Random musings, visionary ideas, deep pondering & an occasional touch of inspiration. Frequent topics include leadership development, technology, and my reactions to current events and political trends.
3.30.2010
Travelocity - Hawaiian Air - Korean Air problem
3.23.2010
Hang on - they're coming for your freedom
20 Ways ObamaCare Will Take Away Our Freedoms
The sections described below are taken from HR 3590 as agreed to by the Senate and from the reconciliation bill as displayed by the Rules Committee.
1. You are young and don’t want health insurance? You are starting up a small business and need to minimize expenses, and one way to do that is to forego health insurance? Tough. You have to pay $750 annually for the “privilege.” (Section 1501)
2. You are young and healthy and want to pay for insurance that reflects that status? Tough. You’ll have to pay for premiums that cover not only you, but also the guy who smokes three packs a day, drink a gallon of whiskey and eats chicken fat off the floor. That’s because insurance companies will no longer be able to underwrite on the basis of a person’s health status. (Section 2701).
3. You would like to pay less in premiums by buying insurance with lifetime or annual limits on coverage? Tough. Health insurers will no longer be able to offer such policies, even if that is what customers prefer. (Section 2711).
4. Think you’d like a policy that is cheaper because it doesn’t cover preventive care or requires cost-sharing for such care? Tough. Health insurers will no longer be able to offer policies that do not cover preventive services or offer them with cost-sharing, even if that’s what the customer wants. (Section 2712).
5. You are an employer and you would like to offer coverage that doesn’t allow your employers’ slacker children to stay on the policy until age 26? Tough. (Section 2714).
6. You must buy a policy that covers ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services; chronic disease management; and pediatric services, including oral and vision care.
You’re a single guy without children? Tough, your policy must cover pediatric services. You’re a woman who can’t have children? Tough, your policy must cover maternity services. You’re a teetotaler? Tough, your policy must cover substance abuse treatment. (Add your own violation of personal freedom here.) (Section 1302).
7. Do you want a plan with lots of cost-sharing and low premiums? Well, the best you can do is a “Bronze plan,” which has benefits that provide benefits that are actuarially equivalent to 60% of the full actuarial value of the benefits provided under the plan. Anything lower than that, tough. (Section 1302 (d)(1)(A))
8. You are an employer in the small-group insurance market and you’d like to offer policies with deductibles higher than $2,000 for individuals and $4,000 for families? Tough. (Section 1302 (c) (2) (A).
9. If you are a large employer (defined as at least 101 employees) and you do not want to provide health insurance to your employee, then you will pay a $750 fine per employee (It could be $2,000 to $3,000 under the reconciliation changes). Think you know how to better spend that money? Tough. (Section 1513).
10. You are an employer who offers health flexible spending arrangements and your employees want to deduct more than $2,500 from their salaries for it? Sorry, can’t do that. (Section 9005 (i)).
11. If you are a physician and you don’t want the government looking over your shoulder? Tough. The Secretary of Health and Human Services is authorized to use your claims data to issue you reports that measure the resources you use, provide information on the quality of care you provide, and compare the resources you use to those used by other physicians. Of course, this will all be just for informational purposes. It’s not like the government will ever use it to intervene in your practice and patients’ care. Of course not. (Section 3003 (i))
12. If you are a physician and you want to own your own hospital, you must be an owner and have a “Medicare provider agreement” by Feb. 1, 2010. (Dec. 31, 2010 in the reconciliation changes.) If you didn’t have those by then, you are out of luck. (Section 6001 (i) (1) (A)).
13. If you are a physician owner and you want to expand your hospital? Well, you can’t (Section 6001 (i) (1) (B). Unless, it is located in a country where, over the last five years, population growth has been 150% of what it has been in the state (Section 6601 (i) (3) ( E)). And then you cannot increase your capacity by more than 200% (Section 6001 (i) (3) (C)).
14. You are a health insurer and you want to raise premiums to meet costs? Well, if that increase is deemed “unreasonable” by the Secretary of Health and Human Services it will be subject to review and can be denied. (Section 1003)
15. The government will extract a fee of $2.3 billion annually from the pharmaceutical industry. If you are a pharmaceutical company what you will pay depends on the ratio of the number of brand-name drugs you sell to the total number of brand-name drugs sold in the U.S. So, if you sell 10% of the brand-name drugs in the U.S., what you pay will be 10% multiplied by $2.3 billion, or $230,000,000. (Under reconciliation, it starts at $2.55 billion, jumps to $3 billion in 2012, then to $3.5 billion in 2017 and $4.2 billion in 2018, before settling at $2.8 billion in 2019 (Section 1404)). Think you, as a pharmaceutical executive, know how to better use that money, say for research and development? Tough. (Section 9008 (b)).
