The Effect of the ACA on Self-Funded Plans & Free Market Medical Providers

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By Maria Robles Meyers, Esq.

[Free Market Medical Association]

Obama Care
Download the presentation Here

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Health Insurance Costs [circa 2016]

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The most devious tax increases in modern history? 

Rick Kahler MS CFP

By Rick Kahler MS CFP®

http://www.KahlerFinancuial.com  

A few months ago I scoffed when my wife told me about a report from CNN that the average individual, unsubsidized health insurance premium was going up over 60%.

After receiving my 2016 premium notice from Wellmark Blue Cross and Blue Shield, I’m no longer scoffing. My monthly premium for family coverage went from $1,400 to $2,140, an increase of $740, or 53%. According to healthcare.gov, the average Wellmark increase in South Dakota is 43%.

I immediately started looking for ways to decrease my premiums. This has become an annual ritual ever since Obamacare was pushed through Congress in 2010. Back then, my family health insurance policy (now considered a Platinum plan) had a low deductible with a maximum out-of-pocket of $3,500 and cost $660 a month.

Despite the President’s promise that “If you like your plan you can keep your plan,” I can’t even purchase that same plan today. If I could, I estimate it would cost over $3,500 a month. In order to keep health insurance affordable, each year I’ve reduced my coverage, increased my deductibles, and paid a higher premium than the year before.

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kidney

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I set out to analyze my options for 2016. After spending six hours crunching numbers and pouring over online calculators, I admitted defeat. There is no simple way to analyze plans to determine whether, based on your personal health care expenditures, you are better served to go with a copay or a deductible plan, a Bronze or a Silver plan, or if a Health Savings Account is preferable to a plan with coinsurance. All the online calculators I found were limited in scope and woefully generic. My health insurance agent didn’t know of any better ones, either.

Adding to my angst, while Wellmark makes policyholders’ year-to-date healthcare expenses available on its website, it doesn’t provide any breakdown of costs. You must figure out for yourself how many drug or doctor co-pays you had, the average cost of a copay visit, the average total costs of those visits, and any other information you need for any type of analysis.

This task was daunting for me, a financial planner and numbers guy. How are average consumers supposed to navigate it? The need for this information is so obvious, one wonders what the insurance companies are hiding by not providing it.

Ultimately, I selected a Bronze plan with no copays and an out-of-pocket cap of $11,900 on in-network providers and $18,500 on out-of-network providers. Based on my family’s average health care costs for the last three years, my out-of-pocket spending for premiums, covered drugs, and approved in-network medical providers will be $2,612 per month, or $31,344, in 2016. It was $11,420 in 2010. That’s an increase of 273%, or 18.3% a year.

By comparison, during the same time period medical costs only increased 16.0%, or 2.7% a year. The increase in premiums is clearly not about increasing health costs.

The $1,660 extra per month I had available to spend on consumer goods and services in 2010 is now going to insurance companies to subsidize the health care of others. This is a clear-cut example of a massive transfer of wealth.

Based on my family’s needs, if I earned $97,000 a year I would qualify for a subsidy of $912 a month. But since I earn over $98,000, I pay the full premium.

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incontinence

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Assessment

Clearly, the only people who find the Affordable Care Act affordable are those who receive a subsidy or who have preexisting conditions. For them, Obamacare was a godsend. For the rest of us, it turned out to be one of the most devious tax increases in modern history. 

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A primer to tonight’s GOP debate

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Health Entitlements & the Deficit

By Nancy Chockley PhD

NIHCM.org

Congress is poised to pass a budget plan that will raise funding levels for the next two years. While these changes are paid for, the plan does not include structural changes to the health entitlement programs that are a leading driver of our budget deficits and mounting debt.

The GOP presidential candidates are likely to discuss a variety of proposals for structural reforms to these programs during tonight’s debate.

As a primer to this important conversation, this chart story presents essential facts about spending for Medicare, Medicaid and the Affordable Care Act and the impact of these programs on the deficit.

http://www.nihcm.org/health-entitlement-spending-a-growing-threat#one

business-valuation1

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[HEALTH INSURANCE, MANAGED CARE, ECONOMICS, FINANCE AND HEALTH INFORMATION TECHNOLOGY COMPANION DICTIONARY SET]

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[Mike Stahl PhD MBA] *** [Foreword Dr.Mata MD CIS] *** [Dr. Getzen PhD]

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Average Advance Payment of HIE Tax Credit Amounts

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By Individual State [June 30, 2015]

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[HOSPITAL OPERATIONS, ORGANIZATIONAL BEHAVIOR AND FINANCIAL MANAGEMENT COMPANION TEXTBOOK SET]

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The “ObamaCare Opportunity” for Financial Advisors

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Why Physicians Need Financial Advisors Now!

[By Vicki Rackner MD]

http://www.CertifiedMedicalPlanner.org

VR MDI recently attended a surgical meeting. Most conversations with my physician colleagues turned to the same singular topic: physicians’ new financial reality.

And the message is, “It hurts!”

Physicians’ Financial Plans

Financially savvy physicians execute thoughtful retirement plans. Yet, today about half of surveyed physicians are behind where they would like to be in retirement preparedness. Further, today only about half of physicians work with professional financial planners.

As a physician myself, I understand why smart physicians fail to take smart financial action. We physicians dedicate ourselves to the alleviation of pain and suffering of others. Retirement is a distant personal concern that does not cause immediate financial pain today. We put it off.

