Tag Archive for 'healthcare'

Healthcare Revolution

Europe is able to have successful and affordable Healthcare, so why can’t we. Well, the answer might be right on the tip of our tongues. We have an obesity rate of 64.5% vs. a 27% and 38% obesity rate for European females and males, respectively. (The European obesity rate is increasing at an alarming rate due to what I believe is due to poorer nutrition, the increase of fast food chains, and to many extents, the McDonaldization of Society, where quality is substituted for quantity). I found a brilliant analysis of the single problem we have with Healthcare and what must be done to change it in this Op-Ed piece in the New York Times. The author, Michael Pollan points out that the single biggest problem with Healthcare is not the system itself but America’s food industry, “a second even more powerful industry,” even more powerful than Insurance. The American diet most clearly leads to health problems in the future.  Super size meals, dollar menus, pound burritos, pretty much everything the Fast Food Industry puts on the table is fodder for the Healthcare industry. Even the salads and healthier food they have put on the menu aren’t as healthy as they appear to be. A salad with heavy dressing is over 1000 calories (like a Chipotle Burrito), and most people, because they think salad is healthy will get fries to complement said salad. You can thank the drive thru for that Type 2 diabetes as well as the fact that you have no insurance. And sure, to an lower to average income American eating 3 burgers, fries and a soda for as much as you would pay for a cup of fruit and a bagel is very tempting. What must be done aside from fixing the Healthcare system of its flaws is to tackle the giant food system and the American way of eating. By providing Americans with cost-effective and healthy eating, we will decrease the burden we are putting on the Healthcare system. If we get the health insurance industry involved in the fight over the farm bill, which they certainly will because they see the profits in having a healthy population, then we can see a true step forward for Healthcare Reform and cutting Healthcare costs.  While Pollan believes the fight should be between “Big Food and Big Insurance,” I also believe that the Healthcare Industry will side with Big Food since it throws money their way.   It looks like a we have a battle of the bigs, I hope us little ones just don’t get lost in the fog.

President Obama’s Healthcare Speech Real Time Updates

Get ready, come 8 o’clock Eastern Time, live updates will be rolling through the wires covering President Obama’s Address To Congress.  You’re not gonna want to miss this.  8pm- First Lady Obama enters into the House    8:11- The President Finally Arrives to warm applause   8:16– Speaker of The House Pelosi Announces The President of the United States   8:18 Describes that a recovery is many months away, declares he will not let up until those seeking jobs will find them  8:18 1/2 “Pulled this economy back from the brink,” only Democrats rise in applause  8:19 Issue of Healthcare, Determined to be the last President to take up Healthcare, again Democrats only stand  8:20 A History Lesson on Healthcare by Obama    8:21-8:22 PersonalAmerican stories of Healthcare’s Lapses, “This is wrong.”  Every seat applauses.  8:23-4 We must do something to control costs, “Our Healthcare Problem is Our Deficit Problem” 8:25 Left: Single Payer System (Public Plan) Right: Individualized Healthcare  8:26 4 out of 5 commitees have finished there tasks and there is an 80% agreement 8:27-8 We have also seen scare tactics that have not helped the debate, “The time for bickering is over.”  8:29 Three goals More security to those with insurance, provide those that don’t have it, slow the Healthcare costs for our country 8:30-2 If you have Healthcare, nothing will require you to change.  Against the law for insurance companies to deny you coverage if you have a preexisting condition, cannot drop coverage when you get sick, no arbitrary cap, place a limit on out of pocket expenses. If you don’t have Insurance you will have quality affordable coverage.  New Insurance exchange (shop for insurance at competitive prices).  Every seat rises in applause 8:33 This exchange will happen in 4 years.  But right now if you get sick you will be covered.  8:34-7 You are required to have Basic Health Care. (It is clear that Obama has looked at the Massachusetts system and how small businesses have many times been left out.)  8:38 Time to put down some rumors: States rumors of “Death Squads” is a complete lie 8:39 Illegal immigrants will not be covered, no abortions will be funded by the gov’t 8:40 “Consumers do better when there’s choice and competition.” 8:41 “I want to hold Insurance Companies accountable” 8:43 “Republicans and Democrats need to work together” 8:44 “If you get affordable coverage then we will give you a choice” Only democrats stand up 8:45 How to pay for this plan, “not a single dime will be added to our deficits.” 8:46 We can find savings within the Healthcare system already 8:47 Medicare “Must be passed down from one generation to the next”8:52 Reforming Medical malpractice laws, Republicans stand up in applause.  8:53 900 Billion dollars over ten years Expect commentary early tomorrow morning

