AMIGOS

No puedo darte soluciones para todos los problemas de la vida,
ni tengo respuestas para tus dudas o temores,
pero puedo escucharte y compartirlo contigo.
No puedo cambiar tu pasado ni tu futuro.
Pero cuando me necesites estaré junto a ti.
No puedo evitar que tropieces.
Solamente puedo ofrecerte mi mano para que te sujetes y no caigas.
Tus alegrías, tus triunfos y tus éxitos no son míos.
Pero disfruto sinceramente cuando te veo feliz.
No juzgo las decisiones que tomas en la vida.
Me limito a apoyarte, a estimularte y a ayudarte si me lo pides.
No puedo trazarte limites dentro de los cuales debes actuar,
pero si te ofrezco el espacio necesario para crecer.
No puedo evitar tus sufrimientos cuando alguna pena te parta el corazón,
pero puedo llorar contigo y recoger los pedazos para armarlo de nuevo.
No puedo decirte quien eres ni quien deberías ser.
Solamente puedo quererte como eres y ser tu amigo.
En estos días pensé en mis amigos y amigas,
entre ellos, apareciste tu.
No estabas arriba, ni abajo ni en medio.
No encabezabas ni concluías la lista.
No eras el número uno ni el número final.
Y tampoco tengo la pretensión de ser el primero,
el segundo o el tercero de tu lista.
Basta que me quieras como amigo.

Jorge Luis Borges

Consejos para vender su casa – ¿Quiere vender su casa?

Nadie mejor que Ud. conoce su casa, Ud sabe cuales son los defectos y cuales las virtudes de su propiedad.

Simplemente se trata de destacar las virtudes. No hablamos de ocultar los defectos, pero sí de ver la parte positiva y cómo solucionarlos a la hora de ofrecer la vivienda a la venta.

1. Compruebe las condiciones de amortización de su hipoteca. Antes de poner en venta su vivienda compruebe las condiciones de la hipoteca que tiene contratada. En particular debe averiguar las comisiones de cancelación o amortización anticipada de hipoteca. Valore igualmente la posibilidad de subrogación de la hipoteca de su vivienda.
2. Determine  el valor de la vivienda. Es un tema clave a la hora de vender la casa: determinar el valor de la casa en el mercado. Una forma directa es que una Agencia Inmobiliaria le determine su precio de venta. Tiene otras posibilidades: tomar como referencia precios de venta recientes de viviendas similares en la misma zona, una tasación de la vivienda por empresas especializadas (su banco le puede facilitar una).
3. Estime  los costes de venta. Vender una casa a un precio determinado no significa que ingresará esa cantidad. Por esta razón, debe tener claro los gastos que generará la venta: Los gastos de cancelación de hipoteca, la comisión por venta de la Agencia Inmobiliaria, Impuestos. Otros gastos (anuncios publicitarios, abogado, puesta al día en gastos u obligaciones atrasadas, gestora, registro, reparaciones…). El objetivo final es que sepa a ciencia cierta el ingreso neto que percibirá tras la venta y que le permitirá llevar a cabo sus planes (por ejemplo, comprar otra vivienda).
4. Determine  el coste de adquisición de una nueva casa. Si la vivienda que va a vender es su casa habitual, deberá dedicar algún tiempo a evaluar el coste de la nueva casa. Gastos de traslado, costes de préstanos complementarios, gastos de compraventa y escritura.
5. En cuanto al aspecto de la casa: Haga las reparaciones necesarias, especialmente de elementos que vayan a suponer una baja importante en el precio de venta.
6. Despeje su casa lo más posible. Venda todos los objetos que no utilice. Nada más lindo y atractivo que espacios amplios, prolijos y acomodados.
7. Escriba en un listado todos los puntos a favor que Ud desee que los “compradores” tengan en cuenta: lugares disponibles en la casa,  confort, es decir todas las fortalezas de la vivienda, etc y entréguelos a la inmobiliaria encargada de la venta.
8. Despeje la vista del frente de su casa, deje la vereda para que estacione el interesado en comprar, mantenga el cesped cortado y las plantas del jardín prolijas.
9. Permita que el comprador visite la casa tranquilo. Deje que el encargado de la venta muestre su vivienda al interesado. No interrumpa con comentarios. Es preferible que Ud no esté con ellos en el momento de la visita.
10. Cuide todos los detalles en cuanto a limpieza y orden de la casa: alfombras, paredes claras, ambientes luminosos, pocos muebles, electrodomésticos limpios, sanitarios, etc, deben lucir como si fueran nuevos. La casa debe tener aspecto de muy cuidada y con buen mantenimiento.
11. Tenga en cuenta el perfume de ambiente de la casa, depende del horario que sea la visita del comprador, por la mañana temprano, aromas frescos y de aire puero, al mediodía u rico olor a comidas (puede tener siempre algo a mano) y por la tarde un lindo olor a pan o galletas recién horneados.
12. Tenga una buena coartada para vender la casa. Si es buena compártala. Muéstrese orgulloso de su casa. Si conversa con un posible comprador, nunca se disculpe por lo que usted considere ser menos valioso de su casa.

www.seguroslatinos.com - www.rabasoinsurance.com

>>> para vender mejor su casa…

 

 

 What Is Estate Planning?

