Tag Archives: US

National Health Care Boogie

I was taught all through elementary school and high school that communism, and its first cousin socialism, were failed models. Such a system was said to kill one’s incentive to excel by taking from those who produced and giving to lazy slackers–redistributing wealth. The detractors say the idea of socialism is to dumb everything down to the lowest common denominator and attempt to make everyone equal regardless of who earned what. This, of course, appeals to “have nots” and really takes root in societies where there is no middle class. On the other hand, the advocates quote a particular philosopher (Kant?): “The greatest good for the greatest number”.

See, when I was educated in the public school system (which is actually a government school system if we want to be precise) capitalism was proudly recognized as the US system. And why not? We had a track record of uncommon success. After World War II, the Japanese built on the US model courtesy of Douglas MacArthur and W. Edwards Deming, again to uncommon success.

The models of socialism that have existed in my lifetime have track records that feature government control of practically everything including the media, and cowtowing to the squeakiest wheel regardless of right-and-wrong. Actually, there is no right and wrong. Well, to be fair there is some, but most areas are varying shades of gray, which fits well in our (since the 1960s) growing litigitous society. Tell me what lawyers produce? Do we really need one lawyer for every fifty people? Another feature is that all the government controls are for the masses, but not the administrators (mostly lawyers) and/or people who have never worked at a regular job. The political bosses are exceptions to the rule(s). Brings to mind Orwell’s “Animal Farm” doesn’t it? This came to mind during the recent National Health Care debate when we discovered the politicians wouldn’t be subjected to the same system as the rest of us.

Well, what about health care? Is our present system THAT good? (At least we have choice or the illusion of it.) Also, we know anything run by Federal and State governments is terribly inefficient, wasteful, and fraught with sleepy-eyed, don’t-give-damn-government workers. Once on the GS system they have something even better than tenure. They can’t be fired. I used to work for an international company that had factories all over the world. In socialist countries (like Italy) we had to be very careful during the hiring process because those you hired had a lifetime guarantee no matter poorly how they performed.

So my motto has been: SOCIALISM SUCKS! Unfortunately that’s exactly the direction the US is heading, and it’s probably too late to do anything about it. On the other hand, maybe neither socialism nor capitalism sucks. Maybe it’s our human condition to corrupt any system that sucks.

Okay, I’m a fair guy. So after trashing socialism and the socialistic health care system forced upon us, can we say the present system is better? I’m not talking about those who DO NOT have coverage, which includes me. I’m referring to those who DO have coverage.

The purpose of this article is to present a brief look at two actual cases and let you draw your own conclusion. You may be surprised at the outcome. On one side we have Kate from England, and on the other side Ray from Toledo, Ohio.

Keep in mind there are those who are FOR and those who are AGAINST the National Health Care system forced down our throats by congress. The extremists on both sides predict wonderful / horrible results. Anyway, take a read at two real cases. See what you think.

Kate and her husband, Bob, resided at the Sylvania (Ohio) Senior Center while in the US. She went back to England to have surgery to correct a foot problem. Here is a letter she sent to Ray about how the Nationalized Health Care System took care of her. By the way, her costs were covered 100%.

Dear Ray, The second cast was removed on Tuesday. Surgeon very happy with results. Now in a “moon boot”–looks like a cross between a robot leg and something out of Star Wars, but I can put my weight on it. Still need to use a walking frame for the next month, then go back to see “the man”. He said I would have to wear this thing for 6 weeks. I can take it off when I go to bed. The greatest joy is being able to have a bath!!! Glad you were able to get out to California to visit your family. Have you finished your treatment yet?? I’ve kind of lost the place regarding that. Love, Kate

