SHBP Protest Groups Misguided

Georgia SHBP protest groups are misinformed and misguided. Teachers Rally Against Group Insurance Changes shbp protest(T.R.A.G.I.C.) formed a Facebook group in early January to express their frustration in changes to the GA State Health Benefit Plan. Obamacare is at the root of their complaints, but they refuse to concede this point and would rather direct their efforts toward the governor’s office.

Members and supporters of SHBP protest groups are certainly vocal but completely misguided in their efforts. They have not connected the dots between changes in the SHBP and Obamacare. TRAGIC and their supporters also fail to accept responsibility for the choices they made during last falls open enrollment.

  • The 2013 SHBP package was not ACA compliant
  • SHBP 2014 was required to be updated to meet Obamacare mandates
  • SHBP fall open enrollment clearly outlined benefit changes for 2014
  • Covered participants of SHBP had a choice of accepting the change or purchasing coverage in the open market

My wife and I are covered under the SHBP. We were given handouts at employee meetings and links to the state website where SHBP plan options were delineated. Yet no one complained at that time. SHBP protest groups did not spring up until AFTER the benefits were active on January 1, 2014.

Did they fail to read the handouts or visit the choices site?

One must assume the whiners never bothered to study the plans and weigh options outside the SHBP. The plan cannot be changed at this point. There is no going back. The Obamacare plans are not popular among individuals who have tried to use the exchange which is part of the reason why enrollment goals have not been met. For the 2 million or so that have selected a plan, estimates that 60 – 80% have yet to pay their first premium.

Over 65 million visitors to healthcare.gov but only 2 million have “signed up” for a plan they are required by law to have. Perhaps fewer than 500,000 have paid for their purchase.

Had the SHBP protest groups followed a similar process and studied the plans many of them may have refused to accept the plan designs and sought other coverage.

But they didn’t.

SHBP covered participants don’t get a Mulligan. Barring a Special Election Period because of a qualifying event, they will need to learn to live with their choice.

We reviewed the plans during open enrollment. We understood there were changes. Premiums were higher. Benefits were lower. Higher deductibles and more out of pocket.

We also considered our health care needs, our budget and looked at options OFF the exchange. (Most SHBP plan participants are not eligible for a subsidy so exchange plans should not even be a consideration).

So what can you do if you are in the SHBP to minimize your cost for health care?

  • Maximize your HRA dollars and go through the wellness steps at BeWell
  • If you have not read your plan, do it now.
  • Go to the BCBSGA/shbp site and look up everyone of your providers.
  • Print it out, especially participating urgent care facilities
  • Register with Express Scripts. Look up all your meds
  • Consider changing to generics
  • Evaluate 90 day mail order options
  • Consider ordering from a Canadian pharmacy such as Blue Sky

Rather than treating your health insurance plan like an “all you can eat” buffet, learn to manage your dollars. The sooner you master this skill the better off you will be. The current plan design is the future of health insurance. Protest groups like TRAGIC will not be able to roll back the calendar to the old days so get over yourself. If you spent as much time educating your members on ways to save money on health care everyone would be better off.

Many chronic health conditions can be effectively managed with a healthier lifestyle. Diet and exercise can do wonders for hypertension, high cholesterol, back pain and type II diabetes.

You can change the way you manage and pay for your health care, or you can join a Georgia SHBP protest group and be miserable. Your choice.

How Obamacare Works

Do you want to know how #Obamacare works? Who is helping to pay your premiums? Why are old, sick people happy about Obamacare? Who is really benefiting from Georgia ACA health insurance?

Because the law forces insurers to cover those with pre-existing conditions, insurers need to attract a critical mass of young and healthy individuals with lower medical costs into the exchanges to offset the cost. But the Obama administration has yet to release demographic data on those who have picked a plan through the exchanges.

