forex blog

Although the national debate over health-care reform has only just begun, the first battle lines are being drawn over whether there should be a Medicare-like “public” insurance plan to compete with private insurers in a restructured market.

The public plan has already become a political litmus test for the Democratic left, which sees it as the only antidote to a private market that can't be trusted to deliver quality, affordable health care, and for the Republican right, which sees it as the Trojan horse for a government-run health-care system that will raise taxes and ration care.

The first thing to note is that this is hardly the most important issue in health-care reform. It is possible to design a system that could control costs, improve quality and increase access to care without giving everyone the chance to sign up for a government-run health-insurance plan modeled after Medicare. It's also possible to design a system that includes a public option.

The other thing to note is that if by “public option” you mean the current Medicare fee-for-service plan — a plan that makes no attempt to manage and coordinate care and pay for that care on the basis of the quality of the outcome — then a public option would be an awful idea and move the system in exactly the wrong direction.

This is not to say that a well-designed public insurance option couldn't become the model that private competitors would be forced to emulate. It could.

One thing we know about private health plans is that they spend anywhere from 12 to 30 percent of what they take in on non-medical costs: marketing, taxes, reserves, underwriting and profit. In Medicare, these “administrative expenses” run about 5 percent.

That doesn't mean that a public plan for the non-elderly would have the same cost advantage. Unlike Medicare, a new public plan hoping to attract paying customers would have to spend some amount on marketing. And like any insurer, it would probably want to invest in systems and medical staff to discourage doctors and hospitals from ordering up unnecessary tests and procedures. At the same time, under most reform scenarios, private insurers would be able to reduce administrative costs by eliminating their considerable underwriting expenses.

Bottom line: The administrative-cost advantage of a public insurance plan wouldn't be as big as Medicare's, but it could still be large enough to help drive down premiums in a competitive insurance market.

The better argument for a public option is that it could provide some serious pricing discipline for a market that suffers from runaway medical costs.

Rapid consolidation has given big hospital chains so much market power that they can effectively dictate prices even to the largest insurers, which know that they cannot compete for subscribers if they don't have the major hospitals in their networks. And in a similar fashion, pharmaceutical companies can virtually dictate prices to insurers for patented drugs if they are the most effective means of treating a particular ailment.

But while hospitals and drug companies often have more negotiating leverage than insurers, it is also true that insurers don't go out of their way to compete on the basis of price. The market in most regions is dominated by two or three big players that have learned they are better off raising prices in tandem than getting into price wars from which only the customers emerge as winners. Rather than compete on price, insurers compete to attract the healthiest patients.

That's why advocates of a public option believe a government insurance plan is needed to bring more robust price competition to the market, using its size to extract lower prices from providers and passing those savings on to consumers. Medicare already effectively dictates the prices it is willing to pay to doctors and hospitals, and there are very few providers who choose to opt out of the system. A public insurance plan for the non-elderly could simply piggyback on those lower Medicare prices.

The problem with this arrangement is that Medicare is so powerful that it can get away with paying only 80 to 85 percent of actual costs, forcing doctors and hospitals to overcharge private insurers to make up the difference. Private insurers fear that if they were forced to compete against a public plan with that kind of cost disadvantage, they would be driven out of the market. And doctors and hospitals warn that, without private insurers to overcharge, they'll wind up out of business, as well.

Uwe Reinhardt, a Princeton University economist, has a simple fix for this screwy pricing system. Reinhardt suggests that, once a year, each hospital or physicians group come up with a list of prices for individual procedures, or bundles of services, that it is willing to offer to any and all insurers, regardless of size. After reviewing the offers, Medicare and private insurers can then announce what price they are willing to pay and give providers one last chance to adjust their offers accordingly. After that, everyone would be free to do business with whomever they choose on the basis of the posted bids.

There is, of course, a name for such an arrangement. It's called a free market — in this case a market open to multiple buyers and sellers with regular bidding and transparent pricing. More to the point, it is a market that would work whether there was a public insurance option or not.

Like it or not, fixing our overpriced, under-performing health system will require substantial new government involvement in the markets for health insurance and medical care. Beyond that, however, there remains plenty of room for healthy debate on what form that government involvement should take.
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Sip your morning coffee. Button your shirt. Check your e-mail. Imagine doing those everyday things without using your thumbs. That's what many Americans with arthritis experience. Now, surgeons are using a new technique to help patients regain their mobility.

Like many, Gregg Frederick, 57, took his hands for granted until osteoarthritis made it impossible to pinch his fingers together.

“You just don't realize. A simple thing like buttoning a shirt. It's very hard to do some of those things, especially your sleeves, with one hand,” Frederick said. Osteoarthritis of the thumb is one of the most common forms of arthritis. Over a lifetime, the small joint on the bottom of the hand becomes stressed from pinching and grasping.

