Category Archives: Healthcare

Living in Switzerland ruined me for America and its lousy work culture

Chantal Panozzo | February 1, 2016 | Vox

I was halfway through a job interview when I realized I was wrinkling my nose. I couldn’t help myself. A full-time freelance position with a long commute, no benefits, and a quarter of my old pay was the best they could do? I couldn’t hide how I felt about that, and the 25-year-old conducting the interview noticed.

“Are you interested in permanent jobs instead?” she asked.

“I could consider a permanent job if it was part-time,” I said.

She looked at me like I was speaking a foreign language and went right back to her pitch: long commute, full-time, no benefits. No way, I thought. Who would want to do that? And then it hit me: Either I had become a completely privileged jerk or my own country was not as amazing as I had once thought it to be. This wasn’t an unusually bad offer: It was just American Reality.

Now that I’m back, I’m angry that my own country isn’t providing more for its people

Before I moved to Switzerland for almost a decade, American Reality was all I knew. I was living in a two-bedroom apartment making $30,000 a year in a job where I worked almost seven days a week with no overtime pay and received 10 days of paid time off a year.

In other words, for the hours worked, I was making minimum wage, if that. The glamour of this job was supposed to make up for the hours, but in reality, working every weekend is a ticket to burnout — not success.

My husband and I were so accustomed to American Reality that when he was offered an opportunity to work in Switzerland, we both thought about travel and adventure — not about improving our quality of life. It hadn’t occurred to us that we could improve our quality of life simply by moving.

But without realizing it, or even asking for it, a better life quality came to us. And this is why, now that I’m back, I’m angry that my own country isn’t providing more for its people. I will never regret living abroad. It taught me to understand another culture. And it taught me to see my own. But it also taught me something else — to lose touch with the American version of reality.

Here are seven ways living abroad made it hard to return to American life.

1) I had work-life balance

The Swiss work hard, but they have a strong work-life balance. According to data from the Organisation for Economic Co-operation and Development, the average Swiss worker earned the equivalent of $91,574 a year in 2013, while the average American worker earned only $55,708. But the real story is that the average American had to work 219 hours more per year for this lesser salary.

Which brings us to lunch. In Switzerland, you don’t arrive to a meeting late, but you also don’t leave for your lunch break a second past noon. If it’s summer, jumping into the lake to swim with the swans is an acceptable way to spend your lunch hour. If you eat a sandwich at your desk, people will scold you. I learned this the hard way.

“Ugh,” said Tom, a Swiss art director I shared an office with at a Zurich ad agency. “It smells like someone ate their lunch in here.” He threw open the windows and fanned the air.

“They did. I ate a sandwich here,” I said.

Tom looked at me like I was crazy.

“No. Tomorrow you’re having a proper lunch. With me,” he said.

The next day, exactly at noon, we rode the funicular to a restaurant where we dined al fresco above Zurich. After lunch, we strolled down the hill. I felt guilty for being gone for an hour and a half. But no one had missed us at the office.

Lunchtime is sacred time in Switzerland. When I was on maternity leave, my husband came home for lunch to help me care for our daughter. This strengthened our marriage. Many families still reunite during weekdays over the lunch hour.

Weekends in Switzerland encourage leisure time, too. On Sundays, you can’t even shop — most stores are closed. You are semi-required to hike in the Alps with your family. It’s just what you do.

he author and her daughter in Urnaesch, Switzerland, watching the cows come home. (Brian Opyd)

2) I had time and money

The Swiss have a culture of professional part-time work, and as a result, part-time jobs include every benefit of a full-time job, including vacation time and payment into two Swiss pension systems. Salaries for part-time work are set as a percentage of a professional full-time salary­ because unlike in the United States, part-time jobs are not viewed as necessarily unskilled jobs with their attendant lower pay.

During my Swiss career, I was employed by various companies from 25 percent to 100 percent. When I worked 60 percent, for example, I worked three days a week. A job that is 50 percent could mean the employee works five mornings a week or, as I once did, two and a half days a week. The freedom to choose the amount of work that was right for me at varying points of my life was wonderful and kept me engaged and happy.

When I took only 10 days for a trip to Spain, my colleagues chastised me for taking so little time off

Often, jobs in Switzerland are advertised with the percentage of work that is expected. Other times, you can negotiate what percentage you would like to work or request to go from working five days a week to four days a week, for example. There is normally little risk involved in asking.

Continue reading Living in Switzerland ruined me for America and its lousy work culture

Gallup CEO: Economic Recovery Hasn’t Actually Happened

Jim Clifton | September 21, 2016 | EFT Daily News

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Jim Clifton, CEO of Gallup, one of the largest polling organizations in the world, just penned a piece that pans the supposed U.S. economic recovery — and he has the demographic data to support it.

