The pivotal question hanging in the balance: How do we reduce healthcare costs? And to whom does the responsibility fall? Is it reigning in pharmaceutical companies? Is it improving and implementing state of the art health information technology (HIT)? Is it stopping insurance companies from gouging consumers? Is it encouraging physicians to stop practicing defensive medicine? Sure, all of these are reasonable ways to reduce costs and save the system some money. However, in this ongoing debate over healthcare reform, an important piece continually gets ignored. The less people get sick and have to visit a hospital or physicians office, the less it costs the entire system. Plain and simple. Decrease the demand with a stagnant supply and prices (or costs) will go down. Take any economics 101 class at a community college and you will learn this nugget of knowledge. The largest threat to decreasing healthcare costs is apathy and neglect from people towards their own health. PPACA offers no incentive (or disincentive) for that behavior to change. Reducing true healthcare costs begins with the patient. The rest is just healthcare financing, cost shifting and organizational development.
Creating an efficient and less wasteful healthcare model will undoubtedly help reduce spending.
Reducing unnecessary stays in the hospital and eliminating administrative errors, like billing fraud, will work to maximize efficiency. The continued proliferation of HIT will contribute to the effort by improving waiting times and increasing patient safety. But if the line of patients keeps growing, costs will continue to skyrocket and negate any savings seen by other efforts. Paying people less, a key government strategy in reducing costs, isn’t reducing a healthcare “cost”, it’s reducing a government expense. In some cases, it actually will punish a physician or provider who does their part, follows all the protocols, but a non-compliant patient keeps them from meeting certain “quality standards.”
What about the patient’s role in helping to reduce costs? In all the uproar over healthcare reform, the patient has been portrayed as the victim abused by greedy drug companies and forgotten by profit hungry insurance companies. A 10 year old with a rare genetic condition, a very unfortunate circumstance, is not bankrupting the system. What about attacking the high number of preventable illnesses and conditions that plagues and drain money from the healthcare system? The prevalence of cardiovascular disease, obesity, diabetes, joint injuries and other chronic conditions continue to increase and worsen because patients refuse to take care of themselves. Nothing in the PPACA bill will directly address and aggressively impact the near $147 billion in healthcare spending related to obesity other than the drugs might be cheaper. Giving more obese patients access to cheaper drugs will only serve to increase future spending. If we reduced the number of obese individuals, causing less demand for those drugs and other services, true costs would go down. Not to mention it may improve the quality of life for those individuals and their families.
Americans should want healthcare reform to address access to healthier foods, including fruits and vegetables, and promoting the LIFELONG benefits of exercise and a healthy lifestyle. Patients who don’t take care of themselves shouldn’t be treated like victims. If we continue down this path, the United States will have the most efficient, least wasteful healthcare system in the world with waiting rooms full of overweight patients with diabetes that smoke. Is that what we want?
Friday, February 11, 2011
Sunday, August 15, 2010
Why Health Insurance is Doomed to Fail
The health insurance market, currently in dire straits, has a forecast that isn’t very favorable. For starters, health insurance resembles traditional insurance only slightly, but all the holes, gaps and traps make it self-defeating. Health insurance is inherently adversely selective, full of moral hazard and pays for things that “insurance” isn’t designed to cover. All these characteristics lead to market failure and a host of other problems.
Traditional insurance is meant to protect individuals (or corporations) from catastrophic or severe financial disaster resulting from accidental or unforeseen losses. For a single individual to “insure” themselves, the cost of assuming that risk is so astronomical that only a few can afford it. The Law of Large Numbers, a mathematical and guiding principle of insurance, teaches us that a large pool of individuals is needed for an optimal market. However, when an individual can opt out of purchasing health insurance, the market suffers. In that scenario, the spread of risk becomes concentrated among fewer participants causing premiums to increase. Also, the participants who choose to stay frequently “utilize” the system because it’s cheaper than assuming the full cost themselves. That’s adverse selection. The new healthcare law aims to deter the free flow of market departure, but the effectiveness will depend on whether the constraints are strong enough.
In its current structure, health insurance, for those who have it, does provide for protections against catastrophic losses. Within that framework, it also provides coverage for catastrophic losses caused or mitigated by individual negligence. This contributes to market failure. When insurance covers losses resulting from individual negligence, and sometimes intentional behavior, with no apparent consequences, the insured (patient) will continue to incur these losses. This is regardless of whether they are aware of the behavior or not. Insurance should cover fortuitous or accidental losses. Trauma related losses such as car accident injuries and broken bones from sports can be considered more conventional catastrophic losses that health insurance should look to cover. Bariatric surgery or heart bypass surgery needed subsequent to a life full of poor eating habits and a lack of exercise are losses incurred due to negligence. Without a market mechanism to recognize these and other behaviors as high risk or uninsurable, the health insurance market will suffer. The new health care law may exacerbate this problem by removing lifetime coverage limits for individuals and setting a fixed range for premium for certain classes of individuals.
