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You may have heard about Big Blue’s recent ad campaign that takes a dig at Amazon.com. In its marketing material, IBM claims to power 270,000 more websites than Amazon, via its cloud computing service. It’s a flimsy jab at Amazon because IBM has been a major laggard in the cloud rental market, having bought its way into the business in July with its acquisition of SoftLayer Technologies.
Far from being a cloud pioneer, IBM has spent most of the past few years downplaying services such as Amazon’s as insecure, low-margin businesses of little interest to a serious computing company. “You can’t just take a credit card and swipe it and be on our cloud,” IBM executive Ric Telford told me in early 2011. The company’s pitch to customers was that it knew them intimately and its cloud system was safer. But thousands of startups, including Dropbox and Netflix, were more than happy to swipe their credit cards and get going on Amazon.
IBM’s cloud strategy has been complicated by questions about its accounting. The company disclosed in July that the U.S. Securities and Exchange Commission was investigating IBM’s cloud-revenue figures. More recently, IBM lost out to Amazon–twice–in a bid for a CIA cloud contract. With the CIA using Amazon, IBM’s security pitch is a much tougher sell. Its $2 billion purchase of SoftLayer, and its use of SoftLayer’s cloud tech instead of its own, appears to strike a final blow to IBM’s old cloud strategy.
The Armonk, N.Y.,-based computer giant has been in Rochester since 1956. For most of that time, it publicly has reported its employees numbers at the end of each year. That practice came to an end in 2009, as the company cited competitive concerns.
The last official IBM tally was 4,200 Rochester employees as of Dec. 31, 2008.
An IBM insider recently took a different approach by filtering the internal company-wide employee directory from the "Bluepages" intranet through a spread sheet. ...
An unofficial data "snapshot" taken on Tuesday found 2,740 full-time IBM employees, 244 contractors, 239 supplemental workers, 348 vendors and 30 part-time employees. The full-time tally includes eight people assigned to work from here for a site outside the U.S., two people outside the U.S. assigned to work for IBM Rochester and one "pre-hire who is not on board yet." ...
IBM officials declined to comment when asked about the calculation. "IBM does not comment on the authenticity of any alleged internal documents provided by an unnamed source, and we do not disclose employee numbers of our IBM locations, for competitive reasons," stated IBM spokesman Doug Shelton in an email response this week.
He cited IBM's charity work and donations locally as well as the high number of patents issued to IBM inventors in Rochester. ...
The number of regular employees in the list sounds right compared to what we know," said Lee Conrad, the leader of the New York-based pro-union group Alliance@IBM. "Clearly the IBM regular employee population in Rochester and the U.S. has shrunk dramatically as jobs are cut ,offshored, and contractors replace regular employee job positions."
Alliance@IBM has unofficial nationwide employee numbers on its website. It lists 66,251 full-time workers, 12,087 contractors, 2,959 supplemental and 6,853 vendors employed by IBM in the U.S. ...
IBM was the city's top employer for much of the late 1950s and early 1960s. In 1966, Mayo Clinic tied it, when each employed 3,600 workers. Mayo pulled ahead in 1967 with 3,850 employees compared to IBM's 3,800. Today, RAEDI says Mayo Clinic has 33,500 employees in Rochester.IBM remains the second top employer, and Rochester Public School system is third at 2,367.
First, underlying business fundamentals matter. Rarely do companies in decline prove to be strong investments. Since 2008, IBM has been unable to grow revenue, and revenue has declined in six consecutive quarters. Importantly, during the last five years, IBM has spent over $17 billion on acquisitions. In other words, it has a negative organic growth rate as competitors like Salesforce.com, SAP, and Oracle have taken share. CIOs have plenty of cloud and business service companies to choose from; it is no longer IBM and no one else. At some point, IBM needs to begin growing again if it is going to sustain cash flows. ...
I believe a reason for this has been the company's dogmatic focus on its five year EPS roadmap. When companies focus on hitting near term earnings target, they often will push off investment or focus on financial engineering to deliver good short-term results with disastrous long-term consequences. Hewlett-Packard (HPQ) under Mark Hurd is a good example of this. In no sector is this truer than in technology where heavy investment is required to maintain a competitive advantage. IBM would be better off throwing out its guidance, focus on the core business, and reposition the company for growth in the future. Instead, management continues to stick to its plan of pulling various levers, namely buybacks, to boost EPS while the business is on fire. ...
Therefore, IBM has a cash flow problem with declining cash flows offsetting the company's extremely large buyback program. IBM has no growth and is in organic decline, which suggests future cash flow erosion that will drag down shares. To get a fair rate of return, IBM shares should fall by at least 6% even under an optimistic view of its business. With a more reasonable forecast of flat revenue growth, its stock has 20% of downside. Warren Buffett rarely invests in tech companies, and I believe he will grow to regret buying this one. IBM is a sell.
It was only fitting since the walls of the gleaming new center are littered with the colorful notes as designers hash out new ideas for IBM products. Rometty’s outsized blue Post-It bore just two words intended to indicate what Big Blue employees say is the company's purpose. It read: “Be essential.” ...
IBM is establishing four such design centers, the first of which is on the company’s North Austin campus off Burnet Road. It opened in July and now employs 100 workers. But officials expect that number to grow to 1,000 during the next five years. ...
The bubbly, enthusiastic Rometty appeared genuinely enthused about the Austin center. “It is the perfect city for a wonderful challenge,” Rometty said. “I believe, if I could be so bold, that the work done here will change the world. This is a re-commitment to a heritage (of innovation) that has transcended IBM.”
Cons: Unrealistic PBC-personal business commitment goals. Total focus is on separating clients from their money. Directed to work more hours at financial period ends to meet advertised revenue expectations. Executed "resource action'...layoffs instead of reassigning trained and effective consultants to fill current openings. Too many psychophants who drank the koolaid.
Advice to Senior Management: Learn some leadership skills and quit treating your revenue treating resources ("practitioners") like disposable chattel. Learn to 'walk your talk', consultants are your bread and butter. No, I would not recommend this company to a friend. I'm not optimistic about the outlook for this company.
Cons: Extreme focus on Earnings Per Share is starving many areas of the needed funding for everything from development to commissions. Executive compensation based on stock price is skewing the decision process to focus on short term gain.
Advice to Senior Management: Abandon the road map, stop stock buybacks, eliminate all excess management layers (including executives), and establish a long term focus on revenue growth. Given the level of expense pressure, everyone on the payroll should be contributing, but that still isn't the case. Make the choice to divest of certain business areas, but do so before starving them to death. Read the Washington Post article titled, "Maximizing shareholder value: The goal that changed corporate America". No, I would not recommend this company to a friend – I'm not optimistic about the outlook for this company
Cons: ...but not bad enough to force you to look elsewhere. The frustration, for me and I'm sure for gen x and y, is that IBM is:
Advice to Senior Management: Shed parts of the organization, both people and technology, in a bold, share-accretive way that allows the sprinters to sprint and the linebackers to block. I'm not optimistic about the outlook for this company.
Cons: IBM employs a staff ranking system against a bell curve, meaning that 10%+ are always deemed not to have done enough—doesn't work in a company where everybody goes over and above. No delegated responsibility or rewards, just blame. There is also a culture of working longer hours being 'rewarded' more than working smarter, or being more productive with your time. Advice to Senior Management: Get rid of the staff ranking in the PBC process. More carrot, less stick. No, I would not recommend this company to a friend
Advice to Senior Management: You need to steer heavily in the direction of Cloud, Smart Planet and value added services, keep your prices competitive, drop the dead wood executives and business lines (like Strategic Outsourcing) and you may have a chance to dance again. But it's unlikely. No, I would not recommend this company to a friend.
Forcing you to use such drugs could cause allergic reactions or even death; maybe that is what IBM wants. Sounds like a good case for a class action suit. YOUR DOCTOR knows what they want you to take and the "Insurance" groups are NOT YOUR DOCTOR. Sounds like IBM is trying to save themselves a few dollars ( IBM IS SELF INSURED ) and don't care what the effect to you is.
