Every Blue down in Blueville liked Healthcare a lot...

But the Pinch, who lived to the left of Healthcare did NOT!

The Pinch hated Healthcare, the whole Healthcare system!

Just don't ask why, only he had the wisdom.

 

It could be his head was screwed on to the left,

It could be his ears were plugged up and deaf.

But I think the most likely reason of all,

Was that he thought the Blues brains were much much too small.

But whatever the reason, his head or his ears,

At enrollment season, Pinch took glee in their fears.

Staring down from his Tower he took some delight,

As they worked through enrollment and pondered their plight.  

"They're struggling, their choking," he coughed with a sneer.

"The deadline's approaching.  It's practically here!

Then he growled with his tiny heart nervously pumping,

"Each year they get an insurance thumping!"

"With enough pain in Healthcare, they'll eventually see...

The only way to Healthcare is directly through Me!

But every year undeterred, the Blues found their way,

To Healthcare solutions and new ways to pay.

HSAs, HRAs, an alphabet soup,

Consumer Driven Health made the Pinch feel like poop!

 

Then his brain started working, he came up with a thought.

A horrible, dreadful and awful old thought!

"I'll run for office, then they can be bought!"

"I'll promise them Healthcare.  Every man, woman, child.

We'll tell them it's FREE, he said with a smile. 

So he threw on his coat, and dragged along Mrs. Pinch,

With his trusty bullhorn, this would be a cinch.

 

A tight message, Ms. Pinch, and his bullhorn in hand,

He blazed into Blueville with promises grand.

FREE healthcare for all, if you all vote for me,

They lined up with big smiles and voted with glee.

Every Blue man and wife, cast their ballot for Pinch,

He won by a landslide, by more than an inch.

He cleaned out the Cabinet as quick as a flash,

Put them all in a bag and out with the trash.  

Into his new post, he jumped rather nimbly,

And anyone in his way, he rammed up the chimbley.

But while bagging and ramming, he heard a small coo,

He spun quickly around and there stood a Blue.

A wee little Blue, named Sweet Mary Lou.

 

"Is this some sort of micro, terrorist," he thought?

"Or maybe a rodent that needs to be caught?"

Without batting an eye, he asked, "What is it dear?"

"I'm here to take care of you, you have nothing to fear."

Then Mary Lou Blue, this sweet little tart

Looked straight in his eyes, then pulled at his heart.

"All the Blues, here in Blueville love you so much,

They want you to help them, but not be their crutch."

She said, "Dear Mr. Pinch, please don't act as our Mother,

Please stand beside us and be like our brother."

We want you to help us with Healthcare that's true,

There are so many, so many, things you can do.

Insurance companies need to be rid of their greed,

With some of their excess to help those in need.

Reward, those who are healthy with lower cost plans,

And breaks on their taxes, and more tools in their hands.

And what about good people whose health is not great,

But do all they can with what's on their plate?

They could use tools and insurance for sure,

But going broke in the process isn't the cure."

 

Then she paused for a moment and breathed deep some air.

Taken back by such wisdom, Pinch simply stood there.

But she was not through, little Mary Lou Blue,

The little Blue girl who was no more than two,

"Let all the Blue people, Blue employers and you,

Stand together and work all of these healthcare things through.

You see Mr. Pinch, the Blues are all very smart,

 And if you will work with them and for them, they'll all do their part."

 

With that Mary Lou Blue, walked out of the place

Mr. Pinch stood there standing, a strange look on his face.

For awhile Pinch stood there, with no place to go,

But he had an idea and it started to grow.

And what happened then...?

In Blueville they say

That Pinch realized Government healthcare was not the way.

That the Blues down in Blueville were pretty damned smart

And when faced with a challenge did take it to heart.

If all of the Blues worked together he knew,

That healthcare would not be reserved for the few.

So with newfound leadership they developed a plan,

That with carrot and stick brought healthcare to the land.

And when it was done, and the plan was released

He.....HE HIMSELF....

Got himself into shape, and Mrs. Pinch was well pleased.  

Dan Crowell represents the changing face of health and healthcare in America.  Dan is the street superintendent for the city of Lafayette, Indiana.  Now I don't know Dan but I read about him JConline.com, the online edition of the Journal Courier Newspapers of Lafayette and West Lafayette Indiana.

