Is Blue Cross Blue Shield of South Carolina onto something? They recently created a network of international hospitals for its insurers to use by partnering hospitals in Thailand, Singapore, Turkey India, and Ireland. The list continues to grow. A key component for measuring quality is whether the Joint Commission International, an arm of the Joint Health Care Commission that accredits US hospitals, approves the hospital.

With the costs of procedures at foreign hospitals being substantially less than US hospitals and the state of health of individuals at these hospitals no less than US hospitals it seems that money does not make a better quality of care.

In many comparison studies on health care of the US and other industrial countries where there is universal health, the US population does not live longer or have better outcomes, wait times or successes. The only difference is that the US system is the most costly.

A shift to using the health care system of the world seems like opening competition to the US health care system may just be a way to lower costs. However, buyers beware, it is very difficult to sue for malpractice in many other countries.

One aspect of opening the health care system that I would advocate be assigned to insurers, is the liability that they yearly certify that the appropriate accreditation is current and that procedures be pre-approved to ensure the health insurer referral system documents are current.

Nationwide unions have the ability to set up their own unionized nonprofits and compete.

There is a major lack of childcare units and access throughout the USA. Childcare and after school programs are funded with government funds and private pay. Early Childcare education has been shown to be important for every child.

There is a major lack of affordable housing. The unions have all of the necessary trades and the training systems to bring about a fundamental change in the number of units available.

The unions have been great advocates of a living wage. Housing costs and medical costs are two of the biggest factors effecting the amount of salary necessary to meet a living wage. Unions are used to running under contract standards. Thereby creating a work force that is credentialed and has a training program in place to apprentice individuals.

Of the billions of dollars that are placed in the retirement accounts of federal employees and in social security, the government should commit 50% TO EDUCATIONAL LOANS.

There should be no financial institution or college involved in the selection of the loan.  Payments should be issued to qualified schools directly.

The IRS collects taxes; the Social Security Administration issues retirement checks; the INS processes passport and citizen requests; and Federal Stafford loans help pay for college.  These are all examples of large volume transactions exceeding hundreds of thousands of dollars.  This provides the proof of the capacity of the federal government to run a student loan system.  There will be no enticements to use any particular service, no revenue sharing, and everyone qualifies who is an US citizen. The mission should be to have the best rates for students in need of loans for education.  The US government could provide a loan forgiveness incentive for students to go into needy fields of study and/or to serve in geographic locations where there are shortages of credentialed people.  The US government can add a loan forgiveness program as well as blend in the other training programs already supported by the government.  One government agency to be the center of supporting higher education for all individuals who seek to learn and improve the likelihood of advancements in quality of life and economic impact.

Rates should be tied to the treasury bonds as fixed in order to have similar expectation of return.  These education loans will then create a return for social security and the retirement funds not dependent fully on future taxes or revenues.  If the success of the program provides adequate return it may be possible to increase the amount made for loans to more than 50%.  However, the federal budget has to stop using the social security money for other purposes.  The money will only run out because it is not getting a return, it is being used for the current base federal budget.

Let’s get serious about higher education and invest in our future.

Debt Collection agencies.

When debt collection agencies call your employees during this time of financial hardship make sure your employee understand their rights. Too many of the debt collectors use techniques that people do not know are wrong. Do not let the debt collectors tone or use of the English language make your employee feel stressed out or feel they are at risk of immediate harm. Help an employee stand up for their rights. It is as simple as letting them know to contact their state Consumer Affairs Office or Division of Banks for knowing their rights. Many of these rights can be found on line.

In Massachusetts anyone can Know their rights by going to the Office of Consumer Affairs: The summary below is from the Massachusetts Trial Court Law Libraries web site.

209 CMR 18: Conduct of the Business of Debt Collectors and Loan Services, Division of Banks. “The purpose of 209 CMR 18.00 is to establish standards, by defining unfair or deceptive acts or practices, for the collection of debts from persons within the Commonwealth of Massachusetts by debt collectors and third party loan servicers, and to establish procedures and requirements for the licensing and supervision of debt collectors and the registration and supervision of third party loan servicers.”

940 CMR 7: Debt Collection Regulations, Attorney General. “The purpose of 940 CMR 7.00 is to establish standards, by defining unfair or deceptive acts or practices, for the collection of debts from persons within the Commonwealth of Massachusetts.”

If your employee is having problems with the debt collector in Massachusetts they can file a compliant form with the Division of Banks which can be obtained from the Division of Banks web site.

