Unreported health care costs, such as ambulance services and non-approved treatments, add up to more than $300 billion a year in health care costs. Image from Wikimedia Commons.

Health care costs that aren’t reported in many surveys and studies add up to billions. Costs beyond co-payments and deductibles add up, and those costs have hardly diminished since the passage of health care reform laws last year. As the baby boomers are crossing the threshold into retirement, these costs could increase.

Caring for family and friends can cost workers

A recent study by the Deloitte Center for Health Solutions found that unreported costs of health care add up to an estimated $363 billion per year for Americans, according to CNN. The “hidden costs” include alternative therapies and treatments, ambulance services and prescription drugs not covered by health insurance plans, among other things. However, one of the biggest costs is providing care and supervision to loved ones, such as the elderly and the disabled. The study estimates that the cost of providing unpaid home care came with a price tag of nearly $200 billion, as the average person who took time off from work to care for a loved one lost $12.60 an hour, on average. Additional health care expenses are estimated at $1,355 per year.

Elderly facing greater burden

Compounding the rise of health care expenditures and costs above the rate of inflation is the growing population of the elderly. The Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services, projects that the number of people 65 or older will rise in the next decade, increasing from a projected 40.8 million in 2011 to 50 million by 2018. The elderly pay a steep price for increasingly expensive health care; bankruptcies among people 65 to 74 rose by 178 percent between 1991 and 2007, according to Fox News. Health care expenses have risen by 56 percent since 2002 for retirees, with an average $535 per month expenditure on health care. The only thing that the elderly are estimated to spend more money on than health care is food.

Here come the Baby Boomers

Life expectancy in the United States, according to the Wall Street Journal, has risen to an average 78.2 years — 75.7 years for men and 80.6 years for women. Because the baby boomers are set to start entering retirement, more people will retire and live longer after they do. More people are going to have to provide at home care for their parents and grandparents, spend more out of pocket and miss more work opportunities to do so. The cost of health care is likely to keep rising.

Sources

CNN

Fox News

Center for Medicare and Medicaid Services (PDF – requires Adobe Reader)

Wall Street Journal

Lawmakers in Maryland are facing a huge budget deficit. Image: Wikimedia Commons

State budget time is here again, and shortfalls are plaguing almost every state. Maryland is attempting to fill a $1.6 billion shortfall using emergency money and creative tactics. With several unfunded long-term liabilities, however, the state may have to take on more than a single year’s budget.

The Maryland budget shortfall

The Maryland state budget is currently facing a $1.6 billion shortfall for the fiscal year. Governor O’Malley is proposing that the full budget shortfall be filled without adding any taxes or fees to the state budget. Beyond the individual year’s deficit, Maryland also has more than $18 billion in unfunded pensions due in the next 25 years. There is also an estimated $15 billion in Medicare, Medicaid and health care costs.

Addressing Maryland’s budget deficit

Democratic governor O’Malley is proposing several reforms to help fill the budget shortfall. There will be several million, if not billions in cuts to state budgets. State employees, however, will also be providing a large amount of the emergency money the state needs to make ends meet. The state is inviting applications for a buyout offer — where the state pays employees to leave their jobs. There have already been 1,500 applications for buyouts, most of which the state is very likely to accept.

Health care costs a point of contention

A point of contention for a large part of the Maryland legislature is health care. There is a huge deficit built into the system. Long-term care providers in Maryland are already facing over $180 million in budget cuts. States are responsible for a significant portion of the costs of Medicare and Medicaid, and with budgets being stretched to the limit, the amount they are willing to pay is going down. For many long-term care facilities, that means trying to care for seriously ill patients on less and less money every day. In Maryland, no additional fees or taxes mean they could have to try and make do with even less.

Sources

Bloomberg

Virginia District Court judge Henry Hudson has ruled the health care law unconstitutional. Image from Wikimedia Commons.

A federal judge in Virginia has ruled the health care reform laws unconstitutional. District Judge Henry Hudson ruled that Congress had overstepped its constitutional boundaries, but did not block the law from being enacted. The law wasn’t enjoined as Hudson anticipates appeals up to and including the Supreme Court.

Health care law slapped down in court

A judge of the U.S. District Court in Virginia has ruled the health care law unconstitutional. Several months ago, it was announced that a few state Attorneys General were suing the federal government on the grounds that the health care reform laws weren’t constitutionally valid. Judge Henry Hudson held that the laws, dubbed “Obama Care” though the president didn’t author the laws, were not within constitutional boundaries, according to the New York Times. Judge Hudson found that one of the central tenets of the law, the mandate that most Americans purchase health insurance by 2014, was unconstitutional. However, Hudson did not enjoin the law from being enacted.

Appeal expected

Judge Hudson declined to enjoin the law from being enacted in whole or in part for two reasons. First, the portion of the law that he ruled on doesn’t take effect until 2014. Secondly, Hudson is anticipating an appeal to a higher court. Should the ruling be appealed, and it appears likely it will be, it will first go to the Court of Appeals, though this is likely an issue that will go to the Supreme Court. In his ruling, Hudson offered that since it is likely a “higher court,” will ultimately decide the matter, he wouldn’t issue any injunctions. A deadline of 2014 gives the appeals process enough time to work.

Other suits pending

There were 25 suits filed by state Attorneys General across the nation, according to the Washington Post. Hudson is the third judge to rule on the matter. The other two decisions, in Michigan and another in Virginia, both found in favor of the government. Another suit against the health care reform law is under way in Florida.

Sources

New York Times

Washington Post

For about 1 billion people, healthcare is unaffordable. (Photo Credit: Public Domain/Maj. Ann P. Knabe /U.S. Air Force)

According to the World Health Organization, approximately 1 billion people cannot afford any form of paid health  care whatsoever. Not only that, reports Reuters, but paying for healthcare pushes about 100 million people into poverty each year.

Nations that cannot afford health care must increase efficiency

The WHO’s global report on health care pays particular attention to financing, as the number of nations with large numbers of people who can’t afford health care has growth significantly. Considering ways to increase efficiency and use taxes and fund-raising measures to make health care more affordable and less poverty-inducing are of vital importance, particularly if universal coverage is to be the ultimate goal.

