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Rationing Health Insurance For Texas Has Profound Consequences

Texas houses the world’s largest medical campus with 14 hospitals and three medical schools spread across 14 square blocks. The Texas Medical Center draws former first ladies and even Arab sheiks to their high-tech facilities with aquariums and spraying fountains.

However, for more than six million Texans without Texas health coverage, these world-class health care institutions remain largely out of reach. Texas is still the state with the highest percentage of population without health coverage. During Governor Rick Perry’s tenure, the 24.6 percent uninsured rate boomed to 35 percent this year. In human terms, that translates to one out of three people lacking health insurance for Texas in Harris County, which includes Houston.

Dr. Leonard Zwelling, an oncologist at the University of Texas M.D. Anderson Cancer Center, expressed it this way: “Houston is such a rich city, with some of the best medical care in the world… And yet the people without insurance have a heck of a time getting into most of these facilities because they can’t pay.” For Dr. Zwelling, this is “ground zero” in the health care disaster.

Rationing Texas Health Insurance Spreads Pain Across Texas

According to researchers, so many people going without Texas health insurance plans means that Texas pays the cost with a host of health problems. Overall, quality in the delivery of health care is poorer than in every other state. In the 2010 report released by the federal Agency for Healthcare Research and Quality, Texas had poor health care quality for preventive, acute and chronic care, including conditions like diabetes, cardiovascular and respiratory diseases.

Commonwealth Fund data on the state’s health system performance ranked Texas third to the last when it comes to the percentage of adults with a regular source of medical care. Texas placed 39th in the percentage of adults over 50 who get screening procedures such as mammograms and colonoscopies. And, one fifth of the state’s pregnant women do not get prenatal care during their first trimester. As for children, more than a third of them did not receive preventive care and immunization rates were low, as well. According to doctors, a lot of people without Texas health insurance die of treatable diseases because they delay seeking medical help due to the cost or because they have long waiting periods to get appointments to see specialists.

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Health Care Reform – Let It Come But Be Ready for Change!

To stir emotions the health care reform debate doesn’t have to peel the onion back very far. There are those who could always afford health insurance and are worried that their costs will significantly rise in the attempt to cover the cost of care for those who have gone without. There are those with numerous and expensive to treat medical problems, who have no health insurance or inadequate health insurance coverage and they need relief, now! And there are those who are healthy, have chosen not to have health insurance, and resent a mandate requiring them to “buy-in” or face monetary penalties.

The Health Care Affordability Act of 2010 is wide in its scope and goals. First, it moves us to a place where most Americans will be covered by health insurance. This will remove “the” key impediment to “routine” health care services for millions of Americans. Subsidies will insure health care insurance regardless of an ability to pay and just because you have pre-existing medical conditions you will still be eligible for “reasonably priced” coverage. Stated another way, insurers will not be able to reject you or drastically increase your premiums if you suffer from chronic illnesses that generate a high level of claims, nor will they be allowed to set dollar limits on health insurance coverage.

To fund these objectives the Health Care Affordability Act requires all Americans to purchase health insurance. There will be subsidies if you are in a low income category and if you have no ability to pay anything you will be eligible for Medicaid as these state level programs will be more accommodating and act as the ultimate safety net. Through its mandates, the law requires millions of healthy individuals to pay into the system. The idea here is that those of us who are not in need of health care will fund those who draw from it. Since any of us can succumb to a health emergency at any time and thus become in need of potentially costly health care interventions those who support the mandate feel that this is fair – we are simply looking out for each other. Next, there are numerous plans in testing phases that are designed to make the delivery of health care more efficient and more cost effective. These pilot programs are being managed by the Center for Medicare and Medicaid Services (CMS) and include the cooperation of health systems throughout the country. These are complex to say the least and in early development stages and until proven, which is years from now, it is not known what their effect will be.

