New Jersey Should Approach Health Insurance Exchanges ...

Commentary ? By Paul Tyahla on March 30, 2012 at 7:56 AM

Poonam Alaigh MD, MSHCPM, FACP
Board of Directors, Former Commissioner of the Department of Health and Senior Services

We, in the state of New Jersey under the leadership of Governor Christie, continue to implement provisions of health reform law as deemed appropriate to improving the health of the people of New Jersey. One such provision is creating a health insurance exchange, which is a marketplace for individuals and small businesses to buy state-approved insurance policies. The goal is for these exchanges to provide individuals and small businesses with a ?one-stop shop? to find and compare affordable, quality private health insurance options. Currently the federal law requires that each state have an exchange, offering the opportunity for states to create their own, providing subsidized insurance options for individuals up to a FPL of 400%. We estimate a minimum of 500,000 New Jerseyans buying insurance through the exchange, with a potential of 150,000 people transitioning from the employer sponsored health plan coverage to the insurance exchange. The administration has been evaluating this, seeking input from community and industry stakeholders, and last month was awarded $7.67 million in Level One exchange grants from HHS. In addition, last week the legislature passed a bill that would create a health insurance exchange in the Garden State in anticipation of full implementation of the Patient Protection and Affordable Care Act with key components that include an active exchange, a governance structure and a basic health plan or ?optional Medicaid expansion?.

As we decipher our current environment, it is important for us to recognize that there are some factors affecting our position and decision in the state. Firstly, our state already has two ?mini-exchanges?- the Individual Health Coverage Program Board and the Small Employer Health Benefits Program Board. Both are ?in but not of? the Department of Banking and Insurance. We will have to develop rules that will help the integration and interaction of these exchanges with the state-wide exchange. Secondly, creating a new system to administer the federal requirement will be costly and time-consuming, so we will have to identify ways to make the process effective and efficient. Although the federal government will pay for exchange start up, state exchanges will have to fund their own administrative costs starting in 2015. Our state is still working with actuaries to estimate the cost, but Rhode Island received the first Level Two Exchange Establishment grant in November 2011, of $58.5 million to fund the development, design, and technology procurement of the Exchange through December 2014. Another aspect to consider is whether the state should set up a ?passive? exchange, which simply acts as a clearinghouse, or an ?active? one that would allow the exchange to be the purchaser and negotiate its rates. While we assess this, it is important to recognize that the active approach will require significant resource allocation, and the possibility of duplication and redundancy of governmental and regulatory functions. Finally, The United States Supreme Court will later this month, consider a lawsuit challenging the federal law that requires the mandate with a decision widely expected to be issued by the end of June.

The clock on that deadline is not as close to midnight as initially interpreted to avoid a federally operated health insurance exchange in our state. With all these confounding variables in this current environment, the Governor should approach the next steps in creating the state health exchange carefully. Most importantly, waiting to see the U.S. Supreme Court ruling in June, before seeking the additional grants that New Jersey will continue to be eligible for until the end of 2014. If the lawsuit to overturn the PPACA is successful, then the governor?s administration would have wasted valuable resources building a program that will not be put into place.

As a physician, previous health insurance executive and the former commissioner of health, I know that our collective goal remains to ensure access to high quality healthcare to all New Jerseyans. The state including the policy makers, legislators and the Governor should carefully assess and evaluate all these factors before intuitively reacting and embarking on an effort that may be futile. While waiting for the Supreme Court decision, we should continue our due diligence on creating the best state operated health insurance exchange for our state, which is void of bureaucracy, administrative duplication and red tape. Having worked personally with many of the stakeholders in this domain, I am confident that we will continue to have these healthy debates, while finally reaching consensus on the best approach for our collective New Jerseyan community.

