Saturday, December 11, 2010

ERRP Fails to Stem Rise in Uninsured

The headline read, "City Workers May Drop Coverage."  San Angelo's early retirees are in the same sinking boat as workers.  Retiree-dependent health insurance premiums soared 34% to 58% for the City of San Angelo, an Early Retiree Reimbursement Program (ERRP) recipient. ERRP is intended to keep health insurance premiums more, not less affordable.

The City came up with $318,000 between Council meetings to cushion the $1 million blow. However, 70% of the cost increase was passed onto workers and early retirees. GoSanAngelo reported new rates for retiree dependents (on a high deductible plan):

                                  2010        2011    Percent Increase
Retiree-Spouse      $377.31    $506.64    34.28%
Retiree-Children    $240.26     $342.63    42.61%
Retiree-Family      $435.58     $691.27    58.70%

The City hemmed and hawed on ERRP, keeping City Council members in the dark and completely mischaracterizing the program as "a lottery."

It's akin to stop-loss coverage, which the City dearly counts on.  ERRP funding is not the least bit questionable.  ERRP began accepting claims for reimbursement the end of October and promised a 30 day turn around time for payment. 

The end result is the City will bank 19 months of ERRP funding before sharing any proceeds, while 51 retiree-dependents struggle to keep health coverage.. 

To maximize ERRP funding, the City would work to keep early retirees in the plan, not drive them away with massive rate increases.

Employee-dependent rates also soared.

Employee-Family plans skyrocketed 48% to 58%.  Human Resources brought CHIP applications to their employee "open enrollment" meetings.  The City suggested government health insurance for those now unable to afford their portion of an employee benefit, 280 employees with some form of dependent coverage. 

Given Texas' budget woes, CHIP insurance premiums will likely soar, as well.  That's if Texas doesn't pull an Arizona and eliminate the plan altogether.

One thing is clear.  Employers continue shifting the burden to struggling individuals.  America's legions of uninsureds will grow until 2014.

Update 12-12-10:  Another retiree expects no help from ERRP.  This one is from GM.

Update 1-12-11:   According to a letter sent Wednesday by HHS Secretary Kathleen Sebelius, Department of Labor Secretary Hilda Solis and Treasury Secretary Timothy Geithner, HHS began making reimbursements late last year and as of Dec. 30 said it had paid out about $1 billion.  Has the City of San Angelo received its first check?

Friday, December 10, 2010

Hospital For-Profiteering & Jeb's Windfall

CNBC reported on Community Health System's takeover bid for Tenet Healthcare.  Tenet snubbed the offer, while their stock soared 53%.

Red Jeb Bush's holdings rose to $1.44 million, while Blue Bob Kerrey's topped $1.38 million.  Both serve on the board of Tenet.

Tenet believes the $6 a share offers is inadequate.  In their "Dear Wayne letter," Tenet cites the value of $1 billion in net operating loss carry forward and an expected $320 million federal payment under the HITECH Act.

A CNBC guest expects more buyout activity on the nonprofit hospital side.  PPACA's three year wait for widely expanded coverage should stress safety net hospitals, enabling for-profiteers to buy them on the cheap. 

Should CHS succeed in buying Tenet at the offer price, corporate debt would soar to $15 billion.  Two prior buyouts, CHS-Triad and KKR-HCA,  added over $2 billion in interest expense to America's health care costs.

PPACA sets the table for more greed in health care.  Extrinsic motivators do severe damage to an intrinsically noteworthy mission of healing.  Ignore the curious history of John Ellis Bush at Lehman Private Equity and his appointment to the Tenet Board.  The decade of mean and greedy leaders is far from over.

Update 1-21-11:  Tenet adopted a "poison pill" strategy to defend against the CHS takeover.  Tenet's NOL carryforward somehow doubled to $2 billion.  Note the bad taste in the poison pill defense, given Tenet's 35 patient deaths in Memorial Medical Center after Hurricane Katrina.  While W. sat on his hands, patients suffered terribly, none of which made the White House Lessons Learned report.  Tenet did lobby the Executive Office of the President on corporate governance changes.  The next new board member added was Jeb Bush.

Wednesday, December 08, 2010

San Angelo's ERRP Chickens to Hatch

The City of San Angelo is self insured for employee and early retiree health insurance.  It received approval from the federal government for the Early Retiree Reinsurance Program (ERRP).  From June 1, 2010 to December 31, 2011 the City bears the following risk for early retirees:

$15,000 or less--100% of risk
$15,000 to $90,000--20% of the risk (80% ERRP)
$90,000 to $125,000--100% of risk
over $125,000--0% (stop loss coverage)

The City has three cases where claims exceed $125,000, over $375,000 total.  Stop loss coverage kicked in.  If those are early retirees and all claims came after June 1, 2010, Uncle Sam will reimburse the city $180,000. 

Reimbursement could be thirty days away, the promised turnaround time for paying claims.  Senator Jay Rockefeller (D-WV) stated:

"Since October, companies have been able to submit claims to obtain reimbursement for 80 percent of health care claims in the $15,000 to $90,000 range."

The City counts on stop-loss coverage.  It can count on ERRP funding, but chose not to.  Leaders did say they could conduct a mid-year review based on experience and ERRP chickens hatching.  Rates could even be adjusted.  However, retiree spouses and dependents may drop coverage January 1, giving the City fewer egg laying chickens.

Update:  Thanks to General Dynamics Information Technology in Oakton, Virginia for their interest in this topic.  

Tuesday, December 07, 2010

Cheney's African Graft

Vice President Dick Cheney will not be extradited to Nigeria for trial for crimes occurring while Cheney was Chairman and CEO of Halliburton.  Although bribery charges are associated with Cheney's work prior to serving as Bush's VP, the U.S. will not serve up an ex-Vice President to a foreign country for trial, even to one with an extradition agreement.

Halliburton's facilitating payments policy is at the root of Cheney's trouble.  It stated:

The Company may be required to make facilitating or expediting payments to an official or employee of a government outside the United States, the purpose of which is to expedite or to secure the performance of routine governmental action by such government official or employee. Such facilitating payments may not be illegal under the FCPA and similar Laws of other countries. Nevertheless, it may be difficult to distinguish a legal facilitating payment from an illegal bribe, kickback or payoff. Accordingly, facilitating payments must be strictly controlled and every effort must be made to eliminate or minimize such payments. Facilitating payments, if required, will be made only in accordance with the advance guidance of the Law Department.