But in a filing with the Securities and Exchange Commission, Humana disclosed to investors, “as a result of the December 2013 federal and state regulatory changes allowing certain individuals to remain in their previously existing off-exchange health plans, the Company now expects the risk mix of members enrolling through the health insurance exchanges to be more adverse than previously expected.”

Washington Post

If Obamacare is to work, young, healthy people need to sign up for coverage. Why so many scofflaws? Do they not understand how Obamacare works? Are they like the war protesters in the 60’s and 70’s?

Some are already seeing the benefit of ACA health insurance in Georgia and taking full advantage of the new plans. Several of my clients are taking expensive medication that normally runs over $1000 per month. We helped them find a plan that pays 100% of their medical and prescription drug expenses for the year after they pay the first $950.

One client got a much needed new hip for $3500. All her rehab, medication and follow up doctor visits are no charge for the rest of the year.

Still confused about how Obamacare works? A late night comedian answers your questions. Click the link below.

 

Obamacare 2014 – What Happens Next?

Obamacare 2014 finally sputtered out of the gate and we are 13 days into a new way of doing things. What next? If you don’t like your new plan, can you change? Did you lose your doctor(s) in the transition? Is the obamacare 2014premium affordable but the deductible too high? Did the plan you get match what you thought you were buying? Do you feel like Private Benjamin (Goldie Hawn)? “I did join the army, but I joined a different army. I joined the one with the condo’s and private rooms”.

First the good news. For now at least, you are not “married” to your Obamacare 2014 plan. You can still make a change and live to see another day.

 

Can my Obamacare 2014 plan be returned for a different model?

In most cases yes. In some situations it takes 10 minutes. But if you bought on the exchange and you want a DIFFERENT subsidized plan the answer is, forget it. You may be able to exchange one subsidized plan for another but getting there won’t be easy or a lot of fun.

Moving from a subsidized plan to one OFF the exchange (no subsidy) should be simple. Moving from a non-exchange plan to another non-exchange plan can be accomplished in 10 minutes.

 

Why would I want to change my 2014 Obamacare plan?

Many reasons.

Maybe you just came out of the ether are realized the plan you bought has no copay’s and you have to fund the first $6000 or more before the plan pays. Or you bought a plan with an HMO network and there is only one hospital in the network. If you bought a Blue Cross plan (on or off the exchange) and thought “Everyone takes Blue Cross” you need to understand about 70% of the docs and many hospitals in the Blue HMO are not included in your plan.

We have several carriers and plans off the exchange that may be a better fit for you. One 2014 Obamacare plan that is only available outside the exchange limits your out of pocket expenses to $950 per year. If you are one that will be using their plan a lot you really should consider this one. We have several people that use over $1000 per month in prescription drugs and this plan is a perfect fit. After January they will never have to pay for another Rx or doctor visit.

What a country!

We will be glad to discuss options or you can go through the drive through and use our free and easy quote engine to shop and compare rates at ACA Health Insurance Georgia.

 

Did you lose your doctor(s)?

It happens. Many doctors are not participating in Obamacare 2014 and especially if you bought on the exchange. But there is a wide range of options outside the exchange and most of these plans (except Blue Cross) have most of the doctors and hospitals in Georgia. Even if you wander into a doctors office that is not in network you still have coverage for most non-emergency care situations.

If you did lose your doctor because you signed up for an HMO it is not too late to get back into a PPO. Shop and compare!

 

Can’t afford your high deductible?

High deductible plans are great as long as you are in good health. But if you normally use your plan a lot, with doctor bills, hospital stays and high prescription drug costs you may actually come out ahead with a lower deductible plan.

We have plans off the exchange with $0 deductibles, $950 and $1000 deductibles. It is so fast and easy to shop and compare plans and rates on ACA health insurance.

 

Did you get what you wanted and needed?

If your Obamacare 2014 plan isn’t a good fit exchange it now before it is too late. You only have a few weeks left to still get a 2014 Obamacare plan that works the way you need it to.

