There is so much confusion about what is in (and what is out of) the proposed healthcare reform legislation. With the Senate bill still in committee, and the Congressional bill still being debated, should you be concerned about the funding of Medicare and Medicaid?

The short answer is: Yes, but if you are a current senior, there are some good things in the proposed legislation. For Baby Boomers, you will face many more challenges, and the Medicare that will exist will, most probably, be materially less than what your parents had.

The basic math is as follows: The House bill has funding going down 3% over 10 years, and the Senate bill has funding decreasing 5% over the same period.

Here are a few important things to keep you eye on, as the debate continues, and the bills get tweaked.

1. Medicaid benefits will be under extreme pressure, and will most likely be cut materially. In order to make the federal economic impact of the proposed healthcare legislation be more balanced, the US government is looking to have the individual states pick up $37 Billion in Medicaid funding. If you live in states like California, New York, and Ohio, you know the fiscal crisis that is occurring, as the states wrestle with huge budget shortfalls. The states’ collective ability to absorb the $37 Billion of Medicaid funding is, for the most part, almost zero. That means deep cuts in Medicaid funding for seniors.
2. Government accounting may make it very difficult to ensure that Medicare savings are used to pay off the huge Medicare funding shortfall we will encounter over the next decade. As of this year, Medicare now spends more annually that it takes it – that’s a big problem. There is a case to be made that some of the changes proposed in the healthcare reform bills will materially reduce the annual cost of the Medicare program. Unfortunately, there are lots of other parts of healthcare reform that would like to use these Medicare “savings” to offset the costs of their proposed new benefit programs. That’s not a sustainable model. We need to ensure that the Medicare funding deficit is addressed, or we will face a material reduction of benefits over the next decade.
3. Here is some relief in prescription costs, but it is limited at lessening out-of-pocket deductible expenses. Several measures that might apply market pressure on prescription drugs (e.g., allowing for coverage of prescription costs of people buying drugs from from lower cost Canadian pharmacies, etc.) are not part of either bill.
4. If you are currently a Medicare Advantage plan member, there is a very high probability you are going to see higher premium costs and lower benefits. There is no one who believes the current government contribution to the Medicare Advantage program is sustainable. The one open question is whether there will be a “Grandfather provision” that lets current members of the program still continue with the current program, or whether it will be massively redesigned for everyone, new and old.
5. There are no death panels, but there will be approved tests of new care models for selected classes of patients, especially those that are chronically ill. The results of those test will potentially shape future changes in Medicare.

At OurParents, we do believe that some form of healthcare reform is required, if only to address the now-effectively-bankrupt condition of Medicare. Healthcare reform needs to address a much broader swath than seniors. You only need to spend a day in an emergency room (the doctor of last resorts to many) to see how many people are slipping through the healthcare net. The challenge is what form that healthcare reform takes, and whether it will fundamentally address the cost of provisioning of healthcare.

If you have an aging loved one, you need to understand the major elements of the proposed healthcare legislation, and make your voice heard, one way or the other.

Here is the latest press release we did on some of the new community features we have added over the last month to OurParents.com.  It has been great to see members of the community step up and be willing to help other seeking senior care advice by sharing their own experiences and knowledge!

OurParents.com Launches User Forums for its Directory of Senior Care Providers

Internet’s largest independent directory of senior care providers adds user forums, allowing members to get their senior care questions answered by the OurParents community

Washington, DC (September 23, 2009) – People searching for care for their aging parents find almost no independent advice about senior care facilities online.  Often, these families are drawn to misleading sites whose sole function is to sell their personal information to the highest bidder.

In response, OurParents announces the addition of user forums to OurParents.com, the largest free and independent online senior care directory on the web, with information on over 100,000 nursing homes, assisted living facilities, and in-home care providers. 

Membership to OurParents.com is free and members have access to the best, most complete senior care provider profiles online.  These profiles include Medicare quality data, user reviews, cost information, and more. The site provides free detailed reports to consumers about each senior care provider, a $25 to $90 value, and gives members free access to powerful decision-making tools such as the remarkable Care Options Advisor.

The User Forums help users discuss any senior care related question or issue they may have, be it about nursing homes, “aging in place” (home care), how to pay for senior care, and more. Users can ask questions or provide insights from their own personal experiences.