Note the difference in directed energy between Julian Assange and Dick Cheney over possible crimes. Oddly, both ordered the release of secret information. "Two crime" Cheney remains free, with his own personal army of Secret Service agents.

Julian sits in a London jail without bail, access to his defense fund or the ability to garner donations. The powerful protect their own, which includes eviscerating challengers.  Assange badly needs help from his friends this holiday season.  Clarence!  Mary!  Zuzu!

If ever deposed, Dick Cheney will plead ignorance, like peers Lord John Browne (BP-Texas City), Tony Hayward (BP-Deepwater Horizon) and Rick Scott (Columbia/HCA-fraudulent billing).  Cheney will settle out of court, like The Carlyle Group and Riverstone Holdings on pension bribery.

The Greed & Graft brothers run in a tight circle.  They have the most amazing comebacks.  Rule #1:  Oligarchs beat blokes.

San Angelo's ERRP: Bank or Lottery?

City Council acted on health insurance coverage.  As a result, early retiree health insurance coverage for dependent spouses will soar from $377 to over $500 per month, at least a 33% increase.

The monstrous burden will occur in 2011, a period when the City of San Angelo will get federal money intended to help early retirees, via the Early Retiree Reinsurance Program (ERRP).  Benefit consultants project ERRP will save retiree plans 25 to 33%.

Why are San Angelo's retiree rates going the opposite direction?  It's the result of a strategic decision to bank ERRP funding for 19 months.  The decision was made outside City Council, given members were unaware of the program.  Human Resources admitted they had not informed elected leaders and City Council minutes bear this out.

When asked why a portion of ERRP funds were not used to offset retiree increases, Mayor Alvin New and City Manager Harold Dominguez stuck to the "iffy" script on funding?  Councilman Johnny Silvas compared ERRP funding to buying "a lottery ticket." 

For those in the know, ERRP is more akin to a bank.  Uncle Sam is shouldering 80% of claims from $15,000 to $90,000.  Funds are coming, soon.  The question is how much?  In that regard, the city has years of experience, six months are directly reimbursable.  I've never seen a lottery ticket with those attributes.

How many of the City's 51 retiree dependents will drop coverage, unable to pony up more than $500 a month?  The irony is this.  The more retirees the City drives from the plan, the less opportunity for ERRP reimbursement.

Retired spouses may have $377 to spend on lottery tickets in 2011, one option for funding future health care expenses.  It's a high risk strategy, but what alternative do they have?

Update:  KLST noted that a family of four would pay $200 a month more for coverage.   The Standard Times live reported on the meeting.  Neither mentioned, much less investigated, the city's weak ERRP assertions.

Monday, December 06, 2010

San Angelo City Council Kept in Dark on ERRP?

Retired Police Chief Russell Smith brought up the Early Retiree Reinsurance Program during public comment on health insurance increases for employees and early retirees.  After the November 16 meeting, Smith followed up with City Council members, two of whom said they never heard of the program.  How could that be, given San Angelo's ERRP timeline?

City representatives signed the ERRP application on July 7, 2010 

HHS approved San Angelo in the first round of announcements, August 31, 2010 (which I reported on)

Standard Times ran a blurb on ERRP approval, September 19

No city council agendas/minutes mention "Early Retiree" or "ERRP" from July 6 to December 7, 2010 (12 regular meeting opportunities)
I began communicating with the City on this issue on August 31.  A follow up phone call in October muddied the water.  Then I saw Russell Smith lament draconian health insurance increases for early retirees, with his ERRP "pin drop" moment.

That agenda item deserved a thorough and clear ERRP explanation by City representatives.  Instead, staff stammered, hemmed and hawed.

Seeking answers, I formally requested copies of the Holmes-Murphy report and the methodology for applying ERRP savings, required in section E of the federal application. 

Nov. 17--requested copy of report
Nov. 29--City sends ERRP application, minus section E1 which states how funds will be used
Nov. 29 (evening)--requested language submitted in E1
Dec. 3--followed up with City representatives, HR busy--maybe Monday
Dec. 6 (evening)--no E1

Note:  the federal ERRP application is electronic, in PDF form, capable of being moved rapidly via the internet. 
The practical outcome, should it stand, means the City will bank 17 months of ERRP funding, before considering what to do with federal funding.  Who made the decision to set aside federal funds for a rainy day, while hail beats early retirees?  When will Section E1 arrive?  Will it be read in Council Chambers tomorrow morning?

"New" money is available to help early retirees.  I hope an honest conversation about the program occurs in the morning.  It should make interesting television.

Update:  No E1 arrived before the City Council meeting.  It was not read to Council members.  ERRP remained a virtual secret until raised by the public.  The City stuck to their "unsure source of funding" line, despite the program accepting claim submissions the end of October.    City Council members had three weeks since Russell Smith raised ERRP to ask questions.  None did.  They claimed ignorance.  As for the missing E1, staff blamed it on a quirky electronic application.  Odd, HHS required a hard copy be mailed in.  Did the feds want an incomplete hard copy?  There's either one layer of government incompetence or we're facing a fractal.  My E1 request remains unfulfilled.  It's a sad state for knowledgeable citizens, who expect all cards on the table when dealing with difficult issues.

Sunday, December 05, 2010

Below the Surface

Sunday morning shows discussed the impact of WikiLeaks, citing government efforts to control and limit information. Fareed Zakaria's GPS hosted diplomat Richard Haas and Harvard's Niall Ferguson.  Ferguson suggested history could be lost, if diplomats ceased to reduce important things to writing.  Haas noted a similar thing happened under Nixon.  Secretary of State Henry Kissinger used circuitous communication methods, with very little official record keeping.

Ferguson compared U.S. debt to Greece, kneecapping Uncle Sam.  It sounded like a line from the latest Bilderberg script, calling for "a new sustainable economic world order, with less sovereignty."  The IMF intervened in Greece and Ireland, imposing draconian debt restructuring.  Given the slate of countries with debt problems, where will the U.S. fall in the global restructuring cycle?