Long Term Care Insurance and The AARP’s Media Blitz (No Relation)

Watch out ladies! You may not be planning and preparing for long term care properly, according to a report by the American Association for Long Term Care Insurance.  Looking at the data though, I cannot see a link between the economic downturn and the ability for women to plan and prepare for long term care.  Nonetheless, the takeaway from this data is that long term care and long term care insurance are important issues that very often get overlooked.

 

In other news, be prepared for a media blitz this Labor Day weekend by the AARP as it attempts to prove to retirees that it is has no political leanings in the Healthcare Reform Debate.  They are rolling out with millions of dollars in advertising budget to convince people that they are only looking out to help its members in the Healthcare Debate.  This advertising is rolling out because of the fact the AARP lost 60,000 or so members who thought the association was flat out siding with Democratic camp.  This is yet another reason why I’m glad I have DVR. 

Addendum to A Generational Battle

And now to add to yesterday’s blog, as a recent businesswire article, “Americans Dramatically Underestimate Health Care Costs in Retirement, First Command Reports” states that retirees need to show some foresight and put extra money for the rising costs of healthcare and clear deficit in Medicare and Social Security spending.  So ensure you and your financial advisor discuss and plan on having enough money for rising healthcare expenses and the rising taxes required to fund the government stimulus packages.  

A Generational Battle Awaits

The baby boomers and their kids are involved in serious debate over Social Security, Medicare and their respective futures.  The Social Security program is clearly running out of money, according to the Social Security Trustees report, if we do nothing, negative cash flow will commence in 2017, and all the money will be gone by 2040.  At this point in time, the boomers and their children are both supplying social security but come 2011, there will begin to be a turnaround as more and more boomers, eventually 76 million come 2029, become benefactors of the program. 

  Add to this problem the fact that life expectancy at birth is about 76 years old and life expectancy at 65 is now 17 years and there is something economically uneasy about the situation. As boomers are living longer, their medical expenses are increasing, so where are all the workers to cover these increasing costs? Well we don’t have enough workers to cover these expenses, so serious debate, as is happening now, must take place as to the next steps.  Someone, or rather a particular demographic, is going to have to cover the cost, so what is the best way to settle this without causing a generational debate. It seems boomers’ children are going to have to carry the weight of their parents but as Garver states in his article “Social Security Sets the Stage for Generational Warfare,” “Because boomers’ kids neither created the Social Security problem not let it fester more than 40 years, the problem is potentially one of generational warfare.  And boomers’ kids would hold the moral high ground by reminding their boomer parents about being taught to take responsibility for one’s own mistakes.

  There are many plans in the works about ensuring the future of Social Security and Medicare, and in a recent New York Times article, “A Basis is Seen for Some Health Plan Fears Among the Elderly” the boomers have some reason to fear about the future of Medicare as they have known it under the Obama administration.  In a Kaiser Family Foundation poll this month, only 23 percent of respondents over the age of 65 felt they would be better off if health reform passed. Younger respondents were more optimistic To many boomers Obama’s cutting of healthcare costs, and combined emphasis on effectiveness of certain programs has lead them to see that he wants to curb some of Medicare’s services.  Many are even going so far as to say that Obama is implementing so called “death squads” that will decide people’s medical fates in the last parts of their lives.  While these death squads are one extreme viewpoint and takeaway from a lengthy and constantly expanding (1,017 pages) reform bill, it still reflects as one Gallup poll released last month shows that by a 3-to-1 margin, seniors believe that reform will reduce their access to healthcare.  But as one article in the “Christian Science Monitor” points out Why GOP sees Seniors as Crucial to Health Reform Battle” seniors are the ones with the time to attend town meetings, and they pay close attention to the details of their benefits. 