OurParents.com also provides free access to user reviews, to allow visitors to hear first-hand from others about their experiences with a given care provider.   The goal of OurParents is simple: to be the sole trusted place online to find the best care solution for a family’s aging loved one.

“We launched user reviews last month, and the response to that has been fantastic.  We already have 2,000 user reviews, and we are just getting started,” said John McKinley, founder and CEO of OurParents.com. “It showed us that members wanted to help others in the search for the best senior care, often by sharing their own experiences.  We have some great members of the OurParents community who have shown that they are more than willing to help families in need.”

“Our founding principle is that we are, and always will be on the side of the consumer,” added McKinley, “and it’s our members who help make Ourparents.com the best source of senior care information on the internet.”

For more information, visit www.ourparents.com.

Washington DC based LaunchBox Digital, an early stage investment firm and incubator founded in 2007 by John McKinley, Sean Green, and Julius Genachowski (now the new head of the FCC and divested), just wrapped up its second annual 12-week program. Modeled in the same vein as YCombinator, LaunchBox invests seed capital of around $20,000-$25,000 into teams, and provides them with 12 weeks of education, mentorship and access to a small army of advisors.

Drawn from a pool of over 275 applicants, we chose eight teams were selected to comprise the 2009 class.   Below is a brief description of each, with notes by me, as well as links to screencasts of their products and their websites.

SEC Watch www.secwatch.com Founders: Jason Zucchetto and Chris Auer Click for Screencast

SEC Watch deals with a big problem facing individuals interested in research and investing – a mountain of invaluable data exists in SEC filings, but those filings are really difficult to deal with as an information source. Most people are dealing with filings many hours after they are issued, letting those with real-time access have first mover advantage The sheer volume of filings each day is massive (there were over 1MM filings, totally 15 million pages in 2008 alone) The search experience offered online by finance sites and the government is very 1.0 in functionality There is no easy way to collaborate with others on the analysis, and share comments/observations. Why does this all matter?  Well, if you looked at AIG’s filings, you would have found information about their sub-prime mortgage exposure almost a year before things blew up.  It was just buried in a footnote. SEC Watch brings state of the art search technology, combined with user annotation and sharing capabilities to the problem, and has crafted a compelling product that both retail and professional investors and analysts can use.  It is easy to track companies and keywords (e.g., “subprime”,”litigation”, etc.), and get automated results in near real-time when filings are done that match your criteria.  You can then dive down to the relevant sections, and annotate a given filing for your own personal use, your team’s use, or to share with the public.

Bandsintown www.bandsintown.com Founders: Todd Cronin, Phil Sergi, Mike Costanza Click for Screencast

Bandsintown deals with a big shift in the whole economics of the music business.  Nowadays, 70% of a band’s income comes not from music sales, but from touring.  That’s up from 20% only four years ago.  Ticket sales have never been more important, but the marketplace for tickets has become incredibly fragmented.  There are 70+ separate ticket marketplaces on the web.  That makes for a bad experience for a fan, but also a bad experience for music sites trying to encourage ticket sales for all the different artists they cover. Bandsintown has dealt with this problem by building interfaces to 62+ different ticket marketplaces, and then exposing all ticketing information as a simple to use API that music sites can integrate.  They have increased their traffic to over 500K monthly unique in the five months since they launched their API, and have a global partner base (including Spotify, the Hype Machine, and PureVolume among others). Bandsintown does a great job in automatically integrating with players such as iTunes, last.fm, Pandora and other sites to learn your artist preferences, and then lets you track your favorite artists (and related ones) and receive alerts when events of interest are coming to your area.  They are also preparing to release a new iPhone app (it’s awaiting approval from Apple) that lets you see local concerts based on your musical tastes and geo-location– think of it as Urban Spoon for live music. There is lots of other good stuff, like their live event twitter integration to allow you to easily track yours and others’ concert experiences that are part of their overall experience.  If you love live music, you’ll love Bandsintown.

