INTERVIEW: A Healthcare Financing Solution for Entrepreneurs?

Former: CEO and Founder
Superior Consultant Company, Inc.
[SUPC-NASD]

EDITOR’S NOTE: I first met Rich in B-school, when I was a student, back in the day. He was the Founder and CEO of Superior Consultant Holdings Corp. Rich graciously wrote the Foreword to one of my first textbooks on financial planning for physicians and healthcare professionals. Today, Rich is a successful entrepreneur in the technology, health and finance space.

-Dr. David E. Marcinko MBA CMP®

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Staff & Contributors - CHAMPIONS OF WAYNE

By Richard Helppie

Today for your consideration – How to fix the healthcare financing methods in the United States?

I use the term “methods” because calling what we do now a “system” is inaccurate. I also focus on healthcare financing, because in terms of healthcare delivery, there is no better place in the world than the USA in terms of supply and innovation for medical diagnosis and treatment. Similarly, I use the term healthcare financing to differentiate from healthcare insurance – because insurance without supply is an empty promise.

This is a straightforward, 4-part plan. It is uniquely American and will at last extend coverage to every US citizen while not hampering the innovation and robust supply that we have today. As this is about a Common Bridge and not about ideology or dogma, there will no doubt be aspects of this proposal that every individual will have difficulty with. However, on balance, I believe it is the most fair and equitable way to resolve the impasse on healthcare funding . . . .

CITE: https://www.r2library.com/Resource/Title/0826102549

Let me start in an area sure to raise the ire of a few. And that is, we have to start with eliminating the methods that are in place today. The first is the outdated notion that healthcare insurance is tied to one’s work, and the second is that there are overlapping and competing tax-supported bureaucracies to administer that area of healthcare finance.

Step 1 is to break the link between employment and health insurance. Fastest way to do that is simply tax the cost of benefits for the compensation that it is. This is how company cars, big life insurance policies and other fringe benefits were trimmed. Eliminating the tax-favored treatment of employer-provided healthcare is the single most important change that should be made.

Yes, you will hear arguments that this is an efficient market with satisfied customers. However, upon examination, it is highly risky, unfair, and frankly out of step with today’s job market.

Employer provided health insurance is an artifact from the 1940’s as an answer to wage freezes – an employer could not give a wage increase, but could offer benefits that weren’t taxed. It makes no sense today for a variety of reasons. Here are a few:

1. Its patently unfair. Two people living in the same apartment building, each making the same income and each have employer provided health insurance. Chris in unit 21 has a generous health plan that would be worth $25,000 each year. Pays zero tax on that compensation. Pat, in unit 42 has a skimpy plan with a narrow network, big deductibles and hefty co-pays. The play is worth $9,000 each year. Pat pays zero tax.

3. The insurance pools kick out the aged. Once one becomes too old to work, they are out of the employer plan and on to the retirement plan or over to the taxpayers (Medicare).

4. The structure is a bad fit. Health insurance and healthy living are longitudinal needs over a long period of time. In a time when people change careers and jobs frequently, or are in the gig economy, they are not any one place long enough for the insurance to work like insurance.

5. Creates perverse incentives. The incentives are weighted to have employers not have their work force meet the standards of employees so they don’t have to pay for the health insurance. Witness latest news in California with Uber and Lyft.

6. Incentives to deny claims abound. There is little incentive to serve the subscriber/patient since the likelihood the employer will shop the plan or the employee will change jobs means that stringing out a claim approval is a profitable exercise.

7. Employers have difficulty as purchasers. An employer large enough to supply health insurance has a diverse set of health insurance needs in their work force. They pay a lot of money and their work force is still not 100% happy.

Net of it, health insurance tied to work has outlived its usefulness. Time to end the tax-favored treatment of employer-based insurance. If an employer wants to provide health insurance, they can do it, but the value of that insurance is reflected in the taxable W-2 wages – now Pat and Chris will be treated equally.

Step 2 is to consolidate the multiple tax-supported bureaus that supply healthcare. Relieve the citizens from having to prove they are old enough, disabled enough, impoverished enough, young enough. Combine Medicare, Medicaid, CHIP, Tricare and even possibly the VA into a single bureaucracy. Every American Citizen gets this broad coverage at some level. Everyone pays something into the system – start at $20 a year, and then perhaps an income-adjusted escalator that would charge the most wealthy up to $75,000. Collect the money with a line on Form 1040.

