[Vision2020] Response to Mr. Budge's misfacts--Gritman/UI

[David M. Budge]

You got me there Mr. Arnold.  I was unable to complete my MENSA 
application due to my inability to spell and I figure I have an IQ of 
about 81, but hey, who's counting. 

For the sake of efficiency I'll make notes in red below your latest 
comments.  And just to add a little context, beside being a Registered 
Investment Advisor, I'm also licensed to sell health insurance in 
several states (of which I admittedly do little.)

Donovan Arnold wrote:

> Mr. Budge, and others rushing to defend something you have no clue about,
>
> "Have some of you been raised under heavy power transmission lines or 
> grew up on a diet of lead based paint chips. I take what I can stands 
> and I can't stands it no more."--DB
>
> Well Popeye, any time you would like to compare IQs that is find with 
> me. I know me WISC score, what bout u? I even got it be documated. God 
> knows I have my social disabilities, but IQ is not one of them things 
> I score low on.
>
> "A)  Accrording to the online U of I Student Health Insurance Program 
> brochure, the Idaho State Board of Education requires proof of health 
> insurance for ALL publicly funded institutions of higher education in 
> the state.  This is not solely a U of I policy." --D. Budge
>
> That law is there because UI and Gritman lobbied for it. Only 25% of 
> public colleges mandate health insurance. UI automatically charges all 
> students (4 or more credits) $1000 for the Student Health Insurance 
> Program (SHIP). Students must prove they already have $500,000 in 
> coverage and meet other stipulations to wave out of SHIP. Since most 
> 18-22 year-olds don't know details about their insurance as dependents 
> on their parent's policy (ask one at randam if you doubt), they do not 
> wave out. Many parents, who pay for their child's education, do not 
> analyze the fee breakdown to realize they are paying for double 
> insurance (ask one if you doubt). Further, UI exceeds the state 
> requirements for health insurance, in both amount, about $500,000, a 
> student status, 4 credits instead of 8. Just read yourself.   
> http://www.idahoboardofed.org/policies/health_insurance/index.asp 

Perhaps it is true that the U of I and Gritman lobbied for this bill.  I 
would have as well seeing that college students, typically not 
understanding their own subjection to morbidity and mortality tend to 
ignore the risks of mundane existence. I also dispute that most parents 
do not analyze the fee breakdown as patently untrue. Accordingly, using 
Adam Smith's tenet that purchases are made rationally, I think the 
postulate those who can do not opt out of the fee is absurd.  Surely it 
happens form time to time, but this system isn't designed to protect 
stupidity or neglect.

You are also correct that part time students have more leeway in not 
participating in the SHIP program at Boise State.  Several causes may be 
in play here, not the least of which may be the contract with Mega to 
ensure an adequate number of students participate to keep premiums low.  
This question of policy is beyond us both, but I find no evidence that 
it has anything to do with greed on the part of Gritman, Moscow Family 
Medicine, or Student Health Services. 

>
>
> "B) The insurance program is underwritten and administered by the Mega 
> Life and Health Insurance Company of America.  Ergo, the University 
> makes not one damn dime form the insurance program."-DB
>
> Incorrect Mr. Budge. It is ONLY underwritten by Mega Life Insurance 
> (MLA). It is administrated by 
> (http://www.klais.com/services/students.htm) Klais & Company. You 
> would know this if you had SHIP because it is printed on the insurance 
> form. The services are also administered by Gritman.
>     UI makes money in three ways. It still charges students for health 
> insurance services it use to provide but is now outsourcing. This fee 
> is $40 per full time student. Second, And it makes another chunk of 
> change because the amount of money it charges, $1000, is not the same 
> amount it pays out to pay the insurance company. So times $40 by 8,000 
> students. Then times 6,500 students by $50-100. Add together. Subtract 
> cost they don't have to pay to provide sevices they are now 
> outsourcing, That is how much they are making just from those three 
> sources. Gritman is making money because UI is now outsourcing 
> students to them instead of servicing them at the UI Health Center. 
> Understand? Or is this too confusing for you to follow? 

I stand correct as well that Mega does not administer the program.  
After some review, I learned that Klais is an independent third party 
administrator (TPA) that performs as an intermediary claims management 
service to coordinate claims between the three providers under the 
umbrella system of SHIP.  In insurance vernacular, administration 
applies to claims processing.  It is unlikely then that Gritman does not 
provide this function.  I'll admit I don't know for sure but I can 
assure you that it would be highly unlikely unless Gritman was an HMO, 
which they appear not to be.

