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News and Opinion Concerning Health Savings Accounts, Medical Costs and Health Care Reform

• Wall Street Journal: Open Season for Drug-Insurance Swindlers. By Tom Lauricella. Excerpt: Holiday season coincides with the open enrollment period for Medicare prescription drug coverage, and regulators are warning that an increasing number of unscrupulous insurance agents also view it as open season for preying on older adults.

  The wrongdoing, among other activities, involves violating federal regulations against door-to-door selling of coverage and the forging of signatures. "It's the wild, wild West out there," says Mary Jo Hudson, director of the Ohio Department of Insurance.

• Forbes: How To Find The Best Deal On Health Insurance. By Maureen Farrell. Excerpts: The numbers are enough to scare you sick. Some 60% of companies now offer health benefits, down from 69% in 2000, according to the 2007 annual health benefits survey from the Kaiser Family Foundation. Small businesses are even less generous: Just 45% of companies with three to nine workers offer health benefits. Total number of uninsured Americans: roughly 47 million, or 16% of the U.S. population.

  Buying insurance as an "individual" is nothing less than a nightmare. For starters, employees of firms that offer health insurance can use pretax dollars to purchase it; individuals can't (at least not yet). Worse, individual buyers are entitled to fewer protections than employees of large firms. In most states, insurance carriers can deny coverage to individuals with a preexisting condition like cancer or diabetes. And for the fortunate few who can afford to buy insurance on their own, there's a labyrinth of options and loopholes to navigate when choosing a policy.

• Denver Business Journal: Health care executives blame government and insurance companies for big markups. By Bob Mook. Excerpts: Most anyone who's been in a hospital -- and survived the panic attack that follows when they see the bill -- finds out quickly that no one expects them to pay the total amount due. But why do hospitals send out bills that bear no resemblance to what insurance companies, the government and most individuals actually wind up paying? And what effect, if any, is it having on the rising cost of health care?

  Hospital administrators admit that billed charges are marked up well beyond what most insurers and patients really pay. And they agree the process of setting staggeringly high charges isn't logical. "We have an irrational pricing structure that we've created as an industry over the last 30 years," said Ned Borgstrom, CFO of Exempla Healthcare, which manages three Denver-area hospitals. "We created a monster, of course." Indeed, billed charges are so much higher than the actual costs or what insurers pay, they're practically meaningless to health care consumers.

• Houston Chronicle: Doctors' Survey: Insurance companies impede patient care. By Lynn Cook. Excerpts: Health insurance companies often block needed patient care through delays in processing claims and intervention by unqualified personnel, according to a first-ever survey of Houston-area physicians. ...

  Greg Bernica, CEO of the Harris County Medical Society, said the group had hoped to rank insurers from best to worst. Instead, the companies all scored so low there was not enough statistical difference to do an actual ranking. "They all came in last," he said. ...

  The survey found:

  • 70 percent of physicians responding said insurance companies had denied claims for medically necessary procedures.
  • 66 percent said they had trouble getting insurance company preauthorization for scans and other imaging.
  • 83 percent said the red-tape and delayed payment involving insurance companies required them to fill at least one, and often two or three, administrative positions per doctor to deal with filing and billing issues.

• California HealthLine: Fewer Medicare Drug Plans Offer 'Doughnut Hole' Coverage in 2008. Excerpts: Few Medicare plans in 2008 will offer brand-name prescription drug coverage in the so-called "doughnut hole" gap because of cost, meaning that Medicare beneficiaries will have fewer options when choosing a plan during the open enrollment period that ends Dec. 31, the San Francisco Chronicle reports.

  The doughnut hole gap in 2008 begins when drug costs for an individual and his or her insurer reach $2,510 and ends when spending reaches $5,726. Only one plan, located in Florida, will provide coverage for brand-name prescription drugs in the gap in 2008.

• The New Republic: And Now for a Really Bad Idea on Health Care Reform... Excerpts: With the Iowa caucuses less than a month away, it's important to scrutinize the health care reform plans of the leading Democratic presidential candidates. But it's also important to keep these differences in perspective. Hillary Clinton and John Edwards would require everybody to obtain insurance, Barack Obama wouldn't. But they're all talking about the same goal: Covering every single American though some sort of government action. And their plans still have a great deal in common. That's a good thing.

  You almost never hear that kind of talk on the other side of the aisle. With a few important exceptions, what you hear are ideas that would not help very many people and might -- quite possibly -- hurt some. A case in point is the Republican crusade against state regulation of insurance.

