Hospitals are now required to publish the rates they charge for services. Will this be helpful for patient’s health, for controlling costs, for lowering premiums? Let’s see.

This Federal legislative mandate is another fine example of Government wanting to help, thinking it can help, penalizing business and general community to do something it hadn’t before, then mucking it. It’s a mandate for hospitals to publish the rate they charge for the services it provides. The “no insurance coverage rate” or sticker price if you like.

Anyone who has ever purchased automobile understands what “sticker price” means. Simple, it’s the cost listed on the sticker glued to the car you’re looking to purchase.
Is that what every one pays? No.
Is it the starting point for negotiating. Yes.
Would the provider charge uninsured patients less if asked. Yes

If you are old enough you will remember the rate card nailed to the inside of every hotel room in America. The hotel and lodging industry referred to that as their “rack-rate”. It was mandated that the rate be displayed.

But, every time you looked at the rates on the card you would ask yourself “Does anyone ever pay that much?”. It was the hotel’s “not to exceed” rate but rooms would be priced based on supply and demand.

So, now patients and technically potential patients will get access to what a hospital will charge for the healthcare services, supplies and facility it provides for the treatment the patient seeks.

Of course this won’t be helpful to anyone and adds cost to the venders.

If insurance, Medicare or Medicaid is paying the bill then it will not pay anywhere close to the “rack rate” hospital’s post. In fact, even a person, uninsured, will not paid this amount.

So what good is this mandate?
Technically, a hospital can divulge what a service would cost under the coverage and discounts the member’s plan pays. They all have discounted PPO rates which could be used to divuge cost to a patient.
But insurers won’t like that and in fact would go nuts, then go to court. Insurers guard their negotiated discounts like the United States guards Fort Knox.

Insurers would hate to see their negotiated rates scattered among the internet for all competition to see. It goes along with the Insurer’s resistance to publishing claim experience or loss ratios publicly.

Your humble author has long advocated that Insurers be mandated to provide insured’s the loss ration on their plan for the year even if it be made available only at renewal time. Do you think it would be helpful for an employer, large or small, to be able to see that its loss ration is less than 100%. How  would an employer respond if its loss ration is 55% at the same time the insurer offers a 30% increase at renewal.

Posting rates will do little to improve healthcare outcomes, little to lower out-of-pocket cost and nothing to lower premiums.

So, this new mandate will not:

• Lower out-of-pocket costs
• Lower premiums
• Improve healthcare outcomes

But, politicians can boast that they have done something. Just as the ACA caused a complete disruption to healthcare delivery and financing this mandate will provide a veil behind which insurers can hide. You’ll see.

Let me know what you think because we’re all in this together.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

What if SCOTUS holds that the ACA is Unconstitutional? What can the GOP put in its place? You hold the solution, here!

Several years ago I jotted down a few ideas which, if implemented, would address at least the biggest issues in medical insurance and healthcare delivery: cost and access. With the recent Court decision deeming the ACA unconstitutional we need, that is the GOP, needs to offer betters solutions. The ideas below are a start toward that better solution.

You all know that I am an optimist trapped in a cynic’s body so my hopes of replacing the ACA with a workable solution are real but also guarded. But, what if you/we were asked for input to design a workable solution. Could you do it?

I have expanded the solutions, since jotting down my initial 12 points in prior posts, because I believe that there is an easier and less expensive means to address healthcare financing for the chronically poor, the uninsurable and the chronic uninsured. You may think that I have left a few issues untouched and if so let me know your thoughts.
However, I know that these ideas, if put in place, build the framework to address:

• Those that want to buy insurance but are un-insurable.
• Those who want to buy but who can’t afford the premiums charged for insurance.
• Those who currently buy and pay for their coverage but are finding the increasing premium too much to pay. 
• Those that don’t want to buy or will wait until they have a problem to buy insurance.
• Guaranteed acceptance.
• Pre-existing conditions.
• How to push premiums lower
• How to push unit cost of healthcare lower
• Transparency (Total & Complete Transparency).

So, together we can develop the core outline of what Congress could build if it truly tried to bring about the best reforms for our system. Please give us your input to improve upon these points as well as address issues that we have not addressed or not addressed well.

It may be fun and interesting but who knows we might even make a difference.

