Two years ago I wrote this about the glowing predictions that consumer-run health insurance co-ops under Obamacare would have lower premiums and save money. They were backed by hundreds of millions of dollars in federal loans. My prediction was not especially insightful because in the 1980s I had seen and participated in the same scenario only they were called HMOs and all the consumer-run, non-profit, idealistic plans failed.
Remove the profit motive and you remove the reasons to care about costs and run things efficiently. It’s really that simple. Why do you think so many charities actually use only a small portion of their receipts on their stated cause? And then there is the fact, often buried in political rhetoric, that only a small percentage of insurance premiums represent insurance company profits.
Another ObamaCare Dream Goes Bust – WSJ.
Health-care cooperatives last year suffered an estimated 7 million in net underwriting losses.
The Affordable Care Act created a new kind of “cooperative” heralded by supporters of health reform. These Consumer Operated and Oriented Plans, chartered and regulated by the states, would compete with for-profit health-insurance companies and were meant to appease disgruntled advocates of a single-payer and “public option” model for the nation’s health-care system.
All but one of the co-ops are operating in the red. One already has been shut down, and others are in precarious financial condition. Chalk up another ObamaCare failure.
Generous federal loans helped 23 cooperatives to get up and running. They have enrolled more than a million people, according to the National Alliance of State Health Co-ops. Their supporters believed that consumer cooperatives, which must meet the same regulatory requirements as private insurers, would provide better benefits and lower prices than commercial carriers.
In practice, most co-ops have significantly underpriced premiums and grossly underestimated medical claims. Many seek significant premium increases for 2016: 58% for individual plans in Utah, 38% in Oregon and 25% in Kentucky, for example.
Iowa’s CoOportunity Health, which operated in both Iowa and Nebraska, was the first to confront the hard reality of insurance economics as medical claims far outpaced premium income. After the co-op burned through 5 million in federal loans, an Iowa state court in February ordered the organization to be liquidated.
At least 120,000 members were forced to quickly find coverage elsewhere. The Iowa Insurance Division had this helpful advice: “Your coverage with CoOportunity Health will stop, and claims will not be paid after cancellation. If you do not purchase replacement insurance, you may be penalized by the federal government.”
Meanwhile, Standard & Poor’s Ratings Services reported early this year that 10 co-ops had worse loss ratios than Iowa’s in the third quarter of 2014 resulting from a “high medical claims trend and not enough scale to offset administrative costs.” Citing Iowa’s experience, the report warned: “The solvency problems experienced by CoOportunity Health introduce questions about co-ops’ finances in general.”
A separate analysis by the insurance-rating agency A.M. Best expressed concerns “about the financial viability of several of these plans” as losses escalated throughout 2014. Other estimates based on quarterly financial statements filed with the National Association of Insurance Commissioners show co-ops as a whole reported net underwriting losses of 7 million in 2014. Only Maine’s Community Health Options has been operating in the black. Wall Street Journal 6-24-15
Filed under: Observations on life
Is it fair to say that fraud is rampant in Medicare parts A, B and also D? Looking at the dollars involved one might say so. Considering that fraud warnings have been ignored or slow to be responded to for decades, rampant fraud is a fair conclusion I would say. All this wasted money is the result of fraud by health care providers and frequently with the cooperation or complacency of patients who simply don’t ask questions or care about cost.
For years, the inspector general, an internal watchdog that evaluates HHS programs and investigates wrongdoing, has dinged Medicare for its failure to keep a close enough eye on doctors, pharmacies, beneficiaries and even its fraud contractors. That’s beginning to change, officials say.
“CMS has made progress on a number of recommendations we’ve made, as well as on the initiatives that they’ve had,” said Jodi Nudelman, regional inspector general for evaluation and inspections in the New York office. “They’re starting to use data to drive their strategies.”
At the same time, she said, “There are still concerns. More needs to be done. We can’t stop here.”
via Fraud Still Plagues Medicare Drug Program, Watchdog Finds – ProPublica.
