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15 января, 00:30

Mad As Hell

Submitted by Chris Martenson via PeakProsperity.com, Fair warning, my family just received a 61.5% increase in our healthcare insurance premium of 2017, on top of last year’s 24.8% increase, so I am quite annoyed at the moment.  For my non-US readers, perhaps what follows will interest you as a means of understanding how and why Donald Trump came to be elected President.  I am going to be channeling some of my inner crank today. If you want to understand why Trump won the recent US presidential election, you can't overlook the economic data.  If you do, his victory may look mighty confusing, alarming even.  But once you understand the degree to which the average US family and the entire Gen-X and Millennial generations are being completely hosed economically, everything starts to take shape. As most struggling Americans can tell you, real household income has gone nowhere for more than 20 years: This multi-decade burden of "running ever faster just to stay in the same place" is what led many US voters to reject Hillary Clinton, the establishment candidate, and instead roll the dice on the iconoclast promising to upend the system. But if Trump's plan to “make America great again” means a return to the 1980s and 1990s when median real incomes climbed smartly, he’s not going to be able to pull that rabbit out of the hat, I’m afraid.  None of the conditions in place then are with us today including cheap, abundant energy (remember, oil was $10 a barrel in 1998); not to mention that we were riding the tailwinds produced by all of the gains from the early, explosive stage of the technology and internet revolutions. Instead, we're at a stage where the pie is no longer expanding -- it's now a zero-sum game where those with power are using their advantage to continue to increase the size of their slice at the expense of the rest of us. The US now routinely subjects its citizens to racketeering, charging excessive prices that are increasingly cumbersome to avoid. One example among thousands; a Viagra pill that costs less than $1 in India, costs over $38 in the US: (Source) Cell phone plans in the US are 2x to 3x more expensive (and more limited in terms of both data and speed) than any of the other countries I’ve traveled to in the past few years.  A phone bill from AT&T in Hong Kong is a single page long and clearly explains how your unlimited high speed plan ended up costing you around $30/mo. In contrast, my bill from the same company in the US runs about 30 pages, and seems intentionally opaque in helping me understand why I'm spending over $100/mo for a limited data plan with much slower speeds. There's no good reason for this except that in the US, companies have learned they can get away with predatory tactics by “wearing down” customers with gigantic, indecipherable billing statements. This is pure racketeering. Your phone carrier is counting on your cable company to be running the same complexity scam.  Ditto especially for all of your insurance providers whom you just know, in your heart, you'll have to battle ferociously with for what you're owed should you ever need to really use that coverage. And it's not just corporations; the government is in on the action, too. The US tax code is now over 74,600 pages in length, and the IRS cannot even get close to answering questions accurately.  Yet the citizen is on the hook for getting everything exactly right or else incurring stiff penalties, necessitating the use of expensive CPAs -- which is still no guarantee that an auditor's subjective judgment might go against you.  Fun fact: during the first 26 years of its existence, the US income tax code grew by 104 pages. Over the past 30 years, it has grown by 50,000 pages. While our politicians to expand the tax code, as far as I know nobody from any US government agency has been at all interested in the obvious price collusion displayed in this chart: (Source) Believe it or not, there are two price lines on this chart (one red, one blue) from supposedly independent companies who are allegedly competing with each other -- but most clearly are not. Humalog and Novalog are both manufactures of injectable insulin. Insulin is an absolutely vital, non-substitutable necessity for people with diabetes and these companies saw fit to collude and jack up the prices over 1000% in ten years, from $25 a vial to over $250. Why would two separate companies maintain the exact same price for their competing products for 20 years? I don’t have any other explanation except for collusion. In any sane, rational and caring nation this wouldn't have happened. But under Bush, and then Obama, such predatory behavior went completely uninvestigated let alone punished.  So it's no wonder then that so many people looked at the ‘status quo’ candidacy of Hillary Clinton and said No thanks.  Many families cannot afford more years of status quo predation by the unchecked rapaciousness of US cartels -- er, corporations -- and their government protectors. Look, we all knew that the faux recovery seen over the past seven years had to end sometime, sooner or later. A “recovery”, mind you, that never actually happened except in the fantasy press releases of the government's statistical fabricators, lovingly reproduced by unquestioning “journalists” working for corporate entities harboring deep conflicts of interest. But the “little people” (hereby defined as those occupying the bottom 95% of the socioeconomic ladder) have long known they've been getting screwed. Sadly, it's just getting worse. The Obamacare Disaster Obamacare (a.k.a. the Affordable Care Act) is a disaster. We always knew it was going to be. Why? Because it represents the single largest give-away to the health insurance industry in our lifetime.  Obama and the DC politicians crafted the Affordable Care Act as a monstrously large bill. And they failed to take on the biggest source of fat in the entire system: the healthcare insurance companies themselves. Of course, these companies have very well-funded lobbyists and  pushing back against them on would have required real leadership and possibly cost some political capital.  