the higher costs parents face. 
That sort of ignores the fact that (again according to Mother Jones) lower income folks, including single parent families, will be hurt by the change and that might not  be so good for jobs and economic growth. And I wonder if two-parents-working families making $150K really need a tax credit of a couple thousand dollars?  I mean, I get that every little bit helps us as individuals, but is that the kind of help our overall economy needs?

I'm wondering something else, too: If not having kids is a lifestyle choice, isn't having kids also a lifestyle choice?  And if lifestyle choices should not be supported by the Federal or State governments, why do we support those who choose to be parents through income tax credits, college tuition tax credits and even 'school choice' tax credits?  Not to mention paying for the parent lifestyle choice through health insurance coverage for things like infertility and erectile dysfunction drugs?

If, as Crying John noted, the goal is to help the families that are "barely treading water in the Obama economy" would it be better to reduce the income tax rates for everyone, rather than providing tax credits just for some people, who get them simply based on their lifestyle?

I've posed this question before, and will continue to put it out there, particularly now that we're getting closer to election season, when politicians on both sides of the aisle will ramp up their rhetoric on taxes, families, and what Americans want.

What I want, if anyone's interested, is fairness and tax equity, where we reduce the amount of taxes that are needed, because we limit the amount of personal welfare that's provided, whether it's going to deserving people who have very little or who have much. And where we limit corporate welfare, the kind that goes to new companies but not to old ones, or the kind that provides tax credits (that you and I pay for) to businesses to offset the minimum wage increase that was passed here in New York. These are but a few examples; I'm sure wherever you live, you can identify similar ones that don't make any sense.

I'm not anti-parent or anti-child or anti-tax break. I just think we all could use a break, across the board, not through piecemeal tinkering that politicians pass off as 'simplification'. We need to overhaul the tax code if we really want to get to fairness and tax equity, and we need to be bold about it.

Is it time for a flat tax? Time for us to have more money in our pockets each payday vs. having to plow through income tax software trying to find ways to put more money back in our pockets each spring? Time for everyone to be treated fairly across the board? Is it time for us to tax income like income, and stop fiddling around passing judgement, via tax credits, on how people spend that income?

What do you think? Is flatter fairer?

July 22, 2014

Tuesday's Number: $497,447

Tuesday is the day my local paper, the Syracuse Post-Standard, publishes the weekly business section. In addition to special features, tips from stock experts, budgeting advice and the like, we get the judgment and bankruptcy listings.

Each week, I track health care related filings. I include anything that is clearly a debt owed to a hospital, nursing home, physician or physician group, medical supplier, and so on; I do not include filings by insurance companies, many of which are so diversified it would not be a fair assumption that the filing is related to medical care or health insurance.

·         This week, there were fifteen new judgments to hospitals, doctors, or other medical providers totaling $436,858.

·         There were two satisfied judgments, for $20,431.

·         There were three health care related bankruptcies listed, totaling $40,158.

New this year, I’m tracking filings for each of the four Syracuse hospitals. Here’s the breakdown for this week:

·         Crouse had five, totaling $55,045
·         St Joe’s had three, totaling $30,188
·         SUNY Upstate had twelve, for $412,214
·         Community General, a part of Upstate, had none

The paper publishes only those accounts of at least $5,000.

July 20, 2014

Painting with a Broad Brush

By now the number of people who have listened to the Comcast customer service recording has probably climbed to to stratospheric heights; it had reached over four million listens in a few days and there didn't seem to be lack of folks talking about it in both mainstream and other media, so 'earviews' have likely soared.

Briefly, a woman called Comcast to cancel service; after about 10 minutes she handed the phone to her husband, and he recorded about eight minutes of his extremely patient, extremely frustrated attempt to cancel, in the face of an unrelenting call-taker who refused to believe that anyone would not want to have the fastest Internet in the world, would not want the best service, simply would not want Comcast.

