Head to head on health care

Jul. 14, 2008 02:35 PM
The Arizona Republic

	Barack Obama	John McCain
Uninsured	Obama: Advocates a new national health plan that would be similar to the Medicare program that provides coverage for senior citizens. All children would be covered, either through an expanded State Children's Health Insurance Plan (SCHIP) or private plans. Young adults could be carried on their parents' insurance until they are 25. His goal is universal health coverage by 2012.	McCain: Would reduce the ranks of the uninsured through a combination of tax credits, promoting health-savings accounts and increased competition among private insurers. He would eliminate the tax exclusion on employer-paid benefits. The federal government would give a $2,500 tax credit for individuals or $5,000 for families to purchase private insurance or sock away in a medical savings account. Also, McCain would work with states to create a "guaranteed access plan" that would provide coverage for people who have had difficulty securing private insurance due to pre-existing medical conditions or other reasons.
Impact on employers	Obama: Employers would be required to help pay for health insurance for employees or contribute a portion of their payroll to a national health plan. Some small businesses would be exempt (based on revenue thresholds).	McCain: It's unknown what impact McCain's plan would have on employer-sponsored health plans. Employees would have the option of taking the tax credit and dropping their employer-based health coverage. Some experts believe that would be an appealing option for younger, healthier workers who can purchase inexpensive private insurance.
Private insurance companies	Obama: Private insurers would be subject to oversight by a group called the national health insurance exchange. Insurance companies would be required to issue a policy to every applicant and could not reject applicants based on pre-existing medical conditions.	McCain: His plan to offer tax credits to consumers may bolster private insurance plans, particularly those that sell to individual consumers rather than groups such as large employers.
Consumers	Obama: Consumers could purchase private insurance or the government's plan.	McCain: People would get tax credits and would have access to portable insurance that provides coverage even if they switch jobs.
Prescription drugs	Obama: Would allow consumers to purchase cheaper prescription drugs abroad if they are proven safe. Wants generic drugs to be made available sooner.	McCain: Would allow consumers to purchase cheaper prescription drugs abroad if they are proven safe. Wants generic drugs to be made available sooner.
Technology	Obama: Would spend $50 billion over five years to establish advanced information technology for health providers to reduce costs, medical errors and inefficiency. Also would advocate federal funding to biomedical research.	McCain: Would spend an unspecified amount to establish advanced information technology for health providers to reduce costs, medical errors and inefficiency. Also would advocate federal funding to biomedical research.

Software, BPO industry growth will slow down in 2009: NASSCOM

The Economic Times

NEW DELHI: The software and business process outsourcing (BPO) industry's growth is expected to slow down considerably next financial year, the organisation representing the Indian software industry says in its annual report released Wednesday.

The National Association of Software and Service Companies (Nasscom) report said while the industry clocked a combined growth rate of 28.2 percent in 2007-08, this is expected to slow down to between 21-24 percent in the next fiscal.

But even the projected growth rate of 21-24 percent is "robust" and in sync with the industry target of achieving $60 billion of exports by 2010, Nasscom president Som Mittal told reporters.

He said the industry was "right on target" to achieve the 2010 export goal.

"In the last eight years the average growth rate has been 33.7 percent. We have had as much as 50 percent growth in a single year initially. But it is natural for the growth to stabilise as the industry grows," he said.

The gross revenue from domestic as well as export markets increased to $52 billion in 2007-08 as compared to $39.6 billion the year before.

However, the growth rate fell from around 33 percent in 2006-07.

Exports of information technology (IT) services alone grew by 28.2 percent to gross $23.1 billion, while the BPO sector showed an increase of 30 percent, fetching $10.9 as compared to $8.4 billion the previous fiscal.

Mittal said the industry handled the subprime mortgage crisis in the US well by venturing into industries that were not affected, such as transport, telecom and healthcare.

He, however, admitted that 2007-08 was a "difficult" year because of slowdown in the US economy, the oil and food crises, and currency fluctuations.

Mittal said the full impact of the situation in the US is yet to be felt by Indian companies, and that corporates would have to find ways to cut costs and enhance productivity.

