“Just the Facts Mam” – Finding Truth in the Health Reform Debate

There is plenty that one can argue and disagree with in the new Health Insurance Reform bill and lots of areas  not adequately addressed yet.

However, it is a start and I think it is important that we honestly appraise reality and not cooked up talking points and sound bites from the right wing media and blogosphere that are simple lies.

From here on out we will employ Joe Friday of Dragnet fame to try and get us the truth – “Just the facts mam”.

We have a addressed a few of them recently and links are below:

Bill is Socialist? – NAIC charged with implementation

Reform will cause a Dr. Shortage

Pre Ex Exclusion for Kids is Not Included

Mandates are Socialism

Insurers Rates Will Rise in 201o due to New Taxes

Nazism, Communism, Socialism … Plan

The real whopper and the hardest to understand relates to the Medicare Part D “taxes” on corporations. In essence companies have been double dipping on writing off their retiree drug expenses and getting a subsidy of $663 per retiree that they got to write off as well since 2006. Now they are losing 2/3’s of the writeoff but NOT  the subsidy. Not exactly an unfair tax on plans.

We will continue to call out any item on healthcare from either side of the aisle that is not true. if you want us to track something own let us know and we will get the “facts mam, just the facts.”

I am all for civility, debate and facts. More to follow..

To Aetna’s CEO – Did you Read the Bill?

It looks like the CEO of Aetna was not well prepared for a Business Week Interview. Here is Mr. Williams comment:

Will insurance premiums go up? (BW)
The answer is yes, and some of the things that will drive those premiums are significant additional taxes the industry will ultimately have to pay in the first year.

The problem with this comment is that is flat out wrong and misleading. One might call it a lie.

There are NO new taxes on Insurers until 2013 per the Tax Foundation.

Remember Aetna is the same insurer that showed such respect for the new HIPAA HITECH law that they didn’t even communicate with their producers until days before its 2/17/2010 deadline.

At least Cigna CEO, David Cordani offers a bit more honest but still self serving appraisal of why costs increase in an interview with Neil Cavuto:

Insurance commissioners in every state will continue to be very diligent…the underlining premium costs are driven by underlining health care costs and in an environment where emergency room utilization and costs have quadruped in five years, use of MRIs have doubled in the last five years, biomedical utilization is growing rapidly. The costs will continue to grow and that’s the opportunity that wasn’t addressed.

Once again we see one of the major players in health insurance, who according to him represents 35,ooo employees not telling the truth.

This is why people find it hard to trust any insurer when even the simplest facts are disregarded.

3 More BOR Scalps to Report Due to HITECH Noncompliance!

I have gotten 2 emails in the last week from reader/brokers who had taken my posts on BORs to heart and have had success getting new clients from brokers who have neglected to get compliant with HIPAA HITECH.

From Chicago the broker wrote – ” I have been trying for 3 years to make inroads with a 700 life account in the Chicago suburbs. Their broker is ” xxxx” one of the top 3 or 4 firms in town and one of our major mid market competitors.

I called my contact there and asked them how it was going and what they had done to get compliant with the new law. They said they knew little about it.

When I told them more and about and sent them to The Industry Radar for more info. they appreciated my help.

I then asked them if their broker was using encryption for ePHI and if they had a BA agreement with them?

They did not know so they called their account manager at the broker who told them – ” as brokers we are not covered by HIPAA”.

My contact pushed this up to the the VP of HR and CFO. The CFO was friends with the broker and called him personally and relayed the account managers comments and asked what XXX was doing about HITECH. The response was silence, then ‘we are looking at it”.

The CFO was so furious he fired his friend on the spot….

I hate to say I told you so but I have on several occasions. Just ask does your broker comply with Federal law?

The other email I got was from a broker in Virginia, outside DC who picked up 2 smaller accounts recently (50-100 lives). Her story is similar except she used a local SHRM meeting to ask folks she knew about what their brokers were doing about HITECH. Several knew, most did not and she had 5 people who asked her to send them info on HITECH which she did using some of our tools.

Thus far 2 of the 5 have named her BOR.

If you are still trying to figure out what to do, not encrypting you email, have not done a full risk assessment and put your policies and procedures in place then you are vulnerable to losing your accounts and livelihood.

We can help you solve your encryption needs in 48 hours or less whether you are a 1 man shop or a national, publicly traded firm.

