Precept Employee Benefits Blog

This issue is not as simple as it seems. To me, it’s an issue of of property rights of the employer vs. the right of the employee to protect himself. I have a hard time with an employer who will give someone a dangerous job and then forbid them from protecting themselves, despite the employee being fully licensed by the law to carry a weapon in public.

As an example, think of the graveyard shift at a convenience store in a bad area. Should an employer be allowed to make that employee work without protection? Another example would be any employee who closes up a store or restaurant at night and carries the cash to the bank. There’s definitely danger in a job like that, and most small businesses will not pay for expensive armed transport services. Those guys carry guns for a reason.

I find it fascinating that an individual with no means by which to protect himself would dare comment on such a topic. What with all the citizens armed and “dangerous” to both themselves and the public now allowed to carry at work my gosh the steets must run with blood. The fact is Mr. Coulter lives in a world where the constitution does not exist. Nor does the ability to protect oneself and those around them. Rest assured if Mr. Coulter and myself were working in the same office and an armed gunman came into the building to threaten his life…….I and others who have the sense of responsiblity to carry would be his best possible friend. However he is not willing to admit such a valid point. In his mind he would be able to defend himself with some form of “talking it out” with the perpetrator. Before the everone else gets upset…think of this. I have to pay for all expenses in dealing with a negligent discharge et. al. should I “draw on the copy machine line.” Think about it. I am not covered by the police union etc. I must be sure that it is a life threatning situation, this is not the old west….check the nubmers of people that do carry….and the number of “crimes” they commit near the copy machine. Mr. Coulter, do yourself a favor, read a copy of the constitution. Earn some respect for yourself and others by realizing we live in…….oh my goodness a REPUBLIC, not a democracy as you would have us belive.

The principle reason that the Governator’s plan does not address fraud is that fraud is so endemic to the health care system that the revenues of almost ALL physicians and hospitals and chiropractors and medical device makers and ancillary services such as Rx and imaging etc. would be SIGNIFICANTLY impacted. FRAUD accounts not for just a few percentage points but one of the bigget slices of the pie. Almost ALL providers engage in some fraud and quite a few get a MAJORITY of the revenue from fraud.

I agree with many of your comments. Progress is often “two steps forward, one step back,” and bringing medical practice into the 21st century is no exception. I also agree that HIPAA privacy concerns and liability issues give pause to physician offices, hospitals, and health plans who contemplate placing medical records online. Incidentally, this is also one reason why physicians have been slow to adopt email as a way to communicate with their patients, despite overwhelming demand. But organizations are moving ahead with online medical records, and there are compelling reasons for them to face the privacy and liability issues. First, it promises a significant competitive advantage with patients and health plan members. Second, organizations who “stake out turf” in the world of online medical records will have an head start on owning the databases which will drive quality, marketing, and economic decision making. And third, this can actually help avoid litigation over “failure to inform” and other negligent practice lawsuits. The fact is that a number of health plans, including Kaiser and Aetna, are already making online records available to plan members, and plan to roll out national programs this year and next. A coalition of employers has also announced that they will provide their employees with an online medical record system, so they can own their own medical information. There is no shortage of those who wish to provide the service, and while potential liability issues have slowed the adoption of online medical records, I believe that the train has already left the station.

I wholeheartedly agree with you that preying on vulnerable populations for organ transplants is unethical and should not be supported by any government or individual. However, it’s important to note that organ transplants comprise an infinitesimal part of the total medical tourism sector, and most patients traveling abroad for treatment are well within the ethical bounds for common procedures such as dental, cosmetic, cardiovascular, orthopedics, et al. I would also point out that not all countries practicing organ transplants do so unethically. For example, the Albert Einstein Jewish Hospital in Brazil and the National Heart Center in Singapore both perform transplants (liver and heart respectively), are fully accredited, and are held to the highest ethical and procedural standards. Our newly published “Patients Beyond Borders: Everybody’s Guide to Affordable, World-Class Medical Tourism” provides well-documented information on dozens of excellent, above-board choices for organ transplant candidates. While the subject of unethical organ transplants has its place, and aggressive steps should be taken to stop such practices, we do not wish to see legitimage candidates for transplants discouraged amidst a spate of sensationalism on this important matter.