I have not done the exact math. However, removing the process to prove eligibility and having one versus many bureaucracies has to generate savings. Are you a US Citizen? Yes, then here is your base insurance. Like every other nationalized system, one can expect longer waits, fewer referrals to a specialist, and less innovation. These centralized systems all squeeze supply of healthcare services to keep their spend down. The reports extolling their efficiencies come from the people whose livelihoods depend on the centralized system. However, at least everyone gets something. And, for life threatening health conditions, by and large the centralized systems do a decent job. With everyone covered, the fear of medical bankruptcy evaporates. The fear of being out of work and losing healthcare when one needs it most is gone.

So if you are a free market absolutist, then the reduction of vast bureaucracies should be attractive – no need for eligibility requirements (old enough, etc.) and a single administration which is both more efficient, more equitable (everyone gets the same thing). And there remains a private market (more on this in step 3) For those who detest private insurance companies a portion of that market just went away. There is less incentive to purchase a private plan. And for everyone’s sense of fairness, the national plan is funded on ability to pay. Bearing in mind that everyone has to pay something. Less bureaucracies. Everyone in it together. Funded on ability to pay.

Step 3 is to allow and even encourage a robust market for health insurance above and beyond the national plan – If people want to purchase more health insurance, then they have the ability to do so. Which increases supply, relieves burden on the tax-supported system, aligns the US with other countries, provides an alternative to medical tourism (and the associated health spend in our country) and offers a bit of competition to the otherwise monopolistic government plan.

Its not a new concept, in many respects it is like the widely popular Medigap plans that supplement what Medicare does not cover.

No one is forced to make that purchase. Other counties’ experience shows that those who choose to purchase private coverage over and above a national plan often cite faster access, more choice, innovation, or services outside the universal system, e.g., a woman who chooses to have mammography at an early age or with more frequency than the national plan might allow.  If the insurance provider can offer a good value to the price, then they will sell insurance. If they can deliver that value for more than their costs, then they create a profit. Owners of the company, who risk their capital in creating the business may earn a return.

For those of you who favor a free market, the choices are available. There will be necessary regulation to prevent discrimination on genetics, pre-existing conditions, and the like. Buy the type of plan that makes you feel secure – just as one purchases automobile and life insurance.For those who are supremely confident in the absolute performance of a centralized system to support 300+ million Americans in the way each would want, they should like this plan as well – because if the national plan is meeting all needs and no one wants perhaps faster services, then few will purchase the private insurance and the issuers will not have a business. Free choice. More health insurance for those who want it. Competition keeps both national and private plans seeking to better themselves.

Step 4 would be to Permit Access to Medicare Part D to every US Citizen, Immediately

One of the bright spots in the US Healthcare Financing Method is Medicare Part D, which provides prescription drug coverage to seniors. It is running at 95% subscriber satisfaction and about 40% below cost projections.

Subscribers choose from a wide variety of plans offered by private insurance companies. There are differences in formularies, co-pays, deductibles and premiums.

So there you have it, a four part plan that would maintain or increase the supply of healthcare services, universal insurance coverage, market competition, and lower costs. Its not perfect but I believe a vast improvement over what exists today. To recap:

1. Break the link between employment and healthcare insurance coverage, by taxing the benefits as the compensation they are.

2. Establish a single, universal plan that covers all US citizens paid for via personal income taxes on an ability-to-pay basis.  Eliminate all the other tax-funded plans in favor of this new one.

3. For those who want it, private, supplemental insurance to the national system, ala major industrialized nations.

4. Open Medicare Part D (prescription drugs) to every US citizen. Today.

YOUR THOUGHTS ARE APPRECIATED.

Thank You

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TODAY’S INVESTMENT WORLD STRATEGIES

RICH HELPPIE: The COMMON BRIDGE

Featuring Beata Kirr

This is the first of a two part series with Rich’s special guest, Beata Kirr, the co-head of investment strategies and national managing director in the Chicago office of Bernstein. We think you’ll find this conversation very fascinating.

Exploring Today’s Investment World

Editor’s Note: We hope you enjoy the video above. If you’d rather just listen to the podcast, click this link to Apple Podcasts: The Common Bridge.

