RT @nycsouthpaw: RT @joshgreenman: On the Tonight Show, Romney is explaining, quite articulately, the precise logic behind the health ca …
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RT @nycsouthpaw: RT @joshgreenman: On the Tonight Show, Romney is explaining, quite articulately, the precise logic behind the health ca …
RT @nycsouthpaw: RT @joshgreenman: On the Tonight Show, Romney is explaining, quite articulately, the precise logic behind the health ca …
The U.S. Postal Service’s proposal to withdraw from the Federal Employees Health Benefits Program is likely to be included in legislation due for debate on Capitol Hill next month, but lawmakers on both sides of the political spectrum remain skeptical that it would solve the cash-strapped agency’s fiscal woes.
USPS claims that leaving FEHBP and providing its own employee and retiree health benefit plan would save $7 billion annually and eliminate the need for further scheduled prefunding of retiree health benefits. Under the proposal — part of a five-year business plan unveiled in February — active employees initially would be covered under a simplified plan similar to FEHBP. The Postal Service would establish a separate program for new hires following private sector best practices, including incentives for Medicare-eligible beneficiaries to enroll in Medicare and wellness programs.
Debate on the Senate’s bipartisan postal reform bill originally slated for this week is unlikely to occur until mid-April, according to The Federal Times. That bill includes a measure that would require USPS to negotiate with its unions to develop a health care plan. The legislation also would restructure its prefunded retirement health benefit requirement.
About $21 billion of $25 billion total in Postal Service losses over the past five fiscal years stemmed from a provision in a 2006 law requiring the agency to prefund its retiree health benefits, according to USPS Postmaster General Patrick Donahoe.
“We have insufficient revenue to cover our costs and are rapidly approaching our statutory debt limit of $15 billion,” Donahoe said in testimony before the House Oversight and Government Reform Subcommittee on the Federal Workforce, U.S. Postal Service and Labor Policy on Tuesday.
Even if lawmakers adopt the Senate’s proposal and eliminate USPS’ prefunding requirement entirely, the Postal Service still would want to withdraw from FEHBP, Donahoe told reporters.
“We never can stop trying to be as efficient as possible and that means looking at health care and continuing to manage a network even after the 2016 time frame,” he said.
Rep. Darrell Issa, D-Calif., chairman of the full committee, said he would “probably support” the Postal Service’s health plan proposal but had reservations. He said the agency’s contention that it could generate $60 billion in revenue in 2015 with all the reforms in its five year business plan was a “rosy” scenario.
“Let’s have no illusions, you’re just cost shifting,” Issa told Donahoe. “There’s no cost savings to the American people. The money will be paid out of one hand in order to save it in another hand.”
According to Walton Francis, an economist and independent analyst who also testified at Tuesday’s hearing, health care premiums for other General Schedule and nonpostal workers would decrease if Postal Service employees left FEHBP since USPS’ workforce skews older than that of other agencies.
Despite that possibility, the National Association of Retired and Federal Employees still opposes the proposal, said Julie Tagen, NARFE’s legislative director.
“Nothing [Donahoe] says allays the fears of retirees, workers or taxpayers,” Tagen told Government Executive. They would be better off if USPS focused solely on eliminating its prefunding requirement payments first, she said.
Francis said the Postal Service’s health care expenses would rise by about 10 percent if it left the governmentwide program and no longer benefited from the larger and younger on average insurance pool.
Nonetheless, the agency could save nearly $500 million annually under its own program, simply by contributing less to premium costs, he said.
“It is more than passingly ironic that a USPS system facing ever more devastating competition, including parcel carriers and the Internet, fails to understand that competition among competing health plans drives down costs while improving service,” he said.
Francis recommended that postal employees be encouraged to switch from one of the highest cost plans offered through FEHBP to one of the 12 lowest cost plans offered. He estimates that could generate roughly $2,000 per employee in savings. USPS could offer $200 per year to employees who agree to switch to the lower cost plan, he suggested.
The House was preparing to abolish the Independent Payment Advisory Board on Thursday – a board that Republicans once derided as a “death panel” and that even some Democrats don’t like because it could bigfoot Congress. While the repeal bill isn’t going anywhere – President Obama has threatened to veto it – it’s another chance for some political theater.
Republicans have torpedoed any chance for a bipartisan vote on this, apparently on purpose, by attaching some legislation that Democrats won’t support.
The IPAB was created in the 2010 health care overhaul law as a last line of defense against out-of-control Medicare costs. The 15-member board of experts from across the health-care field has the power to step in and cut Medicare payments if they seem to be spiraling too high.
