Useful links

Whatifpost.com is a healthcare blog that does a nice job of breaking down the Exchanges, especially for the people who don’t get a consistent salary:

5. For those living in states that don’t expand Medicaid: If you overestimate your income, you don’t have to repay anything

True to the stereotype of the starving artist, many of the ones I’ve talked to have incomes hovering right around the federal poverty line (FPL- $11,490 for an individual). If you live in a state that doesn’t expand Medicaid and your income is below that line, you’re especially screwed– you’re not eligible for subsidies to buy private coverage, and unless you were eligible for Medicaid under the old rules, you can’t get that either.

But say you estimate that your income will be over the FPL and thus qualify a subsidy to pay for private insurance– if your actual income at the end of the year is lower than FPL, you don’t have to pay anything back. And in many cases the federal subsidy will be enough to cover the entire cost of private insurance on the marketplace.

Healthcare Renewal on Pfizer being labeled a RICO organization:

Pfizer, amazingly, has the malodorous distinction of having been convicted by a US jury as a RICO – a racketeering influenced corrupt organization in 2010 (look here).  Pfizer executives, of course, kept their office of counsel busy by appealing the conviction, all the way up to the US Supreme Court.

As discussed on the 1BoringOldMan blog, the court has now turned down the appeal and let the conviction, which had been affirmed by lower federal court, stand.   So Pfizer is now officially a racketeering influenced corrupt organization.  

Yet although the description of the RICO statute that 1BoringOldMan quoted notes the law can be used to go after the leaders of organized crime, no individual at Pfizer who authorized, directed, or implemented the relevant misbehavior, which was in this case the promotion of Neurontin for off-label uses, for which its benefits were at best unproven, at worse nonexistent, even if its harms are well-documented.  Thus even this RICO conviction has not affected the impunity of top health care corporate leaders. 

BrainWrap at GOS:

Meanwhile, many of the insurance companies are on record as saying that they’re willing to accept payments up through January 10th for coverage retroactive to January 1st under the circumstances, so that’s still not an issue right now. Admittedly, this isn’t true in every state, but most of them are allowing it.

So, in short, your best response is along the lines of this:

“The limited data available so far indicates that almost half of the 1.8 million have already paid. For those who haven’t, most payments aren’t due for another 2 weeks anyway, and seeing how most people don’t pay their utility/credit card bills until shortly before they’re due, WTF is your point?”

 

And Cats in Boxes:

 

Share On Facebook
Share On Twitter
Share On Google Plus
Share On Pinterest
Share On Reddit

39 replies
  1. 1
    WereBear says:

    Part of the appeal of the little cats is that they are very little different from the big cats.

    I was hoping a friend could get insurance for her husband, but because she has it and he does not, bupkes.

    I blame Republicans; because it is their fault.

  2. 2
    Cervantes says:

    Morning, Richard. Happy New Year and all that sort of thing.

  3. 3
    amk says:

    Loved the vid.

  4. 4
    Richard Mayhew says:

    @WereBear: She can get insurance for her husband, just probably without subsidy.

  5. 5
    WereBear says:

    @Richard Mayhew: Yes, thank you. I also tried to explain that $300 for a Bronze plan IS a bargain, but she does not see it that way.

  6. 6
    The Red Pen says:

    Is the 1.8 million signup figure a disappointment? Within expectations? Somewhere in between? I thought they were aiming for 3 million.

  7. 7
    MikeS says:

    My wife and I enrolled on wed the 15th (we had some issues we wanted a navigator for (my wife goes on medicare in April while /I have 6 years to go for one thing. Her policy had been canceled while mine had not, etc.) and we had to wait for an appointment.

    The enrollment went well except we had to reenter our password and answer security question about half a dozen times.

    We selected our plan a Highmark (Pennsylvania) silver at $49/ month with reduced copays and enrolled a few days after the appointment and check for our Dr and Hospital in the network.

    Actually the funkiest part of the processes was Highmark’s web site that has tiny scroll windows for picking Dr specialties out of. you can only see eight choices at a time with out glitchy scrolling!

    We are saving over $600/month! And we have vision coverage now!

    I tried to pay right away but Highmark didn’t have our application yet when I called the next day. The call took only a few minutes with no wait. and I should call back after $48 hours.

    I called back Monday morning (the 23rd), again no wait, and they said they had the application but it wasn’t processed yet which take 7 to 10 business days and they couldn’t take my payment until it was processed. But the agent said we had until January 15th to pay for coverage effective January first. I will call again on the 31st to see if I can pay yet!

