September 23rd brought the first real changes of federal healthcare reform:

24 09 2010

September 23rd brought the first real changes of federal healthcare reform:

For nearly four years I have worked in the healthcare industry. Often conversations about healthcare reform seem to only bring up frustration. A few of my friends have asked for help with their health insurance situations. I hope that the information below is helpful to you.

Here are a few of the changes to health insurance.

1. No lifetime maximum. Your health insurance policy can no longer limit how much is paid for your medical treatment over your lifetime. Previously it was common for your health insurance to have a limit of between two and five million dollars. In truth, lifetime medical claims very rarely exceed five million. I did have a friend who had a million dollar surgery. This is rare.

2. Preventive care is now free to you. When you need a check up (blood test, mammogram, colonoscopy) you no longer have to pay for those expenses. This may be a shock, but health insurance companies are in a for profit industry, which means that these expenses will be built into your monthly premium.

3. Children under the age of 19 will not be declined health insurance and will have no preexisting condition exclusions. If I happened to be down on my luck out of a job, with a sick child, I would be thrilled! No sarcasm here. It would be the best day of my life! I love my kids. I would give my life for them. This would be better than winning the lottery! They would be able to get the treatment they needed!

The reality is that even just these three things will cause your health insurance to be more expensive this year!

Over the past 80 years health insurance companies have averaged a 3% profit margin in the US. Regardless of WW2, recession, etc they have been able to maintain that 3%. You may not want to know what prescription drug companies have averaged.

If a health insurance company is now required to pay for each of the three changes listed above they have make changes to cover you new expenses.

Reform, in the way of change, would be happening regardless of who was elected. Having worked in the industry for a few years I heard rumblings of the major players (Hospitals, Dr, Rx Companies, Networks, and Insurance Companies) finally all being ready to come to the table, at the same time, and say “the system is broke we need to fix it”. This was happening long before the election. It just didn’t get done.

Among those major players health insurance companies have the lowest profit margin. That’s easy enough to verify. A 3% profit margin versus a 16% profit margin of other industries.

I believe that if you and I actually knew what was being billed for Dr visits, medications, and various medical treatment the system would change within a few years. Full disclosure would bring more change than people realize. One of the crazy things about our free market system is that the decision makers don’t have good information. Unfortunately, most of us decision makers feel that it’s all too complicated to get good information. How can we make good decisions without good information?

Free market doesn’t work if both the buyer and the seller don’t know what the actual cost and the actual selling price are! If you have ever worked at a pharmacy, a hospital, or for a Dr and you started to check out how things work, you know what I’m talking about. Many Dr’s don’t know what a medication actually costs (it just gets billed to insurance or costs the patient) and most patients don’t know either!

Dartmouth Atlas of Health says that 1/3 of all healthcare is waste. Think about that. This has a definite effect on the economy!

We live in the most law suit happy culture in human history. This eventually has an effect. I believe that a law suit can be a necessary evil, but our current situation has allowed less than ethical people to get wealthy.

Truth is that our current system is not the result of anyone’s design. I’m not saying this as a negative. Most people just don’t know how it happened. It is what it is. Comparing it to Canada or Europe is like comparing apples to tigers. Our system is a completely different animal.

Consider the history:

In 1900 healthcare was cheap in the US, and hospitals were primarily dark dirty places to die. Dr’s visited the wealthy in their homes and the rest of us only went to a hospital when it was too late. Back then medications were not actually causing cures!  People forget this!

So what happened? (NPR’s economy people pulled together a pretty succinct bullet point list – here’s my rendition.)

1.       Start Curing Illness: 1909 first Rx to cure illness (Salversan cure for syphilis).

1910 people start to expect Dr’s to have a cure. Hospitals start to change. They become a place with happy outcome: birth, curing. Demand increases, supply increases, and cost increases.

2.       Great Depression: (even before crash cost had risen and people had stopped going to hospital) Baylor University Hospital in Dallas estimated that an average ribbon counter clerk would spend more on cosmetics than healthcare. They started a strategy to market healthcare benefits. So Baylor started offering public school teacher’s a plan that cost $6 year giving them up to 21 days of hospital visits. Then the Great Depression hit. The Baylor idea became a popular way to make money selling medical benefits. This effort by Baylor later became Blue Cross where health benefits were marketed to groups of workers.