The company expressed regret, noting
We are very embarrassed by the way our employee spoke with (the customer) and are contacting him personally to apologize. The way in which our representative communicated with him is unacceptable and not consistent with how we train our customer service representatives. We are investigating this situation and will take quick action...
Quick action likely means the representative has learned his fate, but for the rest of Comcast's employees, the ramifications will linger. This will likely become a topic in the Comcast/TimeWarner merger discussions, for example.  And for everyone who works in Customer Service, chances are things will be a nightmare for a while, as typically happens when there's negative media attention.  And if those employees have families and friends like mine, there'll be some 'splainin to do, questions to be answered. And maybe, it'll be a few days before folks wander around sporting Comcast logos in public.

I'm familiar with this, because I work for a health insurance company, something that's not a secret to regular readers. I don't work in Customer Service - I have nowhere near enough patience for that -- and, (official disclaimer alert), I do not speak in any capacity for my employer, and have no involvement in corporate communications, media relations, or other similar functions. The opinions expressed in this blog are mine alone.

My company is still the Big Man on Campus (BMOC) here in Syracuse even though  through mergers, our home office is in Rochester. There are several hundred of us who work in the local office, and who every day give it our best shot for our many varied customers, including individuals, employer groups, medical professionals, and an alphabet soup of regulators. Not surprisingly, these customers have different and at times clearly competing interests, and sometimes it's hard not to fail in the eyes of one customer on an issue, and at the same time exceed the expectations of another on the very same issue. Such is the world we work in, and likely the world you work in as well.

  • Part of being the BMOC is media attention, and corresponding media heat.  For example, every year in March, there's an article about the salaries of people who earn more than $200,000. This information is public because of a required regulatory filing. The local newspaper, in service to their many and varied customer interests, gives this a lot of attention, and the comments in response to the article are, well, they're as you might imagine. On the one hand, my Dad, when he was alive, used to call me at work and let me know whether or not I had made the list. On the other end of the spectrum, anonymous comments have suggested the people on the list should be shot. 
  • We'll also take heat if a person has a claim denied, even a legitimate denial, and decides to take it to the local TV stations who encourage stories of this kind, as part of their charge to meet customer demands and expectations. Again, the comments include the good, the bad, and the ugly, with focus on the latter two. For some reason, doing bodily harm to a health insurance company's employees seems to be acceptable in some circles.

I'm not on the $200K list, and don't aspire to be. I hate the list, and empathize with the families of people who do make the list, having some experience with this type of media intrusion. When I was a kid, I got to read my Dad's salary in the paper, because it was 'important' for people to know how much teachers made, even if it was barely more than the average blue collar worker.

When this type of media attention happens, I cringe, because I know my company is about much more than $200K salaries and denied claims. I know that my company and my coworkers here and in all of our locations do a whole lot of good for people and our communities, day in and day out, and that's the norm.

The vast majority of those good things we do never get a lot of media coverage, any more than the hundreds? thousands? of calls that Comcast employees take every day, and likely handle with grace, get a lot of media coverage.

One horrifically notable customer service exchange. One sensitive denied claim. Fifty or so high salaries. These things do not a company make, but all employees get painted with the same broad brush, in the color horrible.  I wish it wasn't like that.

July 15, 2014

Tuesday's Number: $441,044

Tuesday is the day my local paper, the Syracuse Post-Standard, publishes the weekly business section. In addition to special features, tips from stock experts, budgeting advice and the like, we get the judgment and bankruptcy listings.

Each week, I track health care related filings. I include anything that is clearly a debt owed to a hospital, nursing home, physician or physician group, medical supplier, and so on; I do not include filings by insurance companies, many of which are so diversified it would not be a fair assumption that the filing is related to medical care or health insurance.

·         This week, there were twelve new judgments to hospitals, doctors, or other medical providers totaling $378,335.

·         There was one satisfied judgment, for $5,555.

·         There were two health care related bankruptcies listed, totaling $57,154.

New this year, I’m tracking filings for each of the four Syracuse hospitals. Here’s the breakdown for this week:

·         Crouse had seven, totaling $67,657
·         St Joe’s had four, totaling $276,842
·         SUNY Upstate had three, for $79,218
·         Community General, a part of Upstate, had none

The paper publishes only those accounts of at least $5,000.