Since Americans are used to the ACA mandates of kids to 26, unlimited lifetime, and wellness or preventive let’s leave those in. But,  let’s eliminate the Medical Loss Ratio (MLR) limits since no other industry in the world has its profit margin restricted like insurers are by the ACA. Other than that let’s assume we have a blank canvas upon which we can draw our ideas.

Here are the basic ideas to include in a bill to replace the ACA:

1. Make health insurance premium 100% tax deductible for anyone who pays it.
2. Make all fully-insured plans for individuals and families guaranteed issue but with a reasonable Pre-existing period for no prior coverage.
   Example – Pre-ex period: 12 months.
3. Group plans of 2+ employees remain guaranteed issue with full take-over or “No Loss-No Gain” as it used to be called..
4. Allow carriers a reasonable corridor for Risk Adjustment Factors (20%). Also, eliminate artificial pricing rules (such as 3:1 ratio) and let insurers determine pricing with their area rating factors based on their data and statistics.
5. Tort reform: Loser Pays and/or Fixed Attorneys at 15%.
6. Allow carriers and plans such as Association Health Plans to sell across state lines. (Possibly the most difficult of all.)
7. Eliminate Essential Health Benefits and allow No new benefit mandates from states or Feds for five years. Allow insurers freedom to build plans as they determine.
8. Mandate HRAs and MERPs permissible and available to implement on all plans.
9. All insurers must publish and release statistics and experience data.
   It’s ok and can remain consistent with Hippa.
10. Universal enrollment forms for all group plans and all individual/family plans.
11. Health plan commission set at level 7% and does not increase as premium does.
12. All Providers must post their rates per service. Hospitals must post their outcome statistics as well as infections, error rates, and other outcome data.
13. State based or plan based re-insurance pools to assist Insurers in controlling premiums. If unlimited lifetime benefits are retained then Insurers and Plans need support to handle the increasing number of mega-claims. 
14. Providing coverage for those who can’t afford to pay premium regardless of its cost:

• Eliminate Exchanges. Allow people to be enrolled directly with the Insurer or Plan of Choice.
• The IRS can maintain these enrollment records and disperse payments to Insurers and do so without adding fees to premiums.
• That also eliminates the huge fees added to premiums by Exchanges to compensate the Exchanges.
• Set the income levels for participation in subsidies (even use the current formula).
• Eliminate the Medicare Expansion as it pushes people toward poverty.
• Instead, keep these folks covered by the private market and allow them to obtain their coverage from private Insurers and Plans.

I also think we need to build incentives for employers to support wellness plans. If we want to bend the cost curve downward we must address behavior and expectations through affective wellness and benefit structure.

I do address coverage for the poor as I mentioned above. Setting a poverty level which assists folks in need but forces folks into Medi-Cal (Medicaid for outside Cal) is problematic as it may discourage folks from working their way out of their financial circumstances. Besides, those Medi-Cal plans “suck”. You would not want to be covered by one so why push these unfortunate folks into it.

So, this is our starting point. I encourage you to give this some thought and to give us your input. If we offer a worthwhile solution then who knows; we might make a difference. That’s what I mean when I say “We’re all in this together”.

Let me know what you think.
Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

U.S. Court rules the Affordable Care Act is unconstitutional. What should Americans expect?

So far, it’s amazing how little attention this Court’s decision is getting. Maybe there’s too many other headlines on which the Media must focus. Border security, N Korea, aggressive moves by both China and Russia, the 2,500 point reduction in the Dow, or the booming economy and threats of Fed interest rate increases, partial Gov. shutdown, or maybe even Christmas (Nah, probably not) are all getting headlines but the ACA being deemed unconditional is not.

Maybe the Media and the ACA supporters don’t want to highlight the Court’s decision for some political reason. The GOP doesn’t want to focus on it because it wasting of the best opportunity to Repeal & Replace. No, the GOP really has nothing to gain in bragging about this Court’s ruling.

To be fair and honest, there is nothing anyone on either side of the issue can do right now because the Court’s ruling will not be effective for at least a year and the Left will appeal the Court’s decision. Many believe this decision will be decided by the Supreme Court.

