Friday, 31 May 2013

07:53 – Barbara’s dad was doing very well when I visited him yesterday, acting almost like his old self. I took him the peanut-butter-and-jelly sandwich he’d requested, along with a small cup of strawberry ice cream, both of which he ate. The Hospice representative stopped by later, and told Barbara that Dutch was exactly where he needed to be for the time being. Barbara’s friend Marcy stopped over yesterday afternoon to visit as well. I’ll run over there today to return the clothes I washed yesterday, and Frances and Al plan to visit Dutch this afternoon. Barbara may also stop to see Dutch on her way home from work, and plans to go over for a longer visit tomorrow. So, overall Dutch is getting plenty of visitors. It’s not much, but we hope it’ll help keep his spirits up. Being stuck in a nursing home is no fun at all, even one as good as the Brian Center.

I met yesterday afternoon with Abby Esterly, and wrote her a retainer check to get her started on doing a logo for the business and a hand-out sheet. I told her that I was the client from hell because I don’t know what I want, but I’ll know when I see it. I again encouraged Abby to focus all of her efforts on building her own business rather than beat her head against the wall trying to find a job in the film/animation industry. That’s what she’s trained to do, but there are simply no jobs available and not likely to be. At age 26, Abby is part of the new Lost Generation, coming into the job market just as the job market has collapsed, with no prospect of any significant improvement any time soon, if ever. But Abby is smart, talented, and hard-working, which still counts for something. I told her that there is no security, other than what she makes for herself. And she has all the tools necessary to do that.

Barbara and I are about three quarters of the way through series six of Heartland, which we’ll probably finish this weekend. They just finished shooting the first two episodes of series seven, so it’ll be almost a year before we can start binge-watching series seven. So, once we finish series six, I’ll go back and start again at series one episode one and watch my way through the whole six seasons again at least once and probably twice while I wait for series seven.

16:08 – Stuff like this really pisses me off: Smoke? Overweight? New regulations could raise your insurance rates

And here’s the problem in one sentence: “Smokers, of course, run up more health care bills than non-smokers.” The only problem is, that’s utterly wrong, as is grouping “smokers” without differentiating between cigarette smokers and others.

Cigarette smokers tend to die young and quickly from causes like heart attacks. Few of them make it to 80, which is when the real health-care costs start to kick in. My father-in-law, who is a non-smoker, is almost 91 years old. I have no doubt that in the last year Dutch has consumed more health care resources (and costs) than he did in the previous 90 years combined. It’s end-of-life care that is costly, and people who don’t smoke cigarettes both live longer and consume more resources for much longer than those cigarette smokers, most of whom died quickly years before they reached 80.

Any honest actuary will tell you that cigarette smokers incur higher health-care costs than non-smokers, but there’s a key gotcha concealed in that statement. In the past, insurance companies could drop coverage on people who became seriously ill, and deny coverage for those with pre-existing conditions. So, while their policies were still in effect, cigarette smokers did indeed cost the insurance companies more, so those smokers accordingly paid higher premiums. With Obamacare, it’s a whole different ballgame. Now, everyone is eligible for coverage regardless of their health or pre-existing conditions. So the insurance companies will be stuck paying the bills. As that actuary who he’d rather have a policy on: a cigarette smoker who will probably die of a heart attack, with their only costs an emergency room visit and possibly a day or two of ICU, or a non-smoker, who is going to be in and out of the hospital as he ages, and eventually in more than out. There’s simply no contest. The non-smoker is going to cost much, much more than the smoker possibly can.

Then there’s the problem of lumping in cigarette smokers with pipe smokers, like me. That honest actuary will tell you that pipe smokers on average outlive not just cigarette smokers, but NON-SMOKERS. It’s not that pipe smoking is particularly good for your health, but pipe smokers are self-selected Type B personalities. We tend not to get excited, and we tend not to die of the stress-related problems that kill a lot of those non-smoking Type A personalities. Before political-correctness, pipe smokers were rated for life insurance the same as non-smokers. For that matter, people who smoked half a pack of cigarettes a day or less were also rated as non-smokers. That’s because the actuaries knew that life expectancy was the same for non-smokers, pipe smokers, and those who smoked half a pack a day or less of cigarettes. That’s still true, although you’ll have to do quite a bit of digging to discover the kind of raw data that establishes it. It’s also true that the general health of pipe smokers is statistically indistinguishable from that of non-smokers, and insurance companies used to write health insurance policies at the same rates for pipe smokers and light cigarette smokers as for non-smokers.

So why is Obamacare going to charge smokers 50% higher rates than non-smokers. They should be giving smokers a discount. And the higher premiums also apply to those who are “overweight”, which is just as outrageous. The problem there is that people who are of so-called “normal weight” actually have higher morbidity and mortality than those who are the next step up, so-called “overweight”. That speaks volumes: being “overweight” means you’re healthier and less likely to die than if you’re “normal weight”. That makes one wonder who defines “normal weight” and, uh, what they’ve been smoking.