"When I write a prescription for a patient sometimes an insurance company denies coverage because it is not in their ever shrinking formulary. They often suggest that I try another medication and even have the nerve to specify my choices. This pressure tactic is totally outrageous. The insurance company has not examined or diagnosed my patient and is not qualified to do so. How can they dictate the treatment? They rely on the diagnosis code I supply and then consult the list of medicines in their formulary that they will pay for to treat that diagnosis. We call it "cookbook medicine." Patients sometimes react by asking me to prescribe "something else." When possible I do, but sometimes that "something else" might be ineffective exposing the patient to a waste of time, money, and lengthened suffering. Sometimes there simply is no "something else."
"I am a specialist and it is my job to provide care within my specialty that is better than those who do not practice my specialty. Sometimes this requires special medicines. I use generics whenever possible as long as I am convinced that the generic will be as effective as the branded drug. It is the insurance company's job to collect premiums, raise copays and deductibles, and limit the outflow of dollars. Many have shareholders and investors to please. Even many generics are now being refused coverage by insurance companies as too expensive or nonformulary. With the high price of medication it is unfortunate that I must advise some patients to pay for their medicines out of pocket. Getting better faster is more cost efficient. Insurance companies should trust "
When I called the Employee Help Center, they said they can only tell you the rates ONCE you are on leave. Well, that's not very helpful, is it? Appreciate any insights folks may have! Thanks for reading.
After my COBRA ran out on September 30th of this year, I switched to the mid-deductible PPO (without an HSA.) The cost for the two of us on it is around $1400 per month.
Not sure what I'll do about next year...I'm shopping the ACA exchanges since I should be eligible for a subsidy given my post-retirement income. (I'm 58 years old.)
For what it's worth, I've been trying since Oct 1 to complete and submit my ACA application (I too should get a big buckaroo subsidy) but have not been able to. My application just loops back to some prior screen. I asked here a few days ago if anyone thought it made any sense to go ACA now and let FHA sit. Even if it's possible to go ACA now, given the current mess it would seem prudent to wait until 2015.
The IBM Employee 2014 Enrollment Guide address this by stating that the plans are grandfathered (p.8). The IBM Retiree 2014 Enrollment Guide for non-medicare retirees makes no such statement that I can find.
The NetBenefits rep I spoke with today didn't know the answer, and thought I was referring the the HIPAA continuous coverage certificate. I appreciate hearing from anyone who has a definitive answer, and better yet, can direct me to something in writing.
The stated rationale: mental health services are available under the EH plans.
That rationale ignores the fact that EAP had many services unrelated to mental health, such as helping to find community services like: wheel chair transportation, home helper services for house-bound seniors, and I'm sure there are many additional ways that EAP helps with other life challenges that are, again, unrelated to medical or mental health.
Page 9 of the first IBM EH "Announcement Newsletter" does indeed omit EAP from the list of benefits that IBM continues to provide after the transition to EH. IBM should have stated it more clearly, imo, that EAP is dropped.
EAP is still provided free to a non-medicare eligible spouses/dependents, according to the ESC rep. The benefit does not extend to medicare-eligible family members. This was a surprise to us. Anyone else?
Omitting a benefit from a list is not the usual way of announcing that it is no longer provided.
I already gave IBM (thru ESC) my feedback on this loss. I suggest others do the same. Maybe EH has a replacement in mind for the future.
|IBM High Deductible PPO - Anthem||0.00||532.00||0||500.00||6%|
|IBM Med Deductible PPO - Anthem||296.00||1230.00||278.00||1157.00||6%||6%|
|IBM Low Deductible PPO - Anthem||473.00||1650.00||445.00||1552.00||6%||6%|
|IBM High Deductible PPO With HSA Anthem||251.00||1153.00||236.00||1085.00||6%||
|IBM EPO Anthem||338.00||1410.00||318.00||1326.00||6%||6%|
|IBM CIGNA DMA||22.00||53.00||21.00||51.00||5%||4%|
|IBM High Deductible PPO - Anthem||593.87||1,187.75|
|IBM Med Deductible PPO - Anthem||710.23||1,420.47|
|IBM Low Deductible PPO - Anthem||965.39||1,930.77|
|IBM High Deductible PPO With HSA Anthem||685.48||1,370.96|
|IBM EPO Anthem||813.76||1,627.52|
|IBM CIGNA DMA||36.14||67.73|
I'm fortunate to live in the county that I do. NC has the least ACA competition of any other state that I am aware of. The majority of the state only has one insurance company available where I have two. It makes a big difference in the available policies and prices. It's interesting to note that before the ACA I could find similar health coverage that was lower in price than IBM charges FHA retirees. My problem is preexisting conditions did not let me get this coverage until the ACA.
I really think IBM is inflating the cost. Not just based on my wife's plan rates but those available from other sources. I don't necessarily believe IBM is doing anything not allowed by law but the law allows for a number things that can be used to inflate the cost of the plans. It's more of an ethical thing than legal and we all know what has happened to ethics within IBM.
Having the employees and retirees in the same pool makes a huge difference in the rates. It means that the employees end up paying a bit more to subsidize the retirees, but the retiree rates end up being much lower.
IBM used to do it that way years ago, but then they split the retirees into a separate pool and the rates became much higher.
I have friends who have access to retiree-only insurance from other companies and I find that the rates they pay are very similar to what IBM charges.
It's no surprise that the ACA rates are lower than the IBM FHA rates. What you are seeing is the effect of a larger pool of people, many of them younger. Plus the fact that the ACA limits the difference in rates that can be charged for younger vs older people to no more than 3x. Prior to the ACA, a factor of 5x or more was not uncommon.
When I checked the ACA exchange rates in NY a few weeks ago, I could find plans with similar benefits that cost about 1/4 to 1/3 less than the FHA plans. So when the FHA money runs out, it makes perfect sense to switch to an ACA plan from the echanges.
But if you think the less expensive insurance available under the ACA might go away, then you have to balance that risk against the FHA risk. I don't know how to evaluate that with any certainty. So I guess once again, we are left with a situation where we each just have to go with our gut instincts after giving all of the possibilities some thought.
Since the ACA involves many more people than just IBM retirees, I think it will be much harder for Congress to completely do away with it and the plans and the exchanges will survive in some form, with possibly changes to the mandates. Just my opinion.
After this year IBM plan premiums won't really be an issue for me. While I intend to maintain Access Only I highly doubt I will ever use it. I also feel IBM will drop the Access Only altogether at some point. One reason is due to it's cost to IBM. I also expect the ACA plans will draw most folks who are Access Only due to it's lower cost and no longer having restrictions for preexisting conditions.
What upsets me tremendously is that when I was hired almost 50 years ago, I was told that we would have "cradle to grave" coverage. In essence, we have no dental coverage, and the medical coverage is a joke in my state, where we have only ONE Medigap company, with 3 options. I don't call it a CHOICE, when you only have one company to "choose" from. Shame on IBM for yet another reneg of promises made.
The other promise when I was hired, was that as long as I performed my job well, I would always have a job with IBM. I was always and 1 or 2 performer, and a regional specialist. I was part of the 1993 purge that took place. In fact, on my team of specialists, there were 13 of us. All of us were forced out, while our manager kept his job, even though he had no one left to manage. That's the "good old boys" network for you.
The changes were something IBM chose to do all on its own. And yes, some retirees are paying more (much more) and others are paying less. But it was purely an IBM business decision that had nothing to do with Obamacare, even if IBM might like you to believe otherwise.
On the date I retired, I was promised that "coverage will be continued under the IBM Medical Plans with Medicare for: The surviving spouse for his or her lifetime"! I not only have it in writing, but was given a "Retirement Financial Analysis" showing Post-Retirement Medical Coverage with the following: "coverage under these plans is extended to your dependents for their lifetimes as well as your own"!
So, not only did IBM "promise" this to me, it presented this to me as a lifetime benefit as a retiree. With this language, I see no legal way that IBM can now change its mind and blatantly try to charge us for what is already ours.