See all the options we offer in our RadarMail 360 suite of solutions here.

“Just the Facts …” – Health Insurance Reform Will Cause A Doctor Shortage?

Every day brings a new issue meant to undermine the Health Insurance Reform bill passed last week. AP raised a doctor shortage over the weekend in scary terms and now that has found an echo chamber in its syndication in under staffed local papers and Republican strategy rooms:

“Better beat the crowd and find a doctor.”

The implication being that Reform, not already predicted issues were causing this shortfall, including a small thing called “Aging Boomers”, expanding lifetimes etc. is the culprit.

I’d like to ask a few obvious questions here to test this supposition:

• Insurance vs. Care – now the reform bill will get 32 million people insured. Have these folks not been getting care somewhere already? How about:
  • Emergency rooms
  • Pro bono care
  • Convenient care clinics
  • Free clinics etc.
• How many of these folks have not been getting any care? Not many, just at the expense of the rest of us at emergency rooms.

So getting insurance can channel these folks to better alternatives  – like convenient care clinics and others that will evolve -and the doctors at these other options will be available as well to everyone.

Yes, we have an impending doctor shortage that has been predicted for years. If not for foreign doctors, many who are Indian – who make up nearly 25% of all US physicians -we would already have a major shortage.

One issue for non US nationals is that with medical tourism exploding, and national economies booming in places like India there are opportunities to return to their home country and practice in world class facilities near friends and family.

This issue is at least as acute for nurses as well.

Nothing to do with Health Insurance Reform and every thing to do with globalization.

These facts are really tough things to address. Rather than trying to scare people news organizations like AP actually should do some real digging and educate us all on the root issues of an issue like this rather than try to sensationalize it.

Implementing “Socialist” Obamacare Relies on the Radicals at the NAIC

Lions and Tigers and Bears , Oh My!!

Seems like the Socialist healthcare revolution of Obamacare is relying on that known troublemaking organization – the National Association of Insurance Commissioners (NAIC) –  to help turn this nation into a Canadian and European clone in the Dem’s hidden agenda of government takeover of healthcare.

This article  gets to the heart of the matter!

What is this nation going to do now when the establishment insurance organization of every state, district and protectorate in the union is directly involved in the detailed policy and procedures for state level rules and implementation of Obamacare as required by the law?

As the head of NAIC put it this week in referencing HCR:

“Through it all, state insurance regulators were focused on preserving the states’ ability to protect consumers, and they were looked to as a professional and objective voice of reason by members of Congress. “

The NAIC charter has a radical agenda to help state insurance regulators achieve five primary and clearly revolutionary goals:

1. protect the public interest;
2. promote competitive markets;
3. facilitate the fair and equitable treatment of insurance consumers;
4. promote the reliability, solvency and financial solidity of insurance institutions; and
5. support and improve state regulation of insurance.

In fact the new law requires some really Socialist actions:

“… the NAIC to help the Department of Health and Human Services develop numerous other regulations, ranging from making sure that documents pertaining to benefits and coverage limitations be standard throughout the industry, to determining how health insurance can be sold across state lines while maintaining consumer protections.”

The radical actions of this group are even focused on being sure- God Forbid –  that the voice of the consumer – the most important person in reform and cost containment – is heard.

“To ensure that consumers’ interests are at least taken into consider as the NAIC fulfills its mission, the organization several years ago established a consumer liaison committee. This year the NAIC expanded the committee to include 29 consumer representatives from across the country.”

This group – with radical members from state insurance consumer advocates and the American Cancer, MS Society and other equally socialist groups – requested these over the top radical ideas be incorporated into the NAIC work over the next 12-18 months:

* Create a publicly accessible “plan of action” developed with input from consumer representatives
* Fully incorporate consumer advocates into the NAIC health reform work plan
* Prioritize their tasks based on the needs of consumers
* Significantly expand consumer participation at NAIC proceedings.

Once again the reality of reform is solidly grounded in the systems and infrastructure established for the state based regulation of insurance.

This is really radical change that should be protested.

So we have a new system with an individual mandate that Republicans had long favored (starting as an option to HillaryCare in 1993).It had been championed by folks like Sens. Grassley and Hatch and even seen put into play by Presidential candidate Mitt Romney in Massachusetts. Even Newt liked championed the idea in 2 books no less!