16. The government will extract a fee of $2 billion annually from medical device makers. If you are a medical device maker what you will pay depends on your share of medical device sales in the U.S. So, if you sell 10% of the medical devices in the U.S., what you pay will be 10% multiplied by $2 billion, or $200,000,000. Think you, as a medical device maker, know how to better use that money, say for R&D? Tough. (Section 9009 (b)).
The reconciliation package turns that into a 2.9% excise tax for medical device makers. Think you, as a medical device maker, know how to better use that money, say for research and development? Tough. (Section 1405).
17. The government will extract a fee of $6.7 billion annually from insurance companies. If you are an insurer, what you will pay depends on your share of net premiums plus 200% of your administrative costs. So, if your net premiums and administrative costs are equal to 10% of the total, you will pay 10% of $6.7 billion, or $670,000,000. In the reconciliation bill, the fee will start at $8 billion in 2014, $11.3 billion in 2015, $1.9 billion in 2017, and $14.3 billion in 2018 (Section 1406).Think you, as an insurance executive, know how to better spend that money? Tough.(Section 9010 (b) (1) (A and B).)
18. If an insurance company board or its stockholders think the CEO is worth more than $500,000 in deferred compensation? Tough.(Section 9014).
19. You will have to pay an additional 0.5% payroll tax on any dollar you make over $250,000 if you file a joint return and $200,000 if you file an individual return. What? You think you know how to spend the money you earned better than the government? Tough. (Section 9015).
That amount will rise to a 3.8% tax if reconciliation passes. It will also apply to investment income, estates, and trusts. You think you know how to spend the money you earned better than the government? Like you need to ask. (Section 1402).
20. If you go for cosmetic surgery, you will pay an additional 5% tax on the cost of the procedure. Think you know how to spend that money you earned better than the government? Tough. (Section 9017).
3.22.2010
Real practical advice: sandwiches
3.21.2010
Another pound down
Posting a day early since I plan to be out and about all day Monday and might forget to do it.
I am down exactly one more pound for the week, despite being locked in my office for days on end completing papers and projects during Fuller finals week, which meant I did NOT eat as well or as often as normal, and I probably nervously snacked more. I am pretty sure I didn't drink nearly as much water as I should have last week, because the constant interruptions for bathroom breaks was messing me up! SO... in short, I'll take one pound and run with it!3.15.2010
The ides of March weigh-in
The magic number for this week is 185.7 pounds. That's a loss of 1.2 pounds for the past week, so the downward trend continues. A loss of a pound a week works well for me at this stage. Think about it… if a person could lose a pound a week, that would be 52 pounds per year. (The inverse of this is the way weight gain creeps up on us. If we GAIN a pound a week, we put on more than 50 pounds in a year.)
The quest for the skinny me hidden under layers of padding continues. Stay tuned.3.08.2010
March 8 weigh-in
There you have it. 186.9 -- actually just under a half pound MORE than a week ago, but that's a relief. I spent a large part of the past week at a conference, eating out, having buffet lunches with not always the most healthy options, sitting in sessions 12 hours a day unable to eat meals on a good schedule and no exercise.
I was really thinking "this weigh-in could be a disaster… I might have gained 5 pounds this week!" The number on the scales this morning were a huge relief.You might actually see my shirt tucked in more often!
3.05.2010
What's a Magic Jack, and does it work?
You purchase a small device about the size of a Zippo lighter: it is 2.5 inches x 1.5 inches x a little more than 1/2 inch thick. It plugs into the USB port on your computer and downloads a small piece of controller software that enables dialing on your computer. The Magic Jack device has a jack into which you can plug any standard telephone that uses an RJ-11 connector:
That's all there is to it. Pick up the phone and dial. It works. You can order it online at http://www.magicjack.com or purchase it at local retailers like Target, WalMart, Radio Shack, Walgreens and others. The price ranges from about $39 – $49 dollars, but that includes one year of service at the $19.95 annual rate.
In terms of practical value for churches? If you travel on short-term missions, or sponsor/support a missionary in another country, a Magic Jack enables them to avoid expensive cell phone charges and -- if they have a reasonably fast internet connection -- they can make and receive calls on a Magic Jack and stay in communication regularly.3.03.2010
The advantages of a Google Voice number
What is Twitter, and why would I want it?
3.01.2010
Café Church
The chain that owns Costa Coffee also owns lots of pubs and restaurants, so you might expect to see it rolled out there as well."