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

• The Commonwealth Fund: Health Reform in a New Era: Options for the Obama Administration. By Karen Davis. Excerpts: In 2007, the number of uninsured stood at 46 million, up 20 percent from 2000. And the number of underinsured—people with health insurance that fails to provide adequate access to care or financial protection—jumped 60 percent over four years, to 25 million in 2007. Today, people are worried about keeping their jobs and health coverage, and are increasingly concerned about their debt, including medical debt. The Commonwealth Fund 2007 Biennial Health Insurance Survey found that about two-thirds of U.S. working-age adults, or 116 million people, struggled to pay medical bills or pay off medical debt, went without needed care because of cost, were uninsured for a time during the year, or were underinsured.

  While President-elect Obama has set forth the substance of his health reform agenda, he has not yet revealed his overarching strategy or precisely when and how he would move on health reform, but there are a number of courses of action open to his Administration.

• New York Times: Some G.M. Retirees Are in a Health Care Squeeze. By Nick Bunkley. Excerpts: General Motors is living on borrowed time, spending more than $2 billion in cash a month and lobbying for a government bailout to keep it out of bankruptcy. And for about 100,000 of its white-collar retirees, time is about to run out on G.M.’s gold-plated medical benefits.

  To conserve its dwindling cash reserves, G.M. is eliminating lifetime health care coverage for its legions of retirees at the end of this year, leaving people like Ken Hewitt to fend for themselves in deciding how to cover their doctor’s bills and prescription drug costs. ...

  To help retirees pay for their new coverage, G.M. is raising monthly pension payments by $300, which typically means $240 or $255 after taxes. ...

  “Anyone that thinks they can go out and replace insurance that you had with General Motors for $255 and get the same kind of coverage, I’d like to sell them a bridge in Wisconsin somewhere,” said Mr. Dickinson, 65, whose irritation with G.M.’s move is apparent in the headline “G.M. Robs Their Elderly Retirees” on his Web site atop information about the changeover.

• New York Times: Deported in a Coma, Saved Back in U.S... By Deborah Sontag. Excerpts: Soon after Antonio Torres, a husky 19-year-old farmworker, suffered catastrophic injuries in a car accident last June, a Phoenix hospital began making plans for his repatriation to Mexico.

  Mr. Torres was comatose and connected to a ventilator. He was also a legal immigrant whose family lives and works in the purple alfalfa fields of this southwestern town. But he was uninsured. So the hospital disregarded the strenuous objections of his grief-stricken parents and sent Mr. Torres on a four-hour journey over the California border into Mexicali.

  For days, Mr. Torres languished in a busy emergency room there, but his parents, Jesús and Gloria Torres, were not about to give up on him. Although many uninsured immigrants have been repatriated by American hospitals, few have seen their journey take the U-turn that the Torreses engineered for their son. They found a hospital in California willing to treat him, loaded him into a donated ambulance and drove him back into the United States as a potentially deadly infection raged through his system.

  By summer’s end, despite the grimmest of prognoses from the hospital in Phoenix, Mr. Torres had not only survived but thrived. Newly discharged from rehabilitation in California, he was haltingly walking, talking and, hoisting his cane to his shoulder like a rifle, performing a silent, comic, effortful imitation of a marching soldier.

  “In Arizona, apparently, they see us as beasts of burden that can be dumped back over the border when we have outlived our usefulness,” the elder Mr. Torres, who is 47, said in Spanish. “But we outwitted them. We were not going to let our son die. And look at him now!”

• Physicians for a National Health Program: Unhealthy Solutions: Private Insurance, High Costs and the Denial of Care. An Interview with Steffie Woolhandler. Excerpts: We have looked at bankruptcy to see what share of all U.S. bankruptcies are due to medical illness and medical bills. It turns out that at about half of all U.S. bankruptcies are due at least in part to illness. The most surprising thing in our study on bankruptcy was that the overwhelming majority of those American families pushed into bankruptcy by medical bills had insurance, at least at the onset of the illness that bankrupted them. About 76 percent of all people in the U.S. pushed into medical bankruptcy do have health insurance when they first get sick.

