Exhaustion and Exhaustion of Remedies

The administrative idea of exhaustion of remedies is daunting for those who are well, let alone those who are sick, but follow the steps. Your insurance plan will out line its appeal process. Read through and get those steps in order: Start with a claim form, have the insurance company statement explaining the processing of your claim form, prepare a form letter for yourself to use in the case of the need for appeal, you can use it for all appeals (include your policy number, blanks for date of service, blanks for claim number, blanks for date claim submitted, blanks for what has happened since you filed the claim eg claim submitted, claim denied, appeal filed, appeal denied).
Exhaustion is a descriptive word used for this process.

Now after the appeal is denied, where do you go? Many employer plans provide for an employer review of your complaint only after you have EXHAUSTED insurance company avenues. Okay, send them a copy of your file. After they go along with the insurer (usual), you can now go outside to your state insurance department.

For health insurance, ERISA is a killer in obtaining relief from insurance company practices. Basically, it is a federal law that is tilted in favor of any entity that helps pay for your insurance. So, Medicaid and Medicare, employer funded plans, you might be up a creek. You can still file claims but you have a real burden in bringing this kind of a claim.

Task a day insurance: When all the free market economy nuts (nuts because they incorporate the fraud, price fixing and loophole using behavior of theirs as some noble free market economy virtue) get what they want, start examining new opportunities. Once we've all been empowered to go out and hunt down our own insurance policy, and pay exorbitant prices for it, think of the upside: These new plans will be ERISA exempt. If nobody but you is paying for your health insurance you can sue, sue and sue again for every hideous thing an insurance company does. And we should.

Who do you contact? Health Insurance Runaround

Anyone who has tried to contact their insurance provider knows that there are layers upon layers of people, departments and subcontractors to whom they are referred.

Task a day insurance: I learned this one the hard way. Get written confirmation from any "voice" on the end of the line who assures you of coverage after you follow insurance company step of notifying them that you plan to use a specific service.

Be specific, tell them you need a confirmation that authorizes the treatment and reimbursement for that treatment that also includes any other specific hoops you will have to jump through such as receipts. Understand that HIPAA does not always protect you from having to share results from testing..including the results of psychological testing in order to be eligible for reimbursement.

The second thing to know is that subcontractors, for instance companies that handle the assessments of need for long term care are operating as AGENTS of the insurer. This is a good thing because your INSURER is responsible for the actions of its subcontractor in many instances. In reality, the INSURER will try to claim ignorance so make sure every contact you have with the subcontractor is also communicated to the insurer.

It's not ECO friendly, but you need a file, a copy, a written word of everything that transpires.
Some may keep it on their computers, some using loads of paper, but the file is worth it. Don't worry if it's not perfect, keep the paperwork.

The answer to the RUNAROUND is that TURNAROUND is fair play. Start your own campaign of writing and notifying your insurer. For you, it will only require sending additional copies of your communications. If you think something fishy is going on allege it, you're probably onto something and as long as you insert the words, I believe it seems like....you're fine.

Make these papers part of your PHR. The PHR, the personal health record is encouraged to put the onus on patients to keep track of their medical prescriptions, conditions, etc. The good news is that a lot of this will be taken care of by keeping track of your money because insurance statements include what you were charged for in the first place.

Obamacare, Valeant, Making a Killing, Literally

 Obamacare, Valeant, Making a Killing, Literally

Valeant Pharmaceuticals is the flashpoint for a conversation that quite frankly should have been addressed by the self-proclaimed “reformers” when it came to smug self-congratulations on passing Obamacare. Like many other problems that have emerged with Obamacare, the philosophy and practices outlined in the Act ENABLED rather than prevented bankrupting American people who have the misfortune to become sick in our country.

The PPACA incentivized two OLD-TIME GAMES played by health insurers and providers that puts us in peril, first allowing for increasingly narrow networks of providers, especially specialists which essentially limits access to needed medical services for the sick and secondly by omitting any requirement that prescription drugs, ALL prescription drugs be counted towards a patient’s out of pocket maximum.

Instead, our rights under the PPACA merely codified the old-time, inadequate concept of leaving patients without access to needed medical services and medications in the face of insurance company denials with their only recourse being to appeal decisions of denial of coverage and seeking exceptions to denial of coverage of specific prescriptions.

Sure, if you’ve got the money then paying for those needed services in cash remains AS IT’S ALWAYS BEEN an option. But if not then the PPACA is merely business as usual—and worse—you’re up a creek, Death by Denial.

I LIKE what Valeant did, because instead of the death-by-1,000-cuts approach of other drug prices which even according to the, “Go business,” view of the Wall Street Journal have increased 76 PERCENT over the last five years (http://www.wsj.com/articles/for-prescription-drug-makers-price-increases-drive-revenue-1444096750, Joseph Walker, 10/5/2015), Valeant simply and LEGALLY raised the price of Daraprim from $13.50 a tablet to $750 a tablet overnight.