July 13, 2014

Extreme Conservatism, Texas Style

Remember a while back when our Sonuva Governor Andrew Cuomo noted that those pesky extreme conservatives don't belong in New York?  In case you had forgotten, here's the crux of what he said that people, naturally, took out of context:
Who are they? Are they these extreme conservatives, who are right to life, pro-assault weapon, anti-gay? Because if that is who they are, and if they are the extreme conservatives they have no place in the state of New York, because that is not who New Yorkers are. 
That caused a lot of consternation on the right, not surprisingly.It was pretended that he mean all conservatives need to pack up and move, or worse, stick around and then be sent off to 'camps' evoking Nazi Germany, or, say, America with our camps for the Japanese after Pearl Harbor.

In the months that have passed since Cuomo 'went there' on New York not being extremist, other states have boldly continued on their mission to take the National Championship of Extremism. We've seen the anti-equality laws, we've seen climate change denial, we've seen religious freedoms extend to bricks and mortar people equally as they extend to living breathing people, and we've seen moves to allow businesses to refuse service based on, well, pretty much whatever they want.   And now, we have the Texas Republican 2014 Party Platform.

Here are just a few tidbits from that document:
  • Preservation of Republican Form of Government: We support our republican form of government in Texas, as set forth in the Texas Bill of Rights, and oppose initiative and referendum. We also urge the Texas Legislature and the United States Congress to enact legislation prohibiting any judicial jurisdiction from allowing any substitute or parallel system of law, specifically foreign law (including Sharia Law), which is not in accordance with the US or Texas Constitutions. And because Sharia Law within our borders is such a threat, especially now that our first 'Muslim President' is a lame duck..
  • Climate Change: While we all strive to be good stewards of the earth, “climate change” is a political agenda which attempts to control every aspect of our lives. We urge government at all levels to ignore any plea for money to fund global climate change or “climate justice” initiatives. So when the 367 miles of Gulf Coast shoreline begin their inevitable degradation in the face of rising waters, and coastal cities, oil rigs, fisheries, billions in tourism and the like are threatened, we can all sit back watching Texas drown in their convictions, and ignore their pleas for even a penny of assistance. (And there won't be a citizens revolution in the form of 'initiative or referendum' to change this, because that would be wrong.) 
  • Homosexuality- Homosexuality is a chosen behavior that is contrary to the fundamental unchanging truths that have been ordained by God in the Bible, recognized by our nation's founders and shared by the majority of Texans. Homosexuality must not be presented as an acceptable alternative lifestyle, in public policy, nor should family be redefined to include homosexual couples... Additionally we oppose any criminal or civil penalties against those who oppose homosexuality out of faith, conviction, or belief in traditional values.  So that part about all men being created equal, and endowed by their Creator with certain unalienable rights including life, liberty and the pursuit of happiness, we'll ignore that part entirely.  And in case you are lost and wandering down the path of 'choice', there's hope for you: 
    • Reparative Therapy- We recognize the legitimacy and efficacy of counseling, which offers reparative therapy and treatment for those patients seeking healing and wholeness from their homosexual lifestyle. No laws or executive orders shall be imposed to limit or restrict access to this type of therapy. Not sure if seeking healing and wholeness 'from' their lifestyle is really what they meant with this. Isn't that what gays are seeking 'with' their lifestyle, just like straight folks?
  • Food Choice- We support the right of individuals to make their own dietary decisions. We oppose any laws regarding the production, distribution, or consumption of food. Government should not restrict non-genetically engineered seeds. Any laws regarding food? Really? Roadkill can be distributed as food? Infected cattle can be turned into steaks, distributed and eaten? Note to self: no eating in Texas. And doesn't the part about seeds seem backwards? I don't think folks are really concerned about 'natural' seeds, the concern is all about the ones that are GMO or 'genetically engineered'.  Or do extreme conservatives think differently on this one?
  • Immunizations- All adult citizens should have the legal right to conscientiously choose which vaccines are administered to themselves, or their minor children, without penalty for refusing a vaccine. We oppose any effort by any authority to mandate such vaccines or any medical database that would contain personal records of citizens without their consent. So your personal choice to not vaccinate your kids against preventable infectious and contagious diseases can endanger my health and that's good with you, Republicans?  Hope you still fee that way if one of your family members is impacted by someone else's decision not to vaccinate.
  • Controversial Theories- We support objective teaching and equal treatment of all sides of  scientific theories. We believe theories such as life origins and environmental change should be taught as challenge-able scientific theories subject to change as new data is produced. Teachers and students should be able to discuss the strengths and weaknesses of these theories openly and without fear of retribution or discrimination of any kind. Yea, though I walk through the valleys of Texas with dinosaurs by my side, near underwater cities, I fear no evil for I have been educated in Texas!
  • Traditional Principles in Education - we support school subjects with emphasis on the Judeo-Christian principles upon which America was founded and which form the basis of America's legal, political and economic systems. We support curricula that are heavily weighted on original founding documents, including the Declaration of Independence, the United States Constitution, and Founder's writings. Except we'll disregard all of the pieces that have been changed over the years like ending slavery, voting rights, civil rights, etc. Unless they're about 'science' in which case we can re-think them "as new data is produced."  And then there's that whole Judea-Christian economic system thing. Definitely going to need some help on that one. 
  • Right to Keep and Bear Arms- America’s founding fathers wrote the 2nd Amendment with clear intent – no level of government shall regulate either the ownership or possession of firearms. Therefore we strongly oppose all laws that infringe on the right to bear arms. We oppose the monitoring of gun ownership, the taxation and regulation of guns, ammunition, and gun magazines. Welcome felons, and mentally disturbed, and people with restraining orders... welcome to freedom-loving,gun-loving Texas. 
They also believe in adoption for embryos, separate (but presumably equal) polling places for Democrats and Republicans, elimination of just about all taxes, Texas sovereignty (including ignoring federal laws), repealing environmental regulations, and banning any kind of Census activity other than straight counting.