I support the attempt by the Obama administration and others to get something done on this pressing national issue. But there is a lack of candor about the cost, where the funds will come from, what treatments and medical technologies will be restricted due to very high costs and how the demand of millions of newly insured patients will be managed in terms of timely access to care and treatments. I have spent forty-one years of my life in a medical technology career that focused on global health economics and reimbursement issues and believe me, something will have to give. In every country outside of America, health care budgets are limited and capped. Fees to hospitals and physicians are set, annually reviewed and kept in check and new medical technology prices and access to them are restricted in subtle and not so subtle ways. And if you think that these policies won’t happen in America – think again, as spending limits are being set and will be set and we will have to live within them!

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Fight Rising Texas Health Insurance Costs

In a statement made by Texas State Representative John Smittee, “You look at the cost of health care in general and it’s increasing faster than the cost of living.” According to a Commonwealth Fund report, we have seen individual Texas health insurance premiums increase by almost 50 percent in the past eight years. The rise in family and group Texas health insurance plan premiums was even greater. A 2011 survey conducted by the Kaiser Family Foundation found that the cost of giving health benefits to employees increased by 118 percent for large firms and 103 percent for small firms in the past 10 years.

Health Savings Accounts Made Available To Texans

Under the “IRC Section 223” or state “Qualifying High Deductible Health Plan,” certain high-deductible Texas insurance plans are allowed to pair with a Health Savings Account or HSA. Health Savings Accounts started back in 2004. Since then, there had been an influx in people enrolling in HSA plans. Health Savings Accounts are available to Texans who buy their own TX health insurance plan, who are self-employed or who have employer-provided HSA plans.

In a study by United Benefit Advisors it showed that HSA-qualified plans have fewer and lower rate hikes as well as lower premiums compared to traditional health care plans. The rate of HSA premium increases is one third to one half that of what traditional plans has been. Results showed that the cost of HSA plans had only risen by an average of 3.4 percent while premiums for all plans combined increased an average of 9.6 percent in 2005 alone.

Between 2004 and 2005, Health Savings Account plan premiums increased by an average of 2.8 percent while the combined cost of Texas health plans rose by 7.3 percent as affirmed by a survey released by the Deloitte Center for Health Solutions.

Employers And Employees Can Both Benefit From A Health Savings Account

Since Health Savings Accounts started, many employers have realized that switching from group coverage to Health Savings Account plans offered in the individual market increases their savings that permit them to fund an HSA for every employee. Thanks to the new health care reform law, HSA plans now cover preventive health care from in-network providers with no out-of-pocket costs. This is even before the policyholder meets their deductible. If the medical expenses are not covered by their health insurance plan, employees can withdraw HSA money tax-free to pay for qualified medical expenses.

How Can Health Reimbursement Arrangements Help?

Health Savings Accounts and Health Reimbursement Arrangements (HRA) can be used together. However, their use must not overlap each other. For example, you are not allowed to reimburse medical expenses that are meant to go toward the deductible of the HSA-qualified Texas health insurance. The main purpose of HRA plans is to reimburse workers for health care costs not covered by health plans as well as health insurance premiums. HRAs offer flexibility to employers because they can control the healthcare benefits of their workers without compromising the healthcare they receive.

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Who Needs Health Savings Accounts And Health Reimbursement Arrangements?

Employers and the self-employed are using two main strategies to keep the cost of health insurance low and to reduce their taxes. Known as an HSA, a Health Savings Account can make most health care expenses tax deductible, and provide tax-deferred earnings. Individuals and business owners can start an HSA once they purchase a health plan that’s certified to be HSA compatible. These plans are available in the individual market for much lower premiums than plans in the group coverage market.

Can Health Savings Accounts Be Combined With A HRA?

Employers and people who are self-employed if the spouse works in the business may add a Health Reimbursement Arrangement to substantially increase the tax savings available with an HSA alone.

To put it simply, a Health Reimbursement Arrangement (HRA) is an employer-funded medical reimbursement plan for employees. Someone who is self-employed cannot have an HRA in his or her name, but can reimburse the spouse, who works in the business as a W-2 employee, through an HRA. All of the family’s qualified health care and insurance expenses can be reimbursed, and that includes the expenses of the self-employed business owner by virtue of being a member of the HRA-covered family.

