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TECH/POLICY: Things to think about in Katrina’s aftermath

Here’s my FierceHealthcare editorial today:

In Katrina’s wake the inquests are beginning after the tragic failure to get help to where it was needed, especially in New Orleans. For healthcare organizations there are some immediate lessons, wherever in the country (or world) you might be. What is your disaster plan, and is it good enough to sustain you for several days in a potentially lawless environment, with no outside power or supplies? And do you have an evacuation plan for patients and staff? Obviously this matters most for hospitals, but given that all paper records and many computer systems have been destroyed, all healthcare organizations — no matter what size — need to make sure that their data is electronically backed up, redundantly, somewhere far away from them. If your vital data isn’t electronic, now is the time to make it so. Finally as a nation, we need to find a way to guarantee health care insurance and access to everyone displaced, and the best way to do that would be to guarantee it to everyone in America. –

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  1. Matthew –
    Your final point is the most significant: Guarantee healthcare for all Americans. I was at the HIPAA Summit in DC last week, and a congressional aide pointed out that our health care costs 50% more as a percentage of GNP than the rest of the industrialized world — *AND* that we have 43 million uninsured.
    The dots somehow did not connect. I would turn around his quote and substitute the word *BECAUSE* for the word *AND*. Simple arithmetic: It takes more money to care for sick people than to care for well people. A national health system (and that’s what we have, whether public or private) that drives a large percentage of its population into sickness and keeps them there will also drive costs through the roof. Up to, say, 50% more than the countries we compete with on a global scale.
    We can’t “afford” universal healthcare? We can’t afford what we have now.

  2. You can read this site in less than 5 minutes per day.
    Which is 5 minutes more than I will give it after this week.

  3. “If you want to say more, set up your own blog.”
    Now there’s a great idea. Then the folks who come to read Matthew can make their own choice (Hey, Ron, it’s all about choice, right?) as to whether to click over to Ron’s blog.

  4. Ron, I’m at a loss as to what the hell you’re talking about….and I’m getting more and more complaints about your comments. Now can you PLEASE try to keep your comments to one or two paragraphs….
    If you want to say more, set up your own blog and feel free to link to it in your comments. You are making my comments unreadable. I dont want to pull an Ezra on you, but please try to excercise some restraint.

  5. You are right Dr. John.
    Matthew, look at the bigger picture for once in your life and try and get a leadership position in the “Ownership Society.” Knowledge is flowing in Pittsburgh. We advertised in Pittsburgh right up to the election last year trying to do our part. I knew Florida was in the bag so we went to PA which was sooo close. The editor at the Pittsburgh paper told me, “I know all about the tax-free HSA.” He is combining the tax free HSA with wellness. (This is the reporter that Hillary attacked)
    They report: //Costs vary depending on the sort of programs employers want to provide, which can range from simply encouraging people to take the stairs to creating an on-site gym. The richness of the incentives varies, too. But comprehensive programs can cost $100 to $150 per employee per year, said David Steurer, membership director at Wellness Councils of America, which provides educational materials to companies that run wellness programs.//
    Our friend Ben Cutler was in charge of the Wellness Councils of America. Currently, Ben is top dog at USHEALTH GROUP that is buying their shareholders’ stock back for only $0.31 per share because there is no future in online tax free HSA health insurance. Or at least that’s what they are saying. I think Ben will get 50,000,000 shares. I hope that stock doesn’t go to $50 a share and all us shareholders have to feel bad.
    Anyway the Pittsburgh paper spins HSAs in their story: //Wellness programs are part of a broader movement that is seen shifting more of the responsibility toward controlling health-care costs onto individuals, Culyba said. Another example would be the growing use of HSAs, which let individuals put pre-tax dollars into investment accounts. The funds are not taxed as long as the money is spent on qualifying medical expenses. The accounts typically are coupled with high-deductible insurance policies.//
    http://www.casperstartribune.net/articles/2005/09/12/news/business/a6d9a56c4828dd4487257078002102ff.txt
    I ran 6 Richard Simmons weightloss centers in Denver with 30,000 clients and 350 employees. I came from the sales department. Boy can I hoze fat women.
    I know you love MN health care Matthew. The Pittsburgh paper has been there too. They report on Target: “//The nation’s No. 2 retailer, Target Corp. is helping to turn health care delivery upside down, offering in-store medical treatment next to the medications, electronics and women’s clothes.//
    Power to the consumer. They should have said that medical treatment at Target could be paid electronically with clients’ tax free HSA VISA cards but they didn’t.
    Other MN News: Community banks embracing health savings account trend
    Nicole Garrison-Sprenger
    Staff Writer
    A number of community banks across the Twin Cities are jumping on the health savings account bandwagon.//
    I bet they are. Good luck to them with their monthly fees and low interest rates. I kind of feel sad for them, bunch of rookies. At least this article explains that financial institutions are using tax free HSAs to expand their client base. Grabbing the clients for cross marketing is the way these cororate types think.
    http://www.bizjournals.com/twincities/stories/2005/09/12/story7.html?from_rss=1
    In other MN News: Tampa Bay Bucs Spank Vickings in Metrodome.