COMMENTS APPRECIATED

Thank You

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INSIDER TRADING 4 ME: Stock Markets


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INSIDER TRADING FOR ME, BUT NOT FOR THEE
See the source image

By Richard Helppie

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Capital markets require confidence that all market participants have fair access to the same relevant information about a company and its prospects. Laws governing the trading of securities have been in existence since stocks were first traded. It seems as if each piece of legislation, from the Securities and Exchange Act of the 1930’s through to the 2002  Sarbanes-Oxley Law fought the prior corruption as successfully as preparing an army to fight the last war.

Curiously, the issue of insider trading by members of Congress is not a partisan issue. If behavior is any indication, certain Republicans and Democrats are fond of having the ability to profit from access to material, nonpublic information. Others of both parties are introducing legislation to block illegal insider trading.

Congress has passed laws that prohibit people with insider knowledge from trading on non-public information, and from sharing that non-public information with others who may trade stocks based on that information. The former is known as “illegal insider trading” and the latter as “tipping.” There exists legal insider trading, which is bound by rules of disclosure and third-party decision makers, but we will leave that for another day. Illegal insider trading is enforced through Federal Agencies including the Securities and Exchange Commission (SEC), Internal Revenue Service (IRS) and the Department of Justice (DOJ), as well as by regulations on major stock exchanges such as the New York Stock Exchange (NYSE) and National Association of Securities Dealers Automated Quotation Systems (NASDAQ).

While there is universal agreement that executives, board members, employees and others with access to non-public information may not use that information to trade stocks, members of Congress and their staffs face few practical barriers. And in more recent months, members of the Federal Reserve and their staffs have made questionable, if not downright suspicious trades of stocks.

History is littered with cases of both average citizens and celebrities like Martha Stewart being prosecuted for insider trading. Stewart was ultimately prosecuted and jailed for obstruction after denying insider knowledge.

There are members of both the US Senate and US House of Representatives who want to stop illegal insider trading by their peers. For example, in 2012, President Barack Obama signed the Stop Trading on Congressional Knowledge (STOCK) Act to prevent insider trading by members of Congress and Congressional Staff. However, there have been no prosecutions under this statute to date. The reason is that the “Speech and Debate” clause prohibits questioning an elected Senator or Congressional Representative.

Moreover, much of the disclosure of material, non-public information that would establish a foundation for illegal insider trading occurs outside the public eye. Members of Congress cannot act on information obtained from companies themselves. The difficulty arises in proving that a member of Congress or Congressional staff knew of material, non-public information acquired in a confidential congressional meeting. Let me rephrase that. There is no way of knowing what transpired in the confidential committee meeting so there is no provable path to a stock trade benefiting the member of Congress or their staff.

Suppose two publicly traded defense contractors were bidding on a new weapons system. In a confidential committee, a Department of Defense (DOD) recommendation to accept the bid of company A versus Company B was made and endorsed by the committee. At that point, everyone with access to the non-public information about the weapons system bid would know that it would be good for the stock of Company A and bad for the stock of Company B.

Take this a step further. Company A and Company B are notified about the confidential decision and advised to keep this material, non-public information protected. At this point, if any executive, board member or employee with that knowledge traded in the stock of Company A or Company B they would be subject to prosecution, including fines and imprisonment. Also, if any person at the company provided that material, non-public information to another person, including a member of Congress, that action would be subject to investigation and potential prosecution.

Now suppose a Senator, Congressional Representative or staff member, after receiving the news of the weapons system award went to their broker, computer or telephone and bought stock in Company A while selling (or shorting in another way) Company B. Or perhaps communicated to a friend or family member on a trade “suggestion.”  Relaying or exploiting information – material, non-public information —  behavior that would land any other person in an investigation and make them subject to prosecution, cannot be practically pursued because there is no way to use the committee deliberations as evidence.

When Senators Richard Burr (R-NC), Kelly Loeffler (R-GA) and Diane Feinstein (D-CA) were accused of insider trading, instead of being subjected to investigation and potential prosecution through the SEC, IRS, or DOJ, their actions instead were reviewed by the Senate Ethics Committee. The Senate Ethics Committee, made up of other US Senators, found no wrongdoing.  Let me rephrase that –  other US Senators, who might benefit themselves from insider trading – decided to give suspicious behavior a pass. Even if the conduct of the Senators was on the up-and-up, the optics do not inspire confidence.

