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READERS FORUM FOR OCTOBER 1, 2016

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Todays READERS POLL question is:  Should City Controller Russ Lloyd Jr tell the pubic who is the consultant and what he is being paid to administer the Employees Health Care program?

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40 COMMENTS

  1. Jon Web. What the H is an NHL unaffiliated team. Is that similar to a President of the United States that unaffiliated with the USA? What type of writing is that? I mean it’s a good article and all but why did you have to try to build up the new Evansville Hockey Team that has NO affiliation what so ever with the National Hockey League? Why did you even put the “NHL” in that sentence at all? You didn’t have to go there. Everyone knows that both Geary and the Mayor are LOSERS in this bad deal. We lost the Icemen which were AFFILIATED with the NHL and got a team that’s below the NHL affiliated teams. We got a team that could easily play at Swonder Ice Rink instead of the Fraud Center. Who wants to go see these third rate teams other than the players family? Ice hockey originated in the Northern Areas of North American…. IE Canada. It took many decades before Ice Hockey Arenas were built in the Southern Parts of the USA. This southern league is much smaller than the league that the Ice men were in. And everyone knows this fact. It’s like comparing AAA rated bonds to B rated bonds. There is a whole of difference in the skills of the players. Geary could not get a filled Ford Center to help him pay the bills. I’d bet money that he was not making the money he needed to keep the Icemen team in town playing at the Fraud Center. And that’s a crying shame. Evansville, IN is not ready for a professional Ice Hockey Team yet. We need to draw more than 3000 or 4000 people to the Ford Center to make a go of this and it didn’t happen. Even with all the promotions he could not get the people of Evansville, IN to get up off their cans and go watch the Icemen Play. We can’t get these same people to vote even. If they had got up and voted in the last 10 Mayoral elections we would not have a Fraud Center and there would be no need for a Ice Hockey Team. Why don’t we fill the Fraud Center with Broom Ball players instead. They make for a lot of excitement and you don’t have to buy ice skates to play. All you need is some shin pads, helmet and a broom and the ice rink.

    Yes it was inevitable that the Fraud Center was going to go down the tubes faster than Roberts Stadium.

    If it’s not obvious to everyone. I’m totally against Cities building Sports Structures for the Rich at the expense of the tax payers. What percentage of the people living and paying taxes in Indianapolis actually can afford to buy season ticket to the Colts Game? Has anyone tried to calculate that figure? I’m sure that those with the best paying jobs and lots of excess cash on hand could find the extra $3000 to buy a lot of tickets for their family and friends. But the rest of the 8 to 5 working class don’t have that type of extra cash for going to ball games every week. Most are working and surviving paycheck to paycheck. But those are the people who paided for the Stadium that the Colt’s play in.

    IMHO let the Sports Team owners pay for their dam stadiums and Fraud Centers. The City should not be building Roman Entertainment Coliseums. IMHO. Now I’m sure that some of the fat cats downtown will disagree with me. But they will be the ones you see buying the Suits in the Fraud Center for their Business Associates and friends. The rest of us sit in the Cheap Seats or don’t go at all.

  2. Post it notes stock on the monitor’s screen in strategic places are as good as Popup Blocker Software. That and turning the Sound Volume down on the computer’s speakers. Works for me. LOL

    Does anyone else hate that stupid ads that we have to watch on the internet before we can see the video that we really want to see? Or how about when you are reading the paper online and the is more screen space devoted to the advertising that the article that you are trying to read?

    Watching TV these days I have to give up the bottom of my TV screen to those Crawling Ads that run across the bottom of the screen. Now MSMBC has the entire Right Side of my TV devoted to more advertising or other BS. The actual program that I’m watching is limited to just the upper and center part of the TV screen these days. What is the world coming to?

  3. I remember when St Mary’s Hospital started charging more for employees insurance based on the health of the individual employee. Those that had high Cholesterol Number got to pay more for their health insurance.

    Would it be cheaper over all for the City to hire healthy employees and not sick ones to help keep the city tax payers cost down? Did the city even think about this. I mean if you look at some of the city employees are they all looking healthy and fit? Or are some of them having to put a extra notch or three in their belts?

    Sick people cost the city tax payers more money. So should the Mayor still be hiring unhealthy people? Now I know that everyone deserves to work and have a job. But if you don’t take care of your self and your health is on a downward spiral due to things you have done that maybe you should NOT Have done then maybe just maybe the tax payers should not be charged more for your problems.

    IE for example if you still smoke cigarettes should you not be paying more for your own health insurance. And when you come down with a preventable case of lung disease why should the city tax payers be paying for your treatment cost? You should have know better to smoke and increase your risk of getting lung cancer or another form of lung disease.