It was that enormous and overnight increase in price that finally got our silly politicians to notice that WE, the consumer had finally noticed yet another bad outcome of Obamacare that they SHOULD HAVE disclosed and fought against before the ridiculous plan became law in 2010.

Instead we’ve got the government class wagging their fingers at Valeant, with more money about to be wasted as we pay these lame ducks to hold yet another “investigation” off taxpayer backs (this time the Senate’s Special Committee on Aging) into Valeant’s conduct.

Because Obamacare incentivized this sort of endless increase by omitting any requirement that prescription drugs be covered by health insurance plans AND that such expenses for prescription drugs that are covered MUST contribute to out-of-pocket maximum, neither of which is true under Obamacare, those who need prescriptions omitted from insurance company formularies are essentially sh*t out of luck (see HealthCare.gov, Getting prescription medications, advising patients denied prescription drug coverage to try and APPEAL).

As for the ever-predictable Republicans with their allegiance to “free market,” the secret’s out: They APPROVE of the Obamacare provision that will end the lives of people unable to get their prescriptions covered by insurance or afford the out-of-pocket costs for those prescriptions as part of their idiotic capitalism argument of whatever the market will bear in terms of prices charged.

So what is the sudden politician uproar about Valeant about, the public finger-wagging and attempts to shame the company into better behavior?

FIRST, Valeant is being targeted by politicians as a distraction away from what the situation really proves which is that the criticisms of Republicans by Democrats and Democrats by Republicans were both true when it comes to Obamacare.

It proves that Democrats are right, the Republican inaccurate reliance on the “free market” and whatever that market will bear results in THIS.

The Valeant situation also validates Republican criticisms of Obamacare that Obamacare’s primary goal to save government money by forcing insurance companies to cover certain things that not all subscribers need while leaving subscribers vulnerable to bankruptcy or no access to needed medical services and medications when they’re sick by raising coinsurance, copayments, and deductibles, and in the case of drugs increasing the number of medications that are NOT COVERED results in THIS.

SECOND, Valeant has gained attention because of the sheer AMOUNT OF THE INCREASE in its prices. This argument is silly—There is no limit on what they’re allowed to charge that’s why we’re hearing the word “immoral” rather than “illegal” around the story.

Increasing drug prices have been addressed before, with even the Go Business! Wall Street Journal reporting on 10/5/2015 in an article by Joseph Walker, “For Prescription Drug Makers, Price Increases Drive Revenue,” noting that “…the 30 drugs analyzed by the Journal averaged 76% over the five-year stretch from 2010 through 2014. That was more than eight times general inflation.”

So what increases are moral? Obviously it must be somewhere between the seemingly perfectly acceptable 76 percent increase in prices overall and Valeant’s price increase on Daraprim of 5,000 percent.

In between we know that Gilead came under fire for its $1,000 pill for Hepatitis C (http://www.wsj.com/articles/gileads-1-000-hep-c-pill-is-hard-for-states-to-swallow-1428525426) with public outcry prompting an attempt to get rid of Gilead’s patent which here in the US continues though China rejected it.

We also know from a 10/20/2015 report by CNN (http://money.cnn.com/2015/10/20/investing/drug-price-hikes-martin-shkreli-valeant/), “Sticker Shock: Drug Prices with Price Hikes of Up to 1,200%,” by Matt Egan, that Horizon raised the price of its drug Vimovo 1,170 percent from 2013 to 2015.

THIRD, desperate to do “something,” the federal government is running around trying to wipe the egg off its face as citizens live through this next revelation of what Obamacare really IS for citizens and what Republican’s pro-business stance really IS for citizens by acting as if they’re “outraged” and seeking to find SOME LAW, ANY LAW or any REGULATION that they can use to “stick it” to Valeant.

VALEANT’s business conduct is the hook that our politicians are using to try to clear themselves and their anti-consumer policies. Whether the allegations and examination lead to some or any finding of wrongdoing is NOT relevant for consumers because it won’t be based on the price hike but instead on some business practice that politicians hope to find Valeant violated. Unless they’re stockholders in the company (the stock has dropped precipitously).

This leaves us where we started…NO LIMIT on what can be charged for prescription drugs, because ultimately VALEANT isn’t the problem, it’s the result of Obamacare and its failure to require that prescription pharmaceuticals be covered by health insurance plans AND that any out-of-pocket expenses for those prescriptions must be included in consumers reaching their out-of-pocket maximum under their health insurance plan. 

Democrats are Doing it to Us Again, Virginia Medicaid Expansion

 Democrats are Doing it to Us Again, Virginia Medicaid Expansion

Far from bringing us closer to universal health care or coverage, Obamacare, a partnership between insurance companies and the federal government created a tepid, minimal requirement for health insurance policies focused largely on the cheap treats, finite costs of free checkups and preventive services, that left those ill arguably in a worse position than before with larger out of pocket expenses in the form of deductibles, copayments and coinsurance and an out of pocket maximum established by the government itself that could crush an individual or family dealing with illness.

