Connected, yet drained!


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In the current digital era, the highly networked age, everyone you know or do not know has a connected device at hand. Mobile phones, tablets, laptops and personal computers are everywhere around us. You have them at home, at work and everywhere in between. You can reach anyone across the world at the speed of thought! You can call, leave a message, email, text, and chat or get on social networking sites and apps and share. Boy, are you connected! You have the reach at your fingertips that, a couple of decades ago was only dreamt of.

But, do you really connect? The human mind is so flirtatious that it cannot afford to stay put on one interaction for longer than a few seconds to perhaps, a couple of minutes. It has to keep moving, has to find new interests and fleet to the next as the previous one starts to wane away. That is what the rapid and overwhelming influx of information and our highly networked times has done to us. How many times have you glanced at your mobile phone today? Checked that Facebook app, that LinkedIn page, those Twitter tweets for the nth time yet?

There is no denying the fact that what technology has enabled is highly valuable. To reach someone on the other side of the planet in real time is immense. It has brought us all together in various aspects of life, personal and professional, and made the world smaller. It has made us one people and erased boundaries and other demarcations that once divided us. And, in every sense of what it set out to do, it has enabled us to make progress as better educated, aware, enlightened and open-minded humans that care about, not just what’s around us, but across the world.

And, this ability, in the larger scheme of things is highly efficient and valuable. However, what it has also done is, robbed us of what we once cherished and valued. True social interactions, in person meetings where we greeted each other and shared bonhomie, family and friends get-togethers where we cherished knowing each other and encouraged finer aspects of our personalities, social events where we met, talked, shared opinions and thoughts, all those are not as frequent or as rich as they once were. Perhaps, it is now that we reminisce the value of what we are continuing to lose. Think about it, you live in the same home, but communicate with your spouse and kids via devices. The family room conversations, the dinner table chitchat, the long ride interactions and coming together to participate in events that enriched us and strengthened our bonds are becoming rare; perhaps only on special occasions do these occur, if at all. Its in our best interest to save these and cultivate them, not just in ourselves but in future generations for they enriched us and defined our very existence, as people, as those who loved each other for what we were and strived to excel.

Technology has to be leveraged and used to enrich our lives, but we shouldn’t become a slave to it. It takes a conscious effort to do that and it’s in the best interest of us, humans to let it not rule our lives. And who better to begin this reversal than you. Take up the challenge and bring life back to you and those around you.

Image Courtesy of FreeDigitalPhotos.net

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Aetna-Humana merger – What does this mean to Healthcare Consumers?


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On Friday, July 3rd, 2015, Aetna and Humana announced a $37 billion merger, the largest in the history of Health Insurance, in part cash and part Aetna stock for Humana stock at a modest 29% premium over Humana stock price as in May 2015. This merger values Humana at about $230 a share. Humana shareholders will receive $125 in cash and 0.8375 Aetna common shares for each Humana share. Aetna’s shareholders would own approximately 74 percent of the combined company and Humana’s shareholders would own approximately 26 percent. Upon approval from regulators, the merger is to be closed in the second half of 2016.

Over the past few years, Humana has set itself up as a leader in the Medicare Advantage space.

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According to a study conducted by Kaiser Family Foundation, Humana holds about 19% of the Medicare Advantage market as compared to Aetna, which holds only about 7% of the market. This merger allows Aetna to triple its Medicare Advantage business taking it to the #1 single carrier spot in the business trailed by United Health.

Nearly 7.5 million of Humana’s 14.2 million members were enrolled in individual or group-related Medicare plans as on March 31st, 2015; that’s more than double the combined number of Medicare enrollees at Aetna, Cigna and Anthem. This made up nearly 72 percent of Humana’s total revenue in 2014, compared to 25 percent for non-Medicare plans.

By contrast, Aetna is a leader in the diverse commercial insurance space.

With the employer sponsored insurance landscape changing and potentially slowing down, Aetna saw government business as the avenue for its future growth. The Affordable Care Act (ACA) is helping expand Medicaid coverage in several states as it attempts to provide health coverage for millions of uninsured people. Meanwhile, Medicare Advantage has seen its total enrollment triple over the last decade to 16.8 million people.