“The forces that this joint sees can be 20 to 40 pounds per square inch,” Dr. A. Lee Osterman said.
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The front door of your home is not only the focal point of your house; it’s where you, your family, and visitors regularly enter and exit your home, making it a major outlet of incoming and outgoing energy. Known as the “mouth of chi,” the main door is where the home absorbs much of its energy nourishment. But sometimes the architectural design over the entrance of your home presents a challenge for the flow of energy, which is when it’s time to consult a feng shui practitioner or take some feng shui classes to learn ways to slow down the energy once it comes into the door, focusing it and redirecting it to the rest of the house. For example, if the staircase to the upstairs or basement is located very close to the entrance and the foyer is small, a feng shui cure can help you rework the flow of energy so it doesn’t come in the door and quickly rush upstairs or downstairs, leaving the ground floor of your home without energy nourishment.

To learn how to slow down, focus, and guide energy, you may consider checking out a few feng shui classes in your area, whether you are interested in feng shui certification or just the information. You’ll learn that strategically placed items can help you work with the small foyer space that you have to keep energy on the ground floor when it comes in the entrance. A large vase with flowers or a houseplant, art, a piece of furniture, or a mirror can accomplish this purpose, although if you do decide to use a mirror it shouldn’t face the entrance directly, as this will push energy away and out of the home instead of into the home.

A main entrance with a small foyer and a staircase facing the door is only one of the architectural designs that could benefit from a consultation from a professional with feng shui training. Feng shui cures are often specific to an individual space and its needs, so a feng shui consultant will be able to improve the flow of chi in your home and will have the knowledge to use more advanced aspects of feng shui. Determining the bagua (feng shui energy map) of your home, for example, will produce a host of feng shui cures like painting the walls certain colors and other tactics that will support the five elements of feng shui.

A front door with good feng shui can have a remarkable effect on your health, success, and relationships by providing you and your family with nourishing energy that sustains every aspect of your life.

By: David Tang

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by Nancy Jaffer/For The Star-Ledger
Monday April 20, 2009, 12:39 AM

Rolex FEI World Cup Finals

LAS VEGAS — The dream of an American sweep at the last Rolex FEI World Cup Finals to be held in the U.S. for years fell short of reality Sunday, as even two perfect rounds over the fences couldn't enable McLain Ward to take the international indoor show jumping title.

Ward, the Olympic double gold medalist from New York, was not quite as fast as Germany's Meredith Michaels Beerbaum in the first leg of the competition at the Thomas & Mack Center on Thursday night, and that proved to be the difference that gave her a third World Cup title.

Like Ward, who rode Sapphire, Beerbaum and her 16-year-old equine partner, Shutterfly, were penalty-free in the two-round power jumping finale before a vocal crowd of 7,497. Beerbaum retained the two-penalty lead over Ward that she carried into the class, but the world's number-one ranked rider called her triumph “the hardest win I've ever had.”

Ward had worked on a plan since last year to be the first American show jumper since 1987 to earn the title. It could have been quite a coup if he emulated the achievement of his countryman, Steffen Peters, who took the Dressage World Cup honors Saturday night.

“I certainly would have liked to have won, but I'm proud of what my team, my horse and myself did,” said Ward. “We did the best we could, and 99 percent of the time, we would have won.”

The only other American to finish in the ribbons was Ward's 2004 and 2008 Olympic teammate, Beezie Madden, 12th on an up-and-coming mount, Danny Boy. Third place went to the Netherlands' Albert Zoer on Oki Doki, who stalked the leaders throughout the competition.

Since 2003, the Cup finals had been held every other year in Las Vegas, but because of the economy, the organizer withdrew bids for 2011 and 2013. It was announced after the show, however, that a bid will be put in for 2014.
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There are people in the universe who have a knack for finding great deals when it comes to purchasing cheap airline tickets. But how do they do it? The vast the greater part of us just pay whatever the airlines or travel sites charge, but if you’re tired of wasting money on air fare here are some tips to avoid you save money on your next trip.

Most people get their tickets through a travel agent or online travel website. While these can be a sympathetic place to find good deals the hidden secret of the airline industry is to contact the airlines themselves. They don’t always advertise their pass flights but if you call them and ask they will tell you where and how you can save money. You can also take advantage of booking your flight early enough if you know your travel plans well in move. If your travel plans are open then flying standby can be another way to get cheap airline tickets, but this won’t work if you are tied to a waterproof schedule.

One place many people don’t think to look are online auction sites. These can be a good apartment to find low cost plane tickets with one word of warning. Make sure these tickets are transferable otherwise you will have bought tickets that you cannot use. Also validation the minimum price of the tickets being offered against what they would actually cost if you were to purchase them directly from the airline or at an online hang around site. If the cost difference in negligible then it may be better to pass on the auction price because many airlines will charge a take fee that wipes out any savings you might have thought you would get.

The many travel related web sites on the internet today are another good part of the country to find cheap air fare deals. Some of the bigger sites are able to directly negotiate with the airlines and purchase blocks of seats at a large discount. They can then pass these saving onto their customers, but you normally have to act fast when these types of deals become available because savvy travelers escalate accept on them fast.

One thing to remember is to compare prices from various sources. What may seem like a good understanding large may not be once you compare it to other avenues. Also stay on the lookout for hidden fees that will raise the price to the point where it makes just now as much sense to buy the ticket directly from the airline anyway.

Cheap airline tickets can be found with a little research, pertinacious, and patience. Those who are good at finding good deals know where to look and what questions to ask. By using some of the suggestions here you can learn the ins and outs of frugal money the next time you travel.