#Medicare #MedicareAdvantagePlans #MedicarePartC #HealthCareNetworks
The ads are relentless this time of year, trying to get those on Medicare to sign up for Advantage plans, the so-called Medicare Part C.
These plans can indeed, in many cases, offer more benefits and lower costs.
But, if you want absolute – or as close to absolute as possible – freedom of choice in where you get your care, stick with the Medicare Part A, B and D plans.
These Part C plans, in most cases, are tied to a network of practitioners. In other words, you have to go to someone in that network to get your care covered by your insurance. In many cases, practitioners outside the network will not take you as a patient.
As a patient, you may develop a rare or complicated disease, even if you are relatively healthy today. Sometimes, going to see a specialist that is far from where you live would give you the best chance at recovery or survival. Chances are, that specialist won’t be in the network with which your Part C plan is affiliated. That may preclude you from the best care you can get.
Also, some of the Part C plans also require referral from a gatekeeper, usually a primary care doctor in the network, to see a specialist within the network.
Then, with Part C, there is the risk that large medical providers within the network will have battles with the insurer over reimbursements. When the practitioners hold the insurer hostage, or vice versa, the patients suffer and may lose their health care providers – temporarily or permanently.
These Part C plans are the more profitable products for the health insurers. Those who sell them earn much higher commissions. And, as we all see, they spend a fortune in advertising that might be better spent on patient care. Reports indicate that these plans actually cost the government more than regular Medicare.
All this isn’t to say that everyone should stay away from a Part C. plan. If you are someone who doesn’t often go far from home, and the practitioners you like are in the network, it could work for you. Be advised, however, that in many of these plans, the practitioners can come and go at will, while patients are locked in for the year.
If you do shop your Medicare plans, it might be best to find someone who sells multiple plans and could give you more choices. However, if want the flexibility that Part C plans do not give you, don’t let someone talk you into settling for a Part C plan. As of today, Parts A, B and D are still an option.
Medicare has been a marvelous way for retirees to get health insurance, usually with no questions asked. If you opt for a Part C plan, and it doesn’t work for you after a time, going back to Medicare parts A, B and D may be difficult, more expensive and may not cover pre-existing conditions.
Some of the ads for Medicare Part C often are created to make older people look stubborn, angry and, well, uniformed. Not everyone is like that. Or, others have celebrities doing everything they can to get you to call a certain number to examine plans.
But, it boils down to a simple decision: do you want flexibility in deciding where to get your care? If it doesn’t matter to you, then shop around for the best price, most convenient practitioners or whatever you are looking for.
If you get sick or injured on vacation, the practitioners you need where you are may not be in your network. Make sure you know what will happen to you, financially, if that occurs.
The hard sell for these Part C plans not only turns people off, it should be unnecessary.
Peter
Category Archives: Uncategorized
MAKE TEACHING AN ATTRACTIVE PROFESSION AGAIN
#teachers #PoliceOfficers #ArmedTeachers #ImprovingEducation #AttractingTeachers
Teachers have gotten a bad rap for many years.
Today, however, the problem is getting out of hand.
Now, they want teachers, in some jurisdictions, to carry guns.
Georgia is attempting to get a handle on how to make teaching at the K-12 level attractive again.
Maureen Downey, education columnist for The Atlanta Journal-Constitution, took on this problem in her November 22, 2022, column.
Downey cites a working paper from the Annenberg Institute for School Reform at Brown University, which documents the state of the K-12 teaching profession over the past half-century. It analyzes 50 years of teaching, looking at prestige, interest among students, preparation for entry and job satisfaction, according to Downey.
The conclusion is damning: the state of teaching is at its lowest level in 50 years, Downey writes.
To top that off, as Downey writes in her column published November 7, 2023, Georgia wants to arm teachers to curb gun violence. They want to take advantage of the relatively low teacher pay by giving teachers who volunteer a $10,000 stipend for firearms training, and the willingness to carry them in schools, Downey writes. Would you want your kid’s teacher to be armed? Downey doesn’t think it’s a great idea.
Let’s look at the history of teaching as a profession. In decades past, most teachers were women. Since it didn’t pay very much, it was tough for a teacher to make a good living on teaching alone. Although it didn’t pay much, there were good benefits: summers and lots of other time off, good insurance, a decent pension for those who stayed long enough and, in many places, good union protection. That meant job security for as long as a teacher wanted, in most cases.
