Perhaps Obamacare Should Be Called Obamadon’tgivarip?

I find it mildly humorous and mildly disturbing that President Obama is doubling down on his rhetoric regarding the 8 million enrollments into Obamadon’tgivarip, aka Obamacare.  This in light of my personal experience so far with the Affordable Care Act (ACA).

So this morning I began round four with the actually nice, hugely apologetic, and functionally impotent folks at healthcare.gov.  My mission was to speak with a real person and try to understand why, despite the fact that I am recently unemployed, I am not actually eligible to enroll in Obamadon’tgivarip.  I am becoming a bit cynical, but not wholly unobjective.  This on the heels of my failed third attempt to enroll.

I did speak with a live human; two in fact.  First with Robert, who looked at my eligibility letter and confirmed that it said…what it said, and who then transferred me to Priscilla.  Priscilla in turn confirmed that the letter said….what it said and ultimately could not help me.  Turns out neither Robert nor Priscilla could actually look at my application.  There neither could not begin to help me troubleshoot my application, which, as previously noted says I am both eligible and ineligible to purchase through the Marketplace.  After Priscilla asked me a bunch of questions, including whether I was recently unemployed and on what date, she said she would refer me to a case worker who would review my file and would be “in touch.”

She could not tell me when my file would be reviewed (wouldn’t even venture an estimate when asked) or if I would be notified by phone or email.

Here’s the rub, the clock is ticking on my 60 day window  (but it is more like 45 if I don’t want a coverage gap in June) to enroll for healthcare on the marketplace which should be possible from the date I lost my job.  I can COBRA if I have too to the tune of $927 per month, which for a guy with no income at the moment is not a sustainable value proposition.

So, for the moment I look for employment and wait for the next chapter of my healthcare.gov story to unfold.

As an aside, if you look at the bottom right hand corner of healthcare.gov there is a logo depicting The White House and a website called USA.gov with the slogan “Government Made Easy” under it.  I have no clue what USA.gov’s role is in the Marketplace, but if it is to make it “Easy” they are getting an F- in my book.

Obamacare – Welcome To The Land Of The Lost

Apparently I am both eligible to purchase health coverage through the Marketplace and I am also ineligible. At least that is what my eligibility letter says…

So last Friday I went through the online enrollment process…online….again. If you want the history of my first two attempts read my previous post. Friday was attempt #3.

I spent 1.5 hours re-applying/re-enrolling, ultimately to be told on my eligibility letter that (and I am paraphrasing here) while I am eligible to purchase health coverage through the Marketplace, I cannot enroll at this time. So in effect, I am NOT eligible (although I actually am) to get coverage. Can you see why this might be confusing and perhaps frustrating?

During the course of attempting to complete my application, I was booted off the site four separate times. Each time I was kicked off, I had to go back and re-enter various bits of information which were not saved prior to me being disconnected. I should mention, because there are four members in my family, I had to answer most every question 4 times….over….and over…..and over again.

I fought the healthcare.gov website for 1.5 hours and was then dismissed. You can pick your own colorful adjectives for the word “dismissed” and you will probably have a sense of how I felt I was being treated. Rejected if you will.

I should note, that during the process a tree fell on a power line down the street, and I completed the application using my mobile hot spot. I was determined to succeed.

WRONG! I think it was divine intervention that the tree fell on the power lines, because the power was knocked out for 5 hours and by 7:00 Friday night, I knew I had until Monday to cool off from my rejection.

In the meantime I am sitting here wondering if anyone is actually benefitting from Obamacare, if the government is counting all 3 of my applications as enrollments, what the heck I put on my application that caused the rejection, if this will ever be resolved, and why exactly am being forced to waste my time mucking around with this when my time would be better spent trying to gain employment with a friggin’ health plan.

The Power Of Pink and Juicy…

If you read this blog with any regularity, first, God Bless You.  While I’d like to think it is because you are sophisticated, self-aware and desire to be highly informed in issues related to health, health care and HSAs, more than likely it is due to a very specific need, that landed you here, and our appeal to quirky nature and sometimes lack of political correctness that caused you to come back. 

I was in mid-town Manhattan a few weeks ago and saw a woman in a bright yellow sweat suit walking up the sidewalk.  Plastered across her two bouncing butt cheeks was the word “Pink.”  The First Amendment allows for freedom of speech, so while I respect the woman’s right to draw attention to her caboose, I’m not sure why she was doing it.  I felt like I was looking directly into the sun itself.  My retinas burning, I had to squint in pain and turn away.  I wonder if that was her intent?