Obamacare Cancels Policies on 650,000

On December 31, 2013 650,000 participants in the GA SHBP (state health benefit plan) lost their old health insurance plan. Why? Because Obamacare cancels policies when they don’t meet federal requirements. obamacare cancels policies

The Georgia State Health Benefit Plan provides health insurance for all state employees. Municipal groups and school systems can opt into the SHBP or establish their own plan. TRAGIC, a group started by Ashley Cline, vows to fight the state over their loss of coverage. Teachers Rally Against Group Insurance Changes (TRAGIC) is a Facebook group that has made numerous calls to the Governor’s office and plans a rally at the capitol steps on February 18, 2014 to make their frustrations known.

In spite of the presidential promise over the last four years that you can keep your plan, the fact remains. Obamacare cancels policies.

As pointed out in my earlier post, their cause is noble but misdirected. The loss of their prior plan was mandated by Obamacare and had nothing to do with the new TPA (Blue Cross), the Governor or the Department of Community Health that awarded the contract to Blue Cross.

I tried to explain this to the group and to Mrs. Cline but my counsel fell of deaf ears. Now they are back in the news again.

Cline said the plan to call was the first action step for the group and was posted this week.

“This week we’re going to contact the governor in force … we’re also going to turn our sights toward contacting the nine-member board who makes these decisions,” Cline said. “Our goal is to impact decision in the future.”

Cherokee Tribune

The contract with Blue Cross is for 3 years. The plan design is sanctioned by ACA. The benefits they had prior to 1/1/14 are too costly to continue in light of the new ACA mandated Essential Health Benefits and other provisions the federal government believes you should have. If your plan isn’t one the government likes then your policy is cancelled because it isn’t an Obamacare design.

The Cherokee county school district, and any other district that does not like the SHBP plan design should develop their own plan that complies with ACA rules.

Jamie Lynn Wills, mother of two and a teacher in Cherokee County, said she’s just starting to see the impact of the changed health insurance plan.

“The biggest impact so far, is that I can no longer take my children to see their doctor,” Wills said. “I just lost it on the phone, I broke into tears. It’s an emotional thing because they know my children. The doctor was there when one of my daughters was born. She knows my children inside-out.”

Wills said her family was “so attached” to their pediatrician, and now they can’t see her again.

Actually, that Ms. Willis is misinformed.

She and her family members are free to use any doctor they wish. If they use a non-par doctor they will simply pay more for the services.

In making the switch to an Obamacare plan design Blue Cross priced the benefits based on a limited POS network. During the open enrollment period in October, 2013 employees were given summaries of the 3 new plans so there should not have been any surprises on January 1, with one exception.

The materials we received indicated the plan would use a much broader Blue Cross PPO network.

That was a misrepresentation.

My wife and I also have coverage through the SHBP. We selected a Bronze plan and made sure our doctors were in the PPO network.

They were, but they are not in the POS network actually used by Blue Cross. Wonder how that happened?

We know that Obamacare cancels policies and we can roll with the punches. Our medical needs are minimal and changing a few doctors is not an issue for us but I do understand the frustration expressed by Ms. Willis and others in their group. Communication about the new plan design during open enrollment was sketchy at best. Neither Blue Cross nor the consultant for our school system were helpful or knowledgeable. No doubt we would have been in worse shape had we not known the questions to ask and how to properly evaluate the new plans.

I empathize with the members of TRAGIC but they are not the only ones impacted by Obamacare. This scene will continue to play out in the private sector as employees review their new benefit levels and try to use their plan over the next few months. The SHBP impacts not only teachers, but 650,000 Georgia citizens that lost their old plan due to Obamacare.

Obamacare is here to stay and with it comes leaner health insurance plans with higher deductibles and higher premiums. If employers and employees are willing to pay even higher premiums they can get some semblance of their old coverage back, but I doubt many can afford that move. It is time to accept the fact that Obamacare cancels policies.