  6. How are you going to guarantee healthcare insurance to everyone?
    It is somewhat meaningless when you can’t guarantee that those with insurance (particularly the Blues insurance) will get care with that insurance.
    So you want to give the Blues government funds?
    That is like giving their execs a payday. Won’t change a thing.

  7. gadfly, that’s why I love you.
    We already have computer people up the wazoo changing software so fast it’s hard to keep up with all the changes. The consumer should be in charge of their personal, and dependents’, medical records. This is pretty important. For SelectSolution HSA consumers they have “Identity Theft” protection to a maximum benefit of $2,500 for legal fees, expenses and related costs. Maybe we should consider including “Medical Records Theft” as a covered expense tooo. With a much higher “Lifetime” limit.
    Hospitals chains, insurance companies and others will do just fine in the “private sector” in the free and open markets. Giving untold billions from the tax payers to politically connected companies only props them up for a while longer so their marketing, advertising and company guests, the politicians, can fly away and play golf.
    Matthew, you wrote, //And your attack on the Blues is just another part of the same HSA note from your tuba.//
    Oh please Matthew, I have already told you that the tax free HSA is a bit magical. It’s the last thing you want to argue against, remember? No one anywhere is discussing the problem with Katrina and automatically terminating thousands of diagnosed employees’, and their dependent’s, health insurance. This has nothing to do with the HSA (except unemployed employees can use their HSA balances to pay the premiums of their health insurance, electronically I might add). But I never said anything about the HSA. The HSA and health insurance are two separate things. Usually self employed people, like you, pick this up quicker than W-2 employees. Talk about people who are uninformed about health insurance.
    That NPR podcast that I posted had an interesting arguement against tax free HSAs from that idiot PHD fruitcake from Prinston. What a hozer. He is too stupid. I bet Matthew knows him but probably won’t admit to it. It is like Karl Rove is feeding the Liberals with false arguements. I can just see an ’06 Governor Debate and the Democrat, the only ones against the HSA, use this logic:
    It will cost $300,000 for an individuals retirement health care costs. A married couple will require twice this amount, or $600,000. Even if people start saving young in life, they will not be able to amass that much in their tax free HSAs, so why even bother?
    Don’t even try to save because you will require so much!!!!! It’s not only what he said it was the tenor of his voice. He was so unsure of himself and stumblin’, he communicated to his listeners a total lack of credibility. Ironically, one of our new radio commercials, “f”, says exactly the same thing except my wife is the voice. Listen to both the Prinston Big Brainer PHD Bozo, then listen to our commercial “f”. Of course I wrote what she said. It’s the way she said it that communicated the truth:
    09/01/05 60 Sec. Radio Spot – “Quarter Million”
    Dave: A quarter million at 65 just for retirement healthcare.
    Pam: Will married people need two times that or $500,000!!
    Dave: It’s time to save, in the smartest way, with tax free deposits, growth and withdrawals.
    Pam: President Bush said, “Become empowered with an HSA.”
    Dave: Money that is NEVER taxed, will last longer in retirement.
    Pam: Federal and State taxes are saved with an HSA.
    Dave: Plus, HSAs make health insurance affordable again.
    Pam: Save premium, eliminate taxes, build wealth
    Pam: Many families have HSA health insurance for $200 a month, then they grow their savings in a tax free HSA.
    Dave: Get low cost HSA health insurance
    Pam: The HSA with class, no-fees, and 6% interest.
    Pam: Medical underwriting required and interest rates are subject to change.
    Got the Blues, paying too much for health insurance?
    Dave: Reform has begun, at Blah,Blah,Blah.com
    Pam: Blah,Blah,Blah.com
    XXXXXXXXXXXXXXXXXXXXXXXXXXXX
    I should put this up on our wesite in audio, that so-called Prinston HSA expert too, then I could just link the 2 audio soundbites here. If Pam was debating that Prinston “muffin man” she would eat him alive. We just hired a full time computer geek so when I come back in the future maybe I’ll have visual and audio linking powers.
    My wife did write commercial “A” Matthew. So that is exactly how she thinks. She didn’t say, “President Bush”, one time. That’s a big difference between her and me. Listen how she says, “Be part of the solution.”
    Also, the Priston propaganda is a lie. A 30 year old couple maximizin’ their tax free HSA, spending $1,300 a year for medical, vision and dental expenses, will have over $300,000 at 65 years of age, with just 4% interest (We are paying 6%). 65 years old is very young in a 21st Century life span. What will some future retired couple have at 75 years of age in their tax free HSA. Remember, large HSA balances that are dedicated to retirement health care expenses are never taxed. Of course, money that is never taxed will last longer in retirement.
    President Bush figured out the magic of the HSA and says them in every speech because no one will even argue with him. I wish a few Republicans, or at least one, running in ’06 for a state governor would support Republican health care reform and the HSA. That’s why I love Governor Jeb Bush because he has great HSA quotes like the President. Jeb cut Florida tax payers costs by $14 billion dollars and unemployment is down to 3.8%, but by state law, he can’t continue.
    Maybe Jeb will run for President in ’08. Lord knows he would be a much better hurricane President than W. He would be the best hurricane, Soonamee and HSA President, that’s for sure.
    I know, like they told Mozart, too many notes.
    But really, the HSA is the doorway to the 21st Century Financial Services Sector.

