Archive for April 1st, 2010

Great idea: How about extending SarbOx to Congress ?

April 1, 2010

Several companies have announced mega first quarter earnings charges to reflect the impact of ObamaCare. AT&T’s write-off: a staggering $1 billion.

The accounting is relatively straightforward: the companies have a future liability on their balance sheets — benefit payments to retirees for prescription drugs.  That liability was being partially offset by a favorable tax treatment that’s being eliminated by ObamaCare.  So, the liability has to be restated upward by the amount of the lost tax benefits.  That’s done by a non-cash charge to the P&L that must be recognized as soon as it’s evident.

Now, the Feds want the companies’ CEOs testify and provide evidence of the law’s projected impact.

Almost immediately, House Energy and Commerce Committee Chairman Henry Waxman of California and Rep. Bart Stupak of Michigan, chairman of the Oversight and Investigations panel, announced plans to hold an April 21 hearing on “claims by Caterpillar, Verizon, and Deere that provisions in the new health care reform law could adversely affect their company’s (costs) and ability to provide health insurance to their employees. These assertions appear to conflict with independent analyses, which show that the new law will expand coverage and bring down costs.”
http://blogs.wsj.com/washwire/2010/03/26/companies-charges-prompt-a-hearing/

One can reasonably expect that the Feds will try to browbeat the companies into making the charges go away (after all, its bad publicity) by recognizing that ObamaCare will substantially bend the health care cost curve downward.

Yeah, right.

Under Sarbanes-Oxley, CEOs have to sign off on the integrity of their company’s financial statements under penalty of fines and jail time.

Now, pardon these CEOs if they conclude — like many other folks — that the administrations’s financial projections re: huge cost savings, premium cuts, deficit reductions, etc., are at best uncertain, or at worst complete BS.

If that’s what they conclude  — and if they sign financial statements that are based on the incredible projections —  and if the pie-in-the-sky ObamaCare projections don’t materialize — then they get carted off to jail under Sarb-Ox. Uh-oh.

Perhaps Reps. Waxman and Stupak should have to sign the companies’ financial statements — under penalty of hard time in jail if the ObamaCare benefits don’t materialize.

Thinking more broadly, why not make all Senators and Congressmen who voted for ObamaCare sign statements that they’ll go to jail if the cost curve isn’t bent down, if the deficit isn’t reduced, and if premiums don’t plummet.  They should be willing since they profess to believe and voted accordingly.

Or, thinking even more broadly, why not make our sleazy reps sign similar statements every time they sign a bill with economic consequences.

If not jail time, at least make them forfeit their lucrative government pensions and retirement businesses.

Why not ?

Posted in Congress - Senate, Health Care / Medical Insurance | 3 Comments »

How many government boards, commissions and programs does it take to "not takeover" healthcare ?

April 1, 2010

Answer: At least 159

All being staffed by Fed gov’t employees making 44% more than comparable private sector workers.

All to improve our healthcare and whittle down costs …

* * * * *
Here’s a starter list, right out of the 2,474 page bill, the reconciliation addendum and the Speaker’s amendment.

