Let me help Rick Moran out a little bit, because he seems confused about what Lori Gottlieb claimed and how I concluded that she is a liar. Let’s go very slow. Here is Ms. Gottlieb’s opening:
THE Anthem Blue Cross representative who answered my call told me that there was a silver lining in the cancellation of my individual P.P.O. policy and the $5,400 annual increase that I would have to pay for the Affordable Care Act-compliant option…
What can we learn from this?
She talked to a representative of Anthem Blue Cross who (she claims) provided her the information she relied upon for her column. She was told that her old plan was cancelled because it was not compliant with the Affordable Care Act‘s requirements for minimal coverage. She was told that she would have to pay $5,400 more annually for a compliant policy than she had been paying for a non-compliant policy.
Mr. Moran raises some questions about my analysis:
What if she doesn’t want the Bronze Plan? What if her insurance company was being accurate when she asked how much a similar plan as the one that was cancelled would cost on the exchanges (Silver or Gold)? What reason would the insurance company have in lying to her when, if she chose, she could go to the website and find out herself?
We don’t know.
Here’s my response:
1. She told us how much it would cost her to buy a compliant plan, not an equivalent plan. They are no equivalent plans because her old shitty policy was so horrible that it is now illegal to offer people such crap. If she wants something better than a bronze plan, that’s wonderful, but no one is forcing her to pay more than necessary. And she has no business comparing the cost of a Silver or Gold plan to the cost of a plan that was so bad that it is now banned. In other words, the bronze plan is better than what she was getting in terms of costs and basic protections, although she may have legitimate beefs about doctors who are now out-of-network. Regardless, as we shall see, even with a Gold plan, she’d still be a liar.
2. Using the assumption that Ms. Gottlieb has two children, I discovered she could buy the L.A. Care Covered Bronze 60 plan for $426/mo or $5,112/yr. I understand now that she only has one child. Here are the quotes I am getting today from the California exchange for a 46 year old woman with one dependent child living in Los Angeles County with an income of $80,000:
Bronze: L.A. Care Covered Bronze 60: $328/mo, $3,936/yr
Silver: Health Net Silver 70: $408/mo, $4,896/yr
Gold: Health Net Gold 80: $461/mo, $5,532/yr
Silver: Health Net Platinum 90: $520/mo, $6,240/yr
Obviously, if your Gold policy only costs $5,532/yr, it cannot possibly be $5,400 more expensive than your old plan. It appears that she is quoting the price for a gold plan but reporting it as the size of the increase in the price.
3. Maybe some representative of Anthem Blue Cross actually told her that she’d have to spend over $5,000 more for a policy. Maybe they were trying to rip her off. Let’s have the police investigate that. But it’s more likely that Ms. Gottlieb is just a big fat liar.
I’ll take the charitable view again and assume Gottlieb is accurately recounting her conversation with Anthem. That said, wouldn’t simple curiosity prompt her to investigate whether the price quoted by Anthem is typical of offers from the competition?
Don’t you think it’s probably not a coincidence that a Gold Plan would cost her almost exactly as much as she said the plan quoted to her would increase her bill?
In other words, the cost of a Gold Plan for her is about $5,500, and she said the increase would be $5,400.
At best, she totally misunderstood the conversation.
But she had to know that a Gold Plan is significantly better than her old plan and in not equivalent. She also had to know that both Bronze and Silver plans are available and both are compliant.
It’s a big bunch of lie.
Its puzzling.
If you knew you were lying, how would you think some Boo Man wouldn’t come along and light you up? If you were someone like this woman, who has had a NYT nonfiction bestseller, been involved in tech startups, etc, how could you just take Anthem at their word especially before going out on an op-ed limb?
And how can the NYT not check this? Do they not check op-eds? Do they just let them hang themselves if they are so stupid as to put forwards easily disprovable statements?
Christ, when my wedding announcement ran in the Times, a fact checker called me to go over it!
This should come to the attention of the Times public editor. This sort of FUD is being seriously unhelpful.
The Anthem rep probably pitched the most expensive plan at her and certainly didn’t mention the competition’s price. You have shopped for cars, haven’t you, Boo?
Bravo! Absolutely! Tell ’em, Booman!
Two different companies, two different quotes. No rip-off. No lies. It’s like Bigger’s Chevrolet quoting me $4,000 more than Castle Chevrolet for an Impala that differed only in color.
In Illinois, Blue Cross offers four Gold plans on the Exchange. From the cheapest to the most expensive there is approximately a 50% increase in premium. I doubt if those Exchange Chevrolets had the same equipment even if they were Impalas and not Malibus or Sonics.