 ”Estate planning” is a process to consider alternatives for, to think through, and to set up legally effective arrangements that would meet your specific wishes if “something happens” to you or those you care about. Good estate planning is more than “just a simple Will”. Estate planning also typically minimizes potential taxes and fees, and sets up contingency planning to make sure your wishes regarding health care treatment are followed.

On the financial side, a good estate plan coordinates what would happen with your home, your investments, your business, your life insurance, your employee benefits (such as a pension plan), and other property in the event you became disabled or if you die.

 On the personal side, a good estate plan includes directions to carry out your wishes regarding health care matters, so that if you ever are unable to give the directions yourself, someone you select would do that for you and know when you would want them to authorize “heroic measures” and when you would prefer they “pull the plug”.

 What Is An Estate?

 The term “estate” consists of all the property a person owns or controls, whether in his or her sole name, held in a partnership, in a joint ownership arrangement, or through a trust, and all other monies that would be generated on the person’s death, such as through life insurance. It includes:

• real property and things attached to it (houses, buildings, barns, etc.) all personal property (including automobiles, bank accounts, stocks and bonds, cash, furniture, jewelry, art, collectibles, retirement plan benefits, etc.)
• all businesses and business interests (sole proprietorships, partnerships, corporations, joint ventures, and the goodwill, inventory, tools and equipment, accounts receivable, and other business property, etc.) powers of appointment (the right to direct who gets someone else’s property)
•  life insurance, pension benefits, and pension plans, all debts and obligations owed to others

 Who Should Have An Estate Plan?

 You should have an estate plan if: 

• you are the parent of minor children
• you have property that you care about
• you care about your health care treatment.

 If you do not have minor children, do not care about your property, and have no concerns about your health care treatment, then you do not need an estate plan. But if you meet any of these categories above, you should have an estate plan.

 When Should I Start My Estate Plan?

The only time that you can prepare and implement an estate plan is while you are alive and have legal capacity to enter into a contract. If you are unable to manage your own affairs or suffer from some other disability which affects your legal capacity, your estate plan may be effectively challenged by those who assert that you lacked capacity at the time the documents were created, that you were subjected to fraud, coercion or undue influence during the creation and implementation of your plan.

The best time to start an estate plan is now, while you have the capacity to do so.

  Where Can I Find Some Examples?

 A Will

Sometimes called a ” Last Will and Testament”, is to transfer property you hold in your name to the person you want to have it. A Will also typically names someone you select to be your Personal Representative (or “executor”) to carry out your instructions and names a Guardian if you have minor children. A Will only becomes effective upon your death and after it is admitted to probate.

“Durable Power of Attorney for Health Care”

Appoints a person you designate to make decisions regarding your health care treatment in the event that you are unable to provide “informed consent“.

“Living Will” or “Directive to Physicians”

Isan advance directive which gives doctors and hospitals your instructions regarding providing or stopping health care treatment should you suffer permanent incapacity, such as an irreversible coma.

 “Durable Power of Attorney for Property”

Appoints a person you designate to act for you and handle financial matters should you be unable or perhaps unavailable to do so.

“Living Trust”

Can be used to hold legal title to and provide a mechanism to manage your property. You can select the person or persons you want — often even yourself — as the Trustee(s) to carry out the instructions you want in the Trust. Unlike a Will, a Trust, usually becomes effective immediately, continues in force during your lifetime even in the event of your incapacity, and continues after your death. Most Trusts are “revocable” which allows the person who creates the trust to make future changes, modifications and even to terminate it. (If the trust is “irrevocable“, changes, modifications and termination are very difficult, although such trusts often carry some tax benefits). Trusts also help you avoid or minimize the expenses, delays and publicity of probate.

“Family Limited Partnership”

To own and manage your property, in a similar manner to a Trust, but allowing additional tax planning techniques to be employed. Family Limited Partnerships are typically used for those who have large estates and thus have a need for specialized estate planning in order to avoid federal and state estate/death/ inheritance taxes.

 Should I Use A Lawyer?

 Only an attorney who regularly practices in the fields of wills, trusts, probate and estate planning is able to provide you with really sound legal advice as you put your estate plan into place. Attorneys are subject to regulation by bar organizations, many of which have continuing education requirements and mandatory liability insurance in case the lawyer makes a mistake.