On April 12 and 15, 2010, Ray wrote back…

Dear Kate, Glad to hear you are semi mobile. Hope you make rapid progress. We are well. I went to California to see my two sons’ families–one grandson–at the end of March. Asparagus is up; frost got some of the fruit tree buds. Trying to kill the white pine weevils that keep knocking out the tops of my white pine trees; fungus in the azaleas–and so it goes at the “cow palace” on Holstein Road in Toldeo, Ohio. Finished treatment; just beginning to pay the bills. The US system is nuts. The initial charges are twice the real costs. Medicare agrees to half of what they quote, and pays 80% of that. I pay the remaining 20%. The billing is so weird in that it is all in code. 713 costs $1200 and 432 costs $435 etc, etc.; then the hospital and the physicians (separate company) both bill for the same code as well. Totally incomprehensible. When I call each entity, they cannot explain anything. All they know is code 713 = $1200. I asked the doctors and they claim they don’t know anything about the codes. All they know is what procedure they performed. And on and on and on. I hope your system is better. Over here they tell us when the new system kicks in we will have to wait months to get an appointment either to see a doctor or get a procedure. Best wishes, Ray

From Kate…

Dear Ray, Glad to hear you have finished your treatments! The rest of your message sounds like it would drive you round the bend. The prices are astronomical and codes sound weird. I cannot imagine why in this day of computerised systems no one can tell you what the codes mean! Our system is far better. It might take 2 weeks to see someone at first, then the ball gets rolling and things happen. The only time you might have a lengthy wait is if the consult you want to see is unavailable for some reason. Of course, my op had to be delayed due to lack of beds at the hospital–caused by number of accidents during our worst winter in 30 years. Had my op been for a life-threatening condition, I would have been fast-tracked. Just one more reason why I’m glad to be back “home”. Regards, Kate

From Ray on April 19…

Dear Kate, It seems you got quick access to the care you needed in England. So my question to you (and one that is ranted and raved about here in the US) is: Has your government refused to treat some of the elderly? As for me, I think spending huge sums on people with an extremely short life expectance is questionable. I have often stated that if I am ill but cannot be returned to an interesting active life, pull the plug. Best, Ray

From Kate…

Dear Ray, To the best of my knowledge, they are treated as needed. There are some cases of cancer patients that have been unable to get some drugs, but they are usually denied because they haven’t been proven against their condition. Other than that, they are as well cared for as any other age group. Considering my age is creeping ever higher, I’m glad that the system is working so well. Love, Kate

Both Kate and Ray are octogenarians.

Copyright by Gene Myers

Author of “After Hours: Adventures of an International Businessman”

web site: www.strategicpublishinggroup.com/title/AfterHours.html

Also available at: www.amazon.com and www.barnesandnoble.com and borders.com

Coming August 23, 2010 from PublishAmerica: “Songs from Lattys Grove”

Are We Talking About health Care Reform, Or sickness Care Reform

All the talk about “Health Care Reform” has certainly ignited a fire in countless Americans! Every national news and talk radio show is focused on this hot button topic recently.

The economic crisis is clearly the catalyst for the proposed sweeping changes in national “health” care. Scarce funds and resources, as well as a pending economic “collapse” (as some describe) are forcing us to consider how to manage health care in tough times… and in extreme circumstances.

We’re hearing terms like “rationed health care”, “socialized medicine”, “universal insurance” and the “value of human life”. It’s no wonder this subject has sparked such heated dialogue.

Spending the first 23 years of my life in “socialist” Canada, and still spending much time and energy in their medical system with both of my parents, I may have a different perspective from the sensationalized one being portrayed in media.

I’m perfectly willing to admit that I don’t understand all the politics and red tape involved. I simply have a memory of how things really played out in that system and countless experiences to call upon.

Growing up, I quite clearly recall paying out of pocket for many doctor’s and specialist’s visits, treatments and procedures, and paying a partial “co-pay” for the remaining forms of care: physical therapy, surgery, prescriptions, etc. Not exactly the picture I continue to see painted on the news.

Studying and working within the field of health and wellness for the past 18 years, I know I have a different perspective. First, I wish we’d quit calling this “health care”. The subject of this conversation is “sickness care”. I know I can’t change that, but it annoys me! Words are important.

I have no challenge with paying for – investing in – my own health. I will gladly invest in lifestyle choices that proactively build better health. Choices like: healthier foods, high quality nutritional supplements, pure water, exercise classes, equipment and tools, Chiropractic care, massage, less toxic personal care, household and lawn care products, and so on. I don’t expect a hand out for any of these things… although it would sure be nice! It’s just not realistic. My health and my family’s health is my responsibility.

