Tax Cheats or Just Stupid?

Actually, maybe a little of both.

There are a bunch of people on the Healthcare Exchanges. How many? We really don’t know. Last year the media dutifully reported all the IRS announcements about what an exciting growth in enrollment the Exchanges had experienced. I heard numbers like 7 million, 8 million, 10 million. All cited, of course, as “proof” that Obamacare was a success and Obama was brilliant for making it happen. Read more »

End of Life Care for Kids

Sad, sad story. This JAMA Oncology article ( talks about kids’ and adolescents’ end of life care with cancer. 22% went to the ER in the last 30 days of life; 22% had ICU treatment in the last 30 days.

For adults the percentages are 4%.

Adults and doctors choose not to have heroic measures performed on them when they know the end is near. 90% of doctors say they would forgo aggressive treatment if terminally ill.

Why do we force our kids to go through it, then? I’ve got to believe that it’s the parents calling the shots, and I believe they have to be driven by guilt and hope and fear of loss.

Guilty because if they refuse treatment they feel they’ll deny their children a chance at life. Hope because what parent WOULDN’T hope for her child’s recovery, even against staggering odds. And fear of loss because what parent couldn’t stare into the abyss of separation they know faces them if this bundle of love, to whom they’ve devoted their entire existence for the lifespan of the child, is taken away.

And yet … think about it. They force on this child, who is unknowing and unable to make his or her own decision, intolerable pain and suffering. The child would surely fare batter in hospice care at home. Hospice it to make the last days as comfortable as they possibly can be. Yet the parents, on whom this helpless child depends, take away the opportunity to have that last little bit of respite.

So sad for everyone involved. I’m really sorry I saw the article because it is truly depressing. Sorry to burden you with it.

Jim Edholm

Health Care Costs – Medicare Attempts to Reduce Health Costs

Medicare is embarking on a new program, and I think it’s a good one. I hope more insurers follow their lead.

Basically what’s happening is that Medicare is proposing a trial program in the hip and knee replacement surgeries in which they reward QUALITY of healthcare rather than VOLUME of healthcare.

While it’s generally true that hospitals and doctors who do MORE of a procedure usually do it better, there are hospitals where the quality is lacking and the readmission rate is dramatically higher than elsewhere.

Currently, that benefits the hospital because every procedure is billable. So if Harry has a knee replacement, the hospital gets to bill Medicare. Then when Harry goes home but later is readmitted because of an infection, great news for the hospital! They get another admission, another billing, another profit opportunity. Read more »

Eaten in a Waffle House Lately?

We don’t see a lot of Waffle Houses in our part of the country – thank Heaven.  But get south of Massachusetts, and they proliferate.

Driving down to Florida in early February, Kathy and I were looking for a breakfast place.  We had scooted out of our motel to beat the early Washington DC traffic and hadn’t take the time to look up a breakfast place on our computer before we left.  So we arbitrarily got off at a busy off-ramp and looked for a place to eat.

Nothing, nada … except for a Waffle House.

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In Which Jim Agrees with the Globe

It is indeed rare when I agree with the Boston Globe, but we aren’t always at odds.  On February 24 the Globe penned an editorial about the ACA and what Congress and the President should allow.

For a change, I think they got it right.

They offered four recommendations, summarized and commented on here:

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Across State Lines … the Chimera of Cheaper Health Insurance

An opinion column in the State Times, the newspaper for Arizona State University, declares that “it’s not fair” for people to be restricted to buying health insurance only issued by carrier in the state where they reside.

If, they postulate, we only had a system wherein people from all over the country could buy from whatever carriers they want, we could intelligently shop for the most affordable high-quality coverage.  They make the illogical comparison that, heck, you can buy Waylon Jennings CDs across state lines, why not health insurance?

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2015 Newsletter Back Issues

January 2015 – Volume 9 – Issue 1

February 2015 – Volume 9 – Issue 2

March 2015 – Volume 9 – Issue 3

May/June 2015 – Volume 9 – Issue 5

July 2015 – Volume 9 – Issue 6

One Reason for Medical Inflation?

I ran across a story by a reporter for the Milwaukee Journal-Sentinel [1] about drugs.  It’s very instructive.

Here’s the bottom line:  We all “know” that there’s a diabetes, particularly Type 2 diabetes, problem in the US, right?  At least, that’s what we’re told regularly.

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Be a Smarter Patient

Like with GEICO, “everybody knows that” it’s not entirely up to your doctor to cure your ills.  You’re a player, too.  So you have an obligation to participate in how your doctor treats you.

Unfortunately, that attitude (i.e., “we’re in this together, Doc.”) isn’t shared by nearly enough people.  There are two reasons for this:

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Non-Compete Agreements and Keeping Them Valid

You all know that we at BBI provide our clients with complimentary access to ThinkHR.  ThinkHR is a terrific resource that allows you to ask specific questions about YOUR firm, YOUR practices, and YOUR problems.  You ask a credentialed HR expert – there’s no limit on the number of questions or the topics they can cover (see this month’s ThinkHR Contest insert), and it’s a great way for you to dot your HR I’s and cross your HR t’s.

ThinkHR puts out various articles on a regular basis, too.  Plus CE-credit webinars.  It’s all part of the BBI client experience.

Read more »