Tuesday, January 26, 2010

Major insurance carrier in controversy over sharing revenue payments for retirement plans

Here’s another good story (link), by Daniel Solin, about a company managing retirement plans. This time it is Nationwide, which may not be “on your side” according to the story. Nationwide allegedly “accepted revenue sharing payments” from mutual funds as a hidden “fee” for managing retirees finds. The story appears in Daily Finance and was shared with AOL subscribers Tuesday morning.

Nationwide maintains that it is not a “fiduciary” for plan participants, making it free to accept such payments. The Nationwide home page has a “Business Retirement” icon and service and it also has “Retirability Check” here.

In my 12 years at ING/ReliaStar, I don’t recall hearing the “fiduciary” issue ever being mentioned.

Sunday, January 24, 2010

Medication errors at home can be prevented by pricey new devices

Caregivers at home may want to look into using devices called “Personal Automatic Medication Dispensers”, which can alert caregivers when medication is to be taken or has been missed, or misused. Some devices can hold up to four weeks of medication along with computerized records that could be used for forensics.

The devices tend to be expensive, ranging from the $100’s up to the $800’s.

A typical website with a reference is “techforltc”, here.

Vendors include CompuMed, MD.2, MedReady, and MedTime.

Saturday, January 23, 2010

Social security (partial) privatization proposals: they're back!

Michael Tanner from the Cato Institute has a piece in the Friday Jan. 22 Washington Times, “Social Security: Private Option: The Answer to looming entitlement disaster is opting out”, link here.

This op-ed refers to the social security privatization proposed during the Bush years and often recommended by libertarians and libertarian-leaning conservatives. Although shot down, partly because of the conversion cost (since the original entitlement in FDR days was just that; it was funded by contributions from original beneficiaries), Tanner argues it needs another look now.

Raising the potential security tax wage base to infinity will only extend “solvency” for Social Security by seven years, Tanner argues. Furthermore, dips in the equity markets because of instability like the 2008 financial crisis don’t mean that private accounts wouldn’t do well in the long run (although they would be a tremendous problem for people who got into this kind of arrangement later in the game).

Check it out.

Friday, January 22, 2010

New Bayer quick acting aspirin may unblock heart attacks and save lives

Bayer is offering a new aspirin formulation that dissolves quickly under the tongue, in the case that someone believes he or she is having a heart attack. There’s a Wordpress story on it here. They are called the Bayer Quick Release Crystals, with the company link here.

The Wordpress essay indicates that about 60% of people who have a heart attack (coronary thrombosis( in their sleep never wake up from the event, which becomes fatal.

However sometimes pain wakes up the person, when two tablets could be taken immediately while calling 911. Rush Limbaugh says, don't tough it out.

I’ve always wondered if a dream that you can’t come out of could signal the end – maybe not a good outcome spiritually. Maybe someone stays locked in the dream forever – in another dimension (besides space-time, physicists tell us there are 7 other dimensions we don’t use). Dreams are experiments; normally you can reverse what happens in them.

Thursday, January 21, 2010

Dr. Oz: Anti-oxidants, lifestyle changes could prevent or delay most Alzheimer's (ABC GMA today)

Dr. Mehmet Oz, who commonly appears on Oprah, appeared on ABC Good Morning America this morning (Thursday Jan. 21, 2009), talked with George Stephanopoulos on “The Five Warning Signs for Alzheimer’s,” with a news story link by Kate McCarthy /here.

He gave some differential examples. Forgetting where you put your car keys when you were preoccupied is not a warning sign, but putting them in the refrigerator is. He gave Stephanopoulos a memory test of 8 items.

He compared Alzheimer’s to having sap on transmission power lines in the brain. But he came across very strongly with the message that lifestyle changes could prevent the disease in maybe 75% of potential victims. Type II diabetes, obesity, high blood pressure, and similar or resulting circulatory system disease certainly can affect brain “performance” with aging. Besides preventing atherosclerosis and strokes, which will would help preserve memory people without family histories of dementia, even people with known genetic predispositions to plaque formation may avoid most symptoms for years or even decades with certain dietary changes. Oz pointed out that people in certain “blue zones” in the Mediterranean have much less Alzheimer’s than people in the US and the rest of Europe, partly because of the consumption of certain plant oils containing antioxidants (Omega-3, curcumin, Vitamins E, B6 and B12) which seem to be protective. India has only 25% of the rate of incidence per age of Alzheimer’s as the US, he said. Other reports about Blue Zones include observations that social and familial cohesion in these communities is strong, which may also help explain much better cognitive health.

This observation on lifestyle and nutrition, if it holds up, would have implications. First, the various herbs and oils could be studied to make more anti-memory loss drugs for treatment. But the bigger impact is the prospect of prevention as medicine extends lives by preventing deaths from other causes like heart attacks and cancers. This finding would be particularly important because of the grim predictions for staggering increase in Alzheimer’s in the coming years, with enormous costs for society, both for publicly funded care and especially for adult children, who in many states can be held legally responsible for their long term care because of filial responsibility laws. Prevention of most occurrence of this disabling disease with lifestyle changes (while otherwise extending lifespans with medical treatments), if possible, starts to become a moral imperative because of the potential impact on others. We’ve seen this kind of thinking about prevention in our health “morality” debate before, back in the 1980s, with HIV. Conservative columnist George Will, particularly, talks about “behaviorally based disease” in conjunction with the health insurance debate. This is not something people like to face, but the debate is inevitably coming down the pike for all of us.