“I don’t think it’s true,” writes Clifton, in response to recent reports in the New York Times andFinancial Times about a recovering economy. He notes that the amount of Americans who consider themselves above “lower class” has plunged in recent years:


The percentage of Americans who say they are in the middle or upper-middle class has fallen 10 percentage points, from a 61% average between 2000 and 2008 to 51% today.

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Ten percent of 250 million adults in the U.S. is 25 million people whose economic lives have crashed. 

Clifton identifies three main data points that he’d like to see serious improvement in for him to believe in an actual recovery, specifically, anemic full-time employment, a dearth of publicly-traded companies, and a lack of new business startups:

There are three serious metrics that need to be turned around or we’ll lose the whole middle class.

  1. According to the U.S. Bureau of Labor Statistics, the percentage of the total U.S. adult population that has a full-time job has been hovering around 48% since 2010 — this is the lowest full-time employment level since 1983.
  2. The number of publicly listed companies trading on U.S. exchanges has been cut almost in half in the past 20 years — from about 7,300 to 3,700. Because firms can’t grow organically — that is, build more business from new and existing customers — they give up and pay high prices to acquire their competitors, thus drastically shrinking the number of U.S. public companies. This seriously contributes to the massive loss of U.S. middle-class jobs.
  3. New business startups are at historical lows. Americans have stopped starting businesses. And the businesses that do start are growing at historically slow rates.

For thing to truly improve for the majority of all Americans, says Clifton, we’ll need to see a renewed boom in small business creation:

Gallup finds that small businesses — startups plus “shootups,” those that grow big — are the engine of new economic energy. According to the U.S. Small Business Administration, 65% of all new jobs are created by small businesses, not large ones.

In an era where the big just keep getting bigger, and the small seem to simply fade away, it’s easy to see why how the wider economy — and everyday Americans — will suffer. Despite relatively low unemployment and stocks trading near all-time highs, real economic growth has been very slow to respond, and that won’t change until we see a renaissance in smaller firms.

Bottom line: The two most trusted institutions in the U.S. are the military and small business. Most people know about our military’s importance, but not as many appreciate the role small business plays in creating the majority of new jobs and in national security itself.

Most people’s preferred measure of the economy, The SPDR Dow Jones Industrial Average ETF (NYSE:DIA) was unchanged in premarket trading today ahead of the upcoming Federal Reserve decision. The DIA, which is the largest ETF that tracks the DJIA, has risen 4.06% year-to-date.

Des Moines Register Editorial: Branstad’s legacy: Killing health care jobs

Des Moines Register | August 20 2016

For someone who talks big about job creation, Gov. Terry Branstad is doing a stellar job of jeopardizing the solvency of some Iowa employers. Four months after implementation of his plan to privatize Medicaid administration, the carnage is in full swing. Stories of small employers not being paid by managed care companies are being reported across the state.

Cedar Rapids-based JVA Mobility is no longer selling medical equipment to nursing homes. Despite obtaining prior authorizations from the insurers to repair or provide wheelchairs to residents, the company is not being reimbursed for the cost.

“They’ve come up with all sorts of answers why,” owner Vince Wolrab told the Cedar Rapids Gazette. “Some say it’s trial and error — we’ve used the wrong (billing code). But then some they just flat out deny and tell us it needs to be billed to Medicare, when they know Medicare won’t cover it.”

Senior Resources in Muscatine, a nonprofit organization that helps older Iowans live independently, may soon need to take out more loans. It has no other way to make up for the loss of revenue after being stiffed by private insurers.

Continue reading Des Moines Register Editorial: Branstad’s legacy: Killing health care jobs

Iowa: Time to Pull the Plug on the Medicaid Mess?

Iowa House Democrat Leader Mark Smith | August 11 2016 | Journal Express

A few months ago, Governor Terry Branstad and Republicans privatized health care for over 500,000 Iowans on Medicaid. After months of delays, confusion, and scandal, Branstad’s privatization scheme is now officially a disaster.

All around the state, we’ve been hearing horror stories from Iowans and local providers dealing with the new private, out-of-state companies Branstad picked to manage Medicaid (called MCO’s).

Providers are facing huge financial burdens because of payment delays and lower reimbursement rates from the MCO’s. According to a recent survey, nearly 80% of providers said they aren’t getting paid on time while nearly every provider said their own administrative costs have increased trying to navigate the new system.

We heard similar stories from providers at a legislative health committee hearing at the State Capitol last week. I held a listening post in my hometown of Marshalltown just a few weeks ago to get feedback as well. When I asked what was going well with Medicaid privatization, the room went silent.

My biggest fear about Branstad’s privatization scheme has always been the impact on health care services Iowans depend on.

