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News and Opinion Concerning Health Savings Accounts, Medical Costs and Health Care Reform

• New York Times: Health Care Hopes. By Paul Krugman. Excerpts: All the evidence suggests that it has finally become politically possible to give Americans what citizens of every other advanced nation already have: guaranteed health insurance. The economics of universal health care are sound, and polls show strong public support for guaranteed care. The only thing we have to fear is fear itself. Unfortunately, there’s a lot of that around. [...]

  John Edwards broke the issue of health care reform open in February, when he proposed a smart and serious plan for universal health insurance — and bravely announced his willingness to pay for the plan by letting some of the Bush tax cuts expire. Suddenly, universal health care went from being a distant progressive dream to something you could actually envision happening in the next administration.

  Senator Clinton delayed a long time before coming out with her own plan — a delay that created a lot of anxiety among health care reformers, and may, as I’ll explain in a minute, be a bad omen for the future. Still, this week she did deliver a plan, and it’s as strong as the Edwards plan — because unless you get deep into the fine print, the Clinton plan basically is the Edwards plan. [...]

  The Edwards and Clinton plans as well as the slightly weaker but similar Obama plan achieve universal-or-near-universal coverage through a well-thought-out combination of insurance regulation, subsidies and public-private competition. These plans may disappoint advocates of a cleaner, simpler single-payer system. But it’s hard to see how Medicare for all could get through Congress any time in the near future, whereas Edwards-type plans offer a reasonable second best that you can actually envision being enacted by a Democratic Congress and signed by a Democratic president just two years from now.

  To get there, however, would require overcoming a lot more fear.

  There won’t be a serious Republican alternative. The health care plans of the leading Republican candidates, such as they are, are the same old, same old: they principally rely on tax breaks that go mainly to the well-off, but will supposedly conjure up the magic of the market. As Ezra Klein of The American Prospect cruelly but accurately puts it: “The Republican vision is for a world in which the sick and dying get to deduct some of the cost of health insurance that they don’t have — and can’t get — on their taxes.”

  But the G.O.P. nominee, whoever he is, won’t be trying to persuade the public of the merits of his own plan. Instead, he’ll try to scare the dwindling fraction of Americans who still have good health insurance by claiming that the Democrats will take it away.

  The smear-and-fear campaign has already started. The Democratic plans all bear a strong resemblance to the health care plan that Mitt Romney signed into law as governor of Massachusetts, differing mainly in offering Americans additional choices. But that didn’t stop Mr. Romney from denouncing the Clinton plan as “European-style socialized medicine.” And Fred Thompson claims that the Clinton plan denies choice — which it actually offers in abundance — and relies on “punishment” instead.

• Reuters, courtesy of the New York Times: One-Third Of U.S. Lacked Health Insurance: Survey. Excerpts: More than one-third of the U.S. population under the age of 65 went without health insurance for all or part of the last two years, a consumer group said on Thursday. The nonprofit Families USA group used data from last month's U.S. Census Bureau report that found 47 million Americans went without health insurance for all of 2006. [...]

  "The huge number of people without health coverage over the past two years helps to explain why health care has become the top domestic issue in the 2008 presidential campaign," Ron Pollack, executive director of Families USA, said in a statement. "The expansion of health coverage in America is no longer simply a matter of altruism about other people but a matter of intense self-interest." [...]

  Texas had the most people without insurance -- 45.7 percent of the non-elderly population.

  The report found that more than 79 percent of those without insurance were in families in which at least one person had a job, 70.6 percent were themselves employed full-time, and 8.7 percent were employed part-time.

• New York Times: Mayo Clinic Recommends Universal Health Insurance Plan. By Milt Freudenheim. Excerpts: The Mayo Clinic jumped into the national debate on improving health care yesterday, calling for every individual to have basic universal insurance as a step toward gradually replacing the current employer-based system.

  But Mayo, in a proposal hammered out over 18 months by a panel of more than 400 health policy experts, is not advocating a government-run single-payer system. Instead, it suggested that private insurance companies be required to offer standard plans with many options, like the Federal Employees Health Benefits Plan available to government workers. Applicants for this insurance could not be turned down, under the Mayo plan.