In those days, parents left teachers alone. Sure, they’d visit during PTA meetings, occasionally volunteer in the schools etc. But, for the most part, teachers had free rein to teach and discipline children as they saw fit. As a kid, if you were bad in school, you often got punished again at home. Parents didn’t question the teachers in those instances.
Then, as widespread economic hardship hit families over the years, people in other usually better paying professions who were losing jobs became jealous of teachers’ job security and union protection.
Gradually, politicians of certain persuasions started blasting teachers unions, and still are.
Today, that resentment is manifesting itself in extreme parental and political interference in schools. Remember, teachers, in general, don’t get paid much. Despite their good job security, there’s only so much many will put up with for the compensation they get. Most teachers like, even love, what they do, providing they have enough latitude to teach as they see fit. When that latitude is gone, teachers will go, too. And they are. Having armed teachers in school may hasten this exodus.
This outside interference is NOT improving education. Kids are not learning what they should learn, particularly in history and science, because of this interference. Arming teachers likely won’t make schools safer. It may even do the opposite.
Other professions, besides teaching – law enforcement , for example – are also relatively low in pay and high in responsibility. They, too, often face far too much outside interference in their work. No one wants, say, a police officer going rogue in the streets. But there’s a vast difference between good oversight and training, and bad interference.
Educators, as Downey points out, are studying the problem of making teaching attractive again. Many studies are shelved and never implemented. Suffice it to say that if we can’t put good teachers, preferably unarmed, in every classroom, the children – and the world – suffer.
If you have a child in school, get involved, but don’t interfere. Most teachers know what they are doing. They are well supervised, and usually have good curricula on which to base their efforts.
Previous generations of children, in most cases, had no difficulty reconciling what they learned in school with what they learned at home or at church, even when some of that knowledge appeared contradictory. It would be hard to believe that today’s children would be incapable of doing the same.
In short, support your teachers, your police officers etc. Hold them accountable when necessary. Be involved in your children’s school(s) and your community. But don’t stand in the way of good and proper education or policing.
Peter
RIGHT TOOLS CAN MAKE A DIFFERENCE IN A JOB
#tools #jobs #employers #employees #WorkingRelationships
To paraphrase a PayCom TV ad: Are you using the right tools for your job? Why would any company not want you to have the right tools?
To illustrate, the ad shows a ditch digger using only a spoon and a high-rise window washer using only a toothbrush, for example.
The questions posed by the ad, however, are on point.
So many employers throughout the years have skimped on giving their employees the right tools for the job.
Perhaps they were hesitant to make the investment. Such thinking is shortsighted. The employer will either pay now, or pay later for that mistake.
Such thinking also forces employees to “make do” with what they have. That can have varying effects. It can bring out creativity and innovation among employees. It can also create frustration among employees, even to the point that they leave.
Though it may be difficult to have ideal situations in the workplace, it would be wise for employers to see employees simply “making do,” and wonder how much better their operations would work if the employees had the right tools.
In the modern workplace, the “right tools” can change quickly. Technology can become obsolete as soon as it is first integrated into an operation.
It’s a tough ask for employers to constantly update the technology. An employer can be constantly chasing shiny new objects. But the onus is on both employers and employees to find the sweet spot among jobs and tools.
Here’s a good rule: if employers and employees have good communication among each other, and everyone knows where everyone is coming from, that’s a great beginning.
Employees who need better tools need to sell the employer on the advantages of investing in such tools. Employers have to make it clear to employees how much money is available to invest in tools, and what the best bang for that buck is.
Some employers have surveyed employees on what they would like to have to do their jobs better. Answers can vary by the job, of course. But, in all cases, good communication and good working relationships among all concerned are required.
Some unions have resorted to destroying their tools in disputes with employers. Why would any worker destroy the things that THEY work with?
Do they think, by destroying their tools that they are never going to need them again?
In short, good tools make good work and good workers. Even with limited company budgets, employers have to know what tools will give their workers the best productivity.
Sometimes, that requires investment beyond a company’s perceived limit. Sometimes, employees have to innovate and create to compensate for the unavailability of certain tools.
