Appreciate any discussion. I've got a call in to Michelle O'leary -Comptroller for the Illinois Life and Health Insurance Guarantee Association. They backstop the LTC policies written in Illinois. The Web page says the policy would be backstopped to the tune of about $300,000 (a little more than the policy face value). Illinois Dept of Insurance confirmed that that the $300K is in 2014 (non-inflated) dollars. The question I left on Michelle's voicemail is "tell me how much of a potential liability does this represent against the insurance guarantee fund" What percentage of the total fund does LTC policies represent?" If we have to count on the State of IL stepping in in any way it will be a disaster.
I've made 20% of the 10 pay payments and the next installment comes up in a month. I anticipate an increase is coming. At some point in the next couple of weeks, I will need to make the decision whether to keep paying, or try to claim the $17K in payments that have been made already as a tax loss.
I posed this question to a Ric Edelman type of advisor and should have an answer tomorrow.
I believe this is a huge issue since the government definitely does not want to see the incentive for being responsible and trying to make arrangements for LTC
disappear. Looks like the Guarantee fund needs to be underwritten by the government itself. If it sounds like I'm walking down the road to socialism , I'm wondering if that is the only option. If all the major private insurers have either exited this line of insurance or are floundering what is the alternative?
We are close approaching the 3rd installment of a 10 pay policy. Looks like in the case of a default on Genworth's part, the policy would fall into the state's insurance guarantee fund.
What a mess!! I only blame GNW to a small extent. Quite simply, the cost of Long Term Care is a run away freight train that stands to bankrupt the Country. Picture how many baby boomers will require LTC in the next 30 years. If private insurers are not able to make it work, then 90% or more of the aged will eventually end up on Medicaid.
It will take a long time to break the drought. Unfortunately, the water has to infiltrate and restore groundwater levels before the reservoirs can recover. Otherwise the water will exfiltrate from the reservoir. It's a great start but probably way too soon to talk about removing any incentives for conservation.
By the same token, if Brazil's climate is changing in a manner that makes droughts more common in the future (think about California over the past 30 years - the drought have occurred more frequently and lasted longer), then they will not be able to think of water as a unending renewable resource. Longer term preparedness will be necessary if the region is to remain the economic hub of Brazil. This may be a tall order to a left leaning administration. However, without adequate water supplies growth will be stifled and normal life will become more difficult.
The New Governor Rauner in Illinois should be a little easier to work with but this election may be a mixed blessing. The Illinois Citizens utility board was packed with Quinn appointees So life should get easier when Rauner takes more of a hands off market approach. However, with the changes in the senate the hope for carbon taxes or limitations will likely wither.. Sorting out relief to keep EXC from closing non-performing nukes will be a tough sell. However , Rauner may take up the matter since a lot of jobs in downstate areas are tied to these plants. Furthermore, Rauner may take up the matter since the previous wind plant subsidies may be viewed as an artificial force that should not have warped the market. As the Polar vortexes last winter proved, nuclear energy provides reliable base load energy. With Harry Reid no longer majority leader, there is a good chance that the nuke repository in Nevada may go forward.
Do you have any back up to document that chemo physicians are resisting medicare reimbursement for the prostate test. Certainly they stand to loose money from a reduction in the rates of over-treatment. However, I'm unaware of any organized resistance.
No problem. 25" in any short time period would trigger massive floods & mudslides. 2.5 will definitely help. Unfortunately, it is probably necessary to recharge groundwater levels some before the reservoir starts to hold a lot of water. An encouraging sign will be a sustained break from the drought pattern.
I still think of this as a call for SBS to strengthen the system so it is not so heavily dependent on water levels in a few reservoirs. Of course any company would want to be compensated for capital investments to improve the system. I'm not sure whether the current political system rewards long term thinking.
The entire response to this drought seems to be economic incentives to curb demand. What about some remedies on the supply side. GW supplementation of the reservoirs (better yet right to the treatment plants), modular or mobile desalinization plants. Aquifer storage and recovery, diversion of surface water from other sources.
This is on the verge of being crippling for Sao Paulo. They ought to be considering all options including tankering in water from other geographic areas. Of course, the users should bear the costs of extrodinary measures.
I'm also not a big fan of Zack's. To me the most interesting thing about GHDX is that they are posting pretty strong growth in Europe while the EU is mired in a deflationary recession. GHDX is moving up without much change in volume. A good quarter could light a fire under the stock since there is very little available float. Similarly, Medicare reimbursement coding for the prostate test would be a huge development. While someone out there did not like the Exact Science post, it does however demonstrate two points:
1) Medicare is not afraid to pay up and reimburse at higher than anticipated rates for tests that ultimately save overall health care costs; and
2)These approvals can act as a launch pad for nice upward moves in share price.