Related posts:

1. In Need of Healing: Medicaid and the New Jersey Budget
2. Federal Healthcare Law Only Adds Urgency to Need for Medicaid Reform
3. Judge Finds Budget Cuts to School Districts Unconstitutional
4. Medicaid Safety Net Needs Mending

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Kansas, Ohio State meet in 'The Other Game'

Kansas head coach Bill Self passes a ball during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Kansas plays Ohio State in a semifinal game on Saturday. (AP Photo/David J. Phillip)

Kansas head coach Bill Self passes a ball during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Kansas plays Ohio State in a semifinal game on Saturday. (AP Photo/David J. Phillip)

Ohio State head coach Thad Matta walks watches his team during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Ohio State plays Kansas in a semifinal game on Saturday. (AP Photo/David J. Phillip)

Kansas forward Thomas Robinson catches a pass during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Kansas plays Ohio State in a semifinal game on Saturday. (AP Photo/Mark Humphrey)

Ohio State center Trey McDonald (55) slam dunks during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Ohio State plays Kansas in a semifinal game on Saturday. (AP Photo/Mark Humphrey)

Ohio State players run a drill during a practice session for the NCAA Final Four basketball tournament Friday, March 30, 2012, in New Orleans. Ohio State plays Kansas in a semifinal game on Saturday. (AP Photo/Gerald Herbert)

NEW ORLEANS (AP) ? Welcome to "The Other Game" at the Final Four.

OK, so, the Ohio State-Kansas matchup may not have the fantastic freshmen, the outspoken coaches or blood-feud story line of the opening semifinal between Kentucky and Louisville. But this one still should be worth a two-hour investment in front of the TV set Saturday night.

Besides the chance to watch two top-line teams play for a spot in the national title game, the Buckeyes-Jayhawks game offers a rare opportunity to see two All-Americans going at it with everything on the line.

Ohio State is led by Jared Sullinger, the sophomore forward who missed the first matchup between these teams with a bad back. Kansas' best player is Thomas Robinson, who had 21 points and seven rebounds in the Jayhawks' 78-67 win on Dec. 10.

"In my eyes, he's the college player of the year," Sullinger said of Robinson. "I know some think different. But with his season, the way he took his team to the top, you've just got to give it to him."

In fact, it's Kentucky's Anthony Davis who took player of the year awards from The Associated Press and college basketball writers Friday. But while Davis is a story of an ultra-talented freshman trying to lead his team to a championship in what likely will be his only year with the Wildcats, Sullinger and Robinson approach college in a different way.

At one point last season, Sullinger was viewed as a surefire lottery pick, a one-and-done prospect with nothing much left to prove in college. He never saw it that way, however, and when Ohio State was eliminated from last year's tournament as a No. 1 seed, the 6-foot-9 forward committed to staying in college.

"I wanted to make a statement, that not everybody is using college basketball as a pit stop to go the next level," he said. "That there's more than money and endorsements. There's championships that you've got to win at every level. That's what I pride myself on. I've won a championship all the way from elementary to now. I pride myself on winning. That's the biggest thing. That's why I came back."

"Pride," was also one of the first words Robinson used when asked about his decision to return for his junior year.

He spent most of his first two seasons playing limited minutes behind the Morris twins, Markieff and Marcus. NBA scouts were telling Robinson he could be a first-round draft pick if he left.

"It was a pride issue," Robinson said. "I didn't want people to guess and be like, 'I think he can play. We've seen glimpses.' I wanted to come back and prove to everybody that I'm a good player."

He did. Widely viewed in the preseason as a player who might nudge his way onto some All-America lists, Robinson outperformed the predictions. He averages 17.7 points and 11.8 rebounds a game and is learning the difference between coming off the bench as a role player and leading a team.

"Guys can be prepared to get a check, but I'm not sure they're all prepared to make a living," Kansas coach Bill Self said. "Thomas wasn't prepared to make a living. I mean, let's call it like it is. He never had to carry the water. To me, it wasn't a hard decision. He needed to show everybody and himself that he was a guy who could make plays to impact a game."

While Kentucky coach John Calipari, never one for understatement, said he thinks Game 1 will be played in the 90s, Las Vegas oddsmakers disagree. The over-under for Louisville-Kentucky is the exact same as it is for Ohio State-Kansas: 136.5. The Buckeyes are 2.5-point favorites over Kansas ? a sign of how big a difference Sullinger and a neutral court mean in the eyes of the "experts."

Of course, both teams have changed considerably over the past three months.

"Guys were still finding their own way. Guys were trying to define their own role to the coaching staff," Ohio State coach Thad Matta said of the December meeting. "Eventually it hits and guys say, 'OK, this is what I need to do.' I know that has been a big thing for us."

