Laudra's Lessons - "AMERICA'S BITTER PILL" ANALYSIS PART 2

This article is a continuation. Click HERE to read part 1

…… What happened to the Affordable Care Act that made it so un-affordable for so many?  What stood in the way?

First, Ted Kennedy became very ill with a brain tumor and subsequently died.  Healthcare’s hardest worker, most effective and ardent supporter was not there to champion the changes that needed to be made.

COSTS and POLITICS: Doctors conflicts of interest: 94% of all physicians accept consulting fees and free samples and that amounts to 7 billion for pharmaceutical reps and 18 billion in the form of free samples to doctors.  Hospitals and insurance companies provide enormous salaries to their top executives which are not often publicized. However, because of a SEC lawsuit, it was publicly released that United Healthcare paid their departing CEO over a Billion (no that is not a typo dollars in his severance package.

Sixty votes were needed in the Senate to pass the bill establishing ACA and that left those designing the plan open to blackmail from Senators that wanted something special in the bill for their state.  As an example, the Indiana Senator wanted the medical device tax lowered as there were device makers in Indiana. Drug companies, the medical device industry, and the “non-profit” hospitals leaned on the Senators in their states to exempt them from cost cutting that was needed to make the plan affordable.  It needs to be said, “non-profit” hospitals are anything but; they are big businesses and in some states the biggest with huge profits. Steven Brill gives one example: University of Pennsylvania Medical Center in 2009 had an operating profit in excess of 580 million and the chief executive officer took home four million in compensation.  Every Democratic vote was needed to pass the bill, so no Senator’s demand could be ignored.

The lobbyists really went to work, one example AMGEN, the drug company that wanted protection for their name brand drugs, delayed acceptance of generics and protection for their super expensive biologics spent more than 38 million on lobbying in the three years leading up to the start of the ACA. This at the same time that the company was being investigated in fifteen states for questionable sales and marketing.

In addition, the Republicans were determined to stop anything the new president submitted and they are traditionally opposed to big government programs. It should be noted that the ACA was modeled after plans that were proposed by Nixon and Johnson and passed by Romney.

RESULT: Americans cannot import their drugs from other countries, Medicare could not negotiate drug prices, no cuts in Medicaid payments, biologics are protected for twelve years; and thanks to the Supreme Court, namely John Roberts, there is no individual mandate.  The whole idea of insurance is sharing the risk. We all pay into the pot and when one of us gets sick the insurance pays for our treatment. Those young people who don’t want the insurance do have accidents and someday they will be old and the next generation will subsidize their insurance premiums.

To be continued…

Work Life Balance Opinion: Parental Flexibility

In recent news, Starbucks has announced that they will start to provide subsidized child and adult day care via Care.com for emergency situations for their employees.  This small, simple benefit can end up yielding huge financial and cultural benefits since 70% of workers have said they’ve had to take time off from work "or make other work adjustments because of caregiving."*

Here at EBC this got us thinking about Parental Flexibility, especially for Lachelle with her 18 month old daughter and Jessica, EBC’s Digital Marketing and Client Services Manager with her 10 month old son.  

Starting a family while also working on a career began with the best intentions. Then baby was born and all my plans were thrown out the window.  Going back to work full time was more physically and mentally painful than expected. On top of that, our new little one with his new immune system got sick about every other week and daycare do not allow sick babies.  But myself and my husband had zero sick or vacation days since they were all used during maternity leave. I suddenly understood the stresses of working full time and being a parent.  

I immediately start talking to other mothers at my job to see how they cope with this lifestyle, but they all had their own complaints that were similar to my own.  It all begins with this feeling that we didn’t have enough time with our newborns before we even had to return to work. The time off wasn’t just for the sake of our newborns but also for our own health.  Recovering from birth takes time especially if surgery is involved.

Through all this, I ended up needing and wanting to quit my job so that I could have the flexibility to take care of my family when they got sick and take care of myself both physically and mentally.  My husband also became stressed with the amount of time that his job was pulling him away from our new family. The whole situation became strained which is not how we intended to start a family.

Luckily for us, my husband was offered a job in an industry he always wanted to be in and I was fortunate enough to begin to work at EBC from anywhere I needed to be during hours that worked for my schedule.  We packed up our family and moved to a small town so that we could have the life we always imagined we could. I am so grateful for the opportunities we were given and the life we now have. But it pains me to still see so many women struggle with the same issues I did.  

It is a horrible thing to be stuck between your family life and career ambitions.  It is even worse when a company does not have policies that offers flexibility. While there are no federal laws that require companies to have parental leave or flexible hours, these benefits are becoming increasingly asked for by employees.  Especially in the age of globalism, people are realizing what other countries are offering their citizens and wondering why those benefits can’t be offered here. Low unemployment rates also means that companies are competing for employees rather than the other way around and therefore, benefits are becoming a top reason to apply for a job or choose one job over the other.  Companies no longer have the upper hand when recruiting the right employee and will need to start listening to the outcries for better parental and family-centric benefits.

The information below is provided by Lachelle:

Family Benefits

There is a law currently in place to provide job-protection for eligible employees who take time off work for certain family and medical reasons. This is the Family Medical Leave Act.  The DOL’s website description says “ The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.”

While this does offer job protection this only covers unpaid leave, therefore it would not be seen as a “fringe benefit”.  Also, only Employers with over 50 employees have to comply with this law so smaller employer groups are not required to provide any sort of family leave.  Lastly, this law has specific outlines for what type of leave is covered. The time off of work for a mother taking care of her child with chickenpox would qualify her under FMLA.  The time off for a mother who needs to take her child to the dentist would not.