So they were left entirely alone, with all of the massive increases in healthcare premium costs left to be borne by “somebody” other than them. Well that “somebody” has turned out to be pretty much everybody: Obamacare Benchmark Premiums to Rise 25% in Sharpest Jump Yet Oct 24, 2017   Monthly premiums for benchmark silver-level plans are going up by an average of 25 percent in the 38 states using the federal HealthCare.gov website, the U.S. Department of Health and Human Services said in a report today.   Last year, premiums for the second-lowest-cost silver plans went up by 7.5 percent on average across 37 states. (Source) Now what’s both fascinating and part of the electorate anger is that the same government that forced Obamacare on everyone is also the same government that swears that health care inflation is running at only 2.5% to 3.5% per year over the past few years. Here are the governments numbers: (Source) I find myself wondering what country (or planet?) those numbers are for. Because for those who actually pay for their health insurance, the answer for sure isn't either "America" or "Earth". In total, US health care premiums have fully tripled since 1999. But for fun, using the government’s own CPI-Med data from the table above, if healthcare premiums had tracked the government’s stated rate of inflation between 2006 and 2015 then they would be some $2500 less today than they actually are: People are angry because they are being lied to. Or more accurately: lied to while being robbed.  Even worse, while the rate of health care inflation is being understated at the individual premium level shown above, it's also wildly understated in the larger inflation statistic used to level-set everything from cost-of-living adjustments (COLA) to pay raises across the country. As explained in the Fuzzy Numbers chapter of The Crash Course, even though healthcare spending is nearly 18% of GDP, for some reason healthcare comprises only 5.85% of the CPI basket: [C]urrently CPI-MED accounts for 5.825% of the overall CPI. Increases in the share of medical expense paid by individuals (as opposed to their insurers), will not affect CPI levels.  (Source) And: U.S. health care spending grew 5.8 percent in 2015, reaching $3.2 trillion or $9,990 per person.  As a share of the nation's Gross Domestic Product, health spending accounted for 17.8 percent. (Source) Does it make any sense to record something that's nearly 18% of GDP as only 5.8% of your inflationary experience? Nope, it sure doesn’t. Unless your desire is to mask the actual rate of inflation. In simple terms, just healthcare's share of inflation alone comes to (0.25)*(0.18) = 4.5%.  That’s more than twice the rate of the supposed total inflation we are experiencing all by itself.  Throw in rising rents, car prices, and energy and it’s far more likely that an urban consumer is experiencing total price inflation closer to 6% or more per year. Now, if you were a government bean-counter who want to mask the impact of a rapidly-rising factor within the nation’s inflation rate, presumably to blunt the statistical damage and make things look rosier than they actually are, all you need do is weight that item less in the basket used to calculate inflation. For example, if the vegetables making up 18% of the cost of your shopping cart have gone up in price by a whopping 25%, that’s going to leave a mark.  But what the government does is pretend that your shopping cart only has 6% vegetables, and is increasing at a much lower annual rate -- say 3.2%. Voila! Reported price inflation for carrots and celery is now much lower: (0.06)*(0.032) = 0.12%. Even though you're forking out 4.5% more at the grocery counter, the government is loudly telling everyone you're only seeing an increase of 0.12%  This is infuriating, of course.  Here’s what this looks like in chart form. Total inflation is being sold to us as low – "too low" and "dangerously low" even. But I’ve helpfully included where the chart would show the total rate if were only what we're seeing with health care costs: (Source) Imagine how much higher it would be if we added in the actual inflation observed in other costly sectors like food, housing and education. Obviously there’s something desperately wrong going on here. This is statistical lying and weaseling of the worst sort, which of course everyone can see through because it gets harder and harder each year to balance the family budget. If you're alarmed by fake news, perhaps you should be more alarmed by fake data, something the US government has perfected and continues to perpetuate.  All of this is deeply unfair. And -- surprise! -- people really get annoyed when they're constantly lied to. Eventually their trust goes right out the window. Is it any wonder that a profoundly status quo candidate (HRC) could not sway the voters in rural America, where these trends and insults are even more acutely felt than in urban areas? The status quo is figuratively and literally killing these people.  As mentioned earlier, my family's health care plan premium went up over 60% in cash costs alone this year. The rate of increase is an even larger when the plans' reduced benefits and increased deductibles are factored in. The out-of-pocket amount for my family will be pretty close to $30,000 this year before any insurance actually kicks in. In other words, I'm subsidizing somebody. Unfortunately, that somebody is probably not a lower-income person up the street who badly needs coverage, but rather someone in the C-suite at one of the major heath companies.  Check out the 2013 compensation packages for the CEOs of the major US health insureres.  They're truly breathtaking: Maybe 2013 was a standout year, and is an errant data point.  Maybe things moderated in 2014?  Nope.  Everybody apparently deserved an even more massively large payout: You have to wonder how much care was denied to patients in order to afford those executive salaries.  