If you would like to see the prescribing habits of your doctors, you can use this tool to get all the facts.
People can use Prescriber Checkup, a tool created by ProPublica, to look up doctors and see how their prescribing patterns compare to peers in the same specialty and state.
Filed under: Medicare Tagged: Health care costs, Medicare, Medicare Part D, WPrightnow
(Left to Right: Alyson Hannigan [Date Movie, 2006], Philomena Kwao, Essie Golden, Tess Holliday)
For the typical size 18 girl like myself, the summer months bring along the ever complicated dilemma: wear longer clothes that cover up “problem areas” but threaten to cause heat stroke, or throw caution to the wind and go for the shorts and tank top that show every jiggle and bump. Up until my senior year of high school, skirts and shorts were out of the question. The last thing I wanted was for everyone to see the bits of me that made me the most insecure about myself. It was a question of comfort. At least clothes left everything to the imagination; I would rather burn under the summer sun to please others than show everyone my chubby arms and legs.
And that’s when it hit me. It’s not like my body was a secret. Even under layers of denim, the size of my thighs never changed. My arms were still large, and my ass was still huge.
So why did I pretend like covering it up in the summer would change people’s opinions? And furthermore, why was it that my comfort had the potential to offend people I didn’t even know? Well, after a long year of soul searching and chats with intelligent people, I slowly began to include knee length things into my closet. With time, I eventually evolved to skirts that ended just above the knee–which ended up being somewhat of an achievement for someone who spent all of high school afraid of her own knees. I’m aware that people stare; I’m aware that people make comments about my body because I’m fat. No one wants to say it, but it’s true. It’s not a bad thing, merely facts.
My eyes are brown, the earth is round, lambs bleat, and I’m fat.
Just because I acknowledge this doesn’t mean I hate myself. And I especially dislike when people try to beat around the bush by telling me that I’m “curvy” because they don’t want to admit that I’m fat. To them, fat is synonymous with ugly, unwanted, worthless, and lazy. But I don’t fit that stereotype at all.
So, obviously, I can’t possibly be fat.
I hate to break it to you (not really), but I am fat. My body is fat.
Side note, I believe I should make a few things clear: Just because I call myself fat doesn’t mean I’m okay with a bunch of other people calling me fat. For one thing, it took eleven years for me to get to unlearn everything society has ingrained within me. Even then, I still have moments of absolute doubt. When others call me fat, I know for sure that it’s used as a form of humiliation. Second, unless this person gave birth to me or has a genuine concern for me, they have absolutely no reason to comment on my body.
That being said, this brings into question the word “fat.” Why is it an insult? Why do we fear it? Why do we deem it unattractive and the worst trait anyone can have? Why are fat people the subject of so much toxicity in the media? And why are fat people considered untouchable and a burden on the eyes?
It’s no secret that people fear fat people, especially fat girls…it seems like a genuine phobia. Some people fear sleeping with fat girls, some women fear becoming fat, people fear looking at fat girls, and if a fat girl hits on someone then that’s the biggest insult to their ego. We’re stereotyped as easily screwable. We’re considered a last resort, an experiment, a one-time experience. Our enjoyment and self-love is frowned upon and made fun of.
All that this tells me is that our happiness and self-acceptance are a threat to other people’s perceptions. It is expected that we’re supposed to hate ourselves as much as others hate us. Our fatness doesn’t allow us the right to be sexy, or delicate, or energetic, or even aggressive. Our sense of sexuality is over-exaggerated, as we are painted as overly eager and desperate. On the off chance that someone actually wants to be with us, it’s because they have a fat girl fetish. We’re viewed as overly emotional women who sit in the corner and eat all of our feelings.
We eat full cakes…sometimes even whole pizza pies.
It’s funny when we cant fit in chairs, or when our clothes are too tight. It’s funny when we flirt, because it’s unbelievable that we’d have the audacity to try and find someone to be with.