Both cities, faced with ever rising healthcare costs have joined together to save money on health insurance and to promote healthier employees.  One of the keys to their strategy is through employee engagement.  This goes beyond the health risk assessments that most city employees participated in this year, and  includes the formation of a joint city committee comprised of city employees to analyze the data from the risk assessments and then collaboratively determine which health issues to focus on through to promote more healthy lifestyles.

The city managers are looking at other ways to reduce costs and improve overall employee health, and have added HDHPs with HSAs as an insurance option for their employees in 2009.

This brings us back to Dan Crowell.  You see, Dan Crowell, Lafayette's Street Superintendent, is one step ahead of the game and is the city poster boy for what can be.  Dan, over the past couple of years dropped 100 pounds through regular exercise (and I would guess a more healthy diet, but the article didn't say) which he maintains to this day. 

Some folks can get motivated on their own, and others need a little help.  But in order for us to drive our healthcare costs down and our health up, it will take collaborative efforts between employees and employers, between insurance companies and individuals, between the Government and all of us.  Dan and the cities of Lafayette and West Lafayette, get it and are doing their part to become part of the healthcare solution.  A tip of the hat to them.

So if you are reading this article there's a decent chance you are actually interested in learning about Health Savings Accounts or maybe taking control of your healthcare, or maybe taking control of your health.  Or then again, maybe you are looking for some information on the Haiku Society of America or perhaps the Handicap Scuba Association.  If the latter two, sorry, but you are hopelessly lost.

If you are an HSA wonk or someone just wanting to learn more, there is all kinds of good information on this site, HSAeducator.com, but if you want even more, the folks at HSAeducator.com have added a new link on their site that will pull up the latest and greatest news, videos and blogs related to Health Savings Accounts, High Deductible Health Plans, and CDH.  It actually is pretty cool, although, at the moment a little challenging to find.  If you look up to the right of the first article on this page, up under the "search hsaeducator.com" box, you will see a little  round widget that looks like a throwing star with the words, "  Related Content" next to it.  If you are looking for the latest in HSAs just click on that link and it will bring up a window and you can see what others are saying about HSAs out there.     Check it out and let us know what you think.

The American media community recently alighted on "Joe the Plumber" like a fly on poop and I couldn't help but wonder if he was truly represented the face of the America or if, perhaps there was something else going on there.  This has been nagging at me for weeks until today, when I was bobbing up and down on the basement treadmill, trying to read an article in this week's edition of Business Week.

It suddenly hit me, with the force of a diarrhea bomb the morning after a dinner of Kung Pao chicken.  The U.S. media is obsessed with the toilet and all things related to it.  Joe the Plumber was merely the media's toilet obsession, personified.

The article of "inspiration" entitled, "Toxic Assets: Still No Takers," was flush with toilet related imagery.   In a mere eight paragraph article, covering just one page that included an illustration, a big headline and a chart, I counted 28 throne-related images. Key among them were:

• Bailout
• Plumbing job
• Toxic
• "Ass"ets
• Flowing again
• Passed
• S"crapped"
• "Sit where they are"
• Impasse
• Unload
• Dumps
• Pumping
• Lack of pressure
• No pressure
• Sitting on

My favorite, and the final sentence was, "You could have it back up on you in an ugly way."

Whether we agreed with the message of Joe the Plumber or not was irrelevant.  For me he was merely the allegory for American media.  Toilet obsessed. 

You may be asking, "what does this have to do with Health Savings Accounts, High Deductible Health Plans, Consumer Driven Health, HSA education, health or wellness?"   I suppose the only advice we can offer is, stay away from the Kung Pao chicken, and if you can't, remember, you can pay for Pepto Bismol from you HSA.  Can anyone "spare a square?"

A classic. 

  You are new to the world of High Deductible Health Plans, and your new plan is   HSA eligible, or perhaps you have an HSA but haven't had the time to open a corresponding Health Savings Account.  Or you opened an HSA but have put no money in it this year.  With Christmas, Hanukkah and the general holiday season upon us, you are light on cash and thinking maybe you'll hold back on that contribution to your HSA.