The concierge medical practice model in Fort Myers, FL has been well received. This is where I practice, and in general I have had positive feedback from my patients and the community. The concierge model gives the patient another alternative to manage their healthcare. The patient has immediate access to their physician with same or next day appointmets, phone accesibility via the physician’s cell phone, urgent medical attention in the patient’s home or office when appropriate, and in my office they have access to other ancillary care such as dietitian and personal fitness consultation. The concierge physician is able to personally oversee the patients care to include scheduling of diagnostic testing and specialty consultation which in a non-concierge practice is delegated to the office staff. This type of practice model is not suited for everyone, but for those patients who have tired of the traditional primary care office and feel that their care is marginalized by the perceived lack of physician time, this is an attractive alternative. Patients should have a choice in how they manage thier most important asset–their health. We as physicians should have the resources to be able to give the patient our most valuable commodity–our time. I do not forsee the concerge model replacing the current status quo, but the concierge practice does give the patient an important choice. Wayne M. Burr, MD

It would be bad enough if it were just “vapor” disease management, but what makes it even worse is the breach of trust with employers and their health plan participants. Disease management is promoted to employers with stories about the impact disease management nurses have had on people’s lives, and rightly so. But it is cynical and short-sighted to take advantage of benefit managers who may not have enough health care expertise to realize they are being short-changed, and to deny needed help to their beneficiaries.

Jim, see today’s Wall Street Journal, page D1. The press, including the general business press, has been good about covering this issue, so many of us who work in employee benefits have been aware of Pitney Bowes’ pharmacy programs. I can’t comment on the company’s internal communications of its benefit programs, since I haven’t worked with Pitney Bowes as a client. I would comment, though, that keeping employees and retirees informed of benefit program changes is a difficult challenge for every employer.

Sounds interesting

I think you answered your own question in the last paragraph… the rest of the world’s people are anxious to get here because they can scam an obviously flawed system. And I don’t think anyone is suggesting that illigal “aliens” be provided gov. funded healthcare any more than they already get. I’m not defending Moore, I’m suggesting that our insurance system is a scam and only benefits it’s BODs.

People ARE sneaking into Canada for their healthcare. People come to America to avoid persecution in their own countries, not because their healthcare system is bad. It would be nice to see more facts cited on your site.

Are you kidding me? Mom and Dad at the interviews? Excuse me while I pick myself up from the floor–I’m sorry, our “politically correct generation” has reached retardation. Get over it! If you’re going to join us in the work force, then do it with some class, please.

Open Enrollment for many companies is at the beginning of the year. However for some it’s at the beginning of the new fiscal year such as for universities. Working in the benefits office of a major Big 10 University I have seen many scenarios played out between the GIR (group insurance rep) and the employee; both staff and faculty. The percentage of employees who are not aware of the choices they are making when it comes to their benefits, is staggering. Even though representatives from each of the insurance companies that are offered come to the campus to peddle their wares and explain in great detail what their company will do for the employee. Many do not understand what a flex spending account is, medical or dependent. These accounts can save the employee thousands per year in pre-tax dollars. This is where the GIR needs to be accessed. They can go into great detail with the employee on how the flex works and why it would benefit or perhaps not benefit the employee. Some of the most confused about their benefits and what is offered, are faculty. Those people who have the highest education on campus. Some are ignorning options open to them that would not only save them many thousands each year in pre tax dollars but would also enhance retirement accounts. Holding meetings or talks prior to each open enrollment would certainly help some people make their decisions. With having a large campus, talks would need to take place in many different areas and would need to start at least three to four months prior to the onset of open enrollment. However this would help to educate most of the employees on the campus. Of course you will always have the percentage that either are not willing to attend a seminar/talk or ones who do not find it necessary or some who just cannot find the time away from work. Bottom line: All companies and entities that offer benefits to their employees should do all they can to educate their employees regarding the choices they will eventually make.