The big rush to get HRAs in place by Dec. 31 resulted because the cost of health insurance premiums could then be reimbursed for the whole year back to January 2011. Reimbursement for other kinds of health care is not retroactive, though. Those who start a HRA in January 2012 can reimburse their employees for health care, including premiums.

Since group coverage has become an expensive option for both employers and employees, HRAs present a less expensive choice that can help both parties save on health care costs. Compared to group plan rates, policies in the individual market can save employers up to 50 percent. Certain of these plans, known as Health Savings Accounts, This makes if feasible for more employers to provide health care coverage to more employees. By setting up a HRA, employers can legitimately reimburse their employees for individual health insurance premiums and other health care costs.

How Do Health Reimbursement Arrangements Work?

On a regular basis, an employer contributes a pre-determined amount to an account on an employee’s behalf. The employee can submit a reimbursement request for qualified medical expenses, and such reimbursements are not taxed.

What’s Required To Start A HRA?

The primary requirement is that the plan must be funded solely by the employer. It cannot be funded by salary reduction. In addition, the plan may only provide benefits for substantiated medical expenses.

HRAs may be designed in many fashions to suit the specific needs of employer and employees alike. It is one of the most flexible types of employee benefits plans, making it very attractive to most employers.

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How and Where To Get Health Insurance for Low Income Individuals

In the US, reading the statistics of Americans without their health insurance is startling. According to Huffington Post, this 2012, almost 50 million Americans are living without health plans. This is different from years ago. And why does this happen? This is because there are lots of Americans today that don’t have jobs or cannot find stable jobs that can let them have the luxury of paying for their health plans. In some families, paying for their home rent is even a problem. So, is it still possible to secure health insurance for low income families and individuals while in the midst of the crisis? Yes, it is still possible according to experts. We only need to know where to find it.

Health insurance for low income people are actually out there. Unfortunately, some of us know only few of them while other people don’t know how to tap them well. But as we have said, these resources are already here. So in this article we have gathered the most possible sources that we can tap to get almost the same benefits that low premium insurance plans can provide.

Below are the best possible options in place of securing health insurance for low income people.

  1. COBRA. This is the Consolidated Omnibus Budget Reconciliation Act. If you are out of job, you can try applying for COBRA and if you will be eligible you can continue your previous companies’ health insurance through this process. This is better than finding a new health insurance plan but there is a possibility that you may pay higher premium for it.
  2. Workers’ compensation. If you are employed and your job is risky, inquire from your employer if you are under the Workers’ Compensation program. You can have injury compensations if you get injured during your work.
  3. Medicaid. Even if you are employed, better apply for Medicaid especially if you belong to the low income bracket. Medicaid can help you pay your health care expenses or some of it if you can’t afford to pay for it. Medicaid exists through federal and state partnership and was designed to help low income families, disabled and old people with their medical expenses. You can also apply your family to Medicaid because this is an opportunity that your state provides to those who can’t afford paying for regular health insurance plans.
  4. Medicare. This is an option that comes from the government and being administered by the Social Security administration. If you are unemployed or don’t have a regular employment and with a family, you can try enrolling yourselves and your family to Medicare especially if you are getting Social Security benefits. For those who are sixty-five years old or even older, they are most eligible to be under the Medicare programs.
  5. State High Risk State Insurance Pools. All of us do have health problems sometimes and unfortunately when we have pre-existing medical conditions we are usually denied coverage by health insurance companies. If you are denied of such privilege and did not qualify for COBRA while getting health insurance for low income individuals can also be a problem, you can rely on high risk state insurance pools. You can inquire from your city administrators or community hospitals where you can apply for this option. You may still pay premium for the plan but at least this can answer your medical cost even you have pre-existing health conditions.