Then I saw another woman wearing a different sweat suit.  Hers had the word “Juicy” plastered across it back.  With all due respect, this woman was not “juicy.”  As a guy, when I think of the word “juicy,” generally it is the context of a nice piece of meat smoking on the grill and a cold beer in my hand.  Like the “Pink” lady; this woman was neither “juicy” nor was she a T-bone.  In fact she had a bad dye job, huge sparkly sunglasses, and fingernails that never stopped.  While her nails mayhave been good for back scratching, were she to read this article, she’d probably wouldn’t think twice about using them to scratch my eyeballs out. 

As I ruminate (imagine a cow chewing cud) about “Pink” and “Juicy” I can’t help but think; a sweat suit does not a healthy person make (the voice of Yoda in ringing in my head here).   Although putting on sweats, anticipates a little exercise, I’m pretty sure neither “Pink” nor “Juicy” had that on their agenda for that day.  I also doubt either one of them has ever heard of a Health Savings Account.  My point of all this is that good health requires action.  The action starts with some self-awareness, a little planning, and behavioral changes.

If your modus operandi is to draw attention to big cabooses and bad dye jobs, may the power of “pink” and “juicy” be with you. But (pun recognized) if you are looking to take control of your health in a more productive way, then read a few more posts.  Who knows, you might actually decide it’s ok to work up a little sweat in that suit you’re wearing.

Save 50% on Your Food Bill and Lose Weight in the Process. Where was I when Elvis Needed Me?

I am not a doctor.  I don’t play one on TV.  I’m just a normal, if not cheap, American citizen trying to be healthy, feel healthy and stay healthy.  

A few years back I cracked the scales at my doctor’s office at a prodigious two hundred and eight pounds.  For the past couple of years my weight has hovered between 173 and 178 pounds. 

Part of my motivation to shed the tire was that I had lived a Dilbertian existence in corporate America for 18 years.  The most exercise I got at work was walking too and from the parking lot to my office.  About the only running I did was running my big fat mouth.  I was tired of feeling tired.  One day in the fall before I stepped outside of corporate America, I was out raking leaves and I had to sit down because I thought I was going to drop dead.

Before I left my job, I bellied up to my employer’s smorgasbord health plan buffet and had a full blown physical.  The leaf raking thing scared the crap out of me and I wanted to be sure if I started exercising for real, I wouldn’t drop dead for real.  My doctor confirmed I was fat and lazy but the rest of me was in fine shape if not a little round.  Prior to any dramatic changes in your lifestyle, I highly recommend a visit to the doc, to make sure you are well enough to really take control of your health.

You can pay huge money for all kinds of diet advice, but let me tell you, advice won’t lose you an ounce of blubber.   But you will lose weight if you can wrap your brain around cutting your caloric intake in half. 

You don’t need to go out and buy and special calorie counting cards or gizmos.  You don’t need to go out and buy special foods (unless you want to).  You don’t need to read the calories on the side of every box and can at the supermarket.

What you do need to do is to cut every meal in half.  Fix half as much.  If you are dining out buy one meal and split it with a friend or significant other.  Not only will you cut your calories in half, but you will save 50% on your food bill.

That’s your starting point.  You won’t starve.  You won’t be forced to eat crappy stuff you don’t like.  You won’t have to keep a log.  You will know in your head, each time you sit down to eat if you are following the plan or not.   The other important advice to go along with this is drink lots of water.  Substitute it for anything with sugar in it when you can and you will cut down your calories even more.

Once you get into the habit of eating less, then you can begin to focus on eating better.  Eat a little fruit, a few vegetables.  They won’t kill, you and they beat the snot out of that stuff the dude on Man vs. Wild eats on the Discovery Channel.

Lastly if you want to really start feeling better, get some exercise.  Make that a habit too.

In summary Elvis, here were/are the benefits for me:

• I feel better
• I lost weight
• I look trimmer if not better (my face, sadly, is one only a mother could love, so losing weight did nothing for me in that department)
• I cut my food bill significantly
• I don’t crap as much which means I have more time to do other things (like exercise)
• I sleep better
• When I went to get life insurance, all of my vitals tests put me in a health range that lowered my insurance premium
• I became far more aware of what goes in my body and over time made some changes in what I ate in addition to how much I ate.
• I changed some bad habits into good ones

 If you read all of this, good for you.  Now go take the first step baby.