In the interest of this article, what kinds of non-traditional employee benefits or “perks” can we think of that can be beneficial for new mothers, parents and families and are outside of the traditional benefit box?

• Flexible time off which can be used interchangeably for illness, vacation or whatever the person needs time off for (parent teacher conference, doctor’s appointments etc)

• Voluntary benefits – many voluntary benefits such as Accident products can cover spouses and children. This is especially useful for children who are active in sports and recreation.

• Option to work at home – even if it is just for one day a week or several hours a month, having the option to work from home for a new mother or father can be huge. It can relieve the stress of leaving their family or finding a sitter.  Thanks to the technology of this generation, many tasks can be done at home via phone, email, skype and the like.

These offerings can be provided by any sized Employer, in any industry, in any state and could potentially be that one differentiating benefit that draws and retains the employee talent you seek.

For more information on the Family Medical Leave Act, please go to the Department of Labor’s Website.

If you’d like to brainstorm on new employee benefits for your group such as the ones mentioned in this article, please reach out to us at Joni or Lachelle.

CNN Article Regarding new care benefits: https://www.cnn.com/2018/10/09/business/starbucks-care-benefits/index.html

*2016 study by the National Survey of Children's Health

Laudra's Lessons - "America's Bitter Pill" Analysis Part 1

A few years ago I read a wonderful article on the healthcare crisis in Time Magazine.  I wasn’t the only one who thought it was educational and insightful as the article won the National Magazine Award for Public Interest.  So when Steven Brill expanded his narrative to include the antics leading up to the Patient Protection Act aka Affordable Care Act aka Obamacare, I had to buy “America’s Bitter Pill,” money, politics, backroom deals, and the fight to fix our broken healthcare system.

I haven’t finished it yet so am some distance from his solution but am well into the problems that the states, the hospitals, the insurance companies, the drug companies and the lobbyists caused to keep the ACA from becoming what it could have been had everyone had the same goal – a better, less expensive health plan for the American people.

 Brill talked to all of the mentioned group. The President of the United States answered written questions submitted to him about the high cost of treatment and the abuses in our system. In 2014 we spent three TRILLION dollars on healthcare, “that’s more than the next ten biggest spenders combined: Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain, and Australia.”  And in many cases, particularly infant mortality, our outcomes are far worse.

Healthcare has turned out to be a windfall for hospital administrators (who earn way more than doctors), drug company executives, and salespeople of medical equipment.  Apple is considered a premier American company but Medtronic, maker of all sorts of medical devices has nearly double the gross profit.   Healthcare is the only industry where technical advancement has increased costs. 

Healthcare is America’s largest industry and it is profit dominated. If the cost of healthcare is cut, incomes have to be cut as well.  Right now healthcare executives are getting wealthier and care users/patients are getting poorer.  Sixty percent of the 1,000.000 bankruptcies in the US were the outcome of high medical bills.

Stay tuned for more information as this will be my topic for the next few newsletters, or you can buy the book by clicking HERE.

All Things Equal

We are truly blessed to live in a state where ethnicities across the globe have come to settle, live, work and play on the sunny islands of Hawai’i.  The faces of the Aloha State span the ages too, with keiki to kupuna an important part of the fabric that weaves our community together.  I would hope to think that the idea of “Equal Opportunity” would be a non-issue in our very liberal and diversified state. But as all business goes, there are rules and regulations set in place to protect and advocate for equal opportunities for all classes. 

Here we briefly remind you Small Employers of your responsibilities when it pertains to regulations set by the United States EEOC – Equal Employment Opportunity Commission:

If you have at least one employee: You are covered by the law that requires employers to provide equal pay for equal work to male and female employees.

If you have 15 to 19 employees: You are covered by the laws that prohibit discrimination based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, disability and genetic information (including family medical history). You are also covered by the law that requires employers to provide equal pay for equal work.

If you have 20 or more employees: You are covered by the laws that prohibit discrimination based on race, color, religion, sex (including pregnancy), national origin, age (40 or older), disability and genetic information (including family medical history). You are also covered by the law that requires employers to provide equal pay for equal work.

National Immunization Awareness Month

August is National Immunization Awareness Month which highlights the importance of vaccinations for people of all ages.  Vaccines are a necessary preventative measure against serious, sometimes deadly, diseases.

During National Immunization Awareness Month, we want to provide resources to ensure that employees and their families have access to this important piece of preventative care. Please read our Resources Article to learn how you can schedule a clinic at your company and other ways you can educate your employees.

As part of health care reform, most Carrier plans cover basic immunizations at 100% (with the exception of some Grandfathered/Grandmothered plans).  These include all of the Advisory Committee on Immunization Practices (ACIP) recommended Childhood and Adult immunizations with flu shots being the most common.  We here at EBC would be happy to confirm your plan status and benefit coverage for immunizations.

Each week this month we will highlight a different group of people.  The first week is for infants to make sure that all the children who are not in daycare are still getting vaccinated. Other weeks will focus on older children, adults and pregnant women.

National Immunization Resources

Educate your employees about immunizations in recognition of National Immunization Awareness Month!

National Immunization Awareness Month (NIAM) is sponsored by the National Public Health Information Coalition (NPHIC). NPHIC, in collaboration with CDC’s National Center for Immunization and Respiratory Diseases, developed communication toolkits to help you educate people of all ages about vaccines recommended for them.  For more information on the observance and to download the communication toolkits, visit NPHIC’s NIAM website.

During flu season, September through February, Carriers offer free vaccinations to their members at participating pharmacy locations, and also offer worksite clinics.  Worksite clinics often require a minimum number of participants and will even cover employees who are non-members of the hosting Carrier. To get more information about hosting a worksite flu clinic, please EMAIL us and we can help facilitate an event with your insurance carrier.