  Its going to be interesting to see if we will be able to find a common ground, where maybe if you are a senior who has enough money for private insurance you can wave benefits knowing that you will be benefiting from your children’s hard work.  As it seems right now, both sides are taking the extremes of the debate, but hopefully we find a middle ground because if we don’t it’s surely going to be an uphill battle.

Is there a way out of this mess?

This is a contribution from Bud Hebeler who runs Analyzenow.com

The current economic mess:

 

Debts

 

“Households have used 30% or more of their available credit –considered a risky percentage by the industry– has risen to more than one-quarter of all card users.

Average revolving balance is $9,890, up from  $8,069 just four years ago.

US households now hold an average of 2.8 cards—compared with 2.4 cards four years ago.”  Bottom Line Personal, Feb. 1, 2008, p. 15.

 

“The past 10 years will go down as one of the greatest consumer-lending sprees ever.  Adjusted for inflation, consumer debt – including mortgages – rose an average 7.5% per year since 1997, far faster than the 4.2% rate of the previous 10 years. . . If Americans had kept borrowing at the pre-1997 pace, they would have had about $3 trillion less in debt.”  Business Week, 2/4/08,  p. 27.

 

“the average debt-to-income ratio for middle-class Americans now stands at 141%, double what it was in 1983. . . the U.S. hasn’t faced a credit crunch like this in 25 years.”  Business Week, 2/18/08, p. 34, 36.

 

“Eighteen percent of workers had a loan outstanding from their retirement plan in 2007, up from 11% in 2006….[T]he average unpaid balance at the end of 2006 was $7,300 according to  the Employee Benefit Research Institute.”  Wall Street Journal, 2/18/08, p. D1.

 

Surprise retirement costs

 

“Caring for parents can cost children: …People who don’t prepare to care for their sick and aging parents could fall victim to what economists call “negative inheritance.”.. It is when costs to children caring for their relatives outstrip any gifts or bequests they might receive in return.”  Wall Street Journal, Personal Finance: “When Inheritance is Negative.”

 

Public employees enjoy security at our costs.

 

“Public jobs see pay gains. ..State and local government workers now earn an average of $39.50 per hour in total compensation …Private workers earn an average of $26.09 an hour. . . From 2000 to 2007, public employees enjoyed a 16% increase in compensation after adjusting for inflation compared to 11% for private workers. . . The nation has 20 million state and local government employees [+ 2.7 million federal workers not including the military or supporting contractors].  About 116 million people work in the private sector.”  USA Today, 2/1/08, p. 1.

 

“public pension funds have $3 trillion in assets but unfunded liabilities of $440 billion…An economic slowdown would only aggravate the situation for many funds…” Wall Street Journal, 2-28-08, p. C1.

 

 

Medical costs increase naturally as we age—but so does the unit cost.

 

“The survey of 1,000 Americans over the age of 65, conducted for Medco by Directive Analytics, found that one in three retirees say medical and drug costs far outpaced expectations. Results also showed that one in four retirees spend 10% or more of their monthly retirement income on medications alone.”  Reported 2/13/08 on FoxBusiness.com.

 

Taxes

 

“Eliminating the 75-year Medicare deficit would require an immediate 122% increase in the 2.9% Medicare payroll tax, a 51% cut in benefits, or a combination of the two.”

American Academy of Actuaries quote from USA Today 1/17/08, p. 3B.

 

“Daunting future for Medicare.  Spending will soar from 3% of gross domestic product now to 8% of GDP in 2040, according to Boston College’s Center for Retirement Research.  By 2040, income tax rates will need to rise by 20% to cover the government’s Medicare costs, and out-of-pocket costs will devour more than half of the average Social Security benefit.”  Kiplinger’s Retirement Report, January 2008, p. 9.

 

“If today’s tax rates remain in place, 76% of all federal income tax revenue in 2050 [vs. 8.6% in 2010] will be soaked up by [Social Security and Medicare] –before a penny is spent on defense, national parks, health care for the poor or haircuts for congressmen.”  Money, 3/08, p. 88.

 

“Senior benefits costs up 24% [above inflation in last 8 years.]  The average Social Security benefit per senior in 2007 was $13,184…The [total] cost of government benefits for seniors soared to a record $27,289 per senior in 2007, according to a USA TODAY analysis.”     USA Today 2/14/08, p. 1.

