In an effort to provide insurance for the uninsured, President Obama appears to favor a “Federal Option” aimed to compete with private carriers. Such a plan would spell the end to competition in healthcare as we know it. I am not suggesting employers and employees don’t want change. The change most want is for the prices to come down or at least flatten out. However, the cost will not come down without rationing -- either by reducing services (rationing of care), reducing payments to providers (rationing of dollars), reallocation of services (taking from the older with coverage and giving something to those without), or reducing demand (people behaving differently and needing less service).
Presently, there is a limit on resources. If the supply is fixed (limited number of hospitals and physicians) and the demand increases, costs tend to rise. If the supply of providers increases and the demand stays the same or reduces, costs will tend to fall. To have any chance of cost stabilization as a nation (no increase to the current % healthcare represents in the GDP), we need to use the same or less service in the aggregate.
New and improved technology may reduce administrative cost but offsetting that will be new technologies which cost more money. People tend seek out treatments which save, improve and offer convenience – even if they cost money.
I live to the east of Cleveland – just the other side of 271. I have noticed that both the Cleveland Clinic and University Hospitals are increasing the supply of their services to Cleveland residents who live east. With the increase of supply, will our costs go down? I don’t think so, but I do appreciate how convenient these services are for my wife and me. I am just hoping I don’t have to use them.
Remember, eat less and exercise more – and try to eat an apple a day.
- Mark Alder, President, Herbruck Alder - malder@herbruckalder.com
Tuesday, May 12, 2009
Wednesday, April 29, 2009
2009 Mid Market Employee Benefits Survey
2009 Mid Market Employee Benefits Survey
Have you asked yourself the following questions?
- How do my employee benefits compare to other companies in the area?
- Are my premiums on par with similar size companies relative to my plan designs?
- What is the prevalence of high-deductible health plans in my area?
- What kinds of cost control strategies have other employers been using?
At Herbruck Alder, we are continually hearing these types of questions from our employee benefits clients. Although some information is available from national sources, most of it is too general to answer an employer's most important questions.
Clearly, employers need customized benchmarking - a comparison of their unique plan(s) to others of similar geographic area, industry, and size. As a participant in the survey, a customized benchmarking report is provided to you at no cost.
The survey is being offered to companies in Northern Ohio and was designed with your needs in mind:
- Quick - it only takes an average of 30-60 minutes to complete.
- Easy - in a user-friendly, web-based format. You can complete it at any time and even save results for later completion or editing.
- Comprehensive - all of your benefit plans are covered.
- Thorough interpretation - your individual results will be provided in a clear, easy-to-understand format by a qualified and knowledgeable consultant.
Click here to complete the 2009 Mid Market Employee Benefits Survey.
Thursday, April 9, 2009
Author Lays Out Nutrition Tips for the CDC
Author Michael Pollan was recently invited to speak to the Centers for Disease Control and Prevention (CDC) regarding U.S. food policies and the Western Diet. Among his suggestions were his 7 Rules for Eating. Normally, I’m skeptical of anything that tries to simplify a person’s diet to such a degree; and I do have some issues with Pollan’s list, like accounting for those who require more protein. However, most of it makes sense.
Some of Pollan’s rules are funny and also point out what we should already know -- things like, “Don’t buy food where you buy your gasoline.” That one is pretty obvious, I would think, but worth remembering.
Other rules seem to throw down the gauntlet to those of us who don’t eat very well and likely know it. “Don’t eat anything with more than 5 ingredients.” Have you seen the ingredient lists on the stuff you buy at the supermarket? The ingredients in bread alone (even the “healthy” wheat bread!) is enough to make a normal person check out a chemistry book at the library. We don’t even know what’s in bread anymore!
That said, in today’s society it is very challenging to avoid consuming massive quantities of chemicals, preservatives, and other junk that’s shoved into seemingly innocuous food. Pollan is essentially advocating the “whole food” approach. It’s probably the gold standard for the American diet, but not easily obtained. I would suggest starting off on the path to a whole food diet by identifying the easiest changes you can make today.
Do you like coffee? Certainly avoid the big specialty coffees at Starbucks, strictly because they are calorie bombs. Go ahead and have a cup of joe at work, but watch what you put into it. There are at least 8 ingredients listed on the container of powdered creamer in my office. I don’t have a clue what the last 4 or 5 of them are, but they don’t sound good. So, drink it black or add actual milk to it.
Go through that sort of process for everything you eat in a given day and pick off the items that are easiest to change. Then, make it an ongoing process to push yourself towards healthier “whole food” choices and ditch the processed foods most of us grew up on.
Kevin Hignett, khignett@herbruckalder.com
Some of Pollan’s rules are funny and also point out what we should already know -- things like, “Don’t buy food where you buy your gasoline.” That one is pretty obvious, I would think, but worth remembering.