We are not heroines.
We are not love interests.
We are not rebels or muses or poets or artists.
We’re just fat.
Some people believe that the hatred of fatness stems from the evolutionary desires within us. We want to mate with people who are healthy and strong; but because fat people typically are neither, they’re immediately ruled out as potential partners. The problem lies in the fact that body shape doesn’t dictate quality of health. Ever. It’s very possible that someone at 300 lbs could have the same health conditions as someone who weighs 120. The only person who knows for sure what a fat person’s health is like is a medical professional.
So unless you are one, or have an intimate knowledge of someone’s medical history, your assumptions are probably incorrect.
To be perfectly honest, I’m sure no one can truly say why they hate fatness. Some may say it looks gross, but when you get to the root of it all, people only think it looks gross because we were told to think that way. And unless it affects someone personally, there’s a very small chance that someone will put forth the effort to unlearn it.
And this is why I very rarely believe people when they try to be polite about their disgust with fatness. Just because someone doesn’t outwardly say how they feel doesn’t mean that fat people don’t know. We always know. Whether or not we choose to care is what makes the difference. And when people are only nice to the fat people they know/care about, but go on to make fun of those they don’t know, all it does is force us to look at them in a different light. Is this what you think of us behind our backs or when you’re angry with us? Sure, not all non-fat people think this way. But it’s not surprising when they do.
While I do believe that society is making some (albeit very small) advances towards body positivity, sometimes I feel like it’s not enough. Yeah, Tess Munster (size 22) has a modeling contract. That’s very cool, and I’m happy for her. But one person placed in every ad doesn’t mean we’re becoming a more accepting group as a whole. Especially when the majority of plus sized models (my problems with the term aside) aren’t even plus sized. In fact, many plus size models are below the average size of the typical American Woman. Some have even admitted that they used to do straight size modeling in the past, but had to give it up when they began gaining weight. When they realized that they were too small to fit plus size clothes, they used padding. In other words, instead of the plus size modeling industry actually hiring women who are a size 14-16, they hire women much smaller.
So not only do women larger than a size 10-12 have to worry about the typical standards of beauty, we have insecurities about being unable to fulfill the plus-size standard, as well. Not only are we fat, but we’re also the wrong type of fat.
How messed up is that?
I could go on forever about all the completely screwed up things that come with the normalized hatred of fat people. I could talk about how fat comedians typically thrive on jokes about their fatness, how fat girls in movies are only seen as desirable when they lose weight (because how many times have I heard the words, “you’d look so much cuter if you were skinnier”?), how fat men seem to have less of a difficult time finding work in mainstream media than most fat women do.
But since I’ve already rambled far more than I’d care to admit, I’ll end this entry with one last thing:
Your body is nothing to be embarrassed about. Other people’s desire to humiliate says more about them than it does about you. And just because people want fat people to hate themselves doesn’t mean we should. It’s difficult to push against the strong current of negativity. But it’s not impossible.
Lastly, if you want to change your body, cool. If you don’t want to, cool. Your body is no one’s business other than your own.
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Ikhmas Jaya Group Berhad IPO
July 3, 2015 by
Ikhmas Jaya Group Bhd, a piling specialist company, is scheduled to be listed in Main Market of Bursa Malaysia on 27th July 2015. The Initial Public Offering (IPO) consists of 126 million new ordinary shares and offer for sale of 56 million shares at an IPO price of […]
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On May 20th, 2015 the lights went out in Nigeria, Africa’s biggest oil producer. Nigeria suffers from a phenomenon known as the curse of oil which is a subset of a larger issue known as the resource curse. The idea behind the curse of oil is that countries with large oil reserves cannot seem to manage revenues in a way that benefits the majority of the population economically and socially. Some…
CIPE Development Blog
Exactly what is the European way? The above sounds very tempting does it not? Most people will focus on the “tuition-free” part and forget the “using tax money” part, especially those of the age in the picture who pay little or no taxes. One has to wonder about the quality of the education represented by the dollars hanging around their necks if they are so foolish as to sop up Old Bernie’s rhetoric.