You know in your mind that your healthcare is more important than the new Wii under the tree, but irrational spending behavior has taken over and that HSA contribution just ain't happenin'.

Here's the good news; December 31st 2008 is not D-Day for your HSA contributions.  Although it is for getting the account set up if you want to get the tax benefits of it on your 2008 tax returns.

As an individual you may contribute $2,900 to your HSA for 2008 and as a family you may contribute $5,800 to your HSA.   However, if you can't make it before the end of the year you're not SOL because if you fund the account before April 15th 2009, you can still take the tax deduction on your 2008 returns.   So if your brain is in the spend mode as opposed to the save mode, you get a 100+ day grace period to put $s into your account and still get the full tax advantages of your contribution.  But in order to get the benefit, you MUST set up your HSA account set up before the end of this year.  It's holiday season, can you say grace?

About the only things I know about Massachusetts have to do with beans (Blazing Saddles), a bunch of whiteys dressed up as Indians (wonder if they were wearing wigs?), and burning witches at the stake (now that's hot).

 Being from the Deep South, my purview of the rest of the country is somewhat narrow, and I suppose for every one of us, there is enough history, news, and politics in our own states to keep up narrowly focused and narrowly minded for a lifetime.  Thank God, I never had to spell Massachusetts in a spelling bee growing up, because that would have for sure thrown me out of the saddle.

Being interested in healthcare, I have been hearing for a couple of years about this movement by the state of Massachusetts to mandate health insurance for all of its citizens.  Besides finding the idea of it generally suspicious, I've really not paid much attention to it.

I stumbled across an article online in The MetroWest Daily News, written by guest columnist Jon Kingsdale.   Being from the South, I had no clue what market this paper served, so I checked the obituaries for the paper and saw such locals as Sudsbury, Falmouth, Framingham, and Rockland, Westborough, and Westchester.  While I didn't know the people or places, I figured out pretty quickly they weren't  from around here.  This was confirmed when I saw many seemed to have died in various branches of the U Mass Hospital system.

I suppose if I were some policy wonk, I'd also recognize the name of Jon Kingsdale, but I didn't and had to look him up too.  But not in the obituaries.  Turns out he is the CEO of the Massachusetts Health Connector.  Didn't know what that was either so I had to look it up too....

Honestly, I don't know how you folks in Massachusetts keep up with all this stuff, but the Health Connector is the state run agency that is in the middle of making sure all the good citizens of that state get health insurance or get fined.  Don't you just love Government?

Anyway, the short story on Massachusetts health policy is that pretty much all adults in the state have to have health insurance in 2009 or face fines.  I'm not sure about kids, but presume they have to have coverage too, but I'm guessing it would be difficult to collect fines from them.  And the fines are not small.  They could exceed $900 per year.

Citizens of Massachusetts can't just have any old insurance coverage, they actually have to have policies that provide them with certain standards of coverage.  As an aside, it is sad that there are policies out there that purport to provide coverage, but that in fact are crap and will do nothing but make an individual health crisis worse in the event it ever had to be used.

So where is the The Gradock Bulletin going with all of this?  We can read policy geniuses comment on this all day long, but our attention spans are too short.  We want your input.

We want to hear some normal people's perspective on this state mandate. Either individuals or employers trying to provide benefits to their employees.

Is it working?  What is it doing to healthcare costs?  Is it being administered efficiently?  Is it better than what was in place before?  Who is getting rich off of it?  Things like that.  

We have put up a discussion forum on the subject at HSAeducator.com in their Forum section and invite real people to share their experiences.  To tell the rest of the world, the real story.

And for all of us outside the great state of Massachuttes, to ask questions about the program.   Why?  Because it or some version of it could be "coming to a theater or drive-in near you."

To give those outside the state an idea of what those in Massachusetts must have in their insurance plans to avoid penalties, below is the list:     

• A comprehensive set of services (e.g., doctors visits, hospital admissions, diagnostic surgery, mental health and prescription drug coverage).
• Doctor visits for preventive care that are not subject to a deductible.
•  A cap on annual deductibles of $2,000 for an individual and $4,000 for a family.
• For plans with up-front deductibles or co-insurance on core services, an annual maximum on out-of-pocket spending of no more than $5,000 for an individual and $10,000 for a family.
• No caps on total benefits for a particular illness or for a single year.
•  No policy that covers only a fixed dollar amount per day or stay in the hospital, with the patient responsible for all other charges.
•  For policies that have a separate prescription drug deductible, it cannot exceed $250 for an individual or $500 for a family.