They are for a citizenship mark on a driver's license, but against a national ID card. They are for free speech for clergy (meaning political speech without sacrificing tax breaks), letting juries make decisions based on their personal beliefs (not on evidence presented in court), and voting rights for everyone except felons (who will then presumably vote with their un-infringed weapons).

They support fetal rights, protection of life from fertilization to natural death, Advance Directives and patient's rights, except when the patient doesn't want hydration or nutrition, which cannot be withheld.  (We've seen the impact of  Texas 'extreme right to life' policies recently.)

They support continued funding for the Strategic Defense Initiative (Star Wars missile defense, you recall) not only for us, but specifically for Poland and the Czech Republic.

It goes on and on, some 40 pages worth. Some of it is actually reasonable, but for me, it's hard to stick with it in the face of the rest.

This is what Cuomo was talking about, when he talked about 'extreme conservatives.' Like Cuomo, I believe that this is outside the mainstream thinking of most New Yorkers, the majority of whom favor equal rights, reasonable gun control, and understand that man and dinosaur did not stroll to the prehistoric fast food joint together to order a burger or a nice salad.

That doesn't mean there isn't room for improvement, for a change in policies, or even a change in leadership for New York.  It just means we don't want to be Texas.

July 10, 2014

Health Insurance and Cable TV: Separated at Birth?

The other day, I talked about what might be behind the hatred and vitriol that are flooding comment streams on the Hobby Lobby case. I didn't much think it was about contraception.

In researching that post and in doing lots of other research since the Affordable Care Act was passed, I uncovered what might be an educational opportunity.  It seems that, once you get past complaints about people being required to have insurance, or complaining about all those other, shall we say unworthy  people getting insurance under the ACA (which don't really seem to be about health insurance any more than the contraception argument is), some people are complaining about something they don't understand.