While Democrats will pull all sorts of half-informative "metrics" and stats out to "prove" things are better, Obamacare is only a country success in a fairy-tale portrayal that ignores its rotten roots, the very partnership between government and insurers, allowing both to reduce their spending per capita through a variety of means.

But there was an Obamacare bright spot, the expanded Medicaid program that boomed, with states embracing the federal dollars to provide essentially free health insurance and health care not only to the economically disadvantaged, as the program was designed to help, but to an expanded group of those with income and potentially assets as they offered "eligibility" and coverage for those with income and removed any assets test.

But this false narrative has already Obamacized Medicaid. Medicaid program payments traditionally were shared by the states and federal government to provide health insurance and health care to the poorest, sickest individuals in our country. Under expanded Medicaid, the federal government picks up most of the bill, so it's a win for states. But how about the individuals?

Medicaid was designed as a fallback for those who couldn't obtain health insurance, not as a giveaway, or as a change to our healthcare/health insurance system. Governments have always had the right to come after the estates and potentially other assets of Medicaid recipients to help recoup their losses. So why haven't they?

What stopped an endless steady flow of states suing individuals for the Medicaid payments was that oftentimes this was not a money winner for states. After all, by its very nature Medicaid was available to those who had not enough to afford health insurance. Going after these individuals with limited assets was not lucrative for the states, especially since they had to share the money they got back with the federal government, because remember both state and federal contributed to coverage.

In 1993, the federal government decided to make it MANDATORY for the states to go after the estates of those 55 and over who had received Medicaid in order to recoup some of their money. This mandate was necessary for the very reason stated above, states weren't systematically going after the estates of people who were poor and incurring that administrative clog and expense just to recover money they would have to share with the federal government.

Enter Obamacare, expanding who is eligible for Medicaid, meaning that people with means were now eligible for free health insurance and health care within certain income constraints, though any consideration of their assets was put aside. Technically, this meant that someone who owns millions of dollars in assets can get the free treats from government. But remember, the 1993 law is still in place, so their assets are now subject to Medicaid cost recovery by the states on behalf of the states and the federal government.

There was never a free ride, but Obamacare made things worse for individuals seeking a solution to the outrageous costs of health insurance and health care which were not solved by Obamacare at all as evidenced by the explosion of new Medicaid enrollees.

But expanded Medicaid was just another Obamacare band-aid, designed to provide temporary relief so that the government could brag about all the newly insured AND get its money some other way, and it has.

Long before the idea of requiring those receiving Medicaid to work, which makes perfect sense post-Obamacare since Medicaid was changed into a type of welfare entitlement program rather than a government sponsored health insurance program for the poorest and sickest among us, states like New York expanded their definition of "estate" to have access to recover more assets.

Under Obamacare you can be above the poverty level, you can be working, you can have assets, you can be healthy and still be eligible for the program. Calling it Medicaid is a bit of a stretch and Obamacare designers knew it and therefore left the Medicaid recovery rules of 1993 in place, in addition to room for additional state and federal rulemaking to allow or mandate additional recovery options for governments.

It also made such rulemaking much more likely because the federal government pays for the majority of the costs of Medicaid under expanded Medicaid for these increased numbers of newly eligible people.

The drawbacks of this mislabeling of the expanded Medicaid as Medicaid and all the "celebratory" comments for the state of Virginia in the news this week, are a disappointing turn for Americans. Not only does Medicaid NOT offer free healthcare and health insurance, but in fact creates ongoing liability and potential recovery from government but it prevents real policy change to address the untouched health insurance and health crisis problems in the United States today.

Therefore, demand more from your "sources." Celebrating Medicaid expansion in Virginia is as foolhardy as celebrating the passage of Obamacare was based on false narratives. Medicaid is already a government sponsored program that has the tools for governments to recover their costs and those who choose Medicaid are gambling that neither their state nor the federal government will exercise that right.

Who do you contact? Health Insurance Runaround

 Who do you contact? Health Insurance Runaround

Anyone who has tried to contact their insurance provider knows that there are layers upon layers of people, departments and subcontractors to whom they are referred.

Task a day insurance: I learned this one the hard way. Get written confirmation from any "voice" on the end of the line who assures you of coverage after you follow insurance company step of notifying them that you plan to use a specific service.

Be specific, tell them you need a confirmation that authorizes the treatment and reimbursement for that treatment that also includes any other specific hoops you will have to jump through such as receipts. Understand that HIPAA does not always protect you from having to share results from testing..including the results of psychological testing in order to be eligible for reimbursement.