By the way, I do find a lot of criticism of pundits like Will, linking morality to illness, out there. Try this piece in Psychology Today, by Peter Stromberg, Aug. 12, 2009, link here. He writes “From my perspective, this debate is never going to get past the shouting stage until we recognize that some of our ethical concepts-in particular the way we think about intentional behavior and responsibility-have not kept up with the research on why people act the way they do. Morally, we are stuck in the Middle Ages, with assumptions like "except for reflexes, people's actions are intentional and voluntary." And you can check out Wendell Potter’s article on (Center for Media and Democracy) PR Watch, July 3, 2009, “Why do we need health care reform: don’t ask George Will”, link here.

Dr. Oz has more information on his own website here.

Monday, January 18, 2010

Did the fibbies save the banks at the expense to retirees?

The New York Times has an editorial Monday Jan. 18, “How Retirees Saved the Banks”, p. A18, link here.

Banks are filled to the brim with deposits, since investors have pulled out of many equities and real estate markets. But because the Federal Reserve has pushed down interest rates so low, banks can borrow cheaply. But they have not been lending to consumers and small businesses (the business credit markets are still weak) and they have no reason to pay savers or depositors significant interest. This is particularly harmful to retirees who depend on Social Security, which did not go up this year (although Part B supplemental premiums did increase, as did Part D (for me), and Part B basic increased very slightly).

The Times writes “The effect of the financial crisis on retirees — and planning for retirement — has been largely overlooked. It deserves a high place on policy makers’ agendas.”

Sunday, January 17, 2010

AARP article downplays the need for cancer screenings

The Jan-Feb. 2010 AARP Bulletin has an informative article by Sandra G. Boodman, “The Risks & Benefits of Cancer Screenings” (p. 14), link here, with the overall view that sometimes less is more.

Toward the end of the piece, Boodman quotes Dartmouth surgeon H. Gilbert Welch as saying that for every life saved by male prostate surgery (and/or radiation), there are 50 unnecessary surgeries or interventions, sometimes with complications like impotence and incontinence.

The article also downplays the degree of panic over breast cancer, saying that a 40 year old woman actually has “only” a 1.4% chance of developing breast cancer in the next decade, but that risk increases with each decade, obviously.

They're still not letting up on the idea of a baseline colonoscopy at 50, and at 66 I haven't had one yet, even the first "free" one on Medicare. I dread the prep.

Friday, January 15, 2010

Are Fortune 500 companies cheating workers out of defined benefit pensions while spoiling exec's?

While employers are cutting contributions to defined benefit pension funds (or terminating or freezing them altogether), the same companies are increasing executive stock offerings and stock options, according to a sidebar on p. 6 of the Jan-Feb. 2010 AARP Bulletin. The piece is called “What an outrage: Bosses’ Bonuses Trump Workers’ Pensions”, link here. In 2008, S&P 500 companies provided their top executives $44.5 billion in perks while contributing just $39.5 billion to employee pension plans.

The president was supposed to jawbone this practice away. Has the financial crisis changed any of this?

Monday, January 11, 2010

Outright fraud committed on Medicare computer systems

NBC Nightly News (Monday Jan. 11) ran a story on Medicare fraud which is a different variation on what was reported before; instead of selling fake services, crooks simply create bogus claims out of nothing by manipulating security weaknesses in carrier Medicare processing systems.

Visit msnbc.com for breaking news, world news, and news about the economy

I worked on the design of a Combined Medicare System in the early 1980s, a consortium of Blue plans, and the project fell apart because of political turf feuding. I wonder if turf battles today hurt Medicare system security.

Friday, January 08, 2010

Worker in St. Louis factory retaliates over pension dispute in very unusual and tragic outburst

A worker in a St. Louis plant that makes electrical equipment (ABB, Inc.), went on a workplace rampage with three weapons, killing himself and eight other workers on Jan. 7. The St. Louis Post Dispatch story bi Kim Bell is here.

The workplace case may the first ever case in workplace violence related to pensions. According to Bell’s news story, “Hendron is a plaintiff in a class-action lawsuit against ABB Inc., the Pension Review Committee of ABB Inc., the plan administrator and others. Hendron and his co-plaintiffs accused ABB of allowing the workers' pension plan to charge excessive fees and expenses to the participants, the workers, without their knowledge.” The pension plan had accumulated financial losses, and a trial had been held in Kansas City Jan. 5 and 6.

However, for a worker to take disgruntledness over a retirement or pension issue out on other workers is unheard of, even more so since the trial litigation had started. Much more “common” are incidents from people who have been fired or laid off.

Thursday, January 07, 2010

"60 Plus Association": A "conservative" alternative to the AARP?