3.       During World War Two, prices and wages were frozen by the government. Companies needed to produce more with a smaller work force. Free market encourages competition and companies start to offer benefits to attract better employees.  (Prior to that only 9% of workers were insured.)

4.       The IRS decided to offer tax deduction to companies who offer benefits. The government gained some control with this leverage.

5.       Federal and state laws got involved to prevent discrimination. Limited underwriting allowed. Decent motives lead to bad economics

We got sucked into paying for benefits as a nation because hospitals were marketing medical benefits to groups of employees. This is very different from true insurance.

The truth is that when you or a family member is sick you want to get better no matter how much it costs! You no longer care how much it costs you, the Dr, the hospital, or the insurance company. That’s why we carry insurance…just in case. What if? With true insurance I pay a small monthly bill, just in case something bad happens, then the insurance company pays the big bill.

A small fraction of us still have true insurance. Now most of us have policies that are a blend of insurance and benefits.

What are benefits? Three main things could be called the benefits part of your health insurance. First would be paying a higher monthly insurance premium so that when you have predictable expenses like Dr, lab, and prescription costs for predictable conditions like a cough, cold, flu, rash you are actually paying a small portion or none of the cost.

Second would be the preventive services that our government requires insurance to cover.

Third would be the coverage for dental and vision services. Do you know that if you are not having two cleanings per year you are probably paying more in insurance premium than you are using in dental services? Lately almost all dental plans have annual dollar limits. This means that you don’t come out ahead even if you have expensive dental work. You may be surprised to learn that 1/3 of the average monthly cost of employee health insurance is for dental services.

Most of us are prepaying for services that we never use.

The current changes will impact our economy more than we expect. Underneath is all there will be a battle of “state rights” versus “federal control”. We will vote again. Revisions will be made to the reform regardless. Yet government will not relinquish the greater control they now have. Here we are again making decisions in a situation where the popularity contest of partisan politics is effecting our thinking more than the facts. How much did that pill, lab test, or Dr visit really cost? I don’t know.

I just wish that the average American had access to better information. Strangely I hold out hope that if we did, common sense would bring the change we need. I think it was Twain that said, “common sense is genius in a working man’s clothes.”

It will be very interesting to see what the next year will bring. Having spent time in Canada and Europe I know a variety of people who are actually looking to the US, hoping that we can arrive at a better solution than they currently have. Here’s to the optimists, dreamers, and visionaries! My prayer is that the US will find a clear common sense way forward!





We were born to grow. We are wired to grow in relationship. You cannot say that a relationship is meaningful or

16 09 2010

We were born to grow. We are wired to grow in relationship. You cannot say that a relationship is meaningful or satisfying if it reaches a certain point and then nothing changes. Relationship with Jesus Christ is the same. We can find life by growing in a relationship with Jesus Christ.

Life brings struggle. It’s not easy. There is pain. There are barriers that we must push through. We will all hit a wall that we can’t push through.

A growing relationship with Jesus Christ brings life. It brings hope. It brings strength to work through the struggle. It provides strength.

This relationship has been called “The Way of Christ”.

A guy named Paul knew something of this struggle. He wrote a letter to some friends in a city called Philippi about this. They had already started a relationship with Jesus Christ, but he was writing to them about growth.

“I pray that your love will overflow more and more, and that you will keep on growing in knowledge and understanding. For I want you to understand what really matters, so that you may live pure and blameless lives until the day of Christ’s return. May you always be filled with the fruit of your salvation – the righteous character produced in your life by Jesus Christ – for this will bring much glory and praise to God.” Philippians 1: 9-11 NLT

The church in Philippi started with a bang. Paul and Silas visited this major city and saw miracles. By God’s grace, a girl was delivered from her life of slavery. Men were making money from her ability as a fortune-teller. The story describes that she did this by the help of a demon. Paul told the demon to leave and she was free. The men were mad about their loss of income and literally dragged Paul and Silas to the authorities. City officials were worried about a riot and threw them in jail. Paul and Silas sing praises to God from their jail cell. An earthquake opens the prison doors.  Chains fall off each prisoner. Paul stops the jailer’s attempted suicide and leads him (and his family) into the “Way of Christ”. City officials apologize to Paul and Silas then release them.

