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New Pitch to affordable health care containment and health care access.

Walgreens and CVS broaden health care reach by creating In-Store Clinics and Work-Site Centers for employers.  Wal-Mart offers a $4 generic drug program. I would call them neighborhood mini health centers.

Businesses have finally had enough in uncontrollable increases in health care costs and the lack of affordable health for their employees.  This just might be an approach to lowering the number of census tracts that have individuals medically under-served.

This movement shows purchasers changing direction.  I feel this is a wake up call for nonprofit health care industry to listen.  “Your pricing yourself out of business”.  The market place has begun to show that health care is way too expensive and purchasers are seeking alternatives.  For profits corporations are providing new models that are cheaper.

The nonprofit health sector needs to change.  The next big push I project will be government mandating care paid by government subsidies be through more managed care approaches and more Community Health Center plans.

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Tufts set a deadline of February as the date it will stop accepting insurer Blue Cross Blue Shield of Massachusetts.  It is their way to force the insurer to pay higher rates for their services.  Who is playing fair???

Just last month it was reported that Blue Cross Blue Shield was paying another health care group a much higher premium.

The higher prices do not mean better service, just higher premiums that you must pay.

Reduce the effects of health care costs by selecting affordable health care and not letting the sellers of services use repetition to infer better care and the need to pay higher prices.  Dealing upfront with costs reduces medical debt.  Be an educated consumer and check out these web sites.

ACCESS PROJECT link:

Patient Advocate Foundation link: 

Foundation for Health Coverage Education link: 

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The basic four elements to sustaining life are food, clothing, shelter and currency.
Employment is the means by which to create currency to barter or purchase those basics to life that cannot be accomplished within ones own means.

Therefore, when an employer creates an environment that robs an employee of their fair compensation it displays their level of honesty towards negotiating fairly.  Wal-Mart has become one lighting rod of numerous bad employment practices.  The end result is that Wal-Mart continues to be hit with ongoing employment practice lawsuits.  The result has been a number of boycotts that could have resulted in its inability to grow further in the United States profits.

For nonprofits, it highlights that honest interaction in accordance with labor laws will usually give you dedicated employees whom feel they are treated fairly within the means of the nonprofit.  I am not saying that their compensation is within the Living Wage standard of the community.  It should be that the employee views compensation as fair in that the employee is receiving at least minimum wage or a higher wage that is a reasonable wage supportable within the financial resources of the nonprofit.

Whenever an individual’s food, clothing, shelter or currency is going to be adversely effected by an action of another, any organization including nonprofits should expect a swift reaction.  Fairness and reason do not have to mean the same to each individual, the organization or yourself.

If protests do occur it is best to:
1.    Keep the communication coming to make it clear what has occurred and within the guidelines of employee confidentiality.
2.    If the protest is large and ongoing have a third party to review the process and provide a neutral assessment of what they find to be fair and reasonable.
3.    If the nonprofit is small, having employees help with the decision making should result in a more receptive action.

The United States has an economic boycott on Iran to pressure the country to stop funding terrorists groups such as Hamas and Hezbollah, and stop its nuclear program.  A policy the United States has consistently used to accomplish changes throughout the world.  However, one particular company Hewlett-Packard was recently identified as possibly putting its interest first.  In 1997 it formed a partnership with newly formed Redington Gulf, a third party seller to sell its products in the Middle East.  It has become the largest seller of Hewlett-Packard printers in Iran and aided Hewlett-Packard’s ability to dominate the market.  So I ask you how, does a US company whom has complied with all US export laws get to become number one in Iran?  Easy, deniability!!!!  It is the same argument that companies have used for years in the use of child labor, unsafe labor conditions, and unfair labor practices.

However, lets get real.  What corporation do you know that say to its seller, do not tell me whom is buying all of the product and generating these huge sales?    What corporation do you know that says, I am not interested in making the results even more profitable to both corporations?

The circumventing of the United States laws by Hewlett-Packard are another example of how regulations are manipulated by large corporations for their own profits.  Regardless of whether it can be shown that said action indirectly or directly supports terrorists, Hewlett-Packard must stop selling through distributors whom do sell its products to Iran.    As in the past presidential campaign, if it looks like a pig, no amount of lipstick will change the fact it is still a pig.

