What is the purpose of a representative?

I was watching one of the national news shows this morning and the “White House correspondent” made a statement that took me off guard.  He was discussing the President’s health care plan and the number of votes needed to get it passed.  In the commentator’s words the issue was:

Most democrats are worried about how they will vote for the health care bill and still be able to get elected in the fall.

How unbelievably absurd is that?  Isn’t the purpose of the representative in either Congress or the Senate to represent his/her people?  If the representative carries out their primary role (to represent) then would they really need to worry about getting elected in the Fall?   Common sense would say no, but alas it doesn’t seem that common sense or pure representation play a roll in this health care debate.

It seems that term limits might be a step in the right direction.

Cash Price for Healthcare. Can it help you?

As an HR professional working in manufacturing I am constantly looking for better and more efficient ways to help my employees live and work.  The company I work for utilizes an HSA fronted by a high deductible health plan.  This HSA has given our company a health culture of personal decision making and accountability for choices on health care (which we make every day of our lives).  Some of the benefits we have seen are consistent with the recent article posted in the WSJ by Mitch Daniels.  I posted some of these results a fews weeks back on this topic.

Something very interesting I have come across in my recent project called Rx Mole are benefits in requesting “cash price”.   Quite simply this is paying cash for your prescription rather than run it through your insurance company.  At times this can be very beneficial and you can still run the cost through your insurance company on the back end via a manual claim.   Here is an example.

You have a prescription for Nortriptyline.  The cost through your insurance company is $15.  You ask for the cash price and the pharmacist tells you it is $7.  You can pay the cash price (not run it through your insurance company) and then submit a manual claim on the back end and get reimbursed for this prescription.

Why would the pharmacy have a higher price if run through my insurance company?

1) There are a few answers to this.  One possibility is that your plan has a co-pay option that states all prescriptions are $15.  We all naturally assume that this is saving us BIG $$$, however in many cases (especially with generic drugs) the savings are an illusion and actually the insurance company may make money on the deal.  Use this as an example.

Prescription cost = $5
You co-pay = $15
Insurance company makes $10

2)  The insurance company tells the pharmacy at what price they will sell the drug.

This selling price is normally based on AWP or average warehouse price.  The drug companies control this pricing.  A pharmacy in the “network” has no say in what the selling price is set, however if they don’t run the prescription through the insurance company then they can sell the drug at a competitive price.

Understand there are many factors that come into play that I don’t go into here.   At a minimum, I would encourage you to ask for “cash price” the next time you visit your pharmacy to determine if you can get a better deal on your next prescription.

I welcome feedback.

Guns and Latte

Good article on gun rights vs. property rights.

Guns in the workplace

Indiana house bill 1065 is expected to pass the House and the Senate today.  All of the Senators and Representatives for the Wabash Valley have already stated their support.  It will be a new law and employers are expected to comply.

I wonder how much more  safe my employees will feel when this bill has passed .  I honestly can so no clear reason to pass this law other than for convenience of those who feel the need to carry a gun.

While I do believe that guns don’t kill people, (people kill people), it seems terribly irresponsible to allow easier options to retrieve a gun from a car and use it.  What is next?  The government will tell me that I as a homeowner have no rights to enforce no guns brought into my own house?

Additionally, as I understand it, the state lawmakers have decided that gov’t agencies in the state are exempt from this law.  You will do as I say and not as I do?

So all in, it appears that the right to bear arms trumped the right to private property.  A poor decision in my opinion.  Property rights are a foundation for this nation.  Right to bear arms is equally important, but I don’t feel should trump the decision of private property.

If you have the same or other thoughts, I welcome the feedback.

Animal Care vs. People Care

I read a great article from Steve Hamerdinger on healthcare.  Thanks Steve

Animal Care vs. People Care

Health Savings Accounts vs. Obama Healthcare Plan

This week an article was submitted by Mitch Daniels, Indiana Governor on the healthcare debate.  The article is well written and discusses the positive outcomes of the state of Indiana utilizing an HSA (health savings account).  Here are a few highlights:

• The HSA option has proven highly popular. This year, over 70% of our 30,000 Indiana state workers chose it.
• Individually owned and directed health-care coverage has a startlingly positive effect on costs for both employees and the state.
• State employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their coworkers in the old-fashioned preferred provider organization (PPO) alternative.
• Indiana will save at least $20 million in 2010 because of our high HSA enrollment.
• In 2009, for example, state workers with the HSA visited emergency rooms and physicians 67% less frequently than co-workers with traditional health care.
• Overall, participants in our new plan ran up only $65 in cost for every $100 incurred by their associates under the old coverage.