Man Up President Obama

As a general rule of thumb, the primary focus of this blog is health care and specifically, health savings accounts.  Those of you with HSAs know a fair amount about responsibility, since they are highly oriented toward personal responsibility. 

It is my observation that individuals who do not take responsibility, tend to have been in positions in their lives for which little responsibility has been required. 

Blame is something generally heaped on others whereas responsibility is something generally heaped upon oneself.  Blame is about dumping.  Responsibility is about seizing.  Blame is about taking care of oneself.  Responsibility is about taking care of others.  Blame is selfish.  Responsibility is selfless.

I have to say I am getting a bit weary of our President pointing the finger of blame.  Everyone knows that all the problems of America are not his fault.  Even if he didn’t remind us at every bend in the road.

Do you think the President’s focus on blame is a function of his past?  A past in which he has had to take little responsibility?  

One of the big knocks on him during his campaign was his inexperience and how that might affect his ability to lead.   I think for the President, the first step in his quest to become a great leader is to grab and yank the reins of responsibility.

The job’s not easy.  But didn’t anyone tell him that when he campaigned like a bad assed champion to get it?  When it comes to great leadership nobody cares who caused the problems.  They only care about the person willing to take responsibility, the person who will seize responsibility and get ‘em fixed.

 “… From everyone who has been given much, much will be demanded; and from the one who has been entrusted with much, much more will be asked.” Luke 12:48 (NIV)

Or if that does not compute, two words: Man Up!

Snoozing Through The Health Care Debate.

Two back-to-back articles in the May 4, edition of Business Week;  the first, “The Dubious Promise of Digital Medicine,” reading like a college text book, held my attention through the first two pages (of about 7) and the second, “Phillip Morris Unbound” with its dark, smoky graphics and insidious subject matter, grabbed me like a Tom Clancy vacation novel.

 

Which story would you prefer to read?  One that begins as follows:

 

“Neal Patterson likens the current scramble in health information technology to the 19^th century land rush that opened his native Oklahoma to homesteaders.”

 

Or one that starts:

 

“Louis C. Camilleri rarely shows his joy.  But stepping into the role of CEO of the newly formed Philip Morris International (PMI) last March put him in a mood to celebrate.”

 

The article on digital health records turns phrases with words like “carrot, stimulus, energized, serious computer errors, sweet consensus and checkered history,” while the second article, on the expansion of smoking pulled me in with me with words like, “unbound from Altria, social pariah, forces that dogged, very harmful product, unapologetic about hawking, bad boys of Big Tobacco, tobacco wars, and whiff of brimstone.” 

 

Suffice it to say, it was an interesting, and no doubt well considered juxtaposition of articles by the folks at Business Week.

 

The first article was 7 pages of snoozing spiel and the second, 4 pages of sex appeal.  Domestic rhetoric vs Global intrigue.

 

Both articles relate to health care but one shines (albeit darkly) and the other, while well written, felt like just another installment in a very long running soap opera.

 

Here is the point.   To me, the first article on digital medical records me is but a microcosm of the broader debate on health care.  It is complicated. It is confusing.  There are lots of shades of grey.  There are many constituents in the debate.  There are manyt agendas (both open and hidden). 

 

To the average Joe (and I include myself in the mix) it’s so all over the board that it is difficult to engage with it.  But don’t feel bad.  The debate has been running on and off at least since “Hillarycare” of the mid 1990s and it’s just heating up again now.

 

While I think there is a tremendous opportunity for the media to engage the public in the debate by applying more of the “Phillip Morris Unbound” approach to its presentation, I think it is incumbent upon anyone who cares about their future health care to wade into the water and attempt to understand what it is their politicians and the policymakers are saying about it.

 

I would encourage everyone to challenge what they hear, and especially the rhetoric of their politicians.  To speak their voice whenever and wherever they can.  To truly understand their needs and the trade-offs of the various policies that attempt to satisfy those needs.  That may even mean we have to push ourselves beyond our normal “2-page” attention spans.

 

Speaking of which, I guess I’ve got 5 more pages to read.  

What Do Cheese, Chocolate, and Health Care Have In Common?

 

They represent three things the Swiss apparently do pretty well.  Along with banking, watches and of course Fondue (which often involves both cheese and chocolate).

Over the past couple of months I’ve heard that the Swiss, in addition to cheese and chocolate, have created a model for health care that works.  Generally it is tossed out there in the context of our nation’s own health care challenges, but I’ve not heard much more about it than that.  Today I got  motivated and went surfing for knowledge.  There are some appealing things about Swiss healthcare, and in the opinion of one (that’d be me) would be worth some consideration in the health care debate.

