My day just imploded....so much for having an afternoon off...

Thank goodness... it's time to fill out another FRIDAY FIVE!!!

1. Did you vote in your last elections?
Yep...sure did! This was the first time I actually went to the polling place, rather then absentee voting, so being the rookie that I was I overvoted on my first ballot and the machine reguritated it. But...I was allowed to fill out a new ballot and make my voice heard!

2. Do you know who your elected representatives are?
I sure do...even the one who only has a 2-year college degree!!!

3. Have you ever contacted an elected representative? If so, what was it about?
No. I haven't really had the need to.

4. Have you ever participated in a demonstration?
No. Haven't ever wanted to either. Frankly I don't think they do that much good....or, maybe I just haven't had the passion about one cause to demonstrate about it.

5. Have you ever volunteered in an election? What was the result?
Not yet...Jeff and I kept saying that we wanted to this time, but it was a little too late. I would like to get involved in one the next race. It would be a great jumping off point for my future political career....(ha!)

A glimmer of Hope
I haven’t posted about healthcare issues in quite some time...so here you go...

Much fuss has been made over the last 10 years about the Insurance industries migration towards HMO programs. (Health Management Organizations) The low-down-nitty-gritty on traditional HMO's is basically that doctors are rewarded financially for keeping their patient's costs under a certain allotted amount. In a number of cases, this has led to physicians depriving patients of necessary tests and treatments, so that the physicians can earn their bonus at the end of the year. HMO's surged in popularity during the late 80's and early 90's because they were offered to employers at significantly lower premiums than traditions plans. However, from what I have seen, physicians have begun shying away from these plans in the last few years because of the unethical practices that they can promote. Employers have begun shying away from these plans, in part because their employees are irate with the concept of a traditional HMO and partly because the HMO's are having a much harder time lowering per patient spending any further. Thus employers and employees are seeing double-digit increases in premium costs and a trend toward increased employee costs regardless of the format of their insurance.

Alas, a new solution is on the horizon--Paying physicians bonuses for providing higher quality care. The insurance industry is starting to turn their focus towards providing (and paying for) higher quality care today, especially for chronically ill patients, in the hopes of lowering costs in the future. They hope to achieve this by increasing preventative medicine, promoting consistent tracking of chronically ill patients and encouraging physicians to join organizations like the American Diabetes’s Association is the focus of the new solution. In January 2003 quality care based incentive programs will debut in four states. California, the trendsetter in healthcare, announced their version of this program over the summer and today several large employers and health insurers in Massachuets announced a similar plan. Ohio and Kentucky are also experimenting with quality care incentive plans.

As is pointed out in the Boston Globe article, physicians are not completely sold on these new plans. The resounding criticism of the incentive based plan is that the incentive money has to come from somewhere. Physicians suspect that their bonuses will be paid from money that the insurer saves by reducing their overall reimbursement schedule, or by discounting the reimbursements of a physician who is not considered to be a high quality care provider. I believe that physicians have a legitimate reason to voice this concern, it seems that insurance companies continue to increase premiums and at the same time reduce physician reimbursements, placing significant financial burdens on physicians trying to run their small businesses. Another major concern, particularly from the physicians in California, is the criteria used to determine the quality level of care. While the insurers are trying to set up a fair quality evaluation plan it is next to impossible to set up one that physicians and insurers will agree upon because of the subjective nature of medical care. (What one doctor thinks is necessary, another doctor may not and both could be right, taking us back to the HMO sponsored notion of seeking second opinions)

From my point of view, working in the healthcare industry, I think these plans are a step in the right direction. While these first four programs are by no means the answer to the physician/insurer relationship, they are a good jumping off point. I presume that all of these programs will undergo major revisions during their first years life, but I believe the end result could revolutionize the turbulent relationship that physicians have with the insurance industry. It seems to me that people are much more likely to work hard when they are rewarded for doing a good job...I have yet to meet a physician who entered the medical field with a willingness to allow an HMO to dictate what level of care they could provide their patients. Most, but certainly not all, physicians are in medicine because they want to help people. It seems that this new program would finally cater to that desire.