Clearly evidence based medicine says it is safe, even safer than others considering it is the most widley studied oad out there. Lets see, do I want to take a drug where I know in long term trials has no increased risk compared to other oads & improves my sugars better than the conventional oads, or do I want to take something with unkown risks? Hmm, no brainer!

What if your employer refuses to pay you the current rate? Do you itemize the difference on your taxes or is your employer obligated to pay the current rate?

I have the following criticism of Lexi’s comment, which is not original with me, but has been adapted from comments on similar ordinances. The ordinance in question can be criticized as being at once unnecessary, because information about calorie content can be conveyed without requiring that particular restaurants be banned, and paternalistic, because people concerned about their weight have the incentive and ability to inform themselves about the number of calories that they consume. The ordinance may also be ineffectual, because most people eat most of their food at home rather than in fast-food outlets; anticompetitive, because other restaurants can provide the ‘fast’ food anyway; blind to the effect of competition in forcing restaurants to develop menus that will give them an advantage in competing for health or calorie-conscious consumers; and sacrificing a liberty interest without the basis of a responsible cost-benefit analysis. In short, the problem with Lexi’s comment is that the issue is only in part whether or not the government has a ‘right’ to limit individual conduct or choices (which is noncontroversial writ large, the problem is in the application in each case) but the question of whether it is justified in this case, and whether such an ordinance will be likley to accomplish its stated objective, while sacrificing substantial liberty interests.

It’s about time. This is a test.

thank you

Fid bond vs insurance

I certainly would not recommend the purchase of a Wii for the sole purpose of exercise. If that were the only way to motivate a person to get off the sofa then by all means go out and get one. Heck, get two! Purchase a Wii because it will stimulate the mind a bit (very little), maybe even the economy, but please don’t consider it an exercise tool. Change is very difficult. With the incidence of diabetes hitting the younger population, the average belt size increasing year over year, rising health care costs, etc., we simply just have to get serious about our health. We all need to be proactive rather than reactive, so make it a habit to go on that simple thirty minute walk every day (by the way, I once read a study that suggested a habit forms after an action is repeated at least twenty-six consecutive times). So put down the controller, grab the kid(s), dog, neighbor, or the tunes and get out there and have a nice, fun, walk. It may seem difficult at first, but try it for a month and notice how much better you’ll feel. Who knows? Maybe you might realize exercise can be fun too.

As someone who also responds to RFPs, I wholeheartedly agree with both you and Mr. Haraden. I would like to add some technical suggestions for those who develop and issue RFPs. 1. Please issue your RFP in Word. I have received scanned documents where I had to re-type all the questions in order to respond to them. If there are descriptive portions that you don’t want people to alter, then have those separate from the parts that need responses. Also, Excel spreadsheets can be OK if you are limiting responses to yes/no or brief data points, but are not the best for “essay” responses — especially if you have locked the size of the cell. Which brings me to my next point . . . 2. If you decide to limit the length of a response, please consider the type of question and allow an appropriate amount of space for a thoughtful response. It is quite frustrating to be asked a question like, “In 50 words or less, please give a detailed description of your process and show how it complies with government regulations.” Just citing the names of the government regulations can require more than 50 words! We realize that you don’t want to wade through 3″ thick binders, but some responses need more detail (or even diagrams) to answer the question fully. Thanks!

I agree that people need to do their own homework – and FDA approval is no substitute for that responsibility. Plenty of people have been harmed by FDA-approved drugs as well.

Lexi, people have been inventing ways to hurt themselves since the beginning of time, and governments have never been able to stop irresponsible people from doing so.

There are, however, plenty of unintended consequences to the banning of fireworks:

1. Supply and demand – Black market fireworks are smuggled across city, county, state and national borders in large numbers, but without the quality controls that law-abiding businesses would put in place.
2. Parents never get a chance to legally teach their children about the safe handling of fireworks. Later on, when their friends bring some of the aforementioned black market fireworks home, the risk of childhood injury INCREASES rather than decreases. I doubt you would be able to find any boys under the age of 18 who have not managed to procure illegal fireworks at some point or another in their lives.
3. Taxpayers are forced to contribute to elaborate municipal fireworks shows which they may not care to attend. Because all cities have shows on the same date and time, the inelasticity in supply of pyrotechnicians drives prices higher and higher every year.