If we continue to talk about sickness care as though it will somehow provide us with health, we’ll continue on our devastating trend of unparalleled rates of chronic illness in all age groups. We’re confused.

What drug, surgery, insurance plan or federal program could ever fix a problem due to a lack of fresh, healthy, whole, untainted (genetically required) real foods? Or a problem due to sedentary living and lack of regular (genetically required) movement? Or a problem due to a lack of healthy emotions like love and joy? Or a problem due to toxic thoughts and emotions like fear, worry, hate and hopelessness?

Thinking that national “health care” is responsible for our health is irresponsible on our part. It’s also foolish. Their paradigm is still the sickness paradigm. Why on earth would we expect them to deliver us health?

Do I think that we should have a system to help those in need achieve better health and receive sickness care when needed? Yes. But I sure would love to see the main focus of such a program be on “health”! I’m certain we’d spend FAR less on sickness care (and “health care” as a whole) if that were the case.

I’d also love to see the pharmaceutical industry focus on health rather than profits, and drugs only be used for life-saving endeavors… but I digress!

I’m blessed to live in a country with excellent sickness care options. In the case of emergency or trauma or life-saving procedures we have the best. In the case of “health care”… not so much! Sadly though, it’s all there. Everything we need in order to create ideal health is right here at our fingertips. As a culture, we just keep overlooking it and choosing sickness care, expecting health as the outcome.

Our paradigm is inaccurate.

As individuals, imagine if we all began to proactively take steps to create better health. We would no longer play the role of passive by-stander or helpless victim in this game. That’s where I think our focus needs to shift – why wait around to see what’s decided FOR us? Regardless of whatever decisions are made by this current administration, we can certainly become healthier one by one, family by family. Isn’t this the perfect, most necessary time to take responsibility for our own health and safety?

Science has clearly shown us that it’s our lifestyle choices – how we eat, how we move, how we sleep, how we respond to stress – that directly determine our level of health, function, performance and our ability to prevent and reverse chronic illness. Getting healthier means making more pure and sufficient choices while simultaneously reducing toxic and deficient choices. No one can do this for us but US.

When we shift to this responsible, proactive and accurate belief about health care, THEN we will have a truly beneficial health care reform and a profound strengthening of our economy!

How Can Streamlined Medical Billing Help You Deal With Annual Medicare Cuts

As a result of Medicare Sustainable Growth Rate (SGR), physicians face Medicare payment cuts annually. Even though the Congress often steps in to stop the reductions, it has been reported that Medicare reimbursement for physicians will be slashed by 24.4% in 2014.

Physicians and senior citizens to bear the brunt:
Even though annual Medicare cuts are done when Medicare spending outpaces economic growth, it has affected patients as well as senior citizens in the US-

Seniors relying on Medicare Advantage Program might lose doctors, benefits, plans and financial protection they currently enjoy

Doctors will start turning away Medicare patients For instance, in 2012, Medicare patients looking for new primary care physicians had trouble finding doctors

Impact of annual Medicare cuts is also being felt by physicians, especially private practices. They are finding it difficult to strike a balance between the treatment and keeping their practice open. The uncertainty is taking a toll on their practice. Since private insurers consider Medicare rates as the basis for their reimbursement rates, it is getting difficult for them to determine if they can afford to stay in business

Access to care has also been affected due to annual Medicare cuts as practices are deciding to discontinue certain in-house tests. Cuts have also resulted in costly, unnecessary procedures

Medicare payment cuts will also impact hospitals, forcing the management to bring necessary changes in staffing and services to increase efficiency. Due to reductions, growth of operating expenses and total revenue will slow down

To bring down unnecessary hospital admission, more resources will have to be assigned for primary care. Since hospitals will gain or lose 1% of Medicare funding on the basis of 20 factors that gauge quality of care, necessary measures will have to be taken to avoid disruption in cash flow

Till Congress doesnt fix this problem, necessary preparations will have to be done by practices to sail through the impending Medicare crisis. Approximately, 10,000 people gain eligibility for Medicare every day and with the current shortage of primary care physicians in the US, a dangerous situation will arise if doctors start limiting the type of patient they want to treat due to payment cuts.