So today, I thought I'd try to make health insurance understandable by comparing it to something else that most of us are familiar with.  Because for most practical intents and purposes, health insurance works like cable TV. (I'm using cable as the example for this post, but it's true of the dish guys and fiber optic guys too).

I mean, think about it: you know which stations you really want to watch, but it's just about impossible to get only those stations; instead, you end up getting 30, 50 or a hundred or more stations in your all-in-one or bundle-of-joy package that you will maybe watch once or twice a year,  along with the 20, 30 or 40 you've convinced yourself you're going to watch regularly.

Why do you get so much more than you want? Because the cable companies would rather give you a bunch of stuff that you have no intention of watching (in addition to what you really want), because it's easier and/or more cost effective for them to do so. Or, if you're really cynical, they do it because they can, because they're giant conglomerates and in some cases monopolies, and they don't give a hoot about you and me. Of course, the cable guys would probably prefer to say that they can deliver better benefits to more people by having everyone have only a limited number of packages to choose from, a couple of sizes fitting most customers, and by sharing the cost across all users instead of individually charging us for what we actually watch.

Now, look at that description above, and replace cable guy with health insurance company, and see if it makes sense. "Better benefits than you need or want, because it's easier and/or more cost effective to do it that way than it is to individually charge us for what we actually use" sounds pretty much like health insurance, right?

(And yes, so does "giant conglomerates" and "monopolies" and "they don't give a hoot about you and me" -- that's one more similarity between the two, sometimes -- but it's kind of off topic).

When it comes to cable TV, I hate the 'more is better' concept. Frankly, I'd much rather pay for what I want than get a bunch of junk that I don't care about, even if it means I pay more.  Most people think that's nuts -- why pay more than you have to? -- but I think it would help me determine what I really want, versus what I think I want, and frankly if I had to pay what it really cost to watch TV, I'd probably watch less and save money.

When it comes to insurance, however, I'm actually OK with paying for more than I need, (or at least more than I hope I need) and sharing the costs with other people. Why? Because doing it this way means I actually end up paying less for what I need/want than I would if I had to pay the full shot myself.

Most folks know that generally, preventative care is 'free' under the ACA and under most plans in most states, either because of mandates that have been around since before the ACA, or because of what's commonly referred to as 'conforming legislation' that brought many state regs up to the level of the new federal regs.

In addition to the preventative care, and no waiting periods for preexisting conditions, and no annual or lifetime limits on a set of 'essential' services, there are other mandated benefits that are covered under most plans.

For example, here's just a partial list of the ones that are covered (at least to some extent) here in NY:
  • home health care
  • second surgical opinion, and second opinion for cancer diagnoses
  • medical conditions leading to infertility, and some infertility treatments
  • reconstruction after breast cancer related mastectomy
  • enteral formula
  • chiropractic care
  • treatment for eating disorders, chemical dependence/abuse and mental health
  • autism spectrum disorders
  • bone density screening and related treatments
  • diabetic education, supplies and equipment

I don't know about you, but I don't have desire to use some of these, or I'm the wrong age, or I don't have the specific illnesses that benefit from the treatments offered.  And I sincerely hope that I won't need to use some of the other benefits on the list  At the same time, however, I understand that lots of people do need these benefits, that some people are particularly passionate about making sure they're available, and that the passion they exhibit can drive legislators to pass laws that translate into benefits that you and I will have to pay for, even if we will never ever use them.

Let's go back to our analogy:
  • Somehow, all the folks out there who are passionate about things like alligator wrestling, hoarding, cooking, decorating, shopping, sports (individually or collectively), movies, history, antiques, guy stuff, girl stuff, animals, kid stuff and everything in between have convinced someone that they deserve air time, (just like the people who are passionate about health insurance benefits have convinced people to cover them). 
  • Someone figured out that it's cheaper if we all get stuck with the whole shebang even if we're not interested (just like the ACA and state insurance regs do). 
  • And the local TV stations have convinced people that we should be able to get them 'for free' (just like preventative care), and that we should all be able to have it all now (like not having to wait for waiting periods to pass). 