Social Collective www.thesocialcollective.com Founders: Chris Bucchere, Mike Buckbee, and Clinton Bonner Click for Screencast

Social Collective addresses the huge market of conferences and corporate meetings.  There are an amazing 1.2 million conferences and corporate meeting in the US each year.  It is a huge industry – close to $11 billion in spend worldwide.  The problem is that in these tough economic times, revenue for event producers is down, and the demands from attendees and sponsors are increasing, as they want more for their dollar. Social Collective is a SaaS solution targeted at event marketing and the enhancement of the event experience for both attendees and sponsors.  They powered SXSW this year, as well as the Oracle Open World and other big events. They bring innovation to a pretty underserved industry, by allowing things like crowd-sourced agenda design, social graph importing for attendees to reach out to friends and associates attending the same event, marketing tools for pre and post event awareness building by conference organizers, and tools for vendor communications and networking with attendees. They have had great initial success helping both long-standing events re-invigorate themselves, as well as first-time events get their word out to the marketplace. They have good web and mobile experiences, and do some really nice things like allowing you to build your own tailored agenda for an event, and then import it into your online calendar (FYI, this custom-agenda function got over 60% penetration at SXSW).

TapMetrics www.tapmetrics.com Founders: Christopher Brown and Nolan Brown Click for Screencast

TapMetrics is a tool designed by a team of iPhone application developers that brings together sales data, user feedback, software metrics, and other information into a consolidated dashboard to allow developers to manage a portfolio of applications quickly and easily. The whole experience starts with a dashboard that lets you view important information about how your application portfolio is performing, and then lets you drill into each application to investigate any issue that is highlighted.  The nice part of the TapMetrics solution is that while it does a great job on the business metrics of running an iPhone application, it does just as good of a job serving the needs of the engineer.  Everything from detailed environmental data (which iPhone/Touch hardware is being used, which OS level, which release level of the application), to detailed crash reporting, to application messaging/event logs, and session tracking are supported within the integrated TapMetrics experience.  That integration of both business and technical data (including session-level tracking) in a single dashboard is something no one else does today. They also have a nice free iPhone app called TapMini that you can use to track sales data for your applications.  If you are trying to get more out of your iPhone application portfolio (both in terms of improving the consumer experience and making more revenue), this can be a really useful tool.

Unblab www.unblab.com Founders: Anthony Deloso and Eli Holder Click for Screencast

Unblab is trying to attack the email overload problem by answering the question “What emails should I be reading”?  They are approaching this by building a cloud-based service that uses common and user-specific rule sets to identify and prioritize important email messages.  Think of it as attacking the email overload problem from the opposite end of the spectrum as the anti-spam vendors, but using similar technologies. The latest productivity studies have white-collar workers now spending 4 hours a day in email-related activities, and the volume of legitimate inbox messages increasing 10% per year.  The challenge is how to best approach better management of that legitimate traffic. Unblab has two client experiences it is deploying initially to help refine its algorithms and demonstrate the value of importance ranking.  One product is a Gmail add-on called GTriage, and the other is a mobile app called iTriage.  The goal is to get early-stage learnings on the differences of what’s “important” when you are on a limited real estate mobile device as compared to when you are using a pc-based webmail experience. The API for the service will be opened up to developers to define their own user experiences (and to allow additional training events/algorithmic enhancements).

KeepFu www.keepfu.com Founders: Dan Newcome and Josh Ho Click for Screencast

KeepFu is targeted as a simple note-taking and organization tool to help manage consumer-defined “projects” like trip planning, event planning, and important purchases.  The team has built a good Evernote-like note taking tool called Ubernote, and while they got some decent initial traction, they realized there were some key unmet needs that the whole web note-taking space was failing to serve. Feedback from their own user based shaped this next-generation offering.  This new product, KeepFu, is targeting at addressing the organization of information, not just the collection of it.  KeepFu collects data through one-click and passive data collection while a user reads an email, visits a website, IMs with a friend, or send a Tweet.  It then supports a quick drag and drop experience to organize these information snippets into community-created project templates (predefined file folders specific to an activity, like planning a trip).  These projects are then easily published or shared. The goal is to allow information capture without forcing a user to change context and leave the experience they are engaged with, and then support automated and manual classification and organization of the information when it is appropriate, a bit like the weekly photo tagging activity of Facebook users. Simple collection, organization, and sharing is what KeepFu is all about.