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Brendan Eich and His Web Development Theory

Brendan Eich is currently the Chief Technology Officer (CTO) of Mozilla. However, prior to that he has a more important designation attached to his name – JavaScript founder. Yes, it is Brendan Eich whose brainchild is the JavaScript scripting programming language. JavaScript language is used by millions of web developers to create user-friendly, responsive interfaces over the web.

While speaking at the O’Reilly Fluent Conference in San Francisco, Brendan Eich shared his feelings about the road to web development. He thinks the JavaScript developers or web developers have a tough job to do and he really means it. Being a JavaScript developer, a person has to face a lot of challenges and spend sleepless nights.

He compared the web developers with the character Ash played by the actor Bruce Campbell in the popular horror movie of the 1980s “Evil Dead”. Brendan Eich was excited by the way the movie character used his hand as a chainsaw to cut things. The idea of improving JavaScript came in his mind after seeing “Evil Dead”.

At the O’Reilly Fluent Conference Brendan Eich said “To be a Web developer, you have to be tough like Ash. JavaScript is kind of a chainsaw you have in place of a hand on the Web”. He also said he strongly believes web development has always been tough and even today it is not a matter of joke.

Brendan Eich defined ECMAscript 6 specification as the “high road” for JavaScript. He shared his experience of seeing the ECMAscript 6 specification used in almost all top browsers by the various web development leaders. The ECMAscript 6 specification is currently available in the marketplace for anyone to use the same in the browsers.

According to Eich, web developers actually make notable changes in the “ECMAScript” to fill any discrepancy in the language without actually altering the JavaScript to another language. Thus, web developers don’t need to look at pre-compilers or trans-compilers with the availability of the ECMAScript 6 specification since this specification gives them the golden opportunity to make necessary changes within the language and outside of it as well in the most productive manner.

Along with ECMAScript 6 ECMAScript 7 was also developed side by side. Brendan Eich pointed out that ECMAScript version 7 shows the major and minor distinctions of JavaScript as a programming language. For example, object observe, which is one of the high-road capabilities, enables the Model View Controller library to automatically adjust model view without any outside help from a developing expert. To say a bit more about the object observe capability, well it is based on proxy work in ECMAscript version 6 that is already implemented in the Firefox and Chrome browsers.

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What Are the Responsibilities of a Web Developer

A web developer’s job is to build and maintain websites, keeping the customer and consumer in mind. This means the finished design should contain the products/services offered, and show the way to access them. For instance, the customer might need a form to get the visitor’s email address so they could acquire more information, give a newsletter or thank a customer for doing business with them.

A back-end developer is one type that focuses on creating the back-end of a site. Another type, the front-end developer, focuses on the client side to give more style and functionality to the site.

Typically, the work is very focused on every project, which includes working together with a team that helps in coordinating the client’s requirements with the final product. Work may involve having meetings with clients to discuss what they want and need for their website, or how to keep it up-to-date and functioning efficiently.

Generally, web developers build the website’s layout, creating a visually appealing home page, a user-friendly design, and at times, useful content for visitors. Once a website is active, a developer sees to it that the site functions well on all browsers, whatever the screen size/resolution by testing and revising whenever necessary.

Web developers know a lot about technology and the way computers and web servers function. They are versed in most software programs, web applications, plus web programming languages like JavaScript (JS), HTML, C++ and Ruby on Rails. They should be capable of communicating well, setting goals and meeting target dates.

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Web Developer Types:

Front-End Developers

This type of web developer codes the site’s front end. Web design refers to how a website looks, but front end development is the means by which this design is executed on the web.

Back-End Developers

These web developers build and maintain the technology required to supply the components with power, in order to make it possible for the site’s user-facing side to exist. The back-end code gives function to everything created by the front-end designer.

Full Stack Developers

Such developers know how all parts of the web development process go together, and they can guide when it comes to strategies and best practices. Full stack developers will definitely have an important role even more in the future of web development, and have the ability to look at the “big picture”. They are familiar with both the server-side and the client side’s user experience.

Java Script (JS) Developers