When I look at the similarities between health insurance and cable TV, I'm left wondering why we so readily embrace the concept of subsidizing other people's entertainment, but balk at the same process when it's applied to health insurance?

And why we don't see that our own television -- and health insurance -- are subsidized by coworkers or neighbors or family members or complete strangers, so when we complain about people who are getting 'something for nothing' or who are not 'paying their fair share', we're really talking about ourselves?

I'd like to think it's less like the contraception argument and more because people don't know how it works. Do you think maybe this analogy will help?

July 8, 2014

Tuesday's Number: $130,873

Tuesday is the day my local paper, the Syracuse Post-Standard, publishes the weekly business section. In addition to special features, tips from stock experts, budgeting advice and the like, we get the judgment and bankruptcy listings.

Each week, I track health care related filings. I include anything that is clearly a debt owed to a hospital, nursing home, physician or physician group, medical supplier, and so on; I do not include filings by insurance companies, many of which are so diversified it would not be a fair assumption that the filing is related to medical care or health insurance.

·         This week, there were eight new judgments to hospitals, doctors, or other medical providers totaling $85,582.

·         There was one satisfied judgment, for $5,730.

·         There were two health care related bankruptcies listed, totaling $39,562.

New this year, I’m tracking filings for each of the four Syracuse hospitals. Here’s the breakdown for this week:

·         Crouse had five, totaling $53,889
·         St Joe’s had two, totaling $12,614
·         SUNY Upstate had three, for $58,250
·         Community General, a part of Upstate, had one, for $6,120.

The paper publishes only those accounts of at least $5,000.

July 6, 2014

Who Uses Insurance-covered Birth Control?

I've been torturing myself reading comments posted on various Burwell v. Hobby Lobby articles. And out of fairness, I've tortured myself leftly and rightly, not wanting to miss anything. Trust me, there's a lot that's worth missing.

After reading through opinions ranging from the ridiculous to the sublime, it seems that people have no clue how insurance works. There's a huge misconception out there that a health insurance policy should be completely individualized, so that for example a man would never have to pay for maternity coverage, seeing as how he would never have to use that specific benefit. And now that thinking has been extended to include contraception, because a guy would never have to use The Pill or an IUD so why the (insert curse words of your choice) should he have to pay for it for anyone else?

Have you seen or heard a lot of complaining that insurance includes coverage for other things people have no intention of needing?  Have you heard any significant griping about having to pay for coverage of any other illness or affliction, or is it forever and always going to be the pesky female nether regions that cause this angst and hand-wringing?

In the overall scheme of things, only paying for what you plan on using would be fine if the intent of health insurance was to provide a draconian, ageist, sexist form of punishment, rather than something intended to help manage --and yes, even improve people's health.
  • Only under an 'insurance as punishment' scheme would a person be required to pick and choose which benefits they think they'll need,with no coverage for anything else. Didn't think you'd get cancer? Sorry. Didn't think you'd have a stroke? Sorry. Didn't think you or a family member would ever need mental health services? Too bad, so sad. 
  • Only in an ageist insurance scheme would people my age not have to contribute towards services for kids (well child exams, pediatric cancer services, newborn care, etc.) or for nursing home care or Alzheimer's treatment or other services most typically associated with older adults.
  • Only in a sexist insurance scheme would men not have to pay for the girly services, and women not contribute towards the manly services like, I don't know, prostate cancer treatment and vasectomies (a form of contraception, in case that was unclear), and our prime-time friends erectile dysfunction and low testosterone. 
Most people would recognize this as a draconian way to finance health care, if we all were individually underwritten (that means no family coverage folks - we are all on our own), based on a complete medical history going back a few generations, a comprehensive medical exam including tests for all things known to man, God and nature, and an NSA-style examination of what we eat and drink and how we exercise or don't and how long we sleep or don't and with whom, and so on.  Full invasive medical and lifestyle exams for all -- paid for out of your own pocket, of course, because you can't have insurance that covers medical exams until you prove you're worthy. And done on a regular basis, because we know that lifestyles change, with age and circumstance and environment.

