Sunday, March 23, 2008

Weekend Update - Miscellany

Happy Easter!
  • OPM has published the 2009 call letter here. The Federal Times and both featured articles on the call letter last week. NARFE issued a press release about the call letter's request for FEHB plan proposals for sub-options to cover Medicare eligible annuitants. In the press release, NARFE's President Margaret Baptiste states that
    “While OPM says that enrollees in the Medicare pilot “sub-option” would pay the same premiums set for their counterpart FEHBP plans, we are troubled that a plan specifically created for Medicare-eligible federal annuitants could open the door for separately rated retiree plans in the future with substantially higher premiums than other FEHBP plans,” . “In the 48 year history of the program, there has never been a separate FEHBP plan based on retirement status or age.”
    In fact all FEHB fee for service plans offer Medicare eligible annuitants reductions in deductibles, coinsurance, and copayments if they are enrolled in Medicare. Consequently, in my opinion, OPM's request is not a sea change and it simply seeks to take advantage of Medicare and tax law provisions that can benefit annuitants who are enrolled in both the FEHB Program and Medicare.
  • Modern featured an article written by an executive of the Depository Trust and Clearinghouse Co. He explains that
    The National Securities Clearing Corp. and Depository Trust Co. were created in the 1970s to fulfill the vision of an industry-owned and industry-governed utility to fully automate the back-office environment for the post-trade processing of securities transactions and settlement of money owed. The Depository Trust & Clearing Corp., the corporate parent of NSCC and DTC last year settled in excess of $1.8 quadrillion in securities transactions.

    Since the Depository Trust & Clearing Corp. operates solely for the benefit of its users on an “at cost” basis—fees are charged only to cover the cost of running its operations and any profit gained through centralized processing is returned to customers ($984 million in 2007).

    Creating something called the Health Care Clearing Corp., or HCCC, modeled on the successful experience of the financial services industry could be a significant step forward in cutting healthcare costs. * * * An HCCC would operate like the hub of a wheel with spokes electronically linking all medical-service providers and all health insurance companies to a central point where data can be processed and exchanged. The HCCC would eliminate the need for medical-service providers and insurance companies to manage separate procedures and processes to submit claims. And, by bringing about standardization in data exchange and record-keeping, you would speed the payment of claims.
  • The OPM AHIP carrier conference featured presentations on health disparities. The New York Times published a story on a recent federal government report finding a growing gap in life expectancy in the U.S. between high and low income groups.

    Robert E. Moffit, director of the Center for Health Policy Studies at the conservative Heritage Foundation, said one reason for the growing disparities might be “a very significant gap in health literacy” — what people know about diet, exercise and healthy lifestyles. Middle-class and upper-income people have greater access to the huge amounts of health information on the Internet, Mr. Moffit said.

    Thomas P. Miller, a health economist at the American Enterprise Institute, agreed.

    “People with more education tend to have a longer time horizon,” Mr. Miller said. “They are more likely to look at the long-term consequences of their health behavior. They are more assertive in seeking out treatments and more likely to adhere to treatment advice from physicians.” [Mr. Miller's article on reducing health disparities is here.]

    A recent study by Ellen R. Meara, a health economist at Harvard Medical School, found that in the 1980s and 1990s, “virtually all gains in life expectancy occurred among highly educated groups.” [The New York Times also published an article this week on the public health risks created by growing number of parents who refuse to have their children vaccinated.]

    Trends in smoking explain a large part of the widening gap, she said in an article this month in the journal Health Affairs.

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