Lesson from My Dentist

Years ago my dentist recommended that I undergo a procedure to replace a filling. He explained that the filling material put in my mouth about 40 years ago tends to pull from the tooth over time and allow new cavities to form.

As much as I like my dentist, I actively avoid spending time in his dental chair. I put off the recommended filling replacement year after year. That is, of course, until I experienced vague throbbing from that tooth. I rearranged my schedule so I could tend to this small problem before it became a much bigger problem. Who wants a root canal!

For physicians retirement planning is like that proactive filling replacement. We understand that without action there will be problems down the road. However, the threat of a problem in the distant future does not propel many like myself to action today.

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Product Details  Product Details

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The ObamaCare [PP-ACA] Opportunity for Financial Advisors

ObamaCare is the source of acute financial pain for physicians. It’s the financial toothache. Practicing physicians are looking at:

  • Higher taxes. Doctors represent 9 of the 10 highest earners in the US.
  • Rising costs of goods and services as businesses address their own higher tax bills.
  • The costs of building the infrastructure that will lead to greater healthcare efficiencies, like converting to electronic medical records, hiring new staff to address new administrative demands and aligning with new compliance requirements.
  • Lower professional fees. The 24% Medicare fee reduction that was averted this year will become reality soon. As Medicare goes, so, too, go the rest of the insurance fee schedules.
  • Decreasing patient referrals as primary care doctors sell their practices.
  • Physicians know they need to act now to avoid the financial root canal. Each physician is in the process of creating a personal ObamaCare plan.

Physicians’ Wants and Needs

As a financial advisor, you know that physicians NEED a retirement plan. Kids need to eat their broccoli, too. It’s good for them.

Physicians WANT a plan to help them achieve the personal, professional and financial goals that drew them to a career in medicine. Engaging physicians by address their ObamaCare plan is about as hard as getting kids to eat ice cream.

What This Means for You

Today physicians actively seek experts to help them create their ObamaCare plans.

Financial advisor are winning new physician clients. As Seattle Seahawks quarterback Russell Wilson asks, “Why not you?”

If you want to work with more physician clients, this is your moment! Seize it. You have a chance to join the high-performing financial advisors mining the treasures in the medical market.

Assessment

Should wish to learn more here’s a video that addresses 4 questions:

  • Why do physicians need you now?
  • What do you need to know about physicians now?
  • How do you engage physicians now?
  • How do you conduct yourself so physicians want to conduct business with you now?

About the Author

Vicki Rackner MD is an author, speaker and consultant who offers a bridge between the world of medicine and the world of business. She helps businesses acquire physician clients.

VIDEO: https://www.youtube.com/watch?v=CeCyidc4JP8&feature=player_embedded

Enter the Certified Medical Planners

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State Uninsured Patient Rate Reductions

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Five State with Highest Percentage Change for 2013-14

By http://www.MCOL.com

uninsured

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The New “Patient Centered Health Plan” Video

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An Alternative to Obamacare?

[By Staff Reporters]

Did you know that Tennessee’s US senatorial candidate, Dr. George Flinn, just announced his Patient Centered Health Plan as a sustainable alternative to Obamacare?

“This country needs a strong, positive alternative,” said Flinn. “We need to unite behind a solid proposal now because the longer Obamacare is in place, the harder it will be to repeal.”

The PCHP [Patient Centered Health Plan]

The Patient Centered Health Plan advocates a quality, affordable system promoting principles such as portability, competition across state lines, and the expansion of health savings accounts (HSA).

Flinn stated that his plan aims to end the assault Obamacare has created on our liberty and free enterprise in this country.

From massive job loss, decreased quality of care, doctor shortages, layoffs in health services, and millions still uninsured, Obamacare is doing the opposite of what it was made to do.

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GF

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The Plan Link

The plan is available in detail at www.patientcenteredhealthplan.com

Selected Lists On Health Savings Accounts:

Assessment

Both parties criticize one another for different aspects of Obamacare. The only consensus is its inability to effectively function. For the betterment of the United States, party lines need to be overlooked in order to find a solution.

Patient Centered Health may be the answer.

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Appreciating the Highest Rates of Uninsured or Underinsured‏ Americans

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For the Five States with the Highest Percent of People Under Age 65

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Uninsured

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Can Politically-Correct Names Save Obamacare?

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Saving Electronic Health Record Interoperability?

1-darrellpruittBy D. Kellus Pruitt DDS

If HHS successfully persuades Americans to use happy names for its bad ideas, will the cheap trick save electronic health record interoperability which is critical to the success of Obamacare?

Healthcare Lexicon 

According to the government’s modernized healthcare lexicon, doctors have been demoted to “providers,” insurance companies, including Medicare/Medicaid, have been promoted to “payers,” and patients’ position in the hierarchy has diminished from “principals” to “stakeholders” – a rank on par with 3rd parties such as insurers, HHS and other unaccountable parasites.

Wall of Shame

Ominously, HHS recently changed the contentious name “Wall of Shame” to a more innocuous“ breach reporting tool,” to describe the public list of data breaches involving the medical records of more than 500 patients. It turns out that the growing list of major data breaches is unexpectedly shaming  far too many providers and payers – including Medicare/Medicaid. Imagine that!

In fact, since Americans’ growing disgust with privacy breaches threatens the very success of Obamacare, there is evidence that HHS has turned to betraying its lawful obligation to the nation by hiding breaches from those who are most vulnerable – Americans.