The second thing to know is that subcontractors, for instance companies that handle the assessments of need for long term care are operating as AGENTS of the insurer. This is a good thing because your INSURER is responsible for the actions of its subcontractor in many instances. In reality, the INSURER will try to claim ignorance so make sure every contact you have with the subcontractor is also communicated to the insurer.

It's not ECO friendly, but you need a file, a copy, a written word of everything that transpires.
Some may keep it on their computers, some using loads of paper, but the file is worth it. Don't worry if it's not perfect, keep the paperwork.

The answer to the RUNAROUND is that TURNAROUND is fair play. Start your own campaign of writing and notifying your insurer. For you, it will only require sending additional copies of your communications. If you think something fishy is going on allege it, you're probably onto something and as long as you insert the words, I believe it seems like....you're fine.

Make these papers part of your PHR. The PHR, the personal health record is encouraged to put the onus on patients to keep track of their medical prescriptions, conditions, etc. The good news is that a lot of this will be taken care of by keeping track of your money because insurance statements include what you were charged for in the first place

Obamacare Lawsuit More Politician Showboating

 Obamacare Lawsuit More Politician Showboating

No doubt you'll have read the headlines about the Texas led lawsuit challenging the constitutionality of the Affordable Care Act based on the Republican move to lower the individual mandate tax from its current levels to zero in 2019, effectively getting rid of any federal penalty for not having health insurance. Full stop. For consumers, who cares?

Though courts do nutty things, they're usually not cutting edge, they're often a day late and a dollar short when it comes to their pronouncements and those pronouncements are usually pretty narrow, so it's extremely unlikely that anything but the individual mandate will be considered and it likely won't be considered "unconstitutional" but will remain dormant until Democrats get in power and in their budget change the $0 penalty back to a dollar amount. We'll leave that to the legal wranglers.

More frustrating for consumers is another lawsuit about government money, not about either fixing or getting rid of Obamacare. After all, where did that $3 billion in individual mandate fines paid to the IRS go? The government can't tell us. Even the Obamacare facts website doesn't explain where taxpayer individual mandate fine money goes, it's just another taxpayer petty cash pot of money available to be spent by the federal government.

For the partisans arguing about how big a deal the individual mandate lawsuit is, it's not. Insurance companies already have a Republican approved idea for sticking penalties to consumers who don't purchase their product, continuous coverage provisions.

Continuous coverage provisions are where insurance companies penalize individuals who didn't purchase their product in the prior year by way of higher premiums. In some ways this could actually be worse than Obamacare if the partisan showboaters don't address a money and time limit on such continuous coverage penalties.

For the backwards-looking Democrats trying to resurrect the idea that it was only through the individual mandate that insurers could capture those least likely to purchase their product, the young-healthies, no one should take that seriously because when it came to using young people as a tool in kowtowing to insurance company, Obama and Obamacare failed.

FIRST: Young-healthies did NOT take one for the team and enroll in silver-level plans to help fulfill the myth of the single risk pool. They did not think it was way cool that they could be charged more based on the Obamacare ratio of 3:1 rather than 5:1, meaning that the prices charged to old people could only be three times as much as those charged to the young instead of five times the amount charged to the young. Don't take my word for it, look at the facts.

SECOND: After dismal enrollment by the young-healthies in their silver-level plans, healthcare.gov, CMS and insurance companies complained that young people were purchasing the cheaper bronze plans even though they wouldn't get the cost sharing benefits available to lower income Obamacare participants who purchased silver plans. Young people were right…If you're earning money and you're a young-healthy, attractive to insurers because you're less likely to need to use your insurance, why would you pay extra for a possible benefit in the event you needed to use your insurance? It made little sense.

THIRD: The government had a new idea and for subsequent benefits years to strong-arm the young-healthies by raising the price for silver plans less than they raised the price for bronze plans, so now it would seem logical not to pay the bigger increase in the cost of worse plans and maybe the young-healthies would reconsider the silver plan alternative. Nope, it didn't work.

FOURTH: The Obama Administration made a last-ditch effort to compel young-healthies' participation when CMS essentially outlawed the use of short term health insurance plans making individuals liable for the individual mandate tax penalty if they had such health insurance, specifically addressing the use of such plans by young-healthies.

FIFTH: When Hillary Clinton started her failed campaign for President, her idea was to pacify the unhappy insurance companies who even with the individual mandate complained they needed more enrollees by proposing to violate the citizen or legal resident participation rule of Obamacare and change it that anyone, legal or not could buy into Obamacare.

Further, Obama's government deal with insurance companies missed their best bet on getting young-healthies to participate in more expensive plans and that was through their employed parents. Older people purchase more expensive health insurance plans and their families enroll in these same plans when they are added as dependents.

While "allowing" the employee class to cover their grown children's health insurance up to the age of 26 on their own employer-provided health insurance, the stupidity of Obamacare is that it actually discouraged parents from doing so in two ways.