Continue reading Iowa: Time to Pull the Plug on the Medicaid Mess?

Are We Witnessing an Obamacare Exodus?

Sean Williams | July 31 2016 | Motley Fool

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IMAGE SOURCE: WHITE HOUSE ON FLICKR

It’s been more than two years since the Affordable Care Act, commonly known as “Obamacare,” was fully implemented, but the controversy surrounding the health law hasn’t died down one iota.

In one corner, supporters of Obamacare can rightly point to the lowest uninsured rates on record. The Centers for Disease Control and Prevention notes that the uninsured rate as of the end of 2015 was just 9.1%, down 16% from the end of 2013, the year immediately preceding the implementation of Obamacare. Gallup’s Q1 2016 data shows an uninsured rate of 11%, down more than six percentage points from Q4 2013. Don’t forget that on top of the 11.1 million paying Obamacare customers enrolled in the marketplace exchanges as of March 31, 2016, there are nearly as many people who’ve gained access to medical care through the expansion of Medicaid programs in 31 states.

In the other corner are those who can be rightly critical of the program. Despite being told by President Obama that “you’ll be able to keep your doctor,” millions of Americans lost their primary care physicians and health plans because of beefed-up minimum benefit requirements. Additionally, many consumers aren’t too keen on the penalty associated with not purchasing health insurance.

However, premium inflation is arguably what’s drawing the most debate and ire surrounding Obamacare. A recent analysis from the Kaiser Family Foundation of the lowest-cost silver plans in 14 major cities suggested that premium costs could rise by 11% in 2017.

And who do we find in the middle of this battle? Consumers and insurers.

Continue reading Are We Witnessing an Obamacare Exodus?

Des Moines Register Editorial: Iowa Medicaid Privatization Nightmare Becomes Reality

Des Moines Register | July 16 2016

Gov. Terry Branstad insisted his plan to privatize administration of Medicaid would save the state money. It made no sense that handing billions of public dollars to for-profit companies would miraculously reduce spending in the health insurance program for 560,000  Iowans. His administration provided no meaningful details about how savings would be achieved. The public was just supposed to have faith and hope for the best.

Now perhaps it is becoming clear how the Medicaid belt will be tightened: by not paying health care providers for services. Three months after the governor’s pet privatization project was implemented, the billing problems are piling up.

Many Iowans who provide in-home care for disabled people have gone without pay for weeks or months, according to a state workers’ union. These are individuals who change bedpans, bathe and feed patients while earning $9 to $12 per hour. “Missing even one paycheck can be detrimental,” said Danny Homan, state president of the American Federation of State, County and Municipal Employees.

He said his office has received multiple calls about problems. Though the providers filled out mounds of paperwork for the managed-care companies contracted by the Branstad administration, they report not being paid at all, being paid late and other billing problems.

Some health workers, nonprofits and businesses are turning to state lawmakers for help.

Continue reading Des Moines Register Editorial: Iowa Medicaid Privatization Nightmare Becomes Reality

Pew Research Center: More Americans Disapprove Than Approve of Health Care Law

Pew Research Center | April 27, 2016

Democrats increasingly say law has had a positive impact on U.S.

Modest-changes-in-publics-overall-view-of-ACA-since-its-passage-in-2010The public’s views of the Affordable Care Act, which were evenly divided following the Supreme Court’s ruling last summer upholding a key section of the law, are again more negative than positive. Currently, 44% approve of the 2010 health care law, compared with 54% who disapprove of the law.

In July 2015, after the Supreme Court upheld the federal government’s ability to provide insurance subsidies through federal exchanges, nearly equal shares approved (48%) as disapproved of the law (49%). Over the prior two years, somewhat more disapproved than approved of the law.

However, the balance of opinion about the law’s impact on the country has grown less negative over the past three years, even as slightly more continue to see the impact as negative than positive. Currently, 44% say the law’s impact on the country has been mostly negative, 39% say it has been mostly positive and 13% say it has not had much of an effect. In December 2013, amid the flawed rollout of the health exchanges, opinions about the law’s impact on the country were much more negative than positive: 49% saw its impact as largely negative while fewer than half as many (23%) said it had had a positive effect on the country as a whole (22% said it hadn’t had much of an effect).

Since that point, positive views of the law’s impact on the country have increased 16 percentage points (from 23% to 39%), while there has been a modest decrease in negative views (49% then, 44% today).

Continue reading Pew Research Center: More Americans Disapprove Than Approve of Health Care Law

Mayo rebuffs Iowa Medicaid managed-care contracts

by Tony Leys | March 24, 2016 | Des Moines Register 

Iowans with Medicaid health coverage will not be able to routinely use the Mayo Clinic after the state shifts the $4 billion program to private management next week.

