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Archive for the ‘Healthcare’ Category

pope2Pope Benedict XVI has just proven that he is not only mean but just plain crazy. During a visit to Africa last week, the pope said the use of condoms increased HIV infection rates. As someone who worked in U.S. AIDS services for ten years, we have known since the early 1980s that consistent and correct use of condoms saves lives. His remarks have been roundly condemned by aid agencies, the UN and the German, French and Belgian governments. The British publication, The Lancet, today has called for the pope to retract him comments.

But this is par for the course. When he was Prefect for the Congregation of the Doctrine of the Faith, then as Cardinal Joseph Ratzinger, he was affectionately known as “God’s Rotweiler.” Over 25 years, he orchestrated the silence of progressive theologians (e.g. Charles Curran), clamped down on liberal thought, and authored particularly homophobic pronouncements.

As Pope, he has blamed gays for the worldwide priest pedophilia scandal and sent emissaries to every catholic seminary in an attempt to rout out gays (good luck!). Just this year he lifted the excommunication of British Bishop Richard Williamson who has publicly denied the existence of the Holocaust (You Tube video of Williamson defending his position). For me, he is no different that Iran’s Ahmadinejad who has describes the Holocaust as “ambiguous and dubious.” A little known fact is that Benedict was a Hitler Youth.

This should put a final nail in the coffin of “apostolic succession” (i.e., God selecting Benedict to continue the papal line from St. Peter), and papal infallibility. The guy is a bigot — old, out-of-touch and unilaterally irreverent.

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healthinsurance_h3Department of Labor releases model notices on COBRA premium subsidies

As part of the stimulus package recently passed by Congress and signed into law by President Obama, you may be eligible for tremendous assistance in paying for your COBRA benefits if you are out of work (here is an explanation of COBRA benefits). Losing a job in this economy is horrible, but with this help, you don’t have to loose your past employer healthcare.

Due to changes in the stimulus package, the federal government will subsidize up to 65 percent of the cost of the COBRA premium for up to nine months after you lose your job.

It’s important to note that while COBRA healthcare benefits last for 18 months, the 65 percent federal subsidy only lasts for the first nine months.

The Department of Labor (DOL) recently published model notices for employers and group health plans to send to former employees who are eligible for Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidies. Employers and group health plans are required to notify terminated employees of their eligibility. Access the notices.

There are four different model notices:

  • General Notice (full version): The full version of the General Notice must be sent to all qualified beneficiaries — not just covered employees — who experienced a qualifying event at any time from Sept. 1, 2008 through Dec. 31, 2009, AND who either have not yet been provided an election notice or who were provided an election notice on or after Feb. 17, 2009, that did not include the additional information required by the American Recovery and Reinvestment Act of 2009 (ARRA),. This full version includes information on the premium reduction and information required in a COBRA election notice.
  • General Notice (abbreviated version): This version includes the same information as the full version regarding the availability of the premium reduction and other rights under ARRA, but does not include COBRA coverage election information. It may be sent in lieu of the full version to individuals with COBRA coverage who experienced a qualifying event on or after Sept. 1, 2008 and still have COBRA coverage.
  • Alternative Notice: This notice must be sent to those who became eligible for continuation coverage under a state law. Continuation coverage requirements vary among states, and this model notice should be modified as necessary to conform it to applicable state law. Depending on the situation, the model Alternative Notice or the abbreviated model General Notice may be appropriate.
  • Notice in Connection with Extended Election Periods: This notice must be sent to any assistance eligible individual (or anyone who would be an assistance eligible individual if a COBRA continuation election were in effect) who meets the qualifications listed below. It includes information on ARRA’s additional election opportunity, as well as premium reduction information, and must be provided by April 18, 2009. Assistance eligible individuals who must be sent this notice:
    • Have had a qualifying event at any time from Sept. 1, 2008 through Feb. 16, 2009; and
    • Did not elect COBRA continuation coverage OR elected but subsequently discontinued COBRA
    • .mushroomhead, Sanchez (or whatever you call yourself these days), are you going to take me up on my offer for free one-way, first-class airline tickets for you and your partner to Jamaica? And if there is no partner and you live — as I suspect — with your mother, I’d be glad to send her with you. Just think, Liberace-like early bird dinner specials with mom and then retiring for the night to watch Wheel of Fortune reruns. How delightful.

Under the ARRA, employees or members of their family are considered “assistance eligible individuals” qualified for COBRA premium subsidies of up to 35 percent if they:

  • Were eligible for COBRA continuation coverage at any time between Sept. 1 and Dec. 31, 2009;
  • Elected COBRA; and
  • Were eligible for COBRA as a result of the employee’s involuntary termination between Sept. 1 and Dec. 31, 2008.