After all of this a group of believers come together, believing in Christ, and pursuing the “Way of Christ”. This group of people, we call a “church”, live out their faith and make a difference in their city, Philippi a city of influence. Paul really loved these people. They were generous and always keeping an eye out for a way to help.

In that day, “The Way of Christ” was spoken of by people in poverty and people of wealth in power. Just like today people were trying to figure out what it meant to grow in this relationship with Jesus Christ.

Paul writes about their love growing. He also writes about their understanding the growth process. When we come into contact with Jesus Christ we want to learn more about Him. This brings change. Jesus Christ brings salvation! You can be forgiven of your mistakes! When you are changed by Jesus Christ it affects the rest of your life.

Notice in what Paul writes that after the point of salvation we have choices to make. We are called to be active learners. We have a responsibility to seek out God. We will benefit from this pursuit!

The example of “fruit” is helpful. We might plant the seed, water the little sprout, care for the tree, and harvest the fruit. But we cannot take credit for the life that starts in the seed. The love of Christ comes by the initiation of God. It is by His grace. It is His gift. We do have responsibility to be involved with the growth. This balancing act between God’s grace and our response is now our growth process. “The Way of Christ” is just that – our response to His love. He didn’t wait until we were at our best, but when we were at our worst He chose to love us. Now we get to respond to His love!

This is not about “do this” or “don’t do that”. It is about our response to His love. There will be struggle, but we have an opportunity to daily walk in the “Way of Christ”.

So what?

1.       Accept the love and forgiveness of Christ.

2.       Daily remember who He is to you and what He has done for you.

3.       Make an effort every day to learn more about Jesus Christ. Pick up a Bible. Pray.

4.       Share the journey with other people. Be honest and talk about it. Church will help!

5.       Find a guide who is a few steps ahead of you to talk with, someone who will pray for you.

6.       Tell your story to someone who is a few steps behind you. We are all in this together.

7.       Write down a few things about your journey on “The Way”. You may have kids who want to know about how you got where you are.





NFL season kicks off tonight and no one knows what is going to happen, here’s my shot…

9 09 2010

…but every fan has hope!  Millions of NFL fans actually believe their team has a shot this year.  Here’s my shot at predicting what will happen.

After a bit of travel I was lucky enough to have become friends with different people, around the country, who are fans of 30 (of the 32) NFL teams.  Still looking for fans of the Bengals and the Bills.  So you end up watching games and talking with people who know stuff about their teams.

Just for kicks here’s a few predictions from me:

1.  T.O. and Ocho Cinco will end up in a shouting match on the sideline by Week 8.  The ensuing twitter trash talking between them will last through their retirement.  They will end up finishing it in a UFC exhibition bout, but not get the Dancing with the Stars contracts they really wanted.

2. T.O. will score on the Patriots, grabbing the musket (as predicted) in celebration, and then Tom Brady I mean John Shady will run him over in the parking lot.

3.  Green Bay and Aaron Rodgers won’t be quite as good as they looked in the preseason, but they will win more games than the Vikings.

4.  Brett Favre won’t put up nearly the numbers he did this year and will retire before the season is over.  He’ll still be a first ballot Hall of Famer, but the Green Bay management just might look a little smarter.

5.  Chicago Bears fans will boo until both Lovie Smith and Mike Martz are fired.  Lovie will find a better job, but Martz still will not realize that his success had more to do with Warner/Faulk/Holt/Bruce than his system.

6.  Brandon Marshall will drop more balls than T.O. this year and that will be his best accomplishment of the season.

7.  Pete Carroll will “rebuild” the Seahawks down to a 45 man roster making room for more…it won’t matter…he’ll be gone by next year.  The Patriots will bring him back to spy on, errr prepare for, the opposition.