"The cost-cutting measures can have an impact on recruiting process of these companies and the pay-packages offered to fresh graduates," he added.

IT services and the BPO sector has a two million-strong workforce that is increasing by 26 percent annually, the Nasscom report stated.

Mittal brushed aside concerns about the future of outsourcing as it has become a major issue in the run-up to the presidential elections in the US.

"In 2003-04 elections also, offshoring had become a major issue, but the industry has only grown ever since. It is more of an emotive issue. Barack Obama, (the Democratic hopeful) who once voiced his concerns about outsourcing recently acknowledged its importance and referred to it as 'inevitable'," he said.

Muscling in on Medicare

Legislative fight in Washington puts patients in midst of doc-insurer struggle

July 8, 2008 | Newsday.com

A Medicare tweak on the table in Washington is pitting doctors against insurers - with patients in the middle. Doctors are facing a steep cut in Medicare payments, and many say that if that happens, they'll reduce or end their participation in the program. And that will make it harder for elderly patients to get care.

The alternative is to trim what Washington pays private, Medicare Advantage plans. Insurers, some of whom underwrite those plans, are airing television commercials warning that will mean patients losing coverage or paying more.

For patients, this all sounds like heads you lose, tails you lose. But things aren't that bleak. Not if Medicare Advantage plans take the hit, as they should.

The problem is that doctor reimbursements will be slashed 10.6 percent unless Congress acts to stop it. A cut that deep is unrealistic. The House voted June 24 to increase payments to physicians by 1.1 percent. But the bill is stalled in the Senate and, should it pass, President George W. Bush has threatened a veto. The sticking point is cost.

The bill would take the money from those private plans - which is where it should come from. Medicare Advantage plans were pushed by private marketers who said they would save taxpayer dollars. But Washington pays the plans 13 percent more per beneficiary than it would cost to cover that same person under government-run Medicare.

Pitting private plans against traditional Medicare is a sound idea. Competition should make each better. But a fair contest requires a level playing field, and right now it isn't. Not with private plans being paid more per patient.

The pending legislation wouldn't end that disparity. But it would reduce it and free up money to pay doctors. That would be a win for most Medicare patients and taxpayers.

FACTBOX: McCain and Obama on health care and retirement

Mon Jul 7, 2008 9:41am EDT | REUTERS

(Reuters) - Health care has ranked among the top issues with U.S. voters in this presidential election cycle, and the Social Security retirement program is a perennial issue for the country's influential elderly population.

Both Barack Obama, who has claimed the Democratic nomination, and John McCain, the presumptive Republican nominee, have offered health care and retirement proposals. Here is a summary of their positions.

HEALTH CARE

McCain would end tax breaks for employer-provided health insurance and instead provide a refundable tax credit of $2,500 per person, or $5,000 for families, to help people buy health policies. He would promote competition by allowing people to buy insurance across state lines and he would make it tougher to sue doctors in some cases.

Obama has proposed a national insurance program to allow individuals and small businesses to buy affordable health care similar to that available to federal employees, funded by a tax on employers who don't provide coverage. Individuals would not lose coverage when they switch jobs.

He would lower premiums through a program that would reduce the exposure of employer health plans to the costs of a catastrophic illness. Drug costs would be lowered by allowing patients to buy drugs from abroad and letting the government negotiate for lower prices.

SOCIAL SECURITY

McCain has said he would work with Congress to rein in the growing costs of retirement programs and has suggested changing the way benefits are indexed to inflation. He has also supported creating private retirement accounts for younger workers.

Obama opposes private retirement accounts. Affluent workers would pay more in taxes to ensure that Social Security is fully funded.

Obama wants to automatically enroll workers in retirement plans to boost savings, though employees could opt out if they choose.

(Compiled by Andy Sullivan, Donna Smith and JoAnne Allen; editing by David Wiessler)

Healthcare groups use ads to lobby lawmakers on Medicare bill

July 03 2008 | McKnight's Long Term Care News

Congress may be on break this week, but two industry groups launched ads spurring the Senate to take action on a Medicare bill that affects nursing home residents and other older adults when it returns from the Fourth of July recess.