• Health Affairs, courtesy of Physicians for a National Health Program: Health Benefits In 2007: Premium Increases Fall To An Eight-Year Low, While Offer Rates And Enrollment Remain Stable. By By Gary Claxton, Jon Gabel, Bianca DiJulio, Jeremy Pickreign, Heidi Whitmore, Benjamin Finder, Paul Jacobs and Samantha Hawkins. Excerpts: Premiums for (employer-sponsored) family coverage increased an average of 6.1 percent from spring 2006 to spring 2007. This was the lowest annual increase in premiums since 1999 (when premiums rose 5.3 percent) and the fourth consecutive year in which premium increases declined from the previous year’s increase. Nonetheless, the average premium increase is 3.5 percentage points more than the increase in overall inflation as measured by the Consumer Price Index and 2.4 percentage points greater than the rise in workers’ earnings. Since 2001, premiums have increased 78 percent, while inflation rose 17 percent and workers’ wages, 19 percent. [...]

  Comment: By Don McCanne, MD. Many of the media reports celebrate the fact that premium increases for this year have declined to only 6.1 percent. Stop right there!

  This year’s premium will be used as the basis for next year’s increase. This year it is 3.5 percentage points more than the rate of inflation. That greater-than-inflation increase will never be recovered, and will be added to next year’s increase, and to the increase in every year thereafter. Not only this year’s increase, but the greater-than-inflation increases of each prior year and of each future year are also added. In the past six years alone, the greater-than-inflation increase has been 61 percent.

  Some would say that the increase in workers’ wages is a more appropriate comparison than the rate of inflation. For the past six years, the greater-than-wage percentage increase in premiums has been only 59 percent. Only?

• New York Times: Clinton to Propose Universal Health Care. By Robert Pear. Excerpts: Senator Hillary Rodham Clinton on Monday will lay out a plan to secure health insurance for all Americans while severely limiting the ability of insurers to deny coverage or charge higher premiums to people with chronic illnesses and other medical problems, her aides and advisers say. [...]

  Clinton aides said her plan would preserve a large role for private insurance companies; would promote the use of health information technology and low-cost generic drugs; and would create a public-private institute to evaluate and compare drugs, devices and medical treatments.

  Mrs. Clinton will not try to impose an overall limit on national health spending, the aides said. But she is prepared once again to do battle with insurance companies, which she has said “spend tens of billions of dollars a year figuring out how not to cover people” and “how to cherry-pick the healthiest persons, and leave everyone else out in the cold.”

• USA Today: Clinton unveils details of her health care plan. By Richard Wolf. Excerpts: Determined to avoid the fatal flaws of her 1993 plan, Hillary Rodham Clinton proposed an overhaul of the nation's health care system Monday that would require Americans to buy insurance but allow them to keep what they have.

  The front-runner in the race for the Democratic presidential nomination said that under her new plan, the federal government would spend $110 billion a year to help employers and individuals pay for insurance. About half of the money would come from repealing tax cuts and tax breaks for people with incomes above $250,000; the rest would be saved through efficiencies in the system, such as chronic disease management. [...]

  Health policy experts said Clinton's plan is more centrist than the one 14 years ago because it builds on the current employer-based system. "This is designed to be less threatening to insurers," said Paul Ginsburg of the Center for Studying Health System Change.

• New York Times: Health Plan Overhauled at Wal-Mart. By Michael Barbaro. Excerpts: Wal-Mart, long criticized for its health care coverage, unveiled a broad plan yesterday that is intended to cut employee costs, expand coverage and offer workers thousands of cheap prescription drugs. Starting Jan. 1, Wal-Mart’s insurance will look a lot like that offered by many other American companies, but with some twists that even longtime critics described as innovative. Independent experts praised several features of the plan and said it could represent a turning point for the retailer, the nation’s largest private employer.

  Wal-Mart said it would give each employee or family that signs up for coverage a grant of $100 to $500 to defray health expenses while charging premiums as low as $5 a month. It will eliminate expensive hospital deductibles and make 2,400 generic drugs available to employees for $4 a prescription — about 2,000 more than it sells to customers at that price.

  The plans with the lowest premiums would still charge annual deductibles as high as $2,000 — typical for American corporate health plans, but perhaps steep for Wal-Mart employees, many of whom work part time and earn less than $20,000 a year. And the company’s plans have other limitations, including waiting periods as long as a year for new employees.