No one wants ditch diggers to only have a spoon, or a window washer to only have a toothbrush. But finding the appropriate tools for various jobs can be a fluid process. Good communication and relationships among all concerned can facilitate that process.
Peter
VIOLENCE CREATES MORE PROBLEMS THAN IT SOLVES
#viiolence #HittingBack #SolvingProblems #bullies #ChickenVsEgg
When we are hit, we usually want to hit back.
Sometimes, hitting back is necessary. In fact, we may have been taught as children that the best way to stop a bully is to fight back. The theory went that once the bully saw that you were gutsy enough to fight back, he or she would stop bullying.
Today, that doesn’t always work. Some bullies actually WANT you to hit back, because they believe they can show you to be the aggressor.
In some battles, the question of who started them can be illusive. The origins of a dispute can go back long before the actual violent incident.
Often, the origin of disputes becomes a chicken vs. egg question. Ironically, they can be irrelevant to the problem at hand. Or, long simmering grudges can be the crux of the problem at hand.
The point is that violence is unlikely to eliminate the dispute that caused it.
Why would someone commit violence if it doesn’t solve a problem?
Those who commit violence are often people with problems they cannot solve themselves. They feel put upon by someone, a group or something(s). They have no way out but to lash out.
Other times, those who commit violence let their emotions dictate their behavior. In human nature, that’s very easy to do. Committing violence makes the committer feel better, because his or her pent-up emotions have been released, albeit in a bad way.
Usually, they soon find out that their problems are not only unsolved, they are in even more of a pickle than they were before the violence. The good feelings of releasing pent-up emotions soon turn, well, sour.
Jealousy is another reason for violence. Someone has what you want, so you get it through violence.
That can work, at least if it is things that a person wants – until the perpetrator gets caught. Then, the problems begin anew.
If one commits violence over a person, like a jilted lover, he or she may not get that person back. In fact, it may cause the coveted person to resent the violent person even more.
This begs the age-old question. How does one solve problems without violence?
Talking certainly helps. Listening helps even more.
When there is both talking and listening, on all sides, agreements can be forged. Or, at least, decisions that violence will not solve the problem can be made.
So, the next time you feel aggrieved, by someone or something, stop. Think about how you are going to solve the problem. No matter how angry you may feel, know that expressing that anger through violence will only compound your grievance.
It’s much more easily said than done, of course. But, if one person can think first before acting on a grievance, there can be less violence in the world.
That one person could then become two etc. Better yet, those two can be on both sides of a dispute. When that occurs, resolved disputes abound.
Peter
INDEPENDENCE AND HERDING CATS
#independence #HerdingCats #interdependence #leaders #followers
Independence is a virtue.
We all want to do what we want, when we want, regardless of what others want us to do.
But, complete independence of others, in the real world, not only has pitfalls, but also can be hurtful, even dangerous.
Smart, independent people know when to convert independence to interdependence when warranted.
Cats are known for independence. It’s difficult to get them to follow anything. If they come to you, they do so on their terms.
We often see leaders trying to “herd cats” when too many independent people are under them.
Following a leader, or the crowd, has its own dangers.
Following for the sake of following can result in boring contentment, which can lead to underachievement, even danger.
Smart and independent people understand that, often, success comes when people work together. One can make another successful, and vice versa, when combining skill, talent and ambition.
Of course, for people to come together, there has to be a motive that results in the good of all.
Some independent people look for those who will follow unconditionally. Others prefer to earn followers through their own effort, or their contributions to the overall group effort.
Most parents want their children to be independent. They want to raise them with good values, so they can succeed on their own as adults.
Too often, children become so dependent on their parents that they never leave home. That’s not only a burden on the parents, but also a detriment to the child.
But, as parents raise children to be independent, they want them to learn the difference between independence and interdependence. Most parents would prefer children not only to succeed on their own, but also be an integral part of a community that does good things that benefit all.
So, be independent. But, use that independence wisely. Know what your limits may be, and when you may need help.
The world depends on independent people who know when interdependence takes precedence.
An old adage goes like this: lead, follow or get out of the way.
You can choose to lead, but to lead properly means helping those who follow to succeed. If you want to lead for selfish purposes, regardless of the effect on others, get out of the way.
For smart, independent folks, there are times to lead. There are times to follow. There may even be times to get out of the way.