BTW, I have those documents I am quoting from! -Ev Merritt
Does anyone take few minutes and think what type of social structure are we promoting? Think how our next generation will live and what are we leaving behind? A trashed and crumble social structure for our kids. Hope they will not kick our graves and curse because our stupidity.
Among the 180 executives surveyed by Towers Watson in cooperation with Institutional Investor Forums, 58% said they already have or expect to offer lump-sum payouts to former employees to get pension risk off their books. That’s especially true of companies that are ultimately planning to shut their plans down, with 87% saying that they expect a lump-sum offer to former employees to be a part of that process. ...
While the number of defined-benefit plans has been declining for many years, companies that still have them say that they are important for employee recruiting and retention. Among the roughly 30% of respondents that still have open pension plans, 73% said the plan was important to their ability to bring in new talent, and 87% said it was critical to their ability to retain workers.
I am also wondering if anyone here has opted out of the Extend Health suggestions and found their own supplemental, even the ACA?
Any assistance would be helpful. We plan on calling EH tomorrow, but were working on it Sunday and didn't have access to a live person. Thanks for any guidance. Sharon.
If she is 65 or older she does not have access to the ACA, so forget that. You can put her zip code and any prescription drugs into a search at Medicare.gov to see what plans are available in her area. Many of us find a better medical plan here, and buy the Part D Rx plan through Extend Health. If she does not take any drugs now, many find the Humana Walmart Rx Part D plan best as it has a really low premium of $12.60 a month. If she does take a drug, let the Medicare,gov search tool guide as to what is the best Rx plan for her.
After you decide what medical and Rx plans you want, go to Extend Health and do the same search there is see which of the plans are available at Extend Health. There will be fewer plans on Extend Health as insurers decide if they have all, some or none of their plans on the Extend Health (or any) exchange. They do not want to pay commission on standardized Medigap plans so there are very few of these, but usually a lot of the Rx plans, which is why many of us buy the Rx plan through Extend Health.
Some of us like the Medigap plan F because that pays for everything. Others like the Plan N or the high deductible Plan F because these plans can have a very a low premium with some minor cost sharing for Part B things (doctor). With Medigap plans she can go to any doctor or hospital that accepts Medicare It is only the Medicare Advantage plans that have networks that can be very restrictive and a cost sharing for everything including hospital costs.
Some states like NY and some insurers do not have underwriting that charges you a premium based on your health status. Because IBM is closing their plans this year, you do not have to worry about that at all for year 2014, but in the future it can be a concern if you decide to later change the Medigap plan - you may be rejected or have a high premium.
What state are you in?
Call your Mom's doctors to see if they accept the plan you want, and as it is blue cross I am sure all do. I went with Blue Cross, they are great in my state.
“Out of Pocket” – also known as OOP – is just the expense that your mother would pay herself, after insurance paid their portion. If she has a Medicare plan and a supplemental plan, then OOP expense is usually minimal.
By “network doctors,” are you referring to doctors that take Medicare (which is most of them), or are you referring to an Advantage plan, HMO-type, where there are only certain doctors that the plan uses? Easiest way to find out is to call the doctors, and/or the plan itself to check this. Personally, I’d call both the plan and the doctors; as we’ve been reading in this newsgroup we’re finding all sorts of contradictory information everywhere.
Lots of us have partially “opted out” of Extend Health (EH), although there’s no formal “opted out” process, we just don’t use them for some things. But your mother does need to have either (or both) a supplemental plan (Medigap) or a prescription drug plan (PDP – this is a Medicare Part D plan) purchased through EH to receive the HRA subsidy ($3000 or $3500) from IBM.
After a couple months experience with EH, I’d say that the majority of the IBM retirees using this newsgroup believe that you CANNOT trust most advice you will receive from EH. Beware. Ask questions on this group and compare our answers to those from EH. Also be aware that there’s still some controversy as to whether we’ll receive the subsidy if we purchase only a Part D plan – many of us do believe that (if you search the archives on this group, you’ll see a lot of discussion about Dr. Rhee’s statement to group members). But some die-hards don’t believe that, especially since IBM itself has made no written statement through a legal document (lots of discussion about that, too).
Finally, the ACA does not apply to Medicare enrollees. Ernie.
I was scheduled at 6 pm, but nobody picked up the phone on the other end until 6.47.
Then the person who did the enrollment told me that he did not know anything about the plans, that he was a data reader, that if I had any questions he had to transfer me to somebody else.
Well, we started with the dental, the Humana plan for 21.99. He asked me maybe six or seven times the same questions including my gender and that of my wife. Then he said that he had her to be enrolled on Dec 1st. this year. When I said that that was not the case, he had to call a supervisor. That took maybe 20 minutes between wait time and a repetition of the same questions.
Finally we proceeded to the MC. He was there to enroll me on the AAR UHC PPO. I asked him if he knew this plan, and he said no, that if I had any questions he had to transfer me to someone else.
I said I did and he transferred me to a woman, saying to her on an open line that I could listen to that I had questions "about every thing" even if it was my first question. So I asked her 2 questions:
A, if she had had training on this plans or if she was going to read from the same source that I had access to, and B if CVS Caremark was on the network.
To question A she said that she did not know what information I had access to, a very dumb answer as they were both reading my preregistration on the EH page but that she had to read from a computer and B, that CVS Caremark was NOT on the list.
So, having had confirmation that neither one of them was capable of giving me any type of advise we continued with the repetition of questions ad nauseam until 7:45.
Supposedly a company name BEDCO or something similar will contact me about setting up the HRA account. And that was it.
Obviously EX got this fat contract from IBM and ran to hire a bunch of part timers that will be laid off after December 31st.
That took about 90 minutes, which included about 15 minutes of actual conversation with EH employees, 70 minutes of listening to various versions of their hold music and 5 minutes navigating their automated welcome system twice (when I first called in and when I had to call back after they hung up on me). They probably did detect some exasperation in my attitude after the first 30 minutes.
Most of the EH employees were so highly compartmentalized that they only had one narrow area of responsibility and were unable or unwilling to answer anything else. (Is this what it takes to become one of their licensed professionals?)
I found repeating my name, gender, SSN, birthday, etc., multiple times to the same agent within a few minutes to be a deliberate waste of my time.
In this forum it was mentioned there was a 5% discount if both husband and wife purchase the same plan. I was told that is not available in New York. I asked why and no one knew. Has anyone in NY received the 5% discount??
It was also mentioned you can change plans mid-year if you are not happy with the plan you are on. The EH rep told me if I change I am subject to underwriting for the change. I don’t remember underwriting being mentioned as a requirement if I change mid-year.
The first EH rep said I could use my credit card for auto payment of my plan k premium. The licensed rep said they would have to send me a bill and I could then pay by credit card. No auto pay using a credit card. I arranged for my premium to be deducted from a credit union account and the HERA will send the reimbursement directly to the credit union account.
For drug plan I am staying with SilverScript for 2014.
I will probably use Costco for vision. At 72 my primary doctor send me to an Ophthalmologist for Cataracts and Glaucoma and eye tests as medically necessary. Friends who have used Costco say their glasses are very well made and reasonably priced.
I am going to the dentist Thursday and I will get the names of the discount dental plans they work with. I have spoken with a few plans and for an upfront premium of $150 - $200 total for my wife and myself the dentist provides services at discounted prices. One example from my dentist was a cleaning is $101 and the discounted price is $61. My dentist checks my mouth after a cleaning and charges $35 and if I get my teeth cleaned 3 -4 times a year I can refuse the checkup every other visit.
I will get more cleanings at just about the same cost when the premium and dental expenses from the IBM dental and the discounted dental plans are compared.
I was concerned as earlier this year I had lost a vision reimbursement because I followed a verbal instruction and was later told the advice was wrong and I was out of luck. Spent 2 months trying to rectify/escalate and finally just gave up in frustration.
After having to escalate I talked to a very cooperative person who after listening to me and contacted EH directly. EH was not able to provide any formal documentation.
She then told me she would call her IBM contact and that I would either get a phone call or email directly from IBM regarding my concerns,
I waited a week+ and did not here from IBM. I called back early last week and while I did not talk to the same representative (they had some phone issues connecting me) the person on the phone was in contact and told her that I had not heard from IBM.