    And if you are still eating McDonalds Tripple Quarter Pounders and French Fries for lunch every day and have gained an extra 100 lbs should you not be more responsible for your health care costs?

    What I’m really trying to say is that maybe the city should do like St Mary’s did. Test the employees for health ricks and then charge more for those that are at higher risks more for their health insurance cost. After all if they don’t try to reduce obvious health factors then it’s their own fault and they should pay more for their health care cost not the tax payers.

    Policemen and Firemen need to stay fit and not smoke and over eat and then they will save money for health care costs for not only themselves but for the tax payers too. How hard would it be to do that?

    Doesn’t the current Fire Chief expect his firemen to stay in top shape so that they can be called upon to fight a fire when necessary and not keel over with a heart attack during fire operations? How many of the firemen have a few extra pounds around the middle that could be taken off with an exercise program and a better diet at home and at the station? How many of them smoke? Same with the police or any other city employee. They all could help lower the cost of their health care if they wanted to. It would be a win win for the employees and the tax payers.

    We need to start thinking OUTSIDE the Box. Maybe this idea won’t fly and it’s not acceptable to the employees. But would it not hurt to start to try to figure out a better way to save money for the health care costs?

    Right now I know that I’d be hard pressed to pay twice what I’m paying for health care cost if I had to. It would be hard to do for most everyone.

    But St Mary’s did this so why can’t the city? Test the blood of the city employee and do physical exams. People who are seditary and don’t get enough exercise all day long can be expected to gain weight and have poor circulation. Maybe if they had desks that required them to stand up for parts of the day they could lose some weight and be healthier.

    Sick and or unhealthy people cost the tax payers more money. We need to start hiring more healthy people.

    This message was brought to you by Donald J Trump campaign. He said we need to fire the ugly fat girls and hire prettier girls as his California Golf Club……. Hey it’s a thought. Maybe not the best thought but it’s what Donald J. Trump would do.

    I didn’t really mean to pick on the Police and Firemen but they do make up a huge percentage of the City Employees and are the most visible ones. And many of them already are into fitness now. And most all of them really are pretty healthy guys and gals. The ones who sit around all day at the desks in the civic center are the ones’ that need to get moving more.

    Maybe the Mayor and Carol can give them all a free pass to go skating at Swonder or the Fraud Center ever day for a few hours after work. They could throw a big party and exercise together at the Fraud Center when the Icemen were suppose to play a game. They could all be doing jumping jacks on the floor. Heck maybe the Fraud Center Management could charge admission to the general public to come watch them exercise together. They might even try some line dancing to help shed a few extra pounds and get those cholesterol numbers down to a manageable level.

    And if the Mayor fixed the city’s sewage treatment plants and sewer problems it might lead to better and healthier people living in the city. It can’t be good for the employees to be breathing in that bad air at the sewage treatment plants. And anyone that drives down Southlane drive by the East Side Sewage Treatment Plant knows that bad smell I’m talking about.

    • coyotehunter

      The screening method for certain age groups would not be a major problem.

      However, as the age population increases you can (and will) run into more issues for the older participant. There are issues with genetic predispositions that no amount of work or precaution will change. Is it fair to charge them exponentially increased premiums? Yes, I understand that they increase the risk pool for everyone, but it is worth thinking about.

      Another major issue is for employees who have a preexisting condition, something that was thankfully changed when the ACA was placed into effect. If you are young (I’ll just pick under 30 as a SWAG) you have a reduced chance of being affected by this. However, the older you become, the higher chance you may have some sort of preexisting condition. The consideration here is whether that preexisting condition is major or minor, and does it have the potential for costly claims against the risk pool.

      I once wrote a research paper on this, and I can use this as an example of how screening can adversely affect payments by an insured party. Take a look at BMI (Body Mass Index)

      The BMI calculation doesn’t take into account some important factors, like age, gender, ethnicity and race. This is important because, as the CDC points out, in general, at the same BMI:

      Women tend to have more body fat than men
      African-Americans tend to have less body fat than white people
      Asians tend to have more body fat than white people
      Older people tend to have more body fat than younger adults

      On top of all of that, the BMI scale doesn’t take into account muscle mass. The CDC points out that at the same BMI, athletes tend to have less body fat than non-athletes.

