Broken Promises in the 2010 Affordable Care Act

Wednesday, March 21, 2012

In 1994, the health care reform bill proposed by then President Clinton failed, in large part, because it would fundamentally changed health care coverage for nearly every American.  In 2009, President Obama decided he would combat the failure of the Clinton Administration by repeating over and over again to the American public "if you like what you have, you can keep it."

It is my understanding he said that on 47 separate occasions while the bill was being debated in Congress.  And while it may have been political useful to make that promise to the American people, it remains a promise he can't keep.  The fact is that millions of Americans are seeing changes in their existing health plan due to the health law.

The Administration's regulations governing so called "grandfathered health plans" will force most firms?and up to 80 percent of small businesses?to give up their current plan by next year.  When those businesses lose their 'grandfathered' status, they immediately become subject to costly new mandates and the increased premiums that follow.

Families in 17 states no longer have access to 'child-only' plans as a result of the health law.  It's not known how many of the families that lost coverage for their children because of the law have been able to find an affordable replacement.  In Medicare Advantage, there is one study showing Medicare Advantage enrollment will be cut in half, choices available to seniors will be reduced by two-thirds.

Then there is the open question about Americans who receive their health care through large employers.  The Congressional Budget Office recently released a report with that constructed a scenario where as many as 20 million Americans could lose their employers coverage.  And while I acknowledge the Congressional Budget Office report provided the number I just mentioned as only one plausible scenario, there are many of us who believe it is very plausible given the incentives the health law creates for large businesses.

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The President made a further promise that I think we should talk about.  On July 29, 2009, during the consideration of the health law, the President said "Medicare is a government program.  But don't worry: I'm not going to touch it."

So let's take a look at the health care law and see if that promise was kept.  The health care law made significant cuts in the Medicare program.  On April 22, 2010, the Chief Actuary for Medicare analyzed the law and found that it would cut Medicare by $575 billion over ten years.  The President said about Medicare "I'm not going to touch it."  The bill cuts $575 billion from Medicare.  The Congressional Budget Office wrote that over $500 billion in Medicare reductions "would not enhance the ability of the government to pay for future Medicare benefits."  The President said about Medicare "I'm not going to touch it."

The CMS actuary had this to say about the Medicare spending reductions:  "Providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program."  The President said about Medicare "I'm not going to touch it."

The CMS actuary said, in essence, these cuts could drive providers from the Medicare program.  I have a hard time understanding how these massive cuts to Medicare count as not touching the program.  On the other hand, the biggest problem facing Medicare in the near term is the physician payment update problem that we constantly have to address here in Congress.  Of course, the health care law did nothing to address that problem.  Perhaps that's what the President meant when he said about Medicare, "I'm not going to touch it."

Change Begins with a Drop

The best way to understand how important it is to maintain the world's water resources is to figure out how you fit into this global picture. Calculate your water usage.

That's the water you see directly. Water consumption you don't see, known as virtual water, is the amount needed to create the foods we eat and the products we use. Like the amount of water farm animals drink, the water used to grow their feed, and the water needed to manufacture clothing. That adds up quickly.

Water scarcity, a worldwide concern, has been met head-on by Israel for years. Israel is a leader in desalination technology and water recycling, reusing 75% of its waste water every year?the highest rate in the world. Most of this water is used for agriculture, which saves scarce fresh water for human consumption. JNF's reservoirs and cutting-edge wetlands technology have increased Israel's total water supply by 12%. These techniques are shared with the countries around the world, helping to make it a better place.

Trip to Support Illinois Tourism, Trade and Business Investment

BRUSSELS, BELGIUM - March 21, 2012. Governor Pat Quinn today departed on an economic and jobs trip to Brussels, Belgium where he will seek to expand Illinois trade, tourism and business opportunities. In addition to participating in several events organized by NATO in advance of this spring's summit in Chicago, the Governor will address a trade conference sponsored by the European Union (EU) to strengthen ties between Illinois and Europe. He will also host a business roundtable with current Belgium businesses that invest in Illinois, potential investors, and business leaders and associations.

The trip builds upon Governor Quinn's aggressive goal to double exports by the end of 2014, and is the first gubernatorial trade mission to Europe in 13 years.

"We want the world to know that their trip to America starts in Illinois," Governor Quinn said. "We'll showcase Illinois' tremendous economic assets before an international audience and we'll bring back more trade opportunities, tourism and business investment to Illinois."

Governor Quinn will begin his visit by opening the Chicago Exhibit at the NATO Headquarters to promote Illinois to the world in advance of the NATO summit being held in Chicago May 20-21. Later that day, he will deliver remarks at the EU Transatlantic Conference, hosted by the American Chamber of Commerce, where he will focus on opportunities to grow European Union and Illinois trade. Governor Quinn is committed to expanding Illinois' international trade and helping businesses bring more products to global markets.

In front of the conference featuring high-level officials from the EU and the private sector, the governor will discuss the benefits of increasing trade with Illinois and the key role exports play in economic growth. Other keynote speakers at the event include EU Trade Commissioner Karel De Gucht and Ambassador João Vale de Almeida, Head of the European Union Delegation to the United States. The EU is an economic and political partnership between 27 European countries.

