#ACA

Boeing 737 MAX-8 piñatas

The loss of life through any accident is tragic. Make no mistake. Yet if aviation authorities (AA) across the world were truly worried about the safety of the Boeing 737 MAX-8 they’d have grounded it after accident #1 when they’d learnt about the faulty AOA sensor issue. They could have issued Boeing with an immediate action to fix it. They didn’t. Just let the FAA do its work and adopted its resolutions. Now it appears they’ve merely followed the followers. It is as if they’ve felt social media pressure to cover their behind so as not be the last AA do so. It’s irrational. Think of it as aviation piñatas. Bashing with a blindfold.

China was the first to ground the plane. The stunt was in part a trade related issue because the FAA airworthiness directive wasn’t just issued inside a cornflakes packet and as the strictest aviation authority should carry weight. The FAA has said the evidence is not broad enough to justify a ban.

Having been a former aerospace analyst, this is the first time in a very long time CM can remember that a virtual global ban was put on any aircraft type. When Qantas flight QF32 (an Airbus A380) had an uncontained engine failure which ruptured the wing tanks and severing hydraulics, the airlines grounded their own planes as a safety measure, not the authorities. Singapore Airlines suspended its A380 flights for one day before resuming operations.

When AA587 crashed in Queens after the tail and engines sheared off, Airbus A300s weren’t summarily grounded. When AF447 crashed into the ocean off Brazil, A330s weren’t grounded as a precaution.

The Boeing 737-400 series had inert fuel tank issues where near empty scenarios could cause the vapor to ignite in the centre tank and lead to a deadly explosion. Several did explode. Some in the air. Some on the tarmac. These planes weren’t grounded. World aviation authorities, like Australia, issued advisories on how to ensure it doesn’t happen. Not knee jerk copy thy neighbor responses.

The list of 787 airworthiness directives (from fire issues, wings, flight controls to landing gear) stands at 52. FIFTY TWO. Sure a 787 has not crashed yet but where have the authorities been trying to ground the type until it has no ailments at all? Do they need a crash to rally into action? Or do they look at the issue on its individual merits? The 737 can fly without this AOA safely, which is why the FAA still allows its operation.

This seems to be follow the pattern of board governance today. Aviation authorities reacting with emotion, not data. Seemingly acting for fear of a twitter backlash rather than applying common sense to a problem and shutting out noise. Are social media trolls experts on aviation matters? Yet another “it’s better to be morally right than factually so” argument it would seem.

Maybe the biggest qualification is whether airlines ground them because passenger refuse to board 737 MAX-8s where they’re allowed to operate. However most passengers don’t look at the “registration plate” affixed to the top of the front left hand door jam as they board to see what type of plane they’re on. They don’t look at the safety placard in the seat pocket. Most certainly don’t pay attention to the cabin attendants during the pre flight safety instruction.

By the way, flight AA293 from Miami to Washington DC is scheduled to land 11 minutes early today. It’s a MAX-8. Passengers in America are prepared to put their faith in the FAA not the whims of social media activism led policy to unnecessarily ban something to appear virtuous.

US Healthcare bankruptcies surge 270% in 2018 vs 2017

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6 months ago we wrote of the growing crisis of hospitals declaring bankruptcy in America. While The Affordable Care Act (Obamacare) is often lauded by some as noble legislation, according to bankruptcy lawyers, Polsinelli, the changes made to reimbursements that used to help cover hospitals who treated uninsured patients that were pulled under ACA have sent many hospitals to the bankruptcy A&E ward. Polsinelli wrote this month,

The Health Care Services Distress Research Index was 455.00 for the first quarter of 2018. This is an increase over 173 points from last quarter’s record high, approximately 62 percent. The index has experienced record or near-record highs in seven of the last eight quarters. Compared with the same period one year ago, the index has increased over 333 points, approximately 270 percent, and compared with the benchmark period of fourth quarter of 2010, it is up approximately 355 percent.”

HCBR

Polsinelli also wrote in 1Q 2017 that,

“Unlike the public markets, the Polsinelli/TrBK Distress Indices include both public and private companies, creating a broader economic view and one which may show developing trends on Main Street before they appear on Wall Street….Health care distress is high and it seems to be getting worse…

…The business of health care is unlike other industries, such as manufacturing, real estate, or retail. Health care faces all the traditional business challenges, such as competition, the impact of technology on services, and increasing wages. But more, the health care industry is needing to adapt to increasing regulations, changes in reimbursement rates from government or private payors, and a shift from traditional fee-for-service to value-based models that impact profitability…There is unprecedented pressure of major systemic changes to the existing health care system, particularly the implementation of the Affordable Care Act over the last several years and the current status of the program, which is alternately being repealed, repealed and replaced, phased out, or simply defunded…The (Obama) administration’s recent decision to terminate cost sharing reduction payments will also directly impact the health care market. Insurance companies may continue to provide insurance at a higher premium or decide to exit the markets. Eliminating these payments and the resulting premium increases may increase the cost to the government through premium subsidies.”

In short many Americans saw a doubling of premiums (an average increase of 113%) under Obamacare inside of 4 years causing many to forgo the insurance. The reimbursements under the old system (which helped compensate hospitals administering emergency treatment for the uninsured) that were stopped on the proviso people would take up ACA plans backfired. Not enough people signed up and more hospitals running on a days cashflow have been forced to close because the reimbursements designed to protect them against uninsured patients disappeared. When Jonathan Gruber, the architect of Obamacare, testified to Congress he candidly said,

The Affordable Healthcare bill was written in a tortured way to make sure the (Congressional Budget Office) did not score the mandate as taxes…If CBO scored the mandate as taxes, the bill dies, OK? Lack of transparency is a huge political advantage … call it the stupidity of the American voter or whatever … that was really, really critical to get the thing to pass … I wish … we could make it transparent, but I’d rather have the law than not.”

Makes one wonder what the status of the medical equipment suppliers who lease equipment to these hospitals does with the machines they repossess.