The article then answers the question that most critics of HSA’s ask:

It turns out that, when someone is spending his own money alone for routine expenses, he is far more likely to ask the questions he would ask if purchasing any other good or service: “Is there a generic version of that drug?” “Didn’t I take that same test just recently?” “Where can I get the colonoscopy at the best price?”

This is the key to anything we do as a society.  When people have control to make our own choices they are much happier.   Child psychologists use this with little kids.  They tell parents to “give them a choice”.  Even if we are faced with 2 bad choices, at least we had a say in which bad choice we made.

My company has been offering an HSA plan for 4 years. Our results are consistent with those in this article.  We have seen positive trends in our claims and feedback from our employees.  I would note that initially our employees were confused and apprehensive about the plan, but with education and time to learn, I feel confident that our employees would be angry if we took the HSA away from them.

In comparison, how is the state of Massachusetts doing?  A recent article on The DC website gives statistics that are not surprising to those who understand consumer driven healthcare and the benefits of choice.  Here are some of their findings.

• Since 2006, the cost of the Massachusetts insurance program has increased by 42 percent, or almost $600 million.
• According to an analysis by the Rand Corporation, “in the absence of policy change, health care spending in Massachusetts is projected to nearly double to $123 billion in 2020, increasing 8 percent faster than the Massachusetts gross domestic product (GDP).”
• The cost of insurance premiums in the state is the highest in the nation, and double-digit rate hikes are expected again in 2010.
• Physicians for a National Health Plan, a doctor’s group that supports a fully socialized, single-payer health-care system, warned in a February 2009 report that the new system had failed to reduce medical spending, and has subsequently drawn funding away from crucial health resources such as emergency room care.
• In summer 2009, the state announced plans to drop coverage for 30,000 legal immigrants with a goal of cutting $130 million in health-care expenses.

In summary,

One problem the state has faced is that it failed to accurately anticipate the true cost of the program. At the time the program was signed into law, estimates indicated that the cost of Commonwealth Care, which is responsible for the program’s biggest single cost, its health insurance subsidies, would be about $725 million per year. But by 2008, those projections had been revised. New estimates indicated that the plan was to cost $869 million in 2009 and $880 million 2010, an upwards increase of nearly 20 percent.

As I understand it, the Obama healthcare plan uses the template established by Massachusetts.  The question becomes, can we all afford it?

I welcome your thoughts.

Should your company incorporate blogs into it’s safety culture?

My company is currently trying to wrap it’s mind around blogs and can they contribute to our safety culture. This discussion was born out of a recent rash of OSHA recordable injuries that seems to have no rhyme or reason. As is the case in many of these type of events, we huddle and try to look at the situation from every angle possible.

One such idea that has come up is the incorporation of blogs as a means to facilitate better conversation and feedback.

Now we all know that blogs are not new technology, but to companies that are driven by structure and control a blog is a totally different way to approach a serious subject like safety. 

Blogs in essence take control from those controlling information sharing and thrust that control back onto the general population.  Control and the direction of conversations essentially are in free fall.  The direction and tone of the conversation is taken over by the masses.  This can be a huge paradigm shift for companies whose culture and business is based on structure and control.

So what do blogs give a company that they might not be getting through their current safety program?  In my opinion the quick answer is more communication.  In many organizations, more communication leads to better quality conversation and better understanding of thoughts and data.  This communication has the potential to create faster and higher quality safety improvements.  I will stress that faster is not always the best way, however in the case of a blog it might lead to a faster path to a higher quality face to face conversation. 

I would like to note that blogs can lead to as much bad as good if not packaged right.  This is a major fear for our group.  If employees send comments on blogs and no action is taken, response time lags or responses are negative, detrimental or aggressive then people are less likely to give quality feedback or any feedback at all.  If action is not taken on comments (don’t confuse the term “action” with “give away the farm”) or suggestions, then the richness of the blog is degraded and it can quickly become “white noise”.  If the content is not interactive then people will lose interest quickly.  This recipe is a sure disaster waiting to happen and can actually make things worse than better.  Additionally within safety it is important to package the blog in a way that doesn’t present the tool as a “work around” to face to face interaction or accountability.  In our organization, we expect our employees to take action and be accountable for everyone’s safety.  If you see an unsafe act or equipment, it is your responsiblity to take action (whatever that might be) to ensure everyone’s safety. 