 When you speak with an attorney, you can get answers to your questions –including how much it would cost. Often the expense incurred in retaining an attorney to prepare and help you put an estate plan into place is worth hundreds of times what you and your family would pay with no planning or poor planning. It would also avoid the financial and emotional nightmares that can occur with a poorly drafted (or improper) plan.

 Source: Simpler Times http://www.simplertimes.org/

Jorge E. Rabaso specializes in Estate Planing

Call   818 785 0126

¿Qué es Estate Planning?

Estate Planning es un proceso por el cuál se ven las alternativas que se tienen para arreglar cualquier efecto legal que se adecue a sus expectativas en caso de que algo le suceda a usted o a los suyos. Un Buen Estate Planning es mejor que un “simple testamento”. Con Estate Planning se pueden disminuir los impuestos y organizar un planeamiento para asegurarse que su tratamiento de salud será como usted espera.

Desde el aspecto financiero, un buen Estate Planning coordinará que sucederá con su casa, sus inversiones, su negocio, su seguro de vida, sus beneficios de empleado (como la pensión) y otras propiedades, en el caso de enfrentar discapacidad o fallecer.

Desde el aspecto personal, un buen Estate Planning incluye instrucciones para que se lleven a cabo sus expectativas en cuanto a cuidados de salud, por lo tanto si en algún momento usted no puede dar las directivas por sus propios medios, alguien asignado por usted va a hacerlo y sabrá también en qué momento está autorizado para tomar “medidas heroicas” o cuándo “cerrar las puertas”.

¿Qué es un Estate?

El término Estate consiste en todas las propiedades que una persona puede poseer o controlar, ya sea en su solo nombre, en una sociedad, en un arreglo de propiedades en conjunto, a través de un testimonio, y cualquier otro ingreso que pueda generarse a través del fallecimiento de otra persona, como ser un seguro de vida. Incluye:

-         Terrenos e inmuebles

-         Propiedades personales (automóviles, cuentas bancarias, créditos, efectivo, muebles, joyas, piezas de arte, colecciones, jubilación, etc.)

-         Negocios e intereses comerciales (propiedades privadas, sociedades, corporaciones, empresas conjuntas, fondo de comercio, inventario, herramientas y equipamientos, cuentas, y cualquier otra propiedad de negocio, etc.)

-         Poder de disposición de bienes (Derecho de determinar quién obtendrá las propiedades de otro).

-         Seguros de Vida, beneficios de pensiones, planes de pensiones, deudas y obligaciones hacia otros.

¿Quiénes deberían tener un Estate Planning?

Usted debería tener un Estate Planning si:

-         Es padre de un menor de edad

-         Si tiene propiedades a cargo que le interesan

-         Si le interesa su tratamiento de cuidado de salud

Si usted tiene alguno de esos intereses entonces es importante que tenga Estate Planning. Pero si ninguna de esas condiciones está presente entonces no es necesario.

¿Cuándo debería empezar con Estate Planning?

El único momento que usted puede preparar e implementar Estate Planning es mientras esté con vida y tenga capacidad legal para ingresar en algún contrato. Si usted no es capaz de manejar sus propios asuntos o sufre alguna discapacidad que afecte sus capacidades legales su estate planning puede ser juzgado por aquellos que afirman que usted perdió su capacidad al momento en que sus documentos fueron creados, o que usted fue expuesto a fraude, coerción o influenciado durante el momento de creación e implementación de su plan.

El mejor momento para comenzar un estate planning es ahora, mientras tenga la capacidad para hacerlo. 

¿Dónde puedo conseguir ejemplos?

Testamentos:

También llamado como “Último Testamento”, sirve para trasferir propiedades que usted posee a nombre de alguna persona que usted decida. A través de su Testamento usted puede nombrar a alguien para ser su Representante Personal para llevar a cabo sus instrucciones y puede nombrar a un Tutor para su hijo menor.

 Su testamento se vuelve efectivo al momento de su fallecimiento y después está sujeto a aprobación.

 “Poder notarial duradero para atención médica”

Designa a una persona para que pueda tomar decisiones con respecto  a los cuidados y tratamientos en el caso de que usted esté incapacitado para proveer un “consentimiento informado”.

 “Voluntad en Vida” o “Directiva a los médicos”

Es una directiva por adelantado que da a los médicos y hospitales las instrucciones concernientes a proveer o detener los tratamientos de salud en caso de sufrir incapacidad permanente, tal el caso de un coma irreversible.