FIRST, for their under-employed children, enrollment in Obamacare bronze plans was likely cheaper than what parents would pay for these grown children as dependents on their more expensive health insurance plans. It would make more sense for these grown children to purchase their own plans and for parents to provide funds for such plans than to carry them on their parents' insurance.

SECOND, the increased costs for copayments, coinsurance, and deductibles in addition to overall premium price increases made these employer plans less attractive and feasible as an alternative for grown children, in the worst cases becoming casualties of the family glitch where dependent coverage became unaffordable to workers, thereby leaving grown children on their own who purchased the cheapest plans they could.

Real Consumer Fix: The primary consumer fix to health insurance costs as a barrier to rather than a means of obtaining needed health care and health services is a governmentally set out of pocket maximum and a dollar for dollar income tax credit for any and all medically-related expenses whether they are for insurance plan covered expenses or not.

CMS gets to determine our out of pocket maximums each year. This is the OOP maximum and sadly has reached levels that can leave most families broke if they're paying for needed medical care and services. Obamacare's OOP rates illustrate the problem, from 2015 self-only coverage limits of $6,600, family coverage limits of $13,200 to self-only coverage of $7,350 and family coverage of $14,700 in 2018.

Remember Obama's deal with big pharma to leave them free from regulation and that prices have gone up 10X the rate of inflation AND that insurance plan formularies are excluding more and more of these potentially life-preserving and life-saving drugs making them ineligible as part of your OOP, and you can see the problem. Insurance companies should not be able to partner with government to exploit individuals' healthcare needs by ignoring the costs of these needs and disallowing them from contributing towards an individual or family OOP. Similarly, deductibles, copayments and coinsurance costs would all contribute (as they often do) to the OOP.

The biggest reform needed is to bring the OOP down to a percentage, just like costs of health insurance, not exceeding X percent of a household's income, PERIOD. The second step is to prohibit the exclusion from OOP calculation of any needed medical service or product, PERIOD. This would protect consumers in two ways, first allowing them for the first time ever to calculate the potential costs of healthcare per year and second would incentivize insurers to stop excluding from coverage more expensive items and treatment or people with pre-existing conditions.

The individual mandate is simply political partisan showboating. Not a single one of the public officials who today are reaping the benefits of taxpayer funded health insurance and superior benefits off our backs could care less about consumers. We have an opportunity to learn from our mistakes and read through the doubletalk and we shouldn't miss it. 

The Mentally Ill Platform of Today's Democrats Should Worry Everyone

I do not treat mental illness lightly and unlike Democrats like Hillary Clinton who constantly accused her detractors as "crazy," I also don't casually use that word. But I'm using it here for the warning signs that Democrats, as a group, are becoming the party of delusion and that having failed to win an election as the party of illusion, and without some influx of rational thought are becoming dangerous.

This is a mental health issue and the Democratic verbiage that is threatening the lives of others is a well understood sign of mental disorder…Not free speech, not opinion, not dialogue, a hallmark of mental illness: Representing a threat to themselves and others.

It began with Obama, whose ability to maneuver timing and sales strategies and enabled him to win a second term using both skills despite the bomb of Obamacare with its most draconian pronouncements perpetrated against consumers taking effect in 2014, four years after its passage and neatly after a second election win.

The endless deceptions and lies to the American public earned Obama a winner of telling the LIE OF THE YEAR in 2013, "If you like your health care plan you can keep it." Credibility for Obama was not regained by those who didn't buy into his salesman pitch because reality did not match what he'd said on Obamacare and other issues.

Obamacare was Democratic illusion at its best. But as Hillary Clinton realized she couldn't just ride Obama-style coattails to get elected, after all, the Obama created illusions were already cracking under undeniable reality, Democrats turned from illusion to delusions.

Suddenly the political Democratic tale-spinning that had worked so well to convince voters, as Obama pal and Obamacare architect Jonathan Gruber advised on how Obamacare passed because of the "stupidity of the American voter," wasn't working. Instead, en masse, Democrats started believing that all non-Democrats were "Nazis," or stupid or as Hillary often said, "Crazy."

Democrats too far gone to know better believed President Obama who bragged that Trump was "Unfit," another mental illness warning sign of not of Trump's but Obama's own mental fragility which though requiring professional treatment for specific diagnosis could be rooted in him being an abuser or merely projecting, where Obama was seeing his own incompetencies as President in Trump.

The delusion was complete as media fancifully predicted the "sweep" for Hillary, blaming false "metrics," or false information, or Russian conspiracy instead of the obvious that regarding a "win," saying it just didn't make it so.

Suddenly the "Party of Tolerance" en masse was calling anyone who disagreed with them on anything deplorables, the phrase coined by their candidate and a glaring example of the intolerant, backwards, rambling in language of prejudicial judgmentalism that combined with their Obama years conduct indicated the sheer intolerance, small mindedness and dishonesty of the Democratic Party that so obviously contradicted their claims of tolerance and progressiveness that many Democrats simply couldn't vote for Clinton. I could not.