• The Boston Globe, courtesy of Physicians for a National Health Program: Health reform failure. By Steffie Woolhandler and David U. Himmelstein. Excerpts: In 1966 - just before Medicare and Medicaid were launched - 47 million Americans were uninsured. By 1975, the United States had reached an all time low of 21 million without coverage. Now, according to the Census Bureau’s latest figures, we’re back where we started, with 47 million uninsured in 2006 - up 2.2 million since 2005. But this time, most of the uninsured are neither poor nor elderly.

  The middle class is being priced out of healthcare. Virtually all of this year’s increase was among families with incomes above $50,000; in fact, two-thirds of the newly uncovered were in the above-$75,000 group. And full-time workers accounted for 56 percent of the increase, with their children making up much of the rest. [...]

  Health reform built on private insurance isn’t working and can’t work; it costs too much and delivers too little. At present, bureaucracy consumes 31 percent of each healthcare dollar. The Connector - the new state agency created to broker coverage under the reform law - is adding another 4.5 percent to the already sky-high overhead charged by private insurers. Administrative costs at Blue Cross are nearly five times higher than Medicare’s and 11 times those in Canada’s single payer system. Single payer reform could save $7.7 billion annually on paperwork and insurance profits in Massachusetts, enough to cover all of the uninsured and to upgrade coverage for the rest of us.

  Of course, single payer reform is anathema to the health insurance industry. But breaking their stranglehold on our health system and our politicians is the only way for health reform to get beyond square one.

New on the Alliance@IBM Site:

• The Future of Your Health? By Rick White, Co-Chair Health and Safety & Web Maintenance, CWA Local 1701. Excerpt: Now the information is starting to flow; at a pace similar to the flow meter reading on the equipment that ‘failed’ and resulted in the “release” of hundreds of thousands of gallons of chemicals into our community environment. Did it happen that way? Apparently, that may have been one way that it happened. The community and the employees of the IBM Endicott facility still don’t know ALL the details.
• From the Job Cuts Status & Comments page
  • Comment 09/15/07: I 'hated' my job when I was an IBM'er. You know the story, remote employee with half the team H1B visas (in other words team meetings were comparable to ordering late night Taco Bell, no offense of course but the language ppl). To cut a long story short, heard lean was coming, basically devoted 80% of my time (while claiming the 50 mandatory hours a week) to finding a new job because IBM sold out. Plain and simple, IBM puts hard working Americans out of work, regardless if it's 1 or 100,000, they are NOT an American company unless it's to reap the benefits financially.

    Prepare, use the company as they've used you, and look forward to your new career without your schiesty manager(s). I'm loving life, rewarded for what I do, paid well, training is actually pushed on us (who would have thought, grow your own employee's, it's like IBM in the 90's, amazing).

    Final thought ... IBM hurts it's American employee's in most cases than it helps, period, didn't used to be that way, used to be once you got onto IBM you were basically set. Now once you get into IBM you can basically plan on getting it up the rear at some point.

  • Comment 09/15/07: Labate - Seems to be common practice to be let go on your birthday -I was RA'd 3/19/07 - a Monday - only because my birthday fell on Sunday this year. Nice touch IBM - Sums it right up doesn't it - I don't miss the BS - but I'm also 50 years old - 26 years with IBM - I still haven't landed a job - The job hunt as you know is to say the least very exhausting - wish you and your family the best -Anonymous-
  • Comment 09/18/07: Sorry anonymous,, I too was RA'ed. 51 years old 26 years with the company, 2+ performer. This is a pattern not a coincidence. Good luck. -Anonymous-
  • Comment 09/19/07: There appears to be certain individuals being tapped behind closed doors and offered an early retirement package. Why not make it fairly available across the board to all. -sonOFsam-
  • Comment 09/20/07: True, I have heard it. That's why the ESC was forcing those who had submitted retirement papers to a specific date that couldn't be changed. Band D's and above seem to get the early retirement incentive automatically. They are building a case for discrimination, but the current administration won't let a case go through. -Mad at not being tapped-
• General Visitor's Comment page:
  • Comment 09/17/07: In solidarity for those IBMers who have been the victim of the unfair IBM LEAN practices that have hit Southbury CT (as well as Fishkill, Poughkeepsie (NY), Essex Junction (VT), and other areas), please boycott the 9/19/2007 IBM "Spirit" Day event in Southbury. -sby_willie-
  • Comment 09/19/07: I worked in East Fishkill for nine years and was fired. It felt great! Doing much better now. It was like getting dumped by an ex who didn't treat me all that well and I realized I would be better off with out them anyway. IBM is sneaky and cant be trusted. Just take full advantage of everything when your there cause no one is safe and a hard working loyal employee means nothing to IBM. Hey Ron what's up! Say hi to Kenny and AL and the hot chicks! -Steve G.-
  • Comment 09/20/07: How did the Boycott of Spirit Day up in Southbury go ? Just curious. I'd like to see boycotts of Spirit Day activities in Lexington KY (and RTP and Boulder). Spirit Day is a hard slap in the face. -Anonymous-
  • Comment 09/21/07: It's starting now. I mean the financial collapse of the United States. This article just about sums it up: America’s Hegemonic Status Slipping Away . IBM is just a tiny part of all this. After the elimination of the socialist threat, America's upper class launched an all out attack on the middle class. They are after the wealth that we accumulated for the past half a century. This must be the greatest heist in history: robbing the richest nation on Earth while keeping us distracted by war, terrorism and religion. We are entering an era of anarchy. Corporations are out of control and they want everything you own. If we don’t stop this madness soon, our children will be slaves and live in Third World poverty.