HIPAA Failure

The half-baked plan to shame providers who experience data breaches – perhaps through no fault of their own – is not working out like HHS had hoped. Due to HIPAA’s abysmal failure to halt data breaches, the Wall of Shame has become a national embarrassment and an obstacle to EHR adoption. I expect the public listing of major breaches to be quietly scrapped soon in favor of keeping patients in the dark concerning their risks of identity theft.

Dentistry 

In dentistry, on the other hand, common sense as well as market resistance evidently caused HHS and other stakeholders to give up trying to prohibit use of the 8 syllable “electronic dental records” in favor of the 14 syllable “electronic health records for dental practices.”

Nevertheless, holdouts (including Dissent Doe) still occasionally feel it is important to correct this dentists when I use “EDR” instead of “EHR.” You got to love ‘em.

Obama Care 

Assessment 

Transparent silliness suggests that HHS is failing in its duties. Due to lack of accountability, we can expect EHRs and EDRs to become even more expensive and more dangerous, possibly bringing an end to Obamacare.

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Eligibility for Health Insurance Coverage as of 2014

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Among the Currently Un-insured for Selected United States

By www.MCOL.com

Eligibility

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American’s Personal Experience with the PP-ACA

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The Law of the Land

By www.MCOL.com

ACA

More:

Assessment

So, tell us your personal experi9ence with the ACA

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Enrollment, Coverage and the PP-ACA

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For Medicaid

By www.MCOL.com

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Assessment

1. Aetna CEO: Only 11% Of ObamaCare Signups Have Been Uninsured 
2. The Individual Mandate for Health Insurance in the U.S.
3. Survey of Americans’ Preparations for Health Care in Retirement
4. Medi-Cal at a Crossroads: What Enrollees Say About the Program 
5. The Affordable Care Act: The Exchanges Go Live

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My Experience with ObamaCare

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Not a Unique Story – to Date

Rick Kahler CFPBy Rick Kahler CFP® http://www.KahlerFinancial.com

Like millions of Americans, I jumped on Healthcare.gov on October 1 to view the long-anticipated plans on the insurance exchanges mandated by the Affordable Healthcare Act, known as Obamacare. I needed a new healthcare plan and purposely held off buying one in September to compare the coverage and prices of an Exchange plan.

My disappointment paralleled that of thousands of other Americans wanting to do the same. After six tries that day, I gave up. I tried the site multiple times for each of the next six days. No luck.

The Short Form

Finally, on the seventh day, the site actually let me start an application. I chose to go with the “short” form since I was certain I would not qualify for a subsidy.

The short form application took 30 minutes to fill out. There were very few questions about health, just whether anyone in the household smoked. A number of questions had me wondering if I was applying for a passport. These included my Social Security number, race, citizenship, relationships to everyone in the family, and whether I was ever incarcerated.

When I reached the end of the form, I hit “submit,” anticipating that plan options and costs would appear. Instead, I was sent back to the starting page of the form. After 60 minutes of trying to get out of this endless loop, I gave up.

Three More Weeks of Trying

For the next three weeks, I went to the site at least once a day. I was never able to get past the endless loop to view plans or prices. I took a two-week break.

On November 14, I tried again. Success! Well, sort of. No endless loop. Instead, the site said it lost my original application and I needed to complete a new one. After another 60 minutes filling out the application, I ended up stuck in a loop again, unable to view plans or prices, much less choose one.

Giving Up

Frustrated, I decided to give it a rest until the site re-launched on December 1. I figured I would still have plenty of time to meet the December 15 deadline for enrollment.

On December 1, I eagerly popped onto the site. Not only was the site not functional, it had lost my application for the third time.

I gave up.

Enter the Insurance Broker

I phoned my insurance broker. She was able to give me all the information I had tried to get out of healthcare.gov for the past 60 days. She also said my insurance company was canceling my current plan. Obamacare deemed the coverage substandard because it did not cover pregnancy, mental health costs, and pediatric dental and vision costs. Although I don’t want or need any of that coverage, Obamacare gives me no choice.

Prices

My old policy cost $1,192 a month. The new one costs $1,506, which includes $59 a month in mandated surcharges on non-exchange policies to help fund Obamacare. My maximum family out-of-pocket expenses must also increase $208 a month. The total potential increase is a staggering $524 a month.

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Obama Care

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A Skeptic

As someone who listened with great skepticism as politician after politician promised that Obamacare would lower health care costs, lower our deficit, and guarantee we could keep any existing plan, I feel sadly vindicated. In March 2010, when Congress passed Obamacare, I paid $660 a month for health care that had better coverage than I have now. For that same coverage today, my premium would be $2,450 a month.

Assessment

Unfortunately, my story is not unique. It is ubiquitous to the average American who has health insurance. Our elected officials and government agencies failed us miserably. So far, there appears to be no relief in sight.

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Doctors, Sole Proprietors and ObamaCare Taxes

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On the Self-Employment Tax

By Perry D’Alessio CPA

perry-dalessio-cpaA sole proprietor is an individual business owner [medical practice] physician-executive whose business [practice] is accounted for on a separate schedule of the owner’s individual income tax return.

Typically, owners filing their business returns via the use of Schedule C of Form 1040 have the lowest level of reporting requirements and also (in general) do the poorest job of keeping good records of business activity.

There is only one level of tax for the sole proprietor. The net profit (or loss) from the Schedule C business is reported on page one of Form 1040 and is combined with all of the other income items reported to arrive at gross income.