Health insurance is not a draconian, ageist, sexist punishment system. It's also never been intended to be a 1:1 premium-dollar-to-benefit-dollar investment. Nor has any other insurance I can think of.  So. Either people who have long had insurance of other kinds (homeowners or renters or auto insurance or life insurance or flood insurance) are totally clueless on how insurance works, or they're pushing an agenda under the guise of having a conversation about health insurance.

In reality, the hatred and vitriol (spliced with an occasional very detailed description of natural birth control) isn't about health insurance, it's about lifestyle and about women and about the 47%.  Because "if those whores would just keep their legs closed this wouldn't be an issue" and if they were good girls not "those skanks who sleep around and expect someone else to pay for their goddamn birth control" we probably wouldn't be having this discussion at all.

I suspect the men who are spewing this bile might know that the insurance they have has probably long covered birth control, lots of different kinds of birth control, as did the Hobby Lobby policies before the Affordable Care Act.  They might even know that their wife, teen-aged daughter, sister or mother is probably using some kind of FDA-approved birth control right now, paid for with their insurance. They might even have had a vasectomy, covered by their insurance. And certainly there are women commenting in these threads who are using or have used contraception paid for under their health insurance too.

But of course wife, daughter, sister, and mother on insurance-covered-birth control, and men with insurance paid-for vasectomies, and honest-to-God hardworking me, well, those are the antithesis of skank, whore, and 47%er.

And we know that those people are the only ones who are going to use the contraception covered under the ACA health insurance plans, right?

Because those people are the only ones whose sisters and daughters and mothers should have to trust the "$1 condoms" for birth control, right? Or keep their legs closed?

Because those people aren't like us, right?

July 3, 2014

Hotel Syracuse Transferred to Developer

YES!  Whoo hoo!
AB Drummond photo, July 2013

Today, according to published reports, the City of Syracuse (through the Syracuse Industrial Development Agency) seized the abandoned Hotel Syracuse and transferred it to developer Ed Riley's Syracuse Community Restoration Company 1, LLC.

Why is that worthy of fireworks?

Well, SCRC1 is the company that's going to redevelop our grand old lady into a shining new old lady, in a $57 million project that was announced a while back.

I've preached about the need to get the Hotel out of foreign hands and back into the hands of  local folks who actually want to do something with it. In January, Syracuse's mayor Stephanie Miner made a point of calling out the Hotel Syracuse project as a priority in her State of the City speech.

In announcing the deal today, Miner noted that
Today is a major day for the Hotel Syracuse and the redevelopment of Downtown.  There is much work left to be done to make this long-held dream of may into a reality but this is a big step in a major transformation.
Today, I'm happy to give up my claim to one of the old gargoyles - I'd much rather have the Hotel, thanks very much. Let's hope that this truly is the start of something big!

July 2, 2014

The Update Desk: Gambling on Wilmorite

A few days ago, I wondered aloud if we in Onondaga County should have even considered gambling on Wilmorite and their Seneca County casino dream, given the developer's recently spotty record here.

Here are a few updates related to the earlier post:

  • This past Monday, Wilmorite was one of sixteen groups to submit proposals for the handful of spots to be awarded to new, non-Native American full service gambling resorts.  Which basically means a casino, hotel, parking garage, and spa - I think those would be the minimum requirements.  Golf courses are helpful too, from a full-service perspective.  As I've noted, if I were a betting woman I'd put my money on Tioga Downs for the Fingerlakes/Southern Tier location, but we'll see what happens.  Next steps? Vetting of the proposals by the lawyers, and then I think we wait to hear from the NY Gambling Facility Location Board (who names these Boards, anyway?) on who gets the first shot in each of the regions.
  • More importantly, at least for us here in Syracuse, we learned that the old Sibley's Building has been sold. You recall the Wilmorite connection there -- a default on the mortgage, which could have put a proposed rehabilitation project in the dumpster.  Happily, the building was sold to folks who are affiliated with Robert Doucette, the developer with an $18.7 million plan to create apartments and retail space in the building; hopefully the sale will start the ball rolling on this vacant-too-long property on a busy downtown corner. Doucette has a great track record over the years, and I think this is a gamble we can afford to take.

