President – History and tall orders

On January 20th history was made when our 44th President took office. He is very intelligent, charming, and one of the best communicators I’ve ever seen. He is a family man, loves technology, and thinks big. I am 10 years his senior and a partner in a small business with 50 employees. I have a conservative’s outlook, but I am an American first. Mr. Obama is my President and, thus, I am cheering for his success and for our nation’s continued prosperity.

I recently finished the President’s book, The Audacity of Hope, and would like to recommend it to you. Though I don’t agree with the President on many fronts, I now have a better understanding of where he stands on the issues. I believe he is pragmatic and smart enough to do the right things to keep the American dream alive.

Our business is employee benefits. Most of what we do involves helping employers with their health plans. We have problems to solve for our clients – small and mid-sized companies in Ohio. For our clients, the problem is cost of coverage, not access to coverage. Mr. Obama wants to provide access to coverage to Americans who do not have it today. Affordable healthcare for all Americans is a big and complex problem and requires something from everyone. The government already has cost issues with the plans they presently manage. An aggregation of the masses into one large bucket doesn’t necessarily solve the problem.

A large part of the problem is that people are using too many services from doctors and hospitals. Demand for service is greater than supply – employing “nip and tuck” or “replace and remove” as solutions rather than eating less and exercising more. Simple, but certainly not easy.

Today, our “system” rations coverage by asking people to pay for it personally, or elect it through their employers or various government programs for which they may qualify. Relatively few get turned down. People who can’t or won’t participate don’t have coverage. Thus, service is rationed away from these folks and provided to others who do participate.

Perhaps the solution lies in people behaving differently: Slowing the demand for service, everyone paying something, all taking personal responsibility for their health issues (lifestyle), providers charging less for care, fewer lawsuits, and greater efficiency on the part of insurance companies. In short, everyone pulling on the oars to solve our common problem.

America has big problems, with health insurance near the top of the list. The solutions will need to come without the politics.

This is our business and we are willing to help.


- Mark Alder, President, Herbruck Alder - malder@herbruckalder.com

Health-Related Provisions to the Economic Stimulus Package Proposed by House Democrats

As expected, House committees last week approved a number of health-related provisions to the economic stimulus package proposed by House Democrats, setting the stage for an expected House floor vote this week.*

The House provisions include a 65 percent subsidy for COBRA premiums for workers laid off between Sept. 1, 2008 and Dec. 31, 2009, the right for certain workers (55-year-olds employed for a decade or more) to keep COBRA (with no subsidy) for a full 10 years as a bridge to Medicare, aid to states for low-income health programs, a 4.9 percent increase in the matching rate for federal funds for Medicaid through 2010, and incentives for Medicare and Medicaid participating doctors to purchase and use new health information technology. Beginning in 2016, health care providers who don't use certified health technology would begin to see their Medicare payments decrease, by a growing percentage each year. The horse trading will continue until the final floor votes.

* The House passed it on January 28, 2009 and it now goes to the Senate.

Source: Health Reform Weekly, Aetna. January 29, 2009.