This type of reform  brings current insurers 32 million new potential customers, within existing trusted organizations like the NAIC at the local state level – whether you like this imperfect bill or not – is not exactly socialism or a government takeover of the existing system.

Sounds like pretty moderate, responsible and  a lot less radical and disruptive to our industry than the 2008 Republican plan chanpioned by McCain/Palin to end the deductions for employee benefits and throw all consumers into the individual market to fend for themselves.

Healthcare Gets Really Personal – Targets, Cut Gas Lines, Threats ..

I think we all consider healthcare a personal matter but now the Tea Party and Republican hate mongers have taken the meaning of personal to a whole new level. We have already covered the ugliness of the weekend protests in my earlier post...

1. Spitting on members of Congress
2. Calling Congressman the “N” word
3. Calling Barney Frank a faggot
4. Threatening a Hispanic congressman
5. “Baby Killer” yelled at Bart Stupak on the floor of Congress.

Now we have even more to report:

1. Half Governor Sarah Palin telling supporters on Twitter to “reload” and posting a map of 18 Congressman with rifle scope targets on them as people to try and unseat in the fall elections
2. VA Congessman Perriello’s brothers home address was posted online for protesters to “pay a visit to”  instead of his own had a gas line into the house cut. Thanks God these idiots forgot the matches.
3. Minority Leader  – “Hell no we can’t” – Boehner saying this in an interview that Rep. Driehaus  if he supported healthcare.

“may be a dead man” and that he “can’t go home to the west side of Cincinnati” because “the Catholics will run him out of town.”

1. A full page ad ran in the Cincinnati Enquirer with a picture of Driehaus and his 2 young daughters urging him to vote no on reform. The paaper has since issued a full retraction
2. Rep. Driehaus’ home address being posted online and people exhorted to pay him a visit. A protest is planned at his house in Cincinnati on Sunday. Police have been guarding the house as well. Threatening phone  calls have been received by hos wife.
3. Bart Stupak with over 50 threatening voicemails he has turned over to police. You should listen to some of them. They threaten both Mr. Stupak’s life and that of his family and are vile and disgusting.
4. Numerous Democratic and local Congressional offices with broken windows or break ins and threatening messages (NY,VA,AZ,OH).

We could go on and on.

What is the response from the Republican leadership. Here is Leader Boehner’s stirring rhetoric on the subject:

“I know many Americans are angry over this health care bill, and that Washington Democrats just aren’t listening,” Mr. Boehner said in a statement. “But, as I’ve said, violence and threats are unacceptable. That’s not the American way. We need to take that anger and channel it into positive change.”

Unacceptable? Channel? Please..

How about Boehner’s Tonto- Eric Cantor, the minority whip’s stirring appeal :

“I do not condone violence,”  “There are no leaders in the building, no rank and file members that condone violence, period.”

Right before saying this about not politicizing the situation:

Dems are “….dangerously fanning the flames by suggesting that these incidents be used as a political weapon.”

Politicizing? Hmmm.  Rep Neugebauer who owned up to saying  “baby killer” and  apologized to Bart Stupak now has a YouTube fundraising video using the footage…I guess he really wasn’t sorry.

Words from our elected leaders matter. People listen and take cues from them.

The incendiary rhetoric that started with Joe the Plumber and that death panels and all the rest continue to stir up matter.

Republican leaders continue to court this lunatic fringe and even show up at the rallies to whip up the faithful.

Good old Michelle “America’s Congresswoman” Bachmann says all the time in public:

“[I]t’s like Thomas Jefferson said, a revolution every now and then is a good thing.

Something tells me that our Founding Fathers did not have this type of hate mongering, uncivil type of behavior in mind for “democracy”.

Trying to make this all go away as a lunatic fringe, over the top few and all the other excuses is total BS.

For nearly 2 years here, starting in the fall of 2008 this type of behavior has been whipped up, supported and facillitated by the behavior of the Republican party, its leaders and their rhetoric.

Once the genie is put of the bottle it is hard to put it back in and the problem is now out of control threatening not only members of Congress but their families.

But, hey but if you are a really lucky and wealthy loon you can get your picture taken with Bachmann and Sarah Palin for just $10,000 at an upcoming fund raiser!

This is not the America I grew up in nor the one any of us want but it is here, it is real and it is dangerous, very, very dangerous. I lived through the JFK, RFK and MLK being assassinated and this boiling pot worries me.