The latest SPD available on NetBenefits is USHR 0012, effective January 1, 2013. You should write to the Plan Administrator and ask for a copy of the updated SPD and Legal Plan Document, since you have to make a choice of health care plans with incomplete information and January 1, 2014 is too late for you to make any changes to your choices.
The Plan Administrator can be reached at:Office of the Plan Administrator
Also, the assumption that IBM *wants* you to have the HRA subsidy is probably not a good assumption. Back in 1999, it became crystal clear that IBM wanted to take away all the retiree pension and medical benefits they could get away with, and they have continued to do so ever since.
As you say, it is sad. But that is the IBM of today. IBM changed to a cold hearted company over 20 years ago.
Last week, I called to ask a simple question, when a benefit adviser answered and persuaded me to go ahead and choose my options. I had already filled out my doctors and prescriptions on the website.
I knew I wanted a Medigap Plan F plan. The advisor recommended AARP United Health Care for my Medigap plan and AARP Drug Plan. I did tell the advisor that I am also covered by my husband's medical and drug plan. My husband has an excellent health plan since he retired from the Federal government.
I am eligible for IBM's Future Health Account, which is a lump sum that I draw from to pay my health premiums. I retired in 2007 and became Medicare eligible in 2008. The only reason I signed up for IBM plan previously and Extend Health now is because being in a plan is the only way I can draw from my FHA. Previously the FHA could only be used to pay health premiums. It does not go to my heirs. If I don't use it, I lose it.
I told the BA that I was also covered by my husband's plan both medical and drug and asked if there was any problem being covered by both plans. He told me many IBM retirees have more than one coverage and it is not a problem. I called my husband's plan and asked the same question. She told me that by having 2 drug plans, I would have very limited options with his drug plan and probably would not receive any benefits from his drug plan even for charges my drug plan does not pay.
I then called back Extend Health and asked another BA is it OK to have 2 drug plans. He went away to check then returned and told me that you can only have 1 drug plan if you have a Medicare D Plan. If I am signed up for 2 drug plans, the Medicare D plan would be my only drug plan and I would automatically be dropped from my husband;s plan. I immediately cancelled the drug plan from Extend Health since my husband's plan is much better. He told me that I will have to have either the medical or the drug plan from Extend Health in order to get reimburse from my FHA. Also, I can get reimbursed from my FHA for my husband's plan premiums, my Medicare Plan B costs and any other medical expenses that I have to pay out of pocket.
The Vision and Dental plans are a joke. I signed up for both initially. Then I read the fine print and discovered that with the Dental, I would be paying $50 a month; $600 a year and the max I can receive is $1000 a year. I would pay $600 to receive $400. I normally only have 2 cleanings and maybe 1 filling a year, that does not cost $600. My dentist advised that I would be paying more in premiums than what I actual use. I cancelled the dental. I am about to cancel the vision plan also.
Personally, I feel the canceling of IBM retirement plans and forcing us to switching to individual plans is totally selfish and uncaring to seniors, who at this time in their life, most likely have difficulty making decisions. This is a serious decision and it is confusing and upsetting to most of us. If I took the Medical, Drug, Vision and Dental, I would be paying much more than I pay now with less coverage. Individual plans can not be as good as a group plan. We lose the power of numbers to acquire better coverage. BTW, I live in Northern California.
Thank you all for sharing your experiences. I hope my experience helps others. I hope all of you enjoy good health and don't need these crappy plans. Good luck to you in making the best choice for you and your family. Brenda Nickelson.
I currently have a Medicare Advantage plan that was NOT one of the ones listed on EH site. In reading through the responses thus far, it looked like IF I just signed up for one of the IBM Prescription Drug plans and dropping drug coverage from my Advantage plan, that all would be good. Or so I thought!
Went through the call today and the first part was quick and then put on hold for about 25 minutes and passed to another rep. This rep told me essentially that Medicare itself does NOT allow a prescription drug plan alone (unless something like VA or Tricare) to be coupled with an Advantage Plan that does not offer drug. We went round on this for awhile and finally I ended call and called my Advantage Plan (Highmark Freedom Blue Value Rx in Pennsylvania). At first the rep was not sure but in checking with a higher supervisor found this to be exactly correct (is a Medicare rules "gotcha").
So at this point I will likely pass this year on the HRA. I KNOW there are other ways to skin this cat, but I have investigated other Advantage plans offered through EH as well as just using a supplement.
It would have been SO MUCH easier if IBM had just contracted EH to have an HRA for any valid medical expense for a retiree. (most of us married retirees on medicare could have pretty much used it up on JUST the Part B dollars paid to Medicare alone)
Thankfully, I will be able to handle this situation, but others who have to live from pension to pension may have a problem paying the new insurance bills without an increase in their pension starting in January 2014. Am I missing something? I sure don't want to worry anyone if I am wrong.
At first I was told that EH would have to explain it to me, etc, etc. Finally this very nice person explained that yes, as long as I was getting my health care through IBM they were contributing $3500 per month towards my insurance. However, when they moved me to HR, because my husband was no longer living that amount got cut in half. Had my husband still been alive and he had selected survivor benefits for me at the time of the transfer to EH, and then passed away, I would have retained the full benefit amount. I told her that did not make sense, he had already done that when he retired and now he is deceased and they are moving me and there is no way he could "check" any form today. He retired believing that I would always have full benefits. She said she understood, but that is the way IBM handled the widows and widowers in this transition.
I ask if there was anything or anyone I could speak to because it seems so unfair that IBM could just take away 1/2 of my health benefit when my husband had designated differently and they had been paying differently. She said that is how IBM decided to handle the transition to the EH Insurance and there is nothing that could be done about it. I am still in shock as I type this. So end result is that IBM kept half of the $3500 and gave the other half to EH. EH then takes a portion out of the $1700 leaving me with $1,189 to purchase my medical, dental, prescription drug and vision insurance. Basically I just lost $2,311 annually.
This seems so unfair if not illegal. I could understand if they gave EH the $3500, then EH take their portion. At least this would leave me a couple thousand, but to cut it in half as they send it to EH is unbelievable!
Since your husband retired after 1992, IBM was contributing up to $3000 (not $3500) per year (not month) towards your medical. We don't know exactly how much since we never saw that money but know it did not exceed $3000/year.
Here's what I think is happening. IBM is treating your situation as if your husband had chosen the IBM Survivor Coverage option. That means you, as a surviving spouse, will get an HRA amount of $1187 (not $1189) towards your medical starting in 2014 and every year after. So the amount they told you is correct within $2.
Strangely, it could be a lot worse. If IBM had treated your situation as if your husband had NOT chosen the IBM Survivor Coverage option, you would be getting nothing ($0) towards your medical starting in 2014 and every year after. Dave H.
With the HRA, the average of $3000/$3500 is provided to each eligible retiree. If the retiree chooses surviving spouse coverage, the annual funding is actuarially reduced to $2374/$2600 since it covers two lifetimes (2nd to die). As being one person, the surviving spouse’s coverage is half of $2374/$2600, or $1187/$1300.
Like I said, subtle, but important clarifications. Note that, even with all the handwaving, at no time did Dr. Rhee’s hands leave the ends of his arms in his presentation.
Nancy’s husband’s survivor benefits depended on his Plan in effect when he retired (2000). Could someone post the benefit documentation for that time? Was surviving spouse medical benefit 1-year, 2-year, lifetime?
Nancy: Sorry about the loss of your husband, and hope we can help you through this benefit change.
Netbenefits refused to put in a request for clarification of his retirement date, saying that their records show he was on disability through 2006 (his year of death) which was the date they were using; and the older records going back to 1990 are no longer available. My husband OFFICIALLY retired in 1990 (the gold watch, luncheon and all).
I always wondered why the pension I received from IBM was so much smaller than my husband said I would receive. I now think they did the same thing with that and used the 2006 date.