Defeat exacerbated the party's mental illness to where Democratic expressions of hatred and incitements to violence were tolerated at best and oftentimes supported by Democrats as they watched their most outspoken fans embrace the madness. Robert De Niro, bully in chief, using his bully pulpit to express hatred in foul-mouthed rants. Kathy Griffin and her beheaded Trump. Last year's Shakespeare in the Park criticizing Trump via the play Julius Caesar.

This has been the trajectory of the Democratic Party and to me it's a frightening trend indicating that the Democrats of today and their party represent a threat to themselves (as it becomes harder and harder to defend their conduct let alone vote for them) and others.

And so we get to Peter Fonda and Pat Dussault, and naturally, Melania Trump's jacket. Days after mentally ill advocacy for pedophilia and for pedophilia against a President's child, using the threat to others standard, Peter Fonda's lukewarm apology was considered by the Dems as enough of a reason to stop covering his threat against the President's child, advocating for his kidnap and placement in a cage with pedophiles, and even inspired Fonda supporter Democrats like Pat Dussault who threatened "we're" coming for Donald Trump Jr.'s child Chloe.

For me, the pessimistic ugly Democratic truth is more obvious in Peter Fonda's "apology" asserting, "I tweeted something highly inappropriate and vulgar about the president and his family in response to the devastating images I was seeing on television."

Apparently what Peter Fonda saw was children being ripped from mothers and being put in cages with pedophiles. And perhaps there are some pedophiles in the population of illegal migrants, that's not an indictment of all illegal migrants, that's a fact of populations, they are diverse and include all kinds and it's also the rational reason why we do scrutinize individuals with children rather than argue that the children should be left with adults, who no doubt aren't all loving and who no doubt aren't even all their "parents" amongst a population of other unvetted adults. In fact, Peter Fonda was arguing for separation of children from unknown adults.

Yet, not surprisingly there's more news coverage and Dem "outrage" about Melania Trump's jacket which said, "I don't care. Do U?" than there has been about the horrendous barbarity of today's Democratic spokespeople.

Let's say you're in the Democratic delusion where everyone who disagrees with you is a crazy, Nazi deplorable, from that dark viewpoint the First Lady's jacket could only "mean" one thing, she doesn’t care. But let's say you're a sane person who knows that the First Lady's child was threatened with kidnapping, child rape and brutalization, as was her niece AND you were trying to raise children who would have to deal with bullying of this and other kinds during their lives…What might you say?

Might you follow the stopbullying.gov website's advice to children who are being bullied and model that behavior? That site advises: "Look at the kid bullying you and tell him or her to stop in a calm, clear voice. You can also try to laugh it off. This works best if joking is easy for you. It could catch the kid bullying you off guard." Might Melania's jacket be a message to her child about the uncivilized assault he'd just faced, a reassuring mother modeling that she too is bullied and ignores it, or jokes about it rather than is crushed, depressed or becoming suicidal about it?

Barron Trump is 12 years old, a vulnerable age for children without having to put up with Peter Fonda talking about how they should be raped as he feeds the Democratic delusion of "tolerance and progressiveness."

I am ashamed of the way people are speaking about our President, his family and his supporters and I hope that at every level we begin to encourage treatment and healing for the party of delusion and its dangerous policies derived from their pessimistic world of hate, contempt and intolerance, and that's the Democrats. 

AIA, Aviva, AXA

AIA, Aviva, AXA, Great Eastern, Income, and Prudential are likely to raise premiums on Singapore’s Integrated Shield Plans (IPs) after they suffered underwriting losses in 2017.

According to their financial returns, the six insurers have been suffering losses on their IPs since the launch of MediShield Life in November 2015.

Their combined losses reached S$390 million (US$286 million) last year, primarily due to AIA’s S$284 million deficit.

Only Income and Prudential experienced a dip in claims ratio last year from the year before, which helped softened the blow because of lower claims against premium income.

According to a study conducted by the Life Insurance Association (LIA) Singapore, average inpatient claims in private hospitals have expanded 8.1% in recent years.

This is in addition to a 7% compound annual growth in claims frequency for private hospital Integrated Plans.

Insurers in Singapore likely to raise premiums after losses

AIA, Aviva, AXA, Great Eastern, Income, and Prudential are likely to raise premiums on Singapore’s Integrated Shield Plans (IPs) after they suffered underwriting losses in 2017.

According to their financial returns, the six insurers have been suffering losses on their IPs since the launch of MediShield Life in November 2015.

Their combined losses reached S$390 million (US$286 million) last year, primarily due to AIA’s S$284 million deficit.

Only Income and Prudential experienced a dip in claims ratio last year from the year before, which helped softened the blow because of lower claims against premium income.