True independence is knowing when and how to exercise it. Taking care of oneself is honorable, even desirable in some cases. But, don’t put oneself over the common good. That could cost you your independence.
To paraphrase the Golden Rule, if you do for others as you would have them do for you, you are truly independent.
Peter
KNOWLDGE, INTELLIGENCE AND WISDOM
#knowledge #intelligence #wisdom #education
Knowledge is different from intelligence.
Both are different from wisdom.
Knowledge is the collection of facts, information and skill. These can be acquired at any age. They can be acquired either through reading, education or by doing.
Intelligence can be acquired naturally. Or, it can be honed through learning. It takes intelligence to apply knowledge properly.
Wisdom can only be required through experience. It can be learned in youth through mentoring, but it more likely comes with learning by doing over time.
One can know a lot, and not apply what he or she knows intelligently. As one applies knowledge, properly or not, presumably, over time, he or she gains wisdom.
However, consistent misapplication of knowledge can help one evade wisdom.
We all want to be knowledgeable, intelligent and wise. Depending on the person, that can be a tall task.
The begged question here is: how does a truly knowledgeable, intelligent and wise person behave?
As humans, we make decisions. Not all decisions are good. Virtually no one can make every single decision a good one.
But knowledgeable, intelligent and wise people make more good decisions than bad ones.
One’s character is shaped by decisions. A person of good character doesn’t just want everyone to think he or she is knowledgeable, intelligent and wise. He or she wants to believe he or she is so.
Usually, that means saying less and doing more. It also means doing good things even when no one is watching.
If you know you are being watched, however, model your good behavior with pride.
Many people, if not all, can attain the three characteristics. But, attainment has to start with the inner desire to do so.
Some have no interest in, and couldn’t care less, whether they are knowledgeable, intelligent or wise. To them, life is lived on their own terms, regardless of the consequences.
Others have disabilities that keep them from attaining their full potential. But they, too, can attain a great deal if they have the desire to do so.
Knowledge, intelligence and wisdom are there for the taking for most, if one has the desire.
The combination of traits does not, in itself, make a good person. But how one applies each of those traits can determine the type of person one becomes.
So, do you have the knowledge, intelligence and wisdom to be the best you can be?
If not, do you want to be your best?
How one thinks about those questions can determine one’s path to success and happiness.
Peter
PRESCRIPTION DRUGS, THE U.S. SYSTEM AND NEGOTIATIONS
#PrescriptionDrugs #DrugPriceNegotiations #DrugCompanies #tgovernment #PrivateSector
The United States is the only country in the world that puts medical care in the free market.
That tells the country that you get what you can afford, or, perhaps, you suffer or die.
The large drug companies, as well as academic research institutions, do the research that creates the newest, perhaps blockbuster, drugs, therapies and treatments.
That research, in the case of private companies, is funded largely by the (mostly U.S.) profits it makes from drugs, when they are approved and sold.
These companies want to maximize their profit initially because they know that drugs will eventually come off patent and can be duplicated by rivals.
That will lower the cost of the drug, usually.
Once a drug is developed and approved, the cost of manufacturing usually drops. Some drugs that cost relative pennies per dose to make are sold for up to thousands of dollars because the companies are trying to recover all their research costs.
So, the question becomes: why should a drug that has been prescribed for many years, that costs relative pennies to make, still cost so much long after the companies have recovered most or all of their research costs?
Perhaps it could be argued that the company is trying to pay for current research on drugs not yet approved. (What will they charge for that drug later, if approved?) Perhaps it could be argued that the companies are also trying to recover research costs on drugs that turned out to be busts, and never approved for sale.
Most of the drugs in the initial rollout of Medicare price negotiations with companies are drugs that have been around awhile. The companies by now should have recovered most, if not all, of their research costs on those drugs.
In some cases, companies are spending millions of dollars on television and other advertising to get people to ask their doctors about these drugs.
Perhaps, when Medicare starts negotiating prices it will pay for some of those drugs, the TV ads for those drugs will stop, or be cut back. That’s not good news for the TV networks and other media outlets that depend on such advertising.
In essentially every other country, drug price negotiations are the norm. There is usually only one buyer – the government – for the whole country. That gives those countries leverage to determine how much drugs will cost within their boundaries. (That’s why a lot of Americans buy their drugs from Canada or Mexico).