The game has other intriguing matchups, namely how the rematch between guards Aaron Craft of Ohio State and Tyshawn Taylor of Kansas will play out. In the first game, Taylor had 13 assists despite playing with a bulky brace on his knee. Craft had 11 points and six assists.

"From December 10th until now, I think I'm a completely different player," Taylor said.

There's also the coaching matchup of Self, who snapped a 20-year title drought at KU in 2008, against Matta, who restored Ohio State's program after the scandal of the Jim O'Brien era.

These are two programs with 62 wins this year and 24 Final Four appearances overall between them.

Some undercard, huh?

Ever the well-spoken diplomat, Sullinger naturally said he appreciated the intensity of Louisville-Kentucky.

"Two great coaches, two great basketball teams that are playing very, very well right now," he said. "But we can't focus on that game. Because if we overlook Kansas, we'll be packing our bags up and heading home."

Associated Press

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Dave Saldana: Journalists Participate in Democracy; Gannett Cowers

You really have to hand it to right-wing media hounds. They've gotten so good at bird-dogging the media that they don't even have to raise their alarm of faux outrage and trumped up claims of bias anymore. Now, so fearful are the once-great bastions of journalism of the mere accusation, that they hound their own.

See, for example, the Wisconsin newspapers of the Gannett chain, which Monday offered mea culpas for their 25 employees among the million-plus Wisconsinites who signed the petition to recall Gov. Scott Walker.

In virtually identical columns, allegedly authored by the local editor, each of the Gannett Wisconsin papers takes great pains to say, with slight variations in verbiage, that "none of the [...] employees who signed petitions are involved with reporting or editing or assigning political coverage."

Nonetheless, the editors accuse these staffers of ethical violations and subject them to disciplinary measures. (Romenesko asks whether claiming authorship for someone else's work is also unethical in Gannett's world. Will the editors face discipline as well?) In doing so, they claim:

The principle at stake is our belief 'that journalists must exercise caution and not become involved with issues that may cause doubts about their neutrality as journalists.' Engaging in political activity is foremost. That belief is even more critical in an era when journalism is under a microscope and our credibility is routinely challenged.

Leaving aside the false, quaint conceit that journalists are neutral, there you have a tacit admission that this action was motivated not by some high standard of journalism ethics -- higher than any news organization I ever worked for; I was always permitted and encouraged to participate in the democratic process -- but by fear that some political bullies might call them biased.

So routinely is every news outlet's credibility challenged that the accusation of bias is no more bothersome than ants at a picnic. Republicans, and conservatives in general, make it a routine part of their game plan, even though they've admitted it's a disingenuous ploy they use to escape blame for their own shortcomings.

But, O! The top levels of management at Gannett quake at the thought that professional name-callers might taunt them.

They assert that "journalists must make every effort to remain neutral and impartial when reporting or presenting the news. Journalists must go to extra lengths to guard against even the impression of favoring a candidate or a position."

That's true. That's why reporters are hired for their ability to report fairly on the issues, regardless of their personal politics, and editors are hired to ensure that they do. Does Gannett not have employees capable of doing so? And if that's the case, why are they still employed? And why are the people who hired them still employed?

But wait -- didn't they just say that none of the people who signed the petitions were involved in reporting on or assigning politics? If not, why are they somehow suspect? How do the acts of those uninvolved in political coverage impact the political coverage?

Granted, taking a position on an issue as contentious as recalling Walker is a political act. Signing a petition is clearly taking sides. But then, so too is choosing not to sign a petition. Are those staffers who did not sign because they support Walker and oppose the recall effort also facing disciplinary action? And if not, how does Gannett rationalize that choice? Because clearly any staffer who did not sign is presumptively a Walker supporter and can't be trusted to report fairly on the issues, right?

Given the choice, I'll take a reporter who owns up to her opinions over one who hides behind a fake veil of "objectivity."

While Gannett blithely allows that its employees have the right to vote, it differentiates here because the petitions are public record. Their staffers, accused of a career-threatening lapse of ethics, disagreed. "They equated it to casting a ballot in an election or simply calling for an election," Gannett wrote. "That rationale might work in an academic debate, but we do not make that distinction."

Actually, that rationale might also work in a court of law. Wisconsin Statute 103.18 holds, "No person shall, by threatening to discharge a person from his or her employment or threatening to reduce the wages of a person [...] attempt to influence a qualified voter to give or withhold the voter's vote at an election."