Keen Guides www.keenguides.org Team: Catharine McNally, Karen Borchert, Martin Franklin, Frank McNally Click for Screencast

Keen Guides started from the personal experience of its founder, a hearing-impaired woman who was visiting a very popular museum in Washington, DC and wanted to have her own tour experience.  They handed her a dog-eared pile of paper, and sent her on her way.  Trying to come up with a better experience, she went home and signed in the commentary as video clips she then viewed the next day on her iPod as she toured the Gallery.  It was a transformative experience for her, and that’s when Keen Guides was born.  The goals of the company are simple: Leverage new platforms (especially the iPhone) to replace outdated audio wands as content delivery tools Create self-paced custom tours, based on prior visitor feedback, what time you have available, and your unique interests Encourage social interaction and sharing of comments, photos, etc., by tour participants Support access by all, including hearing and vision impaired visitors, as well as non-English speakers. They are using the iPhone as their initial tour delivery platform, and will support tour content creation (and monetization) by both themselves as well as third parties like DC By Foot.  Initial deployments include museums, city walking tours, and college campuses (for orientation tours, etc.).

Legal River www.legalriver.com Founders: Reed Atkin, Ben Hatten, Zach Girod Click for Screencast

Legal River is focused on provided a marketplace for matching small businesses with legal professionals.  Looking at search queries, you see a lot of businesses searching for uniquely skilled legal professional in areas like patent law, contract disputes, etc. While there are numerous directory sites for lawyers, they don’t encourage the concept of competing for a given business’s project, and do little to give prior client feedback and other useful data for a business owner to make an informed decision. Legal River has created a market place where a business can anonymously post a given project and get competitive bids from multiple subject-matter experts.  The system allows easy side-by-side comparison of credentials, prices, prior client feedback on similar projects, etc.  The net result is a better, more transparent process that serves both the business owner as well as the legal professional, who gets access to high-quality local leads. Legal River has signed distribution deals with a number of sites to both get their service offering in front of small business owners, as well as qualified local lawyers.

People searching for care for their aging parents find almost no independent advice about senior care facilities online.  Often, these families are drawn to misleading sites whose sole function is to sell their personal information to the highest bidder.  That’s how the so-called lead generation business operates in the senior care industry.  These businesses don’t care about the quality of the providers they sell the leads to, which can lead to some terrible experiences for the impacted families.

That is all changing. OurParents announces today free and immediate access to the largest online directory of senior care providers on the web – over 100,000 care providers across the United States.  The free service is totally independent and unbiased, providing ratings, price information and powerful decision-making tools including the remarkable Care Options Advisor. The site provides free detailed reports about each senior care provider, a $25 to $90 value, absolutely free to consumers.

OurParents.com also provides free access to user reviews, to allow visitors to hear first-hand from others about their experiences with a given care provider.  The goal of OurParents is simple:  to be the one trusted place to go on the web to find the best care solution for a family’s aging loved one.

“Having the largest online directory of senior care providers, over 100,000 so far and growing, was a big goal for us,” said John McKinley, founder and CEO of OurParents.com. “Families need a trusted place to go to see all of the senior care options that are available, and the current lead-gen players fail miserably in fulfilling that role.  Some sites have as few as 4,000 entries.  But OurParents is so much more than that.  We also give consumers a free comparison report with details about a given senior care provider and the surrounding community. Some sites sell less complete reports for $25 to $90. Ours are absolutely free, and the response we’ve gotten from families about them has been great.”

One critical element needed to paint a more complete picture about a given facility is feedback from existing and past residents and their families.  That is why OurParents is also announcing the addition of user reviews for care providers.  “We are the only independent directory in the senior care business.  That allows us to show the good, the bad, and the ugly about any given provider.  Reading user reviews is a great way to understand more about what life is like for a facility’s residents,” said McKinley.  Families of current and past residents can rate a provider along multiple dimensions, including quality of care, helpfulness of staff, and cleanliness.

“It is simple,” said McKinley. “Our founding principle is that we are, and always will be on the side of the consumer.  For families in need of help, there is simply no better source of senior care providers on the internet.”

“What did this brave self-flagellation yield? To be sure, he got the attendees to collectively declare that they would never ever let the Earth’s temperature rise two degrees centigrade from pre-industrial levels. This is supposedly a prelude to the real horse-trading over emissions cuts that will begin in a Copenhagen, Denmark, meeting this December.

But the depressing thing for climate warriors was that Obama could not get developing countries, without whose cooperation there is simply no way to avert climate change, to accept–even just in theory–the idea of binding emissions cuts. India’s prime minister took the occasion to position his country as a major victim of a problem not of its making. “What we are witnessing today is the consequence [of] over two centuries of industrial activity and high-consumption lifestyles in the developed world,” he lectured. “They have to bear this historical responsibility.” And even before the summit began, China declared the West had “no right” to ask it to limit its economic growth.”

via forbes.com

I had the pleasure of listening to a Stanford University professor do his public pitch on the need for the US to actively drive CO2 emission reduction, and my takeaway from his speech was profound, but not what he intended.