From a June 8, 2015 WSJ article:
Just as Mr. Sanders’s speeches are unorthodox, so are his dealings with the press. A Swedish reporter, Anne-Sofie Naslund, asked him a question, and Mr. Sanders—who has long praised the type of social democracy practiced in Scandinavian countries, turned the tables and began interviewing her.
He asked her what it cost for people to get health care in Sweden.
“Like nothing,” Ms. Naslund said.
And what does it cost to go to college? Mr. Sanders asked.
“Nothing,” she said.
Child care? “It’s almost free,” she said.
“That’s pretty good!” Mr. Sanders exclaimed.
Before you jump on the European way of doing things, you might want to look at the big picture. Here area few things you can check:
The average income of Europeans; with a couple of exceptions, less than Americans.
The deductions from paychecks for all the “free” stuff; mostly at least double Americans.
Taxes paid; as you may guess, more than Americans including a value added tax (VAT) on most purchases of 19% to 21%.
The cars Europeans drive or the motor scooters or bikes; they ain’t SUVs, or pickup trucks. Gasoline costs from about .00 to over .00 a gallon in Europe … go fill up your Silverado in Norway. It will cost you 4 ‼️
bitter; bell peppers
You are slicing bell peppers into ribbons when your man tells you that moving in together was a mistake. Next to the cutting board, you’ve measured out a thimble of hot pepper flakes, and the shrimp are shelled and deveined, cooling in the fridge until you’ve finished the rest of the prep. He asks if you heard what he just said. You keep slicing the pepper meticulously; you are proud of this one dish—shrimp fra diavolo—that you make well.
Before you left your job on the coast behind to move further inland with him, the chef at the restaurant had taught you the secret of making the dish really, really well—it wasn’t just the heat of the pepper flakes and the sweetness of the shrimp that gave his version of the dish its reputation as the best one around. It was the bell peppers, cut into matchsticks and added to the pan with the shrimp.
The chef taught you how to pick the right kinds of bell peppers when he took you to the farmer’s market one Saturday, flipping the peppers onto their stems and counting the points on their bottoms—See, the fewer points, the sweeter the pepper, he’d explained—holding your hand, holding the pepper—most people want the one or two pointed peppers. For my fra diavolo, I only use the four-pointed ones, he’d said, plucking the four-pointed pepper from your left hand as though it were a flower. You set down a two-pointed pepper—red and slick as a smear of cadmium red—and ask him why. He tells you to stick out your tongue, and where most men would seize the opportunity to make a rude joke, you trust the chef enough to do it without even really thinking.
He touches the back of your tongue lightly: Here’s where you taste the salt of the sauce, he says, before he softly touches the tip of your tongue, And this is where you taste the sweet of the shrimp. He slides his finger to the side of your tongue: But here and here, he says, these parts taste sour and bitter. The sour comes from the balsamic vinegar I add when I’m caramelizing the onions and garlic—but it’s the bell peppers, the bitter, that finish the dish and make mine different from anyone else’s recipe. The bitterness of the peppers makes sure that all your tastebuds are engaged.
You’d already known on that morning at the farmer’s market that you were putting in your two weeks notice and moving inland. As you continue to slice the peppers into matchsticks, it occurs to you that maybe the chef did, too, and that’s why he taught you how to make this dish, and made sure that you knew how to make it really, really well—as well as he could make it, in fact. On the cutting board, you have created a neat little stack of green slivers, which the not-your-man-anymore in your kitchen carelessly picks up and plays with, asking you, Are you still making dinner? You do not raise your eyes from the Wüsthof blade, and say, Not for you. He slams the door to let you know that even a mistake should have known to let him stay for dinner. After all, it’s the one dish you make really well.