 

Inflation

 

“If you start measuring inflation after the Great Depression, inflation has been 4%, not 3%.  Long periods of recent history had over 6% inflation.  My father retired in 1965.  He lived to 96.  During those years his purchasing power declined 80%!  In the first ten years of my own retirement, my fixed pension lost 30% of its purchasing power–and that was in a time of supposedly low inflation.”  Inflation Can Destroy Retirement, www.analyzenow.com, Helpful Articles by Henry K. Hebeler.

 

Retirees inflation greater than the CPI

 

“By 2017, total health care costs will double to more than $4 trillion a year, accounting for one of every $5 the nation spends…The 6.7 percent annual increase in spending – nearly three times the rate of inflation – will be largely driven by higher prices and an increased demand….That [$4.3 trillion] would be about 20 percent of the U.S. gross domestic product….In 2006, people and the government spent …an average of $7,026 a person.  In 2017, health care spending will cost an estimated $13,101 a person.”  Seattle Times, 2/26/08, p. A4, referencing report from Centers for Medicare and Medicaid Services.

 

 Investments

 

“Corporate Earnings.  Yes, there’s been a profit boom in recent years….But here’s an unfortunate truth – the profit surge has been mainly in one area, financial services.  Financial institutions have benefits from the consumer credit boom, the proliferation of new financial instruments, and relatively low rates.  By contrast, the earnings of nonfinancial companies over the past decade have averaged …about the same since the mid-1980’s.”  Business Week, 2/4/08, p. 27.

 

“In 2003, 10 big Wall Street firms paid $1.4 billion in fines and penalties to settle civil charges by securities regulators that they issued overly optimistic stock research to win investment-banking business from companies they were supposed to analyze separately.”  WSJ, 2/16/08, p. B1.

 

Your home as an investment

 

“As baby boomers retire, home markets will hurt. . .The math is simple:  79 million boomers have driven up housing demand.  That trend will reverse itself when boomers are age 65 to 75;  there will be three sellers for each buyer.”  Dowel Myers, Prof. of policy, planning and development, USC.  USA Today, 1/16/08, p. B1.

 

Count on energy problems

 

“Our energy problems will not go away—at least in our lifetimes.  Our dependence on foreign oil is too great and our political process too weak to permit mobilizing solutions. It is virtually impossible to develop domestic oil fields, increase refineries, build dams, construct power plants, lay pipelines, string high power lines, open coalmines, dispose of urianium, and the like.

 

“Industrial and commercial growth has always demanded more energy.  We have seen it here, and we are starting to see it in developing countries.  China by itself is going to be a massive user of energy—even bigger than the United States.  India is going to add to the problems.”  Getting Started In A Financially Secure Retirement, Wiley & Sons, 2007.

 

The average person can’t recover.

 

It’s important to understand the history of national savings rate, that is, the percent of disposable income (gross income less income tax).  During the Great Depression, savings rates were about 4% and dipped below zero for only two years.  The Great Depression was followed by World War II.  During the war, the national savings rate was its highest value ever averaging about 25%.  After World War II and until 1985, the national savings rate was generally between 8% and 10%.  The exceptions were the couple of years immediately after the war when the savings rate was only about 5% to 7%.  That was when people once again had an opportunity to buy automobiles and previously rationed items.  Still, the savings rate was not negative, and debt was a bad word.

 

The fuse to our financial disaster was lit about 1985 when national savings rates started an abrupt decline until savings became virtually non existent from 2005 on. Consumption increased at a mad pace as men, women and children raced to get the latest electronics, large houses and vacation expenses far beyond their means.  Debts increased as well as people stretched to borrow on the remaining assets to be like their friends and the “Jones” across the street.  Grade school kids had to have cell phones.  High school kids had to have cars.  Mom and Dad had to have a bigger TV and cable connection to the internet.

 

“The financial industry, intent on keeping an image of ever upward growth, makes one excuse after another to minimize the importance of national savings. At one time, financial “experts” said people didn’t have to save because they were going to inherit so much.  When the stock market was booming in the late nineties, these same experts said people don’t have to save because what they have already saved had grown so much.  Then the next excuse was that people have made tremendous savings from the growth of their home equity.  After watching all of these theories fall apart, these experts must have crawled into the woodwork, because their silence is deafening after the tide has turned in each instance.