David Evans, the WHO’s director of health systems financing, said in a media briefing that the current state of health care worldwide forces people to choose between a rock and a hard place.

“When (health services) are not affordable, it means you either choose not to use them or you suffer severe financial hardship,” he said.

WHO plans to improve global health care

In order to keep those who do pay for health care from from sliding into poverty, the WHO recommends that health care and insurance company practices should be tweaked so that 15 to 20 percent of a country’s total health spending amounts to direct, out-of-pocket payments. Currently, there are at least 33 low- to middle-income countries where direct payments amount to more than 50 percent of total health spending. If governments can diversify their revenue sources – sin taxes, currency transaction taxes and wealth taxes are suggested in the report – the spending numbers would reportedly shrink.

Health  care waste

Compounding the problem of 1 billion people who cannot afford healthcare is health care waste. According to WHO director general Margaret Chan, 20 percent to 40 percent of all global health care spending is wasted through purchase of expensive, unnecessary drugs and treatments. Lack of proper medical training also contributes to such inefficiency. Add on the fact that some nations pay as much as 67 times more than the international average for some medicines, and it becomes apparent that the health care dilemma is not one that will be solved quickly.

“There is no magic bullet to achieving universal access,” said Chan. “Nevertheless, a wide range of experiences from around the world suggests that countries can move forward faster.”

Sources

Reuters

The need for health care reform in India

http://www.youtube.com/watch?v=dPsX46Svjmo

Being re-admitted to a hospital could be bad for your overall health. CC by mateoutah/Flickr

Health care in America is exceedingly expensive, which means  any new programs that stem from health care reform have work cut out for them. Efficient practice of preventative medicine is important, yet it’s a category where America fails miserably. A 2009 study by the New England Journal of Medicine shows that 20 percent of Medicare patients are back in the hospital a mere 30 days after release. After 90 days, that percentage climbs to 34 percent. After a year, a frightening 67 percent are back – or dead.

Re-admission is taxing U.S. healthcare

According to the Huffington Post, the cost of Medicare was $17.4 billion in 2004. That gigantic figure forced Medicare to start monitoring hospitals in order to track the high re-admission rate problem. Top offenders were penalized financially. A new industry was born amidst the turmoil; private companies would extend their efficiency expert services to afflicted hospitals. Considering that several studies show that three-quarters of all re-admissions are preventable, it seems likely that the efficiency experts have plenty of business.

Hospitals and nursing homes won’t take ownership

Lack of proper communication seems to be the common ingredient when it comes to hospitals and skilled nursing facilities providing sub-par care that leads to re-admission. Not sharing the right info on patients and medication are among the communication issues at hand. The problem grows significantly for those Medicaid patients who are older and are shuttled between general and intensive care facilities.

Medicare and insurers sometimes lack foresight

The American Geriatric Society found in a recent study that Medicare and insurance companies prefer to recommend skilled nursing facilities over inpatient rehab for stroke victims, reports the Post. This is done due to lower costs up front, but the rebound rate at skilled nursing facilities in this scenario is seven times higher. The foresight to see beyond the lower price tag is a skill Medicare and private insurers must develop.

Make your doctor give you the details

Medical care facilities will usher patients out as quickly as possible unless patients and their loved ones force them to slow down and answer questions. Ask about the risks and be sure that future care instructions are quite clear. For more info on specific questions, see the Huffington Post article listed below.

Further reading:

Huffington Post:

Health care issue

The crux of the health care issue is government involvement. This past week the insurance industry warned that government involvement would “dismantle employer coverage (that) Americans have relied on for a half century and overtake the system.” Two of the largest health care industry bodies have sent joint letters to Congress, stating they don’t believe that a government plan can “compete fairly” with private insurers within the health care market. America’s Health Insurance Plans and Blue Cross Blue Shield Association are the two companies taking the helm at criticisms of the government health plan.

The biggest challenge with health care programs

America’s Health Insurance and Blue Cross Blue Shield are the biggest critics of a government intervention regarding health care programs. AHIP’s chief Karen Ignagni and Blue Cross’ chief Scott Serota wrote in a dually-penned letter stating, “A government-run plan no matter how it is initially structured would dismantle employer-based coverage, significantly increase costs for those who remain in private coverage, and add additional liabilities to the federal budget.” They claimed that it is “impossible” to structure a government plan that can operate on the same level as a private plan. In the end, the government plan would use its advantages to “take over the health insurance market.” Their belief is that this plan would disable independent companies who are trying to better serve the health care system.

That seems to be the biggest challenge with government-created health care. How can the government create effective coverage plans without monopolizing the market? How can it provide health care programs while still encouraging free enterprise? How can their plan be effectively blended into the health care market alongside private health care programs?

The public opinion

Financial motivators are another reason the public is welcoming government-instated health care programs. With the high costs of health care, including medications and out-of-pocket expenses, the public has been struggling to meet the costs. Short term loans and family aid both supplement the high expense of medical care. Claire Danish of St. Croix, Minnesota stated, “We are doing what we can to handle our medical payments, but now with physical therapy bills coming out of our pockets, we don’t stand a chance at staying on track financially.”

Recent studies have shown that most people are in support of government intervention regarding health care. Although the program would compete with private companies in offering coverage, the public reaction is predominantly positive. Health care analyst Anne Summersdale stated, “Considering the number of people without health insurance, there is a huge pool of consumers who are ready and waiting for some government intervention…and the people who are covered have been disappointed by their own providers. They are also looking for government action.”

The cost of health care is rising

Like everything else in the economy, the cost of health care is rising. More and more people are going to have to face out-of-pocket health care expenses with the help of short term loans, family help and dipping into savings. Without some type of change, government-created or not, people will be at a standstill regarding their health care coverage.