Other rules seem to throw down the gauntlet to those of us who don’t eat very well and likely know it. “Don’t eat anything with more than 5 ingredients.” Have you seen the ingredient lists on the stuff you buy at the supermarket? The ingredients in bread alone (even the “healthy” wheat bread!) is enough to make a normal person check out a chemistry book at the library. We don’t even know what’s in bread anymore!
That said, in today’s society it is very challenging to avoid consuming massive quantities of chemicals, preservatives, and other junk that’s shoved into seemingly innocuous food. Pollan is essentially advocating the “whole food” approach. It’s probably the gold standard for the American diet, but not easily obtained. I would suggest starting off on the path to a whole food diet by identifying the easiest changes you can make today.
Do you like coffee? Certainly avoid the big specialty coffees at Starbucks, strictly because they are calorie bombs. Go ahead and have a cup of joe at work, but watch what you put into it. There are at least 8 ingredients listed on the container of powdered creamer in my office. I don’t have a clue what the last 4 or 5 of them are, but they don’t sound good. So, drink it black or add actual milk to it.
Go through that sort of process for everything you eat in a given day and pick off the items that are easiest to change. Then, make it an ongoing process to push yourself towards healthier “whole food” choices and ditch the processed foods most of us grew up on.
Kevin Hignett, khignett@herbruckalder.com
Thursday, March 5, 2009
New Leadership
Our new leadership hopes to get our economy back on track by spending big on a wide spectrum of government initiatives from education to healthcare. The more than 800 pages of the new stimulus package describe close to $800 billion of spending – about $1 billion per page. Some experts say that spending is medicine our economy needs now.
Healthcare spending has been an ongoing stimulus package, and most employers have been at the tipping point for years. Employers and employees want to spend less, not more -- and that would be a good thing. When people pay an ever increasing amount for their healthcare (whether employer or employee – for insurance premiums, deductibles or co-pays) it robs money from other parts of budgets, thus reducing spending flow to other sectors of the economy.
No doubt coming up with a more effective way to extend healthcare or insurance to our non-covered population will be beneficial. However, simply moving dollars around is not the solution. Rationing care on the elderly has been discussed, but if the purpose of this is only to provide care to the previously underinsured, it’s more like a very dangerous game of musical chairs.
Using and needing less healthcare service will lead to lower costs. Does the stimulus package include spending on incentives to be healthy? Eating less and exercising more with better nutrition? I hope so.
- Mark Alder, President, Herbruck Alder - malder@herbruckalder.com
Healthcare spending has been an ongoing stimulus package, and most employers have been at the tipping point for years. Employers and employees want to spend less, not more -- and that would be a good thing. When people pay an ever increasing amount for their healthcare (whether employer or employee – for insurance premiums, deductibles or co-pays) it robs money from other parts of budgets, thus reducing spending flow to other sectors of the economy.
No doubt coming up with a more effective way to extend healthcare or insurance to our non-covered population will be beneficial. However, simply moving dollars around is not the solution. Rationing care on the elderly has been discussed, but if the purpose of this is only to provide care to the previously underinsured, it’s more like a very dangerous game of musical chairs.
Using and needing less healthcare service will lead to lower costs. Does the stimulus package include spending on incentives to be healthy? Eating less and exercising more with better nutrition? I hope so.
- Mark Alder, President, Herbruck Alder - malder@herbruckalder.com
Monday, March 2, 2009
Real World Example Shows Benefits of Getting More Sleep
A recent article on MSNBC chronicled an experiment done at the Glamour Magazine office. It involved a handful of women following the simplest of regimens for 10 weeks to see what the weight loss effects would be. All they had to do was get 7.5 hours of sleep per night.
The results were pretty amazing, especially when you consider the subjects really changed nothing else in their daily routine. The women lost between 6 and 15 pounds over those 10 weeks. Three of them lost a pound or more per week. The article goes on to explain that the extra sleep allows growth hormone to break down stored fat. So, we can be sure that the weight lost was fat, which of course is what we all want.
Sometimes scientific studies have a great message, but the average person loses the point in all the technical details. That’s what I like about this article. It’s not a controlled study at all, but it’s simple enough that anybody can try it. And really, what’s the harm in trying to get more sleep? We all know sleeping more is a good thing for our bodies. Now we have a real world example that shows just how good it could be.
- Kevin Hignett, khignett@herbruckalder.com
The results were pretty amazing, especially when you consider the subjects really changed nothing else in their daily routine. The women lost between 6 and 15 pounds over those 10 weeks. Three of them lost a pound or more per week. The article goes on to explain that the extra sleep allows growth hormone to break down stored fat. So, we can be sure that the weight lost was fat, which of course is what we all want.
Sometimes scientific studies have a great message, but the average person loses the point in all the technical details. That’s what I like about this article. It’s not a controlled study at all, but it’s simple enough that anybody can try it. And really, what’s the harm in trying to get more sleep? We all know sleeping more is a good thing for our bodies. Now we have a real world example that shows just how good it could be.
- Kevin Hignett, khignett@herbruckalder.com
Tuesday, February 17, 2009
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
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
Tuesday, February 3, 2009
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.
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.
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