1. Grant program for consumer assistance offices (Section 1002, p. 37)
2. Grant program for states to monitor premium increases (Section  1003, p. 42)
3. Committee to review administrative simplification standards  (Section 1104, p. 71)
4. Demonstration program for state wellness programs (Section 1201, p.  93)
5. Grant program to establish state Exchanges (Section 1311(a), p. 130)
6. State American Health Benefit Exchanges (Section 1311(b), p. 131)
7. Exchange grants to establish consumer navigator programs (Section  1311(i), p. 150)
8. Grant program for state cooperatives (Section 1322, p. 169)
9. Advisory board for state cooperatives (Section 1322(b)(3), p. 173)
10. Private purchasing council for state cooperatives (Section  1322(d), p. 177)
11. State basic health plan programs (Section 1331, p. 201)
12. State-based reinsurance program (Section 1341, p. 226)
13. Program of risk corridors for individual and small group markets  (Section 1342, p. 233)
14. Program to determine eligibility for Exchange participation  (Section 1411, p. 267)
15. Program for advance determination of tax credit eligibility  (Section 1412, p. 288)
16. Grant program to implement health IT enrollment standards (Section  1561, p. 370)
17 Federal Coordinated Health Care Office for dual eligible  beneficiaries (Section 2602, p. 512)
18. Medicaid quality measurement program (Section 2701, p. 518)
19. Medicaid health home program for people with chronic conditions,  and grants for planning same (Section 2703, p. 524)
20 Medicaid demonstration project to evaluate bundled payments  (Section 2704, p. 532)
21. Medicaid demonstration project for global payment system (Section  2705, p. 536)
22. Medicaid demonstration project for accountable care organizations  (Section 2706, p. 538)
23. Medicaid demonstration project for emergency psychiatric care  (Section 2707, p. 540)
24. Grant program for delivery of services to individuals with  postpartum depression (Section 2952(b), p. 591)
25. State allotments for grants to promote personal responsibility  education programs (Section 2953, p. 596)
26. Medicare value-based purchasing program (Section 3001(a), p. 613)
27. Medicare value-based purchasing demonstration program for critical  access hospitals (Section 3001(b), p. 637)
28. Medicare value-based purchasing program for skilled nursing  facilities (Section 3006(a), p. 666)
29. Medicare value-based purchasing program for home health agencies  (Section 3006(b), p. 668)
30. Interagency Working Group on Health Care Quality (Section 3012, p.  688)
31. Grant program to develop health care quality measures (Section  3013, p. 693)
32. Center for Medicare and Medicaid Innovation (Section 3021, p. 712)
33. Medicare shared savings program (Section 3022, p. 728)
34. Medicare pilot program on payment bundling (Section 3023, p. 739)
35. Independence at home medical practice demonstration program  (Section 3024, p. 752)
36. Program for use of patient safety organizations to reduce hospital  readmission rates (Section 3025(b), p. 775)
37. Community-based care transitions program (Section 3026, p. 776)
38. Demonstration project for payment of complex diagnostic laboratory  tests (Section 3113, p. 800)
39. Medicare hospice concurrent care demonstration project (Section  3140, p. 850)
40. Independent Payment Advisory Board (Section 3403, p. 982)
41. Consumer Advisory Council for Independent Payment Advisory Board  (Section 3403, p. 1027)
42. Grant program for technical assistance to providers implementing  health quality practices (Section 3501, p. 1043)
43. Grant program to establish interdisciplinary health teams (Section  3502, p. 1048)
44. Grant program to implement medication therapy management (Section  3503, p. 1055)
45. Grant program to support emergency care pilot programs (Section  3504, p. 1061)
46. Grant program to promote universal access to trauma services  (Section 3505(b), p. 1081)
47. Grant program to develop and promote shared decision-making aids  (Section 3506, p. 1088)
48. Grant program to support implementation of shared decision-making  (Section 3506, p. 1091)
49. Grant program to integrate quality improvement in clinical  education (Section 3508, p. 1095)
50. Health and Human Services Coordinating Committee on Women’s Health  (Section 3509(a), p. 1098)
51. Centers for Disease Control Office of Women’s Health (Section  3509(b), p. 1102)
52. Agency for Healthcare Research and Quality Office of Women’s  Health (Section 3509(e), p. 1105)
53. Health Resources and Services Administration Office of Women’s  Health (Section 3509(f), p. 1106)
54. Food and Drug Administration Office of Women’s Health (Section  3509(g), p. 1109)
55. National Prevention, Health Promotion, and Public Health Council  (Section 4001, p. 1114)
56. Advisory Group on Prevention, Health Promotion, and Integrative  and Public Health (Section 4001(f), p. 1117)
57. Prevention and Public Health Fund (Section 4002, p. 1121)
58. Community Preventive Services Task Force (Section 4003(b), p. 1126)
59. Grant program to support school-based health centers (Section  4101, p. 1135)
60. Grant program to promote research-based dental caries disease  management (Section 4102, p. 1147)
61. Grant program for States to prevent chronic disease in Medicaid  beneficiaries (Section 4108, p. 1174)
62. Community transformation grants (Section 4201, p. 1182)
63. Grant program to provide public health interventions (Section  4202, p 1188)
64. Demonstration program of grants to improve child immunization  rates (Section 4204(b), p. 1200)
65. Pilot program for risk-factor assessments provided through  community health centers (Section 4206, p. 1215)
66. Grant program to increase epidemiology and laboratory capacity  (Section 4304, p. 1233)
67. Interagency Pain Research Coordinating Committee (Section 4305, p.  1238)
68. National Health Care Workforce Commission (Section 5101, p. 1256)
69. Grant program to plan health care workforce development activities  (Section 5102(c), p. 1275)
70. Grant program to implement health care workforce development  activities (Section 5102(d), p. 1279)
71. Pediatric specialty loan repayment program (Section 5203, p. 1295)
72. Public Health Workforce Loan Repayment Program (Section 5204, p.  1300)
73. Allied Health Loan Forgiveness Program (Section 5205, p. 1305)
74. Grant program to provide mid-career training for health  professionals (Section 5206, p. 1307)
75. Grant program to fund nurse-managed health clinics (Section 5208,  p. 1310)
76. Grant program to support primary care training programs (Section  5301, p. 1315)
77. Grant program to fund training for direct care workers (Section  5302, p. 1322)
78. Grant program to develop dental training programs (Section 5303,  p. 1325)
79. Demonstration program to increase access to dental health care in  underserved communities (Section 5304, p. 1331)
80. Grant program to promote geriatric education centers (Section  5305, p. 1334)
81. Grant program to promote health professionals entering geriatrics  (Section 5305, p. 1339)
82. Grant program to promote training in mental and behavioral health  (Section 5306, p. 1344)