    I haven’t canceled my old policy yet with a different company that isn’t offering plans through the exchanges as far as I can tell. It is a direct withdrawal that take place on the 3rd of the month each month. I assume that is payment for the month it is withdrawn in and I would like to stop that payment and cancel it so I don’t have double coverage and can save about $300.

    So far so good,

    Mike S., Berks County Pennsylvania

  8. 8
    Roger Moore says:

    And Cats in Boxes

    Getting in the true spirit of the blog, I see.

  9. 9

    ‘I haven’t read the article’:

    Turns out Sarah Palin, who has been one of Duck Dynasty’s biggest defenders, hasn’t actually read the GQ interview that includes cast member Phil Robertson’s controversial comments on homosexuality and other subjects.

    When pressed by Fox News host Greta Van Susteren whether the language Robertson used when talking about his opposition to homosexuality was graphic and offensive, Palin admitted she didn’t know what Robertson had said.

  10. 10
    burnspbesq says:

    There are solid, practical reasons for DOJ to choose to go after corporate (rather than individual) defendants when there is the option to do either. Providing restitution to victims is just as valid a goal as retribution or deterrence, and the enterprise is far more likely to have the means to pay restitution than any individual or group of individuals.

    The only reason to prefer going after individuals is if your sense of outrage matters more to you than making the victims whole.

  11. 11
    burnspbesq says:

    I love how customer service at the provider of my current POS “insurance” is shut down for the holidays so that I can’t cancel before they process my automatic payment for January.

    I think a letter to the Insurance Commissioner is in order.

  12. 12
    kindness says:

    The next project needs to be making giant paper bags to see the big cats play with those.

  13. 13
    GregB says:

    Great video, love big kitties.

    The local newspapers and even the Boston Globe are covering two tragic stories that happened in two surrounding towns.

    The first one is about a 20 year old kid who was texting and driving and hit a 71 year old former fire chief and left him for dead in a snowbank. The kid later turned himself in and stated that he thought he only hit a snowbank.

    The other one is a mother of three killed in a car crash and her father was a first responder to the accident scene.

    Shitty news. Don’t text and drive and drive carefully.

  14. 14
    Villago Delenda Est says:

    @burnspbesq:

    The executive vermin need to be made to feel pain.

    Taking away their swag is the way to do that.

  15. 15
    Villago Delenda Est says:

    Totally OT, but I do believe the Senate is ours in 2014:

    Rove: GOP Will Capture Senate in 2014

    Mr. “I have the math” has such a great track record on predictions. Almost Bill Kristol territory.

  16. 16
    El Caganer says:

    @burnspbesq: I’m sure that’s just an oversight. What else could it possibly be?

  17. 17
    Roger Moore says:

    @Villago Delenda Est:

    Taking away their swag is the way to do that.

    Throwing them in jail for the remainder of their natural lives might get some people’s attention, also, too. It needs to be made abundantly clear that the laws in this country apply to the rich and powerful, and if corporate officers don’t want to wind up in prison then they need to prevent their companies from being criminal enterprises.

  18. 18
    handsmile says:

    @burnspbesq: , et al

    On that topic, you might find of interest this essay in the current issue of the NYRB, “The Financial Crisis: Why Have No High-Level Executives Been Prosecuted,” by Judge Jed S. Rakoff. NAL, I found it to be a finely-drawn and thoughtful appraisal of DOJ actions on “white collar crime” in recent decades.

    http://www.nybooks.com/article.....secutions/

    For those unfamiliar with Rakoff, he holds a seat on the US District Court for the Southern District of New York, appointed by Clinton in 1996. Gleaned from his Wiki entry, Rakoff was educated at Swarthmore, Oxford and Harvard Law, and has been a faculty member at Columbia Law since 1988.

    “Judge Rakoff is a leading authority on the securities laws and the law of white collar crime, and has authored many articles on the topic, as well as leading treatises on RICO and corporate sentencing.”

    Another fun fact: since April 2013, Rakoff has been banned from entering the Russian Federation.

    @Roger Moore:

    My sentiments exactly. Resistance is futile.