Because most medical care in the U.S. is in the free market, that hasn’t been possible here. Because of that, people not only had to be concerned whether a drug, or other medical treatment, was going to be the best for their conditions, they had to worry how they were going to pay for it. That’s stress atop stress unnecessarily.
In the U.S. private sector, a large-volume buyer usually negotiates prices. The more one buys, the lower the price per unit. The sellers want to sell lots of product. The buyer wants to pay as little as possible. So, they negotiate. Medicare is a bulk buyer of prescription drugs, and has never been allowed to negotiate prices – until now.
There is no telling yet how much prescription drug price negotiations will bring down the federal deficit, but, very likely, it could be considerable over a few years.
Therefore, there could be a two-part bang for the buck here. Medicare, and, ultimately, patients will pay less for the drugs they need, and the federal deficit could come down a lot. As a bonus, the drug companies will still make plenty of money.
And, over time, as the number of drugs that are subject to price negotiation increases, the difference could be huge, compared to the current situation.
The actual results have not yet been realized, but the whole idea could be a game-changer for the country.
Peter
NEW PARENTING STRATEGIES: LESS FIRM, MORE INCLUSIVE
#parenting #ParentingStrategies #children #ChildrensAnxieties #depression
Children significantly are more anxious and depressed than they were five years ago.
So says a March article in JAMA Pediatrics,. The article was quoted in Nedra Rhone’s “Real Life” column published October 6, 2022, in The Atlanta Journal-Constitution.
Much of this anxiety is attributable to the pandemic, but, as Rhone points out, anxiety in children from birth to age 17 has been on the rise long before COVID-19.
In fact, she points out, from 2016 to 2019, children’s anxiety increased 27 percent and depression increased 24 percent, quoting data from a study from the National Survey of Children’s Health.
Parents and caregivers have suffered a steady decline in well-being over the past five years, she quotes from that study.
Shefali Tsabary has advocated for a parenting style that dispenses with traditional paradigms featuring control, fear and punishment, Rhone writes. Tsabary has a doctorate in clinical psychology and specializes in blending Western psychology and Eastern philosophy.
“What children really need from parents is not a laundry list of rules, and overload of shame and guilt or feeling silenced and oppressed. Children need to feel seen, to feel worth and to know that they matter for who they are rather than their accomplishments,” Rhone writes from Tsabary’s work.
There is much to unpack here, but suffice it to say that the old way of parenting apparently is not cutting it with kids today. In past decades, parents told kids what they expected of them. They may have even told them how they were going to live their lives as adults. Kids who fought such instruction were considered rebels, or something worse.
When some parents were children, rigor was all they knew. Disappointing Mom and Dad was taboo, even though Mom and Dad wanted them to be something they weren’t, or did not want to be.
Certainly, children need to be taught right from wrong. After all, some things are indisputably right, and indisputably wrong. But today, right and wrong have much gray area between them. Children should be allowed, with perhaps some limitations, to explore that gray area and decide for themselves what, to them, is right and wrong.
Kids should have some freedom to “be kids,” again with appropriate limitations. As they navigate childhood, they will make decisions for themselves AND accept consequences for those decisions.
Some will want to be like their parents. Some will want to be completely different from them as they grow.
If they want to be different from their parents, or what their parents expect from them, it likely is not from a lack of love of parents.
Parents, therefore, should encourage children to be who they want to be, with appropriate warning about the pitfalls of pursuit.
Perhaps that will make them less depressed or anxious. Parental and academic requirements can be overwhelming. Parents should strive to encourage their children, while trying to ease their burdens. Parents may not think burdens on children are a big problem, but they can be bigger than many realize.
Raising children in an atmosphere of encouragement rather than rigor may keep many from developing conditions that can be debilitating for life.
Peter
THINK THE ECONOMY IS BAD? NUMBERS DON’T AGREE WITH YOU
#economy #jobs #GoodEconomy #BadEconomy #EconomicNumbers
The U.S. economy is good, according to the numbers.
Unemployment is low, salaries and wages are rising. Yes, inflation is higher than most would like, but seems to be coming down. Also, most experts say pay increases are outpacing inflation.
Yet, people still believe the economy is not so good, according to media reports.