What are your thoughts on this subject?  I would love to hear thoughts.

Why our education system needs an update

My wife is a school teacher and very good at what she does.  She recently send me some very surprising information that stunned me.

Did you know…

1.  Pay scales – Retail store managers make more than elementary teachers on average, though elementary teachers are likely to supervise more individuals who are more difficult to supervise than those supervised by most retail managers.    http://www.payscale.com/research/US/State=Indiana/Salary

2.   At http://www.nea.org/home/ns/20620.htm, NEA shows salary comparisons for beginning teachers and several other professions with similar college credentials. Teachers lag behind all the others.

3.   NEA Research includes this revealing information at http://www.nea.org/home/14052.htm : By 2000, the average female with four years of college made 16.4 percent more than the average female teacher and the average male with four years of college made a whopping 60.4 percent more than the average male teacher.   When the average earnings of male and female teachers are combined and compared with the average pay of all non-teachers with at least four years of college, the difference is 53.5 percent in the year 2000. This actually understates the pay gap because a large proportion of teachers have master’s degrees, making them more educated than their comparison group.

4.  A study by the Economic Policy Institute shows teachers (nationally) with bachelor’s degrees earn 12.2% less per week than their peers with similar college credentials.   Teachers with masters degrees (the majority of Indiana teachers) earn 11.3% less per week than those with similar college credentials.

5.   Indiana Teachers are the Second Most Educated and Fourth Most Experienced in the US according to the National Center for Education Statistics in 2007. Fifty-six percent (56%) of Indiana public school teachers have master’s degree or higher, ranking Indiana as the second highest state in teacher education, after New York.    Only three other states have larger percentage of public school teachers with over 20 years experience.      The 2003-04, Education Watch State Report indicates Indiana ranked first in the nation with core academic subjects taught by teachers who have a major or are certificated in the subjects they are teaching. Despite Indiana teachers’ extraordinary ranking in advanced degrees, certification,  and experience,  NEA Rankings of the States show Indiana’s average public school teacher salaries ranking 22^nd (at $48,500). The Governor’s response to all that is to freeze teacher pay but let health insurance premiums and co-pays rise, and to let all other vendors charge schools higher fees.    The Governor wants schools to enroll employees in the state health insurance plan, but Marie Giese reports Mishawaka checked into that and found that the state’s family plan would cost $4500 more per employee than their current plan. Locals may decide to accept zero increases, but it should be a local decision to do so, not a state mandate.

Updates to Rx Mole are coming

We are meeting with local pharmacists and employers to give a quality product that promotes transparency and unbiased information. More to come.

An employer’s view of the proposed healthcare plan

Letter sent to Senator Bayh

Our employees have done a very good job managing their healthcare costs.  Their healthcare insurance premium costs have gone up one time in the last five years.  Of course they are very interested in what happens if their DC lawmakers pass a healthcare reform act.

Based on the latest look I have been permitted, here is what I will be sharing with our employees if the Healthcare Reform Act passes:

The Bad:

•           The additional government mandates, taxes, penalties, administration costs, and fees will be moving employers who currently offer healthcare insurance to either reduce the company investment in the plan or drop it altogether.

•           Significant reduction in the support of such plans as the FSAs and HSAs, if there is any reason to keep them at all.

•           Healthcare premiums become taxable.

•           Our employee premiums that have been below the national average will increase 53% over the next five years with less services.

•           The threshold for itemized medical expenses will increased from 7.5% to 10%.

The Good, if the employer continues to offer a healthcare insurance Plan.

•           No lifetime maximum (no employee is close to this concern).

•           No denial of services (no issues).

•           Child Dependent coverage age moved from 24 to 26 (the expectation is that our plan was going to 30 anyway).

•           Auto-enroll (already nearly 100% enrolled).

•           Wellness incentives can increase from 20% of premium to 30%. Not a concern.

•           No exclusion from pre-existing conditions (only one case in the last five years).

We certainly hope the legislature considers this view when voting.

Thanks for the well worded letter.