It also bears mentioning, that some of these CEOs ‘earned’ more by 10:30 a.m. on the first day of 2014 than the median household did during that entire year. Put a different way, in order to pay out the compensation for Stephen Hemsley, the United Health CEO for 2014, nearly 4,000 families had to pay the full $16,351 amount for healthcare that year.  In what sort of world should 4,000 families have to pay close to a third of their total income to a single individual simply for the pleasure of having health insurance? Greedy doesn’t begin to cover what’s going on here. If ever there was any sort of 'social contract' between these companies and the public, it's now utterly broken by the rewarding their upper management with tens of millions of dollars – each! – and then jacking up healthcare premiums on families simply because they can.  And now, thanks to the "Affordable" Care Act, you can now be fined for not forking over whatever insane price increases the healthcare cartel decides to dream up from their government protected boardrooms. Bizarrely, the healthcare insurance options in many states have been vastly reduced as carriers claiming losses, while massive premium increases have been justified also on the basis of losses and reduced profits. I say "bizarrely" because you’d imagine, being a regular person, that such losses should show up in actual profit declines for the insurers. Nope: Making a killing under Obamacare: The ACA gets blamed for rising premiums, while insurance companies are reaping massive profits Oct 28, 2016   While Americans continue to be hammered by rising health care costs, and while congressional lawmakers (with their taxpayer-subsidized health care) do nothing to lower the cost of pharmaceuticals and medical care, one group is reaping a windfall in profit: health insurance companies and their investors.   On Thursday, Aetna reported $734 million in profit on $15.8 billion in revenue for the three months that ended Sept. 30. The nation’s third-largest health insurer by revenue handily beat Wall Street estimates for the quarter.   Aetna’s earnings report came a week after UnitedHealth reported a 12 percent jump in revenue to $46.3 billion for the three months that ended Sept. 30 compared with the same period the previous year. The company collected $36.1 billion in insurance premiums, a sum 11 percent higher than for the year-ago quarter, while profits increased 29 percent to $1.98 billion.   A Salon analysis of regulatory filings found that the top five health insurers — UnitedHealth, Anthem, Aetna, Humana and Cigna — have doled out nearly $30 billion in stock buybacks and dividends from 2013 to 2015. (The Supreme Court ruled in favor of the Affordable Care Act in 2012.) (Source) Similar strong results were noted for Humana in their last earnings release.  So how can it be that all these companies are both reporting the need for massively higher premiums while also booking higher and higher profits? Well, when you live in a country that routinely subjects its citizens to racketeering, this is exactly the sort of disconnect you have to live with. They say one thing; but you see with your own eyes, or experience with your own wallet, something completely different. Conclusion Obama’s main failing in the ACA was in not going directly after the powerful insurance industry and forcing its players to participate in the reduction of waste, and sharing in the costs. Instead, they got more than a free pass: they got millions of new enrollees with the right to ‘withdraw’ from any markets and exchanges where they felt their massive profits might take a ding.  And withdraw they did, with 2 million people losing their coverage for 2017 due to major carriers pulling out of state exchanges.  Just looking at the cost of healthcare alone, we can detect massive fraud and deceit being foisted on the American public today. What emerges from these many rackets is a corrosion of the social contract.  In a word, these arrangements are abusive.   The enormous pressures we see across the globe, with the rise of what the mainstream news outlets (aka “largest purveyors of fake news”) are trying to label as ‘nationalism,’ are really in large measure simply a reaction to the economic oxygen having been sucked away from the populace of various countries and delivered into the hands of a very tiny elite. Yes, that elite still controls the ‘news’ and therefore the narrative; but increasingly people are waking up and deciding for themselves that ‘something is wrong’. Not unlike a person slowly becoming aware that they have somehow fallen into and been the victim of an abusive relationship. Let me be clear: if we do not somehow find the courage and appropriate leadership to begin righting these wrongs, this trajectory ends in tears.  And it shouldn’t be up to a government body to have to regulate proper action; the insurance companies themselves should have nobody but themselves to blame if they fail to self-regulate.  Ditto for every major corporation that is running various rackets using a combination of predatory pricing, overly complex practices, and regulatory capture to operate as a cartel.  If the elites don't manage to figure out how to contain their greed, then an angry electorate is just the beginning of their troubles.  Anybody seeking to understand the political landscape really just needs to spend a little time on the eroding prosperity of the bottom 99% over the past 20 years. In Part 2: How To Fix The Future we lay out how a critical movement is arising at this time in history. Each of us can assume a role to play in its formation and development, and therefore its eventual success or failure. It's my personal belief that we are past the time where we can avoid major disruption, so each of us must be personally prepared as best we can for upheaval, while also working towards building a new and better narrative to live by. Do you have the courage to participate? Click here to read Part 2 of this report (free executive summary, enrollment required for full access)  