This merger has been connoted as being inevitable in a changing healthcare landscape post ACA. Both companies have announced that this merger will help consumers in terms of better products and services due to the merger making way for better technology, products and relationships with healthcare providers. Further, they announced this as a merger of complementary strengths in markets served and technologies used.

About 2 years ago, in May 2013, Aetna acquired Coventry Health Care for $6.9 billion as the first step in consolidating its government business. With that acquisition, Aetna had added approximately 3.7 million medical members and 1.5 million Medicare Part D members. In addition, Aetna’s Medicaid business had grown from 1.1 million members to more than 2 million members, and its Medicaid footprint had expanded from 12 to 16 states.

With the current merger, the combined Aetna-Humana company’s government business — Medicare, Medicaid and Tricare — will be based in Louisville, KY where current Humana corporate headquarters are located, and will be the biggest part of the company, totaling about 56% of the combined companies’ projected 2015 operating revenue of about $115 billion.

The combined company will cover more than 33 million people, only led by UnitedHealth Group and Anthem. The combined company would be the second-largest insurer by revenue, just behind United Health.

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Aetna and Humana are in nine of the same states in Medicare Advantage. Combined, they would have market share of 88 percent in Kansas, 80 percent in West Virginia, 58 percent in Iowa and 51 percent in Missouri. Regulator dynamics will soon be in play in these markets to ensure that monopolization is kept at bay and true consumer interest is in action by encouraging competition. How, is yet to be seen. However, such major consolidations potentially increase insurer’s influence with federal regulators.

Although insurers and investors apparently see a benefit in these mergers, it’s yet to be seen how the economies of scale play out for end consumers. With the size of the companies coming together in a yet larger consolidation, is more of scale economics still possible? Or are such mergers only going to lead to consolidation with one or two behemoths taking over an entire market, thus narrowing down any competition or innovation that comes with competition?

From a consumer benefit standpoint, its still unclear what is to come? With the power exercised by such a merger, the combined company could push providers to provide better outcomes at lower prices. You could also argue that there would be more streamlined and limited number of choices available for consumers to choose from. However, less competition could also lead to higher premiums, higher out of pocket costs and narrower networks.

While announcing the merger, Mark Bertolini, CEO of Aetna said, “You need to have enough power and enough presence at the local market level to be able to create relationships and efficiencies that are to consumers’ advantages. That requires “larger organizations, more capital, more technology and more intellectual property. That’s what’s driving the consolidation.”

One signal, if it means anything would be what Mr. Bertolini did in the recent past. He raised the minimum wage for Aetna employees to $16 an hour and lowered workers’ out of pocket insurance costs. He announced that he has incorporated those benefits into financial projections for current Humana employees post merger. He was also in the news recently for encouraging all his employees to take up free meditation and yoga classes at various Aetna locations to combat stress and get on the path of wellness. This speaks to where his true heart lies in terms of setting an example and signals a ray of hope on things to come from this merger.

Image Courtesy of FreeDigitalPhotos.net, Wall Street Journal & Kaiser Family Foundation

SCOTUS rules “For the People” on Affordable Care Act


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On Thursday, 06/25, in a historic 6-3 decision, the US Supreme Court reinforced the highly debated and controversial Affordable Care Act.

As you may know, under the Act, Health Insurance Exchanges were established as marketplaces to help individuals buy health insurance. The Federally Facilitated Marketplace serves individuals and small groups across the country, specifically in 34 states that did not build their own an exchange.

Based on annual income, individuals validate their eligibility for tax credits. Over 10-13 million individuals enrolled during last open enrollment. Around 7.8 million availed the credits during their health insurance purchases. These credits were provided both on the Federally Facilitated Marketplace as well as state marketplaces.

There was a lawsuit, the now infamous King vs. Burwell questioning the structure of the law that stated these credits be made available on exchanges of states. Since there was no mention of FFM or Federal Marketplace, it was implied that the credits did not apply to the states that depended on the FFM and as a result, the subsidies given out to date were deemed illegal.

