Blog, Post, & Contact Benefits Managers Across the U.S. <<Including the BLOG OF THE WEEK
<<-- CLICK ON A CATEGORY TO BLOG or RESEARCH CLICK on PICTURES and VIDEO LINKS to View Information- ->> Download Newt Gingrich Welcome
Opposition Party Health Reform
Shifting From Irate to Ideas
Regardless of party affiliation, the American people are angry with the policies and politics of Washington, D.C.. The Tea Party movement has led the way uniting the “silent majority” giving renewed voice to American principles of limited government, personal responsibility, and self-reliance. In the elections of 2009 and again in early 2010 their votes spoke loud and clear against the corrupt process pushing extravagant health reform, special interest payoffs, and higher tax policies by a tone deaf Congress. The masses opposed health reform that did not lower costs, increase access to care, improve quality, or solve the uninsured problem for 45 million citizens.
People recognized that health reform proposals of 2009 were not about health or healthcare. They were about centralized power, increased bureaucracies, and expanded political control. With a single election the public removed a “Democrat controlled filibuster proof Senate” and let every incumbent politician (Republican and Democrat) realize that they work for the citizens and not the other way around.
But, being against something is always easier than knowing what ideas and initiatives to be for. The challenge for the Tea Party movement and others is to shift from irate to ideas. From success to significance. The Tea Party Patriots can remain a movement against selected policies or grow into a movement that promotes common principles and/or specific policies. It does not need to detail solutions. It can stand ready to choose among options and specific ideas from others. However, a stronger political position would be to understand the possibilities and direct policymakers to take specific actions.
For example, polling indicates that the American public recognizes that there are problems with health and healthcare, but there is no national consensus on a common vision for going forward. It is now time to lay out basic principles, desired outcomes, and general legislative proposals to deal with real health reform. Reform can be accomplished if we first establish a common vision through citizen input, coalesce around shared values, promote American ingenuity, and value bipartisan debate.
Establishing Basic Principles
A uniquely American solution must be founded on basic American principles and values. Before any specific policies are promoted, the following principles are suggested for discussion and debate. Any health reform proposal including private coverage, Medicare, Medicaid, SCHIP, and others aspects of the current health system should be measured against a common set of basic principles:
1. Market-based – The U.S. Congress and States should establish a supportive legal and regula
2. Increased Competition – Competition in an open free market is the best solution
3. Maximize Insurance, Minimize Third-party Reimbursements – Third-party reimbursements foster an environment of entitlement and unlimited demand for healthcare services. A system based on personal responsibility minimizes third-party reimbursements by putting financial power in the hands of consumers. A comprehensive system allows everyone to have insurance coverage, regardless of their current or future health status.
4. Security for the Sickest – No one can be left behind. Health insurance is about financial security when sickness or accidents strike. Solutions must help the sickest patients get the best care, treatment, and understanding of their condition through financial and information empowerment. Any system that works only for the young, healthy, and wealthy is a solution destined for failure.
5. Behavioral Change, Not Cost-shifting – Behavioral change includes wellness, prevention, early intervention, and compliance with proven care and treatments. It means providers delivering evidence and outcomes value-based care. It’s about encouraging personal involvement in altering health and healthcare purchasing behaviors.
6. Personal Responsibility –Personal responsibility means taking ownership for good and bad health and healthcare decisions. Personal responsibility cannot effectively occur without information and support tools for increasing self-reliance. Support programs include patient financial involvement with incentives for participation, rewards for compliance, and educational support for better personal health management.
7. Ownership – Ownership means control of the key decisions affecting coverage, choice of treatments, and selection of providers. Ownership means possession of financial assets, choice of how to spend personal funds, the right to information regarding one’s own health, and ownership of a personal health record.
8. Portability – Portability allows individuals to continue coverage regardless of employment status and/or job changes. Policies that do not rely on employer-based insurance should be encouraged and expanded. Health insurance should not be dependent upon a job or lost when one changes jobs.