If the employee or family member has other group health coverage available, such as through a spouse or Medicare, the individual is not eligible for the subsidy. Additionally, If the employee’s termination of employment was for gross misconduct, he/she and any dependents generally would not qualify for COBRA or the premium reduction. Eligible employees or their family members who did not elect COBRA when it was first offered to them may have another opportunity to do so. In certain instances, ARRA provides for a new election period beginning on Feb. 17 and lasting 60 days.

Individuals who elect to accept the premium reduction subsidy should be aware that they will be disqualified from the Health Coverage Tax Credit Program. Additionally, Congress imposed income limits on the premium reduction subsidy. If the amount the employee earned for the year exceeds $125,000 (or $250,000 for married couples filing a joint federal income tax return), the individual may have to repay all or part of the premium reduction through an increase in income tax liability for the year.

Employers will receive a tax credit to cover the remaining 65 percent of COBRA’s cost. For more information on the tax implications of the COBRA subsidy, view the statement released by the Internal Revenue Service (IRS), as well as the IRS’ questions and answers for employers.

The DOL is holding a COBRA ARRA compliance webcast on March 26; however, registration has closed. The DOL will post an archived version of the webcast online and has said that it will schedule another webcast. For more information on COBRA generally, as well as the ARRA provisions relating to COBRA, visit the DOL Web site.
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editorial2Today is an important day. Today, the White House convened its first meeting on healthcare reform. I spent most of the day listening to the meeting on C-SPAN. Sixteen years ago, when I was executive director of the National Association of People of AIDS, I was involved in the Clinton healthcare reform efforts. I saw special interests spend $150 million using fear and misinformation to scare the American public in order to defeat the Clinton plan. And it worked.

Maybe you recall the “Harry and Louise” (You Tube video) TV advertisement of a fifty-something couple sharing their fears of a “government run” program that would “take away” their choice of doctors. The advertisement pressed the fear button of care rationing and denials. None of this was true, but the truth was not very important. As we all know, the program died a quiet death.

The time for healthcare reform has long come and gone. Today, 48-million Americans are without healthcare; 20% of which are children. But that’s just part of the story, there are another 48 million who are without healthcare during any two-year period. And then, there are those whose annual deductibles and copays are so high that they can’t go to a doctor. Fifty percent of the personal bankruptcies in their U.S. are because people can’t pay the medical bills!

My brother-in-law in Florida is out of work. He has been bleeding from his rectum for the past two weeks. His feet are swollen. He has no healthcare and doesn’t know what to do. If you think he is an exception, I challenge you to go rent Michael Moore’s movie Sicko.

This very day, the White House is holding its first daylong meeting on reform. This is the link to the White House site on healthcare: here. The site provides useful information regarding the healthcare challenge and the evolving plan to address the challenge. I recommend that you follow these reform efforts.

Now become an advocate for reform! Contact your congressional representatives, let them know that you support meaningful reform — that you demand that every American have access to great healthcare. Anything less is just beneath us.

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editorialA March 11, 2008 article in The Chronicle of Higher Education notes that the American Association of Medical Colleges and the American Medical Association have written a joint letter asking Congress to reverse the Department of Education’s decision to end a program that has allowed new physician graduates to lower student loans and defer interest on their student-loan payments.

The article states that “in 2007 the average medical student graduated with $140,000 in debt, and the average first-year resident earned less than $45,000, according to the letter. Eliminating the provision, the letter warns, could discourage students from pursuing less-lucrative careers in medical education, research, public health, or primary medicine.”

Give me a break. I borrowed $100,000 to earn a doctorate in healthcare administration (DBA-Healthcare) last September at the age of 57. I teach at a small college in Northern Virginia, with four international campuses, where I earn $50,000 in base salary. I’d like to believe that what I am doing is working with the future healthcare leaders in the U.S. and around the world.

And I am not alone. There are many occupations where students have assumed substantial debt to earn terminal degrees. I personally cannot support carte blanche treatment of physicians who have been and continue to be bulwarks against universal healthcare in the U.S. What an initiative like this does is continue the stereotype that physicians are somehow medieval lords deserving of subservience and special treatment.

Let’s get behind a federal student loan repayment initiative where payment extensions or loan forgiveness would be indexed to a service contract with America. Make loan repayment a function of the degree to which the student debtor is making a social contribution. For doctors, require free clinic work and uncompensated care, for teachers incentivize teaching in low to moderate-income communities, and for graduate MBAs link repayment to helping community-based nonprofits succeed.

Let’s replace the Neanderthal notion that physicians are “entitled” with one where physicians join equally skilled and indebted graduates who direct their time and talent to service to America.

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. . . and healthcare reform.  Ramesh Ponnuro of Time magazine has written an easy-to-understand summary of where we are on healthcare and some potential options to cover more of the uninsured.  You can read the article here

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