Streamlined medical billing services- the key to dealing with Medicare cuts

Amidst challenges generated by Medicare cuts, other vitals tasks related to ICD-10, PQRS, HIPAA, and medical billing coding will also get affected due to lack of time and resources. In order to ensure efficiency in billing procedures and to maintain a smooth cash flow, practices are outsourcing their billing services.

Billing partners like Medicalbillersandcoders.com has been helping practices balance billing and Medicare cuts along with other ongoing healthcare changes. MBC has the largest consortium of billers and coders in the US and the latest technology is used to handle medical billing, HIPAA compliance and other vital processes. The aim is to maximize revenue and minimize claim denials for providers who are getting bogged down due to annual cuts in Medicare payments.

A Word in Finding the Best Medicare Supplements

Health care is a primary concern in the US. The government recognizes its important role in maintaining a productive citizenry. As a precautionary measure to help its elderly citizens, the US enacted the Medicare bill into law in 1965. This law aimed to cover costs for an elderly person who gets sick and who may need hospitalization.

While Medicare answered the need of most elderly people and persons with disabilities from 1965 onwards, the funds were not without limits. The number of hospital days and the cost of medical professionals are set with limitations so the program can run smoothly. Costs that go beyond these limits are now billable to the patient who will probably pay it out of personal funds.

If you’re qualified for Medicare but you wish to avoid added costs, finding the right supplemental plan should be your first priority. The supplemental plan can bridge the costs you need to pay, which is essential especially if you face a reduced income. In getting a supplemental plan, it will be important to note the following tips that can help you.

Compare prices

No one can get the best Medicare supplement for their needs by just looking at one provider. In this case, it’s best to compare prices of at least five providers so you’ll know the price range. While a low-priced supplement may not be the best choice either, you at least have an idea of the figure you might end up paying.

Buy while you’re healthy

People in good health make better decisions because they can choose the best Medicare supplement for themselves. It’s best to get buy when you have all your faculties working compared to when you’re already feeling sick. Your sickness may impair your ability to make a better decision and you may end up buying a higher priced coverage than the optimum one.

Work out a payment scheme

Some providers are willing to work out a payment scheme if they see that you have a good payment history. If you wish to have the best Medicare supplement while paying in increments, make sure that you have your papers with you when you approach a provider. Having your papers with you will not only show your payment history but your organization skills as well.

All You Need To Know About Afinitor

According to the US National Institute of Health, new cases of renal cancer in 2010 in the US stood at 58,240, with 13,040 deaths cases. Although there are no significant symptoms of kidney or renal cancer, you should approach a doctor if you notice blood in your urine, lump in your abdomen, unexplained weight loss or appetite loss. Afinitor (everolimus), developed and manufactured by Novartis, is the first oral daily therapy for the treatment of advanced renal cell carcinoma. This drug was developed after the failure of treatment with Sunitinib or Sorferib in cancer cells.
Applications and Dosage Related Information About Afinitor
Afinitor, which received the FDA approval in 2009 is also used for the treatment of patients with subependymal giant cell astrocytoma (SEGA) who need therapeutic intervention instead of curative surgical treatments. The medicine stops cancer cells from expanding by cutting off the blood supply to them. Afinitor is an inhibitor of mTOR and prevents cell proliferation and angiogenesis.
The medicine is available in 5mg and 10mg strengths for oral administration. The recommended initial dose for this drug is 10mg, to be taken once a day at the same time every day with or without food. One should swallow this medicine as a whole and avoid chewing or crushing it.
Some commonly witnessed side effects by users of Afinitor are:
mouth ulcers
loss of appetite
swelling of body parts
inflammation of the lining of the digestive system
These side effects are temporary and will go away after the therapy is complete.
However, some serious side effects may be felt by people taking Afinitor. These include:
Breathing problems
Severe infections, such as pneumonia, bacterial, fungal or viral
Precautions While Taking Afinitor
This medicine is not for patients who are already taking medication for fungal or bacterial infections, tuberclosis, seizures, HIV-AIDS, blood pressure or heart conditions. This medicine should also not be prescribed to a pregnant woman or a woman who is breast feeding.
If your doctor has prescribed Afinitor for your treatment, you should follow certain precautions:
Do not drink grape fruit juice or eat grape fruit, star fruit or Seville oranges during the whole treatment
In case of allergic reactions, one should immediately get back to his/her doctor
People using this medicine should not get a live vaccine or be around with people who have recently received a live vaccine

Dentist Cumming GA Dental Assistant Jobs are Available

Dental assisting jobs offer great flexible hours and benefits for those who are looking for a new career. You will quickly get into the workforce, easily fast tracking through certificate of dental assisting training in most cases find an affordable diploma or associate’s degree program which works well with your schedule.