  8. //the elevtronic record bandwagon.//
    It sucks that this is a bandwagon. I’m not exactly a luddite about technology, but I think there has been some serious EMR agitprop and not enough investigation of the drawbacks. At the risk of agreeing with Ron, I think this is going to turn into corporate windfall/pork.

  9. I quoted liberally from this and included the link in an e-mail that I sent to my Senator, but he’s already on the elevtronic record bandwagon.

  10. //bulk of the lawyers in town may never recover//
    While I have every sympathy for loss of livelihood, the demolition of the paperwork is a rather interesting solution to the way the legal practice has made justice a matter of what you can pay for.

  11. Matthew,
    You are always unbiased even though the Blues are your clients. Me on the other hand am biased, you say, because I get income from my HSA involvement.
    Michigan has 4 million workers which about 900,000 are union employees. Michigan Blue Cross reports 4.7 million insured. What exactly is a monopoly Matthew?
    You forgot to explain exactly what my one note is. I know it’s just a propaganda thing of yours. That’s why I like you Matthew, your propaganda is pretty good. It would be better if you would stoop so low as to answer a question once in a while. You know, defend your position.
    I know the Blues get tons of tax payer money. Are you saying that the Federal money you want for EMR, no money will find it’s way into the Blue Cross bank accounts?

  12. “One of the legal blogs I read cites an NYT article and then worries that the bulk of the lawyers in town may never recover and may in fact quit the profession.”
    And this would be a bad thing? Just kidding.

  13. Ron. I havent worked for a Blues plan in more than 2 years…..and they don’t need much taxpayer help as they seem to be doing fine on their own.
    Nothing that I say on this blog is influenced by what my clients may or may not want or want to hear. And nothin I say to my clients is influenced that way either. They pay me for independent unbiased advice and research, and BTW thinks I do for them do not end up here, unless there’s a very good reason for it and all confidentiality is respected.
    And your attack on the Blues is just another part of the same HSA note from your tuba.

  14. Keep talking about electronic records like Hillary and Newt Matthew, who could argue about that? I just hope it’s not a way to funnel billions of tax payer dollars into Blue Cross, Matthew’s clients, to upgrade their computer systems. These guys are so tricky in grabbing tax payer funds.
    Talk about hospital records and when the law is written tons of tax payer money will flow to who it always does.

  15. It might help to hire leadership with expertise and experience in this area instead of making patronage appointments from the old boy network of physicians who will make “physician-oriented” business decisions.

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