According to a study conducted by the Life Insurance Association (LIA) Singapore, average inpatient claims in private hospitals have expanded 8.1% in recent years.

This is in addition to a 7% compound annual growth in claims frequency for private hospital Integrated Plans.

Singapore life insurers post 14% rise in Q1 sales

Singapore’s life insurance industry started 2018 on a positive note, having recorded a 14% rise in weighted new business premiums in the first three months of the year, according to the Life Insurance Association (LIA) Singapore.

Data released by the association showed that the country’s life industry recorded a total of S$925.1 million (US$692 million) in new business premiums, with linked policies recording the highest growth of S$208 million, an 82% rise from the same period last year.

For single premium products, the industry recorded S$282.3 million in weighted single premiums, a 0.4% from last year.

At March 31, 2018, the life insurance industry paid out S$1.30 billion to policyholders and beneficiaries.

Of this amount, S$1.06 billion was for policies that had matured.

The remaining S$237 million was for death, critical illness or disability claims, the LIA Singapore report showed.

Insurers in Singapore likely to raise premiums after losses

AIA, Aviva, AXA, Great Eastern, Income, and Prudential are likely to raise premiums on Singapore’s Integrated Shield Plans (IPs) after they suffered underwriting losses in 2017.

According to their financial returns, the six insurers have been suffering losses on their IPs since the launch of MediShield Life in November 2015.

Their combined losses reached S$390 million (US$286 million) last year, primarily due to AIA’s S$284 million deficit.

Only Income and Prudential experienced a dip in claims ratio last year from the year before, which helped softened the blow because of lower claims against premium income.

According to a study conducted by the Life Insurance Association (LIA) Singapore, average inpatient claims in private hospitals have expanded 8.1% in recent years.

This is in addition to a 7% compound annual growth in claims frequency for private hospital Integrated Plans.

Insurers in Singapore likely to raise premiums after losses

AIA, Aviva, AXA, Great Eastern, Income, and Prudential are likely to raise premiums on Singapore’s Integrated Shield Plans (IPs) after they suffered underwriting losses in 2017.

According to their financial returns, the six insurers have been suffering losses on their IPs since the launch of MediShield Life in November 2015.

Their combined losses reached S$390 million (US$286 million) last year, primarily due to AIA’s S$284 million deficit.

Only Income and Prudential experienced a dip in claims ratio last year from the year before, which helped softened the blow because of lower claims against premium income.

According to a study conducted by the Life Insurance Association (LIA) Singapore, average inpatient claims in private hospitals have expanded 8.1% in recent years.

This is in addition to a 7% compound annual growth in claims frequency for private hospital Integrated Plans.

Insurers in Singapore likely to raise premiums after losses

AIA, Aviva, AXA, Great Eastern, Income, and Prudential are likely to raise premiums on Singapore’s Integrated Shield Plans (IPs) after they suffered underwriting losses in 2017.

According to their financial returns, the six insurers have been suffering losses on their IPs since the launch of MediShield Life in November 2015.

Their combined losses reached S$390 million (US$286 million) last year, primarily due to AIA’s S$284 million deficit.

Only Income and Prudential experienced a dip in claims ratio last year from the year before, which helped softened the blow because of lower claims against premium income.

According to a study conducted by the Life Insurance Association (LIA) Singapore, average inpatient claims in private hospitals have expanded 8.1% in recent years.

This is in addition to a 7% compound annual growth in claims frequency for private hospital Integrated Plans.

Swiss Re: SONAR 2018 – A peek into the future?

Catching emerging risks is a bit like catching fog. Some drops will turn into water nurturing new risk pools while others just evaporate as they won’t hit the ground. But all risks have the potential to impact not only the insurance industry but also society as a whole. So it’s worth looking at them carefully. Swiss Re’s latest SONAR report draws on the company’s unique in-house risk management expertise to chart the progress of evolving risks that could spell both opportunities and dangers for the insurance industry in the future.

Growing geopolitical tensions, the re-emergence of the asbestos threat, cyber risks and new technology, biased algorithms and the erosion of risk diversification are just some of the key themes identified in this year’s SONAR report.

Fast developing technologies can also have broader implications for our general wellbeing. They can exacerbate sleep deprivation, undermine human skills or have both beneficial and negative impacts as in the case of cryptocurrencies. These are some of the additional emerging risks discussed in this publication

Singapore life market posts double-digit growth

Singapore’s life market posted double-digit expansion in the last two years, according to the managing director of the Monetary Authority of Singapore, Ravi Menon.

Speaking at a media briefing on Wednesday, Menon noted a job growth in the city that was largely fuelled by the insurance and fund management sectors, along with the banking industry to some extent.

Singapore’s life insurance market expanded 16% per year over the past two years. On the other hand, non-life insurers experienced more sluggish growth at just 2% per year owing to the excess capacity in this area.

According to Menon, Singapore will strive to maintain its attractiveness in the field of reinsurance.