I noted the irony of Haas, Ferguson and Zakaria attending Bilderberg Society meetings.   As the three lamented a loss of history, they participated in secretive, globe manipulating Bilderberg meetings.  Did the three give the secret handshake after the show?  Did they break for lunch, going together for a juicy, rare Bilderberger, piled high with green onions?  We won't know, as the information is on ice.  Chatham House rules.

Saturday, December 04, 2010

Bitter Chill Aimed at San Angelo's Early Retirees

The City of San Angelo faces a political blue norther.  City Council promised to pass 100% of health insurance increases to employees and early retirees at the November 16 Council meeting.  Mayor Alvin New stated there "is no new money," despite the City's qualifying for Early Retiree Reinsurance Program (ERRP) funding on August 31.  When challenged by Retired Police Chief Russell Smith, City leaders' lips froze.  Council will revisit the topic December 7, agenda item #10:

a. Authorizing the City to make the appropriate premium adjustments approved by City Council for January 1, 2011 through December 31, 2011 plan year with Blue Cross/Blue Shield and The Hartford

b. Authorizing the City to discontinue health and prescription coverage for employees/retirees who fail to satisfy monthly premium payments and who are in arrears in excess of sixty (60) days

c. Authorizing the City Manager to execute related contract agreement regarding the January 1, 2011 through December 31, 2011 plan year renewal with Blue Cross/Blue Shield of Texas

(Presentation by Human Resources Director Lisa Marley)

Given the intense public comment during the last meeting, one could expect more information in the packet.  One might expect an explanation of ERRP, its projected funding and intended use.  Hardly, the packet included one memo:

Date: 12/2/10
To: Mayor and Councilmembers
From: Lisa E. Marley, Director of Human Resources
Subject: Agenda Item for December 7, 2010 Council Meeting
Contact: Lisa E. Marley, Director of Human Resources, (325) 657-4221
Caption: Regular Item
Consideration of the following items related to Health Benefits (items a-c listed above):

Summary: At the November 16, 2010 City Council meeting, staff was instructed to meet with
employees to review the health insurance. On December 1, 2, and 3, 2010, a total of four meetings were held. Staff has several options for premium adjustments for the 2011 plan year as well as a recommendation on making necessary plan changes for employees/retirees who fail to satisfy monthly premium payments.
History: In July 2009, RFP# HR 02-09 was issued for proposals on health insurance benefits and RFP# HR 01-10 for pharmacy benefits. With council approval, the City elected coverage
through Blue Cross / Blue Shield of Texas for the 2009 plan year, with subsequent renewals
for three years.
History on item B – The City currently drops employees/retirees who fail to pay monthly premiums from their current plan to the Employee/Retiree Low coverage plan, primarily because the low coverage plan is at no cost to the employee/retiree and further past due premiums will no longer accumulate. The City then goes through the process of collecting past due premiums, many times unsuccessfully, while claims under the low coverage plan continue to be paid by the City.
Financial Impact: Please refer to presentation.
Other Information/Recommendation: There will be no recommended benefit changes to the current low, medium and high health plan coverage. Recommendations will be strictly for premium adjustments.
Additionally, it is recommended that the City drop health and prescription coverage for members that fail to satisfy monthly premiums payments and how are in arrears in excess of 60 days.
Attachments: None.
Reviewed by Service Area Director: Lisa E. Marley, Director of Human Resources, 12/2/10.
San Angelo will bank 19 months of ERRP funding before considering any break to early retirees.  Will Christmas 2011 be as cold?

Retirees had to wonder why Council had the resources to approve a new holiday, Veterans Day, but not a penny for increased medical costs.  What will the next North wind bring those on a fixed income?  So far, it's not honesty or complete information on federal funds for early retirees.  God bless us, everyone!"

BP's Early Lies Help it Tell Another

Attorney Jamie Gorelick continued her risk management crusade on behalf of BP, the world's best polluter.  Chron reported:

BP is challenging the government's estimate that its damaged Macondo well gushed 4.9 million barrels of oil into the Gulf of Mexico last summer, adopting a strategy that could save it billions of dollars in federal fines for the offshore spill.

The London-based oil giant, contending that the government's numbers are "highly unreliable," is poised to argue that as little as half that amount ultimately flowed into the Gulf.

The government estimates "rely on incomplete or inaccurate information, rest in large part on assumptions that have not been validated and are subject to far greater uncertainties than have been acknowledged," BP said in a white paper delivered to the presidential commission investigating the Deepwater Horizon disaster. "BP is confident that a complete, comprehensive and rigorous analysis of the flow issue will show that less — and possibly far less — oil was discharged from the Macondo well."
The government and BP worked hand in hand to manipulate the public on spill size.  BP's early risk management, along with government compliance, set the stage for BP's latest risk management move.  It's Disaster Queen Jamie Gorelick's chess game.  Someone call Tony Hayward to the stand.  That's if he's willing to testify and can fly out of frozen European airports.

Friday, December 03, 2010

Florida's Royal Couple: Scott & Rhee

"Pay for Performance" Queen Michele Rhee joined "Incentive Pay" King Rick Scott in revamping Florida education. Roll back to the 1990's, when Rick Scott turned Columbia/HCA into a giant Skinner Box.  Employees lied, cheated or stole to avoid the shock or garner the pellet.  That's why HCA paid billions in settlement money for fraudulent billing.

Who got Scott off the hook? Michael Chertoff, of Katrina and naked body scanning machine fame. If Scott was a felon, he would not be Florida's Governor.

Pizza Hut's reading program offered pizzas for books read.  It produced many fat kids who don't like to read, Alfie Kohn's early prediction.

Get ready to hear from students and workers, "pay me."  Watch them loathe learning and reluctantly perform (what was once an intrisically motivating job).  See what Scott's education got him.

The Good Lord would be proud of the Royal couple's education reform..

Thursday, December 02, 2010

San Angelo's Marley Chains Early Retirees

San Angelo's Human Resources Director Lisa Marley held a meeting on health insurance changes for employees and early retirees.  Of the attendees, all but two were early retirees.  Retired Police Chief Russell Smith raised ERRP, the Early Retiree Reinsurance Program.  Marley said any monies would not be available until 2012 and that the Council would decide their use.