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Economy slow to turnaround

The White House’s efforts to cut back notably ignore the Social Security and Medicare issues. Estimates say that $17 billion could be saved by government efforts, but this is only a small chunk of what is needed. It may be that the only answer to truly recovering is to build a strong economy and increase government revenues. But how does the president make this happen? As the AP’s Jim Kuhnhenn wrote, “Pushing ambitious agenda during a tepid economic rebound will require money and presidential muscle that eve a popular president might find in short supply.”

The recent past

It’s been several months since the president introduced his 2010 budget. In those two months the recession has proven to be worse than anticipated. Budget writers hoped for a GDP that shrank to 1.2% by the end of this year, however it already shrank by 6.1% in the first quarter. Moreover, economists are predicting a greater, though slighter, shrinking to occur before an upturn.

In the same vein, Obama’s budget predicted unemployment to be at 8.1% by next year. However, it already has reached 8.5% and is expected to climb a bit higher before year’s end. The president’s agenda will be affected by these new numbers that are surpassing his forecasts. In terms of making a health care policy that is acceptable, this does not bode well. “It doesn’t improve chances,” said Senator Ben Nelson of Nebraska. “It might dampen some enthusiasm about trying to find a health care solution that costs money.”

What this means to the everyday consumer

With huge policies still up in the air, the economy is sure to see continued shifting, and not necessarily in a positive way. Consumers are bracing for the stress by shoring up their savings, looking to payday loans, and using family loan options. It’s a difficult time as people wait out the recession, hoping new policies will strengthen the economy and end the recession.

Glimmer of hope

Despite the current numbers, America is hopeful. Almost all analysts agree that the turnaround is coming; maybe not soon, but it is coming. Ben Bernanke, Chairman of the Federal Reserve, cited growth to begin later this year, predicting home sales, spending and lending all increase steadily. He does warn that activity will be lower than the norm, but the pickup could help pull the country out of the recession. It is this glimmer of hope that Obama’s cabinet is focusing on to encourage the American people. They are hoping that this hope will bring about a continued support for the president’s policies and proposals.

Consumers manage their ways through the recession

In the end, consumers are left to focus on their own finances and wait until the economy turns around. A payday loan, extreme budgets and downsizing are all tactics people are using to manage their ways through the recession. They are hopeful, however, and looking to policymakers to help orchestrate a way out of the recession.

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Growing Health care costs

Although Congress is currently working to reform heath care as one of the Obama administration’s initiatives, any changes are predicting to have little effect on costs to individuals for health care next year. PWC Principal Michael Thompson stated that heath care reform will bring changes, but noted that “the intense focus on health care may [only] slow price increases down, but not stop them.”

The Pricewaterhouse.com data also shows that the cost increase of health care per person for benefit plans factors in price changes and utilization charges. A lot of businesses who have to manage the added cost will most likely pass the financial expense to their customers in the form of higher monthly premiums, deductibles and co-pays. Thompson confirmed that “If the underlying costs go up by 9 percent, employees’ costs actually go up by double digits… [this will have a] major, major impact when employers are also freezing or cutting pay.”

Consumers are fearful of unemployment

Almost half of the employers surveyed said that the increase in health insurance would be passed onto their employees. With everyone still trying to sort through the recession’s aftermath, this could be bad news for the average consumer. Experts remind consumers that the 9% estimated increase for 2010 is down from a formerly projected increase of 9.2%. Mainly the decrease can be attributed to people taking advice from experts and using generic substitutions when purchasing their medications. In an effort to find debt relief, many are asking their physicians to substitute for them.

A new Price Waterhouse survey showed that most consumers are fearful of unemployment. This makes them more prone to seek health care, now that they still have it, rather than put it off like they may have done in the past. The survey also cited that health care providers “tend to shift costs to private insurance plans to make up for the revenue drop they see from a rise in the uninsured population.”

Paying bills

Regardless of how it works out, consumers are going to have to be ready to sustain the added cost of health care. Already deductibles, co-pays, medications and out-of-pocket expenses are weighing heavily on consumer’s finances. Vivian Laiterman of Scottsdale, Arizona fell ill a year ago. Although her health care provider paid for her immediate care, there were many other costs. “I had a deductible of $1,500. Once that was reached my insurance took care of the bulk of my care, but not after-care. I had to pay for my weekly physical therapy bill and medications out of pocket.”

Health care in the future

Consumers seeking debt relief may be disappointed when health care costs continue to rise. Many will have to rebuild the cost of added health care into their budgets. No one knows how the new health care plan will play itself out in the economy, but people have to be prepared for an even tighter financial plan.

Many health industry analysts are blowing off President Barack Obama’s health care reform bill passed Monday. This reform is expected to yield a higher percentage of stocks because it is expected that government payments to privately run Medicare plans will be on the rise, according to one Lewis Krauskopf writer for Reuters.com website. Late Friday it was announced that, indeed, a higher-than-expected payment rate will be in effect for 2011. For this reason, health care share value for health insurance companies with heavy Medicare ties was elevated.

Can reform win approval in Congress?

Obama’s proposal is not the favorite bill amongst many middle and high class citizens who have to rely on short term loans online. Analyst actually expects the bill to fail. Sadly, these people haven’t had the experience of being too rich for state aid, but remaining too poor to afford health insurance. Wall Street was definitely paying close attention to any clues revealed during a bipartisan White House summit held Thursday. Realistically this reform will start off as a subtle change, but anything astronomical is unlikely. Mark the words of analyst Tim Nelson about how sooner or later a health care reform bill will be passed because the ones who advocate for the change simply won’t give up.

Humana Inc (HUM.N) and the UnitedHealth Group Inc (UNH.N)

Humana Inc (HUM.N) and UnitedHealth Group Inc (UNH.N) are two of the biggest Medicare providers of the Advantage plans. Their stocks consequently increased 5.5 percent and 3.5 percent Monday. This includes the Morgan Stanley Health care Payor index, as well. HMO of health insurers was up 1.6 percent, according to Krauskopf.

Obama’s proposal comes after months of debate

This debate is nothing new to the Senate and House of Representatives; it has been amongst the most debated topics in congress for years.