I have come to one main conclusion and that is that if we had a white President none of this would be happening. You may try to deny that but you cannot. Another sad commentary to say the least.

Healthcare Reform – The End of Brokers?

Hell No!

This is America, the land of opportunity and entrepreneurs. It will be up to you to meet the new challenges from HCR or go the way of  the blacksmith, the buggy whip, the typewriter, black and white TV, 8 tracks and cassettes, LP’s, VCR’s and other tools that change has left behind.

I believe that healthcare reform – whether you like it or not – will be a huge boon for brokers who add true value to their customers. The students of the business and innovators who really know and understand customer needs will flourish and grow as they adapt their practices to the marketplace realities and opportunities they create.

Recent History of the Benefits Industry Evolution

In my 35 years in the industry I have witnessed a sea  change in our industry, all of which have created opportunity for quality intermediairies who developed the skills and skill sets internally to deal with the new complexities and opportunities they have created.

Lets look at the major ones:

1. Late ’70’s/early ’80’s – decoupling of benefits from one large carrier providing them all to best of breed being chosen and put together as a “program”
2. Mid ’80’s/Early ’90’s – Flexible benefits arrive requiring new creativity and communication skills and choices for employees
3. Late ’80’s/mid ’90’s – The rise of managed (or mismanaged) care. HMO. POS, PPO, in and out of network et al replace major medical, wraparounds, 100% plans et al
4. Mid 90″s on – The rise of 401K and the decline of DB and DC plans
5. Late ’90’s on – Rise of self funding for smaller and smaller groups.
6. 1997 on – Technology hits the industry and continues to grow in use from enrollment, admin, communication et al.
7. Mid 90’s 0n as HIPAA comes into being and states legislate more due to managed care compliance becomes a must part of any practice.
8. Late 90’s on – Worksite/Voluntary benefits become part of the product portfolio.
9. 2000 on- Benefits Communication comes into its own as the web grows and becomes ubiquitous
10. 2002 0n – As HR staffs get downsized HR and outsourcing  practices grow as new programs are introduced to help clients deal with all this complexity
11. 2003 on- Carving out RX benefits as a separate program to get the best pricing takes hold
12. 2007 0n – Wellness becomes a necessity for cost containment reasons
13. 2009 on – Technology is now a core part of day to day business and servicing customers day to day. Rise of Social Media opens new doors
14. 2010 – Healthcare Reform becomes the law. What does it mean?
15. 2010-2014 – Reform specifics will get clarified and plan options explode from exchanges, associations, carrier innovation etc.

Many readers who are younger probably don’t even realize that the skills and work they do today didn’t exist even 20 years ago but today is an expected part of the services any quality firm delivers.

Whether you agree with the reform bill or not is not relevant now. We all agree change is needed and that change is now official at least in direction. Much will change and evolve as well before 2014 but now we all know that change is occurring.

Consolidation will continue unabated but that does not mean that reform will drive the industry into a world of just a dozen or so large entities.

The specifics and evolution of new businesses and opportunities driven by this and technology will be fast and furious making it imperative that your organization is nimble, keeps up to date and has a team that learns and adapts quickly.

Expertise and creativity driven by knowledgeable professionals using the latest technologies will be the coin of this new realm and there will continue to be great opportunities for the right people and organizations.

I hope you are all up to the challenge because it is going to be an “E” ticket ride, whether you like it or not!

Introducing the New RadarMail 360 Solution Suite

HIPAA HITECH presents a challenge to organizations of all sizes, from solopreneur insurance agents to the largest businesses in America. The same rules apply to everyone and the smaller the organization the harder it is to find comprehensive and cost effective solutions.

As of today the playing field has been leveled when  it comes to world class encryption and compliance solutions!

Introducing the RadarMail 360 Family of Solutions, created by the Industry Radar, powered by industry leader ZixCorp and hosted and serviced by Greenview Data.

Industry Radar has developed a suite of solutions to provide any size business access to the world class tools they need to meet the challenges of HIPAA HITECH, as well as the new state laws in Massachusetts and Nevada, GLBA, “Red Flag” and 48 state privacy and security laws.

We have assembled 4 options that meet the needs of any size business – with or without their own Exchange/email server.

Transparent outbound rules based encryption plus an inbound portal for clients to send you their data – even if you are a solopreneur or very small office.

Learn more here…

“Top O’ The Morning” Willful Neglectors!