    The 20th century proved that communism doesn’t work. The 21st will prove the same about globalism. In fact, globalism must be the most idiotic economic model that mankind ever flirted with. It borders on lunacy. No person in his/her right mind can believe that keeping the consumers here and moving the jobs abroad can work. This idea can only come from people who bend over backwards kissing the boots of their corporate overlords and making up any policy to please them and earn their miserable kickbacks. It’s troubling that most people still think left and right. There is no left and right anymore. Today it’s globalism against nationalism or economic lunacy against common sense. Which side are you on and how soon do you think you can start doing something to protect your country and your kids’ future? That is the question. Sorry for being philosophical. Reading about yet another round of layoffs begs the question where it all ends. Well, it won’t, unless we stop it. -Just me-

• Pension Comments page
• Raise and Salary Comments
  • Comment 09/17/07: Here is the monthly salary survey update:
    • Band 2: 4 respondents, avg: $36K, standard deviation: $9K, range: (min/max reported): $24K to $42K
    • Band 3: 1 respondent, $25K
    • Band 4: 11 respondents, avg: $46K, standard deviation: $11K, range: $32K to $60K
    • Band 5: 3 respondents, avg: $58K, standard deviation: $16K, range: $48K to $77K
    • Band 6: 30 respondents, avg: $61K, std dev: $9K, range: $41.9K to $79K
    • Band 7: 63 respondents, avg: $71K, std dev: $13K, range: $49K to $110K
    • Band 8: 64 respondents, avg: $98K, std dev: $16K, range: $55K to $130K
    • Band 9: 30 respondents, avg: $118K, std dev: $17K, range: $89K to $152K
    • Band 10: 11 respondents, avg: $148K, std dev: $25K, range: $107K to $190K

    It has been reported that the "official" range for:

    • Band 6 is 39.5K to 80.3K
    • Band 7 is 53.4K to 108.5K
    • Band 8 (Software Engineer, 01A) is 60K to 144K

    Bands 1-5 are non-exempt (overtime-eligible) while bands 6-10 are exempt. -Anonymous-

• PBC Comments
• International Comments

Vault Message Board Posts:

Vault's IBM Business Consulting Services message board is a popular hangout for IBM BCS employees, including many employees acquired from PwC.

• "through the looking glass" by "SouthRoute55". Full excerpt: Funny, but interestingly realistic post, I left IBM and doing contracting now. Would you believe it my first contract is working for a client along side the IBMers…same group I was in before leaving IBM….its amazing looking at consultants from the other side, 5 big consultants all sitting analysing simple things to death, brain storming the hell out of unimportant things, recycling the same old documents and slides with fancier logos and diagrams, the consultants desperation is just so pathetic, the sad sad sad longing to be recognised for what they are doing (or think you are ). Its sooo soooo sooo saaaaaad and I think suicide is the best solution.
• "It's the PBC thing I think" by "civilliberty". Full excerpt: They're desperate and spending much time over trivial things because they need to justify themselves on their PBC. I saw a lot of this at IBM where consultants create work so they could justify a high PBC rating.
• "Industry outlook?" by "nobodyinparticular". Full excerpt: Hi everyone, I'm finishing up my undergrad degree this year (MIS/Marketing) from a top school and looking to get into the technology/consulting arena. I've been reading the boards from here, Booz Allen, and Accenture trying to get a feel for the overall industry outlook. I currently have a (pretty decent) offer from ACN, but there really isn't any substantive thought on those boards. (At all.)