      I have done purchasing work on health coverage for employees before, and IMHO the major flaw and exposure for Evansville and Vanderburgh County is that they are still attempting to “self insure”. This means that their risk pool is unbelievably small when compared to the risk pool you would see in a major plan (pick any of the big plans, such as Anthem, Humana, Cigna, and so on), and that means even a single catastrophic illness scenario (cancer, major hospitalization, surgery) can have huge costs to the risk pool. Since we all know by now that the pool has been underfunded for far too long, there are pretty much zero reserves in place. So for every major cost, that reserve shrinks more. And by not having the guts to properly work with City and County employees to find a solution, now they are running around like crazy to figure out how to balance the books.

      A self-funded plan is attractive to employers, because it is less expensive than a traditional insurance plan. Instead of paying premiums to an insurance company, the payments for your medical treatments come directly out of the employer’s bank account.

      But (again, IMHO) employers do not have the manpower, expertise, or resources to set up such a plan, so they look to a health insurer to do this. So you may THINK you are covered under an insurance plan, but you are painfully wrong. In a self-funded plan—you have no insurer at all. Joke’s on you. In the self-funded plan, there is no insurer. “But Acme Insurance’s name is all over my insurance brochure,Aren’t they the insurer?”

      No. When it is a self-funded plan, the insurance company magically becomes the “Third Party Administrator.” They process the claims, they administer the plan.

      The employer is the decision-maker in this set-up. Think about it. It’s bad enough when the insurance company gets to decide whether or not you get your lifesaving treatment. Now your employer gets to decide. What qualifications does your boss have to decide whether or not your child receives a bone-marrow transplant?

      In addition to this, your employer is not an insurance company. Consequently, they are not subject to your state’s insurance laws. You cannot even file a complaint with the Insurance Commissioner, because he has absolutely no jurisdiction over your employer. Since they are not subject to state insurance regulations, your employer does not have to provide certain benefits—such as minimum post-partum hospital stay—which is mandated by state law.

      Based on some of the financial controls (or lack of) that we have seen, this discussion is happening like the Doomsday Clock, and the hands are set at 1 minute to midnight. What angers me is that it has happened year after year after year over the last 4-5 years. Our local governmental employees are trying to afford reasonable healthcare coverage for them and their family, but they only find out about the major problems at 11:59 PM. But for the other 23 hours and 59 minutes we see projects like penguins, North Main, and so on taking up lots of time and money.

      Yes, our City looks nice, but nobody is healthy enough to appreciate it

      • WoW. that was well written and well thought out. I see what you are saying. It’s not easy. Self Insurance and the risk pool is dangerous as you pointed out. I was posting above in some jest or tongue in cheek. Making fun of Donald J Trump and his simplist answers to all our problems. It sounds good in a sound bite but as you just proved when you dive into the details and all the complexities of the subject matter it becomes harder to figure out what to do in real life.

        There are exceptions. Your post made me think about the retirement age. People retire at 65 due to predisposed genetics of the human race that makes us slower after a certain age ON AVERAGE. Not everyone is the same though as you pointed out.

        I only really know one thing. Medical costs are way too high. That for me is the bottom line. Doctors live on the high income scale and no one can really deny that. They make great money and the rest of us have to pay though our noses. But we can’t live without them or the hospitals. We have paid a lot to extend the life of the average human being in the USA. We live longer these days and we we get older there are much more costs associated with keeping us alive longer.

        The only thing that I said above that I really wanted to draw attention to was the way that the Hospital did their employee health insurance. But you are absolutely right about athletic people having more muscle mass and women bodies having more fat and therefore the BMI is skewed in those cases and I expect others. That is why we have statistics with means, standard deviations and coefficient of variations and other ways to estimate the true population from random samples of the population. We can see if the mean is skewed by a few outliers. Which is why some companies force people to retire at a certain age. It’s also why the Government won’t allow us to sign up for social security until we reach a certain age. They hope that on average we won’t live long enough to collect all the money we put into SS all our life. Some may live longer while others die sooner.

        But what I was really talking about above in the other post was reducing ricks that we have more control over. Not our given genotype but our smoking behavior and other things that we do to make us more vulnerable to disease. It’s like if you fly you can buy insurance in case you die in a plane crash. We don’t do that for a taxi ride but we do for a ride in an airplane. why? Because some people think that flying is more dangerous than a taxi ride. Don’t ask me why they do what they do. But that is how it is.

        I’m all open for new ideas that will work. But will the Mayor open his eye or just double down on the increased cost and continue to use the current health care plan for the city’s employees. I read in the paper today or yesterday that he is doubling down right now. I guess when the Police and Firemen go on strike he might pay attention to their needs with more enthusiasm for their cause. Until then he will hunger down in the bunker and try to ride this out. Hey he can always blame this on Steve Shafer or the city human resources director. My bet is that he will be out of town on business at the next city council meeting and have Steve stand in for him as he has in the past when things get hot.