If you did not start receiving a pension until after his death, then I believe what IBM is telling you is correct. From IBM's point of view, he was out on long term disability until his death, at which point you became eligible for 50% of his vested pension under what is called the Pre-Retirement Survivor Protection provision.
If he started receiving a pension before his death, then he was indeed officially retired, But how much you receive after his death depends on the Joint and Survivor option he selected. The default would be 50% of his full pension. He could have chosen a greater or lesser percentage at the time he retired. Choosing a greater value would have reduced the amount of his pension while he was still living, while a lesser value would have increased it. The J&S option is basically a choice of giving up a part of your pension in exchange for an insurance policy that allows payments to continue after the death of the retiree.
But all this would have had no effect on what IBM is telling you your medical benefits will be in 2014. My personal opinion is that the reduced amount is wrong from an ethical point of view but, unfortunately, there are few legal protections for retirement medical benefits and IBM can pretty much do what they want.
If an employee dies before retirement, the spouse receives the default 50% survivors pension benefit. Generally that is true, but as usual, there are special situations. Maybe this is what happened in your case.
In my state the zero premium MA plans are going away, Aetna's only zero premium plan this year is a lower benefit basic HMO plan without drugs. All MA plans in my state seem to have the max deductible of $6700, and plus premium. As the federal generous subsidy of MA plans is reduced each year and goes away, benefits will decline and costs will rise.
Due to this, many on MA plans are switching to the new (2010) Medigap N plan that has the best of the MA and the Medigap plans—very low premium (mine is $98) and coverage is complete like Plan F if you are healthy and don't go to a doctor—if you do it is only $20 a visit after you pay the low Part B deductible. Some find the HD Plan F to be their low premium plan and with total coverage after the $2140 deductible in 2014. Plus you can see any doctor, hospital that accepts medicare, there is no requirement to use a local limited network like with MA plans which, if you leave the area, is treated like worldwide emergency only.
As we see in CT, doctors are being eliminated from networks so those doctors who accept low negotiated pay may be the only ones left. If you are on an MA plan and get very sick, besides paying the maximum costs, you may not be able to get into a friendlier lower cost Medigap plan due to underwriting requirements.
I have friends who are on MA plans and they love it. It is a very personal decision and based on what is available in your zip code and what you think is best for you and your budget and health.
Do I STILL need to call Extended Health?
I want to continue with Aetna and will drop my dental and vision as they are worthless coverage (dental doesn't cover much, and Blue Anthem for vision is a lousy vision plan)
Make sure you understand the changes before you make your final decision.
Having said that, you MUST submit your survivor coverage form this year even though you may not see HRA money for a year or two.
The Exchange Health agent that I talked to didn't have an immediate answer and after putting me on hold came back and said that I could. I asked if he would send me an email or point me to a document that discussed 'life changing events' and enrollment options but he could not. I want to know that I can enroll at the same cost and with pre-existing conditions not being a factor.
Does anyone know of any documentation on this topic or know how to get Exchange Health or IBM to respond in some soft or hard copy form to questions such this? Thank you. Walt Witt.
Alliance reply: What is the actual date of the form or the document? When was it published? "...many years ago" is a clue that IBM has changed its policies by now. IBM can change its policies at any time. There are no laws that protect IBM retirees; except the ERISA law and the Pension Guarantee Fund rules, regarding pensions. IBM is not legally bound to make disclaimers, since they made their own rules and they can break them. If IBM workers had formed a union "...many years ago", there could have been contract negotiations that focused on employee benefits and the rules that IBM agreed to follow, via that contract.
Alliance reply: IBM used to appear "morally bound" to IBM employees in the years before the 1990's; but sadly, the Corporate executives in the 1990's did not carry on with any of IBM's policies of respect for the individual employees. Policies were changed, and management began to fire (layoff) employees by the hundreds in 1994 and continue to do so.
They were never really "legally bound", because IBM never had a union for its employees.
They still don't. Even though you may not like unions or feel they are necessary in IBM; a union contract between IBM and its employees *could* have put medical plans and pensions in writing and *made* them legally binding. If currently active IBMers decide to organize and form a union that can bargain a written contract, then IBM in the US *could* be legally bound by contract, to keep commitments to their employees. Alliance@IBM is still trying help US IBMers do just that. Thank you for your comments.
We created this comment section because we appreciate hearing from IBM retirees, everywhere
While Republicans plot new ways to sabotage the Affordable Care Act, it’s easy to forget that for years they’ve been arguing that any comprehensive health insurance system be designed exactly like the one that officially began October 1st, glitches and all.
For as many years Democrats tried to graft healthcare onto Social Security and Medicare, and pay for it through the payroll tax. But Republicans countered that any system must be based on private insurance and paid for with a combination of subsidies for low-income purchasers and a requirement that the younger and healthier sign up. ...
Thirty years later a Republican governor, Mitt Romney, made Nixon’s plan the law in Massachusetts. Private insurers couldn’t have been happier although many Democrats in the state had hoped for a public system.
When today’s Republicans rage against the individual mandate in the Affordable Care Act, it’s useful to recall this was their idea as well.
In 1989, Stuart M. Butler of the conservative Heritage Foundation came up with a plan that would “mandate all households to obtain adequate insurance.” ...
Romney’s healthcare plan in Massachusetts included the same mandate to purchase private insurance. “We got the idea of an individual mandate from [Newt Gingrich], and [Newt] got it from the Heritage Foundation,” said Romney, who thought the mandate “essential for bringing the health care costs down for everyone and getting everyone the health insurance they need.”
Now that the essential Republican plan for healthcare is being implemented nationally, health insurance companies are jubilant.
Last week, after the giant insurer Wellpoint raised its earnings estimates, CEO Joseph Swedish pointed to “the long-term membership growth opportunity through exchanges.” Other major health plans are equally bullish. “The emergence of public exchanges, private exchanges, Medicaid expansions … have the potential to create new opportunities for us to grow and serve in new ways,” UnitedHealth Group CEO Stephen J. Hemsley effused.
So why are today’s Republicans so upset with an Act they designed and their patrons adore? Because it’s the signature achievement of the Obama administration.
There’s a deep irony to all this. Had Democrats stuck to the original Democratic vision and built comprehensive health insurance on Social Security and Medicare, it would have been cheaper, simpler, and more widely accepted by the public. And Republicans would be hollering anyway.
The template for the Affordable Care Act was the Heritage Foundation’s 1992 report for expanding the health insurance marketplace. Their plan had tax credits, while Obamacare has income-based subsidies paid directly to insurers to make it affordable to the poor, working class and middle class. As former Secretary of Labor Robert Reich points out, this was the Republican’s and insurance industry’s plan, not the Democrats, who wanted to expand existing government programs. Its reliance on the private sector was flawed from the start and is at the core of its current troubles. ...
All insurers didn’t have to cooperate—and didn’t. Not every health insurance company decided to participate in the ACA, which left many small states with very few options for uninsured residents. That means Obamacare is not offering a range of plans, in which competition is supposed to lower costs, in states like Maine and New Hampshire. That’s left state legislators wondering if they will have to create interstate compacts with neighbors to create coverage pools to attract private insurers to give residents more choices. Again, insurers did what was best for their bottom lines, not for the public health. ...
“Had Democrats stuck to the original Democratic vision and built comprehensive health insurance on Social Security and Medicare, it would have been cheaper, simpler, and more widely accepted by the public,” wrote Reich. “And Republicans would be hollering anyway.”
Instead, Obama and the Democrats trusted the private insurance industry, thought it would do its part, and not keep stabbing them—and policyholders—in the back. That doesn’t mean the ACA doesn’t have positive features, as Obama keeps saying in speeches, but with the President as a punching bag the industry can keep doing what it has always done: put its profits first.
The US system is a stark testament to the fact that, at least when it comes to health care, more competition doesn’t lead to lower prices or better outcomes.
Three facts are indisputable. First, the $8,500 we spent per person on health care in 2011 was around $5,000 more than the average among developed countries in the Organization for Economic Cooperation and Development (OECD) — and almost $3,000 more than the average in Switzerland, which was the next highest spender.