  Many states have strict requirements for how insurance companies can price their policies and what benefits they must offer. The requirements generally apply only to insurance purchased by individuals and small businesses. (Plans for large employers are exempt because of a law called ERISA, whose history and meaning I will spare you -- because nobody whose job doesn't involve administering health benefits should have to slog through that explanation.)

• Health Beat Blog, courtesy of Physicians for a National Health Program: New CDC Report: The Nail in the Coffin for Health Care Myths. By Niko Karvounis. Excerpt: On Monday the CDC released a landmark, and in many ways devastating, report on health care in the U.S. The report contains a wealth of data that, while not surprising to some, should help silence the dwindling few who insist that America’s health care system is doing just fine. As a public service, I thought it’d be helpful to list some of the myths that the report demolishes (with some help from other sources as needed).
• New York Times: I Am Not a Health Reform. By David U. Himmelstein and Steffie Woolhandler. Excerpts: IN 1971, President Nixon sought to forestall single-payer national health insurance by proposing an alternative. He wanted to combine a mandate, which would require that employers cover their workers, with a Medicaid-like program for poor families, which all Americans would be able to join by paying sliding-scale premiums based on their income.

  Nixon’s plan, though never passed, refuses to stay dead. Now Hillary Clinton, John Edwards and Barack Obama all propose Nixon-like reforms. Their plans resemble measures that were passed and then failed in several states over the past two decades.

New on the Alliance@IBM Site:

• From the Job Cuts Status & Comments page
  • Comment 12/10/07: I heard through some management contacts that there will be 10% cuts (in staff numbers) in Server System Operations and Server Administration by end of Jan 2008 (LEAN stage 5 they call it I think). Any other Canadian's out there who knows anymore? -DM-
  • Comment 12/11/07: HR in Atlanta and RTP are reporting they are gonna be VERY BUSY come 1Q08 and won't/can't say why. I wonder if there will be another sell off of a major div/org like Network Services. BTW, Network Services folks going over to ATT on 2/01/08. -innovation station-
  • Comment 12/12/07: TO: -innovation station- *** IGF is offshoring almost all functions from NA to SA (Brazil) in 1Q2008. IGS will be having a major services function offshore to India, China and Vietnam. So HR will have to process all the burn out timber that IBM NA gets rid of. So for most IBM NA folks, As Donald Trump was famous for saying: "YOU'RE FIRED !!!" -no-ky-
  • Comment 12/13/07: Hi George, the only rumours I heard cuts about was for Canada in IGS....10% cuts in Operations and Sys Admin, in ADDITION to more outsourcing to Argentina for technical work and offshoring of service/clerical work going somewhere also - Vietnam and/or Brazil is what I heard. -DM-
  • Comment 12/14/07: To RA'd bear. Very true. Customers now call any given support center multiple times in a process I heard them call " Re-Hadji-ing" As in did you re-hadji the question and get the same answer? If so maybe we can try what they suggested. Sad but true.. -Exodus 2007-
• General Visitor's Comment page:
  • Comment 12/09/07: On 08/28/06, Nick executed options on 197,228 shares at $36.0625, and sold them for $80.00 a share, realizing a profit of $8,665,705.20. The expiration date on these shares was 03-12-07. If he had sold them on 01-16-07 when the shares closed at $100.82, he would have realized an additional profit of $4,106,286.90. Pretty costly mistake, kissing away a mere extra 4.1 million. -CostlyMistake-
  • Comment 12/11/07: "On 08/28/06, Nick executed options on 197,228 shares at $36.0625, and sold them for $80.00 a share, realizing a profit of $8,665,705.20. The expiration date on these shares was 03-12-07. If he had sold them on 01-16-07 when the shares closed at $100.82, he would have realized an additional profit of $4,106,286.90. Pretty costly mistake, kissing away a mere extra 4.1 million" Tell me, how many millions has Nick sucked from the IBM company. 4 mil is chump change to Nick. Jolly old Nick. He can kiss my ass. -Anonymous-
  • Comment 12/14/07: Wow! It sounds like IBM is almost insolvent in the East Region! Just received a note from Larry Arrington advising us that we are in jeopardy of missing our 2H spending challenge as a region. He wants our response this week on what actions we can take in the last 2 weeks to reduce or defer spending to 2008. Here is a list of items that I need each of you to review and communicate immediately to your SSRs and confirm back to me that it was done.

