Health Train Express was derailed by a ‘near miss’ and had an unscheduled trip to my “Center for Excellence” in Heart Affairs. I will report on that in my next blog post, but already have this one ready to go.
The Affordable Care Act is a rich target for almost everyone, employers, hospitals, physicians, patients. The only ones not opposed to it are the uninsured and disadvantaged, but they are suspicious as well.
If the Act itself is not sufficient there are annual budget proposals that will modify and tweak it further.
Let’s begins with
Military Tiering: Govt. wants retirees to pay for their health care according to retirement salary. These were earned benefits for all and shouldn’t be treated like a welfare program. It was a promise and part of the package for serving a minimum of 20 years.
The Presidents budget for FY 13 proposes “tiering” which is means testing based on retired pay. This testing is for the health care we have earned through a full career. These were promises made by the government. The health care and pay was earned through many years of service to protect our country. This certainly is discriminatory. Means testing health care fees is rare in the civilian community. The types of programs that are means tested for example are welfare programs. Military retirees have earned their health care for a full career in the military. Now, the government wants to break promises to all those who have served for 20 to 30 plus years. Their word means nothing. This is unfair to all those who have served and protected our country. I am sure many of you out there have friends and family members who have spent years their lives being career military. We need your help to tell congress and the president that this is unfair and discriminatory toward those who have served. Thank you. M. Moll USAF Retired.
Employers are faced with providing insurance to all employees or face penalties. Many may opt out and pay a penalty which will be less costly to them than purchasing insurance coverage.
Providers will be affected by meaningful use requirements, HIT directives, reorganization of payment models using accountable care organization and elimination of procedure driven billing codes. and the burden of installing electronic medical records or suffer penalties in payments. Providers will have to chose carefully regarding Health Insurance Benefit Exchange Offerings, and completely review state Medi-caid plans.
Hospitals are faced with the expensive challenge of forming accountable care organizations to monitor and control cost, and outcomes. Nice new income source for attorneys
Major changes in regulations regarding limits on profit, broad expansion of eligibles, changes to coding, payment models with formation of accountable care organizations.
Retired Means testing and tiering are also being proposed for social security benefits, as well as increasing eligibility age for benefits.
State Health Departments will have to reassess their eligibility standards for state sponsored plans using Medi-caid as an administrative plan. Current standards are highly restrictive and make no sense as they are not based on any type of meaningful coverage nor consistency and are based upon month to month eligibility. Medi-caid eligibility standards are retro based on poverty standards and meaningless maintenance requirements and size of household. Standards are set for disqualifications such as household size and other factors.
All of these complaints lead me to repost something I had posted in the past on Facebook.
“The Donkey in The Well”
One day a farmer's donkey fell down into a well. The animal cried piteously for hours as the farmer tried to figure out what to do. Finally, he decided the animal was old, and the well needed to be covered up anyway; it just wasn't worth it to retrieve the donkey.
He invited all his neighbors to come over and help him. They all grabbed a shovel and began to shovel dirt into the well. At first, the donkey realized what was happening and cried horribly. Then, to everyone's amazement he quieted down.
A few shovel loads later, the farmer finally looked down the well. He was astonished at what he saw. With each shovel of dirt that hit his back, the donkey was doing something amazing. He would shake it off and take a step up.
As the farmer's neighbors continued to shovel dirt on top of the animal, he would shake it off and take a step up. Pretty soon, everyone was amazed as the donkey stepped up over the edge of the well and happily trotted off!
Life is going to shovel dirt on you, all kinds of dirt. The trick to getting out of the well is to shake it off and take a step up. Each of our troubles is a steppingstone. We can get out of the deepest wells just by not stopping, never giving up! Shake it off and take a step up.