As stated before, insurance is traditionally for catastrophic issues. Health insurance routinely covers claims for services and “losses” that are not catastrophic. Should a yearly physical be considered a “loss.” Is there an over-utilization of these types of services because they are covered? And if individuals were to pay the true costs, would the utilization decrease? Would consumers see these costs as too high, driving demand down? Would suppliers (physicians) see this as a reason to lower prices? Without these preventive and maintenance services, would the risk of catastrophic losses then increase due to individual negligence? A look at the behavior of individuals with health savings accounts (HSA’s) or high deductible plans may offer some insight. With increased financial responsibility, would consumers become more aware of their own negligence or vice versa? Answering these questions proves difficult due to the volatility of public and political opinions regarding health insurance.
I am no healthcare economist, but the health insurance market has far to go before becoming pareto optimal.
Traditional insurance is meant to protect individuals (or corporations) from catastrophic or severe financial disaster resulting from accidental or unforeseen losses. For a single individual to “insure” themselves, the cost of assuming that risk is so astronomical that only a few can afford it. The Law of Large Numbers, a mathematical and guiding principle of insurance, teaches us that a large pool of individuals is needed for an optimal market. However, when an individual can opt out of purchasing health insurance, the market suffers. In that scenario, the spread of risk becomes concentrated among fewer participants causing premiums to increase. Also, the participants who choose to stay frequently “utilize” the system because it’s cheaper than assuming the full cost themselves. That’s adverse selection. The new healthcare law aims to deter the free flow of market departure, but the effectiveness will depend on whether the constraints are strong enough.
In its current structure, health insurance, for those who have it, does provide for protections against catastrophic losses. Within that framework, it also provides coverage for catastrophic losses caused or mitigated by individual negligence. This contributes to market failure. When insurance covers losses resulting from individual negligence, and sometimes intentional behavior, with no apparent consequences, the insured (patient) will continue to incur these losses. This is regardless of whether they are aware of the behavior or not. Insurance should cover fortuitous or accidental losses. Trauma related losses such as car accident injuries and broken bones from sports can be considered more conventional catastrophic losses that health insurance should look to cover. Bariatric surgery or heart bypass surgery needed subsequent to a life full of poor eating habits and a lack of exercise are losses incurred due to negligence. Without a market mechanism to recognize these and other behaviors as high risk or uninsurable, the health insurance market will suffer. The new health care law may exacerbate this problem by removing lifetime coverage limits for individuals and setting a fixed range for premium for certain classes of individuals.
As stated before, insurance is traditionally for catastrophic issues. Health insurance routinely covers claims for services and “losses” that are not catastrophic. Should a yearly physical be considered a “loss.” Is there an over-utilization of these types of services because they are covered? And if individuals were to pay the true costs, would the utilization decrease? Would consumers see these costs as too high, driving demand down? Would suppliers (physicians) see this as a reason to lower prices? Without these preventive and maintenance services, would the risk of catastrophic losses then increase due to individual negligence? A look at the behavior of individuals with health savings accounts (HSA’s) or high deductible plans may offer some insight. With increased financial responsibility, would consumers become more aware of their own negligence or vice versa? Answering these questions proves difficult due to the volatility of public and political opinions regarding health insurance.
I am no healthcare economist, but the health insurance market has far to go before becoming pareto optimal.
Sunday, November 02, 2008
The lack of medical liability tort reform ranks high
The lack of consistent and effective medical liability tort reform throughout the country ranks as the largest issue affecting the healthcare system. Physicians and patients could benefit from improved tort reform in the United States. Medical liability tort reform impacts malpractice premiums, access to medical care and the quality of care delivered.
Medical liability tort reform can be split into two key components, pre-trial and post-trial. The pre-trial reform component concerns matters such as who can file a lawsuit and the worthiness of the case, with respects to the medical care rendered. In some jurisdictions family members file suits on behalf of an injured party. This is in addition to the injured party filing a lawsuit. In some instances, “pro se” lawsuits are filed. “Pro se” means that the plaintiff is not represented by an attorney. These caveats only serve to increase the number of suits. Some jurisdictions require a certified medical expert to sign off on a case prior to it being filed. Without this provision and others like it, court dockets fill up with frivolous and duplicate lawsuits.