The Supreme Court (SCOTUS) is allegedly a “conservative” based court with a 5/4 advantage to conservatives. But, we can’t forget that it was Chief Justice Roberts who allowed the ACA to live based on his opinion that the non-compliance penalty was a tax and not a fine as the Dems had argued. 

That still seems surreal to remember that the Dems argued, even before SCOTUS, that the individual penalty was a fine and not a tax. Even the first sentence in Judge Robert’s opinion made opponents believe the ACA would be struck down but then cam the Judge’s second sentence which stated that the fine was indeed a “tax”. I can still remember where I was when I heard that and how fast the Media jumped on the initial statement believing the Court was striking down the ACA.
Geez, that was a bad day for American premium-payers!

So, what should we expect for the next 12 months? Not much really. The Politicians will try to use the Court’s decision to their own advantage regardless of which side of the opinion they stand. But, the only Republicans who may speak up will be the conservative group referred to as the Freedom Caucus. This handful of GOP reps fought hard for R&R but were unsuccessful due to the jello-filled backbones of the GOP leadership.

Heck, even reducing the penalty to zero, instead of repealing it completely, was weak. As you’ve read here before, your humble author has stated many times that setting a fine to zero does not mean a potential penalty is no longer in effect.

As of this moment, the partial Gov shut down is consuming the Media and the Left. They think this is an issue on which they can take the biggest political advantage so they will keep the Court’s decision in their back pocket, for now.

But, Republican, if they are smart, will introduce a replacement for the ACA that includes the features everyone likes but without the features that increase premiums. It is possible and you will read about it in next week’s post.

For now, sit tight. If you have coverage now, which I know you do, then you have nothing to worry about. People concerned about Pre-ex conditions also have nothing to worry about. In fact, the 10 million Americans covered by Exchanges who receive premium support have nothing to worry about either.

The fight will not be pretty and the Media will paint a picture of people suffering in the streets, of children not being immunized, of woman not getting prenatal care (or birth control pills) because they could not get the medical attention they need and deserve.

But, we’re in this together so let’s let people know that there is a better solution and it would increase benefits and lower costs. More to come.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

It’s that time of year again for “reflection”, and to look forward with the knowledge gained over the past year.

The unbearably hectic season of Thanksgiving and Christmas has past, New Year’s Eve is in a few days and frankly most of us are probably worn out or worn down. Face it, life has not gotten easier just because we have smart phones, iPads, the internet and even an economy that continues to boom. No, life is complicated, busy and frustrating as well as rewarding, gratifying and exciting. That’s life in the modern world.

Some people take a little time out of their busy schedules, at this time each year, to think about the year that’s past and consider their hopes for the year to come. In business one must reflect on the past year’s activity or results in order to forecast for the future. Some people do the same for their personal lives.

As you know, I’m an optimist trapped in a synic’s body so this is a most satisfying time of year as I review life insulated by the capsule of time lodged between Christmas and the New Year.
Let’s look at some good and some not so good with these thoughts in mind.

The GOOD
Second Year for Donald Trump to millions was a positive vindication of their honest hope that he could change the negative spiral America had faced for the previous 12 years. Yes, that’s right 12 years.
No Repeal and Replace, but a recent Court decision striking down the ACA as unconstitutional, which will cause more confusion than good. The Media will swarm this as a Trump debacle when in fact it is a result of poor leadership of Rep. Ryan and Senator McConnell. But it does give us a chance to make meaningful corrections. If they follow our  published14 step solution, that is.
Twitter  is a GOOD, even though I don’t know how to use it, but it has allowed the President to get his word out by going around the dishonest liberal press. While not all of the Pres’s tweets have been helpful, Twitter has provided a tool by which he can get his message out.
Snow in Sierras may be a local thing for folks living in the San Joaquin Valley of CA. But last Winter’s extra snow pack and rainfall gave CA a welcome break from the 5+ years of drought.  We pray for another season of snowfall.
Family Health, which is important to each of us, has been relative good for your humble author’s family. Unfortunately though, we do have close friends suffering greatly so we do pray for them. But selfishly, for our immediate family things are good, and  for that I am grateful.