One of the gaping holes that must be fixed is that all plans at the same metal level are not the same. They should be standardized plans. We still cannot compare plans without an insurance expert and a statistician by our side. For example, in the FEHB, Blue Cross offers two plans, Standard and Basic. Basic covers drugs better than Standard. Standard covers hospitals better than Basic. Will I spend more next year on drugs than hospitals? Who knows? Unless plans are standardized with each level covering the same or better than the lower levels, who can intelligently choose. I, like many of my colleagues, choose Blue Cross Standard because it is the most expensive, on the theory “you get what you pay for”. But, sadly, life has taught me that rarely do you even get that.
Someone is going to post that plan brochures are available. I would have to read four 200 page documents written by lawyers just to compare the Blue Cross plans alone, not considering any other company’s plans.
If the Democratic Party wants to give Insurance Companies their vigorish in exchange for campaign contributions, okay. But those plans offered should cover 100% of everything. No co-pays for drugs, doctors, or hospitals. That’s the way insurance was in the ’60s, except that procedures in doctor’s offices were not covered. But 100% of hospital charges, 100% of doctor’s charges for hospital work, and 100% for prescription drugs, the drugs your doctor ordered, with no distinction for generic or non-generic, no ‘tiers’ of payment. When my daughter was born, it cost me zero, nada, goose egg, for medical charges. It cost me $1 for television (now included in room charges, not then) and $10 (rip-off) for some disposable diapers and wipes that they shoved at me at the last moment, saying, “Here! Here’s your baby kit.” With inflation, that would be $110 today, but it was optional, even if they led me to believe it was included.
I turned 65 this year and what is going on with ObamaCare is very similar to choosing an Advantage or Supplemental Medicare plan, also called a health exchange.
Since I was totally new to the idea I asked for assistance from the local agency on aging and talked to a wonderful woman who walked me through the process. It still took me a couple of months of looking through the options, deciding what was important to me, what I could afford, procrastination, and then finally making my choice.
I use homeopathics for the most part and rarely go to a doctor. I have the bronziest of bronze plans with minimum monthly cost, but it provides all kinds of benefits if I need them. My choice was perfect for me. There is an open period each year and I have until Dec. 7 to review and choose again if I want. Guess I should stop procrastinating.
When I hear people complain it really reminds me of the grumping I went through. I think we are used to choosing and insurance company and letting them tell us the plan that fits or just taking whatever the employer offers. We’re not used to making the choices available now.
I don’t mind making the choices when Coverage A > B > C > D with prices a > b > c > d. But when A >B for some things but B > A for others with C > A | B on others but C < A & B on others, it means I have to predict the future accurately with is against all arguments for having insurance. If say State Farm’s policy is better for Fire and Allstate’s policy is better for Hail and Wind damage, but Country Company is better for Flood but worse than the others on Fire and Hail, what do I choose? It’s not like Virginia where HO-2 is better than or the same as HO-1 and everyone’s HO-1 and HO-2 is exactly the same as everyone else’s. Then I can choose based on price and service reputation.
BTW, as a trained Scientist (BS Physics I.I.T. 1967, MS Physics lacking only a dissertation for PhD UMD 1979) I can tell you that the theory behind homeopathy is completely irrational.
Forgot to add that in the Medicare Advantage/Supplement market there will be plans by the same company with different benefits at the same level. It’s a matter of looking at the options and deciding what is most important.
IOW predicting the future. I’m planning to keep my FEHB Blue Cross into retirement as my supplement/Part D, it’s only about $10 a month more, is familiar, and doesn’t increase in price with age as the other supplements do (because the group is all current and former federal employees).
But my understanding was all Plan F’s had the same coverage, all Plan A, B’s etc had the same coverage regardless of company. Are you telling me I was wrong about this?
Maybe she’s the sort of woman who is incompetent when it comes to math.
Like my wife? Ow! Ow! Ow! I’m sorry, Honey. That just slipped out.
She’s in California? Anthem? Is it this company? This article was about tricking people to drop their grandfathered insurance policies. Don’t know if this fits her situation, but they certainly aren’t acting ethically.
Major Insurance Company Faces Lawsuit For Allegedly Tricking Customers Into Canceling Their Policies
http://thinkprogress.org/health/2013/11/07/2906861/major-insurance-company-lawsuit/
…California’s Anthem Blue Cross may have convinced their customers that they fall into the second category — even though they’re actually in the first.
“Blue Cross successfully enticed tens of thousands of its individual policyholders to switch out of their grandfathered health plans and forever lose their protected grandfathered status,” states the lawsuit. “Blue Cross concealed information about the consequences of switching plans and intentionally misled its policyholders to encourage the replacement of grandfathered policies.”…
This was my first thought. I wish these people would give a better breakdown of their finances.