Second, multiple studies have found that we have significantly poorer health outcomes than most developed countries (see here, and here) – by some measures, we rank dead last. And it’s not just because we have higher rates of poverty and inequality — a study conducted by the National Research Council and the Institute for Medicine accounted for those factors and found that, as Grace Rubenstein summarized for The Atlantic, “even white, well-off Americans live sicker and die sooner than similarly situated people elsewhere.” (American men are also becoming shorter relative to men in other highly developed countries – the average height of a population is a proxy for the quality of prenatal health care and nutrition.) ...
And in health care, competition often drives costs up rather than down. According to Adam Linker, a policy analyst with the Health Access coalition, Medicare costs are highest where there are the most treatment facilities competing for patients. He writes:
More competition drives up the cost of care because when several hospitals are competing for patients and doctors they feel more pressure to build more beds, provide more amenities, and purchase the latest expensive gadgets. Instead of focusing on patient preference and improving care, hospitals are in an arms race to gain market share. That makes health care more expensive for everyone. ...
It may sound obvious, but the biggest reason we spend so much on health care is not only because insurance companies take out profits and overhead — it’s that health care costs us more than citizens of other wealthy countries. Everything from pharmaceuticals to surgical procedures to tests costs us more than citizens of other rich countries (the linked study found only a single exception: cataract surgeries cost more in Switzerland). Even a basic checkup is more expensive here than in other highly developed states. ...
Conservatives believe that more government involvement in health care will lead to less freedom and personal liberty, but when it comes to health care, the opposite is true. Why? First, because private insurers aren’t in the business of liberty. They set rules on what they’ll cover and give you lists of doctors you can see without paying extra out-of-network costs. Until new regulations were enacted under the Affordable Care Act, they shopped for the cheapest customers, denying coverage for people with preexisting conditions and using fine print to deny payments to those they did cover.
“If you're an insurance company, you're trying to hang onto the consumers you have at the highest price you can get them,” health policy analyst Laura Etherton told TPM. “You can take advantage of the confusion about what people get to have now. It's a new world. It's disappointing that insurance companies are sending confusing letters to consumers to take advantage of that confusion. The reality is that this could do real harm.” ...
Washington isn’t the only state where this is happening. Kentucky officials have fined the insurance company Humana for sending out misleading letters that say that rates could increase under Obamacare plans, and that they should renew their company plans. And regulators in Colorado and Missouri have seen similar letters from health insurance companies.
The justifiable scrutiny of Obama’s veracity has melded seamlessly into a second and very different claim: That Obama’s broken promise is not merely a violation of trust, a fair enough charge, but an act of unfairness to those who have lost their plans.
The health-care debate has suddenly come to focus almost obsessively on the alleged victims of Obamacare, who have lost their cheap individual insurance. Here’s Matthew Fleischer mourning the loss of his bare-bones plan in the Los Angeles Times; here’s David Frum doing the same for the Daily Beast. Mary Landrieu, a vulnerable red-state Democrat, is introducing legislation to ensure that nobody can lose their individual health-care plan.
The idea underlying this notion, while facially appealing, is in fact misguided and morally perverse. No decent health-care reform can keep in place every currently existing private plan.
The New York Times has a helpful graphic displaying the structure of the insurance market:
The left and top-right squares show the four fifths of Americans who get coverage through the government. Those on the left who get covered through their employer get tax-subsidized insurance, and those in the top right get insured by the government directly. Obamacare leaves that structure in place (though it has a series of mechanisms designed to hold down their cost inflation).
The main coverage provisions affect the people in the bottom right quadrant. Most of that quadrant lacks any insurance at all, which points to the dysfunctionality of buying individual insurance before Obamacare. Some of them — 5 percent of the population — have a health-insurance plan. Health-care reforms have always thought of the people within that segment as being essentially the same group of people. Those are mainly healthy, non-poor people who have been skimmed out of the insurance pool, leaving behind those too poor, or too likely to need medical care.
Three independent estimates by Wall Street analysts and a consulting firm say up to seven million people could qualify for the plans, but federal officials and insurers are reluctant to push them too hard because they are concerned about encouraging people to sign up for something that might ultimately not fit their needs.
The bulk of these plans are so-called bronze policies, the least expensive available. They require people to pay the most in out-of-pocket costs, for doctor visits and other benefits like hospital stays.
Supporters of the Affordable Care Act say that the availability of free-premium plans — as well as inexpensive policies that cover more — shows that it is achieving its goal of making health insurance widely available. A large number of those who qualify have incomes that fall just above the threshold for Medicaid, the government program for the poor, according to an analysis by the consulting firm McKinsey and Company.
I say that, appreciating that Obamacare will eventually bring health coverage to tens of millions of uninsured people, that it will end the cruelty of denials of coverage based on "pre-existing conditions" (we all have the pre-existing condition of mortality); that it will allow young adults to stay on their parents' insurance to age 26; and that it will require free preventive care under all insurance plans.
But there was a much simpler way of achieving this. We could have extended Medicare to everyone. Or if that was politically unthinkable, we could have extended Medicare a few years at a time -- first to 60 year olds, then to 55 year olds, then to the young, and so on until everyone was covered. ...
But the president, facing the legislative fight of his life, decided to build onto the existing commercial system rather than battling to supplant it with something more public and straightforward. He decided to cut a deal with the big insurance and drug companies, rather than defining them as the problem that they are. ...
By creating something of a Rube Goldberg system rather than battling to supplant commercialized health coverage, Obama courted avoidable political damage multiple ways.
First, consumers blamed the government when the sheer complexity created system failures. No fewer than 55 separate private technology contractors have been involved in the creation of the software that beckons consumers to sign up for Obamacare. No wonder the thing is falling of its own weight. By comparison, Medicare is simplicity itself.
Second, since the president was not willing to finance the Affordable Care Act with broad taxes on the wealthy, he proposed to find something like a trillion dollars in unspecified savings from Medicare, scaring seniors silly and losing the votes of older Americans in the disastrous mid-term elections of 2010.
And third, because the mandated insurance coverage establishes minimally decent standards for acceptable private coverage, the unintended consequence was that a lot of people with really lousy but inexpensive insurance are furious at having to give up what they have. Telling them that they will soon have something better doesn't fix the political damage. ...
One other piece of really bad design: Because it was more expedient (and Republican-friendly) to pay for Obamacare with tax credits rather than a straight subsidy or an expansion of Medicaid, that decision got the IRS involved. Some genius made the decision to have the Obamacare software link directly to the IRS database in order to calculate the precise tax-credit and net cost to the consumer, rather than letting people window shop based on estimated incomes, as is done in the Massachusetts system. (You can window shop on the Kaiser Foundation's website) Because of the need for very high security in the linkage to the IRS database, that feature made the system even buggier.
There is no such problem with Medicare, of course. Everyone simply qualifies once they turn 65. You are enrolled automatically and your card comes in the mail.
Some of those people – mostly younger, healthier people who, because they’re in the top third of the income distribution aren’t eligible for subsidies – will have to pay higher premiums for more comprehensive coverage, even if they don’t want to. This can cause real economic hardship, and that’s a legitimate issue.
But it’s still an issue that will affect only a small slice of the population. Jonathan Gruber, a health care expert at MIT, estimates that around half of those six percent won’t experience any real change. “They have to buy new plans, but they will be pretty similar to what they had before,” he told Ryan Lizza. “It will essentially be relabeling.”
Gruber adds that most of those plans being canceled run afoul of a provision of the law banning any policy that requires people to pay more than $6,000 per year in health care expenses – plans that may lead to medical bankruptcies, the number one type of bankruptcy in the US.
That leaves about three percent of Americans who may face that tough situation where they have to pay more for coverage they may not want. ...
The reality, according to a 2012 study by the Urban Institute, is that “95 percent of those with some type of insurance coverage (employer, nongroup, public) without reform will have the same type of coverage under the ACA .” Maybe a different plan name, but the same type of coverage.
