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.

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.”

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

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 ]]> http://greatfallsventures.wordpress.com/2009/07/02/corporate-it-needs-to-get-on-board-with-the-no-sql-movement-huge-strategic-benefits-paired-with-major-cost-savings-longer-term/feed/ 0 John McKinley http://greatfallsventures.wordpress.com/2009/06/30/trainwrecks-along-the-way-as-local-newspapers-try-to-morph-into-profitable-web-businesses/ http://greatfallsventures.wordpress.com/2009/06/30/trainwrecks-along-the-way-as-local-newspapers-try-to-morph-into-profitable-web-businesses/#comments Tue, 30 Jun 2009 21:43:04 +0000 John http://greatfallsventures.wordpress.com/2009/06/30/trainwrecks-along-the-way-as-local-newspapers-try-to-morph-into-profitable-web-businesses/ ]]>

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.