From the State of the County (.pdf) address:
AND SINCE I JUST MENTIONED SAVING LIVES, HERE AS MY GUEST TODAY IS HENRYETTE NEAL. AFTER SUCCESSFULLY BATTLING BREAST CANCER, SHE LOST HER JOB AND HER HEALTH INSURANCE WHEN HER EMPLOYER WHEN OUT OF BUSINESS. WITHOUT INSURANCE, SHE PUT OFF FOLLOW UP VISITS AND IGNORED CHEST PAINS. FINALLY, AS A MEMBER OF HEALTHY HOWARD, SHE SAW A DOCTOR AND WAS IMMEDIATELY RUSHED TO JOHNS HOPKINS HOSPITAL IN BALTIMORE, ONE OF OUR PARTNERS, WHERE SHE UNDERWENT TRIPLE BYPASS SURGERY THAT VERY SAME DAY. BECAUSE OF THE STRENGTH OF OUR PARTNERSHIPS, THE COST TO HENRYETTE OF THIS LIFE SAVING CARE WAS $102. HENRYETTE HAS SAID THAT HEALTHY HOWARD SAVED HER LIFE. WELL HOW FITTING IS IT THEN THAT SHE'S HERE ON HER BIRTHDAY.
If you are at all curious how the HHAP, which is not insurance, provides triple bypass surgeries for $102, here is the answer:
IT DOESN'T! Patients like this get transfered to MHIP which picks up the tab, and the patient pays the much higher MHIP premiums. More details here. I swear, if people actually understood HHAP they would not be so impressed. HHAP did one thing in this case: it got the patient to her primary care doctor who evidently found a serious health issue. I am not dismissing the importance of that. However, this anecdote is always told in such a way that makes it appear like HHAP paid for the triple bypass surgery and that is misleading to put it mildly. The patient was not even a HHAP member when the surgery was performed. Jeez.
I hope to post more about the SOTC address later this week. In the meantime, check out Ulman's twitter frenzy.
16 comments:
Oh, Free Market, why do you continue to promulgate the myth that Ken Ulman is lying to Howard Countians?
The Healthy Howard anecdote used in yesterday's speech is absolutely true. I believe that by piecing together multiple sources of information I can prove that the woman was a Healthy Howard member at the time of her triple bypass surgery.
I gather from a previous post of yours that you have a copy of HHAP's FY09 annual audit. I also have a copy of said audit and nowhere in the line item expenses do I see a cost for an MHIP transfer. In FY09, HHAP's policy was to cover the $2,600 deductible if a member needed to be transferred to MHIP. Surely this cost would have appeared in their independently audited financial statements.
Now, I know what you are going to say: "How can you be so certain that the surgery occurred in FY09. Perhaps it will appear on their FY10 financial statements." My answer is this: The same woman that was featured in yesterday's speech was also featured in a CNN segment that aired on July 12, 2009 (http://www/cnn.com/video/#?video/politics/2009/07/12/bolduan.health.care.experiment.cnn?iref=24hours). This segment aired 12 days after the end of HHAP's fiscal year (June 30, 2009).
I find it very hard to believe that a 62 year old woman would have been able to appear as healthy and vibrant as she did less than two weeks after the surgery. She certainly must have had the surgery sometime prior to the June 30th end of FY09.
This shows that 1.) HHAP did not have the expense of an MHIP transfer in FY2009 and 2.) The surgery did occur in HHAP's FY09.
Ken Ulman is telling the truth. Your constant complaints of Healthy Howard are misleading and tiring. The program is a success. I am sure you must be able to find something else to complain about.
Anon, if I am wrong about HHAP members being transferred to MHIP, it is because the information published by HHAP is incorrect. I didn’t just make it up. You can see the source where I obtained that information if you follow the links in this post. Why don’t you tell us how the surgery was paid for? You conveniently left out that information, as did Ulman in his speech. If HHAP is such a great program I wish it could be discussed with out half-truths and innuendos. How did this person get a triple bypass surgery for $102? Answer that question.
Anon, so are you saying that HHAP paid for the bypass? I don't think her membership is in dispute, just the means by which her bypass surgery was funded.
According to the HHAP literature:
"The program transfers members requiring very costly treatment to the more inclusive Maryland Health Insurance Program (MHIP) by paying down the required $4,500 deductible. Then they are left to pay the somewhat higher MHIP premium."