If the Supreme Court hailed the lawsuit, it meant that about 6 million healthy people who already availed these credits would lose them for the upcoming open enrollment. There was a possibility that healthy people may not purchase insurance in the absence of credits and the carriers faced a skewed unhealthy insurance clientele, resulting in disastrous results on overall healthcare in US. The founding premise of the law, to ensure as many citizens are covered would have been at jeopardy.

Chief Justice John Roberts stated while reading out the majority opinion on Thursday, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

With SCOTUS acting on behalf of the benefit of US citizens, everyone can look forward to next steps in improving US healthcare distribution and delivery.

Image Courtesy of Wikimedia Commons

Clean India Campaign, will just cleaning streets sustain it?


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“Swachh Bharat Abhiyan” or the “My Clean India” Campaign was launched on Oct 2nd, 2014 by the hon’ble Prime Minister of India, Mr. Narendra Modi in New Delhi, India. The PM along with a few others took to the streets, chose a spot and helped sweep the dirt there. The pre and post clean up operation pictures were posted by every newspaper, website and channel worth its salt. The PM went on to kick-start a clean up challenge by inviting 9 other stalwarts of the country to follow suit and in turn, invite 9 others to do so; thus introducing a chain scheme similar to the recent Ice Bucket challenge started to create awareness and raise funds for Lou Gehrig’s Disease. The Ice Bucket challenge went viral and was pretty successful for a period of time.

I personally believe that what Mr. Modi started is definitely a powerful mission especially when being propagated top down. But, without proper planning and measures taken to keep up the momentum and eventually seek perennial penetration within the community, it can be short-lived and fizzle out as quickly as several of the viral campaigns we have seen in this era of social media.

First, the entire BJP rank and file could have participated in the kick off across the country than just a few of the leaders. Second, this is a party agnostic nationalist mission and all parties, should have come together to support it. Before you start reacting, let me clarify that I don’t want to make this political.

However, hear me out before you comment. I, just like other Indians do want this campaign to go viral and sustain, but doubt the sustenance although want to believe that it will.

Here are my reasons:

  1. There is not enough fervor and motivation created so far by the 9 challenged. Some have said, I have always done so and others have said, love the idea and will surely do my part. One was abroad and sought the local embassy to see if he could come in and clean. The idea here is to not clean once and say, “ I have done my job. You next.” The idea   is to create intrinsic motivation to do what is right and continue that. Further, cleaning once or going out there and cleaning a couple of times is not going to make a permanent difference. The goal of the campaign should be to create a permanent transformation of habit in all Indians. I know it’s a lofty task but what is a challenge without one. Even succeeding partially would mean a sea change benefit to not just India and Indians, but the world for it can create such powerful global recognition of the phenomenon and its adoption by others. Don’t you think so? I would like to see all of our “leaders” irrespective of political affiliations or cadre, come out and pick up the brooms, not once but consistently over a period of time. The oath that was administered to clean about 100 hours a year, I implore them to do it each week. Choose different spots and do it, but, over a period of time come back to the spot you began with. If without your cleaning it, it remains clean when you return, you have achieved your mission.
  1. There is an old and famous saying, “ Give a man a fish and he will eat for a day. Teach him to fish and he will never be hungry.” That is exactly what needs to happen with this campaign too. Inspire the population to embrace the habit of cleanliness. In a land of 1.2 billion, much garbage is created and collected. Let’s focus on teaching our people:
    • How to minimize the amount of garbage they create
    • How to recycle since one man’s garbage is another’s gold
    • How to collect and dispose
    • How to become self-sufficient in living practices
    • How to pass the values on to future generations so it becomes second nature
  1. A review and analysis of our garbage removal and containment infrastructure and processes is needed. Modernization of our outlook, infrastructure and practices along with the way we manage waste is crucial so we don’t need a campaign for what should be a part of regular life.
  1. Inculcate respect for our janitorial staff and create better living and working conditions for them. Let’s bring a sense of camaraderie, and honor the work they do to ensure we all live clean and healthy.

I am sure there is much more we can do to make cleanliness practices sustainable over time. Now, I leave you here to discuss and deliberate with a focus to take action since I can hear my wife calling out to start our home cleanliness drive and take the garbage out. You know, it’s the weekend and that’s my job for the day!

Image Courtesy of PTI