The BAD or at least not so good

Congressional Leadership in Washington (not to mention CA) has been a great source of frustration for most of us over this past year. The GOP leadership is unable to communicate well to the people, makes things unnecessarily complicated and does not act together. In addition, it appears intent to maintain the status queue for what’s been so accurately described as a “swamp”.
Plus, January 2019 will usher back Nancy Pelosi as Speaker of the House. Ugh!
Press both national and local continues to be untrustworthy. Whether a Liberal or Conservative, one must agree that we can’t trust what we read or hear anymore without a bit of concern. It was similar in the Cronkite/Viet Nam era but then news traveled slower. Now, with the internet and people deliberately trying to push “fake news” it is tougher to know the facts let alone the truth. It’s hard to imagine this will get better soon.
Internet which I mentioned above, can be a most amazing tool for our life and health. When you search for goods or services or wish to stay in touch with friends it is incredible. Unfortunately, it can be a tool just as useful for confusion, misinformation, and evil. It’s user beware and we must all be aware.
No R&R, that’s right. With the Court decision mentioned above I predict that the 2019 House and Senate will not get anything meaningful done on repealing and replacing the ACA. That may be a good thing given the mess the GOP tried to force through in 2017. But it won’t be good for premium payers that don’t qualify for subsidy and small business that continues to deal with the high priced metallic plans of the ACA.

Hope for 2019, that’s right hope! I’m betting the economy will continue to go well. There will be more jobs and better pay scales available. We will feel the benefits of the American economy every where.
The biggest obstacle and concern will be the ongoing issues caused a Congress bogged down with hatred, illegal immigration, by Russia, China, Iran and their intent to cause damage to America. With their help we can keep North Korea, Iran and the middle east from spreading terror and disasters. Without their help it could be more terrorist acts and crisis. Plus, it would be helpful for Dems stop obstructing progress and to not worry about President getting a “win” on the border, trade, employment, terror, N. Korea, etc.

But, I am hopeful for several reasons. One, we are all more aware of who we should trust or not. We have a President and Cabinet trying to build America up not tear it down. And America is an engine that produces outcomes desired and envied by the rest of the world.
While others around the world try to tear us down they also know that there’s no place on earth like America.

Plus, you have me writing to you every week, helping you understand the “malarkey” our government and Media is trying to pass off as healthcare reform.

Have a safe and Happy New Year. Together we can make it through anything to build a bright and prosperous future. We may even make healthcare better and cheaper.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

Another year in which we can all say “Merry Christmas” without fear of persecution. Thank you Mr. President!!

It’s five days before Christmas and while the Stockings are not yet hung, I bet most of us are thankful that the “war on Christmas” has been placed on-hold, for another year.

So this week instead of promoting or dissecting some aspect of healthcare reform let’s look for aspects of 2018 and our own lives in America that bring peace and good will to man. Sorry that isn’t PC, should have said “good will to us all”.

I say Thank You to:

• First Responders who run toward the crisis or danger while we run away. These brave men and women are better civil servants to our Nation than anyone else, especially politicians, can ever brag to be.
• Military that in spite of a decline in funding and respect over the past 10 years continue to keep us save by stopping the dangers over there from reaching over here. I did not join the military when I was of age, a decision I regret to this day.
• Law Enforcement officers on a daily bases as they walk or drive into unknown danger without hesitation and without the support of too many in our nation.
  We should all stand each time the National Anthem plays!
• Teachers who signed up to help educate our future generations and continue do so even when facing the toughest environments. Wouldn’t it be easier to teach if English was the required language, parents would help from home, and Unions cared about kids more than self-preservation?
• Moms for doing what they do to love their children even when we are unlovable. Giving birth might be the easy part for Moms these days as they too often take on the role of both parents and both bread winners in American homes. Moms are the first responders for our families and they need our help and thanks.
• Our Churches that stand for the true Word of God and don’t give in to the secular-worldly efforts by too many to cast shadows upon what we all know is right.
• Co-workers that come to work each day to work as a team toward similar goals of creating good products, good service, and respect for team.

Thank God, above all else, for His gift of the Lord Jesus Christ, for us all. God so love the world that He gave His only Son for us that we might have eternal life. To those of you who are believers you know that a relationship with Jesus Christ does give us an eternal home but also gives us a relationship throughout the year like none other possibly could.

That’s just a few.
To whom or what are you thankful that makes your life safer and better?

Love to hear from you and especially at Christmas we should know that we’re all in this together. 