While the incentive-based insurance plan seems to be revolutionary by itself it is by no means the final product that insurers have in mind for this program. In their ultimate form these plans could force some physicians out of business. (Thus being another concern of the doctors who are in the medical field for their own gain) The ultimate, quietly spoken, goal of these insurance plans is to find ways to provide consumers with better information about which providers do the best job and to use financial carrots (such as higher employee contributions and coinsurance requirements) to encourage consumers to select them. The skeleton of the next step (a medical Consumer Reports of sorts) of the programs is evidenced by New York-based employees of IBM, Xerox, PepsiCo and Verizon who are able to access a Web site that ranks local hospitals based on quality and performance measures. Thus allowing them to decide to spend their increased financial burden at a hospital that would provide the best care. Why do employers and insurance companies care if their insured’s are seeking care from a quality location? (I wondered this myself...so I looked around the web) In an article about the roll out of the quality ranking website, Bruce Taylor, director of benefits planning for Verizon, was quoted as saying, "We think that 20% to 30% of health care costs can be reduced by minimizing mistakes and doing the procedure right the first time." It's an interesting concept that hasn't been widely discussed in healthcare up to this point (to my knowledge).

You have got to be kidding me...
As part of my daily routine here at the office, I spend a good portion of my week on the phone calling insurance companies about claims they either haven't paid or they have paid incorrectly.(You wouldn't beleive the mistakes insurance companies make) We do a large amount of work with this one third party repricing clearing house out of Omaha,NE and I spend hours every month listening to their hold music because their call processing is so slow. (On average I'd say I wait on hold 9-14 minutes before a live body can take my call). Well...today when I called them I was spared the annoying hold message. Rather I got this message: "Due to high call volume our customer service representatives will be unable to handle your call until 8am MONDAY" What good is customer service if there is no service provided? I think at the very least this is obviously a sign that they need to hire more people and really don't give a shit about their business. It's not like their call volume suddenly sky rocketed overnight. My question now is what exactly do you have to do to call and be included in the calls they take that day? If I call at 8am Monday am I going to find out that my call is being delayed until Wednesday? They are going to be sorry next time they send me a feedback form to fill out...I think I'll start sharpening pencils for it now...although taking time to read my feedback would only delay their call processing even longer...

I am in the process of changing my blog comment site. However, being the raw html idiot that I am. I have managed to mess up the template of my site yet again. So...please bear with me as I correct the situation.

Check this out...you can surprise your family and friends at your next gathering with confetti with their picture on it. I found this link via Not Martha...

Remember a few weeks back when I told you to keep an eye on Derek Kitts...well...he won! He'll be the State Representative in Oregon's 30th District. I am sure we'll see him on the national scene in a few years...

Election Recap
Since it's 12:00pm on the day after the election, I will go ahead and presume that everyone reading this is already aware of the election outcomes from yesterday (if you aren't, crawl out from under your rock and read CNN) so instead of presenting you with redundant information I am going to share so election oddities and factoids with you that I have found around the web this afternoon:

----When choosing to endorse a Gubernatorial candidate in California The Sacramento Bee had this to say: "What a choice: a Republican challenger without a clue and a Democratic incumbent without a conscience." -- They endorsed the incumbent (and winner) Gray Davis.

----After 225 years, Vermont got its first female sheriff as Connie Allen ran unopposed in one of the state's 14 counties.

----David Bacon, the Green candidate for New Mexico governor, has a sun-powered house and a car that runs on vegetable oil. (You have got to be kidding me!!!)

----Daniel O'Donnell, brother of former talk-show host Rosie O'Donnell, won a state Assembly seat from Manhattan.

----In case you were worried that this nutcase would win again, I am happy to report that James Traficant, lost his House seat from the gray-bar hotel, only after he aired campaign commercials filmed in his cell. However...27,487 people (15% of the voters) did vote for this wack job...I would really like to meet these people...actually maybe I wouldn't their stupidity could scar me for life.

----In one South Dakota race the amount of money spent by the candidates on the campaign was so extreme that if they had simply divided the money between all the eligible voters in South Dakota each voter would have been handed $80.

----At least he has a sense of humor...after suffering internal injuries from a horse riding accident two days before the election, Idaho House Speaker Bruce Newcomb stated: "The great news is that, as a good Republican, I clearly veered to the right when I was thrown."

Apathy
It baffles me that the same people who adorned themselves, their cars and their houses in red, white and blue paraphernalia while professing patriotic musings every chance they got after the September 11th attack last year are sitting around today complaining that "boring election crap" is preempting their television shows this evening. I heard someone say this morning, as she turned on her radio, " I don't think it's even worth listening today, it's all going to talk about election returns, no celebrity news or anything fun." Someone else quipped that her son's sixth grade teacher had the nerve to send home a memo to the parents informing them that it was very important that they watch the election returns with their child this evening and to help the child understand the election because they would be talking about it in school tomorrow. She said "I can't sit there and pretend to make this something interesting for him...it's just boring, stupid and it's not really that important anyways." To her I ask: "Is 8 rules about Dating My Teenage Daughter really more important than the government of your country whom you trust with 28% of your hard earned money every year?"

