In a separate document filed on Thursday, Johnson accused International Business Machines Corp of withholding $1.49 million from a retirement plan that he said was due to him upon his departure from the company.
An L-1 Visa is generally for 3 years and is available to employees of an international company with offices in both a home country and the US. It allows foreign workers to relocate to the company’s US offices for at least 1 year prior to being granted L-1 status. There is no quota system and is quite devastating to our economy and the middle class white collar worker. The spouses are allowed to work without restriction in the US.
Critics of the visa programs such as the Nobel Prize winning economist, Milton Friedman, referred to the program as a corporate subsidy because they are supposed to be paid the prevailing wages with safeguards in place. But the data from the US government OES office shows that these H1B wages are below the median for the same occupation as compared to a US worker. So this is how the corporations are being subsidized by the government. Or as Professor Norman Matloff, UC-Davis sums it up “its about cheap labor and there is no shortage of qualified American citizens to fill American computer related jobs”. He further stated that the data offered as evidence by American corporations “needing” H1B and L-1 visas to address labor shortages, was erroneous.
Rick Clark: My manager called me into his office. Um, I expected him to say, "You're safe." But he surprised me and said, "You're included in the layoff."
That wasn't the only surprise. Clark's manager handed him a brochure about an IBM program called Project Match. It offers laid-off employees new positions with the company. But there're in emerging markets like India and China. Engineers there typically earn less than half the salary of their U.S. counterparts. IBM transplants like Clark would earn the going rate.
Clark: I considered it an insult. You know it's pretty common knowledge that IBM has been offshoring jobs, so this is sort of like a cold slap in the face.
IBM wouldn't discuss the program. Companies have long outsourced jobs to save money. But that's not the only reason firms are shifting highly skilled workers overseas these days
What we as Americans fail to understand is that our present approach to offshoring can have but one end result - poverty for the American working man and woman, and future generations left holding the empty bag that will take many generations to refill, if it ever will be. Our "leaders" are breeding the next generation of whores.
Look at our economy. CEO's, senior managers and investment bankers produce absolutely nothing tangible but make millions, while those that actually produce for the good of society are squashed economically. The current group of "business leaders" have but one mantra - cut costs by cutting workers - offshore, and then LIE about it. They simply are NOT smart enough to BUILD a business, so they resort the moral equivalent of theft to fill their own pockets.
How about this - a NATIONAL LAW that mandates that the top 3 layers of management >$500K receives bonuses only after a 5 year vesting (w/o interest). If the business decisions earned sustained profits - they get it, if not, go away. Let's try it with sports figures too - wow, pay for performance. That's something most of Americans deal with EVERY DAY.
It's time for the word "ACCOUNTABILITY" to actually be used in enforcement of moral standards. Otherwise, I fear there's another revolution coming.
Most poignantly, the scale model of the plant, which by memory lingered in the reception area, has attracted no bids whatsoever. Why bother, when you could setup a new plant in Poland for Indonesia for peanuts.
There's an expected $2.3 trillion in potential rollover money up for grabs in the next five years, and these companies—which make their money off the assets they manage—all want a piece of that. Check virtually any of their Web sites and you'll find helpful calculators or educational materials instructing investors as to why a rollover is their best option.
Trouble is, that's not always the case. Sure, taxes and penalties make cashing out a 401(k) an unappealing option. But some companies seem to posit that rolling your balance into an IRA is always the best choice. In fact, they rarely even mention the possibility of keeping your money in your old 401(k). Fidelity's "rollover evaluator" tool, for example, asks four questions, then offers a recommendation—and regardless of the information an investor gives, the answer is always the same: "Roll your 401(k) into a Rollover IRA." (The tool has since been taken off the site "for maintenance," the company says.) Schwab's pros-and-cons grid suggests that there's little difference between rolling over your balance and leaving it in your employer's plan; T. Rowe Price's Web site highlights the comparison between an IRA and a cash distribution, with little mention of other options.