The American Medical Association unveiled an advertising campaign to encourage passing the bill, H.R. 6331. Targeted towards opponents of the legislation, the ads say the issue boils down to a choice: insurance company profits, or seniors and disabled vets who will lose their access to healthcare. Meanwhile, insurance lobbyists are working on their own anti-H.R. 6331 advertising blitz. They argue that the cuts to Medicare Advantage plans that would fund the bill would limit choices, reduce benefits and pass on higher costs to seniors.

This week, two harmful actions went into effect: the expiration of the exceptions process for Part B outpatient therapy caps, and a freeze on Medicare physician payments. Therapy caps, which affect nursing home residents, impose a $1,810 limit on physical therapy and speech therapy combined and $1,810 on occupational therapy for nursing home residents. Residents in Medicare-certified beds at a skilled nursing facility will not have therapeutic services covered past $1,810, according to a note from the Centers for Medicare & Medicaid Services. Others who exceed the cap, however, may obtain medically necessary therapy services at a hospital.

Medicare Payment Fiasco Causes Delay in Claims Processing

Action Should Not Mean Delayed Payments

By James Arvantes | AAFP News Now
7/1/2008

The Bush administration has announced it will delay the processing, but not necessarily the payment, of Medicare claims to give Congress more time to pass a bill blocking a 10.6 percent reduction in the Medicare payment rate. However, the administration's action should not result in delayed Medicare payments to physicians, said Kent Moore, the AAFP's manager of health financing and delivery systems.

CMS is required by law to hold Medicare claims it receives for 14 days before issuing payment on the claims. In normal circumstances, the agency starts to process claims within a few days of receiving them, paying them by the end of the 14-day time frame, Moore said. CMS now plans to hold Medicare claims for 10 business days before processing them to give Congress more time to pass Medicare payment legislation that is expected to negate a 10.6 percent payment cut effective July 1.

"CMS will use that 14-day window they have statutorily and refrain from processing the claim," Moore said. "Instead of processing (a claim) at the front end of that 14 days, they will process it 10 days later on the hope that Congress will act within the first days of July," said Moore. "Physicians should not see a delay in payment," he added.

In late June, the House overwhelming passed an 18-month Medicare physician payment bill that would have prevented the 10.6 percent reduction scheduled for the remainder of this year, along with a 5.4 percent cut scheduled for 2009. But the Senate failed to pass the legislation, allowing the 10.6 percent cut to take effect on July 1. Congress adjourned for a weeklong July 4 recess on June 27 and will return on July 7. Senate Majority Leader Harry Reid, D-Nev., in a prepared statement, said the Senate would address the Medicare legislation shortly after returning from the July 4 break.

Many physicians, meanwhile, are upset and angry, said Moore, thinking CMS will withhold Medicare payments, a perception that he characterizes as a misunderstanding.

"CMS is simply saying that they are going to take advantage of the 14-day payment floor they already have by law," Moore said. "They still intend to pay claims in a timely manner."

Although physicians will experience a reduction in their Medicare payment levels if Congress and the Bush administration cannot agree on a Medicare payment bill by mid-July, there is an expectation that they will agree on a payment bill by then and will make the legislation retroactive to July 1.

CMS has said that physicians should submit their Medicare claims for services on or after July 1 using the pre-July 1 scheduled amount. Claims submitted after June 30 that reflect the 10.6 percent reduction will be paid based on that amount, and "will likely require providers to resubmit a revised claim," said CMS in a June 30 press release.

Submitting claims with pre-July 1 amounts "will facilitate reprocessing of the claims by CMS, if needed, and will ensure that physicians are able to collect the full pre-July 1 allowed amount, when or if the cut is retroactively negated," said Moore.

However, noted Moore, "physician practices may only collect copayments and deductibles from Medicare beneficiaries based on the reduced (Medicare) rate, even if they are charging the pre-July 1 rate to Medicare."