One person on DKos did.
keep on it, BooMan.
keep on it.
Gee, the insurance companies called in all their favors, got their bought-and-paid-for elected officials to make good and sure that they still had their seat at the head of the table when it came to the health care banquet. Then, after all that, they decided that the best business plan under the new regime was the same as it was under the old: Lie to policyholders, jack up premiums, pay any piddling fines that might be levied after years of investigation, screw the public and the providers, and fatten up their bottom lines.
Insurance companies cheating the public! It’s just unheard of, so there must be another explanation. I mean, all you people are total experts at navigating the anti-matter language of insurance policies, right? So there should be no problem deciphering three and four levels of poorly-defined and -differentiated terms.
Yup.
Is his last name actually Moran? Maybe he should think about a pseudonym…
If all Morans did so, half of Counties Mayo and Roscommon would be travelling under aliases.
The Morans of Mayo? Sounds like a surefire reality TV hit to me.
If you want both the Hibernian and Ulster defamation league on your neck, it’s a great reality TV show.
Hmm, sounds dangerous. Maybe I’ll get a co-producer.
Is that the sequel to St. Elsewhere?
Three things about a high percentage of LA psychotherapists:
I was once an accounting intermediary between two psychotherapists. One day, the first called me in exasperation with the second and said, “She’s so weird about money.” Thirty seconds after ending the call with the first one, the second called and at some point also said, “She’s so weird about money.” Both were correct. They both overestimated their billings, overspent based on their income, and carried huge amounts of consumer debt on their credit cards.
Remained on friendly terms with many of them after they “fired” me when it became apparent to them that I didn’t meet the #3 criteria.
Gottlieb is probably less a liar than a financial incompetent. She heard something that she could run with to publicly criticize the PPACA. And possibly make a few bucks and raise her public profile in the bargain.
I do feel sorry for her psychotherapy clients.
Better tell this information to Mary Landrieu because she’s suckering Democratic Senators into a stupid rollback bill based on this hysteria.
Can depend on Sen. Landrieu to help the insurance companies keep their profits.
Is she suckering Dems or finding fellow spineless ones? DiFi jumped on to this. Why? And Jeff Merkley? He’s the one I really don’t understand.
Well, true or not this information is really really hurting Obama. 44-52% believe he’s trustworthy, approval now at 39% in two polls by different companies.
When does that matter again politically, really? Tangentially to the 2014 election, maybe. But who takes those things seriously for a second-term President?
Well like it or not, Obama is still the face and leader of the Democratic party to the public. It also creates a slightly larger reservoir of public support for republican opposition.
Also this
http://talkingpointsmemo.com/livewire/poll-democratic-lead-erased-on-congressional-generic-ballot
Without considering the context of those numbers – the contrast with the same ratings of the GOP and congress – it looks horrible. But I like context.
In addition, Obama’s approval is being hurt by liberals who are pissed off that Obamacare isn’t being implemented fast enough or well enough. That’s a very different bunch than teabeggers who want everyone to trade chickens for appendectomies.
I predict that by about Feb/March of next year, if the signups are fully open and on track for a couple of months by then, we’ll see a huge spike in approval, mainly from liberals and indies. Conservatives won’t like him no matter what.
You have a good observation there. I guess Lori should have been more detailed with what she is explaining or better yet, had a good understanding to the policies because it is really complicated and need to think deeply about the plan you are about to buy. But she should not buy one she cannot afford.
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physical therapy clinic
Heard on ABB7 News this AM, that Bill Clinton has come out saying that the ACA should be amended to allow people to keep worthless crap insurance because Obama promised them they could. I was stunned. This is the lowest thing he has ever done. I won’t forget it in 2016.
Yeah, that was a stupid move on his part. However, it might be the beginning of the Hillary Distancing Campaign which is inevitable.
Figured that out at morning break. The Clintons are distancing themselves from Obama. If they are doing it by a right turn, I want no part of them.
This women needs to be deposed in the lawsuits against Anthem. On its face, it appeared Anthem misled her about her options, so it is relevant evidence. If her deposition tells a different story than her column, that is news, and both the NYT and the Atlantic can be called to answer for her honesty. If she fights the deposition, that also says a lot. A fight over could be news for some time, as there are several discreet steps involved, and the upshot is likely to be this woman forced to admit that she has been lying, and the NYT to admit that they published it. THat would be a much more edifying narrative regarding the rollout than what we have been getting. Alternatively, it would give much more publicity to Anthem’s dishonesty, though I am with Booman in being more suspicious of the author.