That's just plain bad advice, says Alison Borland, a consultant in the defined contribution practice at management-consulting firm Hewitt Associates. Investors in a 401(k) plan often pay much lower fees than retail investors—sometimes half as much. That may be just 45 cents on every $100 invested, but over time those pennies add up. In fact, a 35-year-old with about $100,000 could, by the time she's 70, have paid an additional $116,250 in fees by switching to a rollover IRA, Borland says. But no one tells employees that, she adds: "There's no nice chart that pops up and says, 'By the way, you're going to pay higher fees and earn less in investment returns—are you okay with that?'"
Then, finding that people really wanted a simple, easy answer, I came up with one: “three million dollars.” That’s what you need to retire. No matter who you are, where you live, what your expectations. Trust me.
Alliance reply: You question about WSJ and NY Times answer is: It was news for a day or two. But IBM gets away with only a fraction of the negative coverage they should get; because they've convinced Americans and the corporate media that "they are a Global company and this kind of thing happens all the time"...BAU. Even the SEC leaves them alone, with regard to the way they report their job cuts; because it's 'Global'. Get it? It's just an excuse.
That's why IBMers NEED to organize faster and harder than the media machine can dismiss RA's, as no news. IBMers wanting and needing change; need to do it NOW. Don't sit around ranting and raving about how IBM screwed them. It's too late by then. If you even think there may be a way for you to avoid being fired or RA'd; you're seriously BS'ing yourself. Don't wait for the Govt., the corporate press, or anyone else to come to your rescue. YOU come to your rescue. You can do this. We can do this. Contact us or email: email@example.com
The delay of my being transferred was due to the fact that I had to get a security clearance for the job. Again I was assured that I would be transferred prior to my end date of May 15th regardless of whether or not I had received the clearance.
The official RA announcement for my team came at the end of March and my departure date was moved up to April 23rd. I immediately informed my prospective management team. Again I was reassured that everything would be fine. A few days later I received a call from the hiring manager saying that an appeal had to be submitted to get me off the RA list and transferred into the division. I asked if I should be worried and was told no. A few days after I was told that they would not be able to move forward with the job offer because the appeals board had come back saying that a band 6 could not be removed from the RA list and transferred. I was a band 7 and didn’t quite understand how that affected me. Apparently, I was going to have to be transferred into the division as a band 6 even though I was a band 7.
Further, I was told that my being transferred in could not be justified because Div 16 had been affected by the RA as well and if anything they would have to staff the position with someone over there. I felt that I had been treated unfairly because I had received the offer in writing prior to being put on the official RA list and the hiring management team was well aware of my situation when they offered the position to me. I decided to go through corporate appeals. To date I have not signed my separation agreement. I received my decision today from the corporate appeals office stating that I had not been treated unfairly. I was told that the state of business had changed between the time the offer was made to me and when I was put on the official RA list. Further, I was told that I would not be receiving my security clearance.
I had originally been told several times by the Div 16 management team that I would be receiving my top secret security clearance regardless of me being RA’d because the process had begun when the offer was made and this would be granted to me. Now I have been told that it was not a security clearance that I was going to receive, but some other type of background investigation. Further, the background investigation that was being done would be null and void because I am no longer an IBM employee. I have also been told that I have 48 hours now to sign the separation agreement if I want to receive my severance payment. This situation is really upsetting and completely unfair to me and if anyone has some advice on what further steps I can take, then please respond . . . Email me -Anonymous-
Alliance reply: Throughout this whole situation, IBM was planning on giving you NO advantage. They were planning on firing you, by default; if things they had discussed with you didn't work out to THEIR advantage. I'm sorry to say, that there are no real "further steps" you can take to keep your job or get the job you thought IBM would give you. Don't be deceived into believing that IBM cared about you or that they just changed their mind at the last minute, because of 'the needs of the business'.