Physician practices wishing to avoid confusion may choose to hold their Medicare claims in-house until it becomes clear that new legislation will be enacted or until cash flow becomes a problem, said Moore. "This will reduce the need for (physicians) to reconcile two payments -- the initial claim and the reprocessed claim -- and it will simplify physician billings of beneficiary co-insurance and payment calculations for payers that are secondary to Medicare," said Moore.

Obama for tough stance against job outsourcing by companies

Sridhar Krishnaswami
Washington, Jun 28 | Press Trust of India

Taking a tough stand against outsourcing, the presumptive Democratic nominee Senator Barack Obama said that the choice is between giving tax breaks to companies that ship jobs overseas or give benefit to those corporations that keep jobs domestically.

"We can keep giving tax breaks to companies that ship jobs overseas, or we can give tax benefits to companies that invest right here in New Hampshire," Senator Obama said at a joint appearance with Senator Hillary Clinton in Unity, New Hampshire.

"We can have a tax code that rewards wealth and hands out billions of dollars more to big corporations and multimillionaires. Or we can provide a USD 1,000 tax cut to 95 per cent of families in America, start rewarding work and not just wealth, and eliminate income taxes for seniors making USD 50,000 a year or less," Obama said, adding that's an agenda for change that we can believe in. That's the choice that we can make in this election.

"We can allow millions of Americans to work full-time but still not make enough to support their families, or we can raise the minimum wage, index it to inflation, and ensure that hard work pays off in America," the Illinois Senator said. - PTI

Keeping healthcare reform on the front burner

By Ellen Lutch Bender | June 16, 2008 | boston.com

NO SINGLE reform would do as much to improve the wealth of our nation and the lives of Americans as a comprehensive overhaul of our healthcare system. But the best chance of swift and major reform may have died with the end of Hillary Clinton's run for the White House.

Senator Clinton kept healthcare on the front burner, promising action in her first term. Healthcare has already slipped as the top domestic concern, a position it held earlier in the campaign for the first time since the last Clinton campaign in 1992. The economy has passed it. But you can't have a healthy economy without a functioning healthcare system.

Unfortunately, there are no easy fixes, no simple wands that can be waved to solve what ails our healthcare delivery system. Also, there are far too many constituents to alienate along the way.

America should be the envy of the world when it comes to delivering healthcare, since we pay more per capita than any other nation, soon nearly 20 percent of our gross domestic product. In many areas of medicine, particularly in research, we are leading the world. But in others, we are not keeping pace.

We have the second-worst newborn mortality rate in the industrialized world, and rank highest in preventable medical errors. Even worse, one in six Americans has no access to high-quality medical care. What we need from the next president is real leadership and a vision for changing what's wrong with our healthcare system.

Senators John McCain and Barack Obama have reform plans that take divergent paths, neither of which is as comprehensive as Clinton's. Obama would require that children have health coverage, but not adults. The problem with that is if there is no mandate for adults, the young and the healthy will opt out, leaving the older and sicker in the system. This would likely force premiums up.

Obama takes a page from the Massachusetts health reform law and would require employers to offer "meaningful coverage" or contribute to a new public plan for the uninsured and small businesses. He also says health insurance would be more affordable with lower co-pays and deductibles, and he would require insurers to offer coverage without exclusion for preexisting conditions. He would also allow those without insurance through an employer to buy into plans now available to some federal employees.

McCain's plan follows the Republican playbook, that the answer is to cut costs and inspire all Americans to buy insurance by means of tax incentives. His plan would end the tax deduction that employers get for their share of employees' premiums, thus undercutting the employer base of most families' insurance. Instead, he would give families a $5,000 tax credit toward any coverage they buy.

The McCain camp says the tax credit should encourage insurance companies to develop plans that come in at that price, no easy task in high-cost states like Massachusetts. He would encourage competition by allowing insurance to be sold across state lines.

Both plans fall short, and neither truly promises universal access. McCain's plan is particularly radical in that it would eliminate the "safety net" that employees have come to value and would undoubtedly put more of the cost of healthcare directly on individuals and families. It would likely swell the numbers of uninsured rather than reduce them. Furthermore, individual insurance sold on the open market is inevitably more inefficient for insurers and more expensive for consumers. It may make it harder for those with chronic conditions to get health insurance.

