[From nobody Thu Apr 5 17:49:32 2007 Return-Path: <ccm-l-bounces@ccm-l.org> Received: from rly-ma02.mail.aol.com (rly-ma02.mail.aol.com [172.20.116.46]) by air-ma09.mail.aol.com (v114_r3.5) with ESMTP id MAILINMA093-89246152786af; Thu, 05 Apr 2007 12:45:11 -0400 Received: from ccm-l.org (ccm-l.org [209.31.179.49]) by rly-ma02.mail.aol.com (v114_r3.5) with ESMTP id MAILRELAYINMA024-89246152786af; Thu, 05 Apr 2007 12:44:58 -0400 Received: from ccm-l.org (localhost.localdomain [127.0.0.1]) by ccm-l.org (Postfix) with ESMTP id 8B3AD4C549; Thu, 5 Apr 2007 12:44:52 -0400 (EDT) X-Original-To: ccm-l@ccm-l.org Delivered-To: ccm-l@ccm-l.org Received: from imo-m23.mx.aol.com (imo-m23.mx.aol.com [64.12.137.4]) by ccm-l.org (Postfix) with ESMTP id E5E9C4BDF9 for <ccm-l@ccm-l.org>; Thu, 5 Apr 2007 12:44:50 -0400 (EDT) Received: from KMATTOX@aol.com by imo-m23.mx.aol.com (mail_out_v38_r8.1.) id d.c6b.efde3cf (48576) for <ccm-l@ccm-l.org>; Thu, 5 Apr 2007 12:44:44 -0400 (EDT) From: KMATTOX@aol.com Message-ID: <c6b.efde3cf.3346817c@aol.com> Date: Thu, 5 Apr 2007 12:44:44 EDT To: ccm-l@ccm-l.org MIME-Version: 1.0 X-Mailer: AOL 9.0 VR sub 100 X-Spam-Flag: NO Subject: [ccm-l] Employment and benefits manipulations X-BeenThere: ccm-l@ccm-l.org X-Mailman-Version: 2.1.5 Precedence: list List-Id: ccm-l.ccm-l.org List-Unsubscribe: <http://ccm-l.org/mailman/listinfo/ccm-l>, <mailto:ccm-l-request@ccm-l.org?subject=unsubscribe> List-Archive: <http://ccm-l.org/pipermail/ccm-l> List-Post: <mailto:ccm-l@ccm-l.org> List-Help: <mailto:ccm-l-request@ccm-l.org?subject=help> List-Subscribe: <http://ccm-l.org/mailman/listinfo/ccm-l>, <mailto:ccm-l-request@ccm-l.org?subject=subscribe> Content-Type: multipart/mixed; boundary="===============0595304135==" Sender: ccm-l-bounces@ccm-l.org Errors-To: ccm-l-bounces@ccm-l.org X-AOL-IP: 209.31.179.49 --===============0595304135== Content-Type: multipart/alternative; boundary="-----------------------------1175791484" -------------------------------1175791484 Content-Type: text/plain; charset="US-ASCII" Content-Transfer-Encoding: 7bit From: David Crippen <crippen+@pitt.edu> Date: Wed, 4 Apr 2007 23:39:45 To:ccm-l@ccm-l.org Subject: [ccm-l] Employment and benefits manipulations I (and many others) predicted a long time ago that employers would quickly run out of headroom in their ability to finance "benefits" (read-health insurance) for their employees. A close friend in Indianapolis just got a very nice job, fairly well paying in Indianapolis, Indiana. It was explained that this job existed because they will not provide health insurance. If they did, it would cost somewhere in the range of US$2,000 per month per employee, and that would not only end the job, it would end the company. So they simply don't offer it. They can't afford to and stay in business. What they are doing is providing a monthly stipend for each employee they can use to purchase their own private health insurance. For this particular friend, that stipend is about US$150.00 per month, which will just about purchase enough coverage to assure a hangnail can be fixed, should they acquire one. Naturally, any past history potentially attractive for developing a hangnail will exclude it. So, America is now in the process of systematically excluding more employees from health insurance as employers simply cannot afford it and survive. Government paying for full coverage for all citizens? That will be interesting. KLM response I have NEVER understood why in this country, health care insurance is a condition of employment benefits, whereas religious insurance, house insurance, car insurance, marriage insurance, educational insurance is NOT a condition of employee benefits. Apparently to be competitive, after the end of the WWII, when returning soldiers were re-entering the workplace, major companies added health insurance as a benefit to attract prime workers. Civil Service employees have NEVER had their health care insurance paid for by the government. They are required to purchase health care coverage from one of many different plans, depending on their definition of basic coverage, and their willingness to provide COPAY. Some civil service personnel have the most basic of basic coverages. I really see no need for the government to pay civil service workers an "extra" amount for ANY type of insurance, be it health, school, house, car, lawyers, or religion. Those are personal choices. One very very basic flaw is that society has come to EXPECT that access to equal and high quality and high technologically advanced and "expensive" health care is a RIGHT to be purchased, provided, and paid for by someone else. Such care is a PRIVLEDGE and a RESPONSIBILITY. The responsibility is at the individual level, just as is car insurance, home insurance, choice of a religion, choice of a mate, choice of the amount and type of an education. It is a privilege to have such human and personal liberties by living in this wonderful country. This brings up the point as to whom is responsible for health care when a person or