  There are two ways that they are bankrupted. Sometimes people have insurance through their job, but they become too sick to work, or have to take off work to care for a very sick child, and they lose their health insurance. So they have health insurance and then lose it because of the illness itself.

  But another very frequent scenario in our bankruptcy data involved people who held onto their insurance, usually private insurance, throughout the illness that bankrupted them. They were insured the entire time, but were bankrupted anyway by gaps in their coverage — uncovered services, co-payments and deductibles.

  Private health insurance is a defective product. On one hand, you may lose it when you need it most — when you get sick. On the other hand, even if you are able to hold onto private insurance, the gaps in the coverage mean that you may be bankrupted anyway.

• New York Times: The Health Care Challenge: Sailing Into a Perfect Storm. By Uwe E. Reinhardt.
• U.S. News & World Report on Friday issued its America's Best Heath Insurance Plans rankings and published several articles related to the issue. Headlines and summaries appear below.
  • America's Best Health Insurance Plans: If Your Company Stumbles, What Happens to Your Health Coverage?": The article examines the health insurance costs of several individuals who recently lost their employer-sponsored health insurance coverage (Andrews, U.S. News & World Report, 11/7).
  • "Behind the Health Insurance Plan Rankings: We Looked at How Well Plans Prevent and Treat Illness and Satisfy Members": Health plan rankings include measures of member satisfaction with the ease of making appointments and receiving care, doctors' ability to effectively communicate and experience with claims handling (Comarow [1], U.S. News & World Report, 11/7).
  • "Health Insurance Plans That Hide Their Data: More Than 100 Health Plans Couldn't Be Ranked -- They Refused To Release Information": According to U.S. News, 126 health insurance plans declined to agree to release data on a number of clinical and patient satisfaction categories (Comarow [2], U.S. News & World Report, 11/7). The list is available online.
  • "What If Your Health Insurer Won't Pay?: The Smartest Tactic Might Be To Hire a 'Medical Billing Advocate' To Do Battle For You": The article examines "medical billing advocates," companies that "negotiate with health care providers and insurance companies to lower consumers' medical bills" (Raeburn, U.S. News & World Report, 11/7).
  • "America's Best Health Plans Honor Roll: The 20 Health Care Plans on This Elite List Outperformed Hundreds of Others": Based on a score from zero to 100, the 20 plans that scored the highest are ranked (U.S. News & World Report, 11/7).
• Los Angeles Times: Obama urged to overhaul healthcare, stat. Groups representing retirees, business and labor call for comprehensive healthcare reform in the new administration's first 100 days. By Noam N. Levey. Excerpt: Four leading advocacy groups representing business, labor and retirees are starting a campaign today to press Barack Obama to enact comprehensive healthcare reform, upping the pressure on the president-elect to tackle the issue quickly after he takes office. In a letter to Obama, the Business Roundtable, the National Federation of Independent Businesses, AARP and the Service Employees International Union urge that a healthcare overhaul be a priority in the administration's first 100 days.
• Health Beat: Advice for the “Seemingly Healthy”: Know Your Chances (Part I).
• Human Resource Executive Online: Insurance Producers Worried Obama Health Plan Could Leave Them Out. Excerpts: A decade and a half ago, it was the now-defunct Health Insurers Association of America that led the charge against then-First Lady Hillary Clinton's health care reform plan, marshalling the entire business community in a revolt that had at least a bit to do with the Republicans' take-over of Congress in 1994. But as the health insurance community prepares for revived efforts at health care reform under president-elect Obama, it is not the insurers who write the coverage, but the producers who sell it, that seem most alarmed by changes that could be coming. ...