The timing and use are within the purview of the City Council today.  City leaders agreed to pass 100% of cost increases to employees and early retirees.  Mayor Alvin New stated there "was no new money."   City Manager Harold Dominguez and HR's Veronica Sanchez hemmed and hawed when Smith raised ERRP at the November 16 Council meeting.  The City will bank 19 months of ERRP's new money, before considering how to use the funds.'s Employee Benefit Insider stated:

While reimbursements may be used to reduce either participant or employer costs, it is not clear whether at least some participant cost reduction is required. The preamble states that HHS “encourage[s]” employers to use reimbursements to offset both kinds of costs. 

I believe the City wants to combine employer and early retiree health plans, allowable under ERRP. Given their firm stance of not sharing proceeds until 2012, I believe the City wants to use the funds to cover their portion of future health increases.

What's clear?  The federal government gives, the City takes and not one early retiree gets a break in 2011. Who'd have thought such a thing could happen?

First Jacob, now Lisa.  Add a link to the Marley chain.

Tuesday, November 30, 2010

Podesta's BP Lobbying Blowout

Tony Podesta's BP lobbying revenues rose to $150,000 in the third quarter.  The Podesta Group passed Ken Duberstein's firm, which took in $100,000. 

BP America spent $1.86 million on lobbying in the third quarter.  One issue related to BP's purchase of Azerbaijan energy assets, Caspian Sea gas.

Support the development and export of Caspian gas into European markets.  BP lobbied the Natl Security Council (NSC), State - Dept of (DOS), U.S. SENATE

This sole buy occurred in the midst of massive asset sales.  How will Uncle Sam help BP develop and export Caspian gas to Europe?

BP latest monetization came in Argentina.  China is the beneficiary.

Monday, November 29, 2010

San Angelo's ERRP App

San Angelo's Early Retiree Reimbursement Program application states the intended use of federal funds:

Reimbursement through ERRP will allow the City "to continue to provide the same quality of care without passing on additional costs to its participants."

This flies in the face of the City's plans to pass 100% of health insurance cost increases to employees and early retirees for 2011.  While citing "no new money," the city will effectively bank 80% of ERRP reimbursement.

The full ERRP application is below, for those interested:

PIR - APrest                                                            

City Council plans to act on this item December 7.  Anyone wanting to impact this decision should contact their City Council representative ASAP.

Thanks to San Angelo's Public Information Officer Ty Meighan for this document.

Update 11-29-10:  Section E1 is missing from the above document.  It's not clear if the City failed to fill it out or if something got lost along the way.  I sent a follow-up e-mail to Ty, requesting this portion of the application

E. *Intended Use of Early Retiree Reinsurance Program Reimbursements

1) Please summarize how your organization will use the reimbursement under the Early Retiree Reinsurance Program to reduce health benefit or health benefit premium costs for the sponsor of the employment-based plan (i.e., to offset increases in such costs); reduce premium contributions, copayments, deductibles, coinsurance, or other out-of-pocket costs (or combination of these) for plan participants; or reduce a combination of any of these costs (whether offsetting increases in sponsor costs or offsetting or reducing plan participants’ costs). If necessary to provide a complete response, the sponsor may submit additional pages as an attachment to the application. Please reference such attachment in this space.

Update 1-12-11:  HHS responded to my FOI request.  They received the City's application on July 14, 2010.  The City stated in response to the above E.1 request:

The City of San Angelo is self-insured for health coverage.  Early Retiree Reinsurance Program Reimbursement proceeds will be deposited in a dedicated account for insurance funds.  These funds will then be used to offset increases in premium contributions and increases in participant costs.

Sunday, November 28, 2010

Chertoff's Ethical Irritability

The Honorable Michael Chertoff spoke to students and faculty at the University of Southern California's CREATE Homeland Security Center.  CREATE stands for Center for Risk and Economic Analysis of Terrorism Events.  It has 24 partners, 22 in the U.S.

Chertoff's remarked on emerging security challenges, based on three trends:

1.  Globalization--including travel, trade, finance and communications
2.  Weapons of mass destruction terrorist capability--formerly available to nation states
3.  Ungoverned space--physical territory like Somalia, tribal areas of Pakistan (not financial shadow bankers, deadly Chinese manufacturers or U.S. political corruption)

He believes terrorists are the same threat as former nation state enemies.  The central threat to America comes from Afghanistan, Pakistan and Iran.  Chertoff believes Pakistan's nuclear weapons could fall into the hands of Islamic radicals and a nuclear Iran would use its capabilities or near capabilities for geopolitical leverage.  He noted they willingly armed terrorist groups in Iraq and sees Iran proliferating nuclear material for terrorist use

Chertoff superficially addressed the cargo bombs emanating from Yemen.  He noted planes were the target, not the physical address on the package.  However, he implied that cargo and passenger planes were totally separate, which missed the fact that cargo frequently flies on passenger jets. Why did Chertoff gloss over something he knows deeply about?  Chertoff Group's Jayson Ahern later filled the gap.

Other threats include Venezuela's Huge Chavez, Ecuador's Evo Morales and Nicaragua's Daniel Ortega.  Add Mexican drug cartels, international crime organizations (like FARC) and cyberthreats. While Chertoff charged hard on FARC, he went light on FARC funder, Chiquita Banana.

Michael Chetoff's other hats include white collar crime defense.  He helped Columbia/HCA navigate civil and criminal investigations for fraudulent billing.  Chertoff's work enabled Columbia/HCA CEO Rick Scott to win the Florida governorship in the last election.

Chertoff holds board positions in homeland security contractors, Clear and BAE Systems.   Clear is rejuvenating a subscription service that allows people to jump to the head of airport security lines by submitting to a fingerprint or iris scan.  BAE offers face and iris recognition that works on people on the move. At CREATE, Chertoff noted there are better ways to clear people.

On the need for body scanning, which he pushed in 2005, he said:

"They (terrorists) are counting on the reluctance of people, when they do a search, to really get into those private areas of the body."