Next, your understanding of how the self-insured portion of the U of I 
SHIP program works over the long run if in fact one exists.  It appears 
that the University pays a flat fee to Moscow Family Medicine to cover 
all the health needs of the enrollees delivered through Moscow Family 
Medicine. This then puts the "risk" of a higher level of services 
provided that what are estimated on Moscow Family Medicine.  If a lower 
number of services is provided they get to pocket the difference.  This 
type of HMO model benefits the U of I in that it knows the sum certain 
of expenses to be paid though Student Health Services.  If, on the other 
hand, the University is self insured it takes the risk that Moscow 
Family Medicine would take under the other scenario.  Any surpluses 
would be help in reserve to cover "high claims" years or used to provide 
additional benefits or lower fees.  I challenge you to show me that this 
is a profit center for the University.  If it is, who then profits?  
Would funds collected for general administration be used for poor 
purposes outside the charter of the University?

>
>
> C) The cost of the insurance is about 25% less than the cost of 
> comparable individual policies purchased through any other competitive 
> program in the state.  Pretty good deal ask ANY insurance agent.
>
> Bullhonky(I think this is a word) Mister!! Did you even LOOK before 
> making such a fallacious statement? UI students pay $1000 a year. 
> Boise State University Students pay $756 year. ISU and LCSC $660 or 
> even less. Every public university and college in the state of Idaho 
> pays less then UI students. And you know what else?-- They get the 
> OPTION of having vision and/or dental. 


It also is important to understand the difference in the policies 
between the U of I and BSU.  The pricing differential is a function of 
benefits.  Of particular not is the $250 annual deductible for the U of 
I program compared to the $500 annual deductible for BSU.  There are 
many other significant differences as well.  For example, preexisting 
conditions are excluded from the BSU plan unless covered under HIPAA 
(Health Insurance Portability and Accountability Act) where the U of I 
has open enrollment.  This is a biggie.  Secondly, the BSU program has 
more restrictive limits on certain services such as a $5,000 annual cap 
on mental health services compared to a $10,000 cap at the U of I.  The 
BSU program does have some lower co-payment such as a $5 doctors visit 
compared with a $12 fee at U of I.  By in large, however, it is 
impossible to say which program is more economical as each health 
incident is unique.  I would guess, however, that more students pay 
larger out of pocket expenses with the $500 deductible.  By the way, BSU 
outsources all of its student health services. The link for the BSU 
program is here:  
http://www.boisestate.edu/healthservices/insurance/benefits_summary_chart.asp

Additionally, I know from my practice that a comparable insurance policy 
for a 20 year old male in Montana would run about $1,400 -$2,000 per 
year if purchased as an individual policy.  Since SHIP is a group policy 
it is cheaper that what young working stiffs have to pay.

>
>
> "D) The $11 million charged off for indigent care cannot be written 
> off on their taxes.  They don't pay income taxes for cripes sake.  
> They're a not-for-profit entity!!!!"
>
> The doctors are the ones that provide the $11,000,000 in care and they 
> are for profit companies, Doctors are not free agents. So YES, they 
> can and do write that off. Don't confuse the contracted doctors and 
> the hospitals. See how you even confuse yourself--HAHA! (sorry have to 
> laugh at self induced confusion) 

I don't have the annual report, but I think you're dead wrong here.  
Hospitals bill their services separately from doctors.  Any losses the 
doctors have are tax deductible, but I'll take B.J. Swanson as the 
authority here.  So no, the $11,000,0000 is not tax deductible.  I'll 
bet the permanent teeth of all six of my kids on it.

>
>
> "E) Who, exactly should pay for indigent care?  What is happening 
> right now is that everyone else is paying for those who can't through 
> $20 bandaids.  In fact, the people who get screwed the most are those 
> who either have not the benefit of a collectively bargained health 
> plan (like SHIP) or a government program (like Medicaid and Medicare) 
> but I'll get to that in a moment. Write you strinkin' congressman!"
>
> The state government PAYS Gritman through earmarked funds (VAT value 
> added taxes on liquor which students pay into and their contribution 
> exceeds what Gritman pays for indigent students) to take care of 
> indigents. If the amount of indigent funds exceeds the government 
> funds for indigent care then Gritman has to absorb those extra costs. 
> If Gritman goes under that amount, it gets to KEEP the extra amount. 
> Get how they make money now if there are no indigents? Confused or 
> clear on this? 