    Limit all OT hours and additional compensation immediately.....ALL NON EMERGENCY CALLOUT OT MUST BE PRE APPROVED BY THE SDM..PERIOD! I know it's year end and there's a lot of push on install activity...but please focus hard on scheduling the work to minimize overtime and having duplicate resource assigned to the installs. (Our extra comp numbers only went down a 10th of a % YTD from Oct to Nov)

    • Wherever possible....reduce contractor or supplemental SSR hours through year end.
    • Absolutely no tools or supplies orders until January.
    • Take advantage of all SC 44 activity and ensure all qsars are recorded before year end.
    • Limit all meeting activity that generates reimbursement expense. Hold any WWERS reimbursement activity to January.
    • Limit all unnecessary travel..Request that SSR's look at anyway to consolidate trips for parts etc.
    • No BOND orders......this was already communicated but reinforce it.
• Pension Comments page
• Raise and Salary Comments
  • Comment 12/13/07: Salary = 50,000; Band Level = 6; Job Title = Financial Analyst; Years Service = 0; Div Name = S.O.; Location = Somers; , NY Message = I'm graduating in May from a SUNY (NY state school) with a BS in Finance and no professional work experience. I've received an offer for 50k as an Financial Analyst in Somers, NY, which is an expensive area. I would probably live in White Plains, NY. Is this a good starting salary for me? Do I have any room to negotiable, and if so how? Thanks! -newcollegegrad-
  • Comment 12/14/07: newcollegegrad: IMHO that's a bit low for Westchester Co. NY. but it's typical of what Big Blew is offering these days. Wiggle room? I doubt much but it can't hurt to ask if you plan to go for your Master's whether IBM might pay for it for you. You might want to ask for equity (i.e. stock options) and see what they have to say. That might show to some little degree whether they want to retain you for a few years.. Do your homework and check the salary surveys on the internet. If you do join IBM don't plan on cracking $60K anytime soon thereafter. If you do take this offer be sure to join the Alliance! -anonymous-
  • Comment 12/14/07: Salary = 49k; Band Level = 6; Job Title = accountant; Years Service = 2; Hours/Week = 40; Div Name = IMBPD; Location = Tulsa; Message = -newcollegegrad- Yes, negotiate a higher salary before you're locked in at this current offer. Once you've agreed on a salary then don't expect any kind of a raise for quite a while (or even a raise that keeps up with inflation). $50k does seem low for a NY salary for a band 6 financial analyst. Anyone else in this area that can vouch for this salary range being low? -Tulsa member-
• PBC Comments
  • Comment 12/10/07: Concerning skews, everyone is exactly right. There is definitely a skew with percentage for PBC 1 and for PBC 3. During my last year in management, in my organization, it was a 7% skew for 3 performers (at the 2nd line level). The important point here is that the CALIBRATION SESSIONS TOOK PLACE IN FEBRUARY. YOUR RATING IS SET IN FEBRUARY AT THE SECOND LINE LEVEL. -Former 1st Line Manager-
  • Comment 12/11/07: Doesn't matter what you put in your PBC. I bet if you put in the same almost verbatim PBC results as last year you'll get probably the same rating. I bet managers will not even read one word of it to know about it. I don't waste my time on this BS process anymore. I think the managers will not pay attention to it either anymore. -Anonymouse-
  • Comment 12/12/07: Managers will read enough of your PBC to be able to articulate your results. Your feed back will have no effect on the rating. That was determined in February at the 2nd line level during calibration sessions, and loaded into the tool in October. -Anonymous-
• International Comments

Vault Message Board Posts:

Vault's IBM Business Consulting Services message board is a popular hangout for IBM BCS employees, including many employees acquired from PwC. A few sample posts follow:

• "Desirable?" by "ribbonmatch". Full excerpt: To all the good people on this message board, what are you thoughts about this qualification? It's piqued my interest as I've been studying for an ITIL certificate and I run across references to PMP on w3. Getting a PMP is also an aim for IBM people I work with who have PM responsibilities. For anyone with this qualification, has it helped you become a better project manager? Given two consultants with equivalent experience but only one of them having the PMP, would you hire the consultant with the PMP? (A theoretical question, I know, but one for the sake of argument).
• "Marginally so" by "Dose of reality". Full excerpt: Project management skills are developed on the job, not in a classroom. If I were looking to staff a project, a PM that had certification would have no edge at all over another resource. It only has value for IBM when it pitches you to clients. Also, if you go into industry, in a PM type function, you may also impress the HR folks, as well as hiring managers that are ignorant.

  If you are expecting it to turn you into a better project manager, forget it, unless you are absolutely clueless about PM, and you just want to get an understanding of the elements of project management.

  No good project manager manages by the numbers, and you either have the critical soft skills or you don't. As for the hard skills, there are hundreds of ways to effectively manage a project. Methodology is only window dressing.

• "What makes a good PM?" by "civilliberty". Full excerpt: I don't know anything about PMP. But I have had good and bad PM's inside of and outside of IBM (but mainly outside - in this case not so much a reflection on IBM, but more-so the fact I had relatively short tenure at the company).