 “Fideicomiso”

Puede ser usado para poseer un título legal y proveer un mecanismo de manejo para su propiedad. Usted puede seleccionar la o las personas que usted desee, incluyendo a usted mismo, como fiduciario para llevar a cabo las instrucciones que usted determine en el Fideicomiso. Un Fideicomiso se hace efectivo inmediatamente y continúa durante su vida aun en caso de incapacidad, siguiendo activo luego de su fallecimiento. La mayoría de los Fideicomisos son “revocables” lo cual permite que su creador le haga cambios, modificaciones o incluso lo cancele (en caso de ser “irrevocable”, los cambios, modificaciones o cancelación son dificultosos. Algunos Fideicomisos traen beneficios de impuestos). El Fideicomiso también ayuda a evitar o minimizar gastos, demoras y movimientos de aprobación.

 “Sociedad Limitada Familiar”

Es poseer y manejar su propiedad en una manera similar a un fideicomiso pero permitiendo que se empleen técnicas adicionales de planeamiento de impuestos. Es usualmente utilizado por aquellas personas que tienen propiedades grandes y por aquellos que necesitan un Estate Planning especializado para evitar impuestos del estado y federales sobre herencias y muerte.

¿Necesito de Abogados?

Sólo un abogado que se especialice en Testamentos, Fideicomisos y Estate Planning es capaz de proveerle consejos adecuados para realizar su Estate Planning. Los abogados están sujetos a regulaciones, muchas de las cuales requieren de continuo aprendizaje y están obligados a un “seguro de responsabilidad” por si cometen algún error o equivocación.

 Cuando hable con un abogado puede incluso preguntar cuánto le puede costar el proceso. Usualmente los gastos para pagar un abogado que lo prepare y guíe para hacer un Estate Planning es una gran inversión, pero evitará los problemas financieros y emocionales que pueden causarle si no está bien planeado y organizado.

Fuente: Simpler Times http://www.simplertimes.org/

Jorge E. Rabaso se especializa en Estate Planing

Consulte a 818 785 0126

Los Angeles Times -

Dec. 10: It seems clear that change is coming to the U.S. healthcare system. President-elect Barack Obama wants it. Congress wants it. Even the insurance industry says the time is ripe to do things differently.

But not too differently. The idea of doing away with the employer-based insurance system which has become increasingly unsustainable for businesses and has resulted in 47 million Americans going without coverage seems to be off the table.

“There are very few economists who say that if they were king, the employer-based system is the one they would pick,” said Henry Aaron, a senior fellow at the Brookings Institution who specializes in healthcare.

“The problem is that it’s not possible to just walk away from the employer-based system. The 180 million people who currently receive coverage from employers would go ballistic.” In other words, the crappy insurance system you know is better than the newfangled system you don’t.

This seems like a lame reason to remain wedded to a system that, by and large, fails to serve the interests of both the American people and U.S. businesses.

According to the Organization for Economic Cooperation and Development, the $6,102 spent per person on healthcare in the United States in 2004 was nearly twice the amount than in most other industrialized democracies and well beyond the average $2,660 of the organization’s 30 member nations.

At the same time, the average life expectancy in the United States was shorter (77.5 years) and the infant mortality rate higher (6.9 deaths per 1,000 births) than elsewhere in the developed world.

Clearly we’re not getting a lot of bang for our healthcare bucks. Employer-based health coverage is a historical accident. Businesses began offering it during World War II to attract workers during a government-imposed wage freeze, and the benefit gradually became the primary form of health insurance.

Many large employers now bellyache about healthcare costs. During recent bailout hearings, the Big Three automakers said their Japanese counterparts enjoyed a competitive advantage because workers’ health insurance was provided by the government. Yet U.S. businesses have been reluctant to call for radical change in the insurance system.

“Our membership is overwhelmingly in favor of retaining the current employer-based healthcare system,” said Anthony Wisniewski, executive director of healthcare policy for the U.S. Chamber of Commerce. “By having an employer-based system, employers can make offerings that allow them to attract the most talented people to their organizations.”

That sounds nice in theory. In practice, employers are increasingly opting for cheaper insurance plans with higher deductibles and co-pays, thus saddling workers with a greater share of costs.

According to the Kaiser Family Foundation, 18% of all covered workers now face annual deductibles of at least $1,000, up from 12% in 2007. Among smaller businesses with up to 200 employees, more than a third of workers have deductibles of at least $1,000, up from 21% last year.

I’ve long believed that something along the lines of expanding Medicare to cover all Americans, not just the elderly and disabled, would be the most effective way of providing insurance to everyone and controlling healthcare costs.

But that’s not going to happen any time soon, not if the insurance industry has anything to say about it. An industry trade group recently unveiled a plan for universal coverage that includes requiring all uninsured Americans to buy policies from private insurers. For their part, the insurers would agree to stop rejecting people with preexisting conditions.