The US Senate does not have a monopoly on suspicious trading. For example, Congresswoman Lois Frankel (D-FL), was accused of trading stocks of companies in the fossil fuel industry while a sitting on a Congressional subcommittee that oversees funding for the Department of Energy.

Legislation to Block Insider Trading by Congress and the Federal Reserve

US Senators and Congressional Representatives have made proposals to improve public perception of their ranks with more practical solutions and stiffer penalties. Pre-eminent among the reformers is Senator Elizabeth Warren (D-MA), a person with a strong background in financial matters. Senator Warren appears to be the leading voice in calling for members of the Federal Reserve and their staffs to also be subject to laws prohibiting illegal insider trading and tipping. These restrictions are long overdue, as statements by the Fed has caused wild gyrations in the prices of securities. Senator Warren’s ideas are recommended reading on her web site at

https://www.warren.senate.gov

. Enter “Insider Trading” on the search bar of the Senator’s web site for 61 references.

Senators Jeff Merkley (D-OR) and Sherrod Brown (D-OH) have offered the “Ban Conflicted Trading Act.”  Under the legislation, elected persons and their staffs would be required to either sell or freeze their stock holdings, or put them in a blind trust. Introduced in 2018, the legislation has stalled. Last winter, Representative Alexandria Ocasio-Cortez (D-NY) and others have indicated they would introduce the same legislation in the House.

Earlier this month, Senators Jon Ossoff (D-GA) and Mark Kelly (D-AZ) introduced the Ban Congressional Stock Trading Act. If it becomes law, every member of Congress—as well as their spouses and dependent children—would be required to place their stock portfolios into a blind trust. One benefit of an outright ban or blind trusts would mean that clerical matters would no longer be a concern of those elected. Kelly himself, according to news reports, did not make a timely disclosure about a stock option exercise.

Senator Josh Hawley (R-MO) announced he will introduce the Banning Insider Trading in Congress Act. Wryly pointing out that politicians manage to outperform the stock market year after year, Hawley’s bill would prohibit members of Congress and their spouses from buying and trading individual stocks. Those who violate it would have to disgorge their profits.

Congress: Keep it simple and fix this

The singular, clear way to avoid abuses of insider information is to ban the trade of individual stocks and industry-specific Exchange Traded Funds (ETF) by members of Congress, Congressional staffs, members of the Federal Reserve and their staffs. Double blind trusts (where neither the owner or trustee knows identity of the other) would be an acceptable form of investing. Finally, add stronger criminal penalties for tipping insider information.

This is one of the few things that seem to enjoy bipartisan support, and would seemingly be welcomed by nonpartisans and those on the political poles as well.

Of course, like everything political, proposals of these types do not enjoy absolute, clear-cut support. As House Speaker Nancy Pelosi (D-CA) said about her opposition to such restrictions “We are a free market economy,” Pelosi, purported to be one of the 25 wealthiest members of Congress, continued, “They (Congress) should be able to participate in that.” Pelosi’s recent financial disclosure is said to have 48 transactions made by her family valued at a total of some $50 million so she is sympathetic to serving in Congress and participating in trading.

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SEC REPORT: https://www.seclaw.com/insider-trading/

MADOFF: https://www.msn.com/en-us/news/world/convicted-fraudster-bernie-madoffs-sister-husband-found-dead/ar-AAU6px4?li=BBnbfcL

FRAUD: https://www.msn.com/en-us/money/companies/founder-of-collapsed-dollar17-billion-mutual-fund-charged-with-fraud/ar-AAU3PEF?li=BBnb7Kz

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Product Details

CITE: https://www.r2library.com/Resource/Title/082610254

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PODCAST: Healthcare Challenges Post Pandemic?

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By Richard Helppie

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We’re posting this episode of The Common Bridge, with Henry Ford Health System President and CEO, Wright Lassiter, III complete with written transcript, along with the podcast and video links because there were technical difficulties with Mr. Lassiter’s audio. This way, you can read along, or refer back to us.

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PODCAST: https://www.youtube.com/watch?v=bKC5k7qrfDk

COMMENTS APPRECIATED

Thank You

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