Some Good News on Health Care Horizon!

This agreement isn’t perfect but it’s a start: emc=edit_th_20150416&nl=todaysheadlines&nlid=54404043

It matters because: 

Health Care is a foreign country– with incomprehensible language, rules, customs, bills and money: 

  • Medicare can’t negotiate drug prices but the VA can.
  • Health care services have not been rewarded for quality, safety and outcomes.
  • Insurance rules and rates vary state by state.
  • Rules and taxes differ between large and small employers.
  • Insurance is not considered commerce.
  • Competition actually increases health care costs.  
  • Both Republican and Democratic administrations caused cost increases.

And Much More—BUT..There are things you can do in your own community.

Read The Buck Still Stops Nowhere to find outIt’s a short, 100 page, hard hitting guide you can’t find anywhere else. We’re in the early publishing, print on demand stage to prepare for broader distribution. We have: 

  • ISBN and Library of Congress/copyright numbers.
  • References, readings and a quick reform history since 1869. 
  • Knowledgeable external reviewers.
  • All testimonials newly confirmed.

Price:  $12.95, (plus tax for Washington state orders).  All orders plus shipping and handling–$20. Books currently print on demand only.  Orders payable to:  Kathleen O’Connor LLC (registered in Washington State). Or order on line via PayPal.  Pre-book store orders autographed.  

  • Pre-bookstore copies available late April or very early May.
  • Copies available in some book stores May or June.
  • All pre-digital book costs (including book stores) include shipping and handling
  • Digital books available in late May or early June. 

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Uninsured Rate Drops–But HOT Issues Remain Ahead

The Gallup Poll reported today (4/13/15) that the number of uninsured dropped to its lowest point since 2008. Read the Gallup story here:

This is wonderful news.  BUT.  The biggest fight looms ahead with the Cadillac Tax and potential fines of $2,000 per employee that large employers (100+) could face:

This is a very complicated issue that is filled with legalize about–numbers of hours worked—spousal coverage–job title–, etc.etc. etc.  I am not a legal expert on all the technicalities, but…

BRIEFLY: Large employers self-fund/insure their health care benefits. Therefore, they are not an insurance company. Consequently, they are not regulated like insurance companies nor are they subject to state insurance rules and taxes.  Insurance is regulated at the state level.  Consequently, large employers:

  • Do not pay an insurance company to insure their health benefits.
  • Invest instead what they would have paid in insurance premiums and then hire an insurance company or a third party administrator to manage the benefits.  
  • Are exempt from state premium taxes and state mandated benefits.
  • Don’t pay health insurance premium taxes to the state that small businesses and individuals must pay to their state.

This is going to be a  huge fight over benefits, regulations and taxes.  The summary below is about the most understandable I could find quickly:

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If You Wondered Why I titled the book: The Buck Still Stops Nowhere–Just read this

United’s CEO salary  and compensation speaks for itself. See below.

Pharmaceutical profits have gone from 18.6% in 1999 to over 44% now–this the most profitable industry in the country even over banking and financial interests.  This is why you should read my book!  If we don’t do something, money will keep going to special interest pockets like his!

United, by the way, just bought a pharmaceutical company:

“UnitedHealth’s announced acquisition of pharmacy benefit manager Catamaran Corp. for $12.8 billion on March 31 will make Minnetonka-based UnitedHealth the largest company in Minnesota — public or private.”

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“IT Depends”–Why America’s Health Care IS All Dollars and No Sense–And What YOU Can Do

The Buck Stops Nowhere--Front Cover

 Why America’s Health Care is All Dollars and No Sense and What You Can Do © (excerpt–page 5)

  “A Clear Concise Guide to America’s Health Care”

  • Health Care is foreign territory. Unlike foreign countries there is no embassy or safe haven.
  • What you pay depends on where you live, your insurance and where you work.
  • Insurance rules are different in each state.
  • Even federal programs like Medicare have different rates   and fees in each state including physician fees.
  • Medicare doesn’t cover what most people think it does.
  • Medicaid, which is a joint program between the federal government and the states, has different coverage, costs and fees in each state.
  •  There are no consistent or constant rules. Federal and state policies shift constantly.
  • Insurance rules in one state do not apply in another.
  • There is no common language much less an understandable one.
  • There are no consistent, predictable costs and no way for anyone to compare them.
  • No one is accountable.
  • Nothing is constant.
  • The only two words that apply to the health care system are:



Which is why you must read: The Buck Still Stops Nowhere–3rd Edition.

$20-$25 covers the book, postage, shipping and handling and an autograph.   Kindle/digital versions coming soon.  Contact me for group rates and shipping. Order by clicking on donate button or by contacting me directly.

We must act now to focus on accountability, quality, safety and value–or we can just keep letting special interests win.

Kathleen O’Connor April 6, 2015


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Selected testimonials–3rd Edition The Buck Still Stops Nowhere

The Buck Still Stops Nowhere:  Selected Testimonials Third Edition

Kathleen O’Connor’s updated The Buck Stops Nowhere is a great place for Americans to familiarize themselves with the major flaws in our health care system. And no one attacks this set of problems with more passion and integrity.

Edward Howard,  Executive Vice President, Alliance for Health Reform, Washington DC

Finally! A book that cuts through the complexity and gets to the heart of the matter—safety and quality for everyone.