In order to achieve this, MAS will push into alternative risk solutions such as risk pools and insurance-linked securities

Who qualifies for medical-expense tax deductions

No one wants to be ill, but at least Uncle Sam gives Americans a little relief in the form of federal income-tax deductions for medical expenses.

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"Medical bills can be a huge expense, so the Internal Revenue Service gives people a break so they can recoup some of that money," says Lisa Greene-Lewis, a certified public accountant with TurboTax.

But who can deduct what can be complicated, and experts say few taxpayers fully understand the rules.

Here's a look at the basics of deducting medical expenses from your federal income taxes. Consult your tax adviser for specifics regarding your personal situation.

Who qualifies for medical-expense tax deductions?

The Internal Revenue Code includes two important rules that can limit who truly qualifies for relief from medical expenses:

• You must generally itemize deductions on Form 1040 Schedule A rather than take the "standard deduction" if you want a break on medical expenses. If what you plan to deduct for everything (from medical bills to mortgage interest) adds up to less than the standard deduction ($6,350 for singles, $9,350 for heads of household and $12,700 for married joint filers for tax year 2017), there's no point in itemizing.
• Taxpayers can only deduct allowable medical expenses that exceed 7.5 percent of "adjusted gross income" (AGI). That's the amount you earn in a given year from wages, investments and other sources minus what you paid for alimony, student-loan interest and a few other things. So, if a married couple has $100,000 AGI and $8,000 of qualified medical expenses, they can deduct only $500--$8,000 minus $7,500 (7.5 percent of their $100,000 AGI).

Are health insurance premiums tax deductible?

Yes, in certain circumstances, you can deduct your health insurance premiums as part of your overall medical expenses.

But you can deduct only premiums that you pay with after-tax money from your own pocket. For example:

• If your health insurance premiums are paid entirely by your employer or the government, you cannot deduct the cost.
• If you have health insurance through your employer and your share of the premium is deducted from your paycheck pre-tax, you cannot deduct the cost because the premiums were tax-free already.  If you don’t know whether you pay pre-tax or after-tax, ask your human resources department.
• If you buy health insurance through the state- or federally run health insurance marketplaces, you can deduct only the portion of the premium you pay out of your own pocket. You cannot deduct the amount of any subsidy.
• If you buy an individual or family health insurance plan, either on the open market or through a marketplace, and you pay all of the cost out of pocket, then the whole amount is deductible.
• Your total medical expenses, including premiums, must surpass 7.5 percent of your adjusted gross income to be deductible.

For 2017, the self-employed have several deductions and tax credits they can use. For detailed information, visit the self-employed health insurance deduction 2017 section of the federal Affordable Care Act website.

What other medical costs are tax deductible?

Assuming you pass the above tests, the IRS lets you write off pretty much every out-of-pocket medical expense that's ordered by a doctor or other health care professional. (See IRS Publication 502 for a list.)

Common items you can deduct from taxes include medical appointments, tests, prescription drugs and durable items like wheelchairs and prescription glasses. In fact, you can even write off unusual expenses if they're medically necessary.

You can also deduct transportation expenses for going to the doctor -- parking, tolls, mileage, cab or bus fares -- and even air fare and certain lodging costs for out-of-town treatments.

But remember, you can only write off out-of-pocket expenses -- copays, deductibles, etc. -- not bills that your insurance covers.

What heath expenses are not tax deductible?

There's a wide list of things you can't deduct, from medical marijuana to over-the-counter vitamins and drugs (except insulin). Hair transplants and cosmetic surgery are also out, unless procedures correct underlying medical problems (like breast-reconstruction surgery following mastectomies).

As noted above, you also can't deduct expenses that your insurance covers, nor things you paid for with money from a flexible spending account or health savings account. If you get insurance through work, you typically can't write off your share of the premiums because your employer won't normally withhold taxes on the money in the first place.

Writing off health insurance for the self-employed

One big exception to the above rules involves health insurance premiums paid by self-employed people. You can write those off as adjustments to income even if you don't itemize your deductions. The adjustment to income cannot exceed what you earned, though.

Self-employed people can deduct health insurance premiums directly on Form 1040 (Line 29 on returns for the 2017 tax year). You deduct all other qualified medical expenses on Schedule A, Line 1.

How to maximize your health care deductions

You obviously can't control when you get sick, but Greene-Lewis says Americans who are close to meeting the annual AGI threshold should "bunch up" procedures to maximize any deductibility.

For instance, if one family member has a major illness in a given year and rings up big hospital bills, everyone else in the family should get any needed dental work, prescription eyeglasses, etc., during the same year in order to boost the available tax break.

"You should look at anything you were putting off and bump it up [to the current tax year] if that's going to put you over the AGI threshold," she says.

You don't need to attach receipts to your 1040, but it's a good idea to keep them for three years after filing your return just in case the IRS audits you.