        • coyotehunter

          You are two for two: Excellent starting post and excellent response to my comment

          There are numerous other items I could post about this subject. It is complex to even those of us who have worked within it for decades

          The only comment I want to respond to is about doctors and their compensation.

          Yes, they do make pretty good money, but in many instances they are not as “rich” as people commonly think. While they are in an upper category of income, they do not bathe in bullion as many think.

          Part of this is due to the differences between the types of doctors, and that can be divided between two major categories: Specialists/Surgeons and Family Practice/General Physicians. Let me explain

          For Family Practice/General Physicians, they are paid almost 100% solely on the number of patients they see per day, and their pay is based on an antiquated and (IMHO) difficult to master system of reimbursement. For example, all patients seen in an office visit are classified between a Level 1 and Level 5 patient. Furthermore, those five levels are then divided between a New and an Established patient. I will not bore anyone with the details on that other than this: A Level 1 patient is paid at the lowest level, and a Level 5 the highest. That is further divided in reimbursement between New and Established patients. There is a numeric scoring system used to ascertain what level the patient is classified, and the higher the level, the higher the payment level. However, it is very hard for most general physicians to get above a Level 3, even for fairly sick patients. Level 4 patients can be seen if their care is very complex, but for the millions of patients seen each year in the United States, maybe 5% of them get to the Level 5 reimbursement level.

          Now I will talk about how those 10 levels (Level 1 thru Level 5, New and Established) are reimbursed. They are paid based on what is known as a fee schedule, which is what the insurance carriers set as the rate they pay for a patient who is seen by their doctor. People frequently talk about the “high cost of care” when they see an initial bill from a physician, but what they do not realize is that the price they pay has ZERO relationship to the actual reimbursement. For example, if a doctor cares for a patient and codes them as a Level 3, the doctor may have a “list price” of around $150. However, they may be paid as little as $35-$40 for that visit. Since Level 3 is usually the most common for most general physicians, think about what it would take for them to make headway in a single work day. If they see 75 patients in a 9 hour day (1 hour for lunch), that means their actual payment they will get will only be $2,625.

          I know in advance that a lot of people will say that they wish they got paid $2,625 for a days work. However, think it thru further. Out of that amount for that day, they have to pay their nurses, front desk staff, billing staff, utilities, and a host of other expenses. How much do you think they really and truly net for that day after the bills are paid? Sounds scary, doesn’t it?

          Some folks mistakenly think that if the doctor bills $150 and only gets paid $40, then they can bill the patient for the other $110. Nope! That is universally illegal for insurance patients where the doctor participates in the patients insurance, and is especially illegal for Medicare. And by the way, that $40 the doctor would get for a Medicare patient? If the patient has Medicaid, the doctor could make as little as $20 for that visit. This is why many doctors cannot afford to take a lot of Medicaid patients. Doctors that care will try and take as many as possible, but economics force them to limit the number of Medicaid patients.

          Now I’m going to discuss an asinine part of doctor/insurance issues, which is the payment levels. Medicare and Medicaid are required under Federal and State law to publish and tell the doctors what their reimbursement levels will be per patient. So a doctor who cares for a certain portion of Medicare patients can actually estimate how much they will be reimbursed, making it possible to project their theoretical bottom line. Also, with Medicare, they pay fairly quickly (usually 10-14 days after a bill is submitted), so a doctor knows their cash flow. But what about private insurance?

          Sadly, in many States private insurances are NOT required to tell doctors what they will be paid per patient. Sounds stupid? It is almost a game of russian roulette when it comes to seeing patients. A doctor in a certain region may not have a choice in the types of insurances they contract for because that insurance is huge in their area. For example, locally Anthem and BC/BC are big because Wellpoint is headquartered in Indy. The same is true for Humana and Cigna. When 30-40% of all patients under the age of Medicare (65) a doctor has little choice but to sign up to take those insurances. But since the insurance company can legally withhold the payments levels they pay doctors, can you imagine the headaches.

          In addition, the private insurances are notorius for screwing up how they pay doctors. They frequently hold the payments for 4-6 weeks (or longer), and the most maddening part is that their payment systems are so bad, they do not even pay the doctors the correct amount when they pay. So if a doctor is expecting to be paid $75 for a patient and they only pay $40, the doctor and his staff have to not only catch the error, they have to appeal to get it paid. The average for insurance appeals in America is almost six months. But if you have dozens (or hundreds) of $35 errors you have to wait six months to get paid for, well, you see the poroblem.