Post trial reform includes limits and restrictions on what can be paid as damages and the amount of those damages. Damages are usually separated into economic and non-economic categories. Non-economic damages include restitution for pain and suffering, loss of consortium and punitive damages. Economic damages include lost wages and the patient’s medical bills. In medical malpractice lawsuits, the plaintiff can request as damages the full amount billed by the provider, as opposed to the amounts paid to the provider by a third party payor. Obviously a cap placed on either of these types of damages is beneficial to physicians in regards to the malpractice premium.
The majority of medical professional liability policies provide coverage on a first dollar basis with defense costs outside the limits of liability. The premium has an administrative and claim factor built into the rate for every specialty. The more that factor increases, the higher the premium. The cost of damages is also a factor built into the rate for the premium. Uncapped damages make it difficult for insurers to accurately calculate the indemnity factor. Jury verdicts are often unpredictable and inconsistent even in similar demographic jurisdictions. Plaintiffs understand this and often try to inflate the true “value” of their cases. This increases the severity factor of malpractice claims. Frivolous lawsuits combined with uncertainty in the courts drive up the overall cost of malpractice insurance, including the premium.
Increased malpractice premiums for a physician, or group practice, bring heightened focus to the bottom line and operating more efficiently. Usually operating more efficiently is desirable in any business setting, but for physicians, this has become an increasingly difficult task. Overhead costs are rising as the cost of providing medical care increases. But it is not only the cost of providing medical care, but the cost of doing business. A few expenses that drive up the cost of doing business include employee salaries and benefits, leased office space and utility costs. On the other hand, reimbursements to physicians have been falling in recent years as health insurers and the government programs try to curb their costs. The net overall effect appears in the form of a shrinking income, forcing many physicians to close their doors. For those that struggle to stay open, they attempt to offset this decrease in profit margin, or increase in deficit, by seeing more patients during the already full workday.
As physicians begin to see more patients per day, the quality of care begins to diminish. The reduced time spent with each patient increases the chance of a medical error occurring. As the likelihood for error increases, so does the physician’s potential for liability, thus creating a circular problem. There is a business need to see more patients, but by doing so, the physician increases the chance of an error, increasing his overall liability, which could raise the premium if litigation eventually results. A decrease in the quality of patient care is another tangential effect of liability reform driving up malpractice costs.
While the quality of care to patients suffers, access to medical care also decreases for patients. With shrinking, and sometimes disappearing, profit margins, many physicians find themselves in the position to either close their doors, relocate or retire. This holds especially true in rural areas and poorer neighborhoods where there just doesn’t exist the large number of patients to support the practice. While all types of physicians experience this economic crunch, including specialists like obstetricians, primary care physicians are most affected. In order to maintain a level of profit, or just break even, these physicians are forced to move closer to metropolitan areas where there is a larger patient base. This forces patients in rural and poorer neighborhoods to travel further distances for medical care or choose to go without.
In addition to impacting malpractice premiums and access to medical care, the lack of liability reform gives rise to the concept of defensive medicine. During training, physicians are taught primarily evidence-based medicine. But in the world of private practice, with every patient a potential plaintiff, defensive medicine reigns supreme. This phenomenon results in an increased overall cost of healthcare per patient. Physicians order scores of potentially unnecessary tests and labs mainly to better defend themselves in a potential suit. With the ever-increasing cost of medical technology, defensive medicine in some ways keeps inflating the true cost of healthcare.
Defensive medicine can also have a subtle effect on a physician’s confidence and judgment. If a physician lives in constant worry that their decision, not only could be, but also will be second-guessed, their confidence level may be adversely affected. Typically physicians are well educated, well trained individuals who want to do nothing more than help patients. That confidence level is deflated when, in a courtroom, the physician is accused of “killing their patient.” These accusations can damage the psyche and some physicians find it difficult to recover from this painful experience.
With improved tort reform, the practice of defensive medicine would diminish, malpractice premiums would decrease and the quality of, and access to, medical care would increase. Other aspects of the healthcare system deserve discussion, such as the uninsured and underinsured population. The inefficiencies of Medicare and Medicaid need attention as well. However, reform and modifications to any of those areas will only increase the cost of medical care and potentially reduce the quality of care provided to patients. Consistent and effective tort reform will help to lower healthcare costs and increase the quality of care to all patients.