You are/were an AT WILL EMPLOYEE. You have no bargaining rights, no employment rights or entitlement to a job as long as you work without a union contract. I'm sorry for your job loss and what IBM did to you. It is shameful. That's why we continue to say over and over and over and over.. ORGANIZE! Don't wait for IBM to do you any favors or tell you the truth. They won't. They never will. You work at their will, as long as you are an individual AT WILL EMPLOYEE. You have no legal standing, whatsoever. If you became a union worker; your contract would prevent 95% of the games that were played by IBM against you.
My 1st line was really quite clueless, don't think he was intentionally deceitful on the whole thing.. i just think he had no idea what an impossible task it is to be removed from the RA list.. once you're on it, forget about IBM. It's sad but the sooner you let go of this fight and look forward, the better off you'll be.. and that goes for everyone who finds themselves on an RA list. forget about transferring inside the company. take those 30 days and do something productive, shut off sametime and start job searching. -exibmer-
I sure would have worked a lot LESS overtime / holiday work, spent more time with my family, taken as much internal education as I could, and started looking for another job while I was still employed. Second - you can take some level of satisfaction that you definitely got one or more managers in trouble for disclosing that you were on the RA list or even that a Resource Action was forthcoming.
Third - I had a security clearance once, but almost 20 years ago. The Federal Government pays for those clearances, and if it's not paid directly I'm sure it's passed on to the Gov thru the various overhead rates. Are you sure they started the clearance process? It involves talking to your friends and neighbors, past and present and might even involve a polygraph. If you think they started the process, I would think you should be allowed to know if it was completed - that alone is a valuable asset you can take to any other job. You should probably check with the Government agency that was handling the background checks. -scooby doo-
Seriously, do you REALLY want to keep working at IBM? It's been said dozens of times here - it is NOT the IBM it used to be. It's time to leave. Companies are starting to hire. IBM can't even keep GDFs staffed. No local talent, and the existing talent in IBM is refusing to relocate (I honestly think IBM expected most existing employees to relocate). This is catching IBM off guard.
Iowa was suppose to have opened and been live, I think, this month or next. Last I heard, they have next to nobody working there, and no accounts being support out of it. I'm hearing rumors about high turnover in EFK, too. And remember the posting a few weeks back showing band levels for GDF staffing? Just wait until THAT kicks in. Salary cuts for all.
It's an absolute mess in IBM. All accounts sooner or later will be supported by a BRIC country, or managed out of a GDF. This is the goal of IBM right now. I think it's taking longer than the VPs anticipated, but they're still pushing forward.
Just remember this. IBM WILL meet their EPS this year of 9.x/share at YOUR expense. The easiest way to meet that EPS is to reduce cost, and YOU are costing IBM money. I really expect a relatively massive RA again in 3Q, especially if their EPS is off target for the year. Good luck to existing employees, and good luck to the Alliance. Your efforts are valiant, but I fear too late. Personally, even with a union, I don't want to work here anymore. I have resumes in to 3 different non-IBM job openings. First offer, I'm out. -anonymous-
Alliance Question: Since one of your teammates pointed you to Alliance@IBM AFTER you were RA'd; Do you think finding out about this web site should happen BEFORE IBMers get RA'd? If you do, Please tell your former teammates, and tell them to tell others in your former function to visit this web site and consider joining and forming a union in their respective function or area. I'd also like to know: Do you use Twitter, LinkedIn, or Facebook? Do you know if your former co-workers use any or all of those social networking sites? Please Contact Us with your information and answers.
Hamm's insurance company rescinded the policy of Otto Raddatz after he was diagnosed with lymphoma. Raddatz had not told the company about a CT scan by a now-retired doctor that showed gallstones and a weakened blood vessel. That's because he didn't know about the findings, his sister Peggy Raddatz, an attorney, testified. She spent weeks on the phone and ended up at the Illinois Attorney General's office, which began an investigation. The retired doctor turned out to be off on a fishing trip. "Luckily, they were able to find the doctor, who was able to say, 'Yes, I never discussed those issues with him; they were very minor,' " Raddatz testified. ...