Nearly a decade of TSA and how many bombs have they found via screening?  Micheal Chertoff cited one and he clarified that as "bomb components."

Micheal Chertoff declared his conflicts of interest at CREATE.

"Also, so the cynics don't get wound up, my firm has, over time, you know, represented people, advised people in the area of scanning and every other kind of security device you can imagine.  So, you have that disclosure."
The Honorable Michael Chertoff failed to disclose his personal conflicts of interest.  Board slots usually come with salary and equity positions.  Chertoff did not say he held stock in or was paid by Clear, BAE Systems or other homeland security contractor, current or hopeful.  The Chertoff Group had an agreement with BioNeutral, which included equity compensation.  Chertoff Group terminated the agreement in June 2010.

At CREATE, Chertoff lamented "political irritability" and a "poisonous political atmosphere."  He stated he would rise above the din, yet offered a condescending rant which declared no specific conflicts of interest.

Chertoff stated that airline cargo and port containers didn't need 100% inspection, but could be sampled based on risk criteria, i.e. profiling.  Why does that work for shipping but not for people?  He didn't say.

Chertoff suggested providing liability protections for those undertaking risk management.  How might Chertoff Group clients benefit from dumping lawsuit risk?

While Micheal Chertoff has the right to silence on his specific conflicts of interest, citizens have the right to be groped, but not to sue for molestation.

To see the depths of Chertoff's pathology, read his op-ed on Katrina, where over 1,800 American lives were lost.  Michael speaks of Lessons Learned.  Neither he nor Frances Townsend ever answered my longstanding questions regarding the abysmal response or incompetent investigative report.  From my chair, Chertoff lives in ungoverned space, where the powerful protect their own.

Friday, November 26, 2010

For BP Time Was Money

Obama's Oil Spew Commission posted a slide with eight moves BP made to save time at the Macondo well.  Network World reported:

The project had been running late. While the site was not fully functional it was still reportedly costing nearly £1 million every day to operate. 
 The time is money slide sits in opposition to Fred Barlit's comments. 

Time = money
Money > safety
"Who cares, it's done, end of story, we'll probably be fine".  Not...

Wednesday, November 24, 2010

From Katrina to Naked Body Scanners

Former Bush Homeland Security experts Michael Chertoff and Frances Townsend botched the White House response to Hurricane Katrina and follow up Lessons Learned report.  This disastrous duo currently defends naked body scanners and/or genital manipulation for air travelers.  WaPo noted Chertoff's conflict of interest in pushing scanners, as his firm worked for one manufacturer, Rapiscan, a division of OSI Systems.

Fran defended enhanced pat downs and scanners on CNN.  Defending the horrific is Townsend's specialty, evidenced by her Katrina "investigation.".

Back at the White House, the job of monitoring the storm was left to Kenneth Rapuano, Townsend's deputy.
Fran's White House Lessons Learned report was a whitewash.  The public rightly wrote off George W. Bush for his abysmal Katrina response.  However, disgust turned to anger with the September 2008 financial crisis.

President Obama is on a similar trajectory.  The BP Oil Spew is his Katrina.  Oddly, Obama related it to the financial crisis on The Today Show.  It remains to be seen if TSA pornography/genital manipulation rises to that level of citizen outrage.

People who write negatively about or actively protest TSA practices are "domestic extremists."  Recall, that Defense Department technology is eventually used domestically.  What else do Michael Chertoff, Fran Townsend and Rapiscan have in store for citizens trying to hold onto their privacy and dignity?

Rapiscan Systems is a leading supplier of security inspection solutions utilizing X-ray and gamma-ray imaging, and advanced threat identification techniques such as neutron and diffraction analysis. The company's products are sold into four market segments; Baggage and Parcel Inspection, Cargo and Vehicle Inspection, Hold Baggage Screening and People Screening

Flagship products include:

Rapiscan Eagle C02 – performs safe and effective inspection (less than five seconds) of occupied vehicles at sites such as border crossings and facility entrances.

Rapiscan Secure 1000 – built upon the most widely deployed people screening technology, it is easy to use with a durable, modular design for fast set-up and tear-down in one hour or less. The system is ideal for high security environments because both organic (i.e. solid and liquid explosives, narcotics, ceramic weapons) and inorganic (i.e. metal) materials are apparent in the image.

Rapiscan MobileCheck – a complete checkpoint that integrates people screening and hand luggage screening in a single easily relocated, rugged ISO container.

Metor 300 Portable – is a reliable, durable and versatile security solution for both temporary and permanent security checkpoints. With enhanced discrimination features, it is well suited for the security screening of large groups of people and ideal for outdoor use.

It's harder to follow the money, when firms don't register as lobbyists.  As for declaring conflicts of interest, that's so passe.  The next phase of Airport Security, buying verified ID chips, also points back to Katrina.

What will they do for us next?  Not much, unless you need White Collar Defense or Corporate Risk Management.  Chertoff got Columbia/HCA's Rick Scott off on criminal charges, setting up Scott's Florida Governorship.

Michael Chertoff isn't watching the common man's back, not in the least.  If Fran ever needs help for her Katrina malpractice, Chertoff is the man to call.

Update 3-27-11:  I recently served my civic duty, spending the day as potential juror.  The case involved sexual assault.  The prosecutor said any unwanted touching of the genitals, even over clothing, constituted a felony.

Update 5-3-11:  Will the shooting death of Osama bin Laden end the molestation of Americans in airports?  Apparently not.  That's one story, that unfortunately, won't change.

Update 5-6-11:  Fran Townsend effusively praised President Obama.  Did she pave the way for a possible appointment?  Fran also said, "The war is by no means over."  Rapiscan.

Update 5-24-11:  The Texas Legislature almost held federal officials accountable for unwanted touching of citizens' genitals.  Radio host Alex Jones raised Cain after the Texas Senate backed down.

Update 5-25-11:  Carlyle Group affiliate ARINC stands to make money from the travel security mess via its CrewPASSM Screening Solution.  Recall many federal officials and elected leaders get to bypass TSA screening.