Once he’s gone, you think again about that morning at the farmer’s market with the chef who taught you this recipe, and how to really taste something well, all your tastebuds should be engaged. You carelessly lick a tear from the corner of your mouth and lift a piece of pepper to your tongue. Swallowing the two down together, though, all you really taste is the bitter.
sweet; Tupelo honey
She wasn’t really telling the truth when she said she couldn’t make anything well—the chef remembered one Sunday morning catering job, where she had to be there with all the other waitstaff, dressed like a monkey in a tuxedo to float from rich person to rich person, silently offering a tray of assorted crudité like some sort of ghost who could only speak in descriptions of the amuse-bouche arranged on the silver platters.
She’d brought in a pan of biscuits for everyone to share, overfilled and pinched down with aluminum foil to keep them hot. He’d done the math in his head; she’d have had to get up at four o’clock in the morning to get the biscuits baked and still clock in for the catering call at 6 a.m.
They were big as a boxer’s fist and the fluffiest biscuits he’d ever eaten. She called them cat heads and split one open for him, buttering it generously and holding out a jar of honey to him, saying, Don’t share the honey with everyone. It’s Tupelo that my daddy sends me from his apiary. It’s special. I just brought it because I thought you’d appreciate it on your biscuit. He watched her drizzle a thin squiggle of honey onto the buttered biscuit, and watched it melt into the springy layer of dough at the center, before she tucked the small jar of honey back into her purse.
Later, when he sat down to do the ordering, he added Tupelo honey to the list, instead of the ordinary honey the restaurant had been ordering for the kitchen. Though on many weekends, he attempted to replicate her biscuits, he could never get his to raise up as tall as her pan of cat heads. And though the Tupelo honey he kept in the house was sweet, distinctive, different from the ordinary honey that always came in the little plastic bear, it couldn’t even begin to compare with the tiny Ball Mason jar from her daddy’s bees that she’d kept safe in her purse.
He knew he had to tell her it was a mistake when he saw the limes in the fridge; limes were a commitment that he just wasn’t ready to handle. Limes meant lowball glasses of vodka tonic on the rocks, homemade guacamole whose leftovers would go brown in the Tupperware and pies with scalloped edges and Cool-Whip topping. Limes were a settling down grocery item. Though it was true, he’d asked her to leave her job on the coast and move in with him, he hadn’t really given any serious consideration to their future until he saw that bag of limes, sitting in the vegetable crisper. Seeing the red mesh bag of green globes made him realize that a bag of limes meant you were in it for the long haul.
And, if he were truly honest with himself—he’d never really cared much for citrus fruits of any kind.
Salty; potato chips
See here, Leyla, watch what I’m doing, Grams said, running the rolling pin over the three-quarters empty bag of store-brand potato chips. If you’re gonna catch you a man when you’re older, you’re gonna need to know how to make at least one meal really good, I mean, so good that no one else makes it quite like you—you know to get to their heart you gotta cut a path to it through their stomach, right? Your momma told you that yet? Leyla shakes her blond head up and down emphatically.
On the kitchen counter, Grams has arranged the other ingredients—cooked macaroni elbows, two cans each of cream of mushroom soup and tuna fish, a small bag of frozen peas, and a plastic-looking orange block of Velveeta, cut into small cubes. It don’t need to be fancy, she tells Leyla, just good. She hands the spatula and big mixing bowl to the girl and says, Now dump in everything except the mushroom soup and give it a good stir to mix it all up even. Once all the ingredients are blended to her satisfaction, Grams scrapes out the two cans of mushroom soup, which land in the macaroni like two gray, gelatinous cylinders, which Leyla can’t help but find both fascinating and a little gross at the same time. She doesn’t much care for tuna casserole herself; but because it’s her daddy’s favorite meal, her momma makes it for supper at least once a week. And now that Leyla’s ten, Grams has decided that it’s high time for her to help out and learn how to make supper on her own.