Merry Christmas to all!! And to all, until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

 

Post Mid-term election, pre – Christmas shopping and slower ACA enrollments all make for Blah-blah-blah misleading headlines. Don’t go to sleep!

Every day we see media headlines either boasting of the ACA successes or lamenting its failure and criticizing President Trump for the horrible performance. In fact the only people benefiting from the ACA seem to be the big Insurers but I’ll cover that another time.

Several stories over the past 10 days have skirted around the projected lower enrollment numbers on the ACA public plans. Last week those headlines landed on 800,000 fewer people will be insured “because of President Trump” of course. But the media takes it further. It also projects, based on “expert accounts” that there will be 247,000 fewer children insured and again because of the Trump administration.

Now, why would there be fewer children covered. That makes no sense.

I want to address these two issues because it seems impossible to believe. I expect the enrollment numbers in the ACA to be lower but the rational put forward for the results is too partisan, for me.

One complaint is that the Trump administration cut Federal funds that had been going toward the marketing and sales of the ACA’s IFPs (Individual & Family Plans). But, really?

That sounds fishy to me for a couple of reasons:

• Is it possible that there is anyone in America who does no know about the ACA. Sure, a person may have been neglectful the past 7 years so they don’t know how to access the plans.
• But, there is no provider or hospital location in America that does not have an ACA or Public Exchange placard hanging with in feet of every provider’s office.
• If citizens are unaware of the ACA then how do they know about other welfare benefits like free phones, food stamps, etc..
• But realistically, is it possible that the members on ACA IFPs last year would give up their plans this year? Since 90% of the enrollees get either premium or benefit subsidy, or both, why would these folks not continue their plans since they are immune to the premium increases we all pay.

One plausible answer is the increase number of Americans who are now employed and therefore receiving Employer sponsored plans. If fact any other reasons sound nuts.

So, the moral of this story is that the advocates for the ACA, including the Media, have a biased interest in projecting and proclaiming any mis-fact or un-truth which can harm the President or even move toward Single payer, yuck.

Once again we can see that to be informed means we must use our own common sense and not believe every thing we see or hear.

We’re all in this together so until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

 

Add Electronic Data Collection to the burdens the ACA has added to each of us. Now we must monitor our personal data for hacking, miss-use and mistakes.

The idea of maintaining one’s historical data in an easy to access place where it will always be available is appealing. Whether it is one’s financial records, tax information or family photos, list of friends and contacts or even entertainment it’s becoming easier to maintain any or all of that information in an easily accessible place.

Add to that list the collection, maintenance and storage of all our personal medical records and you have a life full of history at your finger tips. doesn’t that sound appealing? Can you imagine being able to easily look up every medical checkup you’ve ever had, every lab result or every x-ray you’ve ever had and every procedure and every prescription you’ve ever had or taken. Wouldn’t that be convenient not only for your own use but for family members who may be responsible for you, someday.

The ACA included provisions which mandated all providers move to electronic record keeping. The stated goal of the idea (mandate) was to improve efficiency and outcomes of healthcare encounters by being able to better maintain, track and share data between providers. Makes sense doesn’t it?

The implementation of this ACA mandate was not easy nor has it been completed by every provider in the United States. Many small providers or rural providers lacked the resources and capacity to quickly comply. Large providers may have had more resources or better access to technology to help them comply but they also had much larger patient base with huge amounts of data to input.

Your humble author has written and spoken many times about the concern we all should have about this vast collection of “very personal” medical data being stored in a single data base and the ease in which it can be shared. Why was I and still am concerned?

Events, briefly reported in the news, have proven that security is the reason why we should all be concerned or at least not surprised when our own personal data is stolen by hackers or internal evil-doers. Let’s face it, hackers have already demonstrated their ability to get into and steal data from the US Government Personnel Records as well as banks, credit card issuers, credit reporting agencies, Sony, Facebook, Google, and dozens of insurance companies.

Why would we think that our personal medical history, stored by our personal doctor, local lab or local hospital, would be better protected than the biggest tech companies, Insurers and banks in the country not to mention the United States government, itself?

Well, let’s add one more concern to collection and storage of our personal health information. That would be incorrect data.