  19. 19
    doug r says:

    @Roger Moore: Throwing management in jail doesn’t really help, though. Smartypants says it better: http://immasmartypants.blogspo.....t-see.html

  20. 20
    feebog says:

    Richard:

    We had an interesting discussion about the ACA last night after dinner. My ex-wife (yes, there are some people who still talk to their ex-spouses) lives with her mom, who is on Medicare, and her brother, who is severely disabled and on Medicaid. She is sixty-three and has worked in the insurance industry for years. She has looked at the exchange in California and can’t find a plan under $500, which I find hard to believe. Because she is now working again and her Mother and Brother both draw from SSI and her late Father’s pension, their combined family income is too much to qualify for subsidies. This is a woman who has had serious health problems in the past and really needs coverage for the next two years. Any thoughts on this?

  21. 21
    Kay says:

    @burnspbesq:

    Providing restitution to victims is just as valid a goal as retribution or deterrence, and the enterprise is far more likely to have the means to pay restitution than any individual or group of individuals.

    It’s a false choice, burns. They can do both. They can hold the entity liable with restitution and ALSO hold individuals criminally liable.
    They’re doing real damage to peoples perceptions of “the justice system” with this. It’s a mistake. People have noticed that wealthy and powerful people are not held individually responsible. They’ve noticed this because ordinary defendants get absolutely hammered AND they are ordered to pay restitution.
    Did you read the link? They were ordered to pay restitution once before, in 2003. The DOJ issued the same press release we always read, where it was “landmark” damages. They turned around and immediately started breaking the law again.
    Can I do this? Can I go into a county court and pay damages and it’s no harm, no foul and everyone goes home to their own bed? Why does this only make sense for certain actors?
    Our prosecutors and judges don’t seem to have any problem ordering individual sanctions AND restitution for the endless parade of ordinary defendants shuffling thru in belly chains and plastic sandals.
    People perceive this as “buying their way out of prison” and I find it hard to disagree with them. It isn’t good for the justice system. They’re chipping away at their own credibility and they need credibility. Once it’s gone they won’t get it back.

  22. 22
    Three-nineteen says:

    The federal healthcare website never did work for me, but I got settled with a couple of phone calls. After about a week, I got a bill from my new insurance company (almost $200 less a month than my COBRA). The best part? The insurance company is called “Common Ground Cooperative”.

    I’m being insured by dirty hippies.

  23. 23
    J R in WV says:

    @burnspbesq:

    Wrong, so wrong I can’t understand how your mouth didn’t refuse to say those words/fingers didn’t refuse to type those words.

    If the top executives of giant firms feel above the law, because they are for all intents and purposes above the law, what exactly will make them follow the law?

    Their innate responsibility? We already know none of these companies/their executives have any sense of responsibility even to their owners, the stockholders! These executives believe their only responsibility is to fill their coffers to the maximum extent possible, making their family one of the wealthy.

    We need to maximize punishment of corporate management, when their organizations are found guilty of operating outside the law, because otherwise they will take the necessary steps to take ownership of the country and its political levers of control. Indeed, aren’t they nearly there now, with Citizens United decided in their favor?

    You are one of the most thoughtless people posting here, it’s as if your mind has been carefully wrapped and put away where it can’t face any strain.

    Think (if at all possible) about a group of people without the law to restrain them! One of the first current examples that pops to my mind are the Narcos of Mexico, who now own the Avocado industry because they are willing to kill those who disagree with their intentions.

  24. 24
    Gene108 says:

    @Villago Delenda Est:

    Meh… What worries me is the House…

    After the 2014 elections, if the House does not flip, it will be 16 of the last 20 years the GOP controlled the House.

    In other words the GOP are approaching the generational control of the House the Democrats had post-Truman, despite the Senate and Presidency changing hands.

  25. 25
    burnspbesq says:

    @handsmile:

    I’ve seen Judge Rakoff’s article and respectfully disagree with most of it.

  26. 26
    Roger Moore says:

    @Kay:

    People perceive this as “buying their way out of prison” and I find it hard to disagree with them.

    Not only that, but they’re buying their way out with other people’s money; it’s the company that winds up paying, not the corporate officials. And because so many companies have completely broken corporate governance, the criminals rarely even lose their jobs or have to disgorge the huge bonuses they got based on criminal behavior that was later paid back. The whole thing is thoroughly corrupt.

  27. 27
    burnspbesq says:

    @J R in WV:

    You’re entitled to your opinion. I’m entitled to believe that your opinion is ill-informed.