No, I'm not clear on this.  In Fund Balance Accounting all revenues are 
recognized and accordingly the $11,000,000 charge-off tells us 
specifically that there were not enough revenues to cover the costs of 
services, hence Gritman (whoever he is) has no excess funds for 
non-payers.  Get me the annual report and I'll explain it to you.  I'll 
also bet you anything you want on this issue.  If I'm wrong I'll push a 
bowling ball down the middle of Main Street with my now while wearing a 
tutu.

>
>
> "Now, as I say, I don't have a dog in this fight (although I was born 
> there and delivered by the legendary Dr. Wilson for all you townies 
> who may care.)  The current health system in this country is a 
> disaster, but that's little fault of the hospitals.  It's systemic."--DB
>
> Right it is. And it is a disaster because why? We all know corruption 
> and greed is occurring in every state and city except ours? Is that 
> what you think? No corruption in Moscow, no greed, nobody trying to 
> get ahead or twist the system just a bit in their favor? Right, we all 
> know Moscow is nothing but incorruptible saints. We also know that if 
> someone where to come up with a way to make money off mandating health 
> insurance, we would all know, those people would be mean, have no 
> friends, have horns, a tail, and a have a specific line put on a bill 
> statement that was clearly marked that read,
>
> "Corruption and Fraud............................$200"
>
> Right in there somewhere between capsules and crutches. Obviously 
> clever people would not think to use an indirect approach that 
> required a little bit of research and inside knowledge to get at any 
> real understanding of what was going on. We are also fairly certain 
> that since this health insurance program was established under the 
> direct supervision of Dr. Hoover it is fiscally sound and in the long 
> term best interests of the students, University, and community--no 
> evidence to contradict this certain fact, right? 

This is just hyperbole.  If you have evidence of corruption that go to 
the authorities and stop throwing out libelous accusations.  I don't 
know Dr. Hoover and I don't care.  You're going to get yourself sued.  
Who is profiting from this besides the purveyors of the services.  The 
University isn't a person nor is Gritman.  They are "owned" by the 
public as  not for profit entities. 

>
>
> "I assume, but I don't know for sure, that Gritman makes its annual 
> reports available, in one form or another,  to anyone who asks for 
> it.   The accounting used is called Fund Balance Accounting where 
> there is no equity per say as there is no ownership.
>
> Right, like I said, look for the line that says, "Corruption and 
> Fraud...................................$200". they document that 
> stuff well in publically released budget statements, usually now found 
> online. Be careful though, sometimes they hide it under "Fraud and 
> Corruption (Hint: look under the F's)." 

This is unsubstantiated paranoia.

>
>
> Anyone with a bone to pick with Gritman should get that statement 
> before casting ad hominem attacks based on groundless assumptions and 
> vacuous logic.  My guess is, being familiar with such things, that 
> Gritaman has a minimal "free funds balance" and just about all 
> resources are earmarked for specific programs.  If you're really so 
> full of piss and vinegar on the issue get involved, donate your time 
> to the hospital, and study the finacials, so no one has to subsidize 
> you ignorance with spilled ink."
>
> Mr. Budge, I am very well versed in SHIP. I was an ASUI senator for 
> two years and watched this whole SHIP get started from infancy to 
> birth, ASUI was a part of it. I have a stack of the paper work of it 
> being developed. I have lots and lots of documentation on this issue. 
> And I didn't happen upon my understanding of what Gritman and UI were 
> doing by my own right. I had doctors, nurses, administrators, and 
> students at UI that approached me because I was the only ASUI Senator 
> that was openly and loudly opposed to the mandatory Health Insurance 
> Policy and a 25% increase in costs that gave students less benefits. I 
> didn't figure it out on my own, I had about 6 people (professionals, 
> not students) tell me directly. 

Your protestation over mandatory insurance may have merit.  But your 
overall understanding of the health care system is far too provincial.  
You have a complete right to question the program, but you better have 
more than nasty accusations when you accuse people of corruption that 
anything I've seen here.  You're facts just don't back up your rhetoric.