Medical liability tort reform can be split into two key components, pre-trial and post-trial. The pre-trial reform component concerns matters such as who can file a lawsuit and the worthiness of the case, with respects to the medical care rendered. In some jurisdictions family members file suits on behalf of an injured party. This is in addition to the injured party filing a lawsuit. In some instances, “pro se” lawsuits are filed. “Pro se” means that the plaintiff is not represented by an attorney. These caveats only serve to increase the number of suits. Some jurisdictions require a certified medical expert to sign off on a case prior to it being filed. Without this provision and others like it, court dockets fill up with frivolous and duplicate lawsuits.
Post trial reform includes limits and restrictions on what can be paid as damages and the amount of those damages. Damages are usually separated into economic and non-economic categories. Non-economic damages include restitution for pain and suffering, loss of consortium and punitive damages. Economic damages include lost wages and the patient’s medical bills. In medical malpractice lawsuits, the plaintiff can request as damages the full amount billed by the provider, as opposed to the amounts paid to the provider by a third party payor. Obviously a cap placed on either of these types of damages is beneficial to physicians in regards to the malpractice premium.
The majority of medical professional liability policies provide coverage on a first dollar basis with defense costs outside the limits of liability. The premium has an administrative and claim factor built into the rate for every specialty. The more that factor increases, the higher the premium. The cost of damages is also a factor built into the rate for the premium. Uncapped damages make it difficult for insurers to accurately calculate the indemnity factor. Jury verdicts are often unpredictable and inconsistent even in similar demographic jurisdictions. Plaintiffs understand this and often try to inflate the true “value” of their cases. This increases the severity factor of malpractice claims. Frivolous lawsuits combined with uncertainty in the courts drive up the overall cost of malpractice insurance, including the premium.
Increased malpractice premiums for a physician, or group practice, bring heightened focus to the bottom line and operating more efficiently. Usually operating more efficiently is desirable in any business setting, but for physicians, this has become an increasingly difficult task. Overhead costs are rising as the cost of providing medical care increases. But it is not only the cost of providing medical care, but the cost of doing business. A few expenses that drive up the cost of doing business include employee salaries and benefits, leased office space and utility costs. On the other hand, reimbursements to physicians have been falling in recent years as health insurers and the government programs try to curb their costs. The net overall effect appears in the form of a shrinking income, forcing many physicians to close their doors. For those that struggle to stay open, they attempt to offset this decrease in profit margin, or increase in deficit, by seeing more patients during the already full workday.
As physicians begin to see more patients per day, the quality of care begins to diminish. The reduced time spent with each patient increases the chance of a medical error occurring. As the likelihood for error increases, so does the physician’s potential for liability, thus creating a circular problem. There is a business need to see more patients, but by doing so, the physician increases the chance of an error, increasing his overall liability, which could raise the premium if litigation eventually results. A decrease in the quality of patient care is another tangential effect of liability reform driving up malpractice costs.
While the quality of care to patients suffers, access to medical care also decreases for patients. With shrinking, and sometimes disappearing, profit margins, many physicians find themselves in the position to either close their doors, relocate or retire. This holds especially true in rural areas and poorer neighborhoods where there just doesn’t exist the large number of patients to support the practice. While all types of physicians experience this economic crunch, including specialists like obstetricians, primary care physicians are most affected. In order to maintain a level of profit, or just break even, these physicians are forced to move closer to metropolitan areas where there is a larger patient base. This forces patients in rural and poorer neighborhoods to travel further distances for medical care or choose to go without.
In addition to impacting malpractice premiums and access to medical care, the lack of liability reform gives rise to the concept of defensive medicine. During training, physicians are taught primarily evidence-based medicine. But in the world of private practice, with every patient a potential plaintiff, defensive medicine reigns supreme. This phenomenon results in an increased overall cost of healthcare per patient. Physicians order scores of potentially unnecessary tests and labs mainly to better defend themselves in a potential suit. With the ever-increasing cost of medical technology, defensive medicine in some ways keeps inflating the true cost of healthcare.
Defensive medicine can also have a subtle effect on a physician’s confidence and judgment. If a physician lives in constant worry that their decision, not only could be, but also will be second-guessed, their confidence level may be adversely affected. Typically physicians are well educated, well trained individuals who want to do nothing more than help patients. That confidence level is deflated when, in a courtroom, the physician is accused of “killing their patient.” These accusations can damage the psyche and some physicians find it difficult to recover from this painful experience.
With improved tort reform, the practice of defensive medicine would diminish, malpractice premiums would decrease and the quality of, and access to, medical care would increase. Other aspects of the healthcare system deserve discussion, such as the uninsured and underinsured population. The inefficiencies of Medicare and Medicaid need attention as well. However, reform and modifications to any of those areas will only increase the cost of medical care and potentially reduce the quality of care provided to patients. Consistent and effective tort reform will help to lower healthcare costs and increase the quality of care to all patients.