Continuing to introduce new technology and being innovative, dental profession is historical.A dental assistant who learns the trade and stays up-to-date with new advancements not only builds a dynamic career, but adds great value to the dental office, becoming a vital contributor to its success. .

This is a career to be proud off any time. It has many benefits like helping others, working in a clean environment and also good earning opportunities.

There are currently over 294,000 dental assistants employed in dental practices across the US. All of them help in different tasks that keep the dentist’s office running smoothly as they offer clinical and administrative support. This entails handling of patients dental records and also cleaning their teeth meaning the role of a dental assistant is very crucial in every level of dentistry.

Dental assistants usually learn their skills on the job, although some receive training from dental-assisting programs offered by community and junior colleges, trade schools, technical institutes, or the Armed Forces. For those students who are in high school and are interested in taking a career in dental assistant, they should take courses in health, biology, chemistry and office practice.

Reliability, good manual dexterity and being able to work with others are the qualities of a good dental assistant. In some states, dental assistants must be licensed or registered. They may be required to pass a written or practical exam.Dental assistants who perform specialized duties, such as radiological procedures, may have to complete the Radiation Health and Safety examination offered by the Dental Assisting National Board (DANB). In selected states they may need to have passed a radiology course that is state-approved.

To know the ideal candidate for a dental assistant career, he must be able to help others, follows specific procedures, enjoys interacting with others, caring and also pays attention to details. The dental assistant must have a variety of skills because of the wide range of responsibilities as he constantly learns and improves as the dental industry evolves.

Often “chairside” working with the dentist the dental assistants work in a clean and comfortable setting. Clothing and devices like gloves, masks or eyewear must be worn by the dental assistants to protect both themselves and the patients from infections.

The U.S. Department of labor Bureau of Labor Statistics shows that approximately half of dental assistants work part time. An average of 35 to 40 hours a week is what the other half works. Nights and Saturdays may be included in the shifts for dental assistants.

Why would one choose to become a dental assistant instead of having another profession? There are many reasons why. One, dental assistants earn good salaries. Employment can be found in almost any community because everybody is in need of dental care. Again dental care has a continuous need therefore employment is not affected with economic change. Excellent career advancement has been reported with dental assistants.

To get added information or to book an appointment simply click this link: Dentist Cumming

If you need a good dentist in the Cumming or Duluth GA area we are happy to meet your needs.

How To Get Perfect Teeth Through Cosmetic Dental Surgery

We all know that having good teeth give us a good smile too. But speaking of having great looking teeth is something that most people can’t afford to have. Getting a cosmetic dental surgery is certainly the best way to bring back that great smile but it’ll cost you a fortune. Especially in rich countries like the US, Canada, UK. Sometimes you would wish it was available at a reasonable rate like Cox Communication deals.

But as we see every day in TV, magazines, Hollywood stars are showing their great smiles but it doesn’t mean that they naturally have those amazing teeth. They’ve got money to get it done easily for them. Have you ever noticed the way celebrities and supermodels have perfect teeth? Do you think they have these great genes and were born that way? I can assuredly tell you they were not. Their god or goddess like teeth are a result of thousands of dollars spent at a cosmetic dental surgeon. The focus of your average dentist is making sure the functionality of your teeth and the surrounding area around them is good.

They evaluate, diagnose, and prevent disorders and diseases of your gum and oral cavities. A cosmetic dental surgeon focuses more on the aesthetic side of your teeth. Their aim is to make your smile look as appealing and attractive as humanly possible. How do they accomplish this? The main methods used include teeth whitening, enamel shaping, veneers, and gum lifts.

Whitening is one of the most popular and least expensive methods applied by these specialized doctors. Its basically applying a special type of bleach onto your teeth which whitens them. Over time drinking soda, coffee, and certain types of food can stain your teeth and this procedure makes them bright again. While this process will not help the shape of your dentures it will help their color.