The three managed-care companies that will run Iowa’s Medicaid program told legislators this week they’ve been unable to negotiate contracts with Mayo’s famed hospital system, which is just across the border in Rochester, Minn.

Cheryl Harding, Amerihealth’s top executive in Iowa, told legislators that her managed-care firm has signed contracts with three Mayo-affiliated primary care clinics in Iowa, but not with Mayo’s main medical center in Rochester. The other managed-care companies, UnitedHealth and Amerigroup, also said they have not obtained such contracts.

“The hospitals have notified all of us that they do not wish to be a provider for Iowa Medicaid any longer, which is unfortunate,” Harding said.

Continue reading Mayo rebuffs Iowa Medicaid managed-care contracts

The Koch-Fueled Plot to Destroy the VA

By Kevin Drum | Sun Mar. 13 | Mother Jones

A ranking of the various kinds of American health care on a “socialized medicine” scale of 1 to 10 would look something like this:

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If you’re a hardcore libertarian, which program would you be most eager to privatize? The VA, of course, which is America’s only genuine example of purely socialized medicine. In the past, the VA’s status as health care provider to military vets has protected it from attack, but that’s changed over the past few years. Why? Because of a carefully orchestrated smear campaign by a Koch-funded activist group called Concerned Veterans for America. Over at the Washington Monthly, Alicia Mundy reports:

Though the CVA’s incorporation papers don’t reveal its donors, Wayne Gable, former head of federal affairs for Koch Industries, is listed as a trustee. The group also hired Pete Hegseth as its CEO…a seasoned conservative activist, having been groomed at a series of organizations connected to—and often indirectly funded by—the Koch brothers.

…Hegseth became a fixture on Fox and was a guest on Bill Maher’s show….By late 2013, Hegseth and the CVA were making the case that the VA needed “market-based” reform that provided vets with more “choice” to receive care from private doctors and hospitals.

…Then, on April 9, 2014, at a hearing in the House Committee on Veterans’ Affairs, Representative [Jeff] Miller dropped the bomb. He announced that his staff had been quietly investigating the VA hospital in Phoenix and had made a shocking discovery: some local VA officials had altered or destroyed records to hide evidence of lengthy wait times for appointments. And worse, Miller claimed, as many as forty veterans could have died while waiting for care.

This latter charge guaranteed screaming headlines from the likes of CNN, but was later shown to be unsubstantiated…In only twenty-eight out of the more than 3,000 patient cases examined by the inspector general was there any evidence of patient care being adversely affected by wait times…In most VA facilities, wait times for established patients to see a primary care doc or a specialist were in the range of two to four days…For the VA system as a whole, 96 percent of patients received appointments within thirty days.

In short, there was no fundamental problem at the VA with wait times, in Phoenix or anywhere else.

Continue reading The Koch-Fueled Plot to Destroy the VA

The VA Isn’t Broken, Yet

by Alicia Mundy | March/April/May 2016 | Washington Monthly

Inside the Koch brothers’ campaign to invent a scandal and dismantle the country’s most successful health care system.
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Falling in line: Republican candidates like Marco Rubio have made pilgrimages to events sponsored by the Koch brothers-funded group Concerned Veterans for America.

In past presidential primaries, when candidates wanted to win the votes of veterans they would trek to American Legion halls and Veterans of Foreign Wars conventions in far corners of Iowa and New Hampshire. While there’s been a little of that in the current primary contest, a new pattern has emerged, at least on the Republican side.

Over the last year, every major GOP candidate with the exception of Donald Trump has made a pilgrimage to gatherings put on by Concerned Veterans for America (CVA), a group that had barely formed during the 2012 primary cycle. Whereas candidates back in the day were under pressure from the old-line veterans’ groups to promise undying support for the Department of Veterans Affairs (VA) and its nationwide network of hospitals and clinics, the opposite has been true this season. Candidates at CVA rallies have been competing with each other to badmouth the VA and its allegedly shabby treatment of veterans. And all have pledged fealty to the CVA’s goal of moving as many vets as possible out of the VA into private care. Even Trump is calling for more “choice.”

This may not at first hearing seem too surprising. Nearly the whole of the Republican Party has become more radically antigovernment in recent years. And since the spring of 2014, when headlines started appearing about long wait times and cover-ups at some VA hospitals, a strong narrative has built up, including in the mainstream media, that the system is fundamentally broken. A recent front-page headline in the New York Times proclaimed, as if it were a matter of fact, that Bernie Sanders’s support for the VA during the controversy over wait times proved his poor judgment: “Faith in Agency Clouded Bernie Sanders’s V.A. Response.”

Continue reading The VA Isn’t Broken, Yet