their responsible sponsor has not made provisions for any type of service, be it house, car, transportation, gasoline, televisions, health care, churches, or education, etc. In our free society, the answer is simple. Beyond the basic public health provisions of clean air, clean water, etc. it is logically NOT provided "free of charge." Even in big city and county public hospitals someone pays. That someone is usually the local taxpayer that has some social feelings of responsibility to provide some modicum of basic health services and that society becomes the guarantor of the payment for the health service, AND the person who receives the service should be expected to PAY BACK TO SOCIETY as much as possible the amount of money that society invested in them. There is NO FREE LUNCH. There is no guarantee of providing "good health immortality" to persons who have all their life abused their body with ETOH, bad drugs, cigarette smoke, obesity, and too fast driving and interpersonal violence. As we move precariously closer to some form of federalized health payment system (and we will hear a great deal about this during the next few months), it is very important that we understand the basic economic and professional Rubric calculus relating to health care access and provision of services. NO WHERE, NO WHERE is it implicit that the government owes such access and promise of high tech, high quality services of education, religion, transportation, health care, marriage etc. TO ANYONE. Neither does an employer have this implicit responsibility. With our overpriced and under controlled entitlement governmental systems, quality health care becomes problematic. Very problematic. Do I have a solution or solutions. Well, yes, I have several suggestions. The very first is to create a sense of PERSONAL responsibility for paying for what one gets at the store, church, school, office, and hospital. Second, I would remove immediately ALL employer purchased health insurance. Third, every person that seeks care at any public hospital must be expected to PAY IN FULL the calculated (and adjusted) amount of their health care. PERIOD. EVERYONE PAYS. Finally, there are numerous other observations which I am sure will be discussed and re-discussed (professionally) and eventually on Med-Events. Kenneth L. Mattox, MD Houston ************************************** See what's free at http://www.aol.com. -------------------------------1175791484 Content-Type: text/html; charset="US-ASCII" Content-Transfer-Encoding: quoted-printable <!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <HTML><HEAD> <META http-equiv=3DContent-Type content=3D"text/html; charset=3DUS-ASCII"> <META content=3D"MSHTML 6.00.2900.3059" name=3DGENERATOR></HEAD> <BODY id=3Drole_body style=3D"FONT-SIZE: 10pt; COLOR: #000000; FONT-FAMILY:=20= Arial" bottomMargin=3D7 leftMargin=3D7 topMargin=3D7 rightMargin=3D7><FONT=20= id=3Drole_document face=3DArial color=3D#000000 size=3D2> <DIV>From: David Crippen &lt;crippen+@pitt.edu&gt;<BR>Date: Wed, 4 Apr 2007=20 23:39:45 <BR>To:ccm-l@ccm-l.org<BR>Subject: [ccm-l] Employment and benefits=20 manipulations<BR><BR>I (and many others) predicted a long time ago that=20 employers would <BR>quickly run out of headroom in their ability to finance=20 "benefits" <BR>(read-health insurance) for their employees.<BR><BR>A close=20 friend in Indianapolis just got a very nice job, fairly well <BR>paying in=20 Indianapolis, Indiana.&nbsp; It was explained that this job <BR>existed beca= use=20 they will not provide health insurance. If they did, <BR>it would cost somew= here=20 in the range of US$2,000 per month per <BR>employee, and that would not only= end=20 the job, it would end the <BR>company. So they simply don't offer it. They c= an't=20 afford to and stay <BR>in business.<BR><BR>What they are doing is providing=20= a=20 monthly stipend for each employee <BR>they can use to purchase their own pri= vate=20 health insurance. For this <BR>particular friend, that stipend is about=20 US$150.00 per month, which <BR>will just about purchase enough coverage to=20 assure a hangnail can be <BR>fixed, should they acquire one.&nbsp; Naturally= ,=20 any past history <BR>potentially attractive for developing a hangnail will=20 exclude it.<BR><BR>So, America is now in the process of systematically exclu= ding=20 more <BR>employees from health insurance as employers simply cannot afford i= t=20 <BR>and survive.<BR><BR>Government paying for full coverage for all=20 citizens?&nbsp; That will be <BR>interesting.<BR></DIV> <DIV>&nbsp;</DIV> <DIV><STRONG><U>KLM response</U></STRONG></DIV> <DIV>&nbsp;</DIV> <DIV>I have NEVER understood why in this country, health care insurance is a= =20 condition of employment benefits, whereas religious insurance, house insuran= ce,=20 car insurance, marriage insurance, educational insurance is NOT a condition=20= of=20 employee benefits.&nbsp;&nbsp; Apparently to be competitive, after the end o= f=20 the WWII, when returning soldiers were re-entering the workplace, major=20 companies added health insurance as a benefit to attract prime=20 workers.