Also during his visit to the European capital, the Governor will host a business roundtable, where he will sit down with current Belgian investors, potential investors, and business leaders and associations from Belgium and Europe to discuss opportunities to increase investment in Illinois. He will conclude the day with a dinner hosted by the U.S. ambassador to NATO where he will encourage attendees to come to Illinois in advance of the NATO meeting in May and stay late to explore our state's many visitor attractions.

Brussels is the capital of Belgium and Europe, where representatives from 27 EU member states reside. In addition, the city is home to the European Commission, the European Council and the European Parliament. Significant decisions on trade and investment are made in Brussels, and working groups such as the TABD (Transatlantic Business Dialogue) and TEC (Transatlantic Economic Council) are both extremely active in the city.

The European Union and Belgium are both key trading partners for Illinois. Illinois was the first U.S. state to establish a foreign office in Brussels 44 years ago in 1968. In 2011, Illinois exports to the EU grew by over 27 percent, totaling nearly $11.5 billion. Belgium is Illinois' ninth largest trading partner, receiving more than $1.65 billion worth of Illinois exports in 2011, a 42.7 percent increase over 2010. Top industries include industrial machinery, vehicles and chemical products.

European companies' investments in Illinois are the largest from any region in the world, with countries such as the U.K., Germany and France serving as top investors. Countries within the European Union have 723 firms with 3,476 locations in Illinois, employing more than 183,137 Illinoisans. Some of those companies include Siemans Industry, T-Mobile USA, Deutsch Bank, Philips Electronics, Chrysler-FIAT SPA and Volvo Group of North America to name a few.

More information about Illinois trade and business opportunities can be found on the Illinois Department of Commerce and Economic Opportunity's website at www.illinoisbiz.biz.

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Technology is constantly speeding up the pace of business: Decisions once delayed for weeks are now made in seconds thanks to internet communication. Computer analytics puts real-time market information at our fingertips.  Transactions can occur anywhere, any time.

Logic holds that businesses that can't keep up will be left behind.

"Just to keep pace, businesses must develop organizational agility, and it's absolutely critical if they want to do more than just survive," says Mike Richardson, author of Wheel$pin: The Agile Executive's Manifesto: Accelerate Your Growth, Leverage Your Value, Beat Your Competition (www.mydrivingseat.com).

Organizational agility is being able to move quickly and decisively, and one of the biggest obstacles is unproductive, time-wasting meetings he says.

"They start late, run long, and don't achieve much," he says. "But meetings are the backbone of an agile business."

He offers these tips for developing agile meetings with traction:

• Map your meeting: Create a standing agenda and a master spreadsheet with tabs relevant to each agenda item with the expected inputs, throughputs and outputs. That way, the meetings are easy for the chairman to run because everything is crystal clear.

• Set the mood: Set the tone for the energy level by playing a video or music. You can tell a story, read a quotation, or be unpredictable and create a surprise factor.

• Spark creativity: Frame the purpose of the meeting as a question: How do we best ...? Questions get the human brain thinking more quickly.

• Document the action live: Instead of taking notes, editing them and distributing them afterward, save time by capturing everythingelectronically in real time. You can project action items for all to see during the meeting, and keep them in a master spreadsheet hosted on your server for easy access by all.

• Time-box everything: Meetings should last 45 minutes, from 5 after the hour to 10 minutes to the hour. Allot time for each agenda item and especially for presentations. Get people used to the fact that you will guillotine anything which runs over.When you challenge people to figure out how to get things done in the time allotted, you will be amazed at how they can.

• Leverage the wall-space: Wall space is one of the most underutilized assets in your business.  Have the standing agenda on the wall, creative problem-solving frameworks, your core values, key elements of your strategic plan, inspirational quotations, etc., all in a format large enough for you to refer to during the meeting.

• Generate input: Have everyone take a minute to write down an idea relevant to the agenda item. Go around the table and allow each person to share his or her idea, or break into pairs or triads to discuss the ideas and report back. (Remember to allot time for each step of the process.)

• Get fast consensus: Once the options are on the table, facilitate the group toward fast decisions with statements and questions like: "I'm leaning toward this ..."; "Does anyone have a violent objection to that ... ?"; "Can everyone get behind that?"; and then move them into fast action:"How would we best do that?"

"Agility is the ability to be constantly looking for opportunities to move forward toward goals while planning for problems," Richardson says. "It's being able to capitalize on fleeting opportunities, rebound from problems and make decisions on the turn of a dime."

That doesn't happen in businesses where executives and workers are bogged down by burdensome systems, procedures and time-wasting meetings stuck in minutiae, he says. Instead of shooting forward when they press on the gas, they go into a futile wheel$pin.

Creating agile meetings is one big step toward creating an agile organization which is in traction.

About Mike Richardson

Mike Richardson is president of Sherpa Alliance Inc., a management support business and a chair with Vistage International, a global collaborative of CEOs. He holds an MBA from London Business School and is an adjunct faculty member at the University of San Diego Business School. A former Shell Oil petroleum engineer and board member overseeing three automobile dealerships, he led the Aerospace Division of  Spirent PLC in Britain