But anyone who’s ever shopped for coverage in the individual insurance market knows that such policies don’t come cheap, and the only way to keep costs down is to take on sky-high deductibles. Pauline Rosenau, a health professor at the University of Texas, says the U.S. should be looking to the Netherlands for guidance about what to do and what not to do.

“They have a very, very highly regulated system,” Rosenau said. “Private insurers have to sell to anyone who wants it, and they have to sell at the same price that they sell to everyone else in a certain geographic area.”

What wasn’t intended was that most insurers would consistently lose money on basic policies, although some have managed to recoup cash by offering supplemental insurance to those who desire it.

“We can avoid their mistakes,” Rosenau said. “We need to create a system that allows insurers enough freedom to operate, but at the same time regulates them so they compete on price, not on being able to avoid the very sick.”
We serve in California

Business Wire -

Nov. 24: New York – The median individual deductible for health insurance coverage required by employers offering PPOs jumped to $1,000 in 2008, up from $500 last year, according to Mercer’s National Survey of Employer-Sponsored Health Plans. In 2000, only about half of employers imposed a health insurance deductible for PPO coverage (compared to about four-fifths today), and the median amount was just $250. PPOs are the most popular health plan, enrolling 69 percent of all covered employees (CDHPs enroll 7 percent).

Mercer’s survey includes private/public employer health plan sponsors with 10+ employees. Nearly 2,900 employers participated in 2008. What makes this finding more startling is that it refers to traditional PPOs – not the high-deductible plans where a health insurance deductible of at least $1,100 is required in order to deposit tax-free money in a Health Savings Account, or HSA. The HSA is the type of health insurance coverage that is spreading most rapidly.

“The introduction of the HSA may have changed employers’ thinking on how high a health insurance deductible can go without causing employees to revolt,” said Blaine Bos, a worldwide partner at Mercer.

The PPO health insurance deductible is lower among larger employers. In organizations with 500+ employees, the median health insurance deductible for individual and family health insurance coverage is $300 and $800, respectively. But large employers have been moving quickly to add HSA options to their health insurance coverage.

Health insurance coverage spending in an economic downturn

The Mercer survey found the average cost per employee for health insurance coverage rose 6.3 percent in 2008. Annual cost increases leveled off at about 6 percent in 2005 and have remained there. Employers expect a similar increase for 2009 – 6.4 percent. That projection reflects changes that employers plan to make in the level of benefits, the type of plan offered or the plan vendor. (If employers made no changes, the cost of their largest medical plan would rise by about 8 percent, they predict.)

Utilization tends to increase during a recession. When job security is in jeopardy and insurance is tied to employment, consumers rush to get care they might otherwise delay. In addition, laid-off employees paying for coverage under COBRA provisions typically have far higher utilization than active employees. More employees are at risk for stress-related behavioral-health and medical conditions as they deal with investment losses, job insecurity and declining housing values. Prices may also rise, as health plans and providers search for ways to recoup their investment losses; high unemployment leads to more uncompensated care; and public safety nets such as Medicaid respond to higher enrollments by freezing increases in provider compensation.

Consumer-directed health plans may prove a refuge

Rumors of the demise of the consumer-directed health plan are not borne out by Mercer’s 2008 survey. There was a sharp increase in the number of large employers offering CDHPs (a health plan coupled with either a Health Savings Account or a Health Reimbursement Arrangement) in 2008, from 14 percent to 20 percent of employers with 500 or more employees. The plans are most common among largest employers (20,000 or more employees), where they are offered by 45 percent, up from 41 percent in 2007. However, growth has been slower among small employers: Mercer found that 9 percent of employers with 10-499 employees offer a CDHP, up from 7 percent in 2007. These employers are more likely to offer a high-deductible PPO without an account feature.

Enrollment in CDHPs reached 7 percent of all covered employees in 2008, up from 5 percent last year. As employees shift from more expensive plans into less expensive ones, employers’ overall cost per employee drops. This migration into lower-cost CDHPs is one factor helping to hold down benefit cost increases.

The new plan model’s appeal to employers seems clear: CDHPs delivered substantially lower cost per employee than PPOs or HMOs in 2008. CDHP cost averaged $6,207 per employee, compared to $7,815 for PPOs and $7,768 for HMOs. Of the two types of CDHPs, HSA-based plans were less expensive than HRA-based plans ($6,027 compared to $6,420).

The most obvious explanation for the difference in cost between CDHPs and the other medical plan types is the higher deductible. But even compared to the average cost of PPOs with deductibles of $1,000 or higher ($6,661 per employee), CDHPs still cost less by over $400, even though CDHP enrollees are not significantly younger than enrollees in PPOs with a high-deductible and are more likely to elect dependent coverage (which drives up cost per employee). The 2008 cost increase for CDHPs was 4.0 percent, compared to 6.3 percent for PPOs and 9.1 percent for HMOs.