TRAGIC – Teachers Rally Against Georgia Insurance Changes

The Facebook page TRAGIC  (Teachers Rally Against Georgia Insurance Change) is a noble cause but totally misdirected. The group started by Ashley Cline are upset (rightly so) because of changes in the Georgia State Health Benefit Plan (SHBP) that came to light on 1/1/2014.

Mrs. Cline is upset with the state for the plan changes. If she doesn’t like the plan she should petition her school board to get their own plan, separate from the SHBP. Marching on the state capital (as they plan to do) is a waste of time and effort.

Actually, benefit changes were announced during open enrollment in October, 2013 but the reality of the changes didn’t hit this group of (mostly) teachers until last week when some of them actually tried to use their plan.

TRAGIC is upset over benefit changes in the SHBP. They want to blame the Governor and believe their protests will restore their “old” benefit plan.

It won’t.

Higher premiums, higher deductibles, higher out of pocket, elimination of copay’s and skinny doctor networks are a direct result of Obamacare. The benefit reductions they are experiencing today were set in motion 4 years ago with the signing of ACA.

Teachers Rallying Against Georgia Insurance Changes (TRAGIC) already has some 4,000 members who have signed a petition to oppose the state’s health insurance.

The new insurance plan affects not only teachers but an estimated 650,000 state employees.

Teachers said the plan they were forced to sign up for has higher premiums and fewer benefits.

CBS Atlanta

Actually, no one was forced to sign anything. Coverage was offered during open enrollment. Members could sign up for coverage or not.

Having gone through the enrollment process myself, I can say there was no coercion. I will also say that details on the plan were sketchy at best and incomplete.

In some cases we were totally misled.

Our benefit package indicated the plan would use the BCBSGA PPO network. Two weeks ago we discovered the PPO network would not be used but instead our plan had the much smaller and more restrictive POS network.

Fewer doctors. Fewer hospitals.

We also found out that the Rx benefit (administered by Express-Scripts) was NOT part of the health insurance plan. As a completely separate benefit drug claims do not accrue toward the major medical deductible or the out of pocket maximum.

This is where the wrath of TRAGIC should be directed.

Instead they are taking out their frustrations on the Governor’s office in hopes of restoring United Healthcare, the former TPA for SHBP.

Changing benefit administrators won’t bring back the old plan with copay’s and lower deductibles. TRAGIC is in denial about the real culprit.

Obamacare.

TRAGIC is encouraging teachers and state workers to call the governor’s office and express their concerns about the healthcare plan.

“It’s just another attack on teachers from the state government,” said John Carter, a middle school band teacher. “That’s all it is. It is a cash grab, and there’s no other way to put it.  It’s balancing our state budget on the backs of our teachers.”

No, it isn’t.

It is all about Obamacare.

TRAGIC needs to come out of the ether.

 

The Baby Daddy and Obamacare

Who is the baby daddy? In many cases it is #Obamacare. If you bought a subsidized Georgia health insurance plan from the baby daddyObamacare  exchange working taxpayers are funding at least a portion of your cost of your premiums. When you bring a baby into the world you need to tell the insurance company and Obamacare.

Why?

Because Obamacare is your baby daddy.

With regular private insurance, parents just notify the health plan. Insurers will still cover new babies, the administration says, but parents will also have to contact the government at some point later on.

Yahoo News

Working taxpayers, by way of the federal government, are providing tax breaks (premium subsidies) so you can afford to have health insurance. Since we are paying some of your bills we need to know when you have a baby (or adopt). We are your baby daddy.

Such changes affect financial assistance available under the law, so the government has to be brought into the loop.

That new baby may mean your taxpayer funded subsidy amount will change. Your gross premiums will increase. That is a given. But your net (after subsidy) may also increase.

But wait. There’s more.

It’s not just having a new baby that could create bureaucratic hassles, but other life changes affecting a consumer’s taxpayer-subsidized premiums. The list includes marriage and divorce, a death in the family, a new job or a change in income, even moving to a different community.