Different from interest and dividend income, or investment income that is typically considered passive in nature, self-employment income is income considered to be generated by ones’ own actions.

Self Employment Tax

There is “Self Employment” tax to be paid on virtually all self-employment income reported in the tax return.  Many sole proprietors get into trouble because they neglect to take this tax into account when estimating their tax liability for the year and this tax is significant as noted below.

How SET Works

Self-employment tax is paid on 92.35 percent of all self-employment net profits.  This tax is the equivalent of the combination of the employer’s and employee’s Social Security tax and Medicare tax.  Social Security tax is 12.4 percent of the first $117,000 (in 2014) in net income and Medicare tax is paid 2.90 percent of net income without any upper income limit. There is also no maximum for the .9% additional Medicare tax under the PP-ACA [Obamacare] that applies when adjusted gross income exceeds $250,000 for joint filers, $200,000 for single filers, or $125,000 on married-filing-separate returns.

solo

Social Security Limit

The Social Security income limit is indexed and adjusted (upward) annually.  The sole proprietor is allowed to deduct one half of the self-employment tax against income; however, this deduction is worth far less than the actual tax.

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How You Can Financially Profit from the PP-ACA?

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An Obamacare Sales Opportunity

By Dr. David Edward Marcinko MBA CMP™

[Editor-in-Chief] www.CertifiedMedicalPlanner.org

Dr. MarcinkoPresumably, as a result of my financial advisory activities, I received this email solicitation the other day,

So, I thought I’d pass it along [unchanged] to our ME-P readers, FAs, insurance agents and subscribers for comment.

USA BENEFITS GROUP EAGLE DIVISION  ………. PROVIDING CAREER SOLUTIONS FOR 36 YEARS 

[Better Contracts + Better Schedule + Better Career Opportunities] 

Dear Prospect [that would be ME],

I received your resume on Monster.  You already know that the real money in any organization is in sales. The salespeople of the world make things happen and are highly rewarded for that work.  But it’s hard work.

The Product

What if you could find a product that everybody needs, that they have money budgeted to purchase, and are looking for someone to help them buy it?  Do you think you could help that person? That’s exactly  the situation in the health insurance industry today!

Our government is telling people they HAVE to have it.  Folks are either buying it now from somewhere or will soon be eligible for subsidies so they CAN buy it.  And EVERYONE is confused and looking for someone with answers on how to get this product!

You can be that Person

Over the next sixty months, billions of dollars are going to change hands as people readjust to a dynamic health care environment.  How can you get into the river and get your hands on some of that money?  By preparing to serve people!

USA Benefits Group 

The USA Benefits Group is a highly successful team of insurance brokers who are “reform ready” – staying up to date on this perhaps once-in-a-lifetime shift in this industry.  We are independent, non-captive agents who are setting up qualified, turn-key “private exchanges” to help people obtain health insurance in a webinar-based setting from our home offices.

I’m encouraging you to click here: www.usabg.net/dcollins to learn more. If you’re serious and ready to make a move, you can call me toll-free now at 866-328-6182. If you’re qualified, I also have Regional Management positions available.

Advantages of working with my Eagle Division 

  1. 1. 36 year old system for success
  2. 2. 100% control of your future
  3. 3. Equal opportunity
  4. 4. Recession proof
  5. 5. Top Companies to represent
  6. 6. Excellent co-op lead program
  7. 7. Weekly advance commissions ($2,000 To $4,000 Net Weekly)
  8. 8. Vested Lifetime Renewals ($10,000 To $20,000 Monthly In Under 3 Years)
  9. 9. Annual Incentive Trips
  10. 10. Annual Production Bonuses to $50,000+

I’m looking forward to talking to you.
David Collins
DIVISION MANAGER
866.328.6182
DC@usabg.net

Assessment

  • Is this a good product to sell? If so, why does it need an intermediary to push it?
  • Don’t subsidies, carve-outs, exemptions and sales commissions serve to jack-up price and lower quality? [think eMRs]? What about the overall cost of healthcare delivery; up or down?
  • What about the USA Benefits Group; credible or not? Are cold calls the way to go?
  • What is your impression of Division Manager Mr. David Collins and his Eagle Division? Feel free to contact him … and tell him what you think.

Conclusion

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Should HHS Secretary Kathleen Sebelius be Replaced?

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A Voting and Opinion Poll

[By Ann Miller RN MHA]

We are all aware that critics are calling for the head of Kathleen Sebelius after the clumsy online rollout of the PP-ACA.

And so, we ask:

Assessment

After you vote; please leave a cogent opinion, too.

Conclusion

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Is HEALTHCARE.GOV Fundamentally Flawed?

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You Decide

By Ayo Fathiah

Hello Dr. David Edward Marcinko,

My name is Ayo, I’m the mother of two beautiful kids and one of the Americans that was relying on healthcare.gov to provide me with a reasonably priced health insurance.

I came across your ME-P articles when researching what exactly has gone wrong with the website. I was one of the millions that tried to sign up during the first days after the launch and couldn’t get through due to a bunch of errors. While I’m still trying to find the best insurance for my family, I just wanted to share with you some stats showing why the website was a major flop.

***

interface

***

And, I thought it might be interesting to your readers, because I saw a many readers talking about it. Isn’t it surprising that less than 1% of people that went on the website signed up for an insurance?

HCdotGOV_final

The Website

1.) Had extremely low login success rates. 2.) Long delays and time outs 3.) Confusing Error Messages 4.) Non-functional calculators 5.) Scrambled insurance information 6.) Spouses reported as children 7.) Plan pricing misreported.