One of Barton's constituents, Robin Beaton of Waxahachie, Texas, did know that her health history included acne and a rapid heartbeat. But she didn't think they were relevant to her current health and left them off her application. After she was diagnosed with breast cancer and was scheduled for a double mastectomy, her insurer cancelled her policy, leaving her devastated. ...
Committee investigators found a total of 19,776 rescissions from three large insurers over five years. The rescissions saved the insurers $300 million. ...
Rep. Bart Stupak (D-MI), who chaired the hearing, asked all three CEOs if they would agree to stop rescinding policies except in cases of fraud. All three said no. If they don't do something to stop it, said Barton of Texas, Congress will.
The AMA used this image on thousands of posters, adding the caption, “Keep Politics Out of this Picture.” They hoped to convince the public (and did) that government intervention would mean the end of home visits; government intervention would eliminate what Fildes captures so well: the sacred bond between doctor and patient.
“Sacred bond,” alas, is not among the descriptors I hear when patients tell me what they think of us or our health care system. The descriptors fit to publish include “inattentive,” “no-one-in-charge” and “money grubbing.” In fact, a thoughtful lay friend recently said to me in the context of her medical care, “Face it, Abraham, medicine is corrupt.” She stated this casually, as if it were an obvious and well-known fact, not waiting to see if I would agree. At the time I remember that I sputtered. I wanted to protest but the sounds would not come out. That word “corrupt” gnawed at me for days. ...
President Obama pointed to the problem of “a system of incentives where the more tests and services are provided, the more money we pay.” As if to rub it in, he added, “And a lot of people in this room know what I’m talking about.” Oooo, there was that “corrupt” word again, even though he did not say it. This part of the speech drew no applause, just stony silence.
Yes, Mr. President, a lot of people inside and outside that room know exactly what you are talking about. A skewed reimbursement scheme set up by Medicare, a system that pays generously when you do something to a patient, but is stingy when you do something for a patient, is largely to blame. Cut, poke, sew, burn, insert, inject, dilate, stent, remove and you get very well paid; if you learn how to do this efficiently, maybe set up your own outpatient center so you can do it to more people in a shorter time (which is what happened when this payment system was put in place in 1989) and you are paid even more. If, however, you are a primary care physician, and if, just like the young doctor who saw my parents yesterday, you spend time getting to know your patients, and are willing to play quarterback when your patient enters the hospital, so that you can herd the consultants and guide the family through a bewildering experience that gets surreal if you are in the intensive care unit, then you may have great personal satisfaction but you will make five to tenfold less than your colleagues in the doing-to disciplines.
Our reimbursement system, as the president put it, “is a model that has taken the pursuit of medicine from a profession—a calling—to a business.” ...
Poor McAllen, Texas. It happens to be the focus of a recent “New Yorker” piece by Atul Gawande, a piece that President Obama referred to in his speech to the AMA, because health care costs in McAllen are twice that of comparable cities while health outcomes are no different. The reasons are complex but probably because good physicians are ordering lots of tests, calling in lots of consultants, making good use of the equipment they own and the imaging centers they might have a stake in (and yes, they think they can be objective in ordering an MRI or CAT scan that sends the patient to their own facility); it has to do with hospitals competing with each other for the kinds of patients with conditions that are reimbursed well, and wooing patients, wooing high-volume physicians (some of whom are invited to invest in the hospital) to make full use of their PET scan, their gamma knife, their robotic-surgery facility, their cancer center, their birthing center. That was Atul Gawande’s conclusion, and I would concur. ...
Which brings me to my problem with the president’s plan: despite being an admirer, I just don’t see how the president can pull off the reform he has in mind without cost cutting. I recently came on a phrase in an article in the journal “Annals of Internal Medicine” about an axiom of medical economics: a dollar spent on medical care is a dollar of income for someone. I have been reciting this as a mantra ever since. It may be the single most important fact about health care in America that you or I need to know. It means that all of us—doctors, hospitals, pharmacists, drug companies, nurses, home health agencies, and so many others—are drinking at the same trough which happens to hold $2.1 trillion, or 16% of our GDP. Every group who feeds at this trough has its lobbyists and has made contributions to Congressional campaigns to try to keep their spot and their share of the grub. Why not?—it’s hog heaven ...