At a certain level, Swiss health care is consumer driven, if not market driven (certainly not totally market driven that is).   In a nutshell it works like this: 

• Pretty much everyone in Switzerland is required to carry basic insurance that they purchase individually vs. as a family unit or part of a group.
•   Basic (required) coverage is not priced based on risk but on age group. 
•  The prices of medical procedures are totally transparent and regulated by the government. 
•  The pricing is negotiated between the medical industry and the insurance industry and approved by the government.  
• Insurance companies are not allowed to make a profit on basic medical coverage. 
•  Each family member’s cost for insurance is based on their age and in addition to the deductible for which they are fully responsible, there is also a premium and 10% cost sharing once the deductible is met. 
• For individuals who can not afford insurance, the Swiss government subsidizes it.

So, as with high deductible health plans , the Swiss consumer is responsible for the full deductible and the premium before their insurance kicks in.  And Swiss health care, while less expensive on average than health care in the U.S., is not cheap with the basic coverage running upward of $8,000 per year. 

So, is the Swiss model Good?   Bad? Or Ugly?

I suppose beauty is in the eyes of the beholder but I can tell you what I like. 

1. Anyone, regardless of age or health can get coverage.
2. There is no free ride and thus somewhat of an incentive to be healthy.
3. There is transparency in pricing of medical services.  
4. The Swiss can select their own doctors.
5. Swiss health care insurance is portable because it is not tied to an employer benefit.

I can also tell you what I am unsure of:

1. I did not see, in what I read, any real incentives to lead a healthy life like wellness screenings, credit for being healthy, or health savings accounts (HSA).
2. Lack of competition within the medical establishment to drive administrative costs down.
3. The medical community’s and the countries overall satisfaction level with the basic compulsory care.  

It’s an interesting model.  Highly regulated on one end, but for supplemental insurance products, it is highly competitive.  In the overall U.S. health care debate, it will be interesting to see if elements of what is working in Switzerland translate to the U.S. consumer.  We shall see.

Are You a Small Business Looking To Save On Your Healthcare Costs?

 

Back in the early 1990s, auto parts distributor Hedahls Parts Plus considered cutting employee health benefits and even getting rid of them completely.   Today, however,  their employees have health insurance and the company’s costs are 20-30% below the average.  No small feat and one that ought to make any business owner stand up and take notice.

 

They achieved this by shifting some of the cost to employees (which get’s the employee more engaged in their own  health) and then they provided cash incentives for employees and spouses to have certain screenings and also to achieve and maintain certain health goals.  A little medicine followed by a little sugar..

 

We’re not talking draconian measures or anything like that.  Just basic blocking and tackling. And their employees have healthcare choices through their cafeteria 125 plan.

 

Hedahls’ story, along with some great data and ideas on saving money in healthcare were published in the April 7 online edition of Prairie Business Magazine  and written by Ryan Schuster.   If you are a small to midsized business, the article is worth the read.

 

One of the tools outlined in the article are high deductible health plans and health savings accounts.  There is plenty of well packaged and easy to read information  geared toward employers at hsaeducator.com.  Give it a look and maybe it will help set you on the path to better physical and financial health.  

I Searched for Health Savings Accounts and Found Tiger Woods Instead

 

I just got off an hour ride to nowhere on my bicycle.  The exercise is good.  The weather tolerable and the scenery, well, but for the tormenting squirrels outside my window, pretty boring.  The reading however can be good depending on the day, especially if I learn some nugget on consumer driven health, health savings accounts, or high deductible health plans, which generally is what this column is about.  Today, however, was not one of those days.  But I did learn a few things, maybe.

Today’s reading consisted of the April 6th edition of Business Week which ranked the top 50 performing companies in the US.  A couple of them were even in healthcare.  But nothing stuck until page 65.

What struck me on page 65 was not the cartoon drawing of Steve Balmer, but the realization that I had seen Tiger Woods’ picture in the magazine a bunch of times.  So I went back through the magazine and ripped out all the pictures of Tiger woods so I could count them.  If I were my daughter, I might have turned them into a collage or something.

 Now you may think I have a man-crush on Tiger or something, but that’s not it at all.  At least I don’t think that’s it.  I did notice though, he is a fine dresser.  And being a baseball kind of cap guy (they cover the hair loss well), I kind of dug his hats.