Krauskopf states that:

“The proposal draws heavily from the reform bill passed by the Senate in December,” said analysts at Jefferies & Co. “We view the release of the President’s proposal as a relative non-event since it does very little in improving the chances of healthcare reform being legislated through bipartisan efforts in Congress.”

Discounted Health Insurer Stocks

When Wall Street first caught word of the proposed Health care reform bill that would threaten their future incomes, they panicked. To resolve any unnecessary losses, they decided to trade their health insurer shares at a discounted level. This panic subsided when democrats lost their majority vote in the senate last month. This reform will continue to stress out the stocks and its holders. According to Krauskopf:

“The stocks have underperformed since earlier this month when the Obama administration seized on premium increases by WellPoint Inc’s (WLP.N) Anthem Blue Cross unit in California to ratchet up attacks on the industry”.

Share holders must expect the unexpected in this case because it is a sure possibility that:

“Democrats will try to push reform measures through a budget process called reconciliation that requires a simple majority and could bypass Republicans” states Krauskopf.

Hopefully this issue is resolved soon so that the government can focus on something different for a change.

(Photo Credit: http://www.flickr.com/photos/dborman2/ / CC BY 2.0)

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Many older Americans are finding unsecured loans more helpful in handling health care costs than Medicare. Medicare rules these days are difficult to understand. Most people in today’s world are not retiring at 65. That opens the door for a lot of confusion regarding the rules of how Medicare pays out. Senior Americans can’t get into the Medicare system when they want. The simplest way to opt in is doing so when you turn 65 years old and people already collecting Social Security are automatically put into the system. But the new wave of seniors who continue working past their 65th birthdays are having problems with enrollment.

Over 65-years old and still employed

Those who continue to work and stay with their employer’s health care plan end up with limited options regarding Medicare. There are strict deadlines for enrollment and fines to be aware of. Worst case scenario is going without coverage at all until Medicare begins. Barbara Gardner of Austintown, Ohio, continued on her employer’s health care plan after her 65th birthday. She said, “My employer’s plan offers much better coverage.” Though in the beginning her decision made sense, she is now having a difficult time with coverage. According to Medicare rules, people must enroll within eight months of leaving employment. Because of this, Gardner’s next opportunity to sign up is in January of 2010, but she won’t be covered until July. Her employer’s health care plan is over in March and that leaves four months with no coverage. In addition, there is a penalty for missing the deadline that increases her premiums by 10%. She said, “I don’t know what I am going to do…I can’t afford an individual policy for the four month lapse.”

Experts weigh in on Medicare problems

Gardner is not alone in trying to sort out confusing rules. Medicare experts are saying there is a growing number of seniors who are getting caught in the red tape. The Medicare Rights Center notes that prior to the recession they received a few calls a month from Americans needing explanations. Post-recession they handle numerous calls on a daily basis.

Temporary coverage

For younger Americans getting temporary health care coverage for a few months is as simple as tapping into savings or getting small unsecured loans. For seniors, it isn’t that simple. Representative Kurt Schrader said, “Many seniors are going without coverage because of problems transitioning into Medicare and are unable to pick up temporary coverage because of their age.” Schrader has been instrumental in introducing a new bill designed to make laws simpler for those 65 years of age and older to convert from an employer’s health care to Medicare.

Why some opt for an employer’s coverage

Though it may sound odd, some over-65 employees opt to stay with their current employer’s coverage due to the expense. Even though Medicare Part A is free, Medicare Part B, the part that covers doctor visits and outpatient care costs, charges between $96 and $350 monthly. The premium is dependent on the applicant’s income. A lot of seniors choose to purchase “supplemental” policies that cover anything Medicare doesn’t. These are referred to as Part D plans. There are also charges for Medicare Advantage, which is a plan that includes monthly premiums, copayments and deductibles.

Seniors need to take steps to protect themselves

Many seniors are using unsecured loans to cover health care costs that Medicare doesn’t or to manage before Medicare coverage begins. It is important for everyone to do research when it comes to transitioning from an employer’s coverage and into Medicare. Understanding the rules can save a senior citizen from life without health care when they need it most.

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Check out where the jobs will be.

Specialists in short term loans, finances and money in general, are set for the next decade, or so says a recent study of the hottest jobs around. According to the study, Financial Examiners and Compliance Officers should be the nation’s two hottest career choices in the next 10 years.

The Labor Department reported the information this past week. Although financial analysts were high on the list pre-recession, now they have fallen totally off the top 30 list. Robert Johnson, Senior Managing Director at the CFA Institute said, “The finance industry grew so rapidly that people were attracted for the wrong reasons. People were buying and selling assets they didn’t understand.”

The Financial Examiner position

The Labor Department is projecting that Financial Examiner positions should grow throughout the next decade by 40 percent. Banks, insurance companies and financial firms need Financial Examiners and so do government agencies, by the way.

For anyone looking to start a new career, it’s a great option to look into. Johnson added, “In particular targeting a career towards government agencies can be highly beneficial to a worker. These are the types of jobs that will be needed and most likely won’t go away any time soon.”

The Compliance Officer position

The Compliance Officer is similar to a Financial Examiner but they are mostly employed by the government and financial firms. The job forecast for this career is set to increase by 30 percent by 2018, reported the Labor Department.

The total need will be for about 341,000 Compliance Officers able to handle the detailed work of maintaining legal conformance to new government protocols regarding finances. Because of the new model of lenders, there will be a wide variety of needs for these positions. Governmental involvement with a wide variety of money-handling corporations will call for a Compliance Officer’s aid.

Other jobs set to grow

In addition to Financial Examiners and Compliance Officers, there are other career choices set to be in demand. Accountants and auditors are needed. Over the next 10 years, these two markets are projected to add 279,000 jobs.

According to the Labor Department, the two professions “will benefit from an increasingly complex regulatory environment.” Congress is contemplating sweeping legislation to govern Wall Street and its financial dealings in the future. Companies will need experts in the field of short term loans, financial rules, and government protocols on tax filings to help them sort through the new legislation.

The future of job seekers

It’s clear where the future is headed. After the recession almost every company will need financial experts to maneuver the way through hefty changes in rules. In particular financial institutions will need both Financial Examiners and Compliance Officers to help them stay current with all laws.