That’s right, just simple mistakes of data input that might influence a provider to make a draw an incorrect conclusion which could lead to an incorrect diagnosis and worse treatment for a patient. Sounds too simple to worry about, I know. But think about the impact of adding or omitting a single word from the input of data in a patients record.

Let’s say that a Doc is trying to type or dictate that “The patient has a history of high blood pressure.” but instead it gets entered in the records as “The patient has no history of high blood pressure.” You can probably think of many other examples which could be more serious or at least more embarrassing.

Such as, a woman, age 34, goes to her doctor presenting symptoms of nausea, fatigue, and bloating. The doctor runs a panel of tests and after review enters his thoughts into the record “Blood tests reveal no blah, blah, blah but that the patient, Mrs. Jones, tested positive to being pregnant’. The potential problem is that Mrs. Jones’s husband had a vasectomy 5 years earlier. You can imagine the discussion that followed.

But, the doctor had an exceptionally high number of patients to see that day, was rushing to get through and in addition was trying to get finished in time to go watch his 14 year-old son play baseball that afternoon. The record should have stated “Blood tests revealed no blah-blah including pregnancy”. I don’t need to explain further the complications this mistake could cause Mrs. Jones.

Truthfully, we should be more concerned with hackers and evil-doers than mistakes in input. The hackers will use our information for evil and the results could be far more harmful, except maybe for Mrs. Jones.

So, what do we do?  There is probably little that any of us can do. If your general provider has a website on which patients are allowed to access their own data then we should access it from time to time. For instance, my provider’s group provides me access to what they call “My Chart”. I go there from time to time, generally after getting an email from them prompting me to do so. These records available on your provider’s website provide a good means to at least try to verify that your data is accurate. If nothing else you can verify what is says about the Rx you take, your next appointment or just the accuracy of your date of birth. These sites generally allow you to print your information which can be handy if traveling out of country or for a provider not able to access the data.

The easy access to helpful personal health information is a benefit when protected properly. It’s just that no one can guarantee us that they can protect our information. There’s nothing you or I can do about the security of our data or that our data is collected in the first place.

Over the past 30 years I’ve stated many times that the concept of Managed Care is really designed to provide Insurers a means to manage their cost and it’s up to us to actually manage our care. Electronic records are one more aspect of our care which we must manage if we want it to be accurate and safe.

In this case we all are subject to the same risks so once again I say; we’re all in this together.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

The Thanksgiving Holiday is not unique to the USA but we may enjoy it more than most. Given the way History is taught in schools, do younger Americans know its origin? Let’s review.

Next week is Thanksgiving so let’s take a break from discussing healthcare reform and the ridiculousness of Washington DC to pause for one of our most cherished of traditions.

Why is it that we have this Thanksgiving Holiday? It’s a national holiday and generally grants us a 4-day weekend, at least for many of us. If one searches the internet for Thanksgiving there is a plethora of good info. But why do we celebrate it?

Many Americans are not aware of the reason for some holidays and we are perfectly happy enjoying the time off from work. I say this as someone who is not useful in a kitchen and therefore generally banished from it so Thanksgiving Day has always been a full day of food, parades and football. (Except this year, it’s just food and parades since we can’t watch the NFL until the protests against our National Anthem stop.)
But that’s not the story for today.

Let’s take a brief look at the origin of Thanksgiving; courtesy of Wikipedia and the Internet.

Early thanksgiving observances

Thanksgiving, or Thanksgiving Day, is a public holiday celebrated on the fourth Thursday of November^[1] in the United States. It originated as a harvest festival. Thanksgiving has been celebrated nationally on and off since 1789, after Congress requested a proclamation by George Washington.^[2] It has been celebrated as a federal holiday every year since 1864, when, during the American Civil War, President Abraham Lincoln proclaimed a national day of “Thanksgiving and Praise to our beneficent Father who dwelleth in the Heavens,” to be celebrated on the last Thursday in November.^[3][4] Together with Christmas and the New Year, Thanksgiving is a part of the broader fall/winter holiday season in the U.S.