09 января, 17:40

Is Aetna (AET) a Great Stock for Value Investors?

Value investing is easily one of the most popular ways to find great stocks in any market environment. Let???s see if Aetna Inc. (AET) stock is a good choice for value-oriented investors right now.

06 января, 21:02

Republican Attempt To Repeal Obamacare Puts People With HIV At Risk

Scientists have shown conclusively that treatment not only improves the health of people infected with HIV, it also stops transmission of the virus that causes AIDS. That public health issue is just one of the challenges Republicans face as they attempt to overhaul the Affordable Care Act, a law that brought health insurance coverage to some 20 million people - including tens of thousands of Americans living with HIV. Lawmakers are currently considering repealing the massive 2010 U.S. health reform law known as Obamacare as soon as this month. But the roadmap is tentative, and complicated: it would keep the Medicaid expansion and the new individual insurance plans in place and delay major changes for up to three years. This would give Republicans more time to craft a replacement plan, but it is not clear if individual insurance prices would skyrocket during the delay or what the new coverage will look like. HIV experts are among the groups, including insurers and hospitals, that have started lobbying lawmakers. They want to keep the current level of insurance coverage in place and say that even “repeal and delay” would disrupt care, put patients in jeopardy and increase the risk of transmission of a deadly communicable disease. Republicans will have the added worry of reducing coverage for an infectious disease that once represented certain death, but now can be controlled with daily medications that also keep the disease from spreading. “The evidence is iron-clad that when people with HIV are treated and their viral load is suppressed, their likelihood of transmitting HIV goes down to almost zero,” said John Peller of the AIDS Foundation of Chicago. “So, any kind of interruption in care is going to result in more cases of HIV.” In Illinois, one in three people with HIV gained coverage through Medicaid expansion or the new individual insurance plans created under the ACA, according to an analysis compiled for Reuters by the AIDS Foundation of Chicago. The number of HIV-positive individuals covered by Medicaid in Illinois rose by more than 50 percent between 2013 - the year before the new healthcare coverage went into place - and 2016, when 13,694 people with HIV were enrolled. HIV experts in Republican states have already been wrestling with the issue of caring for patients with HIV. Earlier this year, North Carolina became the 48th U.S. state to permit the use of federal grant money via the Ryan White HIV/AIDS program to pay insurance premiums for people with HIV. “We’re late to the party, and now the party may be over,” said Allison Rice, director of the Health Justice Clinic at Duke University School of Law in Durham. Insurers, including UnitedHealth Group (UNH.N) and Aetna (AET.N), pulled out of Obamacare exchanges for 2017. The plans are offered to everyone regardless of their health and cover everything from routine check-ups and emergency room visits to organ failure and cancer, and insurers said costs of doing that were higher than expected. Policy experts say the delay to an Obamacare replacement may give insurance companies little incentive to stick with the Obamacare individual insurance plans. Insurance companies have asked lawmakers to keep subsidies in place and make changes they hope will help stabilize the market, such as delaying deadlines for 2018 plan submissions. “It creates a really difficult environment for insurers to commit to the market,” said Carmel Shachar of the Center for Health Law & Policy Innovation at Harvard. Shachar co-wrote a letter signed by 174 national, state and local HIV organizations urging members of the senate not to repeal or modify the Affordable Care Act without a clearly defined replacement plan. That was followed by a letter on Tuesday sent by more than 950 HIV medical professionals urging Congressional members not to repeal the Affordable Care Act without a viable replacement plan, and to sustain the federal commitment to the Medicaid program. “In most states, prior to the ACA, low-income patients with HIV were denied Medicaid coverage until they became sick and disabled, and did not have the resources to participate in health savings accounts,” the group, which included the HIV Medicine Association, said in a statement. America’s Health Insurance Plans in December said an immediate repeal of federal support - particularly federal cost-sharing programs and Medicaid expansion - would jeopardize care for millions of Americans and disrupt market stability. Vice President-elect Mike Pence told Republican lawmakers on Wednesday the transition team is “mindful of disrupting the market,” but signaled that a replacement plan would not be in place at the time the law is repealed. “The first order of business” was to “repeal and replace Obamacare,” Pence told a news briefing, adding that “the architecture of the replacement” would come together “in the weeks and months ahead.” MEDICAID EXPANSION BOOSTS COVERAGE Before the ACA was passed, only about 13 percent of people with HIV had private health insurance and 24 percent had no coverage at all, according to the Department of Health and Human Services. Medicaid, which provides insurance for low-income individuals, is the largest source of insurance coverage for people with HIV, covering more than 40 percent of HIV-positive individuals, Kaiser Family Foundation estimates. In the 31 states plus the District of Columbia that expanded Medicaid under ACA, the law eliminated rules that prevented all but pregnant women and the disabled from gaining coverage. “Obviously, not every state expanded Medicaid, but for the vast majority that did, this was the single most significant piece of the Affordable Care Act for people with HIV,” said Amy Killelea of the National Alliance of State & Territorial AIDS Directors (NASTAD). Another 25 percent of people with HIV are covered by Medicare, the U.S. insurance program for the elderly and permanently disabled. Nationwide data on how many of the 1.2 million HIV-positive individuals in the United States gained coverage through the ACA are still being tallied, said Kaiser health policy analyst Jennifer Kates. But policy experts say the impact has been dramatic. “A lot of what the ACA did that is kind of below the radar is incredibly important to people living with HIV,” said Matthew Kavanagh, a policy analyst at Health Global Access Project in Washington. Before the Affordable Care Act, he said, people living with HIV “had huge problems accessing medications and insurance.” In non-expansion states, many people with HIV got their insurance premiums for Obamacare plans paid through the Ryan White program, a federal grant program established after the death of the Indiana teen in 1990 of AIDS. The program funds AIDS Drug Assistance Programs (ADAP), which pay for AIDS drugs and insurance premiums for people who are uninsured and underinsured. “It’s the main safety net below Medicaid, below Medicare, below private insurance,” Kates said. Even if the Affordable Care Act were repealed in full, Ryan White would be there as a safety net, but the program has a fixed budget each year. In the past, that has resulted in waiting lists. In September of 2011, nearly 9,300 people were on ADAP waiting lists nationwide, NASTAD data show. Killelea said her group intends to work with members of Congress and the new administration to “underscore the public health and individual health impact” the ACA has had on people with HIV. “The ACA opened up new choices for people who were frankly uninsurable in the United States prior to the ACA.” (Reporting by Julie Steenhuysen; editing by Edward Tobin) -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

04 января, 19:21

'Repeal and Delay' Won’t Prevent Obamacare Repeal Chaos

Republican plans to phase out the Affordable Care Act slowly still might upend health insurance markets in the short-term.

04 января, 17:30

Arotech, Cooper Companies, UnitedHealth Group, Aetna and Humana highlighted as Zacks Bull and Bear of the Day

Arotech, Cooper Companies, UnitedHealth Group, Aetna and Humana highlighted as Zacks Bull and Bear of the Day

04 января, 00:58

Can UnitedHealth (UNH) Maintain Its Bull Run in 2017?

UnitedHealth (UNH) looks well positioned for growth in 2017 by virtue of its diversified business in the health insurance space, exit from Exchanges for 2017 and high-growth Optum business.

30 декабря 2016, 17:30

The Zacks Analyst Blog Highlights: Wells Fargo, Danaher, Colgate-Palmolive, STERIS and Aetna

The Zacks Analyst Blog Highlights: Wells Fargo, Danaher, Colgate-Palmolive, STERIS and Aetna

30 декабря 2016, 17:21

3 HMO Stocks to Consider as Aetna (AET) Falls Out of Favor

Aetna Inc. (AET) has been grappling with a number of issues of late, which are clearly reflected in its share price underperformance relative to the sector.