  And it isn't just life/health specialists who are paying attention. Agents and brokers that traditionally have been engaged primarily in commercial property/casualty increasingly have been relying on the profitable growth of health benefits as a hedge against the waning and waxing of the insurance pricing cycle. "Employee benefits, for independent agents, is the fastest part of their book of business," said Robert Rusbuldt, president of the Independent Insurance Agents & Brokers of America. "For a medium-size agency, employee benefits is now constituting a meaningful size of their book of business, and it's the most profitable part of their book of business, because there's no soft market."

• Physicians for a National Health Program: Lessons from the U.K. By Martin Roland, D.M., The New England Journal of Medicine. Excerpts: The United Kingdom takes the importance of primary care for granted. The U.K. government is effectively the country’s single payer, and successive administrations have been convinced by mounting evidence that primary care promotes high-quality, cost-effective, and equitable health care. If anything, the U.K. government has become more convinced over the past 15 years that strong primary care needs to be at the heart of the country’s health care system — quite the reverse of the situation in the United States. U.K. primary care physicians now have average earnings of $220,000 (in U.S. dollars), which is more than many specialists earn. ...

  Having a single-payer system also means that U.K. primary care physicians hold each patient’s lifelong record, which includes a letter regarding every visit to a specialist. Virtually all primary care physicians use electronic medical records, and laboratories now generally download lab results directly into family practitioners’ computer systems. Again, the government took advantage of having a single-payer system to define common standards to which all suppliers of electronic medical records must adhere. ...

  What can we learn from the U.K.? Through a single payer system the U.K. has been able to build a strong primary care infrastructure with teams organized to provide high-quality coordinated care for everyone. They have done this at a fraction of the costs of U.S. health care, while compensating their primary care physicians very generously. And how is the U.S. going to use this information? We are going to reject it because it is not a uniquely American solution. Instead, we are about to expand our dysfunctional, fragmented, wasteful, costly system of financing health care, simply because it is uniquely American!? ...

  The U.K. system, like that of many other nations, uses their power as a monopsony to purchase much greater value in health care. The United States now wants to use our tax dollars as credits to help us purchase individual plans that do not cooperate but compete. That competition not only results in tremendous administrative waste, it also destroys any prospect of creating an effective monopsony

  So we are going to tax ourselves to provide even more funds to our unique, corporate-model private insurers to allow them to burn up more resources while establishing a barrier to much needed delivery system reform (a barrier because the financing is fragmented).

News and Opinion Concerning the U.S. Financial Crisis

"But dependency on government has never been bad for the rich. The pretense of the laissez-faire people is that only the poor are dependent on government, while the rich take care of themselves. This argument manages to ignore all of modern history, which shows a consistent record of laissez-faire for the poor, but enormous government intervention for the rich." From Economic Justice: The American Class System, from the book Declarations of Independence by Howard Zinn.

• New York Times Op-Ed: Beyond the Fat Cats. By Bob Herbert. Excerpts: The most important thing the Democrats and President-elect Obama can do with regard to the economy is bring back a sense of fairness and equity. The fat cats who placed the entire economy at risk with their greed and manic irresponsibility are trying to lay claim to every last dime in the national Treasury. Meanwhile, we’re nowhere close to an economic recovery program that will help the people who are hurting most. ...

  When the Champagne and caviar crowd is in trouble, there is no conceivable limit to the amount of taxpayer money that can be found, and found quickly. But when it comes to ordinary citizens in dire situations — those being thrown out of work or forced from their homes by foreclosure or driven into bankruptcy because of illness and a lack of adequate health insurance — well, then we have to start pinching pennies. That’s when it’s time to become fiscally conservative. President Bush even vetoed a bill that would have expanded health insurance coverage for children.

  We can find trillions for a foolish war and for pompous, self-righteous high-rollers who wrecked their companies and the economy. But what about the working poor and the young people who are being clobbered in this downturn, battered so badly that they’re all but destitute? Can we find any way to help them?