Yet one can be certain that Roy’s claim that 93 million Americans will be harmed when their insurance policies are “canceled,” while misleading on its face, will be ricocheting around the conservative media, taken as prime evidence that Obamacare is ruining millions of lives when, as Jonathan Gruber puts it, 97 percent of Americans are either untouched by the law or are clearly winners.
In the meantime, the health care crisis continues. Fewer people, even those with health insurance, can afford the health care they need because of out-of-pocket costs. The ACA continues that trend by pushing skimpy health plans with low coverage and restricted networks.
This is what happens in a market-based system of health care. People get only the amount of health care they can afford, rather than what they need. The ACA takes our failed market-based system to a whole new level by forcing the uninsured to purchase private health plans and using the government to sell and subsidize them. ...
If all US residents were in one plan, Medicare for all, rather than the ACA's tiered system that institutionalizes the class divides in the United States, not only would the health system be fairer and improve health outcomes, but it would be less bureaucratic, less costly and easier to implement. The Medicare-for-all approach considers health care to be a public good, something that all people need, like schools, roads and fire departments.
Rather than being distracted by the problems of the exchanges, the more pressing issue is whether we want to continue using a market-based approach to health care or whether we want to join the other industrialized nations in treating health care as a public good. This conversation is difficult to have in the current environment of falsehoods, exaggerations and misleading statements coming from both partisan directions, echoed by their media supporters and nonprofit organizations. ...
The Institute of Medicine issued a report in 2013, US Health in International Perspective, that documents the failure of the US health care system. In summary: "Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, 'peer' countries."
Obama was wrong to promise that everyone who liked their insurance could keep it. For a small minority of Americans, that flatly isn't true. But the real sin would've been leaving the individual insurance market alone.
The individual market -- which serves five percent of the population, and which is where the disruptions are happening -- is a horror show. It's a market where healthy people benefit from systematic discrimination against the sick, where young people benefit from systematic discrimination against the old, where men benefit from systematic discrimination against women, and where insurers benefit from systematic discrimination against the uninformed.
The result, all too often, is a market where the people who need insurance most can't get it, and the people who do get insurance find it doesn't cover them when it's most necessary. All that is why the individual market shows much lower levels of satisfaction than, well, every other insurance market:
Those numbers, of course, don't include the people who couldn't get insurance because they were deemed too sick. Consumer Reports put it unusually bluntly:
Individual insurance is a nightmare for consumers: more costly than the equivalent job-based coverage, and for those in less-than-perfect health, unaffordable at best and unavailable at worst. Moreover, the lack of effective consumer protections in most states allows insurers to sell plans with ‘affordable’ premiums whose skimpy coverage can leave people who get very sick with the added burden of ruinous medical debt.
Jonathan Cohn puts a human face on it:
One from my files was about a South Floridian mother of two named Jacqueline Reuss. She had what she thought was a comprehensive policy, but it didn't cover the tests her doctors ordered when they found a growth and feared it was ovarian cancer. The reason? Her insurer decided, belatedly, that a previous episode of “dysfunctional uterine bleeding”—basically, an irregular menstrual period—was a pre-existing condition that disqualified her from coverage for future gynecological problems. She was fine medically. The growth was benign. But she had a $15,000 bill (on top of her other medical expenses) and no way to get new insurance. ...
If people have a better way to fix the individual market -- one that has no losers -- then it's time for them to propose it. But it's very strange to sympathize with the people who've benefited from the noxious practices of the individual market while dismissing the sick people who've been victimized by it.
Obama is rightly taking flack for making a promise he wasn't going to keep, and he's right to apologize for it. But he shouldn't apologize for blowing up the individual market. It needed to be done.
No, far more serious is the kind of catastrophe facing people like Richard Streeter, 47, a truck driver and recreational vehicle repairman in Eugene, Ore. His problem isn’t Obamacare, but a tumor in his colon that may kill him because Obamacare didn’t come quite soon enough.
Streeter had health insurance for decades, but beginning in 2008 his employer no longer offered it as an option. He says he tried to buy individual health insurance but, as a lifelong smoker in his late 40s, couldn’t find anything affordable — so he took a terrible chance and did without.
At the beginning of this year, Streeter began to notice blood in his bowel movements and discomfort in his rectum. Because he didn’t have health insurance, he put off going to the doctor and reassured himself it was just irritation from sitting too many hours.
“I thought it was driving a truck and being on your keister all day,” he told me. Finally, the pain became excruciating, and he went to a cut-rate clinic where a doctor, without examining him, suggested it might be hemorrhoids.
By September, Streeter couldn’t stand the pain any longer. He went to another doctor, who suggested a colonoscopy. The cheapest provider he could find was Dr. J. Scott Gibson, a softhearted gastroenterologist who told him that if he didn’t have insurance he would do it for $300 down and $300 more whenever he had the money.
Streeter made the 100-mile drive to Dr. Gibson’s office in McMinnville, Ore. — and received devastating news. Dr. Gibson had found advanced colon cancer.
“It was heartbreaking to see the pain on his face,” Dr. Gibson told me. “It got me very angry with people who insist that Obamacare is a train wreck, when the real train wreck is what people are experiencing every day because they can’t afford care.”
Dr. Gibson says that Streeter is the second patient he has had this year who put off getting medical attention because of lack of health insurance and now has advanced colon cancer.
So, to those Republicans protesting Obamacare: You’re right that there are appalling problems with the website, but they will be fixed. Likewise, you’re right that President Obama misled voters when he said that everyone could keep their insurance plan because that’s now manifestly not true (although they will be able to get new and better plans, sometimes for less money).
But how about showing empathy also for a far larger and more desperate group: The nearly 50 million Americans without insurance who play health care Russian roulette as a result. Families USA, a health care advocacy group that supports Obamacare, estimated last year that an American dies every 20 minutes for lack of insurance. ...
The Institute of Medicine and the National Research Council this year ranked the United States health care system last or near last in several categories among 17 countries studied. The Commonwealth Fund put the United States dead last of seven industrialized countries in health care performance. And Bloomberg journalists ranked the United States health care system No. 46 in efficiency worldwide, behind Romania and Iran.
The reason is simple: While some Americans get superb care, tens of millions without insurance get marginal care. That’s one reason life expectancy is relatively low in America, and child mortality is twice as high as in some European countries. Now that’s a scandal.
Yet about half the states are refusing to expand Medicaid to cover more uninsured people — because they don’t trust Obamacare and want it to fail. The result will be more catastrophes like Streeter’s.
“I am tired of being the messenger of death,” said Dr. Gibson. “Sometimes it’s unavoidable. But when people come in who might have been saved if they could have afforded care early on, then to have to tell them that they have a potentially fatal illness — I’m very tired of that.”
But for those of us who think the health security the Affordable Care Act provides marks a fundamental advance in America’s social contract, these White House failures don’t come close to the vices of Obamacare’s adversaries. Let’s just say it: To judge by their behavior, the Affordable Care Act’s enemies couldn’t care less about helping millions of low-income workers achieve health security, and every time they open their mouths, it shows.
When conservatives rant about the latest mess-ups attending the rollout, they never add the obvious empathetic refrain. It would be simple, really. They’d just need to preface or append to their daily attack a line like this: “Of course we all agree we need to find ways to get poor workers secure health coverage that protects their family from ruin in the event of serious illness.”
That’s all it would take. But they don’t say that. None of them. At least none that I can hear. A single omission might seem an oversight. A few might be a sign of distraction. But when day after day you wait in vain to hear such empathy amid the torrent of anti-Obamacare venom being spewed, you realize something bigger psychologically is at work.
Obamacare foes are more than just angry with the “lying” and the bungling they disdain. They are Very Well-Insured People. We all know about “VIPs.” Well, these are VWIPs. Or at least, a certain conservative species of VWIP.
The difference is driven by a difference in the national will. In the rest of the first-world, universal health care is the principle. Governments drive their systems on the basis of this principle. We don't have that, at this point.
When the Bush administration began, we had 40 million uninsured. The Bush solution was to turn the American consumer loose on the problem. Tax sheltered health accounts, coupled with knowledge of outcomes and prices, would empower the consumer to drive inefficiency out of health care. Whereas the rest of the civilized world was doing it with an enforced will to promote the common good, we would do it the old fashioned, American way - informed consumers would drives prices down, making health care affordable to all, just like cars, TV sets and personal computers.