30 декабря 2016, 00:43

Top Research Reports for December 29, 2016

Top Research Reports for December 29, 2016

29 декабря 2016, 20:32

2016 Health Care Year In Review

Coauthored by David Squires This was a tumultuous year in health care and elsewhere. Wherever we looked, the improbable and unbelievable became true and believable: from Brexit to a President-elect Trump to alleged foreign sabotage of our political institutions. Historians will dissect the remnants of these events for decades. For us, for now, let's focus on health care, which is plenty. Trump (and the Republicans) emerge ascendant. President-elect Donald Trump will take the oath of office on January 20, 2017, joined by Republican majorities in both houses of Congress, 68 of 99 state legislative chambers, and 31 of 50 governorships. The Republican Party's commitment to repealing and replacing the Affordable Care Act could not be clearer, but stubborn political realities and technical issues are already forcing Congress to consider delaying the effective date of any repeal by up to four years. Though Republicans can accomplish a repeal without any help from Democrats (using the budget reconciliation process), patching together a replacement package will require eight Democratic votes in the Senate. That will be a challenge, as will managing the transition and finding consensus among divided Republicans on how or whether to cover the more than 20 million Americans who will likely lose insurance if the ACA is repealed. Next year is likely to be fascinating for national health policy, both technically and politically. More important, the lives of tens of millions of Americans will be deeply affected by what the new Republican majority tries to do -- and is able to accomplish. Uninsured rate hits historic low. During 2016, the proportion of Americans lacking health insurance reached an historic low: 8.9 percent. Since 2010, the number of Americans without insurance has fallen by more than 20 million. The result: fewer medical bill problems and more accessible and affordable care for patients, and less uncompensated care for providers. Premium increases and insurer exits raise concerns about ACA marketplaces. This was a turbulent year for the individual health insurance market. A number of high-profile insurers exited the marketplaces created under the Affordable Care Act. Double-digit premium increases in some marketplaces added to concern about their stability. However, the impact of these premium spikes on marketplace customers was dampened by federal subsidies that absorbed the costs for more than 80 percent of purchasers. And some of the premium growth likely reflected one-time adjustments to the expiration of time-limited federal programs (reinsurance, risk corridors) that had buffered insurers against unpredicted health expenditures among their new customers. While fears of marketplace collapse are overblown, these developments do signal the need for reforms in the ACA, should it survive the swelling efforts to repeal it. Another point to keep in mind: in the employer-sponsored insurance market, where the majority of Americans get their insurance, premium growth has actually slowed since the passage of the Affordable Care Act. With MACRA looming, value-based payment spreads. The Centers for Medicare and Medicaid Services issued the final regulation implementing the Medicare Access and CHIP Reauthorization Act (MACRA) in 2016. MACRA will transform how Medicare pays clinicians and accelerate trends toward value-based payment, which is designed to pay for the value rather than the volume of services. As of early 2016, 30 percent of Medicare payments were tied to "alternative payment models," as were 25 percent of private insurers' payments. Whether the new administration will be as committed to payment reform as the departing one remains to be seen. The Innovation Center takes off the gloves. One player driving this payment transition assumed a more prominent role in 2016. The Center for Medicare and Medicaid Innovation (CMMI), created under the ACA, has broad authority to experiment with how our largest public insurance programs pay for services. This year, they took a fair amount of heat for making providers' participation in some of their payment experiments mandatory rather than voluntary, and were forced to abandon one demonstration reducing payments for medications under Part B of Medicare. Rep. Tom Price (R-Ga.), Mr. Trump's nominee for Secretary of Health and Human Services, has been a vocal critic of CMMI and its mandatory payment demonstrations. He seems likely to scale back some of its programs, and a repeal of the ACA could eliminate CMMI altogether. However, a Secretary Price might also find some of CMMI's broad authorities to be useful once he settles into his new office. Bipartisan bill reforms FDA, increases R&D. The 21st Century Cures Act, a rare bipartisan initiative, was passed by Congress and signed by President Obama in 2016. The bill increases funding for the National Institutes of Health, including for pioneering cancer and genomic research, and reforms and boosts funding for the Food and Drug Administration's approval process for pharmaceuticals and medical devices. The new law also dedicates $1 billion over the next two years to fight the opioid scourge devastating much of the country. Little-heralded features of the law promote interoperability among electronic health records, and consumers' access to their own digital health records. Insurer mergers prompt an antitrust reckoning. Four of the country's largest insurers are trying to become two, but not if the current Justice Department has anything to say about it. In July 2016, U.S. Attorney General Loretta Lynch sued to block the Humana-Aetna and Anthem-Cigna mega-mergers, arguing that they would reduce competition and raise prices for consumers. Outrage over drug pricing yields smoke, but no fire, at least not yet. Sovaldi, Daraprim, Epipen--a spate of drug-pricing stories continued to grab headlines in 2016. Resulting congressional inquiries yielded numerous verbal floggings for drug company executives, but no concrete action to quell Americans' rising anger over their out-of-pocket spending for pharmaceuticals. President-elect Trump has pledged to control drug prices. Polls show that large majorities of the American public favor having Medicare negotiate drug prices, allowing drug reimportation from Canada, and other aggressive policies to reduce the growth in pharmaceutical spending. However, with Republicans in the majority, and pharma's lobbying muscle undisputed, the prospects of new legislation to deal with drug costs remain uncertain at best in 2017. Americans' lives are shortening. Finally, we learned this month that our life expectancy is going in the wrong direction. Though the change was small--a decline of about one month--it is just the latest evidence of disturbing deterioration in the general health of Americans, particularly working-class whites. The idea that for the first time in U.S. history our children may be less healthy than we are is deeply alarming, and should make improving the health of Americans a major national priority. Here's hoping for a happy, productive, and HEALTHIER new year. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

Выбор редакции
27 декабря 2016, 16:58

Aetna Continues to Grow Business, Merger Remains Uncertain

On Dec 27, we issued an updated research report on Aetna Inc. (AET).

21 декабря 2016, 02:04

Why UnitedHealth (UNH) Stands Tall Amid All the Noise

UnitedHealth (UNH) has been able to beat all kinds of industry odds to emerge as a winner.

20 декабря 2016, 15:28

Will You Hold Humana (HUM) Amid Aetna Merger Uncertainty?

On Dec 19, 2016, Zacks Investment Research downgraded Humana Inc. (HUM) to a Zacks Rank #3 (Hold).