Saturday, November 10, 2007
Immigration, Part I - The Rant
I don’t really know how to start this blog. I have SO many thoughts on this issue that it has been difficult to get them all into one coherent thought, so I am going to just start typing…
This is NOT racial discrimination. The protesters on television want to make it into racial discrimination, but it is not. Illegal immigration does not limit the discussion to illegal Mexicans or individuals of Latin or Hispanic origin. The last I checked though, I haven’t seen an uprising of illegal Polish immigrants or illegal Canadian immigrants. Why is that? Probably because about 80% of illegal immigrants fit into the former category.
Racial discrimination is about treating individuals a certain way or imposing a certain standard on them with no basis and unfairly and denying them rights they are afforded under the law. But that only applies to LEGAL citizens. Illegal immigrants are screaming they are being treated unfairly, but how can that be? If you are not in jail or being deported, you are getting off pretty easily. If you are not a citizen of the United States, or a legal immigrant, you are not afforded the rights as such.
What else?
The National Anthem should be sung in English. Period. End of discussion. I don’t go to Argentina and start protesting and creating my own “national” song because I didn’t bother learning the language. You know what they would say? Tough shit. If you want to be a part of this country, learn my song in my language.
And stop flying flags other than the one Betsy Ross designed when you decide to march and protest. If you want to be an AMERICAN citizen, why are you flying a Mexican (insert another country here) flag. If that is where you want to be, head south and don’t stop until you reach the border.
Random question? In what country or post Roman-empire jurisdiction of law can you just blatantly break the law and not be punished? I am looking at protesters on television and reading about them in the newspaper proudly chanting that they are here illegally and should not be sent home and how much they mean to this country. I am seeing at the same protest, police and other government officials “monitoring” the situation. Where is INS? People out in public, boldly breaking the law, and nothing happens. What the f*&%?
And what about the individuals who went through the proper channels to EARN the citizenship? To just grant amnesty to all or ANY illegal immigrants should be a slap in the face to those who chose to go about it the right way. Is that fair? Nowadays, fair and right hardly seem to matter compared to good business.
There will be more…
This is NOT racial discrimination. The protesters on television want to make it into racial discrimination, but it is not. Illegal immigration does not limit the discussion to illegal Mexicans or individuals of Latin or Hispanic origin. The last I checked though, I haven’t seen an uprising of illegal Polish immigrants or illegal Canadian immigrants. Why is that? Probably because about 80% of illegal immigrants fit into the former category.
Racial discrimination is about treating individuals a certain way or imposing a certain standard on them with no basis and unfairly and denying them rights they are afforded under the law. But that only applies to LEGAL citizens. Illegal immigrants are screaming they are being treated unfairly, but how can that be? If you are not in jail or being deported, you are getting off pretty easily. If you are not a citizen of the United States, or a legal immigrant, you are not afforded the rights as such.
What else?
The National Anthem should be sung in English. Period. End of discussion. I don’t go to Argentina and start protesting and creating my own “national” song because I didn’t bother learning the language. You know what they would say? Tough shit. If you want to be a part of this country, learn my song in my language.
And stop flying flags other than the one Betsy Ross designed when you decide to march and protest. If you want to be an AMERICAN citizen, why are you flying a Mexican (insert another country here) flag. If that is where you want to be, head south and don’t stop until you reach the border.
Random question? In what country or post Roman-empire jurisdiction of law can you just blatantly break the law and not be punished? I am looking at protesters on television and reading about them in the newspaper proudly chanting that they are here illegally and should not be sent home and how much they mean to this country. I am seeing at the same protest, police and other government officials “monitoring” the situation. Where is INS? People out in public, boldly breaking the law, and nothing happens. What the f*&%?
And what about the individuals who went through the proper channels to EARN the citizenship? To just grant amnesty to all or ANY illegal immigrants should be a slap in the face to those who chose to go about it the right way. Is that fair? Nowadays, fair and right hardly seem to matter compared to good business.
There will be more…
Sunday, October 28, 2007
No, you may not be excused
At Texas A&M, within the confines of Kyle Field, we have a name for those who leave football games early. We call them 2 percenters. If we expect (an we do) the football team (and any other athletic team) to give 100% for the entire game, as the 12th Man, we should give the same effort.