During this time of the financial credit meltdown congress has provided an opportunity for credit worthy individuals to be able to purchase properties. For 2008 they have increased the loan ceiling that they will cover to be tied to the median income of a county. Thereby, allowing those individuals who have traditional been shut out of the FHA loan market to have access to the federally insured loan market. Check out the amount of your county by going to this link:

These loans are currently approximate .375% cheaper than the conventional Fannie Mae and Freddie Mac loans.

With the number of foreclosures and short sales on the market you should expect to find property discounted 20-50%.

Now is the time for nonprofits to invest in creating affordable housing at an affordable price.

Blue Cross Blue Shield of Massachusetts is a nonprofit organization that is a health care insurance entity. The CEO was paid 1.36 million in 2006 and 3.6 million in 2007. The Chairman was paid 1.73 million in 2007. The former chairman received 16.4 million to retire in 2007. Average premiums increased 7.5 percent.

The CEO of Harvard Pilgrim was paid 1.38 million in 2007. The CEO of Tufts Health Plan was paid 1.19 million in 2007.

If the President of the USA can be paid a salary of $400,000 then that should be enough for any executive of a nonprofit regardless of revenues.

Since these organizations are acting like for-profits in the manner in which they run their organization compensations and incur costs should they be stripped of their nonprofit status?

The states should allow access to the nonprofit organizations to have their employees be on the state medicare system for a flat fee per month. This will give the medicare and nonprofit system better pricing options.

The other option is to have nonprofits create a cooperative insurance company that they have better control over for costs and benefits.

Health care insurance and medical expenses should not have to make you bleed money as well!!!

Employer sponsored clubs for employees are useful tools to build camaraderie, help employees get to know each other then work, create company loyalty, reduce turnover, and provides a social context to improve morale.

A happy employee makes a more productive employee.

Allowing retirees of the organization to participate, will increase the number of individuals whom support the organization.

Government needs to get smarter.  There are good choices, good mandates and there are government rules that do not make sense.  One choice is allowing employers to decide whether to have flexible spending plans, Health Service Accounts (HSA’s) or HRA’s.  The fact that HSA’s allow for paying health premiums and the Flexible Spending accounts do not is bad policy.  The fact that Flexible Spending requires guessing the right amount to save but you are penalized if you do not use it is bad policy, especially when the HSA allows no penalty and it rolls over.

The controlling of Health Care costs is the responsibility of everyone.  However, it should not burden any one entity or person more than other.  Therefore, having to pay something should be a fact for everyone.  It should not be a choice of whether to have a Health Savings Account (HSA).  Regardless of employer size every employee should have a HSA account.  Since at some point there are out of pocket expenses there is absolutely no reason to pay taxes on money used for health care costs.  This allows an employee to be proactive and build a health care fund non-taxable and as an investment to their future.  If an employer wants to add to it they can.   It is the employee’s account to manage and to make choices with.  Just like retirement is a function for which every employee should be planning.  Everyone gets sick at some point or may wish to have an elective procedure.  Most individuals are not good at planning and that is where government assists people in making decisions that are best for them.

If insurance companies are making millions and paying high salaries then there is room to shave off the costs to health care.

One option is to have a combination of employers paying into a government sponsored insurance program with a small deductible of $1,500 for individuals and $3,000 for families to be paid out of Heath Savings Accounts is the best way to go.  The Health Savings Account should not be limited to the amount someone can pay into it.  I advocate for no limit because there are many procedures not cover by insurance such as major dental work or laser eye surgery or there is a sudden illness that causes a spike in costs to the individual/family.  An individual should not be held to a percent of their income or a cap on the plan because it only helps the wealthy that would get the service regardless of the tax consequence.  It provides for the government, employer and employee to jointly control health care costs.

Social Responsibility has been on the rise among college graduates. However, there has been a huge barrier created by the institutions of higher education preventing them from following their heart and soul to make a difference. College loans debt is their barrier to choose the job he/she would love to take in the nonprofit field providing public good.

 Providing loan relief provisions in your recruitment will increase the number of credentialed candidates that will apply to work for your organization.

Government support of a living wage will allow more individuals to accept jobs providing public good.

Attention all illegal aliens!!

There is no limit on the number of individuals who can sponsored to be employed in the US by nonprofits. SO go on line and apply to those nonprofit jobs who need direct service workers or credential staff.

Do not risk your lives being smuggled or being taken advantage of. Go thorough the process. Sneak back home and come with valid documents which includes a work permit.

Advocacy agencies should work to connect these potential workers and assist them in the process.