19 декабря 2016, 15:27

How Obamacare Is Getting Worse

Obamacare has failed the American people, and things are only getting worse by the day: Even higher premiums. People who have signed up for the benchmark Obamacare plan will pay, on average, 25 percent more in premiums next year. That is more than three times the increase for 2016. On top of all that, the quality of the coverage is worse than expected. Americans are, in effect, paying more for less than what they were promised. Even higher deductibles. On one of the least expensive types of plans, deductibles for both individuals and families are going up by about 15 percent. Deductibles have gotten so high that it is essentially the equivalent of not even having health insurance. An even bigger bill for taxpayers. Because premiums have skyrocketed so much, so have the subsidies needed to prop up Obamacare. According to one independent study, taxpayers will pay nearly $10 billion more for subsidies in 2017. Even fewer choices. For 2016, only 2 percent of eligible customers had one insurer to choose from. For next year, that number has jumped to 17 percent.  All of these trends are heading in the wrong direction. The trajectory we are on points to the likely possibility that Obamacare is already in what experts call a “death spiral,” where there is such little competition that costs skyrocket and the market collapses. Here's what Doug Badger of the Galen Institute wrote earlier this month: “Obamacare already is in a death spiral that is fast approaching its terminal point. That is because, despite billions in individual and corporate subsidies, insurers are bleeding money. … And 2015 will be remembered as Obamacare’s good old days. Since then, four of the country’s five largest insurers — Aetna, Humana, Cigna and UnitedHealthcare — have all but abandoned the exchanges. The fifth, Anthem, saw its stock price spike upwards last month minutes after its CEO told investors that his company might pull out in 2018. ... The insurer exodus has left more than one in five Americans with an exchange in which only one company participates. The consequences of dumping all the bad risks onto a single insurer are entirely predictable — that insurer will drop out of the market, leaving no insurers in the exchange. The program’s death spiral is irreversible.” The very real possibility of a death spiral picked up last spring, when insurers warned that their losses from Obamacare were “unsustainable.” The Hill reported on April 15: “Insurers say they are losing money on their ObamaCare plans at a rapid rate, and some have begun to talk about dropping out of the marketplaces altogether. … While analysts expect the market to stabilize once premiums rise and more young, healthy people sign up, some observers have not ruled out the possibility of a collapse of the market, known in insurance parlance as a ‘death spiral.’” Sure enough, as the summer unfolded and premium increases piled up, the death spiral began to take shape: “Obamacare ripples through Texas as health insurers propose steep rate hikes. … ‘The individual market is a market of last resort ... And that's not how it used to be,’ said Janna Hamstra, a benefits consultant in San Antonio whose firm, Hamstra Benefit Solutions, advises employers across Texas. ‘In our industry, they call it the death spiral ... As those premiums keep escalating, healthier individuals decide to self insure,’ she said.” (Houston Chronicle) “[Princeton University health economist Uwe Reinhardt] offers an especially thoughtful explanation of why he believes the Obamacare marketplaces won’t work. ‘Liberals think this will settle itself. Eventually, though, we all know about the death spiral that actuaries worry about, and I think what you’re seeing now is a mild version of that. These things accelerate, as premiums keep rising.’” (Vox) “‘I think what we should be expecting is premiums that are substantially higher, and I think there’s a real risk that other insurers pull out,’  said Michael Morrisey, a professor at the Texas A&M University School of Public Health. ‘We may be beginning to see the death spiral of insurance plans in the exchanges.’” (Texas Tribune) “Jeffrey Anderson, a senior fellow at the conservative Hudson Institute, said that the problem is that there is a high likelihood that no young people will ever sign up for Obamacare. ‘There are too many loopholes, too many ways to get around paying if you don't get insurance,’ Anderson told Business Insider. For this reason, Anderson does not believe that Obamacare will ever work and shows it is in a ‘slow-motion death spiral.’” (Business Insider) “‘That’s going to be the future,’ said Roger Stark of the Washington Policy Center in Washington State. ‘What we’re seeing here is the beginning of a death spiral as far as exchanges are concerned as more companies pull out.’” (Fox News) “Democratic lawmakers pushing 'public option' amid ObamaCare woes. … ‘I think we're seeing the public option come back out of desperation,’ said Douglas Holtz-Eakin, president of the conservative American Action Forum. ‘We’ve seen UnitedHealthcare groups, the Aetnas of the world withdraw from exchanges. … As a result, the kinds of people buying insurance there have very expensive medical bills -- insurers are losing money, as they try to cover those bills, jacking up the premiums, people move to other policies so it’s turning into the death spiral that everybody worried about,’ said Holtz-Eakin.” (Fox News) Indeed, even Democrats knew Obamacare was unraveling, and began plotting to impose government-run health care. Now they are digging in to defend the status quo.  But the answer isn’t to ignore the problem. The situation is too dire. The time to act is now. This is the third piece in an ongoing series. Part 1: Repeal Is Relief Part 2: ObamaCare Has Failed