We may not like it, but the only way a government can control costs is by wielding great purchasing power to get concessions on the price of drugs, physician fees, and hospital services; the only way they can control administrative costs is by providing a simplified service, yes, the Medicare model (with a 3% overhead), and not allowing private insurance to cherry-pick patients (some of them operating with 30% overheads, the cost passed on to you). ...
To come back to my favorite painting: a computer cannot take the place of the doctor in Fildes’s painting; an electronic medical record (EMR) may or may not save money (it won’t be anywhere as much as is projected) but what it will do is ensure that we doctors, nurses, therapists, particularly in hospitals will be spending more and more time focused on the computer, communicating with each other, ordering and getting tests, buffing and caring for our virtual patient—the iPatient is my term for this phenomenon—while the patient in the bed wonders where everybody is. Having worked exclusively for the last seven years or so in hospitals that have electronic medical records (EMR), I have felt for some time that the patient in the bed has become an icon for the real focus of our attention, the iPatient. Yes, electronic medical records help prevent medication errors and are a blessing in so many ways, but they won’t hold the patient’s hand for you, they won’t explain to the family what is going on.
Republicans in Congress have fiercely criticized the proposal as an unneeded expansion of government that might evolve into a system of nationalized health coverage and lead to the rationing of care. But in the poll, the proposal received broad bipartisan backing, with half of those who call themselves Republicans saying they would support a public plan, along with nearly three-fourths of independents and almost nine in 10 Democrats.
What Republicans are adamantly opposed to is the idea of adding a public plan to that exchange. They portray it as a “government takeover” of the health care system, or even as socialized medicine. Those are egregious mischaracterizations. There is no serious consideration in Congress of a single-payer governmental program that would enroll virtually everyone. Nor is there any talk of extending the veterans health care system, a stellar example of “socialized medicine,” to the general public.
The debate is really over whether to open the door a crack for a new public plan to compete with the private plans. Most Democrats see this as an important element in any health care reform, and so do we. A public plan would have lower administrative expenses than private plans, no need to generate big profits, and stronger bargaining power to obtain discounts from providers. That should enable it to charge lower premiums than many private plans.
It would also provide an alternative for individuals who either can’t get adequate insurance from private insurers or don’t trust the private insurance industry to treat them fairly. And it could serve as a yardstick for comparing the performance of private plans and for testing innovative coverage schemes.
The question now is whether we will nonetheless fail to get that change, because a handful of Democratic senators are still determined to party like it’s 1993.
And yes, I mean Democratic senators. The Republicans, with a few possible exceptions, have decided to do all they can to make the Obama administration a failure. Their role in the health care debate is purely that of spoilers who keep shouting the old slogans — Government-run health care! Socialism! Europe! — hoping that someone still cares.
The polls suggest that hardly anyone does. Voters, it seems, strongly favor a universal guarantee of coverage, and they mostly accept the idea that higher taxes may be needed to achieve that guarantee. What’s more, they overwhelmingly favor precisely the feature of Democratic plans that Republicans denounce most fiercely as “socialized medicine” — the creation of a public health insurance option that competes with private insurers. ...
The real risk is that health care reform will be undermined by “centrist” Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around “centrist,” by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field.
What the balking Democrats seem most determined to do is to kill the public option, either by eliminating it or by carrying out a bait-and-switch, replacing a true public option with something meaningless. For the record, neither regional health cooperatives nor state-level public plans, both of which have been proposed as alternatives, would have the financial stability and bargaining power needed to bring down health care costs. ...
Thus Senator Ben Nelson of Nebraska initially declared that the public option — which, remember, has overwhelming popular support — was a “deal-breaker.” Why? Because he didn’t think private insurers could compete: “At the end of the day, the public plan wins the day.” Um, isn’t the purpose of health care reform to protect American citizens, not insurance companies?