9. “Wholistic Care” (Physical, Mental, Spiritual, and Social) – Health should be viewed as a dynamic state of well-being within an individual that includes physical, mental, social, and spiritual balance. A focus on health recognizes the potential
Achievable Outcomes
American ingenuity can solve any problem and achieve any goal. By creating supporting policies based upon the above principles, the positive outcomes will include the following:
1. Transformation to Quality– If followed the principles will lead to improved quality in a transformed system. Simple reform of the current health system will not work. With a common vision, transformation will emerge - one that is a uniquely American system that builds on existing strengths and transforms for the better the policies and processes that do not work.
2. Empowerment of Consumers/Patients – Empowerment will come from financial and information sharing. Market-based systems engage consumers in meaningful ways to understand options available to them and the risks and rewards associated with choices. The individual has both rights and responsibilities when it comes to their health and healthcare.
3. Healthcare Consumerism – Healthcare Consumerism will develop by putting economic purchasing power—and decision-making—in the hands of individuals. It’s about supplying the information and decision support
4. Reduction in Costs & Increased Affordability - Affordability is not just the dollars paid as premiums. Affordability will be achieved through health choices and behavior changes. We are generally used to individuals paying less if they are non-smokers (or quit smoking). Similarly, healthcare and insurance costs can be more affordable for individuals if they maintain healthy metrics for blood pressure, cholesterol, and body mass index. Affordability can also be achieved by rewarding Americans with serious health conditions for adherence to disease management standards or compliance with good lifestyles, diet, and exercise standards that stabilize chronic and persistent conditions.
5. Increased Access & Choices –Choice means personal options for insurance coverage, care, treatment, providers, participation, lifestyle, wellness activities, disease/condition support programs, service conveniences, and educational resources. A choice not to be covered by insurance should be allowed, but getting care (even emergency care) without participation in an available insurance pool will have potential treatment and financial consequences. Once a viable robust market-based system exists, government-based programs of Medicare, Medicaid, and SCHIP should allow individual choice for transitions to market-based alternatives.
6. Elimination of Diversity in Outcomes – Whether it is social, racial, geographic or other categories, the diversity of outcomes will be mitigated once the segmentation of the existing insurance system is eliminated and all Americans are covered in the same system, treated by providers who practice best standards of care, and empowered with the same information and decision support tools.
7. Expanded Use of Technology – Health, healthcare, and health insurance will get an infusion of technology to lower costs, improve efficiency and effectiveness of coverage, and appropriately identify and distribute information. Whether it is personal care devices, personal health records, electronic medical records, or e-prescribing the world of health is lacking in adoption of new technologies. Encouraging American ingenuity will advance the use of healthcare technology to lower costs and improve health.
8. Movement to A Culture of Health – A culture of health focuses on wellness and prevention rather than on disease, sickness, and treatments. Health activities should measure and reward participation in wellness assessments, compliance with a condition management programs (e.g. taking medications, diet, exercise, office visits), and maintenance of good health characteristics (e.g. blood pressure, cholesterol, nicotine use, body mass index)
The time is right for developing a consensus based on common principles and desired outcomes. The need is great. The foundation blocks are bipartisan collaboration, support at the federal level, reform at the state level, creative product development, and citizen involvement in their own health and healthcare empowered financially with information and choices.
Ideas from the left, right and middle will have to meet a common set of accepted principles. Only then can we have a rational discussion of ideas such as: tort reform, cross state selling, expanded HSAs, high risk pools, federal regulations, coverage mandates, consumer protections, state/federal responsibilities, national insurance, etc.
The mission is clear – Insure all Americans in a market-based affordable comprehensive health and health care system. The questions are: Who will help? Who will hinder? And who is willing to give power to the people over their most precious asset – their health? Let the people speak, let the collaborations begin!