>
>
> "Lastly, is it so wrong that anyone makes a profit on anything?  How 
> ridiculously obtuse is this proposition?  We live in a market economy 
> and, although it sometimes lacks in fairness, it seems the best 
> current model in the egalitarian distribution of goods and services.  
> (hint to Mr. Arnold - you've got a University in Moscow - how 'bout 
> econ 101.)"--DB
>
> Well, Mr. Budge, first, show me where I said I opposed profit? I never 
> did say that. It seems to me the only way you can win an argument is 
> if you get everyone to agree on false statements as being fact or 
> changing the argument to be something I did not make. I am all for 
> profit. But I believe in honest profit. Not corruption. It is unfair 
> and unethical to give some businesses tax free state supported 
> business and tax exemptions  based on who are their friends. It should 
> be based on merit ONLY. 

Again, corruption?  Show us some facts.

>
>
>
> "Then pathetic whiners that think everything in the country relative 
> to commerce is out to get them will have the opportunity to take their 
> pathetic paranoia and pound sand. You should be thanking him for doing 
> otherwise thankless work. "
>
> No Mr. Budge, I think it is corruption that PREVENTS honest and hard 
> working men and women from getting a fair deal. It is people screwing 
> other people out of a fair shake that is wrong. Not free enterprise. I 
> think it is sick and twisted to make people buy $500,000 coverage 
> health insurance, even people on Medicaid, or otherwise be 
> disqualified from getting a college education. Is that Libertarian? 
> That is wrong, and unfair to the poor. And I will not apologize. 
> Thousands of students pay for SHIP and they don't even know it because 
> they are enrolled automatically. YOU DON"T THINK THAT IS WRONG?? It is 
> just fine and dandy to screw poor students out the last few bucks they 
> got left?? Those dollars should go to businesses that WORK for their 
> money right here in Moscow,  not siphoned out to some insurance 
> company in Ohio. 

People on Medicaid can opt out as they have proof of insurance. And no, 
it's not libertarian.  True Libertarian ideologues would say cover your 
own expenses and to hell with indigent care.  As I've told you, I'm not 
a libertarian ideologue and I believe that we are a wealthy enough 
country to support those truly in need. 

>
>
> "You may have an argument for socialized medicine (regardless of how 
> wrong heades it may be) but you're making assumptions here that are 
> based on, from what I can tell ...nothing."--DB
>
> Just because everything they say that is wrong about Socialism is 
> correct doesn't't mean everything about Capitalism is perfect. Balance 
> is the key. Get rid of corruption and health costs will drop 
> dramatically. Take care of those that are poor and sick and cannot 
> take care of themselves and they get well and contribute back when 
> they are strong. Don't kick a man when he is down and weak and turn 
> away and say it costs to much. In the long run, it is the cold 
> shoulder that costs so much more than the warm hand. 


I said in my earlier post that capitalism was sometimes "unfair."  I'm 
not seeing the corruption you accuse.  Hell, If I were on the board at 
the hospital or Dr. Thompson I'ld sue you into perdition for defamation 
and libel. 

>
>
> Remember the lesson here kids. It is better to be politically correct 
> and defend people doing wrong that are your friends, then to stand up 
> to the ripping off of 12,000 college students. Oh, how I get so 
> confused by this planet and the people on it. And God forbid, that you 
> ever say anything contrary to popular public opinion.
>
> Good Day,
>
> Donovan J Arnold
>
> BTW, Four generations of my family have been serviced by Gritman--And 
> they died anyway :P Can anyone beat that?
>
> PS.  Even people that don't like me (about 95% of the world 
> population) would have to agree that it was incompetence on part of 
> Gritman not to put my ass back as soon as my head popped out in room 
> ten. : P

Listen, I reacted the way I did because I can't accept someone impugning 
the reputation of good people trying to do good work.  I have no 
interest in political correctness and I certainly wasn't trying to chum 
up to anyone.  My politics are 180 degrees from many, if not most, of 
the people on this list. The difference between me and you, it appears, 
is that I go through life believeing that 99.99% of ALL people have good 
hearts.  We all spend our lives getting on and doing what we need to 
make the drole mundacity of existence something meaningful.  For all 
those who think that there is a thief at every turn I have sadness.  
Yep, we're all gunna die soon.  Better we spend those last few ephermal 
moments of life thanking those who are careing for us than worrying 
they're going to steal our shoes after we expire.

Other than that, I'm done with this, unless you can find some proof that 
there is actual corruption going on or I'm wrong in my facts.  If you 
can prove corruption I'll be right there to help you shackle the 
scalawags and hoist them off to the hoosgow.  It'll be my pleasure.

>
>
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