It would take some power out of the hands of Congress, so some Democrats have joined Republicans in opposing it. The Congressional Budget Office has said abolishing IPAB would raise the deficit by $3.1 billion over 10 years, so Republicans have tacked on medical malpractice reform legislation to pay for it.
According to the Congressional Budget Office, the medical-malpractice legislation would save the federal government $57 billion, meaning it would easily cover the cost of the IPAB repeal. After the first $3 billion is used to cover IPAB, the next $54 billion would go directly toward the deficit.
(Image via docent/Shutterstock.com)
Suicide rates among Army personnel have increased by 80 percent since the military began sending troops to Iraq, a new study shows.
Army suicides were trending downward from 1977 to 2003, but started rising in 2004, according to the study written by officials from the service’s Public Health Command and published Thursday in Injury Prevention, an international peer-reviewed journal for health professionals. During the same time frame, there was a prevalent increase in mental disorders among the Army. Male soldiers, troops with mental health disorders treated on an outpatient basis and those in lower enlisted ranks had higher risk of suicide.
“This study does not show that U.S. military operations in Iraq and Afghanistan cause suicide,” study contributing author and spokeswoman Dr. Michelle Chervak, senior epidemiologist at the U.S. Army Public Health Command, told Government Executive. “This study suggests that an Army engaged in prolonged combat operations is a population under stress, and that mental health conditions and suicide can be expected to increase under these circumstances.”
Around 40 percent of the suicides since 2004 might be associated with Iraq-related military events, the study’s authors said. About 20 in every 100,000 soldiers committed suicide in 2008. Nearly one-third of suicides that year occurred among troops who were not deployed. Chervak emphasized, however, that even during peacetime, 10 to 15 in every 100,000 soldiers die by suicide.
The research was based on data from the Defense Casualty Information Processing System and Defense Medical Surveillance System, and took six months to complete.
Chervak said prevention strategies for soldiers — some of which the Army already has implemented — could include more education of chaplains, primary care doctors and other individuals who interact with those most at risk for mental health disorders. The study also suggested initiating mental health and suicide awareness programs, as well as mental fitness and resiliency training.
The Defense Department recently announced plans to streamline the agency that manages its military health benefit program, creating a new Defense Health Agency.
According to Nextgov’s Bob Brewin, the new agency will assume responsibility for common clinical and business processes across the Military Health System, such as medical education for physicians, nurses, medics, pharmacists, medical logistics and health information technology. The department is currently assembling a team to design the consolidation.
The plan, included in the 2012 Defense Authorization Bill, still falls short of a 2006 Defense Business Board recommendation for TRICARE realignment, Brewin writes. The independent panel called for the creation of a unified combatant command — a unit not specific to Army, Navy or Air Force — that is led by a four-star general or admiral.
Still, the new Defense Health Agency represents an elevated status for military health care within the department. It will be run by a three-star general or admiral — two grades higher in military rank than the current TRICARE director, Army Brig. Gen. Bryan Gamble.
According to Federal News Radio, DoD sees the plan as “the appropriate next step in establishing structure and improving the governance of the Military Health System while reigning in health care costs.”
The Obama administration’s fiscal 2013 budget request asks Congress to approve new TRICARE co-pays, additional increases to TRICARE Prime enrollment fees, initiation of standard and extra enrollment fees, and adjustments to deductibles and catastrophic coverage caps.
Last month, Chairman of the Joint Chiefs of Staff Martin Dempsey sympathized with service members’ worries about the fee hikes, telling them, “We’ve heard your concerns.”
Military, Vets Included in FHA Plans
The White House is boosting support for military service members and veterans hit by the housing crisis with a Federal Housing Administration
President Obama announced this week additional protections for military members and veterans “wrongfully foreclosed upon or denied a lower interest rates on their mortgages.”
The White House said federal and state authorities will work together to:
- Conduct a review of every servicemember foreclosures since 2006 and provide any who were wrongly foreclosed upon with compensation equal to a minimum of lost equity, plus interest and $116,785.
- Refund to servicemembers money lost because they were wrongfully denied the opportunity to reduce their mortgage payments through lower interest rates;
- Pay $10 million dollars into the Veterans Affairs fund that guarantees loans on favorable terms for veterans.
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Just days after senators complained of the ineffectiveness of a new software designed to ferret out fraudulent Medicare claims, the Justice and Health and Human Services departments were able to speak softly while wielding a big stick.
On Tuesday, federal prosecutors announced that they had arrested a Texas doctor and five owners of home health-care agencies charged with fraudulently billing Medicare and Medicaid nearly $375 million. They described it as the largest case of its kind ever
And it was software that detected the suspicious patterns in the invoices.