83. Grant program to promote nurse retention programs (Section 5309,  p. 1354)
84. Student loan forgiveness for nursing school faculty (Section  5311(b), p. 1360)
85. Grant program to promote positive health behaviors and outcomes  (Section 5313, p. 1364)
86. Public Health Sciences Track for medical students (Section 5315,  p. 1372)
87. Primary Care Extension Program to educate providers (Section 5405,  p. 1404)
88. Grant program for demonstration projects to address health  workforce shortage needs (Section 5507, p. 1442)
89. Grant program for demonstration projects to develop training  programs for home health aides (Section 5507, p. 1447)
90 Grant program to establish new primary care residency programs  (Section 5508(a), p. 1458)
91. Program of payments to teaching health centers that sponsor  medical residency training (Section 5508(c), p. 1462)
92. Graduate nurse education demonstration program (Section 5509, p.  1472)
93. Grant program to establish demonstration projects for community- based mental health settings (Section 5604, p. 1486)
94. Commission on Key National Indicators (Section 5605, p. 1489)
95. Quality assurance and performance improvement program for skilled  nursing facilities (Section 6102, p. 1554)
96. Special focus facility program for skilled nursing facilities  (Section 6103(a)(3), p. 1561)
97. Special focus facility program for nursing facilities (Section  6103(b)(3), p. 1568)
98. National independent monitor pilot program for skilled nursing  facilities and nursing facilities (Section 6112, p. 1589)
99. Demonstration projects for nursing facilities involved in the  culture change movement (Section 6114, p. 1597)
100. Patient-Centered Outcomes Research Institute (Section 6301, p.  1619)
101. Standing methodology committee for Patient-Centered Outcomes  Research Institute (Section 6301, p. 1629)
102. Board of Governors for Patient-Centered Outcomes Research  Institute (Section 6301, p. 1638)
103. Patient-Centered Outcomes Research Trust Fund (Section 6301(e),  p. 1656)
104. Elder Justice Coordinating Council (Section 6703, p. 1773)
105. Advisory Board on Elder Abuse, Neglect, and Exploitation (Section  6703, p. 1776)
106. Grant program to create elder abuse forensic centers (Section  6703, p. 1783)
107. Grant program to promote continuing education for long-term care  staffers (Section 6703, p. 1787)
108. Grant program to improve management practices and training  (Section 6703, p. 1788)
109. Grant program to subsidize costs of electronic health records  (Section 6703, p. 1791)
110. Grant program to promote adult protective services (Section 6703,  p. 1796)
111. Grant program to conduct elder abuse detection and prevention  (Section 6703, p. 1798)
112. Grant program to support long-term care ombudsmen (Section 6703,  p. 1800)
113. National Training Institute for long-term care surveyors (Section  6703, p. 1806)
114 Grant program to fund State surveys of long-term care residences  (Section 6703, p. 1809)
115. CLASS Independence Fund (Section 8002, p. 1926)
116. CLASS Independence Fund Board of Trustees (Section 8002, p. 1927)
117. CLASS Independence Advisory Council (Section 8002, p. 1931)
118. Personal Care Attendants Workforce Advisory Panel (Section  8002(c), p. 1938)
119 Multi-state health plans offered by Office of Personnel  Management (Section 10104(p), p. 2086)
120. Advisory board for multi-state health plans (Section 10104(p), p.  2094)
121. Pregnancy Assistance Fund (Section 10212, p. 2164)
122. Value-based purchasing program for ambulatory surgical centers  (Section 10301, p. 2176)
123. Demonstration project for payment adjustments to home health  services (Section 10315, p. 2200)
124. Pilot program for care of individuals in environmental emergency  declaration areas (Section 10323, p. 2223)
125. Grant program to screen at-risk individuals for environmental  health conditions (Section 10323(b), p. 2231)
126. Pilot programs to implement value-based purchasing (Section  10326, p. 2242)
127. Grant program to support community-based collaborative care  networks (Section 10333, p. 2265)
128. Centers for Disease Control Office of Minority Health (Section  10334, p. 2272)
129. Health Resources and Services Administration Office of Minority  Health (Section 10334, p. 2272)
130. Substance Abuse and Mental Health Services Administration Office  of Minority Health (Section 10334, p. 2272)
131. Agency for Healthcare Research and Quality Office of Minority  Health (Section 10334, p. 2272)
132. Food and Drug Administration Office of Minority Health (Section  10334, p. 2272)
133. Centers for Medicare and Medicaid Services Office of Minority  Health (Section 10334, p. 2272)
134. Grant program to promote small business wellness programs  (Section 10408, p 2285)
135. Cures Acceleration Network (Section 10409, p. 2289)
136. Cures Acceleration Network Review Board (Section 10409, p. 2291)
137. Grant program for Cures Acceleration Network (Section 10409, p.  2297)
138. Grant program to promote centers of excellence for depression  (Section 10410, p. 2304)
139. Advisory committee for young women’s breast health awareness  education campaign (Section 10413, p. 2322)
140. Grant program to provide assistance to provide information to  young women with breast cancer (Section 10413, p. 2326)
141. Interagency Access to Health Care in Alaska Task Force (Section  10501, p. 2329)
142. Grant program to train nurse practitioners as primary care  providers (Section 10501(e), p. 2332)
143. Grant program for community-based diabetes prevention (Section  10501(g), p. 2337)
144. Grant program for providers who treat a high percentage of  medically underserved populations (Section 10501(k), p. 2343)
145. Grant program to recruit students to practice in underserved  communities (Section 10501(l), p. 2344)
146. Community Health Center Fund (Section 10503, p. 2355)
147. Demonstration project to provide access to health care for the  uninsured at reduced fees (Section 10504, p. 2357)
148. Demonstration program to explore alternatives to tort litigation  (Section 10607, p. 2369)
149. Indian Health demonstration program for chronic shortages of  health professionals (S. 1790, Section 112, p. 24)*
150. Office of Indian Men’s Health (S. 1790, Section 136, p. 71)*
151. Indian Country modular component facilities demonstration program  (S. 1790, Section 146, p. 108)*
152. Indian mobile health stations demonstration program (S. 1790,  Section 147, p. 111)*
153. Office of Direct Service Tribes (S. 1790, Section 172, p. 151)*
154. Indian Health Service mental health technician training program  (S. 1790, Section 181, p. 173)*
155. Indian Health Service program for treatment of child sexual abuse  victims (S. 1790, Section 181, p. 192)*
156. Indian Health Service program for treatment of domestic violence  and sexual abuse (S. 1790, Section 181, p. 194)*
157. Indian youth telemental health demonstration project (S. 1790,  Section 181, p. 204)*
158. Indian youth life skills demonstration project (S. 1790, Section  181, p. 220)*
159. Indian Health Service Director of HIV/AIDS Prevention and  Treatment (S. 1790, Section 199B, p. 258)*