PEOPLE...today is what makes America who we are. The freedom to go out to the poll and punch the ballot for the Elephants, Donkeys, Libertarians, Greens, or whomever else your heart desires is exactly what was attacked last year that made you proclaim your patriotism. Embrace your freedom! Vote! Watch the returns...there are mindless TV shows on 364 other nights a year! Get involved in your country! Don't just sit there are claim to be a patriotic American! Celebrate your country...Celebrate your freedom!

What they don't tell you about marriage during pre-nup prep

Two years ago when Jeff and I started our pre-nup prep at church we had to take compatibility tests and answer questions to the priest about each other. He proceeded to tell us all about marriage and offer insights about how to have a successful marriage. We were bombarded with information about how to fight with each other, how to handle finances and how to communicate effectively. We were reminded that we would never be able to change the other person, or their family, we were offered advice on celebrating holidays, being spiritual and (because we're catholic) how to practice natural family planning. Through our months of preparation with the priests and our sponsor couple, and even throughout all of the outside "advice" we got from everyone who heard we were getting married, there were some things that people never told me about.

For example, No one told me what a peaceful feeling watching my husband sleep would be. No one told me that suddenly I would realize when we are fighting being happy is much more important than being right. No one told me that everywhere I turned someone would have an opinion on my marriage, often based completely in hearsay and uninformed observations, and their opinion wouldn't matter one bit because in my heart I'd know the truth. No one told me how much easier it is to be sick when you're married, because you have someone to take care of you and to keep you company.

Most importantly, no one told me just how wonderful it was going to be to be a part of another family.

Don't get me wrong, I absolutely love my wacky-opinionated-bizarre-family and I wouldn't trade them for the world. At first, joining a new family wasn't easy...was I going to fit in, were they going to like me, etc. etc. But, the longer I am a member of Jeff's family the more I realize what an incredible gift they are to me. I have never known more intelligent, warm, welcoming, loving people than everyone who is a member (and honorary/adopted member) of the Utech family tree. We had the opportunity this weekend to have Jeff's Dad out to stay with us for four days. (Jeff's Mom is very sick and unfortunately it is impossible for her to travel) We spent time visiting with him, watching TV, listening to stories and just relaxing. I really wish we either lived closer to him or we saw him a little more often than we do. In addition to spending the weekend with Jeff's Dad, we also had Jeff's brother Greg at our house along with two of the "adopted" Utechs, Aaron and Erik. Sunday involved even more Utech family when Jeff's Aunt Sue, Uncle Phil, Aunt Margie and Uncle Kip came over for dinner. Spending time with everyone in the Utech family, hearing their crazy stories and memories, helps me not only to know my husband better, but to realize that my children are going to be very blessed to be born into this family. It might sound silly and cheesy, but I am very proud to be in this family.

And even though I say that no one told me before I was married how wonderful it is to be a part of a new family, I think about it now and I don't think there was any way that they could have told me this and made me understood. It's almost indescribable.

The BIG Day is Here!
No, I'm not talking about George and Laura Bush's 25th Wedding Anniversary...Rather...it's Election Day! The day that all American's have the chance to exercise our right to vote and celebrate the beautiful democracy that we live in. It's also the day that the negative ads on our televisions, radios, telephones and in our mailboxes will finally end!!! Many important decisions will be made around the country today. Obviously there are 34 senate seats, all 425 House Seats and 36 governor mansions on the ballots and the outcome of these elections will have a direct effect on the rest of Dubya's presidency and the 2004 election. But in many states there are local issues of importance on the ballots..for example...
...In Alaska they will be deciding whether or not to move the state capital...
...Nevada will vote on legalizing pot...
...Oregon is trying to remove a prohibition from their constitution that bans African-Americans from living within the state's borders...
...Several states in the south are trying to outlaw cock fights...
...and many many more...
Anyways...No matter what your political views are Election Day should be a day filled with patriotic pride...this is one heckuva country we live in.

And the people were heard
Well, it looks like the website Firebobbywilliams.com was a success. MSU canned Mr. Williams yesterday.