In addition, the Labor Department projected the usual need for continued growth in the health care industry. The aging population is creating a bigger demand for nurses, physician assistants and home health aides. For example, physician assistants are expected to jump by 50 percent and create 1.4 million jobs by 2018. Part of their popularity is because they normally can offer the same care that doctors do, but at a much more cost efficient rate.

The Labor Department

The Labor Department releases its job projections every two years, and it predicts how many jobs the economy is expected to generate over the following decade. Financial specialists who understand short term loans, long term asset management, financial projections and investments are going to be in high demand. So will Compliance Officers who can maintain a company’s legalities, and as usual, nursing and health care are high on the list, too. For any consumer looking for the next career move, these are telling signs of where the economy will be heading.

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Consumers are still using payday loans to fund their health care expenses. Health costs remain high and they are a major reason why people file bankruptcy. While people continue to struggle, the health care debate is in full swing.

President Obama has a plan to extend coverage to about 31 million uninsured Americans, police insurance company practices that deny benefits and curb the huge growth of spending on medical care. Last week Democrats pushed to move health care legislation through the senate. The final vote was 60 to 39 and it opened the door for a showdown to be held later this month.

“Doing nothing is not an option”

The debate is creating sharp opposition from both republicans and democrats. Democrat Harry Reid accused republicans of trying to thwart the public debate over national health care. He said, “Imagine if, instead of debating whether to abolish slavery, instead of debating whether giving women and minorities the right to vote, those who disagreed had muted discussion and killed any vote.”  On the other hand, republican Senator Mitch McConnell said that the vote was anything but standard. The bill, he said, would “raise taxes, cut Medicare and create massive and unsustainable debt.” The only unified thought running through both parties was voiced by Senator Mary Landrieu who said, “It is clear to me that doing nothing is not an option.”

What to do is up for debate

Much of the debate over health care centers on specific legislation that requires most Americans to carry insurance and provides subsidies to those who won’t be able to afford it. Corporations could potentially be fined if they don’t provide coverage to employees. The industry as a whole would be regulated under the new bill and no longer allowed to deny coverage based on pre-existing conditions. Budget analysts are projecting that the bill would cost $979 billion over the next ten years but it would reduce deficits over the same period of time and adequately cover 94% of the insurable population.

The health care bill would create insurance exchanges that begin in 2014 and mostly affect lower-income and uninsured citizens. No longer would either group need to use family loans, payday loans or credit cards to fund huge deductibles either. The bill includes billions of dollars in tax credits for those who meet specific income criteria.

House divided over health care

The House approved a version of a health care bill earlier this year in a vote of 220 to 215. All democrats voted to move the bill forward, as did two independents. All opposing votes were cast by republicans. The house is sharply divided on the issue and arguments are expected to continue for quite some time.

Obama’s health care plan in motion

Only time will tell where the health care plan will end up, but the words of Senator Landrieu are correct: “Doing nothing is not an option.” President Obama is currently working to push through a plan that brings affordable insurance options to the voting public. The sooner a bill is passed, the sooner low- to mid-income-level citizens can stop using payday loans, family help, and retirement funds to pay huge, uninsured medical expenses.

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The way things are going, small businesses are going to need more than that. What about a cash advance for all? (Photo: flickr.com)

The U.S. has finally traveled out of the dark ages of recession, or so it seems, because a few people I know have had to utilize cash advance loans to keep their businesses afloat. Many of financial hardships that people are facing aren’t spewing forth from a lack of effort. Typically, recoveries from recession in the United States are lead by small businesses. It’s during this time that small businesses should be springing forth, and advancing the growth of the current economic state.

Positives of This Recession Break

The positive side of a “recession breather” is that small businesses can lease or buy fairly cheap commercial property while they prepare for financial growth and industry expansion. My friend and newbie online business owner Carl R. said, “I believe that in up to six months from now, the unemployment rate should scale back down to the eight percent, or maybe even five percent mark.” At that point, we should be celebrating and enjoying life, because small businesses would provide four out of five new jobs for Americans.

Is There a Dark Side to This?

Unfortunately, if we do happen to regress into another dreaded recession, falling from the “recession breather” we’re currently in, it could go down this way: unemployment could crawl “way above” 10 percent. That would definitely put us into another funk. Commercial Real Estate values would sink more than they expand, due to a lack of small business expansion. When small businesses refuse to expand, they react by rebuffing the notion of hiring, because of the possible lack of expansion. The concept is similar to a revolving wheel. Small businesses are the rise and fall of our country’s financial destiny. Small businesses fear the thought of consistently changing company policies and creating rigid changes in energy, union membership and health care matters. In this case, unfortunately, a cash advance loan wouldn’t help my friend Carl.

There are wonderful possibilities as to how small business power could signal an economic charge against financial woes and provide recession remission. However, the reality is that small businesses still aren’t hiring, and most are aware of the facts presented here.

Some Businesses are Doing Better than Others

Some of the conglomerates like McDonald’s, Green Mountain Coffee and Panera Bread have weathered the current recession, either by keeping profits at a set high or improving their sales figures. However, not all restaurants are operated and provide as much convenience as fast-food chains Most use and need credit lines to run their businesses.

Will President Obama Save Small Business?

There are numerous issues involved in the recovery of small business. Energy and union labor are two big issues worrying small business owners. President Obama’s plans for health care are a current worry as well. Inflation and commodity prices that determine the costs of food production and delivery all play a key factor in the anxiousness small business owners are feeling about what’s ahead in the upcoming months.

Michael Lind had some things to say on Salon.com about the ideas and future plans for Obamacare, in that it practically places small businesses on a financial “sacrificial altar.” I won’t delve into the intricacies of his statements, but if Mr. Lind’s words represent the thoughts of President Obama, and congressional Democrats (who poor and middle class people have been hoping would rescue our country from its existing financial position), small businesses will only be able to dream of expansion.