Charlie Clark joined Government Executive in the fall of 2009. He has been on staff at The Washington Post, Congressional Quarterly, National Journal, Time-Life Books, Tax Analysts, the Association of Governing Boards of Universities and Colleges, and the National Center on Education and the Economy. He has written or edited online news, daily news stories, long features, wire copy, magazines, books and organizational media strategies.
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The Labor Department’s Occupational Safety and Health Administration has filed suit against the U.S. Postal Service, OSHA confirmed Wednesday.
According to OSHA, the Postal Service specifically violated Section 11(c) of the 1970 Occupational Safety and Health Act, when a safety specialist at the Seattle Process and Distribution Center faced discrimination and retaliation after providing information to an employee who wanted to file a safety complaint with OSHA.
After being reprimanded for advising a colleague to file a complaint, the safety specialist was transferred to another office, his work was given to someone with a lower pay-grade and he was blocked from receiving a promotion, according to a press release from OSHA.
The suit, reported Tuesday by the Seattle Weekly, is asking for relief for the safety specialist, including payment of lost wages and benefits and compensation damages for emotional distress.
“An employee’s right to report unsafe and unhealthy workplace conditions must be protected to ensure that workers are not injured or sickened on the job,” Dean Ikeda, OSHA’s regional administrator in Seattle, said in a statement. “Hostility and retaliation against whistleblowers are simply unacceptable.”
Labor also is asking the court to order a permanent injunction against the Postal Service to prevent future violations of the law, as this is OSHA’s second lawsuit against the Seattle processing and distribution center.
Labor sued USPS in July 2009, alleging that an employee was wrongfully discharged after she filed a complaint about unhealthy working conditions. That employee was referred to OSHA by the safety specialist who is the subject of the current lawsuit. According to an OSHA spokeswoman, the 2009 case was withdrawn.
While OSHA cannot sue other federal agencies, Congress amended the Occupational Safety and Health Actin 1998 to make sure USPS was treated as a private employer under the legislation.
A law restricting an employer’s ability to lower its health care costs by offering incentives for working-age military retirees to use TRICARE instead of an employer-sponsored plan could save the federal government tens of millions annually — but those savings might be reduced due to rising private sector health care costs.
A recent
The statute, known as Section 707, was enacted in 2010 and requires employers to stop offering certain incentives to TRICARE-eligible employees. Before the law, employers seeking to keep their costs low gave TRICARE-eligible employees cash or TRICARE supplements to use the military health program. Now, under Section 707, employers are still able to offer enticements to find alternatives to their health plans, but the incentives must be extended to all employees, regardless of military status. They also can offer TRICARE through group plans if the TRICARE-eligible employee pays the full out-of-pocket cost.
The purpose of the law is to net savings for the government. Military compensation and benefits currently account for nearly one-third of total Defense spending, and the fiscal 2013 budget proposal includes signifcant changes to the structure of TRICARE that require higher fees for enrollees.
Because military members often can retire after 20 years of service, many are young enough to continue working in the private sector, where they can choose an employer-provided health care plan. The CBO estimate found that 75 percent of working-age retires still choose TRICARE, however. It concluded that rising health care costs from employer-sponsored plans could reduce savings expected from Section 707.
“If the growth in out-of-pocket expenses arising under employer-sponsored health care plans continues to outpace those under TRICARE by significant margins, more retires are likely to leave employer-sponsored care and enroll in TRICARE, which will probably reduce the savings attributable to Section 707,” CBO wrote. “However, the path of out-of-pocket expenses under TRICARE will depend to a large extent on future decisions about the administration of that program.”
CBO also found that some beneficiaries continue to use TRICARE even without the employer-subsidized supplements, and “almost always” use TRICARE Standard, the fee-for-service plan, rather than TRICARE Prime. CBO speculated this will change due to Section 707.
“With employers no longer subsidizing the supplements for TRICARE Standard, it is likely that many working-age military retirees have stopped using Standard and have instead enrolled in TRICARE Prime (the managed care option of the TRICARE benefit) because it has very low out-of-pocket costs,” CBO wrote. “However, the average cost to the federal government for TRICARE Prime is at least 15 percent higher than it is for TRICARE Standard. Therefore, the change in behavior by these people probably raises the government’s costs.”
CBO conducted its analysis based on a model that simulates certain assumptions of choices, and conceded that it was difficult to completely measure outcomes.
The report was originally requested by Sen. Lindsey Graham, R-S.C., and addressed to him as well as the chairman and ranking members of congressional defense committees.