RADM Herb M. Bridge, USNR (ret) United States Navy, Co-Chairman, Ben Bridge Jewelers

Kathleen O’Connor brings fresh insights to a topic long covered up by industry insiders. Health care reporting becomes clear and incisive in her hands. She speaks for the average person lost in the complications of health care policy, and she does so with clarity and courage.

James Vesely, Editorial Page Editor, The Seattle Times, retired

More testimonials in book. 

Some Key Points:  Learn More

  • Pharmaceutical profits 44% up from 18% in early 2000′s
  • Potential loss of  hospitals’ 501(c)(3) status and potential fines of $10,000
  • Insurance not considered commerce
  • Prices increased under both Johnson and Reagan; FDR and Nixon
  • Who is and who is not subject to Affordable Care Act

And what YOU CAN do!

Support a good cause–the public’s voice!   Order now!  100 pages. Paperback only.  Available April.  E-book in process.  Order with credit card via donation button on website.  Or order by e-mail.   $25.00 includes author signature, postage and handling (one book).  Includes a 5 and 1/2  page Quick History of Health Care Reform since 1869.  Group rates available. 

Updated/new website coming soon.

Copyright, Kathleen O’Connor (c). All rights reserved.  March 2015

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The Buck Still Stops Nowhere–Why I Had To Write It–Excepts from the Introduction

The Buck Still Stops Nowhere: third edition


I am stunningly lucky to be alive. I suffered a stroke in January 2014 but my type of stroke has an 80 to 90 percent recovery rate.  I was on the floor of my home for two days before friends could reach the manager to have her check on me because I was not answering my phone or e-mails. The manager called 911.  The EMT team rushed me to Harborview, a regional medical center.  I was yellow, black and blue over my entire body.  I was barely breathing.  My left side was immobile. Neither the medics nor the ER physicians expected me to live.

I had incredible care from excellent health care professionals. I had robust health insurance through Medicare. I have strong and close networks of friends and colleagues who shouldered me through.  And, I know the health care system.  Even with all these gifts I still faced problems. Too many are not blessed with such gifts for support, which is why I am updating my earlier book—being a patient brought a greater personal immediacy and a deeper understanding of our system’s significant flaws.  I have support, coverage, friends, colleagues and knowledge.  Too many don’t.  Which is why I write….

….I had to make decisions and was faced with forms and bills I still do not understand…. Because I was so near death I was taken to a hospital that was not a contract hospital with my supplemental insurance. I signed the form that said I ‘knew’ this was a ‘non-contract’ hospital for stroke care. I feared for months about the bill that I knew would surely come for non-contract services. Luckily, it never came.  This is now a year later.

I was labeled as anxious because I wanted to understand and know my medications. There were so many white pills. How do I know I have the right pill? How do I know if the dose is correct? I thought I was simply fact checking.

Medicare covered not only my hospital care but my rehabilitation care.  Those without rehabilitation care can face devastating personal and financial blows….

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Selected Sample from The Buck Still Stops Nowhere–Long Term Care

The following is an excerpt from The Buck Still Stops Nowhere: 

Long Term Care and Nursing Homes

The stealth danger in the health care system is assisted living and long-term nursing home care. Assisted living, home health and nursing home costs and staffing are grenades waiting to explode. Salaries for nursing home workers are not on par with workers in other sectors of the economy. Indeed, workers in the pet care industry often receive more pay than personal care workers in senior care facilities or in home health care.

Work in assisted living, adult family homes and skilled nursing facilities is hard work, involving lifting, bathing, feeding and caring for fragile and vulnerable people. People in these settings not only need health care services, they also need extensive social support services such as transportation and social engagement services to keep them mentally and physically engaged rather than sitting and staring at TVs. Continue reading

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European companies financing American health mergers? Under the Radar??

Professional contract physician groups are growing, profitable and attracting foreign investors.   A short article was sent to me from Oregon about one such group. The last few paragraphs peaked my interest. “Sound” refers to Sound Physicians. Italics are mine:

“In the past year, Sound has been swept up in the merger and acquisition trend in health care.

In July, Fresenius Medical Care, which is based in Germany, invested $600 million in Sound, according to Reuters news service, and became its majority owner.”

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Patient Safety Series; Tax Dollars for Health Care; Medicaid and Long-term Care

My book is at the printer and should be ready by the end of the month–topics include among other things an historical chart of health care reform “efforts” and the cost containment backfires of approaches and counter approaches.  The book is short and to the point.  You can still donate and receive a signed copy.

Patient Safety

One of the publications I trust is the non-profit group Propublica.   They have started a series on patient safety that promises to be well worth reading:

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Charitable Assests from Non-profit conversions; Medical Errors Understated? and interesting facts on doctors and patients

There were major virulent battles over conversion of non-profit insurers to for-profit.

An emerging issue is the purchase/merger of non-profit hospitals by private, for-profit hospitals.  According to the January 19, 2015 Industry Insights from the Cain Brothers, this consolidation has attracted the attention of the Federal Trade Commission and the Department of Justice.  State Attorney Generals are now becoming the “….new gatekeepers of health system mergers. Many states have statutes in place that require the state attorney to review change of control transactions involving nonprofit health  care systems, often with higher standards for taxable conversions.”

Given the amount of money that was transferred back to the states from insurance conversion, this is an issue that merits attention.

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