  28. 28
    Kay says:

    @burnspbesq:

    “Pfizer Pays $2.3 Billion to Settle Marketing Case
    New York Times
    By GARDINER HARRIS
    September 2, 2009
    …Pfizer, which is acquiring a rival, Wyeth, reported in January that it had taken a $2.3 billion charge to resolve claims involving Bextra and other drugs. It was Pfizer’s fourth settlement over illegal marketing activities since 2002. “Among the factors we considered in calibrating this severe punishment was Pfizer’s recidivism,” said Michael K. Loucks, acting United States attorney for the Massachusetts district.
    Amy W. Schulman, Pfizer’s general counsel, said that Pfizer had reformed — again. “The reasons to trust Pfizer are because, as I have walked the halls at Pfizer, you would see that the vast majority of our employees spend their lives dedicated to bringing truly important medications to patients and physicians in an appropriate manner,” she said.
    The government charged that executives and sales representatives throughout Pfizer’s ranks planned and executed schemes to illegally market not only Bextra® but also Geodon®, an antipsychotic; Zyvox®, an antibiotic; and Lyrica®, which treats nerve pain. While the government said the fine was a record sum, the $2.3 billion fine amounts to less than three weeks of Pfizer’s sales.
    Much of the activities cited Wednesday occurred while Pfizer was in the midst of resolving allegations that it illegally marketed Neurontin®, an epilepsy drug for which the company in 2004 paid a $430 million fine and signed a corporate integrity agreement — a companywide promise to behave…”

    “Too big to jail” is a valid complaint. It discredits the integrity of the whole system, and IMO it’s government acting with the same short term thinking that corporations operate under, where a settlement, money, trumps the structural integrity and credibility of the justice system.

    I don’t care if people “trust” Pfizer. I do care if people trust the US justice system, and I think this stuff, this two-tier treatment, is long-term corrosive.

  29. 29
    Roger Moore says:

    @burnspbesq:
    And we’re entitled to believe that you’re a bullshit apologist for the corrupt kleptocracy, as both a professional assistant to tax cheats and an amateur defender in online blogs.

  30. 30
    Roger Moore says:

    @Kay:

    The reasons to trust Pfizer are because, as I have walked the halls at Pfizer, you would see that the vast majority of our employees spend their lives dedicated to bringing truly important medications to patients and physicians in an appropriate manner,

    Unfortunately, it only takes a few bad apples to spoil the barrel. It doesn’t matter how dedicated all the researchers and production people are if the sales department is full of criminals.

  31. 31
    Villago Delenda Est says:

    @Roger Moore:

    This.

    Burns always sides with the parasites.

  32. 32
    handsmile says:

    @burnspbesq:

    Would you be willing to summarize your disagreement with Rakoff’s critique or, if aware of one, provide a link/citation to a law-oriented blog post that shares your opinion of it?

    My own Google search finds numerous articles from the business press (e.g, NYT, Bloomberg, WSJ, CNBC) that are praiseworthy or at best neutral of Rakoff’s essay. Adjectives such as “scathing,” “blistering,” “damning”, “detailed,” “fascinating” are regularly applied to it.

    It would seem to me that Rakoff’s career as both a jurist and scholar would render him profoundly knowledgable – in practice and theory – of this subject and his prescriptions well worthy of the attention they appear to have generated.

    With apologies for the length, herewith the final paragraphs of Rakoff’s NYRB article, which in part address Kay’s concerns above (#21 and #28):

    I suggest that this is not the best way [for the DOJ] to proceed [with its currently prevailing prosecutorial strategy]. Although it is supposedly justified because it prevents future crimes, I suggest that the future deterrent value of successfully prosecuting individuals far outweighs the prophylactic benefits of imposing internal compliance measures that are often little more than window-dressing. Just going after the company is also both technically and morally suspect. It is technically suspect because, under the law, you should not indict or threaten to indict a company unless you can prove beyond a reasonable doubt that some managerial agent of the company committed the alleged crime; and if you can prove that, why not indict the manager? And from a moral standpoint, punishing a company and its many innocent employees and shareholders for the crimes committed by some unprosecuted individuals seems contrary to elementary notions of moral responsibility.

    These criticisms take on special relevance, however, in the instance of investigations growing out of the financial crisis, because, as noted, the Department of Justice’s position, until at least recently, is that going after the suspect institutions poses too great a risk to the nation’s economic recovery. So you don’t go after the companies, at least not criminally, because they are too big to jail; and you don’t go after the individuals, because that would involve the kind of years-long investigations that you no longer have the experience or the resources to pursue.