I left a game early ONCE. We were playing #19 Oklahoma State on November 1, 1997 in College Station and putting up a terrible effort. So, middle of the 4th quarter, I had seen enough. I had yelled my last yell. I was done. No sooner did I leave the stadium, before I heard the roar of 75,000 celebrating an Aggie touchdown. Long story short, we tied the game with 43 seconds on a 2-point conversion to send it into overtime. We won in overtime on a Tiki Hardeman touchdown run. Point: NEVER LEAVE A GAME EARLY!
This year in college football has been more of a reason to support that mantra than any year in recent memory. Irrespective of all the upsets, think about things you would have missed had you been the lousy fan who gave up on your team early.
#2 BC at Virginia Tech. BC scores 14 points in the last 2:30 minutes with an improbable onside recovery and an across your body heave into the end-zone by a QB who had been running for his life all game.
How about Boise State and Nevada? Final Score 69-67 with a bunch of overtimes jammed in there. You suck it up and deal with the cold weather and late hour. Call in sick to work the next day. Your boss should understand.
Arkansas versus Alabama. First Bama blows not one, but two 21 point leads. Then throws a fade to the corner with seconds left on the clock to pull out the home victory. I think 50% of Bama fans were in the ER after the game for near heart failure.
San Jose State found out the hard way what happens when you chant “overrated” too early. Bionic armed Colt Brennan gets fired up, ignores the 4 interceptions, RUNS in the game tying touchdown, then beats you in overtime.
If you had left the Coliseum early, you would’ve missed Stanford’s backup QB throw a touchdown pass with 1 second left to beat USC (a 40 point favorite).
Colorado beat OU on a time expiring career long field goal after being down 2 scores in the 4th quarter.
Michigan, after giving up the go-ahead score to Appalachian State, threw a 50 yard bomb at the end of regulation only to have Appalachian State block the game winning field goal attempt. Thrilling to watch it unfold (unless you wear maize and blue).
If I still have not proved my point, let me quote the Tennessee Volunteer fan seated next to me in Tuscaloosa at an earlier Alabama game. According to his father, “If you leave a game before the clock hits 0:00, well you ain’t shit.”
I have sat through a 77-0 drubbing, several 4 touchdown losses on national television, embarrassing lackluster efforts (@ Miami this year comes to mind) and heartbreaking touchdown catches by the opponent with little or no time left. However, watching your team pull off the improbable upset in the Big XII Championship game in overtime makes it all worth it (December 5, 1998). Or forcing a fumble in overtime in overtime (October 23, 2004) to seal the victory, after scoring 16 points in the 4th quarter to tie the game. So, here is hoping your team (unless they are playing the Texas A&M Aggies) catches the Hail Mary, recovers the onside kick and doesn’t miss wide left (or right).
God bless college football!
PS. Yesterday, the Aggies did not catch the Hail Mary pass or recover the onside kick. I know because I watched the entire game.
I left a game early ONCE. We were playing #19 Oklahoma State on November 1, 1997 in College Station and putting up a terrible effort. So, middle of the 4th quarter, I had seen enough. I had yelled my last yell. I was done. No sooner did I leave the stadium, before I heard the roar of 75,000 celebrating an Aggie touchdown. Long story short, we tied the game with 43 seconds on a 2-point conversion to send it into overtime. We won in overtime on a Tiki Hardeman touchdown run. Point: NEVER LEAVE A GAME EARLY!
This year in college football has been more of a reason to support that mantra than any year in recent memory. Irrespective of all the upsets, think about things you would have missed had you been the lousy fan who gave up on your team early.
#2 BC at Virginia Tech. BC scores 14 points in the last 2:30 minutes with an improbable onside recovery and an across your body heave into the end-zone by a QB who had been running for his life all game.
How about Boise State and Nevada? Final Score 69-67 with a bunch of overtimes jammed in there. You suck it up and deal with the cold weather and late hour. Call in sick to work the next day. Your boss should understand.
Arkansas versus Alabama. First Bama blows not one, but two 21 point leads. Then throws a fade to the corner with seconds left on the clock to pull out the home victory. I think 50% of Bama fans were in the ER after the game for near heart failure.
San Jose State found out the hard way what happens when you chant “overrated” too early. Bionic armed Colt Brennan gets fired up, ignores the 4 interceptions, RUNS in the game tying touchdown, then beats you in overtime.
If you had left the Coliseum early, you would’ve missed Stanford’s backup QB throw a touchdown pass with 1 second left to beat USC (a 40 point favorite).
Colorado beat OU on a time expiring career long field goal after being down 2 scores in the 4th quarter.
Michigan, after giving up the go-ahead score to Appalachian State, threw a 50 yard bomb at the end of regulation only to have Appalachian State block the game winning field goal attempt. Thrilling to watch it unfold (unless you wear maize and blue).