&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>Civil Service employees have NEVER had their health care insurance paid= for=20 by the government.&nbsp; They are required to purchase health care coverage=20= from=20 one of many different plans, depending on their definition of basic coverage= ,=20 and their willingness to provide COPAY.&nbsp;&nbsp; Some civil service perso= nnel=20 have the most basic of basic coverages.&nbsp;&nbsp; I really see no need for= the=20 government to pay civil service workers an "extra" amount for ANY type of=20 insurance, be it health, school, house, car, lawyers, or religion.&nbsp;&nbs= p;=20 Those are personal choices.&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>One very very basic flaw is that society has come to EXPECT that access= to=20 equal and high quality and high technologically advanced and "expensive" hea= lth=20 care is a RIGHT to be purchased, provided, and paid for by someone=20 else.&nbsp;&nbsp; Such care is a PRIVLEDGE and a RESPONSIBILITY.&nbsp;&nbsp;= The=20 responsibility is at the individual level, just as is car insurance, home=20 insurance, choice of a religion, choice of a mate, choice of the amount and=20= type=20 of an education.&nbsp;&nbsp;&nbsp; It is a privilege to have such human and=20 personal liberties by living in this wonderful country.&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>This brings up the point as to whom is responsible for health care when= a=20 person or their responsible sponsor has not made provisions for any type of=20 service, be it house, car, transportation, gasoline, televisions, health car= e,=20 churches, or education, etc.&nbsp;&nbsp; In our free society, the answer is=20 simple.&nbsp;&nbsp; Beyond the basic public health provisions of clean air,=20 clean water, etc. it is logically NOT provided "free of charge."&nbsp; Even=20= in=20 big city and county public hospitals someone pays.&nbsp; That someone is usu= ally=20 the local taxpayer that has some social feelings of responsibility to provid= e=20 some modicum of basic health services and that society becomes the guarantor= of=20 the payment for the health service, AND the person who receives the service=20 should be expected to PAY BACK TO SOCIETY as much as possible the amount of=20 money that society invested in them.&nbsp;&nbsp; There is NO FREE LUNCH.&nbs= p;=20 There is no guarantee of providing "good health immortality" to persons who=20= have=20 all their life abused their body with ETOH, bad drugs, cigarette smoke, obes= ity,=20 and too fast driving and interpersonal violence.&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>As we move precariously closer to some form of federalized health payme= nt=20 system (and we will hear a great deal about this during the next few months)= , it=20 is very important that we understand the basic economic and professional Rub= ric=20 calculus relating to health care access and provision of services.&nbsp;&nbs= p;=20 NO WHERE, NO WHERE is it implicit that the government owes such access and=20 promise of high tech, high quality services of education, religion,=20 transportation, health care, marriage etc. TO ANYONE.&nbsp;&nbsp; Neither do= es=20 an employer have this implicit responsibility.&nbsp;&nbsp; With our overpric= ed=20 and under controlled entitlement governmental systems, quality health care=20 becomes problematic.&nbsp; Very problematic.&nbsp;&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>Do I have a solution or solutions.&nbsp; Well, yes, I have several=20 suggestions.&nbsp; The very first is to create a sense of PERSONAL=20 responsibility for paying for what one gets at the store, church, school,=20 office, and hospital.&nbsp;&nbsp; Second, I would remove immediately ALL=20 employer purchased health insurance.&nbsp; Third, every person that seeks ca= re=20 at any public hospital must be expected to PAY IN FULL the calculated (and=20 adjusted) amount of their health care.&nbsp; PERIOD.&nbsp; EVERYONE=20 PAYS.&nbsp;&nbsp;&nbsp; </DIV> <DIV>&nbsp;</DIV> <DIV>Finally, there are numerous other observations which I am sure will be=20 discussed and re-discussed (professionally) and eventually on Med-Events.&nb= sp;=20 </DIV> <DIV>&nbsp;</DIV> <DIV>Kenneth L. Mattox, MD</DIV> <DIV>Houston</DIV> <DIV>&nbsp;</DIV></FONT><BR><BR><BR><DIV><FONT style=3D"color: black; font:=20= normal 10pt ARIAL, SAN-SERIF;"><HR style=3D"MARGIN-TOP: 10px">See what's fre= e at <A title=3D"http://www.aol.com?ncid=3DAOLAOF00020000000503" href=3D"htt= p://www.aol.com?ncid=3DAOLAOF00020000000503" target=3D"_blank">AOL.com</A>.=20= </FONT></DIV></BODY></HTML> -------------------------------1175791484-- --===============0595304135== Content-Type: text/plain; charset="us-ascii" MIME-Version: 1.0 Content-Transfer-Encoding: 7bit Content-Disposition: inline _______________________________________________ ccm-l mailing list ccm-l@ccm-l.org http://ccm-l.org/mailman/listinfo/ccm-l --===============0595304135==-- ]