Inconsistent enforcement by government regulators is another factor in Hewlett-Packard being able to continue said practices.  If it was easy enough for the Boston Globe staff to write up facts about the sales of Hewlett-Packard printers in Iran, then deniability is no longer a fact to be ignored by either the United States government or Hewlett-Packard.

I use this example because it is great example of how an organization can present the truth from a legal battle stance but lose the public relations war of being truthful.

In every state and the federal government there are regulations and laws that are ignored, forgotten, or inconsistently enforced.  Periodically, they are identified for deletion.  Until such time how an organization including nonprofits appropriately deals with them is prone to interpretation.

(pics by fundamental-regime and terrorist sign)

pic by Redrara

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2009 starts the year with examples of boycotts to show how ongoing communication is the best tool be successful.

Gay activist are boycotting backers of Proposition 8 in California. They are strategically identifying certain businesses that had a supporter of Proposition 8 and where they have great influence in their ability to affect the business.

In reviewing the campaigns of each side I have to say that the Gay Community failed to put real faces behind whom the law was to effect.  The drumbeat was more around a core argument of stopping discrimination.  This was a tired cause in the eyes of the voters and many did not see it as an issue, including the gay community as the motivating factor to get active.

The supporters of the Proposition have to thank The Mormon Church for putting its full support behind the passing the bill.  It became their passion with their monetary aid and turnout. They did everything in their power to make a difference.  Proposition 8 provided a focus for a charged group that supported the “Romney for President” campaign.  The Mormon Church members were a motivated group to make a statement during one of the most exciting Presidential campaigns.  Instead of being associated with the failed campaign of Romney, they are well known to have made political difference in effecting election results in California, the largest state of the United States.

The passing of Proposition 8 awoke many beyond the gay community.   In any political campaign where on side distorts the truth using fear to win the battle there is the danger that it only inflames a more passionate response.  In addition, people eventually over come their fear as the truth is made clearer.  History has shown numerous times that fear alone does not win wars.

So you might ask what does this have to do with the nonprofit I am associated with?   It is about getting you to think how the organization you are associated with gets out its message and builds its community of lasting support.  When you have a group of motivated supporters that you may direct towards a specific goal, how can you create a win for the group and energize them even more.

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Here is a recommended list of sites for employees to check out when searching for health information or to more actively manage their health care.

To find health information and networking with others on health check out the following.

1. EverydayHealth.com http://www.everydayhealth.com/
2. HealthCentral.com  http://www.healthcentral.com/
3. WebMd.com http://www.webmd.com/
4. VisualDxHealth.com  http://www.visualdxhealth.com/
5. QualityHealth.com Click here for link
   
6. Healthline.com http://www.healthline.com/
7. Wellsphere.com http://www.wellsphere.com/home.s
8. RealAge.com http://www.realage.com/default.aspx
9. HazMap http://hazmap.nlm.nih.gov/
10. WhyNotTheBest.org http://whynotthebest.org/
11. Consumermedsafety.org http://consumermedsafety.org/

For tools to manage your health care try the following links:

1. Microsoft Health Vault http://www.healthvault.com/
2. Google Health Link (Click Here)

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It is time for Congress and the President to legislatively create health care changes that produce cost containment and better results.  The United States has no proof that its spending level which is way above the rest of the industrial nations has increased the health of its people or their longevity.    When such a measure is used for any year the United States health care system has failed to be cost efficient. It is time to say health care costs have failed to provide the better return. Therefore, health care needs to change to produce better results or its costs need to be lowered to be in line with other industrialized nations.

It is time to make a whole change to the approach of home health care vs facility health care.  Just look at all of the construction being supported in the health care field as the measure of whether the health care system is at fault for promoting facility care over home care.

Why does government policy or insurers make getting long term facility care for an individual easier than services to stay in their home?  It is time to have a tier system.  Use a standard the some states are practicing in the disability field for individuals called individual supports or Community Habitation.

I have provided below an example to consider using an hourly rate of $8.76

Individual supports under 15 hours a week (up to 2 hours a day) up to $17.52 a day.

Individual Supports between 15-48 hours a week  (up to 6.86 hours a day) $18.75 to $60.09 a day

Individual supports between 49-105 hours a week (7- 15 hours a day) $61.32-$131.40 a day.