Even if you don’t mind big-government intrusions into deep-rooted American traditions, it’s clear that the banning of personal fireworks merely shifts costs onto unwilling taxpayers and drives responsible users underground.

Happy 4th!

Well ok then, as long as you’re not trying to ban anything…

Yes, fire departments get called out alot on the 4th of July, even in cities where fireworks are outlawed!

I wonder if any California fire department has ever done a staff reduction as a result of a fireworks ban? Probably not.

The other area that we take into account is the level of services offered as well as the tools a broker is using to communicate with the marketplace. The Precept Blog is one of a handful we follow from brokers and is always well read by our audience. The Precept service model is unique as well.
Keep up the good work!

Hi Cliff. Thanks for your response!

The last paragraph in your argument contains the very conundrum as to why being connected with co-workers on Facebook is not a good idea. At its optimum, Facebook is a tool to provide information about your life wtih family and friends in a uniquely informal way, to the point that it’s practically replaced e-mail as the main way to communicate information electroncially in some circles. As such, we feel comfortable communicating with them in the types of informal, colloquial ways that we would if we were hanging out in their living room. Bringing in any type of work element to it severly damages this purpose and spirit of the site, and we are left with an outlet where we have to carry the same kinds of facades that we must hold at work.

Also, regarding the Facebook rules, there are ways to prevent one’s page from being open to anyone except the people that a person befriends, essentially keeping the public out. That way, one doesn’t have to restrict the information that is posted for fear of the public eye (or people from the workforce). After all, everyone of us have things going on in our lives that we share with our friends and family that we would not think of sharing in work. Why take away a forum to do just that? Additionally, while I’m not advocating public drunkeness or any other kind of debauchery, it seems the rules state that if one has a Facebook account, he or she should essentially live his or her private life as an extention of a company’s employee handbook. To me, that sets a dangerous precedent.

There are other sites where an online connection between co-workers makes much more sense than Facebook. LinkedIn is the one that immediately comes to mind. However, Facebook’s original intention was to be a site for friends and family to have fun, be social, and escape from the pressures of day to day life, including work. What is wrong with keeping it in line with those original intentions?

What’s really sad about the majority mentality in relationship to smoking is that the majority who does not smoke says that the minority who do should not, and that ends the inquiry in their view. By comparison, I could decide that anyone who was overweight should be taxed heavily, or anyone that received a speeding ticket should have their car taken away, or anyone who takes “legal” narcotics propogated by pharmaceutical industry should be subject to controlled susbtance requirements, or anyone who drinks beer/wine should be prohibited from doing so, all on health grounds. That’s not really what’s going on though. What it really amounts to is a self-righteous moral superiority complex – no different than religion, or political, or ideologues – deciding for the minority what should be the norm. The health cost they disguise it with is laughable – it’s just a pretext. If it was a health issue, then all cars would have rev-limiters prohibiting them from going faster than 50 mph, corn syrup would be as illegal as crack, legal addictive substances sold by big pharma would be the outrage it is, and the deadly consequences of alcohol would be accorded proper context relative to marijuana (and the big alochol lobby would be reviled). These health initiatives disguise the real issue, which is majority rule (circa Nuremburg 1933), embellished as a social contract. If we passed a Constitutional amendment outlawing self-righteous, overweight, pill-popping, lead-footed, pickled, narrowminded ideologues, I’d be happy to quit smoking. Until then, not so much.

Very nice post.

From a business perspective, I think the key to a credible (and successful) wellness program is the ability to link the program to real business needs. The WSJ had an article earlier this month (http://bit.ly/Ett2o) that discussed a company that has – so far – been quite successful with implementing a very aggressive wellness program, including mandating all employees to get a physical in order to be eligible to receive health insurance. The article describes very clear business reasons for the company’s policy. As you describe well in your blog, there is really no such connection that would make an aggressive anti-tobacco campaign for soldiers in the field make a lot of sense.