          One other point is that you noticed that I listed a gross fee and a net payment. That is how healthcare reimbursement works. You may see a gross fee of hundreds of dollars on a doctor visit, but the doctor never gets paid that gross fee. They only get paid the net, which is doctor terms called the “allowed amount” Once they sign the contract with the insurance company they can ONLY recieve the “allowed amount” They are contractually and legally prevented from billing the patient for the balance

          I could go on forver, but based on your points about doctors I wanted to clarify a few things. You made a huge number of on-point factual comments. You were not wrong, but the inside details like what I write are things almost nobody knows outside a doctor and clinic management

    • Well neither is banning the machine gun from the hands of all civilians who don’t pay a tax to get permission to possess one.

    • I doubt Trump has any influence in the current administration, but the fact is that there is no crime she’s been found guilty of so there is no need for a pardon. The DOJ has indicated that no prosecutable crime was committed by Sec. Clinton. Is Trump implying that in the unlikely case he is elected that he would try to interfere with our checks and balances by pressuring a prosecution?
      Here’s a short article that explains pardons. http://www.infoplease.com/us/government/presidential-pardons.html

    • You mean don’t do like Ford did when he pardoned Nixon for his crimes before the Dems had time to impeach or arrest the Crook?
      So it’s don’t do as we (GOP) do or else? Ha ha. Now that’s classic hypocrisy.

    • Unless the Penguins can fix the sewage problem for the city I vote to keep them away.

  12. I am beginning to think that we inmates (posters) are running the asylum (CCO). This is the second day we have two references to one of the most classic errors I’ve ever seen, the use of “pubic” instead of “public”. Has no one “in charge” even read the posts in a day and a half?

  13. Have you seen this?:

    https://youtu.be/RIYdjq2Wa6E

    The debate commission has already issued a statement that they had a problem with Donald Trump’s microphone. All that time to prepare the equipment for that debate and only Trump’s microphone has a problem.

    • This ought to be shown on the nightly news casts from now until the elections. You can not even have a debate with Hillary Clinton without her personal corruption defiling the process! After viewing this, who could blame Donald Trump if he said no more debates?

    • Rudy is a LIAR and a CROOKED POLITICAN. IMHO. He told people immediately after 911 that there was no danger from the dust and he was totally wrong. He is an idiot. Many people were needlessly exposed to the dust that could have prevented their contamination if they had been told the truth. It’s guys like Rudy that are the root cause of the terrorism in this world. He created Al Queda and installed the hatred that the terrorists have for the rest of us. But we are not all like Rudy are we. I wish that he would go crawl back under his rock and disappear. He can take Roger Ailes and Trump with him after the election is over and Trump has to go back to New York City.

    • There’s a disease that re-appears in older people who married too many of their cousins when they were younger just like shingles.

      I believe it’s called imbecilitis or syfilitis or nuttilitis or something like that.

      Anyway when Rudy placed the New York City Command Center on the 23rd floor of the World Trade Center against the advice of the Secret Service and CIA because of cronyism, it was obvious the disease was already starting to invade the cells of this loud mouth.

      And now it’s spread through his brain.

      Moral to the story; Leave them cousins alone pilgrims. And for my friends residing on the other side of that money making bridge, sisters even make the disease spread faster.

      Believe me, bigly….

      • [ “…….all mitochondrial DNAs stem from one woman” and she probably lived around 200,000 years ago in Africa.” ]

        You can come down off your high-horse now, sister.

        • Then you need to stop voting for people who believe the Earth is 6,000 years old Miss Press.

          If that 200,000 year old woman would be around today, I imagine Rudy would marry her also if Trump or Gingrich didn’t get to her first.

          Know what I mean?

          100%….

        • Mitochondrial – isn’t that what created Anakin Skywalker and turned him into Darth Vader?

  15. FEC May BAN Fox News From Election Coverage

    http://newcenturytimes.com/2016/10/01/fec-may-ban-fox-news-from-election-coverage-trump-livid/

    The Federal Election Commission (FEC) is considering reigning back access for foreign owned media and foreign owned corporations. That could mean that Fox News could be completely cut out.

    And for the moron patrol, this is not President Obama creating laws where there are none. The law is already in place.

    “In Blumen v. FEC, a decision affirmed by the Supreme Court, a special three-judge D.C. district court held that ‘the United States has a compelling interest for purposes of First Amendment analysis of limiting the participation of foreign citizens in activities of American democratic self-government, and in thereby preventing foreign influence over the U.S. political process.’

    Poor Pussy Press, his head will explode by having to use actual news outlets instead of the Trump Propaganda Network

  16. without a doubt this rant from classless has to come from a mentally disturbed inbred libtard……………….Law And Order 2016 and beyond……………………..Trump………….

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