I am a senior in Corpus Chrsiti, Texas...I am of the opinion all of the plans being debsated in Congress and supported by Obama are less aboue Healthcare refrom and more about big government controlling our lives..and falls
all to heavly on we seniors!
Posted by: Leo H. Stakemiller, Jr | 11/04/2009 at 10:11 AM
PROPOSED SOLUTION TO HEALTH CARE FINANCIING
By: Robert W. Hanle, RHU
I have over 32 years experience in the Health Insurance Industry. I have worked in the capacity of Broker and owner of a Third Party Administration Company (TPA). As a Broker I have gained much experience in the needs of employers & employees in acquiring affordable and quality health insurance coverage. As a TPA owner I work with employers who choose to partially self-insure their employee medical plans. These employers purchase Direct Excess Insurance ($25,000 - $100,000) for catastrophic losses, and self –insure the underlying coverage. This approach is the premise of my proposed plan.
THE PLAN
Have the Federal Government provide catastrophic coverage in the form of a $25,000 - $35,000 annual deductible, 100% coverage plan, to every man, woman, & child with a social security number. Protecting its citizens from catastrophic loss has to be considered one of the primary duties of a government.
For purposes of this proposal I will refer to this coverage as The Federal Catastrophic Health Insurance (FCHI)
Since FCHI will not be attached until $25K-$35K, decisions such as choice of Medical Providers, Protocols, Facilities, etc. will already have been made. This will allay the public’s concern of the Government’s involvement in those personal decisions.
Allow the current health insurance system to provide the underlying coverage. Health Ins. Carriers will provide a variety of innovative approaches to covering all or part of the deductible. They will also serve as a gatekeeper of sorts in the determination of medical necessity. You will also see a dramatic increase in the number of Ins. Carriers entering the market place. Competition will also help lower premiums.
Some may choose to self-insure and/or use a medical savings account (which should be allowed for all individuals as a way to cover the underlying needs).
With a claims liability ceiling of $25K-$35K you will see a dramatic decrease in the underlying coverage premiums. Not only because Ins. Carriers will be providing less coverage, but also because they do not have to rate for potential catastrophic events, where the costs can be unlimited.
FCHI would also apply to programs already in force, such as Medicare & Medicaid, helping to make them more solvent.
FCHI can use the current Medicare Reimbursement mechanism to determine payment amounts, and should outsource claims administration to local Third Party Administrators to lessen the bureaucratic impact that a single source payer would create.
FCHI will be paid for by a National Sales Tax (2% - 3%). The initial deductible will be determined by the actual revenue created by the sales tax. While I would agree that sales taxes are regressive in nature, in this case it makes the most sense. But they are not totally regressive since the wealthier buy more, so they will be taxed more. All will be covered, all will pay. One of the problems with our current system is that the uninsured are not just uncovered, they also do not pay into the system. WE NEED THOSE PREMIUMS IN THE SYSTEM. I have seen many employees, who when asked to pay as little as $5 per week toward their employer sponsored health insurance, have opted out of coverage. These, of course, are the younger healthy individuals, whose premiums are needed to offset the claims of others. With a sales tax we will now be collecting much needed revenue from these individuals. There will be much more equanimity in this approach. THE OVERWHELMING MAJORITY OF UNINSUREDS ARE HEALTHY. THE MAJORITY OF THE SICK FIND A WAY TO PAY THE PREMIUMS SINCE THEY ARE ALSO MAKING CLAIMS. (e.g. ask any employer which ex-employees take COBRA and they will tell you it’s the people making claims). For those currently paying premiums, much (if not all) of the new sales tax will be offset by the reduction in those premiums.
Since many employers pay a large portion of employee’s premiums it might make sense to encourage them use part of the savings they receive from premium reduction to fund employee owned medical savings accounts (again, to offset the sales tax). The incentive can be as simple as allowing $1.25 - $1.50 tax credit for every dollar an employer funds into these accounts. Employees should also be allowed to contribute to these accounts.