Finally, and this is sort of a non-Wilmorite wild card:  in its infinite wisdom, the New York Legislature passed a bill authorizing gambling at racinos until 6AM. Racinos are horse tracks that also have limited gambling, mostly video terminals.  Revenues are down at some of these places, and so our elected representatives decided that they can stay open another couple hours to try and get a few more bucks out of the folks who can't think of anything better to do in the wee small hours of the morning.

Hmm. Revenues are down at existing gaming facilities, at a time when we're proposing a major expansion of gambling?  How ironic.  And who knew?

Well, it shouldn't come as a surprise Some of the experts have suggested a couple of reasons for this, including erosion of the middle class and a saturation of smaller regional facilities that cannot compete with the big guys like the luxury casinos in Las Vegas.

It'll be interesting to see how our new regional casinos will fare against this backdrop, and if the promise of last fall's constitutional amendment -- "promoting job growth, increasing aid to schools, and permitting local governments to lower property taxes through revenues produced" -- will come to fruition.

July 1, 2014

Tuesday's Number Quarterly Update

Another thirteen weeks have come and gone, and I've got the second quarter total for the Tuesday's Number series.

Before we take a look at the numbers, let's take a look at the environment:  first, we're a full quarter into the Affordable Care Act's exchange enrollment, and we know that at least here in New York, a pretty significant number of the folks who enrolled through the NY State of Health were previously uninsured.  They're getting out there, seeing doctors for their free preventative services and their follow up visits.  And that's a good thing.

I doubt that too many of those new-to-the-system folks are reflected in these numbers, since there are typically collection efforts that occur before a judgment is filed, so these numbers are more reflective of prior activities than any occurring as a direct result of an influx of patients into the system.

So how did we fare this quarter? Here are the total dollars by filing type:

  • Judgments: $6,556,305
  • Satisfied Judgments: $322,133
  • Bankruptcies: $428,161

Grand total: $7,306,689, spread out over 396 filings, for an average of $18,451 each. Here's how that compares to the past four quarters:

  • Q2 2013: 335 filings totaling $7,011,084, an average of $20,929
  • Q3 2013: 300 filings totaling $7,697,532, an average of $25,658
  • Q4 2013: 333 filings totaling $6,934,379, an average of $20,824
  • Q1 2014: 253 filings totaling $5,499,218, an average of $21,736

On the plus side, the average cost per filing is down. On the negative? Total dollars up, and the  number of filings is up as well.

We may start seeing the impact from all of the new insureds with the ACA products in the third quarter. While yes, it is a good thing that we have more people insured, when folks get past the fully covered preventative visits, their out-of-pocket costs can be significant until the high deductibles are met, and that may be a financial shock that people might not have prepared for.

It will be interesting to see which direction the numbers go over the next couple of quarters.  Anyone willing to hazard a guess?

Tuesday's Number: $747,943

Tuesday is the day my local paper, the Syracuse Post-Standard, publishes the weekly business section. In addition to special features, tips from stock experts, budgeting advice and the like, we get the judgment and bankruptcy listings.

Each week, I track health care related filings. I include anything that is clearly a debt owed to a hospital, nursing home, physician or physician group, medical supplier, and so on; I do not include filings by insurance companies, many of which are so diversified it would not be a fair assumption that the filing is related to medical care or health insurance.

·         This week, there were 33 new judgments to hospitals, doctors, or other medical providers totaling $620,252.

·         There was one satisfied judgment, for $7,373.

·         There were two health care related bankruptcies listed, totaling $120,318.

New this year, I’m tracking filings for each of the four Syracuse hospitals. Here’s the breakdown for this week:

·         Crouse had 12, totaling $110,491
·         St Joe’s had seven, totaling $130,369
·         SUNY Upstate had 14, for $472,673
·         Community General, a part of Upstate, had one, for $13,022.

The paper publishes only those accounts of at least $5,000.