Assessment

Leading to the larger questions:

  • Will enrollment glitches become provider glitches?
  • Will people who enrolled with the glitchy show up at hospitals with no insurance?
  • Will the information of those who enrolled be at risk?

DANGER: Centralized data SSN Address Ages Names Health conditions Family History

Leads to centralized power over everyday Americans

Good: if we can make an efficient healthcare system

Bad: Governmental Abuse, and all the data an identity thief could want

But this problem runs deeper than just a website… Because the numbers just don’t add up.

Universal healthcare is important, but crony capitalism doesn’t solve anything.

Citations:

  1. http://msnbcmedia.msn.com/i/MSNBC/Sections/A_Politics/_Today_Stories_Teases/Late_October_NBC_WSJ.pdf
  2. https://blog.compete.com/2013/10/15/obamacare-enrollment-stats/
  3. http://www.nextgov.com/health/2013/10/less-1-percent-healthcaregov-visitors-successfully-enrolled-insurance-plan/72041/

Conclusion

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The PP-ACA from Medicine to Dentistry

Obamacare and Dentistry

[By D. Kellus Pruitt DDS]

1-darrellpruitt It seems that problems with the PP-ACA have migrated from traditional medicine to the world of dentistry.

“MaineCare dentists hit with massive fines for minor clerical errors, they say – Some clinics face more than $200,000 in penalties under a new audit system that threatens to wipe out services for kids.”

-Joe Lawlor [Staff writer] Portland Press Herald [November 6, 2013]

http://www.pressherald.com/news/MaineCare_dentists_hit_with_massive_fines_for_minor_clerical_errors__they_say_.html

 “The new system gives auditors, who work for a private contractor, financial incentives to find small errors by paying them more for each mistake they discover.” Maine adopted the auditing system to comply with the federal Affordable Care Act, otherwise known as Obamacare.

 Lawlor continues: “The audits are intended to root out fraud and abuse, but dentists told the Portland Press Herald that auditors are finding typographical or clerical errors that do not compromise patients’ care or defraud the government.”

A Clawback?

Dr. Michael Dowling, co-owner of Falmouth Pediatric Dentistry, tells the Herald, “This is not finding fraud and abuse. This is a clawback. They (state officials) are trying to take back money that we billed them legitimately.”

Still want to help the poor so much that you are willing to take your chances with the ACA auditing system, Doc?

Dentists facing bankruptcy

According to Lawlor, some dentists are actually facing bankruptcy because of ridiculously expensive fines over minor errors. Other Maine dentists who are otherwise willing to work for charity-level fees in order to help children who have nowhere else to turn, are dropping out of MaineCare. President Obama’s plan to use outrageous fines to fund the state and federal coffers, as well as the bonuses of ambitious auditors, is destined to fail.

How can the Affordable Care Act [PP-ACA] possibly make care more affordable for children with toothaches, if it runs off all the dentists?

Mobile-Security

Assessment

Is it beginning to look to you like Obamacare might have been designed to serve the interests of unaccountable healthcare stakeholders rather than the interests of doctors and patients – the healthcare principals? Why do we put up with this crap, Doc?

Conclusion

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Some US Federal Budget Proposals

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Government Shutdown Hoopla for Retirees, Inheritors and Savers

By Rick Kahler CFP® http://www.KahlerFinancial.com

Rick Kahler CFPLost in the hoopla over the government shutdown, defunding Obamacare, and raising the debt ceiling are some proposals contained in President Obama’s budget that will have a significant impact on retirees, inheritors, and savers.

Most of the President’s proposals are aimed at enforcing higher taxes on savers who maximize their retirement plans. This is a way to raise revenue for government entitlement programs, like subsidies for health insurance, Medicare, and Social Security.

Retirement and Retirees

Back from last year is his proposal to cap contributions to IRA’s and 401(k)’s when the balance reaches a level determined by a set formula which is tied to interest rates. The proposal sets the cap at $3.4 million initially. As interest rates rise, the cap will lower. When a saver’s IRA balance hits the cap, he or she will not be allowed to make further contributions to any retirement plan.

This will mostly affect savers who terminate employment and roll large accumulations from profit-sharing plans and lump-sum distributions from defined benefit plans into their IRA’s. It will shut down their ability to save into the future.

Taxes and Inheritors

The President has yet another plan to end tax-deductible contributions for upper income earners. Only 28% of a contribution would be deductible for any taxpayer whose bracket exceeds 28%. For a taxpayer in the highest bracket, this means a tax increase of about 50%.

Another of the President’s proposals would end the ability of anyone other than a spouse to inherit a tax-deferred IRA. Under the proposal, all non-spouses inheriting an IRA would have five years to terminate the IRA and pay income taxes on the distributions. This proposal really impacts Roth IRA conversions, as most parents convert traditional IRA’s to Roths with the intention of leaving their children a non-taxable sum of money that can continue to grow tax free during their lifetime. If the President’s proposal passes, many older savers will discover that the intentions behind their Roth conversions have been nullified.

Forced Savings and Savers

While President Obama wants to cap what successful savers can stash away in retirement plans, he also wants to force employees to save for retirement. Employers will be required to open IRA’s for every employee and to fund the plan at a minimum of 3% of the employee’s pay, unless the employee specifically opts out. The employee can contribute more than 3%, up to the $5,000 cap for those under 50 and $6,000 for those over 50.