There were 5 different ads with Tiger’s image in them.  Besides looking like a spring catalogue for golfwear, I did observe a few things.  Things, that by the time I finish writing this and you finish reading it, we will have both forgotten.  First off, I wonder if I keep tearing all the Tiger ads out of all the Business Weeks, I can actually learn to play golf from studying all the pictures.  Second, you can see the focus in Tigers’ eyes.  Thirdly, Tiger looks very fit and I wonder if he has an HSA?  Fourthly, I wondered what Accenture’s advertising budget is since every ad was theirs.  Fifth, I wondered how much money Tiger makes for his Accenture relationship.  Sixth, I wondered if Accenture has some cool model for quantifying the ROI on all those ads.   If you’ve gotten this far you are probably thinking, what a bunch of crap, but I did think about one cool thing.

I am ready for The Masters!!!  The Azaleas are blooming in Georgia so bring it on baby!!

47 Million Americans Dying in the Streets Without Healthcare

Every time I drive out of my driveway and into the streets, it’s hard to keep from running over them.  Sickly people, on the side of the road, all without healthcare….

Now, maybe this is true in Darfur, but in America, the statement above is extreme and irresponsible.  Yet the media and political drumbeat of healthcare crisis has been steadily beating for years and inevitably it calls out between 40-50 million Americans who are uninsured.  And further, said directly or not, it gives the impression that these people have almost no way to obtain healthcare. 

In a world of soundbites it is very easy to blur the line between healthcare and health insurance.

I pulled some numbers from an article by Sally Pipes of the DC Examiner which tried to shed a bit of light on just who the 47 million uninsured individuals were exactly.  There are lots of breakdowns on the web, and directionally they are in alignment if not in numeric agreement.  If you are a more visual person, please take a look at the attached video which makes the same point.

Anyway, did you know that of the 47 million individuals with out health insurance:

38% of those folks make more than $50,000 per year?  Seem like a lot of those them could afford insurance, even basic programs  like an HDHP/HSA plan.

That roughly 10million of the uninsured are not Americans?  And we’re not talking people from other countries here on holiday?

That a big chunk of these people are between jobs and will be insured as soon as the begin their new employment.  

14 million of those folks are completely eligible for programs like medicaid, medicare and SCHIP?  And that was before SCHIP was just expanded!

That 19-29 year olds (presumably healthy and in the prime of their lives) do not bother to take health insurance?  Damn, I wish I were invincible again.  But at least I outgrew some of my stupidity.

While the political leaning of the video below is very clear and likely very disagreeable to those who lean toward Government driven healthcare, the data in it and the media’s general dismissal of it, is what stands out to me.

Government and the media stir fear to drive their agenda’s by sounding the drum of 47 million uninsured in America.  And while there are indeed millions of american’ without coverage, there are none without access to care.  The larger issue, however, one that can not be covered up by the bandaid of insurance coverage for all, is the cost of healthcare.  Regardless of what system of insurance one advocates, the cost makes healthcare for all unsustainable.

Government mandates and government strong arming, in a market based economy can produce short term cost reductions in health care costs.  But in order for costs to be sustainable, either wages must rise faster than the costs, and or the costs must be driven down through efficiencies or decreased demand for services.   I am not a healthcare policy wonk, Rhodes Scholar, or Albert Einstein.  I’m just a guy making observations.

I believe that one way to lower costs are healthier bodies.  Healthier bodies lower demand, increase supply and lower costs.  I believe that companies who can create efficiencies can eliminate waste, mistakes and errors, which, uncontrolled, drive up costs.  I believe self awareness and personal responsibility can help drive individuals to healthcare earlier and prevent higher costs later and also keep the same people out of the healthcare system at times when they really don’t need it.

My Grandmother was one of the most self aware people I ever knew.  She took incredible care of herself and listened to her body.  For several months she went to her doctor and told him she did not feel well.  She had no energy, her color was gray, she was not happy.  Because she kept going back, he basically wrote it off to old age or  hypochondria I suppose.  But she wasn’t a chronic complainer.  Honestly I don’t know what the Doctor was thinking, but a major heart attack, followed by 8 weeks in ICU, another month in recovery, followed by death and over $500,000 in medical bills (she had medicare and supplemental insurance thankfully) ensued.  There are lots of lessons in this story, but the main one here is that a self-aware individual can be the best diagnostic tool a Doctor could have, and utilized properly, could have, in this instance, saved the Government and insurance companies a great deal of money.

I think if the current Administration and Congress will spend more time on the cost problem and less time on the insurance problem, on balance, regardless of the ultimate course of action, there is a far greater chance of broadening and improving healthcare and healthcare coverage for Americans.