Folks, we want to know The Good, The Bad, and The Buttugly of healthcare in Massachusetts today.  Click Here to get to the Forum   -  You will have to register when you get there if you are not already.

  One thing everyone agreed on regarding the Obama presidential campaign was  that he picked his messages and stuck to them.  And one of the ones that stuck to me, in fact, with all the media coverage I felt like it was nailed to me with a hammer and sixteen penny nails, was the notion that if you liked the health plan your employer offered you could keep it, but if you didn't you could have the same insurance federal employees enjoy.  And for employers if they didn't provide insurance for their employees, they would have to contribute to a medicare type plan to cover the uninsured.

As I tried to read the tea leaves of Obama's healthcare reform, being the conservative guy that I am and generally distrusting of the U.S. Government, my interpretation of the above campaign message was that it cloaked  of a movement toward government run healthcare.  After all, healthcare in America is a multi-trillion dollar industry, power follows money, and the Government loves power.  Being somewhat cynical, I figure the underlying message of the stated policy was that if the new administration could get some traction around healthcare reform, it would make employee sponsored insurance so untenable for employers they would be forced to pay into the Government sponsored plan, and that would be the end of healthcare as we knew it.

But there is another possibility here, one that a conservative and somewhat cynical blogger hadn't really given much thought to.  There is an article in the November 17^th edition of Business Week entitled Heath Care-Immediate Relief From Rising Costs which made me wonder if rather than putting so much pressure on businesses their only option is to default into the Government plan, the Government might create enough incentives for employers to cover their employees meaning that less of the insurance market and burden would fall to the Government.

Personally, I think we need to tools to rely on ourselves when it comes to healthcare.  The Government needs to be an advocate for us, not control us or our employers.  Consumer Driven Healthcare, and specifically High Deductible Health Plans (HDHPS) and Health  Savings Accounts (HSAs) are tools the Government has given us.  Could they be better?  Absolutely, they are far from perfect.

Ron Klar, a guy way smarter than me when it comes to healthcare, the healthcare debate and fixing the problems related to our Nation's ills, wrote a terrific article just before the election entitled, AmericarePlans: A McCain-Obama Hybrid Proposal posted on Health Affairs, The Policy Journal of the Health Sphere.  Being the last guy on the grape vine, it took awhile for me to intersect with his article. 

I'm not going to regurgitate the article here as it is much better chewed, swallowed and ingested in its original form.

Klar points out, that one of the greatest challenges in any health plan, be it driven McCainanites or Obamians, is coverage for high risk individuals or those with pre-existing conditions.  He then goes on to outline a solution that, as the title of his article suggests is a Hybrid of both the Republican and Democrat healthcare platforms.

The thing I really like about Klar's plan is that he points out (without pointing it out) that we need to be aware that while we have been presented for months with but two options, we should not be bound by either the right or the left, but we should be unbound by our creativity.  We should be unbound by solutions.  We should be unbound from the box which politics so often seems to want to put us into.

It's a thoughtful and hopefully thought provoking read.  Check it out if you can. And if you want to learn more about Health Savings Accounts and High Deductible Health Plans, it's all right here at HSAeducator.com. 

 The Atlanta Journal-Constitution's PÉRALTE C. PAUL reported today (11/14) that  Aflac Chairman and CEO Daniel Amos announced he is giving up his $13 million "golden parachute" which represents the large dollars he would get if he were to leave the company.  

I know nothing about Mr. Amos, but admire his willingness to take responsibility for his leadership actions and is representative, in my opinion, of the attitude of those individuals who have embraced personal responsibility and accountability when it comes to their healthcare.  The insurance industry has taken heat over the years for executive compensation and ‘golden parachutes' are fuel for that fire. 

I am sure this is a mere spit in the bucket of customer costs and delivering shareholder value but it is a gesture of leadership I wish more CEOs of publicly traded companies would emulate.    It always bothers me that top level execs can come into a company that is publicly traded and can be unduly enriched regardless of their actions while there and then again on their way out the door.