 

“So, how much would people have to save in the future to make up for lost savings over the past 20 years?   To get this answer, we have to calculate what they would have accumulated with 9% savings over both the past 20 years plus the number of years ahead when they will retire.

 

“Let’s first assume that they have 20 years ahead to save.  Over the past 20 years plus the future 20, they would have accumulated what amounts to 10.9 times the final year’s after-tax wages—if they could get a consistent return as high as 8% in a deferred-tax account and preserve 3% wage growth over the entire period. (10.9 times final wages might finance a retirement income of 40% to 50% of working wages.)  In order to get 10.9 times final wages using the actual past 20 year’s savings rates, they would have to save almost 21% of their disposable income for the next 20 years.  Starting now!

 

“Can you imagine the difficulty of getting the national savings rate to 21%?  The only time it has been that high since the Great Depression was during World War II when virtually all people, wives included, were working and there was nothing to buy.  Industry was focused on weapons production, not goods for civilians.  Further, almost everything was rationed.  It was politically correct for everyone, including school children, to invest in savings bonds.  It took that kind of environment to achieve such high savings rates, all in spite of the highest income tax rates we’ve ever had.”  Quotes above are from www.analyzenow.com from the Economics page of Helpful articles.

 

In fact saving 25% of disposable income took more than war conditions.  It took a nation that had just come out of the Great Depression where people were conditioned to a harder life.  Most people had very little.  There were no television promotions of a more desirable lifestyle or media advertisements for innumerable pieces of intriguing electronics.  Further the nation had a cause: the possibility of being overrun by aggressors just as was happening in Europe.  People were patriotic and united.

 

One would think that people would be saving more as employers abandoned pensions in favor of savings plans.  For the most part, the government jobs are the ones that still have both pensions and savings plans.  Not only that, but most of the government pensions have cost-of-living adjustments, COLAs.  These are very rich pensions indeed—usually supported by strong government unions.  Together they form an extraordinarily powerful voting block that will surely not support a reduction in their jobs (many with tenure), compensation or benefits.

 

With almost one out of every five people working for the government, four out of five must pay for their support—adding to the problem.  This ratio will rapidly deteriorate as the working population decreases when the baby boomers retire and the size of government continues to increase, both in ratio and in absolute numbers.  Remember, too, that the government sector has wage and benefit levels about half again higher than private sector employment.

 

The way out of this economic mess:

 

We won’t be able to solve the nation’s problems, but we in the private sector can do something as individuals to help ourselves.

 

“Forgo the Joneses’ lifestyle,

 

Make conservative plans,

 

Preserve some funds as reserves for unknowns,

 

Shift to fixed income investments [as we age],

 

Ladder immediate annuities late in life,

 

Repeat planning process every year.”

 

Points are from “Getting Started in a Financial Secure Retirement,” Wiley & Sons, 2007.

 

Actions like these will make what is inevitably an unbearable situation for the average person in the private sector to something that’s tolerable for those who save, invest conservatively, and plan for a difficult economy.  This is much of the theme in the Web site, www.analyzenow.com.

 

The final point is the often cited 1787 quote supposedly from Alexander Tyler, a Scottish history professor at the University of  Edinburgh.  There is no evidence of this being an actual quote, but the thought is something to consider.

 

“A democracy will continue to exist up until the time that voters discover they can vote themselves generous gifts from the public treasury.  From that moment on, the majority always vote for the candidates who promise the most benefits from the public treasury, with the result that every democracy will finally collapse due to loose fiscal policy.”

 

I hope that this is not the final outcome of our future years, but the alternative outcome often cited seems quite unlikely.  That alternative outcome is a booming economy with relentless consumerism that provides enough money to support our government’s largess, thriving business and retirees without savings.  This dream will fade as the majority of baby boomers count on Social Security as their primary retirement resource and a financially failing Medicare for their health needs.  All this while the private sector work force reduces and tries to bear ever increasing government costs.


Note:  Many of the things above are covered in more detail in “Getting Started In A Financially Secure Retirement,” Wiley & Sons, 2007, as well as in the Helpful Articles section of www.analyzenow.com.




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