When you sign up for Obamcare the federal government needs to know more about your (formerly) private life. This includes marriage, divorce, children turning 19, moving to a new zip code  . . .

The role of the baby daddy is much expanded.

Insurers say computerized “change in circumstance” updates to deal with family and life developments were supposed to have been part of the federal system from the start.

But that feature got postponed as the government scrambled to fix technical problems that overwhelmed the health care website during its first couple of months.

“It’s just another example of ‘We’ll fix that later,'” said Bob Laszewski, an industry consultant who said he’s gotten complaints from several insurer clients. “This needed to be done well before January. It’s sort of a fly-by-night approach.”

No surprises here. Just more examples of incompetence in the Obama administration.

Just like many real life baby daddy’s, the Obama administration wants no part of actually taking care of matters. Big on promise, short on follow through.

Typical baby daddy.

Out of Network Hidden Providers

Out of network balance billing for P.A.R.E. claims are lurking and will pick your bank account clean. These hidden providers are like gunslingers in the wild west. They are not beholding to any rules and are free to charge whatever they want. If you don't pay they can ruin your credit and there is little you can do about it other than pay up.

Georgia State Representative Rusty Kidd found out the hard way when he took a tumble down a flight of stairs and had to be airlifted to Atlanta for treatment.

Kidd recovered. But he got another jolt when he opened a bill for the helicopter ride — about $27,000. Kidd’s insurer paid what it thought was reasonable: about $8,000. The company wanted Kidd to pay the rest.

“The average person can’t pay $19,000 and I can’t pay $19,000,” said Kidd, an independent.

People such as Kidd, who have what is considered full medical coverage, can end up with crushing medical bills on top of what they pay in deductibles and co-pays through a practice called “balance billing.”

It happens when patients get care from a hospital, doctor or ambulance company that is not part of the network of providers under contract with the patient’s insurer.

This is what insurers refer to as P.A.R.E. (Pathology, Anesthesiology, Radiology, Emergency) claims. While you MAY find par (network) providers in these situations the chances are these providers are not part of any network and are free to bill a "market" rate for their services.

Consumers who study their insurance benefit statements often marvel at the difference between the full-priced charges for a lab test or a hospital stay and the discounted rate negotiated by the insurer. The negotiated rate is often just a fraction of the full charge. Doctors and hospitals say their full charges reflect the expense of providing charity care and accepting government insurance plans that don’t cover their costs. But those footing the bill say that being asked to pay a charge that is often many times what an in-network or a Medicare patient pays simply isn’t reasonable.

How does the consumer know the amount charged isn't reasonable?

If two people buy an airplane ticket from Atlanta to New York, and one pays $99 while the other pays $450 for the same flight, which fare is "reasonable"?

Retail stores inflate their prices to cover such things as bank fee's charged for using debit and charge cards. Is it fair or reasonable for them to "overcharge" customers who pay cash?

Doctors say they also get squeezed by inadequate payments. What many insurers consider a “reasonable” payment is a sum many doctors say is too low. Some doctors are supporting a bill that would allow Medicare patients and their doctors to negotiate a rate — with the patient agreeing to pay what Medicare doesn’t cover.

Failing to pay what doctors consider a reasonable rate is hurting both the doctors and their patients, said Donald J. Palmisano Jr., executive director of the Medical Association of Georgia. “The patient doesn’t realize why they are paying more money and the physician is getting frustrated with the insurance company.”

There is no reason for the doctor to blame the insurance company. When a medical provider such as a doctor joins a PPO or HMO network they tacitly agree to the NEGOTIATED pricing for services rendered. In other words, by signing the contract they agree to accept the designated pricing as payment in full for services rendered.

Just as the non-par doc is free to bill a market rate, you are free to try and negotiate a lower fee directly with the provider. Since the provider is out of network, your health insurance company is unable to compel the provider to accept their payment as "in full". This is a private negotiation between you and the provider.

If you are unwilling to pay the amount as billed, and the provider is unwilling to discount their services, you are obligated to pay as billed. If you fail to do so the provider is free to turn your account over to collections.