Not a Storybook Ending

The sad truth is that locked down small businesses won’t start hiring, and the result will be that the current commercial property bomb might not be defused in time. And I’m sure that no one wants to see America fall prey to the explosion of a second recession. Thankfully, a cash advance loan is there if – or when – you need one.

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Sometimes love just isn't enough (photo by creativecommons.org)

Pet owners love their animals and many of them use payday loans to pay for emergency pet care. Regardless of economic conditions, people will always find ways to provide the best care they possibly can for a loyal dog or a faithful cat.

Today, the average pet owner may have to stretch the budget to the breaking point to pay for an emergency veterinary visit. Dr. Ganner, MD, a veterinarian in Cleveland, Ohio, states, “You never know when a pet can get ill, just like a human. Pets’ surgeries can cost more due to lack of insurance and specialized care. It’s an immediate out-of-pocket expense.”

Save on day-to-day pet expenses

For anyone with a pet, there will always be unexpected medical emergencies. The most basic way to lessen the strain of emergency expenses is to put a little money aside all year long. Here are some ways to save money for your pet’s emergency, without cutting back on the quality of daily care.

1.  Fill prescriptions at Petmeds.com or a human pharmacy. When you fill an animal’s prescription at the veterinarian, you typically pay 30-70% more than you would online or at a regular pharmacy. Rather than blindly accepting the prescription medication handed out at a veterinarian’s office, pet owners should ask veterinarians for written prescriptions and then fill them at regular or online pharmacies.

2.  Buy pet food at superstores like Costco or Sam’s Club. Superstores purchase inventory in great quantities at huge discounts. They carry fairly wide arrays of pet foods, and you are likely to find one of your pet’s favorite brands in their well-stocked aisles. If you don’t find the brand you prefer, talk to the manager and ask if the store will order it. When enough customers ask, superstores respond by purchasing requested products. Their goal is to stock everything their shoppers need, and they work hard to live up to that.

3.  Buy pet toys at superstores or grocery stores. Toys at pet stores and boutiques can cost 50% or more than the same (or very similar) toys at a superstore or grocery store. The reason for this is that pet stores mark up all their products to pay for advertising and promotions. Retail sales are their only source of income, so they have to maximize their markup.

Start an emergency pet fund

If you put aside the money you save on these everyday pet expenses, it will be easier to pay for those inevitable emergency expenses. If your savings are adequate to cover the emergency, a small payday loan can make up the difference. As Dr. Ganner stated, “If people have huge monthly budgets for their pets, it’s difficult to then extend that budget even more when an emergency comes up…but, finding ways to save throughout normal times, can make it much more manageable.”

Love knows no bounds (photo by creativecommons.org)

Love without bounds . . .

People are going to care for their pets regardless of what happens on the economic front. It’s estimated that the pet industry generates over $45.5 billion annually. Global market expert Eugene Fram stated, “It’s a substantial market. The numbers bear that out with more than 60% of households having a pet. It’s a good business and a great target market to pursue.”

But avoid heartache by economizing

Because pet owners are willing to spend so much on the daily care of their pets, they frequently compromise their ability to pay for emergency care. To avoid finding yourself in that stressful situation, it’s a good idea to treat pet care like your other budgeted expenses.

Cut back on daily pet expenses and put the savings aside in an emergency pet fund. You’ll be pleasantly surprised at how much easier it is to afford the best possible pet care when you need it most if you save just a little every day. With an emergency pet fund at the ready, when emergency strikes, you’ll be able to pay for it without borrowing; or in the worst case, with a much smaller payday loan or a lot less help from family or friends.

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image by flickr

Payday loans applications are flourishing as medical costs continue to weigh down Americans.  Currently there are millions of people seeking aid from government programs.  These programs can be confusing, however, and many people are being rejected for innocuous reasons such as location, rather than need.   Government aid comes in the form of health care, housing aid, and food stamps. But each one comes with its own set of rules and regulations to be eligible, and truly needy people can get caught in the red-tape.

Beverly Johnson of Kosciusko, Mississippi lost her job at a Bible college. When she went to apply for unemployment, she was told that as an employee of a religious school she was ineligible.  “That was a shock,” she said.  Most Americans believe that unemployment is there if they are let go but there are underlying rules with every government program.

Because there is so much fine-print when it comes to getting government assistance, payday loans are filling the gap.  When people need money, they look to payday loans as a reliable option because other options are so uncertain.  Martin Summerstein of Miami, Florida stated, “We use payday loans because they are available to us. You can’t count on the government, because one day help is there and the next it isn’t.”

Studies show

The New York Times did a study of state enrollment for six federal assistance programs and found a huge amount of disparity between them.  In California, only 50 percent of people who need food stamps get them, whereas in Missouri almost 98 percent of people get them.  In South Dakota, 19 percent of unemployed people get unemployment benefits, while Idaho gives benefits to 67 percent of its out of work citizens.

Political scientist at Harvard Theda Skocpol stated, “The system for helping Americans in need is very fragmented, and it confuses everyone. Some people are covered, and some people are not, even though they look like they’re in very similar circumstances,” says the New York Times.

The critics

The stimulus package has about $100 billion in safety net provisions but each state is able to decide whether or not to take advantage of it.  A few governors believe that to increase unemployment benefits would increase taxes on businesses and cut down on new job creation.  They rejected the assistance.

Some critics believe that this extra fund is detrimental.  They cited that payday loans and easily available federal aid can cause people to mismanage their budgets consistently.  “If people have options, they won’t be forced to rework their budgets and cut back where they need to. They can become dependent on extra money instead of being responsible.”  Stuart Butler of the Heritage Foundation believes that added government aid could also discourage people from seeking more education and better paying jobs.

Much-needed reform

In the end, President Obama has a lot to sort through.  His team has to react to the crisis and find ways of including needy people in government aid programs, without driving the economy deeper into a recession.

Shiela Zedlewski, of the Urban Institute, said “We have people (receiving all benefits) but we have far more people who get nothing. … A significant group remains outside the safety net.”  In the meantime, people are trying their best to use payday loans, family assistance and the government programs they are eligible for to stay afloat.  Hopefully, the president will be able to include help for everyone based on need and not on whether they find their way through red-tape.