Today is the one month anniversary of the HITECH compliance being mandatory for all size BA’s –  that means ANY and ALL brokers as well as any employers vendors.

Are you still non compliant? If you are you have brought “willful neglect” fines into play for yourself. Good job!!

Have you been receiving PHI unencrypted and not documenting or possibly report it as a breach?

Ah I love the smell of BOR”s in the morning!!

The only pot of gold at the end of the HITECH rainbow is for HHS and the State Attorney Generals for the fines they are levying.

Looks like a large broker will be learning that soon enough.

How about the costs of a breach? $7 million and counting on this one?? The fines haven’t even been levied yet!!

The leprechauns and four leaf clovers can’t help you get compliant but we can.

We offer a full suite of turnkey solutions for email encryption, computer encryption, compliance and more for solopreneur agents through the largest brokerage firm.

Check out our turnkey, cost effective solutions here. and have a secure and compliant  St. Patrick’s Day!

Beecher Carlson is the first Broker Breachmeister!

Eddie Slovik? We predicted it. It had to happen. And it looks like it has.

A major insurance broker based here in Atlanta, Beecher Carlson Holdings, had  two laptops stolen from employees attending an off-site company meeting in January. The laptops contained names and Social Security numbers for employees of Beecher Carlson’s clients, including 1,012 people who live in …..Massachusetts. Jackpot!!

Someone always has to be #1 and Beecher who is #29 on the 2009 BI Top 100 broker list may now be a true industry leader – in the abuse of client data!

In fact is a grand slam – a Massashusetts state law breach and likely a HIPAA/HITECH breach! Add in identity theft issues and you get Red Flag, GLBA as well. Any Nevadans in there? That would be a 5 bagger.

This is the type of power the Braves looked for all winter!! Little did we know we had it in town already.

Congratulations Beecher Carlson, CEO Tom Golub and your venture investors, this little mistake highlights the entire issue that HITECH and these other laws were created for in neon letters.

Frankly, in Beecher Carlson’s defense,  this  could happen to anyone reading this and I suspect that truth be told all the big boys have had these issues and we don’t know about it. I’d take odds on that in Vegas!

“Passion. Innovation. Accountability.” Nice corporate slogan, how does reality work here?

There are a variety of questions to examine here:

• What will the breach cost in terms of  identifying and notifying the clients involved.
  • BCBS of TN has spent $7M to date on their breach issue just on this.
  • How about from a reputation perspective? Any lost clients or new deals??
• What will an HHS/OCR audit turn up at Beecher in terms of corporate compliance with HIPAA HITECH?
  • Is there “willful neglect” here?
• Assuming Beecher has conducted belated privacy/security audit of its entire operation what has that cost them?
• Have all Beecher’s insurers requested audits as a result of their BA agreements?
• How about all their clients who are CE’s under HIPAA?
• Will other State Attorney Generals file any suits here?
• How about any civil suits from customers?

Beecher now has to deal with this issue and by the time this is resolved it will likely cost several million dollars, if not a lot more on lost clients.

As we have predicted their E&O policy won’t cover any of this. As an $82M revenue business – they just raised a new $12.9M from their deep pocketed VC’s. Interesting that this very small capital raise is announced within a few days of this breach becoming public and on the heels of their $92,000 commission settlement with the state of MA 3 weeks ago.

Is this being done to help pay for the extensive audit they just did in the MA commission case as well as anticipated costs of this breach? Studies show that simply to identify and notify people whose data was breached cost $225 per person. That means the MA folks alone could cost $350K. How many more were on that unencrypted laptop. That $150 to encrypt the laptop sure looks cheap now doesn’t it?

Having raised a bit of venture capital myself I am sure this “infusion” was quite costly to the insiders from a personal equity positon, as it should be.

“Accountability” – the management team‘s lack of attention here on commissions and now client data has likely cost them dearly.

It will be interesting to see if HHS finds “willful neglect” here.

Is it your turn next? What would you do if this happens to you? Where would your capital infusion come from? Let alone the ability to repair your reputation?

It would only have cost a few hundred dollars to encrypt the laptops. The final cost will be hundred of times that.

You need to do a full risk assessment and develop an action plan from it – whether you are in the BI Top 100 like Beecher Carlson – or Bob the local broker.

The lesson – Get compliant, stay compliant and encrypt your computers and data! We’ll show you how..