I got interested in CGM Focus since it had the ability to go long or short. Unfortunately Heebner appears to be a perma-bull. With QE being phased out, global deflationary evidence, very high CAPE valuations and the threat of Ebola, one would have thought he would have established a few more shot positions (beside the long bond). The last two times QE ended the market reacted similarly, so it does not take much of a crystal ball to figure out that this was a good time to go short. Fortunately I've done so by buying TWM in some of my brokerage accounts. Does anyone know if Hebner has ever used the short position effectively??
I believe that GHDX is up today because Exact Sciences received a higher than expected Medicare reimbursement rate for their colon cancer test. I think the market is warming up to the idea of genomic testing to reduce health care costs.
Good thing you got out of that position. Any company that shows strength in this kind of a *&^%&* MARKET IS NOT A GOOD SHORT CANDIDATE. Besides there are too may potential positive catalysts that could turn against you.
I think it has held up for the reasons outlined in my previous post. The market the past couple weeks has been anticipating a deflationary environment. GHDX is precisely the type of stock that can do well in a deflationary environment. Stocks that wring costs out of the system (especially by reducing costs to over leveraged governments of developed countries with aging demographics) will do well.
Today's job data was good and may throw some cold water on the idea of deflation in the US. Don't think there is much doubt that Japan and Europe are headed down a deflationary slope.
Another stock I like based on this investment theme is NVS. However it has already run up. I sold 25% of my holdings since I had big gains but would reload if it drops into the 80's. NVS is the #1 biogeneric drug producer in the world. $64B in biologic drugs come off patent the next couple years (including Humira the best selling drug of all time.
Always appreciate intelligent comments in what is otherwise a complete wasteland.
GHDX is trading well thru the small cap carnage going on now. II believe this is a function of four factors:
1) GHDX did not experience much of any share price run up the past several years.
2) If we are headed into a deflationary environment (which much of the market seems to be betting on) then companies that wring costs out of high gov expenditure areas such as health care are in a sweet spot.
3) The PR machine is cranking up in advance of an anticipated reimbursement code for the prostate test. This code will mark a turning point.
4) The float is small and most shares are held by insiders. trading out of GHDX has risks, since GHDX may be hard to re-enter on any good news.
GHDX appears interestingly positioned at the crossroads of a graying demographic that will need more cancer related services especially with regards to making informed decisions. On the other side are the reluctant payers who will be required to get as much bang for the buck (or Euro) as possible. The fact of the matter is the debt laden developed countries will have no choice but to try to be more efficient in health care spending. Europe seems to be crossing this bridge before the US as indicated by NICE putting the clamps on spending in the UK.
My biggest question is whether OncoDX prostate test is better then other tests (similar to the Onco DX Breast Cancer tests)? The GHDX partners (Cleveland Clinic, UC San Fran, CPDR) are appear strong and GHDX emphasizes the advantages such as not as susceptible to heterogeneity issues, . The PR department seems to be cranking up the presses lately. Hopefully this is the precursor to reimbursement approvals.
GHDX tends to put out a few fluff news releases. However, enlisting Joe Torre to put a face on prostate cancer is likely to be very helpful. The battle to up the awareness of genomic testing's role in treating this disease will benefit from having a spokesman that garners name recognition from most men. Referral/testimonial/personal accounts tend to be some of the strongest educational and sales tactics.
Guess I do not understand SBS either. Seems like the unit pricing of water should increase in order to drive SBS to develop alternate sources such as groundwater, pipelines from more distal supply areas, etc. They seem to be totally focused on the demand side by offering price cuts for reduced usage. Even if the rain begins falling again the money spent developing alt water sources is a good investment in the future.
When Science Outpaces Payers: Molecular Diagnostics Pose Reimbursement Dilemmas
Quote:Many see the industry at a crossroads, with reimbursement issues at the center. The future of molecular diagnostics is both entwined in the broader discussion of paying America’s healthcare tab and constitutes its own separate beast, for reimbursement issues present a steep scientific and regulatory challenge. Most of the experts who spoke with Evidence-Based Oncology predicted an industry shakeout would occur, with some promising small companies joining large ones while others will disappear.
Right now, the divide looks like this: Payers have seen a new cost category explode across their balance sheets, and they are determined to understand what they are funding and whether tests are necessary. Molecular diagnostic companies, meanwhile, say they can’t understand what they call a penny-wise, pound-foolish approach. Why, they say, should insurers pay ever-rising sums for cancer therapies, with prices measured in tens and hundreds of thousands of dollars, but balk at a $3000 test2 that would tell doctors whether the drug is likely to work?
“We overtreat people continuously in this country,” said Macey Johnson, vice president of managed care and reimbursement at bioTheranostics, based in San Diego, California. “It’s overkill to give people all these drugs, with oncology being the poster child.”
As both regulators and testing companies implement a new reimbursement law, many stakeholders see opportunities for change. “It brings the industry into the bright light,” said Mike Barlow, vice president of operations at Palmetto GBA of South Carolina, the Medicare contractor that developed the MolDx program to create billing expertise around an emerging industry. “Too often, the lab industry has been opera
From what I understand MNTA filed the necessary data in May and does not see this to be an impediment to approval.