Culling the Risk

Calif. regulators fine Blue Cross for canceling policies | Sacramento Bee | 3.23.07

State regulators fined Blue Cross of California $1 million after an investigation found the insurer systematically violated state law when it canceled policyholders regardless of whether they were dishonest about pre-existing medical conditions.

…

The report said the legal standard for cancellations is high because such action may put the policyholders’ health at risk by making it difficult to obtain care. Such cancellations also hurt hospitals and physicians by denying them payment for treatment that should have been authorized

…

The state investigation was fueled by a series of stories in the Los Angeles Times. The articles disclosed that Blue Cross, along with other insurers such as Blue Shield of California and Kaiser Permanente, routinely canceled coverage of individual policyholders whose medical care resulted in large claims, prompting some to lose their homes or suffer other hardships.

Culling insurers’s high risk groups, by any means, may be widespread and potential fines balanced against risk savings?

Incremental Death

Aged, Frail and Denied Care by Their Insurers | NYT | 3.26.07

Tens of thousands of elderly Americans have received life-prolonging care as a result of their long-term-care policies. With more than eight million customers, such insurance is one of the many products that companies are pitching to older Americans reaching retirement.

Yet thousands of policyholders say they have received only excuses about why insurers will not pay. Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.

“The bottom line is that insurance companies make money when they don’t pay claims,” said Mary Beth Senkewicz, who resigned last year as a senior executive at the National Association of Insurance Commissioners. “They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.

Incremental delay followed by incremental death leads to incremental profits.

Congressional Calculus

Insuring children may squeeze seniors | | 3.26.07

The Democratic Congress, eager to do something that would be popular with voters, is moving to provide healthcare coverage to millions of uninsured children this year, but there’s a catch: Senior citizens enrolled in a popular Medicare program may have to help pay the bill.

Congressional calculus:
   ΔS + ΔC = 0, where ΔS = change in spending for seniors, ΔC = change in spending for children.

What’s 2 Million?

U.S. lowers number its says have no health insurance | USA Today | 3.23.07

The government said Friday it has overstated by almost 2 million people the number of Americans who have no health insurance, lowering the figure to 44.8 million.

The revised figure provided by the Census Bureau for 2005, the most recent year for which statistics were available, was lower than the 46.6 million it reported in August. The new figure for the uninsured represents 15.3% of the U.S. population of about 300 million.

Ah yes, a less than 5% error (if the uninsured are the denominator) or a less than 1% error (if the U.S. population is in the denominator)—seems the real story should be the 15% that are uninsured by any measure.

Voila

Using some time before a night shift the other day I installed Parallels Desktop for Mac, took about 15 minutes. Next, I installed Windows XP Home SP2, about 20 minutes. Voilà, incredibly fast virtualization of Windows on a Mac.

Microsoft’s Internet Explorer 7.0 running in Parallels:

Apple’s Safari:

Subsequently, I’ve installed several other “Windows” applications into the Parallels virtualization with incredible speed in performance and zero problems (including specialized legal practice software). No problems taking an external hard drive from my old Dell box and connecting by USB to the Mac—it appears as drive D in Windows.

Several years ago I decided to center my document management strategy on well established file formats, specifically: TXT, RTF, DOC, XLS, HTML, XML, CSV, and PDF (not forgetting the universal image, audio, and video formats—no worries). The advantages are: almost guranteed long-term viability and cross-platform support. Essentially the only format that I use, that is highly propiertary, is the PST file format for Microsoft’s Outlook (8 years-worth of PST files). Now I can access all those PST files using Parallels runing Microsoft Outlook on a Mac.

The Blog

I’m not certain what I going to do with this blog—although, I’ve been quite successful at ignoring it (for good reasons). I’ve been doing some behind the scene (in the PHP templates) editing and housecleaning. I’ve been torn-between (or evaluating) a move from ExpressionEngine to WordPress. So far I haven’t found a clean (or simple) way to migrate the content from the former to the latter. It was very straight forward in the original move from Movable Type to ExpressionEngine, there an ExpressionEngine script that does it automatically.

The Bar

Due to illness the starting morning of the three-day bar exam, I bailed on the exam until July. In retrospect, a good move—I haven’t had a break from law studies since starting in September 2002—so March and April are no-law months.