Most of the CDHPs added in 2008 were based on HSAs, which don’t require an employer contribution. Employer account contributions are a standard feature of HRAs but not of HSAs: over a fourth of large HSA sponsors (29 percent) do not contribute. Among those that do, the average contribution is $694.
“With the health insurance deductible in traditional PPOs rising, the CDHP is becoming a more attractive option for employees who have a choice,” said Mr. Bos.

The flip side of consumerism – employee health management

Employers are looking to put more teeth into employee health management programs, in hopes that encouraging better health habits will lead to lower health spending and a more productive workforce. While the majority of employers offer one or more health management programs, large employers, in particular, are now adding incentives to encourage employees to use the programs or improve health habits. Of large employers offering a health management program, 26 percent use incentives, up from 23 percent in 2007.
We serve in California

Los Angeles Times –

Nov. 24: The presidential election has come to an end, but a stormy political battle of another sort is in high gear in labor circles, with long-ranging consequences for California healthcare workers.

At issue is whether as many as 300,000 employees now represented by three separate local unions across the state will be rolled into one enormous local, a proposal that was put to a nonbinding vote of members on Monday.

At the same time, the Service Employees International Union wrapped up hearings this week into allegations that leaders of one of those locals misused dues, creating a secret war chest to fight the merger. Both sides say the outcome will affect patients because many concessions the unions fight for such as workloads affect quality of care.

Some within SEIU say the proposed megalocal would be too big and unresponsive most loudly the heads of the United Healthcare Workers West, the subject of the trusteeship hearings and a local that would either be reduced by half or swallowed completely in the merger. They claim that their parent union’s real motivation is to squelch dissent and that they will be ousted either by consolidation or trusteeship, replaced by pliant appointees.

“This is an unprecedented war by an international union against a local,” Sal Rosselli, president of UHW, said outside the hearing room at the San Jose convention center. The rift has become so ugly that guards were hired to stand at the door.

Rosselli and other officers have waged a sophisticated opposition campaign, circulating petitions, courting public officials and the media, running a website complete with video and blogs, and staging large protests outside meeting halls and union offices including one in Los Angeles this month. They have also sent mailers to members, urging a boycott of the merger vote.

UHW has won allies, including at least one with celebrity status in labor circles: Dolores Huerta, who with Cesar Chavez founded the predecessor to the United Farm Workers union. She testified on UHW’s behalf and sponsored a fundraiser in San Francisco last week, pulling together $240,000 for the group’s legal costs.

The SEIU denies that the proposed merger is an effort to unseat Rosselli or others, calling it part of a years-long process to consolidate locals around the country. SEIU President Andy Stern said consolidation gives members more heft in negotiating with international corporations and state governments and makes it easier to organize more workers. “It’s not to be bigger for bigger’s sake,” said SEIU spokeswoman Michelle Ringuette. “It’s to make our members’ voices stronger.”

Dozens of locals have already merged to create larger groups. All three of the unions subject to the current merger vote Oakland-based UHW, San Jose-based SEIU 521 and Los Angeles-based SEIU 6434 had already grown due to prior mergers.

As for the internal trusteeship hearing, SEIU officials say it’s a separate matter. Officials of the international union accused UHW of lying about the purpose of its $3-million United Health Care Workers and Patients Education Fund. They claim the money was meant to fight efforts to dissolve the muscular 150,000-member local.

UHW insists that the fund was meant for a political campaign dealing with healthcare, but acknowledges that the local spent $100,000 to publicize UHW’s internal vote, where its members strongly opposed being swallowed by another union.

A hearing officer’s report is expected in January. The international’s merger vote ends Dec. 11. It asks members whether they would prefer a 300,000-member local representing all SEIU-affiliated California healthcare workers, or a slightly smaller 220,000-member local representing long-term healthcare workers. The status quo is not an option.

The results of the vote will not be binding the international’s board will decide whether and how to restructure California’s healthcare unions, and SEIU officials would appoint the leadership. An SEIU report released earlier this year recommended the larger consolidation.

“Either option as they’re proposing it would eliminate UHW as we know it,” said John Borsos, a UHW executive. SEIU 6434, an already giant 160,000-member local representing home health aides, would dissolve into the new local under either plan. John Ronches, who was appointed trustee of that local this year after The Times exposed financial improprieties by its former leader, said his members are looking forward to the merger.

“Every time there’s an issue, there’s three different operations that have to be put into gear. It just makes more sense if it’s centralized,” he said. “Our members get that. They want to be in the same union.”

The third union, SEIU 521, represents about 40,000 public employees and another 13,000 home care workers in and around the Silicon Valley. It also would be peeled off under either scenario.