Here’s a group that bills itself as the “conservative alternative” to the AARP, the “60 Plus Association”, link here with introductory short video.

One of the major points on the site is that Congress will pay for health care reform on the backs of seniors, cutting back on Medicare (especially Medigap), and “play God” with eldercare. There is also a graphic on the website that says that the AARP is the “Association Against Retired Persons”. It also says that the AARP makes millions on royalties on health plans (Medicare supplemental and Part D, usually partnered with United Health Care). Yet the AARP insists that is it a consumer advocacy group, not an insurance company or a Blue Plan.

60 Plus President Jim Martin has a statement supporting the idea of making Personal Retirement Accounts (PRA’s) available for younger workers, here.

Wednesday, January 06, 2010

ABC reports on elder abuse, especially with medications in nursing homes; also gives links about family elder abuse

Diane Sawyer has reported abuse of patients in nursing homes by employees, especially with over medication. The URL for the video is here. The specific examples occurred in California, and there were comments by California Attorney General Jerry Brown, formerly the governor. Nursing homes are giving anti-psychotic drugs to 1 of 4 patients instead of physical restraints, and 15000 patients die a year from misuse of the drugs. The report appeared on World News Tonight Tuesday Jan. 5.

The Elder Justice Coalition, A National Advocacy Voice Supporting Elder Justice in America”, link (not gov, as on the ABC site; the “blog” at the .org doesn’t seem to deal with eldercare). This site mentions S. 795, the Elder Justice Act, which was authored in the Senate by Sen. Orrin Hatch (R-UT) and co-authored by Senator Blanche Lincoln (D-AR). The full name of the bill is “A bill to amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes”. The link is here.

The National Committee for the Prevention of Elder Abuse (NCPEA) (link).

The National Adult Protective Services Organization (NAPSO), link here. These generally are subdepartments of County of City social services with some police authority.

The National Center on Elder Abuse. The material here seems to deal with the potential for abuse in the nome, for example this pdf on the strain on other family members (link)

One problem can be that some people see that maintaining a certain emotional distance or separation (more common with male caregivers other than husbands, sometimes called “lack of affection” in “the literature”) might be viewed by others as abusive, depending on the social and moral perspectives of others. It may be difficult for men especially to reconcile the cultural values of the individualistic competition in the work world with the need for emotion or at least empathy.

On Wednesday ABC demonstrated a device to be used at home that dispenses medications and keeps records of what is dispensed on a secure web site, for monitoring by caregivers, family or even APS organizations.

Update: Jan. 8

The St. Louis Post Dispatch reports "Nursing home company admits crime and agrees to pay $1.6 million", by Robert Patrick, concerning 11 Missouri and Illinois nursing homes bought by Texas-based Cathedral Rock in 2001, link here.

Tuesday, January 05, 2010

Mayo Clinic in Arizona drops some Medicare patients: a coming trend?

David Olmos has an alarming story in Bloomberg “Mayo Clinic in Arizona to Stop Treating Some Medicare Patients”, link here. The Washington Examiner ran the story Sunday January 3 on p 10 with the title “Mayo move to ditch Medicare spells trouble for government insurance: Other docs may copy touted clinic’s rejection”. The facility is a Mayo family clinic in Glendale, AZ. Doctors say that the government pays about 20% less than normal private insurance plans for the same procedure. But it all sounds a bit greedy.

The report is a bit confusing because even in the employer-based private market before Obamacare reform, the discounts negotiated by major employers with major health insurance companies (like United Health Care) are huge. At the Virginia Hospital Clinic, the list price for an oral cat scan is $1700; the “insured” price is $370. It’s similar with body work and auto insurance.

Wikipedia attribution link for picture of Gonda Building at Mayo Clinic in Rochester MN

Saturday, January 02, 2010

States face pension tsunami with unfillable promises to public employees

The Washington Post on Sat. Jan. 2 runs a “pension tsunami” editorial, “state and local pension plans are on a path to failure,” link here. The editorial points out that local politicians “promise now, pay later” in dealing with employees’ unions. So some states, including California, Illinois and New Jersey, are in particular straits. Virginia and Maryland are said to be “responsible” in managing public employee pensions but are still in difficulty. This is one of the reasons for state budget cuts, even in Medicaid and for teachers.

Public employees generally have better pensions that in private industry, where the average defined benefit pension right now is $7692 a year, whereas the median for “9 of 10 public sector” employees in 2005 was $17,640.

I remember the battles over pensions as covered in the newspapers as far back as the 1970s, when new York City has its financial crisis while I lived there, and the teacher’s union helped bail the city out at the last minute (after the notorious “Ford to City: Drop Dead” headline).

Friday, January 01, 2010

Senior Medicare Patrol looks for Medicare fraud

Here’s an interesting story from the Dec. 29 2009 Washington Post by Matt Sedensky, “Senior Citizen Voluteers Fight Medicare Fraud”, link here.

The article mentions a Senior Medicare Patrol, which does not seem to have its own website but is attached to many states, such as with the Virginia Association of Area Agencies on Aging, here.

One sign of fraud is when “medical” equipment that has not been ordered arrives.