What should the president be focused on? Scheiner thinks that a good health reform would be "Medicare for all," a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system. "A neurosurgeon gets paid $20,000 for cutting into the neck of my patient. Have him get paid $1 million a year instead of $2 million or $3 million. He won't starve," Scheiner says. ...
Scheiner thinks that Obama's "public plan" reform doesn't go far enough. He supports the idea of that option for people who don't like or can't afford their HMO. But he worries that it will be watered down or not happen at all. "It's nonsense that the private insurance companies need to be protected," he says. "Why? Because they've done such a good job?" ...
Scheiner thinks that any health reform should involve paying primary-care doctors better so they don't have to rush through appointments to make ends meet. He says that the medical students he encounters are no longer even taught how to do a patient history and physical exam. Patients get imaging studies and lab work instead of actual work-ups. "It's like in Star Trek where Bones had the thing he would wave up and down. They don't even talk to patients," he says.
Which is precisely why the public option has become such a lightening rod. The American Medical Association is dead-set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won't consider it. No other issue in the current health-care debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course, they don't want it. A public option would squeeze their profits and force them to undertake major reforms. That's the whole point.
Critics say the public option is really a Trojan horse for a government takeover of all of health insurance. But nothing could be further from the truth. It's an option. No one has to choose it. Individuals and families will merely be invited to compare costs and outcomes. Presumably they will choose the public plan only if it offers them and their families the best deal -- more and better health care for less.
Private insurers say a public option would have an unfair advantage in achieving this goal. Being the one public plan, it will have large economies of scale that will enable it to negotiate more favorable terms with pharmaceutical companies and other providers. But why, exactly, is this unfair? Isn't the whole point of cost containment to provide the public with health care on more favorable terms? If the public plan negotiates better terms -- thereby demonstrating that drug companies and other providers can meet them -- private plans could seek similar deals.
But, say the critics, the public plan starts off with an unfair advantage because it's likely to have lower administrative costs. That may be true -- Medicare's administrative costs per enrollee are a small fraction of typical private insurance costs -- but here again, why exactly is this unfair? Isn't one of the goals of health-care cost containment to lower administrative costs? If the public option pushes private plans to trim their bureaucracies and become more efficient, that's fine.
But Ms. Smith said the agent didn’t mention that the policy had a $5,000 annual limit on what the insurer would pay for outpatient treatment, or medical care when a patient hasn’t been admitted to a hospital. She acknowledges that the limit was disclosed in the plan’s full paperwork. Last year, the 52-year-old was diagnosed with lymphoma. She quickly exhausted the $5,000 benefit and ran up an additional $86,000 in bills for imaging scans and other procedures. Ms. Smith hopes to reduce that debt to around $20,000 with aid from a nonprofit organization and other sources. “I’m not health-care savvy, and it didn’t occur to me I had to go over this with a fine-tooth comb,” she says.
“If private insurers say that the marketplace provides the best quality health care, if they tell us that they’re offering a good deal, then why is it that the government — which they say can’t run anything — suddenly is going to drive them out of business?” Mr. Obama said. “That’s not logical.”
Providers and patients have suspected for years that insurers were underpaying for out-of-network care, but they haven’t been able to prove it. Committee investigators found that Ingenix developed its payment models based on claims data provided by its customers, the insurance companies. A committee aide said those companies sometimes would “scrub” the data sent to Ingenix—throwing out outlying high costs. Ingenix then would use questionable statistical models to come to its own rate estimates. ...
Republicans and other champions of private-sector insurers have long argued that making health care more consumer-friendly would drive down costs because patients could “shop around” for the best care. But Sen. Rockefeller and other health-policy experts argue that the lack of information in the private health-insurance market has made competition and informed consumer choice almost impossible.