    In conclusion, I want to stress again that I do not claim that the financial crisis that is still causing so many of us so much pain and despondency was the product, in whole or in part, of fraudulent misconduct. But if it was—as various governmental authorities have asserted it was—then the failure of the government to bring to justice those responsible for such colossal fraud bespeaks weaknesses in our prosecutorial system that need to be addressed.

    In the parlance of our times: Read the whole thing.

  33. 33
    Kay says:

    @Roger Moore:

    Unfortunately, it only takes a few bad apples to spoil the barrel. It doesn’t matter how dedicated all the researchers and production people are if the sales department is full of criminals.

    Oh, sure. I’m not a “lock them all up and let God sort them out” person, no matter who is accused of what.
    I think they should stop making deals and levying what amounts to fines. They’re not a regulatory agency. They’re the justice department. They’re prosecutors.
    Obviously this is more complex than a county court, but I have juveniles who are on work release to make restitution for things like broken windows. They go back to detention in the evening. There doesn’t seem to be this elaborate debate about restitution versus individual and personal punishment in the peon ranks. We do both in the US! We hammer them twice! With adults, many of them GO BACK TO JAIL when they can’t make payments. We seem to have figured this out for ordinary people. I’m confused about why it is much too hard for top executives to navigate.
    I’m not even pro-incarceration, really. I think work release in white collar crime would be innovative. Let them do the whole scene, beg the judge for driving privileges, beg their employer to take them back so they can work off the fines. I’m in the rehabilitation camp! I want them to learn from this experience. I’m sure they have a lot to offer to society :)

  34. 34
    different-church-lady says:

    From the first link:

    Yet, for many self-employed individuals, estimating annual income is all but impossible– it can vary wildly from month-to-month, year-to-year, depending on their luck landing assignments, contracts, sales, etc. One woman in the audience during an Obamacare for artists workshop I attended put it this way:

    “The people who write these laws have no idea how things work in the real world.”

    That woman’s quote is almost verbatim a reflection of my thoughts when I first learned how the application process worked in Massachusetts two years ago. It’s almost as if the social engineers who came up with this were stuck in some past model of the working world where everyone had either yearly salary or an hourly rate. They built the structure for what they thought was the “common” model of compensation, didn’t concern themselves with anyone who didn’t fit that model, and completely failed to recognize that the common model wasn’t so common anymore.

    In short, bureaucrats gotta bureaucrat.

    Fortunately that’s true of how the law and the forms work, but the people on the ground in Mass. were good at finding me a path through all the demands for hard data in a soft world.

    My end result was thinking, “This is confusing, scary, maddening, and put together in a way that only a bureaucrat could love, and we’re all slightly better off for it.”

  35. 35
    Monala says:

    @feebog: My hubby and I were in the same room waiting to be served by an in-person assistor who was helping an uninsured grandmother get insurance. She lived with her daughter, son-in-law and grandchildren. His advice: the “household” follows those claimed on the tax return. Tell your daughter and SIL to stop claiming you on their tax return, and then you will qualify for a subsidy. Yes, that will increase their tax burden somewhat, but what you all gain as a family with you now having insurance is worth it.

    It may be the same with her household. Can she “break apart” the family, at least on the tax return? That might reduce her income.

    Part of the problem, however, is that she is 63 – even with subsidies, the older you are, the more you pay.

  36. 36
    feebog says:

    Thanks Monala. I’m not sure, but I assume the ex claims both her Mother and Brother as dependents, given their modest income stream. I guess she would have to figure out how much she would lose in tax deductions vs. how much she would gain in subsidies. Given her past health problems it would seem to me that going for the subsidies and getting a decent health plan would be the better option.

  37. 37
    Cervantes says:

    @burnspbesq: Really? Why do you disagree with “most of it”?

  38. 38
    Ruckus says:

    @Monala:
    I looked at the Covered CA website an put in my age, 64 and income. I make more than one or two people on SSI could make and I still would get a substantial subsidy. I don’t need the insurance, VA, but it was nice to see that I would have been able to afford a pretty good plan with the subsidy. And if I quit working, my SS income only, would mean that I would be eligible for Medical. Which would be cheaper than Medicare next year.

  39. 39
    Pluky says:

    @WereBear: The lesson I take from the similarity across sizes in the Felidae is not that lions and tigers are cuddly, but that little puddy on the sofa is really a vicious, merciless killer at heart. Not that there’s anything wrong with that!

Comments are closed.