Archive for December 27th, 2010

Retiree Health Care Minefield – Marine Veteran Shafted ? You Decide

Monday, December 27th, 2010

December 27, 2010 3:24 PM
Dave Hendricks
The Monitor

Read the letter McAllen sent to Harold Taylor:
Click here to read the letter.

McALLEN — Facing chronic pancreatitis and the prospect of major surgery, Harold Taylor retired from the police department here during May 2009. Before he left, a city employee assured Taylor the four years he spent with the U.S. Marine Corps would count toward his retirement, triggering full health care benefits.

And for 18 months, everything went according to plan. McAllen paid half Taylor’s monthly health care premium, which covers his wife and children. The policy also covers 11 prescription medications and insulin, which he injects every morning to manage the pancreatitis.

This fall, city auditors discovered those payments to Taylor and several other retirees, and ordered them stopped.

Counting Taylor’s military service was a mistake, according to the audit. His remaining 22 years and two months with the department don’t qualify Taylor for premium assistance.

So the city’s benefits coordinator mailed Taylor one-page letter, explaining his $303.80 monthly premium would double to $607.60 next year. It’s dated Nov. 11, 2010 — Veterans Day.

“If I had known this, I would never have retired,” Taylor said. “I would have stuck it through.”

The mild-mannered, 53-year-old former airport cop said he receives a monthly $1,100 retirement check. Taylor’s new monthly bill would immediately eat more than half.

Taylor’s predicament stems from McAllen’s police contract, which requires an officer to serve 25 years before earning half-off premiums.

While military service counts towards other retirement qualifications, only years worked for the police department count toward the premium payments. Taylor’s stint with the Marines, from 1978 to 1982, took place five years before he worked for the department, and doesn’t count, according to McAllen’s interpretation of the contract.

Even an officer who served in the National Guard during his time with the department wouldn’t be able to count years spent away from the department toward the premium payments, said City Manager Mike Perez. If, for example, the officer spent four years deployed in Afghanistan, he would need to work an additional four years with the department to make up that time and earn the premium payments.

McAllen must follow the contract, Perez said. “As badly as I feel, it is what it is.”

Protecting the premium payments for retirees has been a source of contention during police contract negotiations, which are ongoing.

The city’s chief negotiator has pushed to phase out or eliminate the payments, which currently cover 19 retirees, according to figures from the McAllen Police Officers Union. No other retired city employees split their health care premiums with McAllen.

“Their whole objective is to phase out that benefit,” said Joe Garcia, the union president. “That’s one of the reasons we’re at a standstill. They’re not budging, we’re not budging.”

Come Jan. 1, when McAllen intends to stop paying half Taylor’s premium, the union will take “appropriate action,” Garcia said. “We’re not going to ignore it, that’s for sure.”

Editor’s Note: Political subdivisions in Texas are struggling with past committments towards their retirees. With GASB 45, the move to eliminate retiree benefits is a tough political pill to swallow. It is all about money.

Competition in East Texas?

Monday, December 27th, 2010

Texas Business reports:  Temple-based Scott & White Healthcare plans to build a new hospital in College Station.

The health care entity has acquired approximately 98 acres of undeveloped land that will be the home for a new 143-bed acute care hospital project.

The property was purchased from Weingarten Realty Investors and College Station ISD.

The five-story, 320,000-square-foot Scott & White Hospital-College Station will be located at the intersection of Texas Hwy 6 and Rock Prairie Road.

Construction is scheduled to begin early next year.

An adjacent 75,000 square-foot clinic is also proposed and will be built by a third party developer in conjunction with the hospital.

The hospital and ambulatory facility will be built within 90 days of each other, with a projected completion date of the summer of 2013 for both projects.

Scott & White Hospital-College Station will open initially with 119 beds and can be expanded to accommodate another 24 beds when the need arises.

“This new hospital brings Scott & White’s model of a seamless, continuum of health care—outpatient to inpatient to outpatient—to the Brazos Valley,” said Scott & White chief executive Alfred B. Knight in a prepared statement.  “Our focus on the highest quality, coordinated, cost-efficient health care is unrelenting.”

Scott & White Hospital-College Station will house an emergency department,  cardiac services including cath labs, neonatal intensive care unit, comprehensive cancer services, operating rooms, maternity services suites, endoscopic procedure suites, interoperative robotics and other specialty services, all supported by a pharmacy, comprehensive state-of-the-art imaging technology and other diagnostic capabilities.

“Patient demand for the excellent ambulatory care Scott & White has provided in the Brazos Valley sparked the building of our new clinic on Arrington Road,” said Scott & White College Station region executive William Rayburn in a prepared statement.  “Scott & White Hospital-College Station will be an open staff model hospital and will complement and support both clinics, while enhancing our ability to better serve patients through seamless handoffs between the clinic and the hospital.”

Jason Jennings has been named chief executive officer for Scott & White Hospital-College Station. Jennings previously served as chief operating officer for Hillcrest Baptist Medical Center, one of the 12 hospitals and hospital partners in the Scott & White Healthcare System.   He is a graduate of Texas A&M University, where he earned a bachelor’s degree in biomedical sciences.  He also holds master’s degrees in physical therapy from the University of Texas Medical Branch and in business administration from the University of Texas at Tyler.