16 декабря 2016, 17:30

Zacks Value Investor Highlights: Aetna, AMN Healthcare and Disney

Zacks Value Investor Highlights: Aetna, AMN Healthcare and Disney

16 декабря 2016, 01:44

CSR Grows in 2016 as Companies Embrace Employees' Values

"Success is liking yourself, liking what you do and liking how you do it." - Maya Angelou So many conversations I have with friends, family and colleagues center on this idea of colliding personal and professional passions, being more intentional about working with purpose and trying to find more joy in every moment. Across sectors, employees increasingly want to know and feel that the time and skills they put into their jobs are making a tangible, positive difference in the world. This is a common sentiment, especially prevalent among millennials, who are often more likely to seek out positions with organizations that offer and support active community engagement and skill-based volunteer opportunities. Proof in the pudding: 84 percent of millennials made a charitable donation in 2014 and 70 percent volunteered in some capacity, but only about half reported that they did so through their employers. Seventy percent say a company's commitment to corporate social responsibility (CSR) would influence their decision to work there, according to Douglas Marshall, Managing Director of Corporate Citizenship for Deloitte. As employees continue to show interest in community and volunteer engagement, and their organization's contribution to the global community, leaders are responding with more coordinated and coherent strategies and programs that support philanthropy and purposeful business activities. Fortune 500 firms currently spend more than $15 billion a year on CSR activities. That number is rising as businesses see signs that investments in CSR improve company performance, talent recruitment and retention. Giving in Numbers, a study published by the CECP that analyzes giving and corporate societal engagement trends, revealed companies that increased giving by at least 10 percent between 2013 and 2015 actually experienced upticks in revenue and pre-tax profit, while all other companies saw a decrease in both. Those organizations seeing the greatest success are making deeper and longer-term commitments that align with the values of their employees, their customers and the communities they serve. Stand-out trends include advocacy on social issues, an increase of resource allotment for community volunteerism and a focus on long-term social value versus meeting short-term profit goals. Evolution of the Corporate Statesman: Standing Up for Those Who Can't "A genuine leader is not a searcher for consensus but a molder of consensus." - Martin Luther King Jr. In the past, corporate leaders have shied away from taking a stand on controversial issues for fear of alienating large groups of potential constituents. However, as social media magnifies calls for change from both employees and consumers, CSR-minded corporations are increasing their support for causes, not only with dollars, but also by using their brands and voices to raise awareness of issues that affect our communities. "We're definitely seeing an evolution of the corporate statesman," said Barb Short, Managing Director of Corporate Leadership at CECP. "Bob Forrester of Newman's Own Foundation has often said that Paul Newman, one of CECP's key founders, would be gratified to see the progress in how today's most respected companies and CEOs are using their resources and influence to ensure that business plays a role in solving our most challenging social problems." For example, Adam Silver, Commissioner of the National Basketball Association, pulled the league's All-Star Game out of Charlotte, N.C. in response to protests over HB2, a state law seen by many as discriminatory against the LGBT community. The league's decision will have an estimated $100 million impact on the Charlotte Hornets franchise and local businesses. "It is always important to us to provide the best experience possible to our fans at all of our events," said Mike Bass, the NBA's Executive Vice President of Communications. "In order to successfully host a marquee event like the All-Star Game, we need to be able to provide an environment where all of our fans, players, business partners, league and team officials can feel welcome, and the current environment in North Carolina created by HB2 precluded us from doing that." While we often hear about professional athletes generously giving back on an individual basis, the NBA as an institution has been a progressive leader among major sports leagues in using its resources to reach out and support disadvantaged communities. "Our league and players have a long history of standing up for the principles of fairness, respect, diversity and inclusion," Bass said. "Through our NBA Cares platform, we aim to partner with organizations that embody these principles while also helping to create meaningful change all over the world. Examples include our partnership with LeanInTogether, which supports women and men standing up for equality; our commitment to My Brother's Keeper to recruit more than 25,000 adult mentors of color; and our relationship with Special Olympics, which connects our athletes to Special Olympics athletes around the world to provide opportunities to develop physical fitness and demonstrate courage and empowerment." Kenneth Faried of the Denver Nuggets with Special Olympics athletes. Credit: NBAE Photos. Healthy Leads to Happy and Happiness Matters "If you have health, you probably will be happy, and if you have health and happiness, you have all the wealth you need, even if it is not all you want." - Elbert Hubbard While organizational performance is multi-level and multi-dimensional, there is an undeniable link between the performance of organizational leadership and the overall performance of the entire organization. More leaders are acknowledging the very real correlation between health and happiness, and happiness and productivity (recent research shows that happy workers are 12 percent more productive). Therefore, more executives have increased attention on internal workplace issues such as employee health and wellness. One example is Aetna's CEO Mark Bertolini, who in the last two years, has raised the minimum wage for his employees to $16 an hour and launched a program to lower the out-of-pocket medical expenses for thousands of Aetna's lower-paid employees. Beginning in 2017, the company will start matching employees' student loan payments up to $2,000 annually with a lifetime maximum of up to $10,000 for qualifying loans. These are generous and innovative financial packages, but as Bertolini wrote in his Huffington Post column, companies need to go "beyond the paycheck" when looking at employee wellness. "The wellness programs that are most effective are simple, engaging, based on people's personal values, goal-oriented and fit into people's daily lives," Bertolini wrote. Aetna's initiatives combine the latest scientific research with access to a broad network of resources and healthcare professionals. Employees benefit from this holistic approach to wellness that boosts energy, creativity and productivity levels, and also addresses so many of people's health needs - such as physical fitness, sleep habits, disease prevention and stress management. According to Aetna's research, the 13,000 employees who participated in one of their mindfulness-based wellness programs from 2012-2014 regained 62 minutes per week of productivity with an approximate dollar return, in terms of productivity alone, of more than $3,000. Aetna and Bertolini have received numerous awards for the company's health and wellness programs, and Aetna is annually listed as one of the best corporate workplaces in the country. Increased Commitment to Community Service Opportunities "The best way to find yourself is to lose yourself in the service of others." - Mahatma Gandhi According to the Imperative Workforce Index, employees who work for purpose-oriented companies experience a 20 percent longer tenure, 50 percent greater likelihood to hold a leadership position and 47 percent greater likelihood to serve as company advocates. For that reason, it's more important than ever to connect people with purpose in the workplace. "Interest continues to grow in work that elicits passion and allows individuals to pursue professional, personal and social goals simultaneously - and they are seeking employers with similar values that create opportunities for employees to pursue purpose in their daily work