And how did that work? Well, we got the tax sheltered accounts, but we were never given the right information; we still don't know the cost of a colonoscopy and what hospital infection rates are. I liked the Bush idea because it appeals to the American spirit. But it was naive.
In the end, the structure of the health care market is wrong. Insurance companies stand between buyer and seller in the market place, people don't make consumer choices when an emergency hits, and the entrenched powers-to-be were not about to become transparent and tell us what their actual performance is (I still have better quality information available for buying a car than picking a surgeon for open-heart surgery).
And in the end, we had 50 million uninsured and an ever greater percent of our GDP eaten up by health care costs. We actually went backwards.
Now we have Obamacare, which is our shot at getting to universal coverage. In the best case, it won't cover as much of the citizenry as other countries already cover. And there isn't a national consensus that universal coverage is the right thing, as we can see with all of the grass roots pushback and political turmoil. Somehow, private interests have bamboozled the public into believing that the perception of individual choice trumps the common good, that government is evil, and that our system is somehow inherently better in spite of all objective measures to the contrary.
We are a work in progress. If and when we make a commitment to universal coverage, I don't think that it will make any difference if we have private or public funding of health care. Once we place the common good ahead of private interests, we will have a more efficient system with better outcomes. Just like in the rest of the civilized world.
"But dependency on government has never been bad for the rich. The pretense of the laissez-faire people is that only the poor are dependent on government, while the rich take care of themselves. This argument manages to ignore all of modern history, which shows a consistent record of laissez-faire for the poor, but enormous government intervention for the rich." From Economic Justice: The American Class System, from the book Declarations of Independence by Howard Zinn.
As a member of that committee, I realize that our $17-trillion national debt and $700-billion deficit are serious problems that must be addressed. But I also realize that real unemployment remains close to 14%, that tens of millions of Americans with jobs are paid horrendously low wages, that more Americans are now living in poverty than ever before, that wealth and income inequality in the U.S. is greater than in any other major country and that the gap between the very rich and everyone else is growing wider. ...
How did we go from healthy surpluses to terrible deficits? It's not that complicated. In 2001, President Clinton left office with a $236-billion surplus. The nonpartisan Congressional Budget Office foresaw a 10-year budget surplus of $5.6 trillion, enough to erase the national debt by 2011. It didn't work out that way.
Instead, under President George W. Bush, wars were launched in Afghanistan and Iraq without paying for them. The cost of those wars, estimated at up to $6 trillion, was tacked onto our national credit card. Then Congress passed and Bush signed an expensive prescription drug program. It also was not paid for. Then Bush and Congress handed out big tax breaks to the wealthy and large corporations. That drove down revenue. So did the recession in 2008, which was caused by a deregulated Wall Street. All that turned big surpluses into big deficits.
Interestingly, today's "deficit hawks" in Congress — Rep. Paul D. Ryan (R-Wis.), Sen. Jeff Sessions (R-Ala.) and other conservative Republicans — voted for those measures that drove up deficits. Now that they're worried about deficits again, they want to dismantle virtually every social program designed to protect working families, the elderly, children, the sick and the poor.
In other words, it's OK to spend trillions on a war we should never have waged in Iraq and to provide huge tax breaks for billionaires and multinational corporations. But in the midst of very difficult economic times, we just can't afford to protect the most vulnerable people in our country. That's their view. I disagree. ...
Instead of talking about cuts in Social Security, Medicare and Medicaid, we must end the absurdity of corporations not paying a nickel in federal income taxes. A 2008 report from the Government Accountability Office found that was the case with 1 in 4 large U.S. corporations. At a time when multinational corporations and the wealthy are avoiding an estimated $100 billion a year in taxes by stashing money in tax havens like the Cayman Islands, we need to make them pay taxes just as middle-class Americans do.
While Congress in January finally ended Bush's tax breaks for the richest 1%, lower rates were left in place for the top 2%, those households earning between $250,000 and $450,000 a year. That must end. ...
And frankly, Congress must listen better. Some Republicans learned a hard lesson when the American people said it was wrong to shut down the government because some extreme right-wing members of Congress did not like the Affordable Care Act. Well, there's another lesson that I hope my Republican colleagues absorb. Poll after poll shows that Americans overwhelmingly do not want to cut Social Security, Medicare and Medicaid. ...
In fact, according to a recent National Journal poll, 81% do not want to cut Medicare at all, 76% do not want to cut Social Security at all, and 60% do not want to cut Medicaid at all. Other polls make it clear that Americans believe that the wealthiest among us and large corporations must pay their fair share in taxes
It is time to develop a federal budget that is moral and makes good economic sense. It is time to develop a budget that invests in our future by creating jobs, rebuilding our crumbling infrastructure and expanding educational opportunities. It is time for those who have so much to help with deficit reduction. It is time that we listen to what the American people want.
Gross capital investment by the public sector has dropped to just 3.6 per cent of US output compared with a postwar average of 5 per cent, according to figures compiled by the Financial Times, as austerity bites in the world’s largest economy.
Republicans in the House of Representatives have managed to shrink the US state with their constant demands for spending cuts, even though their uncompromising tactics have exacted a political price, with their approval ratings in Congress at record lows.
They needed us for their roads, for their businesses, for their communications, for their transportation, as their customers, and for their overall success.
The super-rich rode on the same trains as us, and flew in the same planes as us. They went to our hospitals and learned at our schools.
Their success directly depended on us, and on the well-being of the nation, and they knew it.
But times have changed, and the super-rich of the 21st century no longer think that you and I are needed for their continued success. ...
The Society of Civil Engineers says that it will take a staggering $3.6 trillion investment by 2020 - or $450 billion per year - to bring the American infrastructure into the 21st century, and to avoid risking a complete infrastructure collapse.
But the super-rich don't care about how much funding is needed to save this country, as long as they have their private schools, private hospitals, private airports and private places. ...
No matter what Jamie Dimon, Charles Koch, or Shelly Adelson will tell you, America's wealthy elite did not make their fortunes on their own. Without a strong economy and infrastructure, America's millionaires and billionaires would not be where they are today. It's that simple. ...
Right now, the burden for rebuilding America is on the backs of working-class Americans, and that's just wrong. It's ridiculous that working-class Americans struggling to survive day-to-day are paying more in taxes than billionaire banksters and oil tycoons.
The billionaires who received the subsidies or owned companies that did include the Microsoft co-founder Paul G. Allen; the investment titan Charles Schwab; and S. Truett Cathy, owner of Chick-fil-A. The billionaires who got the subsidies have a collective net worth of $316 billion, according to Forbes magazine.
The Working Group said its findings were likely to underestimate the total farm subsidies that went to the billionaires on the Forbes 400 list because many of them also received crop insurance subsidies. Federal law prohibits the disclosure of the names of individuals who get crop insurance subsidies, the group said.
The report is being issued as members of the House and Senate are meeting to come up with a new five-year farm bill. The authors of the report said it is timely, given that lawmakers are debating a House proposal that would cut nearly $40 billion over 10 years from the food stamp program, which helps provide food for nearly 47 million people. A Senate provision would cut $4.5 billion over the same period. ...
“The irony is that farm subsidies are going to billionaires at the same time that there are proposals to kick three to five million people off of food stamps,” said Scott Faber, vice president for government affairs at the Environmental Working Group. “This clearly highlights the need for reform to our farm programs.” ...
Mr. Faber said that one of the proposals he found most disturbing in the farm bill would shift money from farm subsidy programs like direct payments, which have income limits, to those like crop insurance, which do not. Other measures would subject food stamp recipients to drug testing, work requirements and income means-testing.
Unlike traditional farm subsidies, crop insurance premium subsidies are not now subject to income requirements, payment limits or conservation compliance, the Working Group found.
“So basically the bills would allow billionaires to get even more in subsidies, all without taxpayers knowing who they are, while imposing draconian requirements on low-income people,” Mr. Faber said.
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