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Debt relief and health care reform would seem to go hand-in-hand, brothers and sisters (Photo: flickr.com)

In the midst of the health care reform, many Americans are worried about debt relief.  High medical bills are the leading cause of bankruptcy in the nation and many see it as the biggest “ignored necessity.”   Housewife Brandy Giant of Littleton Pennsylvania stated, “When my husband lost his job, we had no choice but to cut corners…when he remained out of work for a year, we had to cut health insurance out of our budget.  It’s easier now because we’re both healthy, but once we have children, that won’t be an option.”

Many Americans are seeing high health insurance premiums as a burden and cutting them out of their budgets.  President Obama is calling for health care reform, declaring the issue a “ticking time bomb” and claiming that without some serious revamping it could cause America to “go the way of GM.”  The president spoke at the American Medical Association’s annual meeting, looking for supporters who will help reshape the industry.  His goal is to bring health care costs down and to bring coverage to the millions of uninsured Americans who are doing without.

Criticism of Health Care Reform

Mitt Romney is a direct opponent of Obama’s plans, stating that government-dictated insurance plans are a “Trojan horse.”  GOP Rep. Tom Price stated that Obama is setting the nation up for a “government takeover” of health care.  He believes that Obama’s proposed committee to police the effectiveness of medical treatments would open the door for a “rationing board” to veto doctor’s treatments and deny patient’s the healthcare they need.

Also garnering criticism is the proposed funding needed for health care reform. The president said that the cost of providing coverage to 50 million uninsured Americans would be approximately $1 trillion over the next decade.   Obama wants to fund the health care cost by cutting federal payments to hospitals, cutting money from Medicare and Medicaid, and increasing in taxes and spending cuts to the health care industry.

Critics are condemning Obama’s proposed tax increases, citing that immediately after the recession is the least favorable time to introduce more financial strain on a country trying desperately to find debt relief.

The AMA Annual Meeting

The president tried to garner support from the 250,000 physicians at the AMA meeting.  His purpose was to free physicians of the role of “bean-counters and paper-pushers” and do a proper assessment of procedures to find the optimum ways to handle health care.  Obama called out for physicians to assist him in informing lawmakers of the importance of reform. “To most Americans, you are the health care system. Americans do what you recommend. That is why I will listen to you and work with you to pursue reform that works for you,” said the president.

Malpractice

One key issue with garnering medical community support is malpractice.  Doctors have long been complaining about the high costs of malpractice insurance, and would like some limit on malpractice lawsuits to be instituted.  Obama addressed the issue stating, he sympathizes with doctors “who feel like they are constantly looking over their shoulder for fear of lawsuits and with the desire to curb them.”  He firmly denied wanting to support capping malpractice lawsuits, however stating that doing so would be unfair to truly injured patients.

The future of health care

The future of health care is an unknown. With huge numbers of Americans going without coverage, something has to be done to help them.  Many Americans are waiting with bated breath for a solution that fits into their budgets and debt relief plans.  Without some careful planning, more and more consumers will find themselves facing outrageous medical bills and no viable option of paying them.

Barack Obama touts health care everywhere he goes. Image from Wikimedia.

Many consumers are struggling with debt relief because of the huge cost of health care.  Congress has taken the cause up as one of its most pertinent issues to sort out, and President Obama is targeting it as a strong focus throughout his presidency.

Although the topic is much cause for debate among congressional leaders and experts, they all agree that at the center of the issue lies the average health care provider.

Patient-centered medical home

The health care industry has introduced a new term: “patient-centered medical home.”  This refers to the primary location for doctors to care for their patients, normally the doctor’s office.

At a patient-centered medical home, doctors would offer services ranging from flu shots to the management of chronic diseases. They would use the patient-centered medical home as a hub to coordinate care with nurses, pharmacists and specialists.  A study showed that if every patient had a central location for their health care needs, the resulting efficiency could reduce health care costs by 5.6 percent, or $67 billion annually, which would be a possible solution to debt relief for the industry.

The current doctor’s office

Today’s doctor’s office is a far cry from the optimum patient-centered medical home of the future. Research shows that the average patient spends just more than 7 minutes with their primary care physician, who gives superficial answers that focus on symptoms. Often times doctors send patients to chronic care specialists unnecessarily.  Many of these chronic ailments could be managed by the physician if he or she were willing to spend more time with the patient.

Another issue to address is the inefficiency of emergency rooms. Often  patients rush to emergency rooms for immediate care when their physician could realistically handle the issue.  Again, it becomes an issue of time and individualized care by doctors.

Reform

The patient-centered medical home is reminiscent of the “gatekeeper” model of the 1990s. Managed-care was set in motion with the primary goal of managing costs.  Today’s model has a new focus: patient care.  Experts are touting that with new digital technologies to help, it is easier than ever for true health care industry reform to happen.

Health care today is known to be “disorganized and wasteful”, according to Dr. Paul H. Grundy, health-care transformationalist for IBM.  He also noted that health care eats up almost 18 percent of the U.S. gross domestic product.  Most of the cost is shouldered by the private sector, that covers about 60 percent of the nation’s insured consumers. Grundy added that “employers can drive the medical-home idea as buyers of care.”  He believes that IBM’s Patient-Centered Primary Care Collaborative, a coalition of more than 500 employers, insurers, consumer groups and doctors, can help to transform the industry as a whole and spur debt relief for the consumer.

There are also four large medical societies endorsing the medical-home concept, and beta programs are currently running in several states.  President Obama is also looking to the idea, saying that any health-care initiative should “encourage and provide appropriate payment for providers who implement the medical-home model.”

The optimum model

In Newport, Va., Dr. Peter Anderson is using the medical-home model. One example is his recent patient, 72-year old Gretchen Parker. Parker was diagnosed with diabetes last year and rather than put her on immediate insulin shots or medications, Dr. Anderson took a model approach.

He developed a plan for Parker to lose 55 pounds through diet and exercise. His team worked with her to best model a new lifestyle for the patient. Her blood sugar is now back to normal. This is an example of how the future of health care is going to be developed.