This is not just limited to health insurance carriers. The same applies to docs that accept Medicare assignment.

If they don't like the payment schedule, don't sign the contract.

 

Dialysis for Illegals

Grady Hospital in Atlanta is negotiating with private clinics to provide dialysis for indigents, including illegal immigrants. Federal and local tax dollars support Grady.

Budget cuts forced Grady to close its outpatient dialysis clinic nearly two years ago. Grady paid for patient treatment at private clinics through the end of last August and then reached an agreement with private providers to share costs through the end of this August.

How much longer will Georgia citizens be required to pay for those who willfully break the law and enter this country illegally?

Last year, Grady agreed to pay Fresenius Medical Care of Massachusetts $750,000 to provide dialysis services to 25 uninsured immigrants — most of them in the country illegally — for a year.

Fresenius, Emory Healthcare and dialysis provider DaVita Inc. also agreed to provide free care for another 13 patients.

Advocates worry that without regular dialysis, the health of the patients with end-stage renal disease will deteriorate rapidly, leaving the emergency room as their only option.  

Grady closed its outpatient dialysis unit in October 2009 in an effort to balance its books. The hospital said it was losing roughly $4 million a year on the unit, treating 100 patients.

Unlimited uncompensated care cannot continue. At some point we have to face reality.

Obamacare Casualties

Five more health insurance companies become casualties in the Obamacare war on consumers. Aetna, Cigna, Guardian, American Community and Pekin will all leave the individual major medical market in the next few months. Together, these 5 insurance companies cover about 10% of those with individual health insurance in the state of Indiana.

Obamacare sinking

As reported by the IBJ . . .

Their major complaint is about the new health law’s requirement that at least 80 percent of premiums be spent on medical bills. That new rule, known formally as a medical loss ratio or MLR, takes effect this year for all individual policies the insurers hold, not just new policies.

The insurers argue that the marketing and administrative expenses on individual policies are so high that they cannot transition so quickly to the new standard.

Even if they could make the change, policyholder services are already suffering due to downsized customer service departments. This means longer hold times and a greater chance of getting voice mail in lieu of a real person.

Many carriers have already shifted their customer service overseas to places like India and Pakistan where wages are lower.

Imposing loss ratio's on company's operating in a competitive market is stupid to say the least. If a carrier spends too much on themselves and it leads to an increase in premium rates they will lose market share.

The idiot's in DC look at pockets where market saturation is dominated by one or more carriers and claim this is proof positive that more regulation is needed. According to the report, Anthem Blue Cross has a 65% market share which politicians use to defend their position.

I look at the same thing and say they must be doing something right, delivering good value, or else their market share would be significantly less.

Golden Rule health insurance is number 2 in Indiana with 10% of the market.

If Blue Cross has 6.5x the market share of Golden Rule one must conclude that Blue delivers a better value than Golden Rule. Their pricing has nothing to do with how much, or how little, either carrier spends internally on administration.

So far Georgia is pretty much immune to the wholesale withdrawal by health insurance companies but our time is coming. I would not be surprised to see Aetna or Cigna pull out of Georgia before the end of the year.

Their products have failed to deliver good value for some time and the same can be said for Golden Rule who have been uncompetitive for over 3 years now.

Bob Vineyard at Georgia Insurance Shop is willing to help GA citizens find affordable health insurance for individuals, families and business owners.

Hospital Exec Pay

The AJC thinks is it important to know how much Atlanta hospital CEO"s are paid. My response is, who cares? If you believe paying execs less will solve problems in the health care system you must be on crack.

The reporter hopes to get you on his side by telling how hospitals are laying off workers and Georgia citizens are filing bankruptcy because they can't pay their medical bills. He wants you to believe jobs would be saved and people would be able to pay their hospital bill if the CEO's weren't so greedy.

I mean really.