  The best PM's I ever had were good people person's and people who had a natural feel for managing stake-holder expectations. They enjoyed and believed in their staff - no amount of training will change you from a technical nerd, or someone who can only manage to process, to a person that likes the company of others. Life experiences might change you, but then again they might not. (Sometimes it helps to be accountable to another person who treats you the way you treat others and then you really know what it's like and how you might be perceived by others - not always a pleasant experience, but of infinitesimal value nevertheless).

  Those who try to develop the soft skills but aren't emotionally tuned in come across as frauds and don't really seem to get anymore respect and subsequently don't get better productivity or trust from their staff.

  You can teach most people technique, if they are willing and intelligent, but you can't teach people to like and appreciate others.

  And, then there are the PM's who sell-out to the client and don't support their own staff who are lured by the idea of good client feedback at the expense of the welfare of their own people. Walking that tight-rope successfully of supporting your staff whilst delivering to the client in my opinion is one hallmark of being a good PM - some do that well, others are appalling.

• "You hit all the hot buttons" by "Dose of reality". Full excerpt: An effective project manager will put the success of the project ahead of the personal and career objectives of client and consulting firm staff. Beyond that, it just takes discipline, organizational skills, and communication skills.
• "So it's not rocket science after all" by "ribbonmatch". Full excerpt: Thanks guys for the replies. I had a sense that these kinds of qualifications can at best only buttress the talent and knowledge that's there already. I suppose, though, that the talent and knowledge is harder to acquire than the qualifications. I like civilliberty's question about what makes a good project manager. Let me turn that question around in a way and ask what you guys look for in tech people when you staff your projects?
• "Preferred attributes" by "civilliberty". Full excerpt: Technical people come in all shapes and sizes with varying skill sets. Answering your question depends on what you are seeking to achieve. These days companies seem to purchase talent based on skill set more than experience even , or ability - it's not the way I personally would necessarily staff a company, but I come from the older school also.
  1. Team work - the person has to get on well with other team members and be willing to share their time and experience across the team. There are many techo's who can't or won't do that - that for me is a real sticking point. It's particularly noticeable with contractor's (of which I am one at the moment - but I'm not like that). I've seen a team of good talent that works well do more and better than one which depends on the premium player who often us a prima-dona - though there are exceptions.
  2. Ability. The person may not have every skill you're looking for, but the question is does he/she have the ability and drive to pick up a skill and with suitable on the job mentoring become a valuable contributor (I was placed in this position more than once)- past history and an interview should be able to determine this. It is particularly important if you want someone who will be flexible to grow with the business and changes in technology and you want to keep the knowledge in-house.
  3. Communication skills. Does the person have an interest in dealing with the business and business analysts/functional resources ?. It's important you don't get someone who thinks their responsibility begins and ends with coding but understands their contribution within the bigger picture. Siloed roles create division and let down the team ultimately. The days of pure technical work are coming to a close. Business is demanding more business knowledge and interaction from those providing the solutions
• "Dose, interested to know if you've known bad managers" by "civilliberty". Full excerpt: Dose, did you have to manage managers at some stage who just weren't the correct fir for the role, and if so, how did you address that. What I see happen a lot is that they still hang around at a company. The company seems more interested often in getting rid of the workers at the coal face than the managers (in particular IBM).
• "Only from a distance" by "Dose of reality". Full excerpt: I have to tell you that I have been fortunate and never staffed an incompetent or over matched PM in a role. A competent PM is THE make or break cog in a project wheel by far. A good PM can even deliver on a poorly conceived project, but a bad PM can easily screw up a slam dunk. I personally interview, or more specifically grill any PM that I staff, and my external hiring standards for band 9 and up are very stringent.

  That being said, some of my colleagues are either clueless in evaluating talent, or so desperate to staff projects that they roll the dice with PMs on a lot of projects.

  There are a few reasons why IBM jettisons the workers before PMs. First, the PM controls the internal communication plan, and it is too easy for the blame to be pushed downward, even if the screw-ups were at the PM level, or as is more often the case, the deliverables are impossible to meet in the time allotted. Second, it is easier to replace a band 7 than it is to replace a band 9. Third, the continuity in a project will suffer more with a change in PM, both in terms of client relations, and execution. It will appear as though the firm screwed up if it pulls a PM, as opposed to the situation where problems are blamed on one of a dozen band 7s that are on the project. The latter just seemed like simple probability, while putting an incompetent PM in reflects much worse on the firm. Finally, IBM is the ultimate hierarchical organization – the higher you are, the more power and perceived authority you have. To defer to an underlying in a contentious issue is really counter-cultural.