8.  “Samurai Mike” Singletary, son of a preacher man, will continue to build the 49ers into a smashmouth monster until management gets him a real QB.  Then they’ll pound the new LA Jaguars until they go back to Jacksonville (2016).  Here’s how he describes what a 49er should be: “physical, tough, disciplined, relentless, smart.”  Why didn’t Paul Allen hire him?

9.  The Ravens will come out of the toughest division in the NFL as the second ranked team of the AFC North, but go deep in the playoffs.  With Flacco and Bulger knocked out of their final playoff game with injuries, Boldin quarterbacks the final quarter – throwing to…and catching his own TD pass…NFL RECORD!!!  Ray Rice will tweet about it for the rest of his life!

10.  The NFL will make more money than ever and be lucky to reach a new CBA.  The 2012 jerseys will be sweet, but UFC T shirts will pass them by in sales.  Today I picked up Gene Upshaw’s players “trading” card (from an antique store while picking up a chair for my wife) and all I could think was, “they better get a deal done!”

Can’t wait for football! It’s possible that my 3 year old son’s favorite song is the Monday Night Football, “Are You Ready for Some Football?”  We’ll have it cranked up!

Let’s go Ravens!  Beat them Jets!

If you’re a real fan…here’s a little more prediction from me:

NFC WEST

1. San Francisco 10-6

2. Arizona 8-8

3. Seattle 6-10

4. St. Louis 3-13

NFC NORTH

1. Green Bay 12-4

2. Minnesota 10-6

3. Chicago 5-9

4. Detroit 4-12

NFC SOUTH

1. New Orleans 12-4

2. Atlanta 8-8

3. Carolina 8-8

4. Tampa Bay 4-12

NFC EAST

1. Philadelphia 11-5

2. Dallas 9-4

3. Washington 8-8

4. NY Giants 8-8

AFC WEST

1. Denver 11-5

2. Oakland 8-8

3. San Diego 6-10

4. Kansas City 3-13

AFC NORTH

1. Cincinati 11-5

2. Baltimore 10-6

3. Pittsburgh 9-7

4. Cleveland 4-12

AFC SOUTH

1. Indianapolis 13-3

2. Tennessee 8-8

3. Houston 8-8

4. Jacksonville 4-12

AFC EAST

1. New England 10-6

2. NY Jets 10-6

3. Miami 8-8

4. Buffalo 3-13

Conference Championships

NFC: Green Bay over New Orleans

AFC: Indianapolis over Baltimore

Super Bowl XLV

Indianapolis over Green Bay

…but who knows what’s going to happen…that’s why they play the game.





A city where they could settle

1 09 2010

This summer we move to Baltimore.  Our friends, the Talaiver’s, are already in Baltimore and the Wheelers will follow us there.  As a team, we are launching a new City Bible Church in Baltimore.

We look forward to meeting people and finding out where we can connect.  We want to serve the city.  Baltimore has a long history of people serving the community.  We hope to join that effort.

City Bible Church Baltimore will serve the city of Baltimore with a vision to connect people with Christ, help them grow in Christ, and inspire them to share Christ.

We want City Bible Church Baltimore to be  “a city where they could settle.”  Psalms 107:4,7.

People need clarity of vision and simplicity of mission to connect with something larger than their own lives. Jesus provides this purpose for life.

But to connect with Him, first you must ask: Who is Jesus Christ? What has He done for me? Why does this matter? How do I respond?

We are looking for the momentum of more prayer, team members, and money.  Please feel free to contact me with questions.

If you would like to donate: please visit www.citybiblechurch.org

You can click on Donations, Online Giving, when you click on “Categories” you will see “Other” select it and then “Baltimore Church Plant” will be an available option.  Thanks in advance!

Stay tuned as we build our team, move across country, and launch a church!

Check out:

www.cbcbaltimore.com

www.cbcbteam.com

…search for the Facebook Group “City Bible Church Baltimore”

follow benmalmin on twitter: http://twitter.com/benmalmin