The event that Americans commonly call the “First Thanksgiving” was celebrated by the Pilgrims after their first harvest in the New World in October 1621.^[5] This feast lasted three days, and—as accounted by attendee Edward Winslow^[6]—it was attended by 90 Native Americans and 53 Pilgrims.^[7] The New England colonists were accustomed to regularly celebrating “thanksgivings”—days of prayer thanking God for blessings such as military victory or the end of a drought.^[8]

Setting aside time to give thanks for one’s blessings, along with holding feasts to celebrate a harvest, are both practices that long predate the European settlement of North America. The first documented thanksgiving services in territory currently belonging to the United States were conducted by Spaniards^[9][10] and the French^[11] in the 16th century. Wisdom practices such as expressing gratitude, sharing, and giving away, are an integral part of indigenous communities since time immemorial.

Thanksgiving services were routine in what became the Commonwealth of Virginia as early as 1607,^[12] with the first permanent settlement of Jamestown, Virginia holding a thanksgiving in 1610.^[9] In 1619, 38 English settlers arrived at Berkeley Hundred in Charles City County, Virginia. The group’s London Company charter specifically required “that the day of our ships arrival at the place assigned… in the land of Virginia shall be yearly and perpetually kept holy as a day of thanksgiving to Almighty God.”^[13][14] Three years later, after the Indian massacre of 1622, the Berkeley Hundred site and other outlying locations were abandoned and colonists moved their celebration to Jamestown and other more secure spots.

Harvest festival observed by the Pilgrims at Plymouth

Americans also trace the Thanksgiving holiday to a 1621 celebration at the Plymouth Plantation, where the settlers held a harvest feast after a successful growing season. Autumn or early winter feasts continued sporadically in later years, first as an impromptu religious observance and later as a civil tradition.

Squanto, a Patuxet Native American who resided with the Wampanoag tribe, taught the Pilgrims how to catch eel and grow corn and served as an interpreter for them. Squanto had learned the English language during his enslavement in England. The Wampanoag leader Massasoit had given food to the colonists during the first winter when supplies brought from England were insufficient.

The Pilgrims celebrated at Plymouth for three days after their first harvest in 1621. The exact time is unknown, but James Baker, the Plimoth Plantation vice president of research, stated in 1996, “The event occurred between Sept. 21 and Nov. 11, 1621, with the most likely time being around Michaelmas (Sept. 29), the traditional time.”^{[16]  ]} The feast was cooked by the four adult Pilgrim women who survived their first winter in the New World (Eleanor Billington, Elizabeth Hopkins, Mary Brewster, and Susanna White), along with young daughters and male and female servants.^[16][17]

So, there you go, a brief history lesson for us all. Can you imagine our Congress declaring a day be set aside for honoring the Almighty who Dweleth in the Heavens in our current political climate? Someone might get burned at the stake.

Over 120 Pilgrims landed on Plymouth Rock but only 53 survived the first year, to celebrate and offer thanks, in the New World.   As we enjoy our Thanksgiving Holiday I hope we all  can benefit by knowing the first years of this celebration were precluded by great hardship and therefore were indeed a blessing for the settlers. They endured much and likely would have all perished if not assisted greatly by the Native Americans living in the region. We each need a little help in our lives from time to time!

There’s a lesson in history for each of us. Unfortunately it is quickly forgotten as the Monday following Thanksgiving arrives. Hey, maybe it will be different this year.

Next week we’re back to healthcare reform, tax reform and the unbelievable mess we call our US government.

Until next week, let’s remember what Thanksgiving is about and that like the Pilgrims in 1621, we’re all in this together.

Until then,

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

Post Election Review: What’d we gain and what’d we lose. By “we” I mean the average premium paying American citizen!

It’s only 12 hours post Election Day as I write this so everyone is still playing nice and watching for the “first dig of the spur” from the other side. When you read this, in 24 hours, I wager that the language used in the political discussions will already have turned back to negative, divisive or worse.

Will the House be nothing but subpoenas, investigations, impeachment, and obstruction?
Will the Senate, as well as other conservative voices reciprocate.
Will anything meaningful for America get done before the 2020 election?
Will we see nothing but gridlock and scapegoating?
I’ll let you fill in the answers to those questions!

Here are a couple random thoughts both Nationally as well as here in good ol’ California.