I have mixed feelings. I have worked for companies where emplyees would get up to $500 credit/year (divided monthly) on their annual premiums for engaging in a fabulous Matria wellness program. Employees had to complete an online assessment, track physical activity, engage in walking/physical programs, and healthy food challenges. However, the management would pick 3 days a week for their department and allocate 1 hour (outside of a honored lunch period) to encourage and allow for employees to participate. The company was trully dedicated to bettering employee health also by allowing employees to order 5 lb weights and a stepper via the company store at no cost, if they would like.

If an employer is not equally committed to not just encouraging their employees but making the effort to ease the burden on employees to participate in mandated programs. it makes it challenging for any employee who is already working 10 or more hours a day, has obligations and commitments to family and community resources outside of the workplace to force a tracking system.

It actually adds to stress in the workplace, as is my opinion. Since, it is not like those that want to be healthier are not doing activities to achieve such personal goals, especially when this is a program targeted to those who may not make life changes.

Those who are uninterested in addition to not being allowed the time, simply wont change the bottom line for your cost of healthcare. My 2 cents.

More concerning than anything for me in considering the push for healthcare reform is the inaccurate data the current administration continues to use in sensationalizing this issue. Despite evidence to the contrary by private sector non partisan groups and our own Census Bureau statistics, the Democratic Congress continue to promote this myth of 47 millions uninsured Americans. The true number of the uninsured is 10-15 million, in my humble opinion this is not a reason to destroy the best healthcare system in the world.
Mark Levin, in his essential book Liberty And Tyranny, explains:
“It is said by the proponents of government-run health care that 47 million people go without health care in the United States. For example, during the so-called Cover the Uninsured Week event in 2008, Democrat Speaker of the House Nancy Pelosi issued a statement declaring that this is the “time to reaffirm our commitment to access to quality, affordable health care for every American, including the 47 million who live in fear of even a minor illness because they lack health insurance…In the wealthiest nation on earth, it is scandalous that a single working American or a young child must face life without the economic security of health coverage.” This is more deceit.
In 2006, the Census Bureau reported that there were 46.6 million people without health insurance. About 9.5 million were not United States citizens. Another 17 million lived in households with incomes exceeding $50,000 a year and could, presumably, purchase their own health care coverage. Eighteen million of the 46.6 million uninsured were between the ages of eighteen and thirty-four, most of whom were in good health and not necessarily in need of health-care coverage or chose not to purchase it. Moreover, only 30 percent of the nonelderly population who became uninsured in a given year remained uninsured for more than twelve months. Almost 50 percent regained their health coverage within four months. The 47 million “uninsured” figure used by Pelosi and others is widely inaccurate.”

Another major area of concern for me is the reality of health care rationing, which is inevitable with a single payer system. The only way to reduce cost in a single payer system is to ration healthcare. Rationing health care means getting value for the money we are spending by setting limits on which treatments should be paid. I do not want a government bureaucrat deciding on the value of extending my fathers life by paying for his treatment vs. paying for the treatment of a younger person who has not paid into the system his / her whole life.

I believe in personal responsibility. I am afforded the choice of which health plan is best for my family by my employer sponsored group insurance. If I were to lose my job, I would have the option of electing COBRA or paying for an individual policy. I do not believe it is not compassionate to make people dependent on the government.

I hear people say it’s a complicated issue, but for me its really not. I expect my elected officials to actually take the time to read this legislation over the next month and to listen to the people who elected them to office. For what its worth, those are my thoughts.

Nice piece. I think dollar cost investing works well provided the investor understands the possible different outcomes that can result from market direction & frequency compared to lump sum investing.

Mickey
My Article:
Does Dollar Cost Averaging Work?

Neither of your voting choices is correct. The answer is NO. Because the BMI index is not an accurate measure of a person’s health/fitness.