Some SEIU 521 members spoke out against a merger at a 2006 hearing, wearing purple T-shirts with the slogan “If it ain’t broke, don’t fix it.”

Kristy Sermershiem, president of SEIU 521, said that, given the current choices, aides in her union who make $11.50 and $12.25 an hour prefer the smaller merger.

“You win some, you lose some. Right now we’re being asked which of the choices do we want,” she said. “We’re very disappointed that UHW has decided to make such a big deal about it when the real issue is how do you organize workers so they have a voice.”

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Business Insurance -

Nov. 20: New York – Employer-provided health care benefits are not likely to disappear, the head of the nation’s third-largest health insurer said Wednesday. “I believe it is one of the strengths of the U.S. health care system,” Aetna Inc. Chief Executive Officer Ron Williams told the Reuters Health Summit in New York.

Most people with health insurance in the United States receive coverage through their employer. But 1.2 million Americans have lost their jobs so far this year as unemployment reaches 6.5%, a nearly 15-year high. That rate is expected to climb as high as about 7.5% next year, according to economists and U.S. Federal Reserve officials.

Aetna has about 17.7 million members, the vast majority coming through employer-sponsored plans. While growing layoffs are likely to push growth in Aetna’s offerings for individuals, Mr. Williams said large companies are still at the forefront of the insurance market. Such employers are the most knowledgeable health care buyers and have been behind many key changes in the U.S. health insurance sector.
“They have a strategic point of view about how a benefit policy fits in with business strategy, and they really quite honestly push us to innovate,” he said.

Mr. Williams’ comments come as the Democratic-led Congress and U.S. President-elect Barack Obama prepare to tackle health care reform next year, with an emphasis on the nearly 46 million Americans who have no health insurance.
Millions more do not have enough coverage the so-called underinsured and even those with policies from employers face rising premiums and co-pays as health care costs continue to rise.

President-elect Obama has called for maintaining job-based health insurance for those who have it while finding other ways to offer care to those who need it. But some Democrats, most notably Senate Finance Committee Chairman Max Baucus, advocate a more universal approach that would require all Americans to have coverage.

Looking at how large employers have streamlined their offerings to continue to provide benefits while controlling costs could offer some lessons, said Mr. Williams, who was one of several CEOs who met with President-elect Obama earlier this year to discuss health care and economic issues.

“We need better ways to pool small employers, small groups, and we need better ways to pool individuals,” he said. “We believe everyone should be covered, and we believe that those individuals who can afford to buy insurance should be expected to buy insurance,” he said.

“Those individuals who can’t afford it should receive some form of assistance, and I’ll leave it to others to determine whether it’s vouchers or tax credits or subsidies or whatever seems to make sense.”

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Daily Breeze -

Nov. 21: Kaiser Permanente earned the best marks among local and statewide health maintenance organizations on a government report that measures patient satisfaction and the quality of health care.

The South Bay physicians association affiliated with Kaiser also was one of the top medical groups in California, according to the 2009 Health Care Quality Report Card issued Thursday by the California Office of the Patient Advocate.

“We’re very pleased,” said Robert Blair, medical group administrator for Kaiser Permanente-South Bay. “I think this shows the strong commitment from the physicians and staff members who actually deliver this level of care to patients.”

This is the ninth year of the report card, a well-regarded measure of care by patient groups and medical officials. The rankings, which assign one to four stars for service and care, are released each year at the end of November, when many employees are choosing their health plans.

“As the delivery of health care changes in this country, more decisions are being put in the hands of consumers,” Sandra Perez, director of the Office of the Patient Advocate, said at a morning press conference in Los Angeles.

“We want to make sure Californians receive the best possible information when making those decisions,” she said. The report card looked at nine HMOs that serve 11 million Californians, along with physician medical groups that patients can choose from according to their region and plan.

The report also looks at how well these groups do when it comes to treatment of specific ailments such as cancer, heart disease and diabetes. This year’s results offer both good and bad news, officials say. Several HMOs, including Blue Shield, PacifiCare and Western Health Advantage, improved their standards of care over the last year, all earning a rating of “good.”

An area of serious concern, however, is that none of the HMOs improved their scores in patient satisfaction, Perez said. “This should be a priority for health plans,” she said. “We’re talking about basic customer service.”

Though Cigna HMO improved its scores in some areas of care, it ranked the lowest among HMOs in patient satisfaction with a ranking of “poor.” “We are disappointed with our patient satisfaction score,” said Gwyn Diday, a Cigna spokeswoman in Southern California.

“We recognize that customers expect a higher level of service from us, and we are determined to turn these numbers around,” she said. Christopher Ohman, president of the California Association of Health Plans, a trade group representing insurance companies, blamed poor patient satisfaction ratings on rising health costs.