• I doubt that the Employer Mandate will be eliminated which we have discussed in previous Posts. That is not a bad outcome because the GOP tinkering with the ACA was not helping.
• Will the Individual Mandate be re-instated?
  Probably not, even though it should be.
• Will anything positive be done to improve the ACA’s adverse rating methodology and burdensome fees and taxes added to it?
  Probably not!
• Will “Single Payer” or “Medicare for All” advance anywhere in the Country or in  any State?
  Probably not, though it will get a lot of press coverage.
• Will the truth about coverage for “Pre-ex conditions” come out showing that the Dems and the Media were fear-mongering the issue?
  Probably Yes, but people will need to listen closely to hear the truth!
• Will premiums start to go down on ACA compatible plans?
  Definitely not!

 

What about the Golden State: California?

• Will AHPs or STPs be allowed to exist and help the tens of millions who could benefit from them?
  Nope, not without a insurrection?
• Will Insurers be allowed to restrict small employers access to HRAs with subtle threats to insurance brokers?
  We’ll see but I know one Insurer that for sure will not be restricting HRAs.
• Will Californians see their premiums continue to increase at each renewal?
  Yep, but the Media will state that the increases are lower due to the good-work of the ACA. We’ve discussed that  effort in subterfuge before, too.
• Should employers continue to sponsor group health plans for their employees
  Absolutely and do so with the Employer Driven method proven so effective.

Am I concerned about the future for healthcare financing and delivery in California?
I have been concerned about this issue since 1985 so I will continue to be concerned but I will not give up hope. Sooner or later (probably later) the status will become so unbearable that the solutions will be so amazingly clear that even the Dems in California can see it.

Let’s allow them to think that independent-competitive insurance plans operating in a less government regulated environment is their idea! Maybe that will do it.

Regardless, we’re all in this together, so keep the faith and keep watching for more “common sense solutions” as we venture forth together.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.

California Voters have a chance to lower healthcare costs plus improve access. But it will take the proper “Vote” in the Mid-term election on Nov 6th.

California voters have a chance to start taking back control of the crazy out-of-control,  high-premium, low-benefit healthcare system in California. Premium increases exceeding 300%, since 2010, have literally destroyed our citizen’s access to the healthcare we need.

We all know that the health plans offered in California are the among the most expensive in the land with killer high out of pockets and “way too skinny” PPO networks.
That’s not News, so why is that important?
Because, with your vote November 6th, you have a chance to set in motion for the real possibility of changing the healthcare delivery and plans available in Ca.
Be sure to VOTE!

To lower premiums, improve benefits, increase access to more providers and get more health plan options – Voters just need to vote:

 Insurance Commissioner  –  Steve Poizner

For Governor  –     John Cox

It’s that simple, REALLY!

Then, we can begin introducing the solutions that you have read about in previous Posts. Can you imagine a California in which you have:

• Dozens of high quality health plans available.
• Plans with benefits that fit your need – not the Government’s.
• Rich plan benefits or narrow plan benefits.
• Plans with huge provider lists.
• Plans with narrow provider lists.
• Premiums that are affordable and 50% lower!
• Reasonable reimbursement for providers.
• Transparency and better control.
• Most of all: available when you need it!

I know what you’re thinking. How can two elected positions create such possibility for change? The truth is that it will take effort and a little time but my bet is that Ca. citizens would start seeing a difference within nine to fifteen months after these men take office.

Reports are projecting insurer premiums for 2019. Estimates are that premium may increase from 15% to as much as 100% depending on the state or region of the country. In Ca. we will see increases on employer sponsored group plans in the range of 10% to above 50% with further push toward Silver and Bronze plans.

Of course, we all know that the premiums we pay for Silver and Bronze don’t usually buy much in first dollar benefits and leave huge out of pocket risks. If they do provide copays then those copays range from $50 to $250 which of course means people defer their medical care.

Regardless if you are Republican, Democrat, Independent, Libertarian or Green; we all have been hurt by the changes brought about by the ACA. This Fall’s election, the so-called mid-terms, provide Ca. citizens a chance to make a difference.

And isn’t that something we all crave, “a chance to make a difference”?

I could spend another 10,000 words outlining the potential improvements that might become reality if we vote wisely November 6th.
But I’ll save that for future Posts.

Certainly we can all agree that elections provide a time when truly “we’re all in this together”.
Let me know what you think.

Until next week.

Mark Reynolds, RHU
559-250-2000
mark@reynolds.wtf
It means “Walk the Faith”.