Certainly, in any economy, there will be some people left in the lurch. Some of them are left behind by their own choosing (they don’t want to work). Many are left behind because juggling child care, a job and other responsibilities is difficult.
At least one day-care center, rather than raising pay for their teachers, is instead providing housing for them. That way, struggling parents won’t have to pay higher rates.
There are specific hardships as well. Tyson Foods is closing several chicken plants in small towns – where it is likely the primary employer — because chicken sales are down.
The post-COVID work world has changed. More people are working from home. Some companies are raising pay rather substantially to get and keep people in their jobs. (That might be one trigger for the inflation numbers.)
People’s feelings about the economy may also be affected by the messaging they receive. Some media outlets don’t want certain people elected to office, so they will keep telling their viewers and listeners that they SHOULD feel that the economy is bad.
Even though numbers may not be what they seem in some cases, except for inflation, the numbers tell a pretty good economic story.
It might make one wonder: why do I not think the economy is good?
Certainly, every person has the power to better their own situations. There are oodles of options out there now that might not be there if the economy really does take a downturn. This economy present golden, if, perhaps, fleeting, opportunities.
Perhaps you don’t like your job. Perhaps your job doesn’t pay enough. In this economy, you can change both of those things by looking elsewhere for employment.
If day care and other life necessities are keeping you from working, perhaps finding something that would allow you to work from home might be an option.
If your skills or job situation doesn’t allow you to work from home, many employers will work with you on your family situation. Most of them need workers. They will do almost anything to keep you, if you are reliable and good at what you do.
Certainly, life and work are complicated. The pandemic exposed many of the vulnerabilities workers can face.
This may be the perfect time for anyone to better his or her situation by checking out options that, perhaps, one may never have thought of doing.
This is the best time in decades for workers. If you work hard, are willing to learn new skills, visit convenient employers to see what they might have available. Most of them are looking for help.
If you like your job, and it works for you, excellent. If not, it’s incumbent upon you to find something else.
Do you still think the economy is bad? Very likely, YOU can do something about it. If you don’t know why you think the economy is bad, perhaps you should re-evaluate where you get your information about it.
Some people in power, when the economy was suffering, would say that if you were not prospering in that economy, it was your own fault. For many, it was not their fault.
Now is the time to take matters into your own hands and find work that you can feel good about. Very likely, it’s out there.
Peter
STRING HAS STRUNG
#string #strung #ties #disarray #TheWorldOnAString #AllStrungOut #DontStringMeAlong
“I’ve got the world on a string.”
“All strung out over you.”
Don’t string me along.
These lyrics or themes from various songs and stories discuss string in its many different and diverse uses.
We think of string as a bonder – something that puts many things together into one.
We think of string as a securer – something that can hold things together.
We also think of it as a dangler, from which an object(s) can hang securely.
In the first lyric, having the world on a string means one is dangling the world securely from his or her hands. Who wouldn’t want to have the world as his or her yo-yo.
In the second lyric, one is in a state of disarray. His or her “string” has unraveled.
In the third theme, one has succumbed to someone else’s string which that person has attached to him or her.
Life can often be characterized by metaphorical string, and how we use it. Do we want to attach others to us? Do we want to dangle the world under the security of our hands? Do we want to unravel and be in disarray?
However we decide to use our “string,” we most often can control it.
We make choices, usually after considerable thought. We accept the consequences of those choices, good and bad.
Regardless, they are OUR choices. Certainly, there are limits to our choices. Generally, if our choices adversely affect someone else, the consequences could be dire.
If they affect others positively, the consequences are usually celebratory.
What we choose and how we choose it (them) are the art and science of living. Unlike other animals, who must do certain things to survive, we empower ourselves to survive by our intelligence rather than our instincts. As humans, we certainly have instincts, some of which are quite powerful and positive.
Other times, we have instincts that produce negative results for ourselves and others. Therefore, we use our intelligence to overcome those negative instincts.
What position would you like your “string” to be in? Taut is usually more preferable than unraveled.
String that is taut can give the holder power. It’s up to the holder to use that power for his or her own good, and the good of others.
Unraveled string creates disarray, and can leave one adrift.
In summary, have your world on a string. Don’t get strung out. And, try not to string others along. Let them follow you because they want to.
Tie up any loose ends. Wrap your world in success, for you and others.
Peter