There are three areas the next president must focus on, and all three must be in balance: making sure every American has health insurance, improving the quality of care, and controlling costs. Viable solutions to our nation's healthcare crisis will require a bold plan for action, not rhetoric. We can thank Clinton for driving that point home. Whether her health plan was right or wrong, she was tenacious and brave, and her plan was the most comprehensive and detailed. We should demand the same from McCain and Obama.

Ellen Lutch Bender is president and CEO of Bender Strategies LLC, a Boston-based healthcare consulting firm.

Inside Politics: Insurance law will bring monthly premiums back up

Rebecca Boyle | The Tribune
June 8, 2008

Colorado motorists who are unfortunate enough to be injured in a crash will have one less thing to worry about thanks to a bill signed by Gov. Bill Ritter late last week.

Or they'll have one more thing to worry about. It depends on your perspective.

Ritter signed Senate Bill 11, which will require every auto insurance policy issued in Colorado to have $5,000 of medical payments coverage, known as "med pay." It has an opt-out clause, too, so people who determine they don't need the extra coverage don't have to get it if they don't want it. But now they will have to have the option.

The law will help motorists, especially those who don't have health insurance, by offering enough money to cover the cost of a typical ambulance ride, for instance. Those who do have health insurance could use the med pay to cover their deductible or out-of-pocket expenses.

But the new system also is likely to increase the cost of insuring your car.

Colorado ended its long-standing no-fault auto insurance program in 2003 and switched to an at-fault system. Under the old system, a driver injured in a crash would have his medical expenses covered by his own insurance, even if it wasn't the driver's fault. Under the newer system, the at-fault driver is responsible for payment, and before payment can be made, someone has to determine whose fault it was.

Medical payments coverage became optional under the new system, and many motorists either thought they didn't need it or decided to save money on premiums by going without it.

But some drivers who don't know about that or don't buy enough coverage can't afford their medical bills. They can sue the at-fault driver, but that might not matter if the person at fault doesn't have much money.

That has meant trauma care providers are often unpaid because the injured motorist can't afford to pay.

The Trauma Care Preservation Coalition, a group of ambulance companies, hospitals and other emergency services providers that formed to address the problem, said the system has cost hospitals and ambulance companies millions of dollars in unpaid bills, and that translates to higher costs for patients who can afford to pay.

In 2002, under the old system, hospitals were reimbursed for about 60 percent of the care they provided to motor vehicle accident patients, according to a report commissioned by Ritter's office in February. By 2006, that number had dropped to 36 percent, the report found.

Reverting back to a mandatory med-pay system will ensure that more of those expenses are covered -- $5,000 worth, at least.

Ritter said the bill would help consumers and emergency services providers.

"Almost everyone has out-of-pocket medical expenses, such as co-pays and deductibles, which could be paid for by medical coverage in the event of an accident," he said in a statement. "Senate Bill 11 will help ensure that every Coloradan has the coverage that he or she needs and that ambulances, physicians and hospitals are paid for the critical care that they provide."

But that comes at a price.

Mandatory extra coverage will likely drive up insurance premiums, said Alan Miller, assistant public affairs manager for State Farm Insurance, based in Greeley.

"We were opposed to SB11 from the standpoint of, as much as we are happy to sell people our products, we don't feel people should be forced to buy additional insurance that they may not need, want or, frankly, be able to afford," he said. "This bill will require people to buy additional insurance."

Though they can opt out, Miller said many people don't, not only because they think they have no choice but because that option requires a written declination of the coverage. That will result in higher costs for everyone, as insurers are forced to carry more policies.

Since the at-fault system went in place, auto insurance premiums decreased throughout the state, up to 35 percent, he noted.

"That's really what moving away from no-fault was designed to do. With no-fault, it was so out of control; there were so many things that had been added on that, that it was becoming so expensive. It was just skyrocketing," he said.

Industry representatives said things like massages and even aquariums were covered under the old system, because they were considered rehabilitative. While SB11 won't reintroduce those kinds of problems, rates will likely creep skyward, Miller said.

"I think we've hit the bottom, and because of these legislative mandates, we're going to be seeing rates go up," he said.