If we want to go down the mandate path, then mandate all employers provide at least 50% of the underlying coverage needs of employees. While I am not a fan of mandates, this would level the playing field among employers. And since it will only be $12,500 - $17,500 of coverage it will not be that expensive.
If medical costs and subsequent claims rise, FCHI may need to increase the deductible, rather than increase the sales tax. This will give consumers the choice of how to address the underlying need for coverage, rather than a force tax increase.
Fraud: Any medical entity found to be submitting fraudulent claims will suffer the following penalties:
1st offense: Disqualified from participation in FCHI for 1 year.
2nd offense: Disqualified from participation in FCHI for 2 years.
3rd offense: Disqualified from participation in FCHI permanently.
With these penalties, a medical facility will be very careful to submit only legitimate claims. Otherwise, they will only be able to serve patients with conditions that generate medical costs of less than the annual deductible of FCHI.
CONCLUSION
I believe this plan is a balanced approach to help address the health care financing dilemma we all face. It is unreasonable to think the Federal Government can handle providing first dollar coverage in the incredibly complex medical system we have. It is also unreasonable to think we are going to change the system. And why should we? It provides us with the finest medical care in the world. I believe you will find that this approach will have the approval of employers, employees, physicians, & medical facilities. It will provide a more equitable distribution of financial responsibilities for our medical care.
Thank you for your consideration of this proposal.
Robert W. Hanle
President
2 Rivers Insurance Group
robert@2riversig.com
Posted by: Robert W. Hanle | 11/09/2009 at 04:08 PM
Having medical alarms present force provide reassurance to those who want to alight sooner than themselves as luxuriously as friends and one's own flesh . It used to be that when someone fell or had a serious medical copy they had to make to the phone and dial it before someone could rise and help. Now, with a medical whistle, all the man has to do is thrust the button that they take hanging approximately their neck. Beyond the shadow of a doubt from the general consciousness, not all private abuse cases are heard in courts. There are permissive ways of obtaining the desired compensation inasmuch as the abuse unceasing as glowingly as the vexation, agony, highly-strung agony and endless disability. It is common that multitudinous employees who beget a bid conception with the illegal activities of their corporation are panic-stricken to be dismissed out like a light and blow the whistle. Obviously, this is healthy and a prime human reaction. Degree, it is an lodge fact that the PC functions as a "white-hot" server that is unlock for any feather of message disseminations with or without the give in permit of the server; essentially lining the the poop indeed, there is always a risk exchange for any transfer of any dirt measured those covered by haven policies between the advertiser and the so called "mothership." In the put an end to lawful as nobody would wish, it drive be sending assimilated matter that capacity escape the benefit of payment from the PC database. This composition of copyright abstract is so fake in support of unknowingly, motives behind depict to follow some ends in command to equivocate something that wishes shake up the mobility of legal tender bubble of the mother host. The sought after for complex aid and support is another availability looking for seriously spyware-infected computers. Another opportunity is to include a through-and-through "cleanup" of the well system. It needs ginormous reinstalling on software in mandate to revitalize as new. What ilk of freebies? Immeasurably, definitely not the kind you get on from immovable rations restaurants, that’s for the sake sure. The freebies being offered along with today’s discount vacation packages are items of real value. Sprung dinner tickets, unshackled tickets to water parks, empty joke tickets to big-name places like bush gardens, and the same vacant overnight stays at top-rated hotels and resorts in sought-after journey destinations are not unheard of. If you’ve bewitched time away from peregrinations because you’re too busy, because you’re bothersome to shield inflame, or because you conceive of vacation packages are unaffordable, you acquire no design the fun times you and your take companions are missing out on. If you’re knackered of saying no to vacation voyages or if you impecuniousness a