Email is Evil!

People will make comments in email they would never make in a formal letter or memo.

This is dangerous to your organization.

Every organization should have clear policies on email, text messages, and social media,

CLASS Act

The health care reform bill included a new program to provide long-term care insurance, with automatic enrollment and then an opt-out provision. This program will phase in.

A New Era Begins - 3/21/2010

An Editorial:

The passage of the health care reform bill is a major milestone for U.S. health care services.
With passage, we will need to unravel the bill and the real story and prepare for the intended and unintended consequences of this massive effort.

The legislation is neither as bad as the Republicans make it out to be, not as fabulous as the Democrats claim. The bill changes the health care system to an amazing depth and breadth, and despite the proclamation of economists, politicians and policy wonks, we do not really know the full impact of the bill.

Reform is needed, we will soon be hitting the point at which employers have trouble providing health insurance to employees at an affordable price, the alternatives being dropping coverage or taking more from employees pockets.

President Obama will be hammered by the political right for going too far too fast, and by the progressive left of his own party for being timid. The left wanted a single payer system, was willing to settle for a public option, but left the table with only hope reform will be revisited, as it will.

The amount of misinformation, over generalization and plain old hot air tossed around during the debate make a calm analysis difficult, and will leave citizens and patients confused and alarmed, probably more than required. The bill is full of slow phase-ins and long transitions as we attempt to turn around one-sixth of our economy and attempt to attain several seemingly contradictory goals.

A great deal of the debate has focused on the budget impacts, and specifically the positive or negative impact on the deficit over a ten year span. The bill is full of wiggles and gimmicks, and as the vote drew near the Congressional Budget Office (CBO) estimated a positive deficit impact of about $140 billion in ten years.

Truth be told no one has any real idea what the bill will do to the deficit over ten years. Anyone who has studied the history of Medicare and Medicaid knows the legislative budget estimates tend to melt in the face of annual politicking and lobbying.

There are problems needing immediate attention. State budgets, hammered by the recession will have to be cut Medicaid benefits, a backwards step. Medicare physician reimbursement formulas, problematic for a decade, are being patched again while Congress dances around a permanent solution. Private insurers and employers will have to adjust quickly to new regulations and cost structures. Changes in Medicare are inevitable.

We can improve coverage and contain cost, but the reforms have to be constructed so carefully it is unlikely any political process has or will do so.

Now we know when the journey begins and the direction it is going. The details will be tough to work out, and there are many battles ahead, but decision making improves as certainty increases. We may get a good place, but not without many bumps and bruises.

The Feds Are Coming

After 8 years of lethargy the Department of Labor is gearing up to vigorously enforce both wage-and-hour and OSHA regulations.

The wage-and-hour regs are complex and widely misunderstood. The OSHA rules are better understood but often ignored.

Details on both topics will follow.

Take Resident Complaints More Seriously (?)

A quarrel between a 98 year old and her 100 year old roommate in a Dartmouth Mass. nursing home led to the 98 year old being charged with second degree murder, for the September death of the 100 year old.

The defendant, who is alleged to have suffocated her roommate, has been placed in a mental hospital for evaluation.

HIPAA Security Alert

HIPAA Horrors


The Blade (Toledo) reports on October 28th an imaging technician was arrested in Ohio for driving infractions and possession of marijuana.

During the arrest the police scanned his cell phone.

In his phone were photos of dozens of partially clad patients preparing for imaging tests, including minors.

Wow.

The penalties and lawsuits are likely to be massive.

Health Care Reform Part 2

President Obama's speech yesterday was "hitting the reset button" for health care reform.

First impressions - the numbers do not add up.

And every President since Nixon has promised to reduce "waste, fraud and abuse" from Medicare and Medicaid.

Game on!