Let's use the recently departed (for another job, not left this earth) Michael Young, CEO of Grady, as an example. The AJC reports his pay was $834,000 for the 623 bed hospital which translates into $900 per bed as his comp.

The author would have you believe this is excessive.

For some odd reason the reporter fails to consider the $22 MILLION in uncompensated care rendered by Grady.

If Young worked for free Grady would still have over $21,000,000 in uncompensated care and that number would probably go higher considering the excellent job Young did of turning Grady around from near bankruptcy to a profitable status.

And what about that $900 per bed figure? Spread over 365 days that is less than $3 per bed per day.

Give me a break!

Twelve of the 15 acute care hospital systems in metro Atlanta are exempt from taxes on more than $2.6 billion worth of property and equipment. They also escape millions in sales taxes and income taxes.

No one has calculated lost revenue from exempting some hospitals from paying taxes. The number is thought to be substantial, however. For example, Tenet Healthcare Corp., a for-profit system of five hospitals in Georgia, paid $10.1 million last year in local, state and federal taxes.

So for-profit is better than not-for-profit?

Common public belief is just the opposite. The lame stream media would have you believe the cost of health care and health insurance would drop precipitously if health care providers would escape the profit directive.

Many tax exempt hospitals also receive millions in government grants.

And where does the government get their money?

From taxpayers.

Taxpayers such as Tenet Healthcare. So it is a cycle. For profit hospitals pay taxes that are cycled back to not-for-profit hospitals . . . less the "vigor" collected by the government for reallocating the wealth.

In exchange, these hospitals are supposed to pursue a social mission — defined loosely as providing uncompensated care, medical training, research and community outreach.

But when their CEOs have salaries rivaling corporate executives, the charitable work is obscured by an apparent pursuit of profit,

But wait.

Most of the Atlanta hospital CEO's skewered in this report work for not-for-profit hospitals. So are the pursuing profits or not?

Does the reporter even know what a profit is? Does the reporter understand that not-for-profit does not mean they cannot pay a competitive wage?

I don't think this guy has a clue.

In fiscal 2009, John Fox of Emory Healthcare made $1,671,999 to manage Emory University Hospital and five associated institutions.

Tim Stack of Piedmont Healthcare, who manages Piedmont Hospital and three others, made $1,340,974 the same year. Piedmont announced last month it will cut 464 jobs, although the hospital system made $46 million above operating expenses in fiscal 2010 and $12.5 million in the first nine months of this fiscal year.

So what?

Emory generates $1 billion in revenues and has 8400 employees. At $1.6 million Mr. Fox's pay is less than 2 tenths of a percent of gross revenues and works out to $190 per employee under his management.

If Mr. Fox worked for $0 each employee could get a $190 annual raise.

The concept of criticizing CEO pay is totally illogical. And if you didn't have someone of that caliber overseeing the daily operations how soon before it failed? What is fair pay for a billion dollar organization with 8400 employees?

If you want to solve the health care problems it is not to be found in the pay scale of the CEO, nor in a discussion of for-profit vs. not-for-profit.

Roughly 80% of health care dollars are spent on chronic conditions and 70% of those conditions can be prevented or reversed with lifestyle changes. We are an obese nation that rarely exercises other than getting up from our chair to find new batteries for the remote.

The other problem is the way health insurance is designed. Health insurance pays over 85% of the cost of health care. Too many people believe they cannot afford to visit the doctor unless they have a copay, even though most copay's are roughly 70% of the cost of the actual visit.

We don't need health insurance for the little things, we need it for the big medical expenses.

We don't buy car insurance with copay's for tires, brakes and oil changes. Why do we think we need health insurance with a doctor copay when the average person see's a doctor less than 3 times per year?

Instead of focusing on CEO pay, someone needs to take a hard look at personal responsibility and leave the folks who keep the hospital doors open alone.

I dare say most who are critical of the pay afforded to CEO's would not be able to run a successful 1 person business much less one with hundreds of employees.

Those who can, do. Those who can't are simply jealous.