Each model is cheaper than the $158 per day that Massachusetts pays for nursing home care.  If an individual receives less than 5 hours a day for five days, their services are even less costly than a rest home, Adult Day Health or Social Day Care program.

Fiscal woes should be about reducing institutional care and increasing community care.  Serving more people at the lesser cost service in their home creates better quality of life care and the ability of an individual to stay healthier longer.

2009 should be the year to remember that government no longer supports programs that do not show a measurable rate of return within a specific time table.  The experiment of the the United States spending more of its GNP on health care than other industrialized nations needs to end.  It has failed to meet the outcome standard of better outcomes for a higher price.

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Consumers and businesses make decisions every day that are based on the intake of information,  the processing of the information and when necessary a comparison is made.  The decision making process results in the management of a nonprofit making choices.  The decision making process is similar for a consumer making choices, with the exception that their pricing power is limited as an individual.

The lack of public information in pricing by health care providers and insurers creates a secret system for getting the best service for the best price.  The clarity of definitions of those services that are required to perform a service would make a setting price and publishing those prices much easier for comparison by all.

The fact that individual organizations complain that their rate includes other services not provided by their competitors rate can easily be resolved by having the additional services listed and the note included in the rate.  If the additional service is mandatory that should be clear, since a CHOICE NOT TO RECEIVE THE SERVICE  is not optional.

The competitiveness of the market place requires rates and information.  Until such time as Congress passes legislation to mandate the publication of the information, pricing will always increase.

Congress needs to take advantage of the fact that Medicare and Medicaid are huge purchasers of health care and have defined every procedure, service or item and have been able to price for their level of reimbursement.   If a new service, procedure or item needs pricing, there is a procedure.

Therefore, the publication of rates and information already has the baseline for the lowest price.  Congress should mandate that all entities need to publicly post on line to a federally supported system their pricing.  This federal supported system will automatically load the Medicaid and Medicare rate information.  This will allow the businesses and insurer a stronger tool to create affordable health.

Recently I was able to review some public rate information in the Boston Globe.  The result is that I am seriously looking into a great hospital in Cambridge Massachusetts called Mt. Auburn Hospital.  Their outcomes are equal to the larger more expensive hospitals in my area.  With my deductible and flexible spending plan I will be able to afford more health care for my family by utilizing them.

It pays to compare.   If your looking as a nonprofit organization to stretch those health care employee benefit dollars be proactive in sharing the information with your employees.  An educated consumer is a smarter consumer.

Annual 300 billion spent on drugs.
For over half the people the drugs will not work as intended.
Further, many of these people will experience a side effect, when it could have been avoided if personalized medicine was more readily supported and used. 

There is concern that there is not enough data on various treatments and more tests are needed to compare treatments, that genetic testing will cause insurers to deny coverage, and that genetic testing is not conclusive. 

The simple answer is that for every day a hospitalization is preventable due to genetic testing that shows the likelihood of how a drug will react to an individual, the more that it should be the norm that each of us has such data as part of our medical record.  It is not just about what a drug will do to an individual but about what environmental factors might do to an individual. 

The majority of health care organizations are nonprofit entities.  There are numerous individuals that are effected in the same way by a particular disease where a Foundation has been created to find a cure or treatment.  All of these organizations have a stake in supporting and promoting genetic profiling.    It will not only support more healthy individuals but lower health care costs. 

On December 27, 2008 the Boston Globe carried an Associated Press article that reported on the isolation and restraining of mental patients.

I would summarize the article as focusing on those rare violent patients whom do not respond to medication or treatment that Mental Health officials have come to call outliers.   Advocacy groups say it is a system whom have given up on those most difficult to treat.  The US Supreme Court has already ruled it unconstitutional to isolate or restain a patient for extended periods.  However, Federal and State Law have a loophole that allows inpatient facilities to lock and/or restrain an individual away for the safety of staff and other patients.  While some patients sue most do not.   If you want to read the details of these efforts check out this link to the article.

Advocates have shown to be the best means to provide direction to better policies for giving the right supports to the mentally ill.  Is it time to make advocates a standard not an after the fact or lucky support to the mentally ill?   What would it take to keep the doctor away and stay healthy mentally?

(pic by jasonthegreat)