Enamel shaping is a procedure most commonly used when someone has a chip in their teeth. It involves removing a small portion of the outer surface of the teeth to create a nice smooth appearance. Its painless and makes the bottom portion of your dentures look symmetrical.

Gum lifts are for people who unfortunately have really gummy teeth. Its highly unattractive and a major hindrance to a great smile. In this procedure the cosmetic surgeon will raise and surgically contour the gum tissue giving it a more balance appearance.

Veneers are thin porcelain laminates that actually go over your teeth. This is probably one of the best ways to get perfect teeth without getting braces. Veneers are placed on top of a tooth, bonded to them, and filled with a material in the back to prevent tooth decay. This is probably the most favorite surgery of most cosmetic dentists because its such an easy procedure and veneers are easy to replace if cracked.

Many of the stars in Hollywood once had ugly teeth. Its amazing when you think about the technology these specialists have at their disposal to correct any sort of defects or misalignment. The skillful hands of a qualified cosmetic dentist can turn the worst looking mouth into something beautiful.

Hopefully now you must have had a clear understanding of what good teeth can do when it comes to great smile and how people like celebrities can proudly show their wonderful teeth, and that’s because the wonders of getting cosmetic dentistry which indeed costs a lot of money that not many people can afford. There is no stopping back in case you want to have a set of pearly white good teeth.

Dental Implants Average Cost

Looking for dental implants average cost? Do you want to get cosmetic dentistry and get dental implants, but don’t know the right dental implants prices so you can do your estimation of a budget? In this article we will look at dental implants average cost as well as how to make savings when getting cosmetic dentistry.

Dental implants average cost is a wide range. Looking at the differences in dental implants prices across different states in the United States, we find it does vary quite a bit. In most cases the work done is the same, the material could even be the same, however based on local living costs and other factors the dental implants average cost can vary quite a bit.

For example dental implants prices in some states could run at $1,000 for a tooth implant. Take this to another state and it can be as much as $5,000 for one tooth! This is a considerable difference.

Finding the best dental implants prices then becomes paramount. Imagine you need 5 tooth implants. At $5,000 that would equal $25,000. With the lowest dental implants prices you could pay $5,000 and save $20,000 in the bargain!

Those kinds of savings mean that you can go on vacation on the other side of the US and have your treatment. You will also have a lot more in your pocket!

The good news is that in most cases the cosmetic dentists will give you the option of 0% financing. This is a bonus considering the huge amount you have to pay for this kind of treatment. Is it worth it? Yes it is. Compare this to dentures and there is no comparison, even though the price is on a totally different level.

There are other options, such as going to another country. For example dental implants average cost in the UK is $1,600 or less. Go to Budapest or another European country and still with great service the dental implants average cost is $800.

If you want to go lower than Thailand or even India offers some great prices. For example in India you could pay as a dental implants average cost a price of $600!

These kinds of savings are immense, and in most cases you do get what you pay for. For example paying $5,000 for a dental implant may be the highest, but it will give you the best treatment around. You likely will have a warranty and more likely to get the dentist asking how treatment was after you have paid.

Though the question arises whether $5,000 treatment is better than $1,000? Obviously most of these costs go into paying the dentists and equipment used. There is not much difference in the material used; however it will mean a difference of how you are taken care of.

For example paying $5,000 for a cosmetic dentistry would likely result in you having the treatment in the best place, new furniture, and top quality service. Though paying $1,000 would give you great treatment it likely would be comparing 5 stars with 3 stars hotels!

Cambodia Pharmaceuticals and Healthcare Report Q4 2010

Original Source: Cambodia Market

Buy Now: Market Research

Browse all : Pharmaceuticals Market

In our Q410 Pharmaceutical Business Environment Ratings, Cambodia is last of the 17 pharmaceutical markets surveyed in the Asia Pacific region, with its situation unlikely to improve in the coming months. Transparency

International rates the country as the fourth most corrupt in Asia, with only Laos, Myanmar and Afghanistan faring worse. Failure to address these structural issues will bode poorly for long-term growth and development. Additionally, Minister of Commerce Cham Prasidh said on August 24 2010 that the government’s decision to introduce competition laws in Cambodia has been deferred. He said the government will wait until 2011 to consider whether to implement the legislation, although a finalised draft version has been completed. The Association of Southeast Asian Nations (ASEAN)’s member states have been given until 2015 to comply with regional guidelines on competition policy. We are concerned that failure to meet the deadline may deter foreign companies from expanding in Cambodia as they await the finalisation of the competition laws.