So I hope President Obama tunes out the A.M.A. and reaches out instead to somebody to whom he’s turned often for medical advice. That’s Dr. David Scheiner, a Chicago internist who was Mr. Obama’s doctor for more than two decades, until he moved into the White House this year. “They’ve always been on the wrong side of things,” Dr. Scheiner told me, speaking of the A.M.A. “They may be protecting their interests, but they’re not protecting the interests of the American public. ...
Yet when the A.M.A. uses its lobbying muscle to oppose major health reform — yet again! — that feels like a betrayal. Doctors work hard to keep us healthy when we’re in their offices, and that’s why they win our trust and admiration — yet the A.M.A.’s lobbying has sometimes undermined the health of the very patients whom the doctors have sworn to uphold. I might expect the American Association of Used Car Dealers to focus exclusively on wallet-fattening, but we expect better of physicians. In fairness, most physicians expect better as well, which is why the A.M.A. is on the decline.
Even worse, unhealthy habits such as tobacco smoking may actually save money in the long run as people who smoke die earlier and use fewer health care dollars. "This doesn't make sense," you say, "Smokers are less healthy than nonsmokers." That may be true, and smokers do use up to 40 percent more medical care while they are alive. A recent study from Holland showed that, on average, smokers die at age 77 and save $100,000 in lifetime medical care costs compared with non-smokers who die at 83.
The same is true for people who are obese. While obesity-related conditions such as Type-2 diabetes, high blood pressure and heart disease are associated with high medical expenditures, the costs that are saved by preventing obesity will only be offset later in life by diseases unrelated to obesity that accompany living a longer life. In the Dutch study, obese people die at 80 and save $50,000 compared with non-obese people who die at 83.
In fact, a recent study showed that for all preventive care, 19 percent saves money and 81 percent costs money. What is going on here? Just like the argument about quality care (discussed in last month's column), prevention is absolutely the right thing to do. It improves quality of life and increases our life span. But it doesn't always save money. ...
Is there a business case for prevention? From the perspective of employers, prevention saves money as long as the patients stay fairly healthy while they are working or until the age of 65, when Medicare pays for the diseases that prevention delayed. For example, employers should certainly pay for mammograms, since paying for advanced breast cancer treatment is significantly more expensive. In one study, when a large employer with 24,000 employees nationwide reduced the co-pays for certain medications that would help manage their employees' asthma, hypertension and diabetes, their health costs per employee dropped 20 percent below those of comparable employers.
Four decades ago, when Congress passed Medicare, the opposition was pretty much one big group: the American Medical Association. The AMA opposes a public health care plan today as well. But it isn't the only interest group involved anymore, says Zelizer. "Today health care has hundreds of different interest groups, each specialized in a different issue, each with its own war chest, each giving money and each seeking to protect its interests." And that brings us back to the room, the lobbyists, and our photos of them. Who are they? Whom do they work for? What do they want health care reform to look like?
Last year, 15,000 registered lobbyists spent more than $3.25 billion trying to sway Congress. This year has brought even more of the same. Oil and gas companies spent $44.5 million lobbying Congress and federal agencies in the first quarter of 2009 -- more than a third of the $129 million they spent in all of 2008, which in itself was a 73 percent increase from two years before. Medical insurers and drug companies are also digging deep: 20 of the biggest health insurance and drug companies spent nearly a combined $35 million in Q1 -- a 41 percent increase from the same quarter last year. All that spending has proven to be money disturbingly well spent. ...
Which brings us to health care and the reform-killing armada currently steaming towards Washington. Their attack is shaping up to be unprecedented. For example, the U.S. Chamber of Commerce has pledged $100 million to defeat reform -- while, of course, calling it reform.
Much of the battle will be focused on the so-called public option, which the American Medical Association has already given a cold shoulder to, telling Congress it "does not believe creating a public health insurance option... is the best way to expand health insurance coverage and lower costs." Indeed, the AMA has been steeling itself for this battle. Since the 2000 election, it has doled out almost $10 million to congressional candidates.