* * *

« School's out for summer ... and it will look different when you get back

Across-the-board tuition increases approved in the past week mean that students will have to pay even more next year to attend schools like Colorado State University and the University of Northern Colorado. But they can take comfort in one area: The campuses will look prettier.

Northern Colorado lawmakers were instrumental in finagling new ways to find extra money for projects at CSU, UNC and Front Range Community College, among others.

Gov. Bill Ritter signed a bill last week that will allow UNC to proceed with renovations to Butler-Hancock Hall, home to the athletics department.

Nate Haas, spokesman for UNC, said the money will pay for renovations to academic areas, including a classroom addition, upgraded electrical wiring and reconfiguring locker rooms to maximize space. The building will also get air conditioning, which does not currently exist throughout.

"The hope was that the facility would be more marketable for private users, and of course for the community who attend events there," he said.

He said the renovations had been on UNC's master plan for a couple years.

It was the first project on the state's list and will cost $11.591 million.

State Rep. Jim Riesberg, D-Greeley, is on the powerful Capital Development Committee and helped push for the legislation that allows the extra spending.

Two Fort Collins institutions will also see funding under the bill. Front Range's Larimer campus will get a hefty $14.81 million to pay for a science classroom addition and renovations.

CSU's monstrous Clark building didn't make out with as much -- just around $2 million -- but it'll be enough for "revitalization," which could mean fresh paint and carpeting.

The money will be available thanks to Senate Bill 218, a bipartisan measure sponsored by Western Slope lawmakers that alters the way Federal Mineral Lease revenues and bonus payments are allocated. According to Ritter's office, the measure creates two new funds to support higher education, one for construction and another for maintenance. Existing FML beneficiaries, including K-12 education, local communities impacted by oil and gas drilling and the Colorado Water Conservation Board, will also reap millions of dollars under the new law.

Last month, Ritter signed a companion measure, Senate Bill 233, which allows the state to issue certificates of participation backed by SB218's new revenue streams. Those certificates, which are similar to bonds, will amp up funding for more than a dozen higher-education construction projects around Colorado.

A look at the presidential candidates' health care proposals

Sunday, June 8, 2008
By Linda Redeffer
TBY | SOUTHEAST MISSOURIAN

As candidates campaign for the nation's highest office, they make promises about reforming health care. Actually delivering on those promises can be another matter entirely.

A visit to the Cape Girardeau Senior Center revealed that most retired people there that day had Medicare and a supplement and were, for the most part, satisfied with them. Some have found they unexpectedly had to dip into their savings to pay for health care costs.

Brenda Hargrave, part-time administrative assistant at the center, has looked at the health care proposals from candidates John McCain, Barack Obama and Hillary Clinton. She said that while she has not yet decided whom she will vote for, she believes Obama has the best proposal.

But any real kind of health care reform will not come from anyone running for office, Hargrave said.

"While [Obama] addresses concerns, there are things going on that if they would enforce what they already have in place, the government would be out a lot less money now," she said.

Hargrave said she has 30 years' experience in medical billing, collecting and management. She has seen first hand where reform needs to take place, she said.

Health care reform, she said, should start with the "usual and customary rates," or UCR, established by Medicare and Medicaid. Medicare/Medicaid providers say they will pay 80 percent of an insured person's medical costs, but in fact pay an amount based on what they consider "usual and customary," often less than what a doctor or hospital charges. Physicians and hospitals write off the difference and recoup it from patients with private insurance or uninsured patients who are expected to pay full price for procedures, often in advance of being treated, Hargrave said.

"If doctors participate in Medicare they're not allowed to charge more than a certain amount. Some doctors refuse to take any new Medicare patients because they know they can't get any more money," she said. "They leave room on their schedule for other patients with private health insurance because they know they will get more money."

"Everybody needs the same UCR, whether private, Medicare, Medicaid or whatever. No insurance should be charged more than the UCR; UCR should be established across the board."

Better oversight on Medicare/Medicaid billing could save hundreds of thousands of dollars, Hargrave contends.