If Advertising on SEC football is a metric of success, then Aflac must be doing pretty well under the leadership of Mr. Amos.  Unfortunately, that is my only personal experience with Aflac, but I have to think that duck is moving a lot of that "get hurt and can't work" stuff.    

Executive comp needs to align with a company's performance over an extended period of time and not insult shareholders, employees or customers.  In these challenging economic times, perhaps Mr. Amos' actions will inspire others.  Three quacks to you sir! 

....NOT! 

I saw a humorous YouTube video which led me down an interesting path of reflection and reinforced the extremes in thinking some people have on healthcare in America.   Healthcare is a complicated social issue, and to the best of my knowledge there is only one only perfect solution.  And that's  perfect health.

I've included the video here as it is humorous, but I present it with a large caveat.  Health insurance in America is indeed less than perfect.  It is kind of like owning a used car.  Most of the time it works and gets us where we need to go.  It might have a few accessories like power locks and windows that provide us with some creature comforts, but overall it's just not that pretty.  Sometimes it breaks down and unexpectedly costs us more than we have on hand expect to make it work which can be frustrating but not devastating.  And on rare occasion something major happens and the clunker leaves us high and dry, in the middle of some barren desert, without a chance of survival.

This video, if viewed in a vacuum suggests that health insurance companies are the cause of the problem, spawn of the Devil, the root of all evil (and healthcare problems).  The creators of the video would like us to buy into this premise and then blindly accept their healthcare dogma.

....But the video is funny.  Just take it with block of salt.

After watching the video I followed the link and landed on the Health Care for America Now website.  I felt compelled to read their story, which at an ideal level has some merit (qualitiy, affordable healthcare for all Americans), but at a practical level takes the incredibly arrogant, and naïve position that they are right and anyone who disagrees with them is wrong.  Their truth is a manipulated and contradictory truth at best.

Remember the video?  The one above that makes insurance companies to be the spawn of the Devil, if not the Devil himself?  Health Care For America disdains insurance companies, yet they basically suggest that if you are satisfied with your insurance you can keep it.  That suggests to me that they have either overstated their cause "insurance is not affordable for families...etc." or their true agenda is something else.

This organization states:

"Our government's responsibility is to guarantee quality affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing:...."

Aha, their agenda....

The thing that really annoys me about this organization is not their desire to improve healthcare for all Americans, but their suggestion that this is a problem for which the bulk of the responsibility for fixing it falls to the Government.  I love it that they are trying to expose social injustice and health issues, but it really frosts my gonads that they fail to suggest that Americans themselves are part of the problem.  That State and The Federal Government are part of the problem.  That healthcare practitioners are part of the problem.  That attorneys are part of the problem.  That big business is part of the problem.  The list goes on, and we nibbled around the edges of this a few days back in our article "The Unscientific Top Ten..."  Yet the face they put on it is one of insurance company greed; part of the problem for sure, but a small part of the problem.

 Government owned, run, and mandated insurance is a slippery slope.  In the end, if the Government is true to form, like that old used care, it will leave us broke and disheartened. 

What frightens me about Health Care For America Now is their proposal rings of the entitlement bell shrouded in the guise of a right.  Unfortunately, rights are entitlements the minds of many.  If healthcare is a right, then it needs to come with an enormous amount of personal responsibility, accountability and some level of sacrifice.  We need to take care of each other.  If we believe  the Government cares a rats about us, I believe we are sorely misguided.

We should treat healthcare must be treated as a privilege for there are people in this world far less fortunate than us who drink dirty water and live in homes with dirt floors and minimal shelter.  Our focus should be on health first and then on healthcare.  For more thoughts on this please read, "Mountains Part Deux."

I think the solutions to our healthcare challenges need to be more collaborative.  I believe organizations like the Healthiest Nation Alliance are healthier at their roots than say Health Care For America. We've shown this video before, but it is worth another look. 

If you have read this far, then you are thinking.  That's good.  Now think a little more about how you can change the world.  Too big?  Then think about how you can change your world or maybe your child's world.  Start with your own health and you will be on your way to better, more affordable healthcare.