In positive news, a US$5.9bn action plan that covers the development of physical infrastructure and trade facilitation in five Mekong countries (Cambodia, Vietnam, Laos, Thailand and Myanmar) was approved in August. Cham Prasidh said on August 26 that Cambodia and Laos may get the most financing support for infrastructure development when the countries start implementing the plan in October. We believe the plan will lead to a significant increase in trade between the Mekong countries over the coming years and speed up economic development in Cambodia.

A decade of economic growth and political stability has allowed Cambodia to begin to tackle its underdeveloped healthcare system. Measures such as health equity funds, a new social health insurance system and the use of nongovernmental organisations (NGOs) have begun to reduce inequalities in the system. The public health budget has grown in line with economic growth. However, per capita health expenditure remains low and around 60% of healthcare costs are paid out-of-pocket.

Cambodia’s pharmaceutical market was calculated to be worth KHR711bn (US$172mn) in 2009. In 2010, we calculate that pharmaceutical expenditure will reach a value of KHR815bn (US$194mn). BMI forecasts drug consumption to increase at a compound annual growth rate (CAGR) of 10.8% in local currency terms and 11.04% in US dollar terms over the next five years to reach a value of KHR1,185bn (US$291mn) in 2014. Our long-range forecast is for the market to reach KHR1,901bn (US$475mn) in 2019, equivalent to a CAGR of 10.3% in local currency terms and 10.7% in US dollar terms over the 10- year period.

Impact Of Health Care Legislation Hr 3962 On The Outsourcing Industry

President Barack Obama had a hard won victory on Saturday night (the 7-8th day of November 2009) when the landmark health care reform legislation (HR 3962) was passed with 220-215 votes. Now if everything goes the Obama way, then by the end of the year 09 Affordable Health Care for America Act would apply as a law impacting almost fifty million US lives. But what does this Act actually imply? How does it stand to impact an average US life? How does the Act affect the outsourcing industry at large? Through my article below I endeavor to answer these and many more questions.
Ab-initio we will refresh the fundamentals of federalism, stating the Roles, Duties, Nature, Scope and Restrictions on the government in a written federal constitution. Next we proceed to see whether the above attempt by the federal government to accede healthcare legislation is ultra-vires the powers granted by the US Constitution.

What is Federalism?

According to the traditional classification followed by the political scientists, constitutions are either unitary or federal. In a unitary constitution, the powers of the government are centralized in one government viz., the Central Government. In the federal constitution, on the contrary, there is a division of power between the federal and the state governments in a way that they are both inter-dependent and independent at the same time.
As we all know that Constitutions are organic documents which operate as fundamental law. The governments and their organs owe their origin to the constitution, derive their authority from the constitution and discharge their responsibilities within the framework of the constitution. The judiciary has the power to declare a law unconstitutional if the law is found to have contravened any provision of the constitution. The American Constitution is the oldest and a well praised example of federalism.

What are the powers granted by the US Constitution to the State Government?

Powers reserved for State Governments are:
Establishing local governments
Issuing licenses (driver, hunting, marriage, etc.)
Regulating intrastate commerce
Conducting elections
Ratifying amendments to the U.S. Constitution
Providing for public health and safety
Exercising powers which are neither delegated to the Federal Government nor were prohibited from the States by the Federal Constitution (residuary powers)
Framing other domestic law (for example, setting legal drinking and smoking ages etc.)

What are the powers granted by the US Constitution to the Federal Government?

Under the Constitution, powers reserved for the Federal Government are:
Printing of money
Declaration of war
Establishing the armed forces
Entering into treaties with foreign governments
Regulating commerce domestically and internationally
Establishing post offices and issuing postage
Making laws necessary to enforce the Constitution

What are the powers shared by Federal and State Government?