Health care

In the end, physicians are the key to reforming health care.  Though the model involves more detailed care and more time, the resulting efficiencies will be well worth it. If the health care industry can scale back costs and help employers, consumers, insurers and physicians find debt relief, then the changes will be well received.

This morning on “Today,” Matt Lauer interviewed Sorrel King, author of the book “Josie’s Story.” Josie was Sorrel King’s 18-month-old daughter, who died in the hospital in 2001 because of the hospital staff’s errors.

Sorrel King’s book, “Josie’s Story: A Mother’s Inspiring Crusade to Make Medical Care Safe,” just came out earlier this month. It is available on Amazon for $16.32. “Josie’s Story” is a good read, according to critics, and an excellent example of a mother channeling her grief and anger into helping a good cause.

Shift in focus on health care

“Josie’s Story” also reminds us that when it comes to health care reform, the cost and potential tax debt associated with medical insurance aren’t the only important issues to consider. The health care system in the U.S. needs more than financial overhaul — it needs quality overhaul as well.

On “Today,” when discussing “Josie’s Story,” Matt Lauer said that 98,000 deaths per year are caused by medical errors. That’s almost 100,000 Americans per year dying because of mistakes.

How to prevent mistakes

When Josie King died, her mother chose to create positive change instead of sinking into despair.

Dr. Nancy Snyderman, NBC’s chief medical editor, was in on the discussion of “Josie’s Story” on “Today.” She said the most important message is that medical professionals need to listen to mothers, who have instincts regarding their children, “and everyone needs to communicate better.”

Of course, there is no way to prevent every mistake from happening. However, through the Josie King Foundation, Sorrel King has fought to have more procedures put in place in hospitals for more careful observation and communication.

Josie King Foundation programs

Thanks to Sorrel King’s work, new programs have been put in place at hospitals, such as the Care Journal program. The Josie King Foundation web site says “The Care Journal has thirty daily journal entries. Each entry consists of prompts that take the guesswork out of what information to remember.” Patients and loved ones of patients keep the Care Journal daily, and the purpose is to bridge the gap in communication between patients and caregivers.

Another program is Condition Help, which sets up a rapid response procedure for patients or families who feel they are not receiving adequate medical attention or have an immediate concern. During Josie’s stay in the hospital, Sorrel many times felt concern and talked to medical staff, but there was no system in place for responding to her concerns.

Watch video of ‘Josie’s Story’ discussion on ‘Today’

You can view the segment on “Today” about “Josie’s Story” using the ‘Today’ show video player. You can also read a description of the book “Josie’s Story” at the Josie King Foundation web site, where you can also read more about the foundation’s programs.

You can make a tax-deductible donation online or get the address to mail a check at the web site. There is also a system set up for people to donate stock to the Josie King Foundation.

Image from Flikr.com.

At a Joint Session of Congress, the president’s speech last night outlined his health care reform plan and addressed controversies and misunderstandings that have surrounded it.The series of videos at the end of this post shows his full speech, but if you don’t have time to watch it, here are some highlights.

The president’s speech last night started off nice and friendly as he spoke about the things Congress and regular Americans generally agree on. He opened by talking abou the economy and acknowledging that we are still deep in the midst of a recession.

President’s speech last night well received

President Barack Obama got his first standing ovation about a minute into his speech when he said “I will not let up until those Americans who seek jobs can find them.” This is great news for people who want to get payday advances, because you need paydays to get payday cash advances.

A hard-hitting moment came in the president’s speech last night when Obama, referring to health care, said “I am not the first president to take up this cause, but I am determined to be the last.” Very loud cheering followed, and it seemed he had his audience in the palm of his hand.

President’s speech last night part one

The first item on Obama’s agenda last night was outlining and explaining the health care bill currently making its way through Congress. The plan has two main parts, he said. The first part “makes what you already have work better for you,” he said.

In the president’s speech last night, he emphasized that nothing in the plan requires people to change the health care coverage they already have. What it does do to existing health insurance is make it illegal for insurance companies to deny coverage because of pre-existing conditions or drop coverage when people get sick. It also gets rid of caps on coverage and adds caps on out-of-pocket expenses.

“In America, no on should go broke because they get sick,” Obama said.

President’s speech last night part two

Obama explained that the second major part of the health care plan provides a way for people without coverage to get it. The health care plan offers a public option for people who cannot get private insurance through their employer or afford to pay for private insurance.

The public option will be self-supporting, paid for by the premiums it collects. It won’t be paid for by taxes. People will be required to carry some type of basic health insurance — who they get it from is their choice — just as people are now required to have car insurance.

“Improving our health care system only works if everybody does their part,” Obama said.

And the evening takes a turn

Up until this point, the president’s speech was punctuated only by cheering and standing ovations. However, it was time to deal with the rough stuff. The president addressed the controversies that have come up because of the health care plan, fabricated by people and “spread by those whose only agenda is to kill reform at any cost,” he said.

Joe Wilson became an instant celebrity — and in this case that is not a good thing — when he yelled “you lie!” after Obama said that the health care plan “will not cover those who are here illegally. You can see a short clip of that moment in my article about the web site called Joe Wilson is Your Pre-Existing Condition. To see the clip in its full context, check out the third video below. The moment of “truth” comes about two minutes in.

All kinds of good stuff

Luckily, that was the only disturbance that distracted from the president’s speech last night. He addressed concerns about how the public health care option will work, which will be similar to Medicare and Medicaid. He emphasized that it won’t put private health insurance companies out of business, much like public universities haven’t driven private colleges out of business. In fact, he believes only about 5 percent of Americans will sign up for the public health care option.

He said it will hold private insurance companies accountable and create competition that will drive prices down and quality up. He explains that the health care reform bill will not add  to the deficit and will mostly be paid for by finding savings within the existing health care system.

Watch the president’s speech last night

If you didn’t watch the president’s speech last night, I highly recommend that you check it out for yourself, as it definitely clears up a lot of confusion and gives you the information you need to form your own opinion about the health care reform bill.