If I were one of the 25 Gannett Wisconsin employees singled out for discipline for participating in the democratic process and publicly accused of unethical conduct, which could substantially harm my prospects for employment and future earnings, I might consider whether Gannett has violated Statute 103.18 and defamed me in the process.

Many supporters of Gannett's public flogging have blamed the victims here, claiming the staffers knew that they were in the wrong, because they "signed a contract" that abnegated their rights and duties as citizens. But as any first-year law student could tell you, a contract that violates public policy or statute is void. You cannot be coerced into surrendering your rights as a citizen in order to receive a paycheck.

Gannett's handwashing ends with a finger-wag at the accused: "The super-charged emotions alone should have been a red flag to the journalists who signed the recall petitions. [...] They should have realized there would be a public backlash resulting from this lapse in judgment."

It takes real chutzpah to tsk-tsk your employees even as you cowardly, preemptively attack them for exercising their rights while admitting you did it because you were afraid that people might call you names.

But if backlash was what you feared, Gannett, I'd recommend you avoid reading the comments to your self-serving columns. Given the overwhelming support for your employees and their rights, you may have to find someone else to throw under the bus.

?

Source: http://www.huffingtonpost.com/dave-saldana/gannett-newspapers-walker-recall_b_1380983.html

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Small Business Friendly Hosting, Domain Registration, Web Design ...

Getting British Business Online You might have come across GBBO ? an initiative through Google, Enterprise UK, BT, e-skills UK and many other partners to help small businesses create their first website and understand the opportunities offered by the Internet. This is a really good scheme to get you started ? for NOTHING Initial free hosting, web design ? the whole works. Now, thats fine if you have the time and the inclination to set everything up and, most importantly, maintain your website. The easy part is setting up your website ? get yourself a template, domain name and a hosting Company and you are away. Or are you? Yes ? you are You will have your website up and running ? but will anyone in this vast network visit your site? Now this is where the average business owner needs help. To get visitors to your site requires a lot of work setting up your keywords, metatags, links and backlinks. Regular analysis of your website?s visitors (if you have any) provides a wealth of information to help target customers and markets. All of this is better taken into account at the initial website development stage. So, if you have taken advantage of the free website services and then sat back wondering where your visitors are, you will then need to talk to a web design Company. It is almost certain that they will need to take you back to square 1 and start a fresh web site design to systematically build in the best structure, keywords and other features to help get you a good ranking on search-engines. In other words, you will need to start again. All that wasted time and effort when you could have been concentrating on your business instead of poring over image placements, header designs, menus and other content of your website. Websites are not made in 5 mins, 10 mins or even 24 hours. A good website requires a great deal of initial thought and consultation with the customer before even getting the design on-line. Once that is done, the hard work really begins For small businesses, the last thing you need is to be spending time pouring over your web-site trying to figure out why search engines are not listing you To get a web presence, these are the stages you need to go through:- Register your domain name ? take some time over this. It could be with you for a very long time. Ideally, it should reflect your business activity in some way ? BUT the name you eventually pick may not be available so you will need to look at the available options or start again with another name. The hosting Company will provide the necessary search tools to check availability. Then you need to decide on what your website will look like ? this is not as easy as it sounds Yes, you can use templates and eventually decide on a style that appeals to you. This is by far the easiest way of getting up and running ? you can do this through the GBBO scheme. There are drawbacks though. You will probably want some individuality and trimming to try and give you an edge. You then need a hosting Company to launch your website onto the internet ? there are many available at a wide range of prices. Important points to consider here are Customer Support, on-line time, bandwidth and tools provided. You will then need to maintain your website, analyse it and keep improving it to generate traffic. This is where the real work begins It is not difficult to use Analytics to get reports on your site performance, to improve your rating with backlinks and site maps ? but it is time consuming By all means, use the GBBO scheme to get your feet wet ? but if your business is to be successful, you will need to use a commercial Web-site design and hosting Company, so why not get off on the right foot from the beginning? Costs are very reasonable if you choose wisely. Tags: domain name, search engines, web design, website development, web site design

Source: http://mybestwebhosting.net/8944/small-business-friendly-hosting-domain-registration-web-design-installation-and-maintenance/

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