Under the Constitution, the shared, or “concurrent” powers are:
Setting up courts
Creating and collecting taxes
Building highways
Borrowing money
Making and enforcing laws
Chartering banks and corporations
Spending money for the betterment of the general welfare
Acquiring private property with appropriate compensation

What is the HR 3962 Act ?

The HR 3962 Act conceptualizes a new, voluntary, public, long-term care insurance program to help purchase services and support for people who have functional limitations. The Act endeavors to form a new national program to provide affordable coverage for those who cant get health insurance today because of pre-existing conditions. Under this, the insurance companies must spend 85 cents out of every premium dollar on medical services, thereby fostering the expansion of Medicaid and improving the Medicare. Under this, the young adults, till the age 26, are covered within their parents policies.

The Obama administration intends to attain this by creating mandates. As a self-sustaining public insurance option (that is financed not by tax dollars but by insurance premiums), this provides an alternative to and competes with private health insurance companies, on a level playing field. Additionally, the Act intends to eliminate the antitrust exemption for health insurers and medical malpractice insurers thereby fostering competition thus targeting the existing monopolies in the health insurance market. It aims to establish a new mandatory essential benefits package that shall become the minimum quality standard for employer plans, with the passage of time. The package places a cap for annual out-of-pocket spending, at a maximum of $5,000 per individual and $10,000 per family to prevent bankruptcies from medical expenses.

This Act requires the employers to either provide insurance to their employees or contribute to the cost of their coverage through the public plan/exchange, though the small businesses are exempted from this requirement.

Arguments regarding Constitutionality of HR 3962

The legal fraternity is divided between two schools of thought about the constitutionality of the Act. First school believes that the Act is unconstitutional and places reliance on Articles I 8 and V of the US constitution and on Tenth Amendment. They claim that their argument is supported by the celebrated case of MARBURY v. MADISON, 5 U.S. 137 (1803) and some federalist opinions. The second school of thought places reliance on Article I 8 and the celebrated case of McCulloh v. Maryland, 4 Wheaton 316 (1819); Steward Machine Co. v. Davis, 301 U.S. 548 (1937); United States v. Butler, 297 U.S. 1 (1936) and some federalist opinions. An in-toto analysis of these school of thoughts would conclude that the true interpretation of the word general welfare in Article I 8 of the U.S. Constitution can only determine the constitutionality of an Act like HR 3962. Till date the court opinions have been more inclined towards Hamilton (Federalist 33, 83 etc.) and Story rather than Madison (Federalist 41, 45 etc.).
Simply put, when the government mandates welfare as a quid-pro-quo for premiums collected, such welfare translates to nothing but a tax liability for the country men. Such an attempt by the government to regulate insurance sector by masquerading as an industry player is inspired from socialism. I personally feel that socialism is a Marxian concept and may not go well in an economy with capitalist foundations. The good thing is that people all over the world should buy insurance; this however turns bad when the government forces people to do so.

What are the implications of HR 3962 on the Outsourcing industry?

The object clause to the Act states that it is meant to provide affordable, quality health care for all Americans and reduce the growth in health care spending.

In reality, the act is a victim of haste. Ideally if the intention of the Obama administration and the object clause of the Act were actually in-sync then the administration should have awaited a confirmed indication of the end-of-recession. The administration should have first looked at strengthening the fundamentals of the economy, by:
better regulating the existing insurance sector,
improving the US agrarian culture and making the country self sufficient regards its food requirements,
checking the cost-of-living index and
creating more jobs in the private sector.
But if the intention is to make more and more Americans dependant on Federal Government for basic requirements, then the attempt is bang on.

Impact on the outsourcing industry:

Prima-facie it may seem complex but there are clear indications for the outsourcing industry to benefit once the HR 3962 is implemented. The benefit roots from the fact that the employees will become expensive for the employers post this Acts applicability. Now given the very competitive market scenarios, thin profit margin and the inability of the employer to transfer this increased cost to the end consumer, the employer is forced to search for the less costly alternatives. It is needless to say here that the Act magnifies the already existing labor arbitrage opportunities internationally. To appreciate the existing labor arbitrage opportunities you can refer to my older blog post.