 Scott & White Healthcare is a non-profit collaborative health care system established in 1897 in Temple.  The system, one of the nation’s largest multi-specialty group practices, provides personalized, comprehensive, high-quality health care enhanced by medical education and research.  The system’s Temple campus serves as the principal clinical four-year teaching facility for the Texas A&M Health Science Center College of Medicine.  Scott & White Healthcare staff of 12,000 includes more than 800 physicians and scientists and nearly 400 specialized health care providers. The system’s 12 hospitals or hospital partners include Scott & White Hospital-Brenham, and more than 60 clinic locations throughout Central Texas, including Scott & White College Station Clinic on University Drive and Scott & White College Station Clinic-Arrington Road.

Corporate-Sponsored, State Provided Cheap Dentistry in Alaska

Monday, December 27th, 2010

Boy was I ever ripped off for a dental degree!

I spent 4 years in college and 4 years in dental school, and according to a CNBC article with no byline titled “ Alaska ‘s efforts on rural dental care paying off,” I could qualify for this job after only 2 years of study right out of high school. What’s more, instead of it costing me tens of thousands of dollars in tuition, the state of Alaska insists that corporations will pay for dental therapists’ education as part of the deal… with strings attached of course.

“Organizations that employ certified dental therapists are Yukon Kuskokwim Corp, Southeast Alaska Regional Health Corp., Maniilaaq Assoc. (Kotzebue), Norton Sound Health Corp. and Bristol Bay Health Corp.”

In return, dental therapists must serve those corporations for four years to pay them back for their investment in the state certification, as well as produce income to cover the corporations’ liability and adequately compensate CEOs for their cleverness in business. Since DDSs aren’t trained to make shrewd business deals like the Alaska plan, I bet the CEOs are MBAs.

Aren’t there laws against this kind of business arrangement in the 49 states south of Alaska ?

Other than the indentured servitude problem, did not one of the RTI researchers hired by W.K. Kellogg Foundation to turn out swell research, have anything at all to say about risks of having inadequately trained high school grads performing surgery in the middle of nowhere? Did not one of the 14 therapists experience an unexpected treatment complication that required the skill and training of a real dentist – and quickly? Since the therapists work under “general supervision” of fully-licensed dentists in Alaska, rather than ”direct supervision,” how far away by plane will the DDS be when unanticipated problems predictably arise? Mysteriously, issues involving tedious parts of the Hippocratic Oath were not covered in the CNBC article.

Are those reaping the profits from this experiment in iatrogenics properly informing Alaskan parents who live in unnamed communities that the dental care their children receive is inferior to that provided by a fully trained dentist? Or perhaps RTI researches have proven that the additional, traditional education makes no actual difference in dental care.

Since there is no bad news to report, politicians could conclude from the CNBC article that the level of care provided by dental therapists with 2 years training is equivalent, or even superior to dentists’ who have four years of post-graduate training. It looks to me like Alaska is proudly racing New Zealand’s to the bottom to save money on dental care in the short term while incidentally boosting corporate profits the American way. So why not push the envelope of humane treatment, and include a capitation plan run by and for Dental Health Maintenance Organizations?

As I write this, the Texas HHS is proposing capitation to state lawmakers as a way to save money on Medicaid dentistry for children in Texas who have no choice or voice. Rather than paying per filling, DHMO corporations reward neglect on a per-head basis. I suppose worse things could happen for dental therapists’ patients.

 Since CNBC’s obviously biased article has no byline, it’s a sure bet it was not written by a CNBC reporter. So who purchased this press release? Follow the tuition.

 D. Kellus Pruitt DDS

Why Waiver?

Monday, December 27th, 2010

Why deal with the hassles and uncertainty of the yearly HHS mini-med waiver process for annual limits and loss ratio? It is likely that the exceptions provided under the waiver process will change next year. Ternian can offer you and your clients stability in this marketplace. Our fixed indemnity limited-benefit medical plans are not subject to the health insurance reform provisions of PPACA.


On-Site Medical Clinic Concept Growing – Old Idea Takes on New Meaning

Monday, December 27th, 2010

On-Site Health Centers: Value, Evidence, Toolkit, Wish We Had Known, More

MyHealthGuide Source: National Business Group on Health, 12/2010, NBGH Resource Page and Complete Toolkit available for download

To assist employers considering establishing an On-Site Health Center or those that would like to improve or expand their offerings, this toolkit offers general guidance for determining the key strategic and operational answers that need to be addressed in order for your center to be a success.

Employers are continually searching for ways to improve the health of their employees, control health care costs while still providing quality health care and provide benefits that their employees will truly value.

One potential solution is the development and use of on-site health centers (OHCs). OHCs are not a new concept; they have been used to address occupational health needs for decades. However, in recent years innovative employers have looked to redesign OHCs, transforming them from occupational health clinics to health centers that treat both the acute and chronic medical needs of their employees.

To assist employers that are considering establishing an OHC or those that already have such centers but would like to improve or expand their offerings, the National Business Group on Health has developed this toolkit, The Value of On-Site Health Centers. Because opening an OHC is a major undertaking, with design and implementation unique to each company, the toolkit offers general guidance for determining the key strategic and operational answers that need to be addressed in order for your center to be a success.

Complete Toolkit available for download.

Toolkit Components 

About the National Business Group on Health

The National Business Group on Health is the nation’s only non-profit organization devoted exclusively to representing large employers’ perspective on national health policy issues and providing practical solutions to its members’ most important health care problems. The Business Group helps drive today’s health agenda while promoting ideas for controlling health care costs, improving patient safety and quality of care and sharing best practices in health benefits management with senior benefits, HR professionals, and medical directors from leading corporations. Business Group members, which include 64 Fortune 100 companies, provide health coverage for more than 50 million U.S. workers, retirees and their families. Visit