Of course, savvy savers and ME-P readers know most of us need to be saving 20% to 50% of our salaries, depending on our ages, so saving just 3% of pay won’t amount to much in the way of retirement income.

Good News

On the positive side, the President wants to end required minimum distributions on IRA balances under $75,000. This will reduce some paperwork for savers with smaller IRA’s who are not making withdrawals.

Typically, most retirees with small IRA’s are those with less savings anyway, who need to take withdrawals from their IRA’s to make ends meet. So it’s doubtful this rule change will have much impact.

Finally, the President proposes letting inherited non-spousal IRA’s enjoy the same benefit of a 60-day rollover window on any distribution, similar to what they can do with a non-inherited IRA. This will simply eliminate a lot of confusion, as most people don’t understand the 60-day rollover provision does not include inherited IRA’s.

Shutdown[US Federal Government Shut-Down]

Assessment

Of course, whether any or all of these proposals make it into law is anyone’s guess. Anyone whose retirement and estate planning includes saving in IRA’s will want to keep an eye on these provisions as the budget moves through Congress.

Conclusion

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Understanding Basics of the Health Insurance Exchanges [HIEs]

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The Four Basic Categories of the PP-ACA

By Rick Kahler CFP® http://www.KahlerFinancial.com

Rick Kahler CFPThe opening date was yesterday, October 1, 2013. And today, the competition is lined-up and ready to go after bronze, silver, gold, and even platinum.

These competitors aren’t athletes, but insurance providers. The field they are entering is the new health insurance exchanges [HIEs] as mandated by Obamacare [ACA].

The New Year

Beginning January 1st 2014, nearly everyone in the US will need to have health insurance or pay a tax penalty. Those not insured through their employers can apply for coverage through these health insurance exchanges, also called “marketplaces.” Enrollment began October 1st, 2013 for coverage starting in January, 2014.

These exchanges are intended to make it easier to find insurance providers and compare their coverage and costs. Each state’s exchange website will list all the policies available in that state, with prices and policy provisions.

So far, over half of the states (including my State of South Dakota) have opted to use exchanges managed by the federal government instead of setting up their own.

The Four Basic [Colors] Categories

Bronze, silver, gold, and platinum describe the four basic categories of policies that will be available through the exchanges at different costs. Here is a very brief summary of each category.

Bronze

The least expensive option is a bronze plan, which might be the best choice for younger people with lower incomes and good health. The plan will pay 60% of health care costs and the insured will be responsible for 40%.

Silver

The second level, silver, will pay 70% of health care costs.

Gold and Platinum

Gold covers 80%, and a platinum plan covers 90%. Obviously, the categories with higher benefits also will have higher premiums.

The Essential Benefits

All these plans are required to cover “essential health benefits.” These include preventive and wellness care like cancer screening, chronic disease management, pediatric care, many prescription drugs, injury rehabilitation, mental health and addiction treatment, maternity and newborn care, hospitalization, and emergency services.

Companies are not allowed to deny coverage or charge more for those with pre-existing conditions. There are no lifetime benefit limits.

The Carrot and Stick Approach

The requirement to have health insurance coverage, the “stick” of Obamacare, is accompanied by a “carrot” in the form of federal subsidies to help pay insurance premiums. It’s estimated that two-thirds of Americans will be eligible for subsidies, which will be figured on a sliding scale. The upper limit for qualifying is four times the federal poverty level, which amounts to about $88,000 a year for a family of four.

Other Outlines

This ME-P summary is just the barest outline of the health care changes coming our way. To find out more, it’s a good idea to spend some time online, especially at two sites that offer a lot of helpful information.

  1. The First site is the federal government website at www.HealthCare.gov. It provides links to the state exchanges, plus detailed information that for the most part is explained in straightforward, plain English.
  2. The Second site is the Henry J. Kaiser Family Foundation at kff.org. An especially useful tool available here (http://kff.org/interactive/subsidy-calculator/) is a calculator to determine the federal subsidy that applies at your family’s income level.

Obamacare 2014

The elements of Obamacare that take effect in 2014 represent a huge shift in the way we cover health care costs. I strongly recommend that you start now to figure out what this will mean for you and your family.

###

Obama Care

###

Don’t wait until December and end up making hasty decisions in a last-minute rush. The more informed you are; the better insurance choices you can make.

Assessment

The changeover to the new insurance environment is likely to be chaotic and confusing. Navigating it will take some energy, commitment, and stamina. When all the scrambling is over, we can only hope the ultimate winners will be the American people.

Conclusion

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Did the NSA End Obamacare?

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Did ambitious NSA officials unintentionally end Obamacare years ago?

[By D. Kellus Pruitt DDS]

1-darrellpruittIf loss of trust in encryption ends Obamacare, can whistleblower Edward Snowden be blamed for that as well? Yep.

What’s even more ominous, the former National Security Agency contractor’s news that encrypted medical records are no longer secure reached Alaska on a weekend.

“Risky electronic health records: Alaska should make information exchange system safer – Imagine: The National Security Agency slips into your doctor’s office and peeks at your medical records,”

by Alaska ACLU executive director Joshua Decker was posted hours ago on Newsminer.com, out of Fairbanks.

http://www.newsminer.com/opinion/community_perspectives/risky-electronic-health-records-alaska-should-make-information-exchange-system/article_a9947eb0-1863-11e3-8153-001a4bcf6878.html

Decker questions the security of the state’s Health Information Exchange (HIE), and offers common sense but costly steps which arguably lessen the danger of privacy breaches – including giving patients the choice of “opting-in” to permit their encrypted, but increasingly vulnerable identities to be shared online via Obamacare’s exchanges.