"I have personal knowledge of one Medicare patient who had a problem with Medicare," she said. "I kept billing, trying to get them to pay. When they did pay, they paid 20 times for the same office procedure. The money went in that patient's account as a credit. I was told not to return credits until somebody found them."

When she made one company aware of double billing for a one-time procedure, she said "nothing was done about it. That's why insurance costs are out of line."

Hargrave said more people should monitor their doctors' office billing procedures and codes and compare what is being charged with the work actually delivered.

"If we could get that done, then health insurance will be within reason and the government will have a lot more money," she said.

Hargrave said she would like to see part-time employees have access to the same insurance as full-time employees. For a semiretired person not yet on Medicare, the cost of health insurance leaves little money for other living expenses. Yet some companies, she said, will hire several part-time people to avoid the cost of providing insurance for a full-time employee.

Monitoring costs and codes would be frustrating and time-consuming for most people. Karen Riley of Cape Girardeau said she and her husband, Dean, are both on Medicare and have a supplemental policy. Both Medicare and the supplement pay for mammograms.

"I called Southeast Missouri Hospital to see if it is in the network," she said. "They said yes. But the doctor who read it was out of network. Since Jan. 15, both insurance companies are arguing over who is going to pay the bill. It has still not been paid."

Riley said she and her husband pay high premiums for their supplemental insurance, partly because she has a pre-existing condition. They dipped into their savings to pay for medical costs and insurance premiums after her husband, who worked at Southeast Missouri State University in the facilities management department, required knee surgery and retired early as a result. While he was working, the university covered the cost of his health care premiums. Until both qualified for Medicare, their monthly costs after he retired meant "we were paying money we could have spent on something else," she said. "It's got to stop somewhere. We can't keep on paying and paying and paying. You can save for retirement, but when you're saving you don't anticipate your medical costs going up and up and up."

Nor did she anticipate that just changing doctors would result in the second doctor asking for lab tests that had already been done not long before that, "so they can get more money."

Riley said she believes Clinton has the best health care proposal.

"She is saying lower premiums and give better quality insurance," Riley said.

Harry Floyd, a retired business owner, said he was considering dropping his supplemental policy because he could pay out of pocket for health expenses for less than his $145-a-month premium. His table companions urged him to keep it, saying they envied him that low premium and warning him that his medical expenses could go up drastically with one illness. Floyd is one of the few not adversely affected by health care costs. He said he supports Clinton because "she has the background. Her husband was president, so she knows a little bit about the ins and outs.

"I figure most wives know what their husbands do and she has a little insight."

Hargrave said that at whatever level health care reform comes, it has less to do with whomever is elected than with the person at the bureaucratic level chosen to implement and manage it. She said she told that to U.S. Rep. Kenny Hulshof when he campaigned at the senior center in his bid for governor.

"I told [him] if anybody is going to reform the health system, it needs to be somebody who knows what he is doing and knows what the program is all about, not somebody who donated money to a campaign," she said.

This article was printed in the June edition of TBY (The Best Years), a special publication of the Southeast Missourian.

Dr Deane Waldman's articles - An Honest Approach towards the US Healthcare System

Only recently, I happened to read one of the articles posted by Dr Deane Waldman in his own blog Medical Malprocess and have started to like his brave and honest opinions about the US Healthcare System which he says is 'the sickest patient'. His opinions come out of his professional experience as a Pediatric Cardiologist for over thirty years and also from his Management background.

Dr Deane Waldman says:

" The combination of life and professional experiences with my knowledge of management and strategy makes me particularly qualified to help us understand why healthcare is sick and what we can do to begin healing. Medical Malprocess is my blog aimed at starting a national conversation that will lead to a process to cure healthcare. "

Check out his Background and Credentials:

• Education and Training: Yale (BA in History); Mayo Clinic; Chicago Medical School (MD); Northwestern; Harvard; Anderson Schools of Management (MBA).

• Practicing Physician – 30 years – in both private and academic practice

• Chief of Pediatric Cardiology: San Diego; Chicago; New Mexico.

• Research: $3 million in grant support; over 100 publications.