  So what would you all tell a new grad who loves tech and wants to do consulting? Is this a dead-end industry, with US operations eventually becoming empty shells? Should I look more towards traditional strategy/management consulting? Or should I focus more on niche IT consulting firms? Thanks in advance for any insight/advice/opinions you can offer.

• "Good question" by "Dose of reality". Full excerpt: Here's my take: The way NOT to start a career in IT consulting is with one of the mega firms. You will do grunt work for a long time, be on a slow career track, and will find it difficult to distinguish yourself before you get burned out.

  Going to a niche firm will accelerate your learning curve, but don’t expect to get a decent salary grade until year 4-5, unless you have a distinctive, marketable knowledge base already.

  If you want to consult, you need to be an expert in a technology, have development experience, and project management skills. You can get those in industry, if you find the right company to work for, and the work-life balance will be much better. We have killed the entry – executive pipeline with all the offshoring that we do. We don’t hire best and brightest, because the entry level salary levels are weighted down by the offshore salary rates.

  The best course of action is to get skilled up somewhere else, and then get a big bump moving into IT consulting when you have something to sell. That way you are not spending your formative years underpaid, under trained, and overworked for nothing. Even then, do NOT come to IBM - we have destroyed the resource model from entry level on up.

• "My experience" by "civilliberty". Full excerpt: I have industry and consulting experience. I certainly got well trained in industry, where generally high standards for project management and solution design are required (much more so it seems in the finance industry than manufacturing, where the production engineers tend to rule. They taught me how to think and work in a structured environment, what was good design and structure and why it was good. This set a foundation for the rest of my industry experience regardless of the technology I worked with.

  Unfortunately IBM and others are spooling the industry and devaluing the traditional technical work by moving it off-shore. The reduced salary rates and quality are trivialising this area in the mind of employers, and it seems to be a downward spiral. Those consultancies poised to do well IMHO are those that can offer a good technical solution with good business consulting/client facing skills - they can easily sell the cost benefit of an all-in-one solution to a client if they have the right motivation/rewards for doing so. This requires though building and maintaining the rapport with the client through superior service. The moment a client thinks all you are offering is a technical skill is the moment he looks for the off-shore/on-shore cheaper technical solution.

  There a smaller/medium size consultancies (in OZ anyway) which continue to offer value across the full-spectrum because they've developed and hired well rounded consultants who can engage the client effectively whilst delivering a technical solution - something IBM is either reluctant to do, or lacks to imagination to do. I suspect it';s just easier for them to off-shore rather than innovate, whilst being lucrative for the lazier senior executives.

Modern-Day Robber Baron Corner:

Today's highly compensated executives face many difficulties, including figuring out how they can possibly spend all of the rich rewards they've earned on the backs of ordinary workers. Take a look at the insider trading of many of our IBM executives—spending the cash from all that stock "acquired at $0 per share" must be a real challenge! Or, imagine the difficulty IBM CEO Sam Palmisano will face spending his $10,000 to $20,000 a day pension when he retires!

As a way of helping out our beleaguered, modern-day robber barons this site will periodically feature "spending opportunities" that the "upper crust" of our society may want to take advantage of!

• Register Hardware (UK): Lenovo unwraps Reserve Edition ThinkPad. By James Sherwood. Excerpts: It's been 15 years since IBM first unveiled the ThinkPad laptop and about two years since Lenovo acquired it as part of a $1.25bn spending spree. So, in an attempt to capitalise on its purchase, Lenovo has unveiled a leather-bound, 5000-unit limited edition ThinkPad.

  Dubbed the ThinkPad Reserve Edition, the machine is clad in hand-stitched, ahem, saddle-grade premium French leather, no less. Each machine is individually numbered and comes with all-hours executive-class service and support.

  This, Lenovo claimed, means users receive access to specially trained, dedicated support staff. So if you spill your Martini on it, they might just tell you how to best clean the leather without spoiling it. However, Lenovo didn't mention how documents will be retrieved if you accidentally wipe your hard drive or how to restore the display if you accidentally drop gold bullion on it.