My POV 

In my opinion, if informed Americans are given the choice of volunteering to risk identity theft, HIEs won’t be around a year from now, and neither will Obamacare. If informed Americans are not given a choice, the costs are even greater. Americans deserve honesty.

National Obamacare Hangs in the Balance

In a related, slow-burning game-changer, Obamacare hangs in the balance, not just for Alaska, but for the nation.

It was September 5th when the Guardian Weekly posted: “Revealed: how US and UK spy agencies defeat internet privacy and security,” written by James Ball, Julian Borger and Glenn Greenwald, and based on top secret NSA information Snowden stole.

http://www.theguardian.com/world/2013/sep/05/nsa-gchq-encryption-codes-security

Snowden told the Guardian that years ago, the NSA joined with the UK’s spy agency GCHQ (Government Communications Headquarters) to successfully make encryption obsolete – including for medical records.

Naturally, if properly informed Americans fear that secrets they tell their doctors might be breached, incorrect EHRs become less than worthless. They become dangerous.

More on Health Information Exchanges

What’s more, even before the added expense of waiting for Americans to opt-in to the exchanges – instead of discouraging them from opting-out – the very funding for the increasingly-battered Obamacare is based on a rumor of savings.

Starting years ago, health IT lobbyists, including former Speaker of the House Newt Gingrich, told lawmakers to expect annual savings of $77 billion and 100,000 lives – quoting the results of a once popular, EHR-friendly 2005 RAND study which was funded by General Electric and Cerner Corporation.

Obamacare

As you can see, while we were not paying attention, we were had!

The RAND Study

Predictably, both GE and Cerner profited immensely from the development and sales of EHR systems before the RAND study was widely discredited months ago – even by RAND.

According to a NY Times article from January, “Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.”

(See: “In Second Look, Few Savings From Digital Health Records by Reed Abelson and Julie Creswell, January 10, 2013).

http://www.nytimes.com/2013/01/11/business/electronic-records-systems-have-not-reduced-health-costs-report-says.html?_r=0

Assessment

Last weekend’s bad news for Obamacare is still under the radar, but I predict within days it will become apparent that the mounting obstacle between President Obama and healthcare reform will be in regaining trust his administration squandered while helping GE and Cerner profits at the expense of soon-to-be pissed off American patients.

Conclusion

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What Does Health Reform Mean for You?

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Ideas Changing the World

By National Center for Policy Analysis [NCPA]

Although the third presidential debate last night centered on foreign affairs, the PP-ACA seems to be the moniker of the Obama Presidency.

And so, here is a slide-show and white paper [updated September 2012] from the NCPA on what health reforms means for you.

Slide show MSFT-ppt link: What-Does-Health-Reform-Mean-for-You_Presentation

White paper .pdf link: What-Does-Health-Reform-Mean-for-You-A-Consumers-Guide

About the NCPA

The National Center for Policy Analysis is a public policy research organization that develops and promotes private alternatives to government regulation and control.

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Pre-2014 Medicaid Expansion for the PP-ACA

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States Acceptance – Cost and Savings Factors

Link: http://www.healthcarefinancenews.com/infographic/infographic-factors-consider-medicaid-expansion

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Understanding the House Democrats’ Health Plan [PP-ACA]

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An Organization Chart

By Staff Reporters

If you have ever wondered exactly how health care reform will work for the United States, there is unfortunately no easy answer.

But, with the democrats and republicans strongly divided on universal health care, it can be tough for the average American citizen to find answers.

Fortunately, the graphic below will help.

PP-ACA

Assessment

However, it is important to listen to both sides to make a well-rounded decision of whether or not you can get behind health care reform.

Conclusion

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The Tax Man Cometh to Police You on Health Care

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About the New Health Care Tax and IRS Job Creation

WASHINGTON (AP)

The Supreme Court’s decision to uphold most of President Barack Obama’s health care law will come home to roost for most taxpayers in about 2 1/2 years, when they’ll have to start providing proof on their tax returns that they have health insurance.

LINK: New Jobs: IRS to hire thousands more agents to collect new health care taxes

Conclusion

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Hospitals: http://www.crcpress.com/product/isbn/9781439879900

Physician Advisors: www.CertifiedMedicalPlanner.org

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Controlling Health Care Spending [An NIHCM Foundation Webinar]

The Imperative to Act and Diverse Views of the Road Forward

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The U.S.now spends $2.5 trillion annually on health care, accounting for well over 17 percent of GDP and growing rapidly with challenging fiscal consequences. Despite the imperative to control spending, we face much uncertainty about how to move to a more sustainable path.

Political opposition threatens implementation of the Affordable Care Act, and many of its cost-control measures are still unproven. A long-term fix for Medicare physician payment remains elusive. The trigger mechanism activated by the failure of the Super Committee is poised to affect myriad health programs, but decisions on the specific cuts await sure-to-be intense congressional negotiations.

And, the many ideas for entitlement reform that were advanced during deficit reduction talks continue to generate much debate but little consensus.

Topics

To shed light on these complex issues, this webinar will feature leading health policy experts discussing topics including:

  • health spending growth and the implications for government budgets, employers and individuals
  • the societal trade-offs we face as health spending grows and as we think about ways to control spending
  • alternative viewpoints on the viability of cost control approaches now being tried and the most promising options for the future.