If I still have not proved my point, let me quote the Tennessee Volunteer fan seated next to me in Tuscaloosa at an earlier Alabama game. According to his father, “If you leave a game before the clock hits 0:00, well you ain’t shit.”
I have sat through a 77-0 drubbing, several 4 touchdown losses on national television, embarrassing lackluster efforts (@ Miami this year comes to mind) and heartbreaking touchdown catches by the opponent with little or no time left. However, watching your team pull off the improbable upset in the Big XII Championship game in overtime makes it all worth it (December 5, 1998). Or forcing a fumble in overtime in overtime (October 23, 2004) to seal the victory, after scoring 16 points in the 4th quarter to tie the game. So, here is hoping your team (unless they are playing the Texas A&M Aggies) catches the Hail Mary, recovers the onside kick and doesn’t miss wide left (or right).
God bless college football!
PS. Yesterday, the Aggies did not catch the Hail Mary pass or recover the onside kick. I know because I watched the entire game.
Saturday, September 29, 2007
Pay You? Seriously?
Seriously? A study was recently conducted about paying overweight and obese individuals money to entice and reward them for losing weight. Seriously?
Healthcare is already a problem in this country. And it isn’t just one aspect of it, it is embedded in all areas. It costs too much, there isn’t enough of it and too many are uninsured. The lists goes on and on.
But this dimension, we as individuals can personally improve. Depending on what study you read, anywhere between 1 in 3 and 3 in 5 Americans tip the scale as overweight or obese. Breakdown: Obese means 30 or more pounds above a healthy weight and overweight spans 1-29 pounds above a similar healthy weight. Granted, most body mass index calculators do not account for muscle mass (muscle weighs more than fat), but let’s not kid ourselves. All the obese and overweight folks in this country are not athletes masquerading as Dell customer service reps or doing your taxes. No, they are fast food addicted, lazy, healthy eating disregarding individuals who want to get paid to lose weight. Seriously?
Yes, obese/overweight individuals cost businesses, and in turn myself, money in the long run. The health risks are higher, including heart dieases and high blood pressure, which mean more trips to the doctor and/or hospital. It means more medication. More time at work missed, which someone has to make up for in their absence. It is the reason smokers pay more health and life insurance. You don’t see people paying them to quit smoking. Just the opposite, they keep raising the price of cigarettes and tobacco products to reduce the demand. Doesn’t seem to be working, but it’s an attempt.
Why don’t we charge more for obese/overweight individuals? Or at least make them assume more of the financial burden. More out of their check every 2 weeks? A higher co-pay? A higher deductible? Something that might make them take some accountability for the position they have gotten themselves into. I know positive reinforcement is said to work better at motivating people to action, but what could be more positive than an increased life expectancy and better health? The ability to walk a flight of stairs and not risk a trip to the emergency room. How about accepting some personal responsibility and stop draining the pockets of others? Seriously.
Healthcare is already a problem in this country. And it isn’t just one aspect of it, it is embedded in all areas. It costs too much, there isn’t enough of it and too many are uninsured. The lists goes on and on.
But this dimension, we as individuals can personally improve. Depending on what study you read, anywhere between 1 in 3 and 3 in 5 Americans tip the scale as overweight or obese. Breakdown: Obese means 30 or more pounds above a healthy weight and overweight spans 1-29 pounds above a similar healthy weight. Granted, most body mass index calculators do not account for muscle mass (muscle weighs more than fat), but let’s not kid ourselves. All the obese and overweight folks in this country are not athletes masquerading as Dell customer service reps or doing your taxes. No, they are fast food addicted, lazy, healthy eating disregarding individuals who want to get paid to lose weight. Seriously?
Yes, obese/overweight individuals cost businesses, and in turn myself, money in the long run. The health risks are higher, including heart dieases and high blood pressure, which mean more trips to the doctor and/or hospital. It means more medication. More time at work missed, which someone has to make up for in their absence. It is the reason smokers pay more health and life insurance. You don’t see people paying them to quit smoking. Just the opposite, they keep raising the price of cigarettes and tobacco products to reduce the demand. Doesn’t seem to be working, but it’s an attempt.
Why don’t we charge more for obese/overweight individuals? Or at least make them assume more of the financial burden. More out of their check every 2 weeks? A higher co-pay? A higher deductible? Something that might make them take some accountability for the position they have gotten themselves into. I know positive reinforcement is said to work better at motivating people to action, but what could be more positive than an increased life expectancy and better health? The ability to walk a flight of stairs and not risk a trip to the emergency room. How about accepting some personal responsibility and stop draining the pockets of others? Seriously.