Anon 10:08- if what you are saying is true, how does that reconcile to the above statement in HHAP literature? Seems like either you are wrong or the info published by HHAP is wrong.
Regardless, it seems that Ulman and Beilenson are at least deliberately ambiguous as to the funding of Neal's care.
How hard would it be to say "Funds raised and contributed to HHAP paid Johns Hopkins for Neal's surgery"?
There's a reason why the statement isn't direct and says that "HH saved her life" or "due to our partnerships" and other rather evasive language.
FWIW, I think that a transfer to MHIP is just as honorable. It speaks to the importance of HHAP as a resource to connect those in need to those who can provide. Just because it's a less direct route of care doesn't make it any less admirable.
But would be nice to know how this was accomplished.
If Ken's lips are moving, you know it's a lie. LOL
Also, Anon 10:08, I took another look at the audit (which I will post online later today) and HHAP had accrued $26,000 for MHIP and $75,000 in urgent care after June 30 for services provided prior to June 30. See the subsequent event footnote. That puts a serious hole in your claims, does it not?
I am obviously unable to tell anyone exactly how care is paid for under HHAP but perhaps, large hospitals and their doctors are willing to donate care to HHAP members. Perhaps HHAP leverages its connections. Don't forget that hospitals get tax incentives for providing care to people in certain demographics.
As for the note in the audit regarding MHIP transfers and other IBNR costs, it seems that the organizations set aside reserved money for liabilities it may incur. It does not suggest that they actually paid out those expenses.
The member also mentions in the CNN piece that she went to the ER when she had chest pains and the bypass surgery was done at that point. How would HHAP transfer someone to MHIP in the short amount of time it takes to drive from HCGH to Johns Hopkins?
I am certainly unsure of exactly how all of this works. All I am trying to say is that if you are going to claim that Ulman is a liar, make sure it is a claim that you can back with facts.
Thanks for your comments and your honesty, anon. Couple of comments: if HHAP simply relies on doctors to work for free, it is not a very good model for replication, is it? Perhaps HHAP and MHIP have a partnership agreement in place which allows for transfers of patients to be backdated or something of that sort. Also, let me be clear that I am not calling Ulman a liar. The sentences he stated are true, although they are ambiguous and evasive. In other words, he is being extremely misleading, which is not the same thing as lying. And the facts on the table certainly back me up on that point.
All things aside, I don't think the member cares how HHAP paid for it. She received services that surely would have bankrupted her without HHAP for $102.
Maybe so, but the devil is in the details and is really unfortunate that HHAP and Ulman can be straight up with people.
Ulman uses this anecdote because it's pretty damn compelling. Ms. Neal said it herself in the CNN video that "yes... without question" Healthy Howard saved her life.
I think you need a little perspective on this. Although it may be your cup of tea, the last thing I want is for a political speech to sound like a financial audit.
There may be some important policy questions embedded in this post -- as there have been in past posts of yours on this topic -- but these questions get lost in your whining about minutia.
Anon, getting her to the doctor quickly probably saved her life. That's something that Ulman can legitimately point to and be proud of. I guess that's not good enough for him, so he starts misleading people.
And with all due respect, I think it is you who needs some perspective. If can seriously look at this situation and not ask questions then I feel sorry for you. My cup of tea is not audits, it is simply asking "why?" and "how?".
I bet something like this sounds familiar to you: Sure the a government guarantee of risky mortgages creates an economic house of cards. But look at all those people who can now afford to buy a house! Yay! What can go wrong?
The fact that Ulman is even "misleading" people is deceptive and dishonest, which equates to lying in my book. Why must he always try and trump things up to his benefit? Oh, that's right, because he's a typical sleazoid politician.
As for how this program is paid for, it ultimately comes out of the tax coffers. Which comes from us taxpayers, so it is NOT free to anyone, except the people who use the program (they probably are below the threshold to pay any taxes). If doctors donate their time/facilities - tax write off which equals a reduction in the tax revenue coffers.
Ulman just wants to be a government provider for everyone so that he can get people dependent on the government for everything, and that basically guarantees votes for himself.
PZGURU, HHAP members are hard working individuals that just don't make enough to afford private health insurance. If they were below the taxable income level they would be eligible state assistance programs and in turn, would not be eligible for HHAP.
"why do you continue to promulgate the myth that Ken Ulman is lying to Howard Countians?"
Yes, why indeed. Ulman has never lied about anything. He WAS a Clinton White House Staffer. He WAS Director of Public Works. He WAS Secretary of the Cabinet.
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