Author Archive

GrandMa Versus ObamaCare: The Coming Political Battle

Over the next 10 years, if left unchanged the Affordable Care Act (ACA) will take $500 billion from Medicare.  Medicare beneficiaries will see higher premiums. Doctors, nurses, hospitals, and medical suppliers will get lower payments. Under ObamaCare Medicare reductions will be used to subsidize expanded Medicaid to low income recipients and to fund insurance for the uninsured. This redistribution of funding from old to young is the most controversial part of Health Reform.   

In addition to the current beneficiaries, 78 million baby-boomers become eligible for Medicare over the next decade-and-a-half. Because of the ACA, they will get less healthcare so that others will get more. Payment reductions will lower their access to high-quality preventive services, early intervention, and acute care treatments. Is this fair?  

Medicare beneficiaries paid for Medicare during their entire working life. They paid for the coverage with Medicare taxes and continue to pay with Medicare premiums. Why should they now be singled out to bear the cost of health reform?

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Over the Counter Changes: Bad News for Patients

The new health law’s restrictions on the use of tax-favored accounts to purchase over-the-counter (OTC) medications will begin on January 1, 2011. Patients with Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs), and Health Savings Accounts (HSAs) who purchase OTC medicines with their account debit cards will find denial confusion, and disappointment at the pharmacy checkout counter.

Those with FSAs or HRAs, who expect reimbursements from their accounts, will see their claims have been rejected. Those with HSAs may experience an IRS audit and a 20% excise tax penalty for an ineligible withdrawal. To make matters worse, the amount of money that can be set aside in FSAs for medical care will be limited to $2,500 in 2013.

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Moms as Doctors

In most families moms are the caregivers. They know the right cough medicine, the right dosage, the difference between aspirin and Tylenol, and what to do for their child’s allergies. Most moms have a box or tray with all kinds of cures for their children. Mom’s “medicine box” is there to fix the middle-of-the-night pains and fevers. God bless moms.

Relief may range from chicken noodle soup to special itch-soothing creams. Moms handle most issues with love and the right choice of home remedies and over-the-counter medications. If it’s not in “the box” a quick trip a local 24-hour pharmacy will secure the needed treatment. If mom’s care and time don’t make the hurt go away, a doctor’s visit may be in order. But, for most situations a caring mom, Mother Nature and over-the-counter medications get the kids well, and avoid unnecessary visits and expenses to the see a physician. 

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Employee Health is Human Capital

Human capital and equipment capital are very different. Human capital brings intelligence, problem solving, creativity, teaming, and “intrapreneurial” values to a business. Employees bring understanding, compassion, mentoring, and flexibility. That is why human capital is the most important asset of any business.  

A June 2010 survey supported by the Institute for Health and Productivity Management found that 62 percent of American businesses and nearly 85 percent of employees say the workplace must play a leadership role in creating a healthier workforce and helping to curb rising healthcare costs. In their own self interest, employees want employers to take an active role in creating a healthy workplace.

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Using Financial Incentives in Health Care

Financial rewards are critical to changing behaviors. If individual willpower were good enough, we would not have growing diabetes and an epidemic of obesity in this country. The recently enacted health reform law allows the use of some current financial incentives and rewards to continue. In some cases it imposes new restrictions. In others it makes the employer’s options more liberal.

Rewards and incentives can take on many forms. The chart below the fold describes several options employers can use to engage employees in healthy choices. Both positive and negative incentives are possible. Existing rules allow a combination of rewards and penalties to exist within the same structure as long as the difference between the best and worst financial impact is within the ObamaCare allowances.

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Have the Worst Features of ObamaCare Even Been Announced Yet?

For flexible strategic planning, there are four major phases to consider: Legislation, regulation, compliance and litigation. 

Legislation. The confusing and sometime contradictory language of the hastily drawn law will likely require a large “technical corrections” bill. In Washington, technical corrections are not limited to a layman’s understanding of the words “technical corrections.” Politicians and special interests can use a technical corrections bill to pass new provisions and mandates. A technical corrections bill could include entirely new provisions not a part of the original law. For example, the public option could return as a “technical correction.” Look for a technical corrections bill this summer. Stay alert, the devil is always in the details. 

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Georgia Taking Lead in Interstate Insurance Laws

Gov. Sonny Perdue is showing the way on how states can implement cross-state selling of individual health insurance. States can voluntarily enter into reciprocity agreements with like-minded states. Together they can create a multi-state market attractive to insurers selling new lower cost comprehensive products.

His push for free-market insurance reform is embodied in two bills, making their way through the legislation process.

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Tea Party Moms: Report from the Trenches

From its early beginnings the Tea Party was dismissed as irrelevant and then derided by the national media. In the summer of 2009 health reform was the hot topic of concern across the nation and to the Tea Party movement. The media, the Obama administration, and Democrats described opposition and questioning Tea Partiers as “mobsters, anti-American, and Nazis.”  President Obama referred to them dismissively as “tea baggers.” The New York Times attempted to link Tea Partiers to militia extremists.

All these characterizations are wrong.

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Congress Declares War on HSAs

While Congress has been debating health reform, employers have been creating new consumer-driven plans that lower costs and improve the quality of care. More than half of employers now offer consumer-driven options, including Health Savings Accounts (HSAs) and by 2010, nearly 18 million people will be enrolled.

Federal legislation can stop progress in its tracks, however. The Senate proposal, for example, does not directly outlaw HSA-eligible plans; but it restricts HSA options in insidious ways that will delay, deny, defeat and ultimately kill them. 

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