Thursday, May 24, 2007
If the worst should happen, thou shalt be covered
I figured it was time for a real discussion blog since the last one was awhile ago. I am still writing the immigration blog. I just have SO much to say that I cannot get it all down in a coherent, non-ranting, non-ruining my future Presidential campaign piece. And now with this new piece of legislation that some claim is not complete “amnesty”...well, don’t get me started.
So, I was at a happy hour with Melissa and her co-worker and her fiancé and a very interesting statement was made, as they usually are at happy hours. The statement was that religion might be the oldest form of insurance. Hmmm. That struck a cord within me, being that I am an insurance professional. Is religion the oldest form of insurance? At first, I didn’t think much of it, but it kept coming back to me with some thought provoking parallels (some weak, some strong).
So, before I get deep into this, I want to make a disclaimer that I am not trashing religion in general or any religion specifically. I just want to stimulate the mind with something different for a change. Here goes...
Most forms of insurance are sold through agents. Individuals who preach (hint) the advantages and disadvantages of coverage and what might happen to you if you don’t have it. Well, isn’t that similar to ministers, priests and rabbi’s or any similar figure in a different religion? Ever heard while sitting there in a congregation what would happen to your soul if you don’t believe or accept/believe certain teachings? Parallel? Possibly.
How about the actual insurance policy? The document that tells you what is covered, what can void coverage and what you have to do to secure coverage. Well, isn’t that what the Bible is? How about the Koran? Now, I have never read either from cover to cover, but my cursory knowledge of both lends me to believe that these books contain similar information concerning what you need to do to get, and keep, your soul protected from eternal damnation.
And last, why do people buy insurance? They want to know they are protected in the event of a catastrophe. That when the worst happens, they will be made whole. It makes them feel comfortable and sleep better at night. Why do some people practice religion? Well, in the event of the inevitable (yes, we all will die one day) they feel their soul will be in good hands for eternity. The theory is that you pay a premium (insurance) or buy into the teachings (religion) so that you benefit from the payoff in the end.
Yes, it sounds a bit crude and sarcastic about religion, but let’s be honest, not everyone in the same religion believes the same thing. And if you think they do, then you are sadly misleading yourself. Yes, I believe in God, but I don’t buy into the notion that I cannot ask questions or have an opinion other than one force fed to me. I was that kid in Sunday school that always had his hand raised. Religion and insurance contain complexities beyond the simple comparisons made here and differ on many levels, but you have to admit, some similarities do exist.
So, I was at a happy hour with Melissa and her co-worker and her fiancé and a very interesting statement was made, as they usually are at happy hours. The statement was that religion might be the oldest form of insurance. Hmmm. That struck a cord within me, being that I am an insurance professional. Is religion the oldest form of insurance? At first, I didn’t think much of it, but it kept coming back to me with some thought provoking parallels (some weak, some strong).
So, before I get deep into this, I want to make a disclaimer that I am not trashing religion in general or any religion specifically. I just want to stimulate the mind with something different for a change. Here goes...
Most forms of insurance are sold through agents. Individuals who preach (hint) the advantages and disadvantages of coverage and what might happen to you if you don’t have it. Well, isn’t that similar to ministers, priests and rabbi’s or any similar figure in a different religion? Ever heard while sitting there in a congregation what would happen to your soul if you don’t believe or accept/believe certain teachings? Parallel? Possibly.
How about the actual insurance policy? The document that tells you what is covered, what can void coverage and what you have to do to secure coverage. Well, isn’t that what the Bible is? How about the Koran? Now, I have never read either from cover to cover, but my cursory knowledge of both lends me to believe that these books contain similar information concerning what you need to do to get, and keep, your soul protected from eternal damnation.
And last, why do people buy insurance? They want to know they are protected in the event of a catastrophe. That when the worst happens, they will be made whole. It makes them feel comfortable and sleep better at night. Why do some people practice religion? Well, in the event of the inevitable (yes, we all will die one day) they feel their soul will be in good hands for eternity. The theory is that you pay a premium (insurance) or buy into the teachings (religion) so that you benefit from the payoff in the end.
Yes, it sounds a bit crude and sarcastic about religion, but let’s be honest, not everyone in the same religion believes the same thing. And if you think they do, then you are sadly misleading yourself. Yes, I believe in God, but I don’t buy into the notion that I cannot ask questions or have an opinion other than one force fed to me. I was that kid in Sunday school that always had his hand raised. Religion and insurance contain complexities beyond the simple comparisons made here and differ on many levels, but you have to admit, some similarities do exist.
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