Assessment

Visit NIHCM Foundation’s website to view an agenda and additional resources on health care spending. And, please register by noon (EST) on February 1st.

Conclusion        

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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Practice Management: http://www.springerpub.com/product/9780826105752

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

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The ACA Individual Mandate [Voter Opinion Survey]

Individual Mandate Opinion Survey

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Do you think the individual mandate of PPACA should be overturned?

Conclusion

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Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com

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The ACO Prescription?

Cure or Disease?

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Accountable Care Organizations are the ACA’s [Obamacare] answer to skyrocketing Medicare costs, but who wins besides the government? Doctors take on the financial risk, and patients could suffer as a result.

Here’s a look at how Accountable Care Organizations could affect the quality of healthcare in the near future. Brought to you by gplus.com

Conclusion

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Healthcare Reform at a Glance

A One-Stop-Look-See with Comparisons

By Staff Reporters

Link: Health-Care-Reform-Comparison-in-Brief

[Courtesy: BuckConsultants]

Conclusion

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Our Other Print Books and Related Information Sources:

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Medical Risk Management: http://www.jbpub.com/catalog/9780763733421

Healthcare Organizations: www.HealthcareFinancials.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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Words of a Healthcare Reform Philosopher

The Lady Speaks

By Staff Reporters

Healthcare reform insights from America’s leading contemporary philosopher, Stefani Germanotta (a.k.a. Lady Gaga).

I want your ugly. I want your disease.
I want your everything, as long as it’s free!

Conclusion

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Congressional Budget Office Healthcare Reports of Interest

Ten [10] Aggregated CBO Reports

By Staff ReportersIntegration

Courtesy of Healthcare Town Hall:

 

 

 

 

 

Assessment

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Conclusion

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Popular Healthcare Reform Articles

Aggregating Content – Disseminating Knowledge

By Ann Miller; RN, MHA

[Executive Director]Text Books 

Here are three interesting and related articles from The Incidental Economist:

 

 

Give them a click, read em’ and comment now.

Channel Surfing

Have you visited our other topic channels? Established to facilitate idea exchange and link our community together, the value of these topics is dependent upon your input. Please take a minute to visit. And, to prevent that annoying spam, we ask that you register.  

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Healthcare Organizations: www.HealthcareFinancials.com

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ReThinking Medical Professional Autonomy in the Era of Obama Care

Eying Contemporary Medical Ethics in Healthcare Reform

By Render S. Davis; MSA, CHE

And, Staff Reportersbiz-book

Not so long ago, a physician’s clinical judgment was virtually unquestioned. Now with the advent of clinical pathways and case management protocols, many aspects of treatment are outlined in algorithm-based plans that allied health professionals may follow with only minimal direct input from a physician. Much about this change has been good. Physicians have been freed from much tedious routine and are better able to watch more closely for unexpected responses to treatments or unusual outcomes and then utilize their knowledge to chart an appropriate response.  

Restrictive Protocols

What is of special concern, though, is the restrictive nature of protocols in some managed care plans that may unduly limit a physician’s clinical prerogatives to address a patient’s specific needs. Such managed care plans may prove to be the ultimate bad examples of “cook book” medicine. While some may find health care and the practice of medicine an increasingly stressful and unrewarding field, others are continuing to search for ways to assure that caring, compassionate, and ethically rewarding medicine remain at the heart of our health care system.

Assessment

Link: For another opinion: http://healthcareorganizationalethics.blogspot.com/2009/09/obamas-speech-good-ethics-and-good.html

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. How does the specter of HR 3200-3400 in the healthcare reform debate impact the concept of medical autonomy and professional ethics? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

About Docs4PatientCare

Politically Involved Physicians

By Staff ReportersUS Senate

Docs4PatientCare is a grassroots organization of concerned physicians committed to the establishment of a health care system that preserves the sanctity of the doctor-patient relationship, promotes quality of care, supports affordable access to all Americans, and protects patients’ freedom of choice.

Mission

According to their website, Docs4PatientCare urges patients and physicians to get involved in the current healthcare debates in order to preserve the good qualities of our healthcare system, address the problems, while preventing their bureaucratic destruction.

Board Members

President: Hal Scherz, MD
Vice President: Fred Shessel, MD
Secretary: Tod Rubin, MD
Treasurer: Joanne Thurston CPA

Board of Directors

Scott Barbour, MD
Carl Capelouto, MD
Ron Anglade, MD
Terry Murphy, MD
Mike Koriwchak, MD
Barry Zisholtz, MD

Assessment

D4PC is a group of practicing physicians uniting to represent the interests and concerns of both patients and doctors in the healthcare reform debate.  D4PC endorses the concept of needed healthcare reform, but recognizes it can only be accomplished by proceeding in a cautious and responsible manner. Their recommendations seek to enable them to reach this goal without requiring the nationalization of the entire American healthcare system.

But, should medical professionals be involved in such political organizations?

Link: http://docs4patientcare.org

Conclusion

And so, your thoughts and comments on this Medical Executive-Post are appreciated. Are these sorts of organizations a form of self-aggrandizement; or not? Can you cite any others? Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, be sure to subscribe to the ME-P. It is fast, free and secure.

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Healthcare Organizations: www.HealthcareFinancials.com

Health Administration Terms: www.HealthDictionarySeries.com

Physician Advisors: www.CertifiedMedicalPlanner.com

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