The basic premise was that if we as a global community do not immediately change our ways, the global temperature of the earth will rise several degrees over the course of this century, with major portions of current tillable land becoming barren and arid by 2050.

Here was the issue: When I saw the relative forecasted contribution to the CO2 problem originating from China and India, countries who have opted opt in large part of emission controls, the relative impact of what the US could do with our own highly aggressive green program made little or no different (it was like the difference between a 3 degree increase and a 2.8 degree increase).

To me, that means if you believe in global warming as a phenomena, then we as the US need to start planning for life in this new, hotter climate. That means three needed infrastructure investments:

Cheap, scalable power
Massive desalination capacity
Distribution systems for water and power to our farmlands in the US.

Positioning the US to be the world’s farmer over this century is a great strategic entitlement to leave our children and our childrens’ children, but we need to start the infrastructure investments TODAY.

That is why I am so sad about the current use of our available global credit line – the amount of focused infrastructure investments with real sustaining benefit is measured in the low single digits percentage of the forecasted deficit increase. That needs to change, and someone needs to take up the mantle of leadership (be they Democrat or Republican).

Let’s invest in change that matters – things that lead to a more vibrant US over the next 100 years. To me, it all starts with being able to feed 6+ billion people, and the US has unique geological and financial assets to position itself to play that role. It just takes focus and commitment.

via wechoosethemoon.org

Major props to Bill Wilson and his team at AOL for creating such a wonderful way to memorialize the 40th anniversary of the Moon landing. Hope kids are aware of this.

With great TV specials like this, and awesome first-gen MTV videos, no wonder things turned out so great! http://www.funnyordie.com/videos/b5e66d4b58/play-helen-and-hall-oates-off-keyboard-cat

 

 

via zerohedge.blogspot.com

When 70% of the US GDP is driven by consumer purchases, do you think this 60% increase in consumer-supplied tax revenue over a 6 year period will have no effect on the current quite-optimistic growth assumptions for the US economy?

via money.cnn.com

Not a great week for the Golden State.  Credit downgrade to BBB,  vouchers-as-currency proving to be a limited lifespan solution, and no legislative solution in sight.

via incharacter.org

As a parent of two young kids, it was great to read this piece on the work of Angela Duckworth at Penn. It talks about what character traits you should be focused upon to help your children succeed.

In a world where we celebrate everything in a child’s life, the real lessons of hard work, persistent, and long-term payoff are often overlooked.

I am a huge fan of the belief that multi-year focus on some form of personal achievement, be it music, art, or sport is one of the most important true growth investments a young individual can make in himself/herself. It is not about comparative levels of performance. It is all about what you can personally achieve in life through concerted effort.

I talk to my son all the time about my own experiences to become a ranked fencer, and what it was like in my first years of of national competition (quite humbling at times), where I managed my definition of “success” by continuing to set personal growth goals each year. I came away from my time in sport with some invaluable lessons around focus and dedication – lessons I am now trying to pass on to my kids.

Through my venture investment work, I see lessons about grit everyday, When I see my friends in the startup space in action, I see the same common flame burns bright within them. They have “true grit”, and they inspire me each day, for which I am truly grateful.

To read more on Angela’s work, you can start here: http://www.incharacter.org/article.php?article=147

The large web players have championed (out of necessity) creative and highly scalable means of managing structured data (from Google's BigTable to Yahoo's Hadoop).  Now things have exploded, with great work from Amazon (Dynamo), Facebook (Cassandra), and others.

The performance stats are staggering.

Now it is time for corporate IT to take up the mantle and start using these innovations in their day to day operations.  In a world where lots of effort has already been expended on traditional cost-out efforts (LAMP stack migration, offshoring, etc.), it is nice to have a new page in the IT playbook that has real strategic benefit, beyond its near-term cost savings opportunity.

Here is a quick overview piece to whet your appetite.

http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9135086

via businessinsider.com

The before picture: 272 employees running the local Ann Arbor News (a paper with a 174 year history). The after picture: All employees laid off, and traffic (4K UVs/Mo) that a blogger wouldn’t brag about. I don’t remember another example of such a rapid decline across an entire industry.