Update 6-29-11:  After being radiated by TSA workers at risk of cancer, passengers can go through Carlyle Group self boarding gates.  It's not clear what exception Fed Chief Ben "Bypass" Bernanke will get at the gate.  Maybe, he'll get a personal escort, but not the Dominique Strauss-Kahn kind.

One Single Isolated Incident

Senior administration officials hit Capital Hill to explain enhanced security measures, including naked body scanners and genital manipulating pat downs.  CNN reported:

"I feel bad for the girl they put in front of 50 people when they were doing a pat down," said one Republican senate staff member about the female TSA employee who was part of the demonstration, reflecting the concerns of many passengers about being touched in their private areas by security agents.

A Congressional staffer noted the public's focus on one single isolated incident. :

For all the things they are trying to do to get the word out, one single isolated incident gets a lot more press than all the efforts they're trying to do.

The staffer didn't elaborate on the single incident, of which there have been many.  So far, there's only one underwear bomber.  In that single isolated incident, his parents notified authorities of their son's terrorist status.

Note:  No Congressional staffer experienced an enhanced pat down.   Did any publicly object?  If so, we might have a domestic extremist in the U.S. Capital.

Tuesday, November 23, 2010

Leadership by Example on Enhanced Pat Downs

I've yet to hear a elected official, government representative or expert say they've experienced "enhanced pat downs" citizens are getting in America's airports.  Those yet to be molested (or to share their experience of having their genitals fondled) include:

President Barack Obama
Secretary of State Hillary Clinton
Frances Townsend
Michael Chertoff

I believe citizens traveling for Thanksgiving are on a pilgrimage, one as dignified as work performed in the U.S. Capital Building.  Therefore, I ask that C-SPAN show every member of Congress going through an enhanced pat down.  After TSA molests members of Congress, it can head over to the White House.  Leadership by example, it'd be a nice change. Tell the Obama girls they can keep their shirt on.

Update 11-23-10  Congressman Ron Paul (R-TX) said he experienced the enhanced pat down and was crotch grabbed.  Instead of knee implants, Paul should carry a diplomatic pouch.  Those don't get fondled.

Sunday, November 21, 2010

December Wind Unkind to City Retirees

Nearly one year ago, San Angelo's City Council discussed wellness initiatives and employee/retiree health insurance.  These topics were reflected in the December 1, 2009 minutes.

Wellness initiatives relate to the CareHere LLC proposal to operate the employee health clinic.  City staff cited the health risk assessment as a key reason for recommending CareHere.  One year ago, HR Manager Lisa Marley reviewed "how the clinic could be used to promote wellness initiatives."

Mr. Dominguez disclosed as staff develops the wellness initiative, it is highly likely that the City may move towards rates based on wellness initiatives. Therefore, rates would be based on the health and condition of the employee. Mr. Dominguez provided an example how a reinsurance provider may set a higher stop loss amount on an individual, increasing the City’s liability for that particular employee from $150K to $250K based on claims experience.

The second relates to health insurance and any baseline number.  Mayor Alvin New and City staff said on November 16, 2010 they can't spend a penny more than $6.4 million.  Last December:

Mr. Dane informed the City’s budget for the self insurance health fund is $7.2M and the retiree portion of that amount is $1.5M.  

Mayor New noted the city's good experience under the health plans at the recent Council meeting.

2011 budget (city portion)--  $6.4 million  
Additional employee/early retiree portion-- $1 million
2011 budget total-- $7.4 million
What accounts for the $800,000 difference?  That wasn't addressed at the recent meeting.  Last year, the City tried to pass $800,000 in costs to retirees and permanently cap the City's contribution at a fixed amount.

Mr. Dominguez noted the proposed plan would take three years to recoup related expenditures under the proposed benefit. By adoption of this plan, he informed changes will cover the self-insurance fund $680K shortfall and add an additional $289K to stabilize the fund balance. He advised by freezing the Per Employee (or retiree) Per Month rate (PEPM) at $332.22, any future increases would be covered by the retiree.

What Council declined in 2009, Mayor New and City Manager Harold Dominguez operationalized in 2010.  Albeit, Dominguez found money to help with health insurance increases (August 3, 2010 minutes):

City Manager Harold Dominguez explained the $318K health insurance proposed amount would allow the City to buy down the employee’s contribution amount, thereby keeping increases as low as possible.
A "no new money" wind blew into Council Chambers on health insurance.  It echoed hollow, given the City's acceptance into the Early Retiree Reinsurance Program (ERRP).  City Consultants, using the same claims experience cited by City Manager Dominguez, project $650,000 in reimbursement for early retiree claims from June 1, 2010 to May 31, 2012.

ERRP funds associated with 2010-2011 total $515,000.  That money can be applied toward the $1 million shortfall.  Keeping insurance coverage affordable for early retirees is the aim of the federal program.  ERRP arrived at the wrong time for City leaders, intent on implementing long range plans.  That's why leaders stammered and stuttered when challenged by Retired Police Chief Russell Smith.

City leaders plan to bank ERRP funds for 19 months before using any savings to offset their portion of increases.  That may be the only clear thing in this turbid issue.

Saturday, November 20, 2010

San Angelo's ERRP Bank

The City of San Angelo's estimated Early Retiree Reimbursement Program Savings are pictured below.  They cover a two year period, June 1, 2010 to May 31, 2012.   Data comes from several sources, city officials and national benefit consultants.

Holmes-Murphy (San Angelo City HR data)
Low --  $193,836
Expected  --  $653,404
High --  $805,819

Hewitt Associates (national projections)
25% of early retiree plan --  $841,935
$3,000 per retiree @250 under 65 retirees --  $750,000
The five projections can be seen in the blue bars.  The City will bank 80% of ERRP funds before sharing any savings with early retirees or employees.  This is represented by the red bars.

There is "new money," contrary to Mayor New's assertion. The City is choosing not to use it until 2012.

San Angelo's Square Dance with Early Retirees

In the last City Council meeting, Mayor Alvin New choreographed his health insurance moves.  New said he wanted to recombine the City's two health insurance plans, one for current employees and the other for early retirees.  GoSanAngelo reported:
A a year ago ..., when the council voted to split retirees and employees into two separate insurance pools to help the city comply with a federal law. That split resulted in higher insurance premiums for retirees this year.