and through company initiatives," said Douglas Marshall, Managing Director of Corporate Citizenship at Deloitte. CECP says employee satisfaction rates continue to increase when employees are offered skills-based volunteer programs. For many employees, this is a critical way for them to find meaning in their work outside the office. CECP reported that companies who offered skills-based volunteer programs through pro bono service and board leadership had the highest participation rates among employees this past year. In an examination of 69 companies from 2013 to 2015, volunteer participation rates increased from 28 to 33 percent. Large economic institutions such as Deloitte and Bank of America are growing their skills-based volunteering programs so that employees can take their abilities beyond the workplace to explore their passions and provide meaningful service to nonprofits. Ninety-three percent of Deloitte employees said their participation in pro bono work made a positive impact on their job satisfaction, while 84 percent reported significant gains in job-related skills. These programs allow nonprofits to learn from experts in their fields who provide financial consulting, membership on boards and committees and development of technology solutions. "We work hard to ensure that our volunteer program offers employees an opportunity to connect in a meaningful way with nonprofits serving community needs," said Kerry Sullivan, president of the Bank of America Charitable Foundation. "From building leadership skills to gaining a better understanding of community challenges, we believe our employees develop and grow through volunteer efforts while also helping to build thriving communities in which to live and do business. Skills-based volunteering, such as board service, advancing better money habits or providing technology assistance to nonprofits, has been a great avenue for employees who wish to leverage their expertise to further the critical work of our nonprofit partners." Focus on Creating Long-Term Value over Short-Term Profits "The important thing is that men should have a purpose in life. It should be something useful, something good." - Dalai Lama With a lens toward sustainability, business leaders are thinking long-term and demanding a new standard of management that prizes constructive stakeholder engagement. Over the summer, Warren Buffett, Larry Fink, Bill McNabb and some of the other biggest institutional investors in the world released a letter called The Commonsense Corporate Governance Principles. In the letter, the investors state, "We share the view that constructive dialogue requires finding common ground -- a starting point to foster the economic growth that benefits shareholders, employees and the economy as a whole." They also suggest that "our financial markets have become too obsessed with quarterly earnings forecasts." They recommend that boards and executives of Fortune 500 companies focus on long-term CSR strategies like increasing diversity at the C level and improving transparency with shareholders and the public. To build solid foundations for their CSR efforts, many companies are linking purposeful activities to their own core competencies, allowing them to highlight the impact they are making on society while showcasing the value of their expertise in the real world. For example, global manufacturer 3M partnered with Discovery Education to create the Young Scientist Challenge, a mentorship program that identifies talented young minds and gives them the opportunity to work with professional scientists to brainstorm innovative, real-world solutions to significant societal challenges. Jon Lindekugel (left), Senior Vice President, 3M Business Development and Marketing-Sales, and Lori McFarling (right), Senior Vice-President & Chief Marketing Officer at Discovery Education, present a $25,000 check to 13-year-old Maanasa Mendu (middle) from Mason, OH, the winner of the 2016 Discovery Education 3M Young Scientist Challenge. Credit: Discovery Education. "We know firsthand the importance of inspiring the next generation of scientists and inventors," said Michele Whyle, 3M Brand Director, Global Marketing Excellence. "We work with schools to strengthen their STEM curriculum, send 'Visiting Wizards' into classrooms to perform experiments and welcome high school students into our laboratories for summer employment...It's a highly successful platform for us to showcase the brand in an authentic way that speaks to who we are and what we care about." Projects like the Young Scientist Challenge are part of a growing emphasis by businesses on education, particularly STEM subjects (science, technology, engineering and mathematics), the CECP report revealed. Corporate leaders hope their investments in public health, financial literacy and education will pay off down the road by creating a future labor force fluent in STEM concepts. This will make their future workers capable of pioneering new solutions that create a better society as well as advance their business interests. "It's tremendously gratifying to see organizations like 3M and others applying their expertise to support teaching and learning in their communities," said Lori McFarling, Senior Vice-President & Chief Marketing Officer at Discovery Education. "We're seeing more and more companies incorporating education into their corporate mission and making it a meaningful part of their brand profile. This authentic commitment to impacting young people strengthens communities and improves student access to meaningful opportunities for learning that were previously unavailable." Looking Ahead at the Future of CSR Efforts "Goodness is the only investment that never fails." - Henry David Thoreau Millennials' commitment to meaningful social impact will play a tremendous role in shaping the future of CSR. For the new generation of workers and consumers, wearing a white hat means more than just making a transactional donation. Investing in CSR has become part of the price of doing business. A recent trend Douglas Marshall from Deloitte said he has seen more of is the mentorship of younger millennials by older millennials and the idea of intrapreneurship. "Intrapreneurship is all about hacking the system, building from existing skills and frameworks, and finding agency and opportunity that are extensions of centrally organized efforts," Marshall said. "This is exciting, and we are actively thinking about how to be responsive to this energy, try new things and look to scale what works. We are committed to continual improvement, which involves assessing what's working and opportunities to enhance, listening to our people, innovating, piloting and evolving." In its report, CECP predicts that companies will consider corporate citizenship qualities such as integrity, altruism and collaboration as they hire and develop leaders at all levels to drive their business growth, weaving CSR into the fabric of their organizations. Fortune 500 companies have a powerful voice in our society and when they use their platform to tackle social issues, they improve their own organizational health, as well as advance the health of communities and society at large. By improving organizational performance, job satisfaction and striving to make the happiness and health of their employees a priority, so many of these organizations mentioned are providing inspiration across sectors of passionate leadership that understands and values today's interconnected society, and how business with a purpose creates both a dynamic culture while making a difference in this world for the better. -- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website.

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15 декабря 2016, 16:50

Molina: ACA Repeal Plans a Threat, Buyout Deals on Track

On Dec 15, 2016, we issued an updated research report on Molina Healthcare Inc. (MOH).

15 декабря 2016, 02:18

The Value Investor's #1 Advantage

When everyone has access to the same information, what can you do to gain an investing advantage?

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13 декабря 2016, 17:05

Aetna CEO Calls Pulling out of ACA Exchanges 'Good Business'

Aetna Inc. (AET) recently came under fire for having allegedly pulled out of Affordable Care Act (ACA) exchanges in 11 states, including the areas covered by the Justice Department lawsuit, in a bid to avoid antitrust claims.

12 декабря 2016, 17:56

Anthem's Membership Growth Impressive, High Debt a Drag

On Dec 9, 2016, we have issued an updated research report on Anthem Inc. (ANTM).