New on the Alliance@IBM Site

• Job Cuts Status & Comments page
  • Comment 11/10/08: Significant but unknown number of job cuts in STG starting today I think, Nov 10. Not location-specific but all in the US. -STG-IBMer-
  • Comment 11/10/08: Looks like all TTPM PMs will be let go to be replaced by PMs in India working remote..why you ask? Because they are cheaper...so we hit the road. -IBM_SUCKs-
  • Comment 11/11/08: Well now, IBM makes +$9B in NET profits, and, of course, the next logical move to to GR as many positions as possible. Sounds about right - yes ? I've worked for this company for a while now and I'm sick of this crap. How about a "CHALLENGE" from some prissy PE? Let me translate : If you folks can work serious overtime, for no overtime pay, and meet some CRAZY date in a project plan, then our reward is that I (the stately PE) will get a HUGE bonus, and you miserable worker-bee types get to try and salvage your personnel relationships because you sacrificed EVERYTING (ie:kids' birthdays, vacations, scheduled vacations, etc...) so IBM can APPEAR to be able to deliver ANYTHING, no matter how nuts the dates and scope are! Oh, and at the end of the project, there is NO, and I mean NO, confirmation that you will still have a job. How's that sound?

    There is always someone, somewhere in this great world, cheaper than you. And, IBM will give that person your job, to save a few "sheckles". It doesn't matter if they speak english well, or not...they are cheaper. Has anyone actually opened a trouble ticket with IBM internal support and gotten any sort of reasonable response? A rhetorical question, I know; everyone knows that if you do not work at a location with an actual IBM hardware or software tech, or your brother, son, or neighbor is not a computer expert, then YOU ARE SCREWED!!!!!!!!!! Good luck getting anything other than "Good afternoon Mr Man, my name is Earl, from Mayanta, India, is your computer plugged in? Yes...then can I please close this ticket (so I can get credit for "resolving" more tickets than my worker-neighbor "James").

    I'm not sure what the answer to this insanity is (see, I'm so messed up that my english diction is f%$ked-up also). Anyway, god bless the a-wholes at the exec level, making $$$$$, while us small workers pick up the crumbs, and HOPE our job will not be "GR'd" this year. No worries though, it will be GR'd next year so IBM can save .5% on some labor cost somewhere in some "cost-case". And in parting, all you SDM's and DPE types out there, remember that the email has been circulated to GR a large portion of the "Command and Control" positions. I think the official position must be to eliminate all of you pesky workers who have some notion of actually retiring from IBM with a livable savings. As Karl Marx was fond of saying "From each according to his abilities (the workers), to each according to his needs (IBM Mgmt and Exec)". Enjoy! -I-Used-2-Luv-IBM-Then-I-Woke-Up