And, again, this fight won't break down along Democrat vs Republican battle lines. Case in point: Tom Daschle. The former Senate Majority Leader, who came within a few unreported chauffeur-driven rides of being Obama's health care reform czar, recently hinted that Obama would have to drop the public option. "We've come too far and gained too much momentum for our efforts to fail over disagreement on one single issue," he told ABC News. Of course, as Daschle certainly understands, without that "one issue," there is no real reform. But that's the reform killer's M.O.: identify the essential element of any reform bill and remove it -- leaving behind a worthless shell. ...
According to a recent NYT/CBS News poll, a whopping 72 percent of the public favors the public option. An NBC/Wall Street Journal poll had the number even higher: 76 percent. And yet you can already feel it slipping away. As Matt Yglesias writes, "So just keep in mind that when people talk about political obstacles to a robust public plan, they're not talking about mass public opinion as an obstacle -- they're talking about the wealth and power of relatively narrow interests."
Both Baracks were on display in the president’s press conference earlier this week. First, Mr. Obama offered a crystal-clear explanation of the case for health care reform, and especially of the case for a public option competing with private insurers. “If private insurers say that the marketplace provides the best quality health care, if they tell us that they’re offering a good deal,” he asked, “then why is it that the government, which they say can’t run anything, suddenly is going to drive them out of business? That’s not logical.”
But when asked whether the public option was non-negotiable he waffled, declaring that there are no “lines in the sand.” That evening, Rahm Emanuel met with Democratic senators and told them — well, it’s not clear what he said. Initial reports had him declaring willingness to abandon the public option, but Senator Kent Conrad’s staff later denied that. Still, the impression everyone got was of a White House all too eager to make concessions. ...
Which brings us back to health care. It would be a crushing blow to progressive hopes if Mr. Obama doesn’t succeed in getting some form of universal care through Congress. But even so, reform isn’t worth having if you can only get it on terms so compromised that it’s doomed to fail. What will determine the success or failure of reform? Above all, the success of reform depends on successful cost control. We really, really don’t want to get into a position a few years from now where premiums are rising rapidly, many Americans are priced out of the insurance market despite government subsidies, and the cost of health care subsidies is a growing strain on the budget.
And that’s why the public plan is an important part of reform: it would help keep costs down through a combination of low overhead and bargaining power. That’s not an abstract hypothesis, it’s a conclusion based on solid experience. Currently, Medicare has much lower administrative costs than private insurance companies, while federal health care programs other than Medicare (which isn’t allowed to bargain over drug prices) pay much less for prescription drugs than non-federal buyers. There’s every reason to believe that a public option could achieve similar savings.
Indeed, the prospects for such savings are precisely what have the opponents of a public plan so terrified. Mr. Obama was right: if they really believed their own rhetoric about government waste and inefficiency, they wouldn’t be so worried that the public option would put private insurers out of business. Behind the boilerplate about big government, rationing and all that lies the real concern: fear that the public plan would succeed.
So Mr. Obama and Democrats in Congress have to hang tough — no more gratuitous giveaways in the attempt to sound reasonable. And reform advocates have to keep up the pressure to stay on track. Yes, the perfect is the enemy of the good; but so is the not-good-enough-to-work. Health reform has to be done right.
"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.
Vault's IBM Business Consulting Services message board is a popular hangout for IBM BCS employees, including many employees acquired from PwC. Sample posts follow:
We all have to play nice-nice with our GR (global resource) peers. and when your GR team lead sends notes to IBM US mgmt that they need MORE WORK from their US counterparts, IBM mgmt. rolls over and gives them more work. Reminds me of an old CCR song: Fortunate Son.
And when you ask them, how much should we give? Ooh, they only answer more! more! more. What a sad, pathetic, f'ng company.
What's more pathetic is how India is not held accountable since they are Sam's chosen ones and how anyone who reports problems with India are considered anti-team, racist and uncooperative.
The sacred cows over in India aren't cattle, they're the "office boys" pretending to be IT professionals working for IBM. What a sad, pathetic f'ng company indeed.
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