*Section 10221, page 2173 of H.R. 3590 deems that S. 1790 shall be  deemed as passed with certain amendments.

Thanks to JC for feeding the lead

Posted in Health Care / Medical Insurance | Leave a Comment »

Will marketing tactics save NYC airlines from the tyranny of 100

April 1, 2010

TakeAway:  The airline game just got a little more interesting. 

The coveted shuttle routes from Washington to NYC, which were previously dominated by Delta and U.S. Air, are now home to three players – Delta, U.S. Air, and JetBlue. 

Does this mean that the previous unspoken rules about pricing are going to go out the window? 

And, the game gets even better because American is going to aggressively challenge Delta on many more routes. 

Will clever marketing tactics be able to save the day for Delta?  Or is the tyranny of 100 going to result in the slow death of a player?

Excerpted from WSJ, “American Airlines, JetBlue Swap Landing Rights at JFK, Reagan,” By Nathan Becker, March 31, 2010

American Airlines it will enhance service at New York City airports and also agreed to partner with JetBlue to offer connections to some of its East Coast flights, setting up a two-way battle for New York business travel.

American’s plan to bolster New York service will add seven new destinations served by 23 additional flights to and from New York City’s two airports …

The JetBlue agreement … should create a battle for control of the fragmented New York business travel market, which Delta has set out to “own” through route expansion and marketing deals such as those with the city’s Major League Baseball teams.

However, Delta is limited by aging facilities at JFK Airport and efforts by regulators to limit its expansion plans at LaGuardia Airport.

JetBlue will begin flying to Reagan National Airport as it obtained gate rights from AMR in return for rights at JFK airport. JetBlue is tied to the Star Alliance through Deutsche Lufthansa’s stake in the U.S. airline, while American is part of the rival oneworld alliance.

American also said it plans to expand its marketing efforts to New York travelers and designated a new executive position that will have responsibility for airport operations and “broad oversight” over the company’s New York operations.

The agreement with JetBlue will allow JetBlue customers “simple connections to American’s international flights and new convenient domestic flight options on JetBlue for American’s customers in and out of New York and Boston.” The partnership will focus on routes into and out of JFK and Boston that “extend and complement each others’ networks.”

Full Article
http://online.wsj.com/article/SB10001424052702304252704575155601088251666.html?mod=WSJ_hpp_LEFTWhatsNewsCollection&mg=com-wsj 
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Posted in Airlines | 1 Comment »