Retirees face a second year of premium increases under the proposal.  It's not clear from the public presentation how much of the $1 million increase comes from the employee vs, early retiree side.

On August 31, 2010 the City learned of its acceptance in the Early Retiree Reinsurance Program.  Consultants project ERRP reimbursement of $650,000 over a two year period. speaks to the issue:

Q.  Can retiree-only plans participate in the ERRP?
A.  Yes. The Affordable Care Act does not prohibit retiree-only plans from participating in the ERRP, provided the employment-based plan and its sponsor satisfy all applicable requirements.
The City's having two plans could be a constraint under ERRP.  Guidance states:
(F)or purposes of ERRP, a sponsor may consider multiple health benefit arrangements as one employment-based plan, unless (1) it is clear from the instruments governing an arrangement or arrangements to provide health benefits that the benefits are being provided under separate plans, and (2) the arrangement or arrangements are operated pursuant to such instruments as separate plans.
Until the two plans are combined, the City may be constricted in using ERRP money outside the early retiree plan.
(F)or purposes of ERRP, a sponsor may consider multiple health benefit arrangements as one employment-based plan, unless (1) it is clear from the instruments governing an arrangement or arrangements to provide health benefits that the benefits are being provided under separate plans, and (2) the arrangement or arrangements are operated pursuant to such instruments as separate plans.

Q.  If a sponsor combines plans during or at the end of a plan year but after it has submitted its application to participate in the program, does the sponsor have to submit a new application?
A.  If plans are being combined into an existing plan that has been certified for ERRP purposes, the sponsor should not submit a new application. The sponsor will need to make HHS aware of the change in plan structure through a process that will be developed and announced by HHS.

ERRP funds have to used to stem cost increases inside the approved plan.  This makes the City's stated use of ERRP funds in the HHS application critical.  That information should be made public.

It's clear City leaders want to hold onto ERRP funding until 2012.  The Mayor's desire to combine the two plans could be driven by the aforementioned information.

Separate..., Combine...,  Do-Si-Do.  Watch to see what New calls next..

Federal Health Money Displaces Local Funding

The City of San Angelo joins Tom Green County in using federal health money to displace local funding. Tom Green County's Indigent Health Care Program leverages Upper Payment Limit (UPL) monies, while the City has Early Retiree Reinsurance Program (ERRP) funding. Both substitute federal dollars for local.

I had the opportunity to ask Mayoral candidates about health care in October 2009:

Jesus healed the people, not just his people. Health care reform legislation is front and center. Yet, national solutions to Texas’ legions of uninsured are at least four years away. Texas passed New Mexico as having the most uninsured years ago, clearly a badge of dishonor. In Tom Green County 23,000 people have no health insurance coverage. The vast majority reside in San Angelo. That data came from 2006, when our local unemployment rate was 4%. It’s now 7%.  How many are uninsured today? 25,000. 30,000?

The uninsured are at greater risk for debilitating deterioration from chronic disease, even for early death. Our country stands by as tens of thousands die every year, merely from their lack of health insurance coverage. Yet, at a recent candidate session held by Bishop Michael Pfiefer, health care was not identified as a critical local issue.

Congressional Budget Office projections show 25 million people remaining uninsured in 2018. San Angelo could have 14,000 without coverage, even five years after reform is implemented. This large problem is not going away in the coming decade.

The City has a health department and an employee health clinic. It distributes Community Development Block Grant money. Past CDBG funds supported primary care for low income residents. Shannon Medical Center, Community Medical Center, Esperanza Health Centers, ASU’s School Based Clinic, and the Tom Green County Indigent Health Care Program are your potential partners in making San Angelo a healthier place. Where is health care on your radar? What plans do you have in this arena?
Candidate John David Fields actually spoke to health care and the city's role at the WTOS Candidate Accountability Session.  Every other candidate showed a lack of interest or knowledge.  Alvin New fit into the lack of interest category, at least in my recollection.

The Mayoral pool presaged the City's ongoing abdication in the health arena.   Under New's leadership, Social Services joined other eliminated services, Primary Care Clinic (for public), and the City Pharmacy (which once housed pharmaceutical assistance).  All shifted to the private sector.

City leaders recommend contracting the employee health clinic to CareHere LLC.  City Manager Harold Dominguez noted two CareHere employees once worked for the City.  One set up the City's employee health clinic.  The other later ran it.  While CareHere approached the City, it's hardly the only company running occupational health clinics.  How many bids did the city get?

The City plans to pass 100% of health insurance cost increases to early retirees and workers.   Employees and retirees alone will fund the $1 million health insurance increase for 2011.  The City of San Angelo plans to save a projected $650,000 in ERRP funding for 2012.  Leaders will bank 19 months of ERRP funding before sharing any savings with early retirees and current workers.

Health care is a target on local radar, where federal monies displace local dollars.  County Judge Mike Brown is on record suggesting indigent health is a Medicaid, not county, responsibility.  Mayor Alvin New said "there is no new money" for City health insurance for 2011, completely ignoring ERRP.

Bishop Mike Pfeifer called government leaders together in September to discuss collaboration, doing so after sitting next to Mayor New during a flight  The Bishop spoke to the plight of the least of these, as he continues to do.

Currently, the City has 1,211 policies covering some 1,400 people.  How many will there be after the New Year?  How many dependents will join the ranks of San Angelo's uninsureds?

The City shed 100 dependents through greater cost sharing, during my time with San Angelo's Health Access Coalition.  State changes saw Tom Green County's CHIP enrollment fall nearly 50%.  Representative Drew Darby expects more CHIP cost sharing, the very thing that caused rolls to plummet.

How much pain will Round Two bring?  I hope Bishop Mike's Justice Lady is watching.

Friday, November 19, 2010

Early Retiree Posse Will Arrive in 2012

It suddenly became clear why San Angelo City leaders didn't want to discuss Early Retiree Reinsurance Program (ERRP) funding from the federal government during the last City Council meeting.  The light dawned as I read Health and Human Services' (HHS's) statement regarding ERRP:

“For example, for a sponsor that pays a premium to an insurer, if the premium increases, program funds may be used to pay the sponsor’s share of the premium increase from year to year, which reduces the sponsor’s premium costs.”  