• Consultant, Professor and Author in Healthcare Strategy

So, I thought of writing this post here in this blog Healthcare BPO News in appreciation to his approach in finding a way to fix the Healthcare System...

. . . And Escape From New Jersey

Source: wsj.com - The Wall Street Journal
May 29, 2008

New Jersey is about the last place one might think to look for free-market policy reform. But this week Jay Webber, a Republican Assemblyman in Trenton, will introduce legislation to let Garden State residents buy low-cost health insurance from any registered policy in any of the 50 states.

Mr. Webber's proposal is a state version of Arizona Congressman John Shadegg's federal legislation to let individuals buy insurance across state lines, and John McCain has also endorsed the idea. But New Jersey would be a perfect test case, because its multiple mandates have made insurance too expensive for hundreds of thousands of families.

The average national cost for a family health plan is $5,799, according to America's Health Insurance Plans, but in New Jersey that same plan costs $10,398 on average. The state's politicians have driven up these costs by forcing insurers to provide gold-plated coverage – even for such voluntary medical services as in vitro fertilization. New Jersey also follows New York and Massachusetts – two other high-cost states – in requiring so-called "guaranteed issue." That allows New Jersey residents to avoid buying health insurance until they get sick, which means they can avoid paying premiums until they need someone to pick up the bill.

This one-policy-fits-all system tends to cause the young and healthy to drop insurance, which only raises the cost of insurance for the sick, which in turn makes coverage unaffordable for ever more families. It's no accident that about 1.2 million people – one of every eight residents – is uninsured in the state.

Under Mr. Webber's choice proposal, New Jersey residents could buy policies chartered in more enlightened states. For example, a healthy 25-year-old male could buy a basic health plan in Kentucky that now sells for $960 a year, about one-sixth of the $5,880 it would cost him in New Jersey. Residents of Pennsylvania pay health premiums that are one-half to one-third as high as do Garden State policy-holders. A new study by the National Center for Policy Analysis estimates that the availability of lower cost plans would reduce by 25% the number of uninsured.

Opponents of interstate insurance say families would be pushed into bare-bones health plans. Not so. Families could still buy the more extensive coverage, but those with modest incomes would have options other than going uninsured. The goal of public policy shouldn't be to cover every medical procedure or doctor's visit, but to prevent families from catastrophic expenses due to a health problem that is no fault of their own.

New Jersey is turning into a microcosm of the national debate on health care. Democrats in Trenton are rallying behind a plan to require that every uninsured individual in New Jersey purchase health insurance from a new state-administered program. So a state that is already so broke that its politicians are contemplating mortgaging its highways might now add a $1.7 billion health subsidy.

The Webber proposal offers lower costs and more choices for consumers, while the Democratic plan mandates public coverage and no choice, while putting a new burden on taxpayers. This is the kind of debate the country should have this election year.

Clinton's hardline view on outsourcing were not against India

8 May, 2008, 1541 hrs IST, PTI
The Economic Times.

WASHINGTON: Democratic Presidential frontrunner Hillary Clinton's recent hardline stance on outsourcing were mainly directed against China rather than India, her top aide has said.

"Her primary language has been directed towards China. Obviously, she talks about China all the time. I've never heard her in fairness, talk about (outsourcing) in the context of India," Terry McAuliffe, Chairman of Hillary Clinton's campaign and one of her closest confidant said in an interview to 'India Abroad' newspaper.

"... We are going to rid the tax code of these loopholes and giveaways. We're going to stop giving a penny of your money to anybody who ships a job out of Texas, Ohio or anywhere else to another country," Clinton had said during a recent debate with Obama at University of Texas in Austin.

McAuliffe, the former Chair of the Democratic National Committee also brushed aside the notion that Clinton was pandering to the labour unions on the issue of outsourcing.

"What she has said, is she will negotiate, she wants trade deals, she thinks they are important to build bilateral economic relationships. She will negotiate fair, but tough trade deals. She is a full believer that we've got to build jobs here, in this country," he said.

He said: "We've got to be competitive, but if people can come in or people that can bring products in and if it's a better product at a better price, then we have to be competitive, and that's not the fault of the country that's bringing it in.