brilliant fly the coop to someplace relaxing where golfing, biking, fishing, sightseeing and all sorts of other leisurely activities are the model, it’s age to confirm out the vacation packages – ignore and if not – being offered to destinations all over the world. Insulting your audience - Talk to them and with them - but not down to them. Don't convey jokes hither the audience. Don't assume that you comprehend more than they do or that you recollect what they think. The barely museum that showcases the arts and culture of a distinct ethnic squad that was shaped and continues to influence Southeast Asia. The Peranakan, which means "locally-born" in the Malay cant, usually refers to the descendants of Chinese traders who settled in the straits Settlements of Singapore, Malacca and Penang in the 14th century and married Malay women. The Peranakans also group those who descended from unions between Indian merchants and local women during the 15th century. This intermarriage produced a fusion of cultures, and is reflected in the colorful cuisine, architecture and the latest thing that put up the multicultural fraternize of Singapore and Malaysia. You should withdraw upper hand of the online security read over to audit ironmongery devices and software applications on a equal-angled basis. The cloud scanning serve ordain also provide a reporting advice allowing you to stand a closer look at the custody vulnerabilities and threats that can endanger the decency of your network, website and servers. You should utilize the recommended patch up d‚nouement to clamp the threats so that risk to your business is eliminated. The cloud fastness scanning service should be peaceful seks filmy for you to capitalize on with a understandable navigator. This modus operandi, you can handle the sanctuary of your hardware and software components on your own without having to problem just about hackers. The museum that appeals to the toddler in us, as who after all didn't acquire a emboss omnium gatherum when they were kids? The museum's aggregation includes stamps and archival philatelic material of Singapore from the 1830's to for the present day. The museum also encourages philately in Singapore, with its permanent galleries not solely dedicated to the worldwide history of stamps, but also organizes workshops and talks on how stamps description Singapore's history. The internet era has made it realizable to access any knowledge from any remote corner of the world. Unfortunately, this has also opened innumerable doors for hackers to prig report with a infrequent tweaks. When you cut a business and play the host your website, you call to press positive that it is impenetrable for hackers. Cloud scanning service enables you to scan any operating set-up, server, contraption, software, program or perseverance remotely without the dire as a service to installing any hardware or software at your site. This online security pore over can be enjoyed in an ad hoc mien at any time during the day. The good affair is that there's another more to relate to approximately it. By means of using undivided of the medical alarms on the demand, you can prorogue bold while providing yourself, and your classification, the erudition that you inclination be masterful to sick with in get near with professionals if an experience takes place. It is a reassurance that you can't fake. Secretively dental offices in your village oftentimes require the friendliest worship army around. While it is trusty that primary dental chains also be enduring sisterly employees, there is silence nothing a certain extent like present to a Herndon, Virginia dentist and intelligent you drive be seeing people from your own town. There is a good unintentionally you have something in regular with the people who accomplishment in the workplace, such as children who pass to Hutchison Clear School. At a chain dentist obligation, the at home serve may be detached and not as lively as it would be in your hometown.
Posted by: Haczt207 | 10/04/2011 at 03:20 AM
I corporate the mass of the health care reform that does not reduce costs, increase access to care, improve quality, or to solve the problem of uninsured citizens of 45,000,000.
Posted by: סידור הבית | 11/15/2011 at 11:52 AM
cEe ugg boots outlet|lQd http://uggboots26.honmag.com/2011/12/26/uggs-boots-outlet-for-everyone/ zZc ugg boots for cheap kGx http://cheapuggs00.bloggr.no/2011/12/26/cheap-ugg-boots-using-tight-legged-skinny-jeans/
Posted by: Mypeeldenda | 12/27/2011 at 04:22 AM
PAWCZOJZEI uggs for sale NHMJXTSZYK http://canadagoose00.blogcenter.de/2011/12/23/uggs-on-sale-another-kind-is-australias-each-brand/
Posted by: Amurrymib | 12/28/2011 at 03:46 AM