The City can use ERRP to pay its portion of premium increases. The City's doing 0% this year, passing 100% of increases to those covered.  Thus, ERRP is off the table.

The City wants ERRP funds to go toward its premium increases, not those passed through to workers or early retirees.  This explains their abject silence, until Retired Police Chief Russell Smith broached the topic.  Once challenged, city leaders stammered and stumbled over ERRP.

Help is available for City employees and early retirees, a projected $515,000 between June 1, 2010 and December 31, 2011.  The City plans to bank 19 months of ERRP reimbursement, before offering improved benefits or decreased premiums.  It seems San Angelo's HR Manager Lisa Marley spoke prematurely, nearly a year and a half early.

The current ruse for not applying a portion of the expected reimbursement in 2011 is a "lack of clarity" regarding qualifying claims.  HHS conducted two webinars on the topic in October. Did the City have anyone participate?

The city remains evasive and non-forthcoming on this issue.  I have compassion for them.  It's hard to publicly state, "we got a gift from Uncle Sam and only wish to apply it toward our share of premium increases."  That could make early retirees angry.

Paid local leaders are clear in their position and show no signs of budging.  How might elected members and religious leaders react?  We'll find out November 30  December 7.  (Two weeks in "City Council time" can be three weeks)

Thursday, November 18, 2010

ERRP Saving for a GASB Day?

San Angelo City leaders said "there is no new money," in regard to health insurance plan increases.  Their charge was:

All 2011 plan cost increases must be passed through to employees and retirees. 

When challenged by Russell Smith, retired Police Chief, about Early Retiree Reinsurance Program (ERRP) funding, the range of responses included

"I don't have those numbers"
"There is not clarity"
"These things are hard to predict"
"When one time funds go away, you have problems"

Yet, the City has projections from Holmes-Murphy on expected ERRP funding for retiree claims after June 1, 2010.  That's new money.  City Manager Harold Dominguez bragged about Holmes-Murphy's expertise when introducing the agenda item.  Yet, Holmes-Murphy didn't speak at the meeting, nor were their ERRP projections shared with the public.  Kiah Collier of the Standard Times followed up with HR's Veronica Sanchez.

"Because there's so much uncertainly with it, we hate to count on that reimbursement prematurely."
I can't think of a program with less uncertainty.  The City will receive 80% reimbursement for early retiree claims between $15,000 and $90,000 until $5 billion runs out.  The City will bank 19 months of ERRP funding, before pondering sharing any savings with employees/early retirees.  That's $515,000 at Holmes-Murphy's expected amount, a major dent in the $960,000 increase being passed on to workers/retirees.

The City's wants to share ERRP savings in 2012, mashing two years of assistance in one.  This aggravates the problem of "one time funds."   ERRP is expected to run out of money in 2012.  Just as the city is ready to share, the program could be gone. 

Consider the City's position when it received ERRP funding:

“It will either be a better benefit or their premiums can be lowered. Those are the two choices we have to use the funds for,” said the city’s Human Resource Director Lisa Marley.

The benefit is the exact same, not better.  Premiums aren't lowered.  They are going up, even skyrocketing.   The countdown is on, given City Council will make a decision on health insurance at its next meeting.  Will the City remain evasive and non-forthcoming on ERRP and its intended use of the funds?

The City's 2009-2010 budget stated:

As a result of GASB 45, the City is required to fund other post-employment benefits anticipated to be provided to current and future retirees. The City’s unfunded liability is substantial. The budgeted amount to fully fund the liability on an annual basis is in excess of $2 million dollars.
ERRP funding could put a dent the City's GASB obligations. Will the feds allow it?

How many workers and early retirees will drop health insurance as a result of the changes?    While working with San Angelo's Health Access Coalition, I watched City employees drop unaffordable coverage for 100 dependents.  I saw CHIP enrollment plummet when the State increased premiums and deductibles/co-pays. 

What happens when a program intended to keep people covered does the opposite?  That may be the real world application of health reform under PPACA.  While Uncle Sam stumbles forward to help, others walk away.

Wednesday, November 17, 2010

San Angelo's ERRP Remains Cloudy

Standard Times reporter Kiah Collier followed up with Human Resources on ERRP funding.  She wrote:

The city HR department says it simply does not know yet how much it will receive in reimbursements from that program.

Estimated ERRP reimbursements come from Holmes-Murphy, the City's health plan consultants.  They used prior claim experience for their calculations.  This is like projecting future tax revenue based on prior collections.   If the City applied the same logic on taxes or expenditures, the Finance Department couldn't prepare a budget.

Kiah continued:

It (City of San Angelo) does have a projected or estimated amount, but even if it does end up receiving anything, it will likely use those reimbursement to offset any increases in the 2012 health insurance plan - not the 2011 (upcoming year) plan.

I just called Veronica Sanchez with the HR department and she said, "Because there's so much uncertainly with it, we hate to count on that reimbursement prematurely."
The City is eligible for federal reimbursement for retiree claims as of June 1, 2010.  The first reimbursements to sponsors, like the City, were expected to be deposited in October.  That's last month.  Has the City or Blue Cross/Blue Shield gotten an ERRP check yet?

Program funding is expected to last two years.  When the city is ready to share any savings with retirees, ERRP will likely be out of money.

There is no uncertainty in reimbursement under ERRP.  Early retiree claims between $15,000 and $90,000 after June 1, 2010 are reimbursable. Checks for 80% of those costs will be cut.  The question is how much?

The City was accepted in the first round.  Why hold onto 18 months of reimbursement, before sharing a nickel with plan participants?  ERRP's aim is to keep insurance affordable, especially for retirees.  Hewitt Associates projected a 25 to 35% savings within any retiree healthcare program.  That's $2,000 to $3,000 per early retiree.

I spoke to Veronica several times on this issue.  The numbers changed each time.  Local data doesn't align with national projections.  I'm sure much of it is explainable.  However, for citizens to understand, the city should share their ERRP application and Holmes-Murphy report.

City leaders have been evasive and nonforthcoming on this issue.  That should concern citizens, as well as retired and current employees.  The Standard Times is in a position to press leaders to be more open and accountable.