  • Comment 11/11/08: I was laid off yesterday. I work in the Systems & Technology Group-Industry Systems. Based in Atlanta. Based on conversations with numerous colleagues, I estimate that 100-200 STG employees are laid off, mostly in the US, mostly working on the STG "worldwide team." I have been offered separation and severance terms commonly extended to US employees: 30-days until official separation, 2 weeks salary for every year worked up to 26 weeks total, 12 months worth of medial and insurance coverage. I am 48 years old. -25-Year IBM Vet-
  • Comment 11/11/08: I was a manager for 15 years at IBM. When it came to layoffs, our VP’s motto was “better a 2 on the old plan than a 3 on the new plan”. Time after time, we would fire a 2 performing “old plan” person rather than a 3 performing “new plan” person doing the exact same job, to meet our layoff quota. Of course we would put them in some sort of job category that sounded different but was totally bogus, like the “new plan” person was a “customer consultant” and the “old plan” person was a “client consultant”, but we all knew they did the exact same job. All other managers I knew in all other IBM areas did the same thing. If someone subpoenaed the lay off records of all 2 or better performing employees, the IBM evidence of age discrimination and bias in firing “old plan” employees would be overwhelming. -Anonymous-
  • Comment 11/11/08: Many have not noticed but the predictions made about the offshoring and the consequences are going on in Texas right now show what future business with IBM will be like for IT direction. Texas recently suspended ALL PAYMENTS until security compliance is done including not sending security/HIPPA docs and data to India for Steady State! Additionally a Bangalore based PM was responsible for the fowl up of a huge DB that was for the state Attorney General office which compromised 100's of cases....get used to it....want to see where SAM thinks should go next - you better read this - really insightful...from US NEWS.
  • Comment 11/12/08: Adding to my 11/10 comment: The STG resource actions in the US seem to be outsourced to IBM-India. -STG-IBMer-
  • Comment 11/12/08: Responding to a message below -- I don't think that the Texas screw-up had much to do with off-shoring. Most govt contracts end up in trouble because the legacy transformation cost is way underestimated just to land the job. Poorly staffed engagements fail whether it is delivered using local or offshore resources. On the topic of this forum -- I can confirm the story about job cuts in STG. The cuts seem to be more widespread including Band 9 & 10 senior employees. -Brandon123-
  • Comment 11/12/08: Lots of executives are being given packages today. They have until January to leave IBM and some are being asked to go to Dubai or China to work. Some are being re-leveled back to the field in sales. -say it ain' t so Joe!-
  • Comment 11/13/08: -say it ain' t so Joe!- Which divisions or sectors are the executives being packaged or pressured to transfer? What level/type and number of executives are being hit with packages or relocation options? -another_ibm_serial#-
  • Comment 11/13/08: STG US Layoffs. "STG SG&R Resource Action (SGAR) Notified 11/10/08 Last Day 12/10/08 Total = 215 40-49 yrs old = 32% 50+ yrs old = 55.4% Mostly in Sales, Marketing & other SG&A -anon-
  • Comment 11/13/08: -Brandon123- guess again bub, was there and know what happened - was offshoring and those were the problems and that was the MAIN problem, the State of Texas was promised in SLA's that NONE would happen and that was their biggest complaint on steady state move. Happened in Global and know all of the problems there and had to even train my SA's and TL's who were switched over to Bangalore Resources after they were RA'd, how else do you explain the HUGE problem with a Indian based PM and team doing that screw up on the DA's file structure and having a completely screwed up Active Directory and botched backups/production runs as well.

    Look for this to happen more as big blue goes more to this model and that we were hearing about constantly from uppers. Figured out why the ST changes yet???? Here's a hint, few of them actually in Denver, Boulder or other locations-think time zone 11 hours ahead. Some SDMs getting word now and would not be surprised if overseas takes over customer facing accounts way before the original 2010 date, like maybe MARCH 2009!!!! Anyone else heard the same? -UC'd-

  • Comment 11/13/08: "IBM slashes 215 senior positions, including six VPs; 38 jobs cut in RTP" .... Does anyone know the names of the execs that supposedly being let go? My bet is that if you check their names in the IBM directory in 30 days you will find that somehow they all have found jobs within the company.... I think this press release is all window dressing! -stillemployed- Alliance reply: You are probably right. Executives protect their own. Isn't it time we protected our non-management co-workers? We all know that most workers do not find new jobs. A union contract would fix that. No new hires until RA'd workers are brought back!
  • Comment 11/13/08: I was one of the 100 contractors discarded at RTP in October. I know that everything I have to say has been said already, but I don't care. I was a contractor for 5 years, originally doing the job of a regular who was 'supervising' me. He had been a contractor at one point too, but that was back in the glorious fabled times when IBM actually converted contractors into regulars from time to time. I did a good job and was instrumental in making and/or saving several large deals for the company.

    The results of my work easily helped IBM get or keep several million dollars of business. Yet, when it was time for them to improve their stock report, I was spat out and left for dead. I remember a few years earlier when they had their 'preferred vendor' business, giving exclusive STG contracts to CTG. I've got nothing against CTG, but everyone knew at that time what they were really doing was getting rid of what little ability contractors had to shop around and get a better deal. I worked with regulars of similar experience who did similar or even less demanding jobs for double or even triple what I was making. I wasn't even the worst. I knew someone who had been a contractor for 10 years who was discarded at the same time that I was.