It’s the potato chips that finish it off right, Grams tells her, shaking out the salty shards of potato over the casserole, after Leyla’s turned it into the greased-up pan. Though sometimes, she admits, even the best casserole can’t keep a man happy at home. Leyla looks at Grams, not understanding. Grams waves her hand at the girl, Oh, land sakes, girl—just remember don’t ever run out of potato chips and you’ll be fine.
Vanilla; a peculiar bouquet
When the chef was teaching Leyla how to make his signature dish, shrimp fra diavolo, for the man she was moving inland to be with, he stood close to her, making sure she was chiffonading the peppers, though that was a technique usually reserved for leafy vegetables and herbs—ostensibly, he was at her elbow to supervise the motions of her blade through the pepper. Really, it was so he could smell the back of her neck—vanilla, like a cookie. He told her once that she smelled like a cupcake and she responded, Vanilla is so boring. He hadn’t explained to her that its mixture of spicy, floral and sweet notes were actually among the most complex flavors known to the human tongue, though he’d thought it. Nor did he tell her that its name translated roughly to “black flowers,” due to its origin legend of the plant springing up from the spilled blood of star-crossed lovers. Later, he’d wish he had. Instead, he said, Vanilla’s like salt. Everyone takes it for granted, and no one really appreciates it until they notice it’s missing.
Allie Marini (Batts) holds degrees from Antioch University of Los Angeles & New College of Florida, meaning she can explain deconstructionism, but cannot perform simple math. Her work has been a finalist for Best of the Net & nominated for the Pushcart Prize. She is managing editor for the NonBinary Review, Unbound Octavo, & Zoetic Press, and co-edits for Lucky Bastard Press with her man, performance poet B Deep. She has previously served on the masthead for Lunch Ticket, Spry Literary Journal, The Weekenders Magazine, Mojave River Review & Press, & The Bookshelf Bombshells. Allie is the author of Unmade & Other Poems, (Beautysleep Press), You Might Curse Before You Bless (ELJ Publications) wingless, scorched & beautiful, (Imaginary Friend Press), Before Fire, (ELJ Publications), This Is How We End (Bitterzoet, forthcoming), Pictures From The Center Of The Universe (Paper Nautilus, winner of the Vella Prize) & Southern Cryptozoology: A Field Guide To Beasts Of The Southern Wild (Hyacinth Girl Press, forthcoming). Allie rarely sleeps, and her mother has hypothesized that she is actually a robot fueled by Diet Coke & Sri Racha. Find her on the web: https://www.facebook.com/AllieMariniBatts or @kiddeternity.
Freshly Pressed: Editors’ Picks
Hamilton and the Tenner
June 30, 2015 by
It does seem to me historically tone deaf for the Treasury Dept. to consider taking Alexander Hamilton, of all people, off U.S. currency, of all things, or even reducing his presence there. I can’t say I care who is on the money — easier to have nothing there but graphic design, I think — but if any face should […]
Freshly Pressed: Editors’ Picks
This from Politico.com
“President Barack Obama will this week release a long-awaited overtime rule aimed at raising wages for 5 million people as soon as 2016, according to sources familiar with the plans.
The proposed rule will more than double the salary level under which virtually all workers qualify for overtime pay whenever they work more than 40 hours in any given week. That threshold, now ,660, will rise to ,440.
The regulation would be the most sweeping policy undertaken by the president to assist the middle class, and it would constitute the most ambitious intervention in the wage economy in at least a decade.
Obama will announce the proposed regulation formally on Thursday during a trip to La Crosse, Wisconsin, but details will begin to be released by the White House on Tuesday.”
For more information… http://www.politico.com
Or, employers will reduce overtime, hire a worker to cut time and a half or use more part-time workers
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Sunway Construction Group Bhd, the construction arm of Sunway Bhd, is scheduled to be listed in Main Market of Bursa Malaysia on 28th July 2015. The Initial Public Offering (IPO) will involve distribution of 175 million shares to entitled Sunway Berhad shareholders on the basis of one for […]
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