The results show it is “imperative that policymakers work collaboratively to control the rising cost of medical care,” he said. In the South Bay, most of the physicians groups affiliated with larger HMOs – including Torrance Hospital IPA, HealthCare Partners IPA and Talbert Medical Group – ranked “good” in health care and patient satisfaction.

The lowest-scoring medical group was Centinela Valley IPA, with a ranking of “poor” in care and “fair” in patient satisfaction. Southern California Permanente Medical Group-South Bay/Harbor City earned the highest marks among local groups with a ranking of “excellent” in care and “good” for patient satisfaction.

Ted von Glahn, director of the Pacific Business Group on Health, which conducted the survey and devised the rankings, said health providers improved in the area of preventive medicine such as colorectal screenings.

However, “there was a big disparity between top performers and low performers,” he said Thursday. The health plans also did poorly in helping diabetic patients improve cholesterol levels, and none of the plans did well in treating adults with bronchitis.

Of particular concern, officials say, the survey revealed that many patients received antibiotics when they shouldn’t, a problem that can increase the body’s resistance to these drugs.

Aileen Harper, director of the nonprofit Center for Health Care Rights, said the report card is a useful tool for consumers. “This is a great way to get easy-to-use information,” she said. “Picking a health plan can be pretty overwhelming.”

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Kaiser Daily Health Policy Report -

Nov. 24: Rep. Ron Wyden (D-Ore.) and 14 co-sponsors of Wyden’s Healthy Americans Act (S 334) on Friday sent a letter to President-elect Barack Obama asking him to consider the plan as a model for universal health care, CQ Today reports. The bill would effectively replace the employer-sponsored health care system with a system in which individuals would be required to purchase private health insurance through state-administered purchasing pools (Wayne, CQ Today, 11/21). Congressional Budget Office Director Peter Orzsag estimated that the plan would become “more than self-financing” after a few years (Bolton, The Hill, 11/21).

The also letter was signed by Sens. Lamar Alexander (R-Tenn.), Bob Bennett (R-Utah), Maria Cantwell (D-Wash.), Tom Carper (D-Del.), Norm Coleman (R-Minn.), Bob Corker (R-Tenn.), Mike Crapo (R-Idaho), Judd Gregg (R-N.H.), Daniel Inouye (D-Hawaii), Mary Landrieu (D-La.), Joe Lieberman (I-Conn.), Bill Nelson (D-Fla.), Arlen Specter (R-Pa.) and Debbie Stabenow (D-Mich.). The lawmakers did not propose that Obama back Wyden’s plan, but they wrote that health care overhaul should reflect the principles behind the bill, including establishing universal health coverage, ensuring affordable coverage, overhauling the private insurance market and improving health care quality (Wayne, CQ Today, 11/21). In addition, the lawmakers said Obama must demand reform that promotes improved disease prevention, makes health care prices and choices easier for consumers to understand and modernizes federal tax rules for health coverage.

The senators wrote, “Over the last two years, we have come together as Democrats and Republicans to co-sponsor the Healthy Americans Act because we believe that for health reform to succeed it must be bipartisan,” adding, “We also believe that in these tough economic times with soaring budget deficits, it is critical to fix our broken health care system without breaking the bank” (The Hill, 11/21). The letter states, “We believe Congress must explore financing mechanisms that would maximize the use of existing health care dollars and ideally produce savings in the future” (CQ Today, 11/21).

Wyden said he plans to “work very closely” with the incoming Obama administration, as well as Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) — both of whom are crafting separate health care overhaul legislation.

Baucus Meets With Budget Leaders

In related news, Baucus last week met separately with Senate Budget Committee Chair Kent Conrad (D-N.D.), ranking member Gregg and members of the Senate HELP Committee to discuss how pay-go rules could affect efforts to overhaul the health care system. According to CongressDaily, “Baucus has said recently that he will try to convince Conrad and Gregg that a health care overhaul will need to skirt budget pay-go rules, given the economy.” Baucus said, “I think there are going to be upfront investments that are necessary — that you have to invest in order to reap long-term savings and increase in value.”

According to CongressDaily, Conrad “is a fiscal hawk who is unlikely to throw pay-go rules to the wind”; however, last year he said that health care reforms that have “potential for long-term savings, even though they may have upfront costs” should be considered. House Ways and Means Committee Chair Charles Rangel (D-N.Y.) on Thursday said, “I really don’t see if you’re talking about education, health care, infrastructure, that you can possibly say that you can’t afford it when your economic status means that you’re not competitive now.” CongressDaily reports that House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.) “has echoed those thoughts on pa-go” (Edney, CongressDaily, 11/21).

Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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