    I'm angry and I'm afraid. I watched jobs go overseas to Taiwan and other places - people asked to train their replacements, knowing that they were being replaced. I think this 'off-shoring' stuff is despicable. Most of all, I hate the euphemisms that IBM spokespeople use for all of this stuff. Resource reductions, rebalancing skills. It's an outrage, and it should be illegal. I think that US companies shouldn't be allow to move jobs out of the country - period. If they want to add new jobs in another country, fine, but they shouldn't be allowed to sell us out like this. These people don't deserve our loyalty. I hope IBM crashes and burns. They deserve it. -used_and_discarded-

• General Visitor's Comment page
  • Comment 11/12/08: I see that the "Blue Harmony" folks in SBY have to pay for the their Kickoff meeting buffet. $23-$28 for 11/18/08. Can't the head of this "Blue Harmony" project or Sammy "I just cashed in $74,000,000 in stock options" Palmicrapo spare a few scheckles and treat these folks to a decent meal for this "important" project "event"? Oh, gee, I forgot the IBM Value system is based on their employees spending more and more of their money and sacrificing more and more so IBM can supposedly save money to increase "investor value".. What a &^%$ing joke! I ain' t paying for the buffet or going since I don't think the Kool-Aid served with the buffet will be sweet at all! But, yes. some on this Big Blew harmony "let's make it finally work" project will pay for it and think the drink is better and sweeter than that concocted by Jim Jones. -bigblewharmonysux-

    Alliance Reply: Why not call for a boycott of the meeting? Not just because of the meal price; but for all the reasons IBMers have become disgusted with management's 'important events', like layoffs, offshoring, and pay cuts. Spread the word that it's being boycotted. See what happens. It's just a suggestion.

• Pension Comments page
• Raise and Salary Comments
  • Comment 11/09/08: Salary = 170000; Band Level = 9; Job Title = Consultant; Years Service = 10+; Hours/Week = 40; Div Name = 5; Location = NY; Message = Not including bonus -Anonymous-
  • Comment 11/11/08: Salary = $56k after 15% cut; Band Level = 7; Job Title = IT Specialist; Hours/Week = 40 after "remix", 50+ while exempt; Message = Consistent 1 and 2+ performer, but IBM never had the budget (yeah, right) to even pay me at their below-average "midpoint". I stayed solely due to the work from home deal, but when the lean and GR initiatives starting proving that IBM now values low cost over quality and client satisfaction I just couldn't take it anymore. -LongGone-
  • Comment 11/12/08: Salary = 1030000 ($21,203.20 US Dollars); Band Level = 7A; Job Title = Advisory technical services professional; Years Service = 5; Hours/Week = 40; Div Name = IBM india; Location = Bangalore; Message = I want details on of this Band 7A -Anonymous-
• PBC Comments
  • Comment 11/08/08: This Yr Bonus = less; Prior Yr Bonus = tiny; Message = More PBC "2" and PBC "3"'s this year since IBM wants to pay out less GDP. They need the money to give Sam and his thugs more stock options and to fund another big buyback. Also you won't see too many of tate your manager this year either. Wonder why.. -anonymous-
  • Comment 11/14/08: Prior Yr PBC = 3; This Yr PBC = 2+; This Yr Bonus = 2.5%; Prior Yr Bonus = 0; Message = 30 year employee age 61 Female. Band 7. I would never recommend working at IBM to a young person. Or for a person to study for a job in the IT industry in college. -none-
• 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. Some sample posts follow:

• "What are my chances?" by "Ineka". Full excerpt: What are my chances getting in as an entry level consultant in IBM? I have 1.5 yrs of experience with the government doing auditing, a bachelor's degree in accounting and good internship experience. I just applied via the IBM web site but I am wondering how effective that is. Unfortunately, I do not know any insiders who can forward my resume in but my main question is, what are my chances? Thanks!