FRIDAY, OCTOBER 24, 2014
A special supplement to the AUSTIN DAILY HERALD
The First to 40
Debra Klouse has worked at St. Marks Lutheran Home for 40 years, making her the first to reach such a milestone at the home. Jenae Hackensmith/jenae.hackensmith@austindailyherald.com
St. Marks employee first to hit milestone By Jenae Hackensmith
jenae.hackensmith@austindailyherald.com
D
ebra Klouse is the first employee to hit her 40th anniversary at St. Marks Lutheran Home in Austin. “I wouldn’t be here 40 years if I didn’t enjoy it,” Klouse said. Klouse started at St. Marks soon after finishing her schooling, starting on Oct. 8, 1974. Because it was hard to come by nursing jobs, she started as an oncall nurse. She got a position within six months and has worked all three shifts over the years as a licensed practical nurse. It’s a job she loves. “You learn so much from the elderly people, and sometimes we’re the only ones that they have for families,” Klouse said. “It’s just so rewarding.” She’s been in the skilled care nursing area for most of those years, although she has worn many different hats, working in the therapy program, wounds and treatments, working with the foot doctor, and others. In March, she moved to the new assisted living unit, where she has even more direct care access to residents. Over the years, Klouse took care of her grandparents as they aged. “I’ve taken care of people all my life so it’s just part of me,” Klouse said. She said nursing runs in her family, as her mother was a nurse, and now her daughter and daughter-in-law are nurses. Klouse has another reason she enjoys her job. “I have a lot of respect and am very in awe of a lot of the elderly people because they’re just marvelous people,” she said. Klouse said her husband, Morris, says she must be a magnet for elderly people, because when she goes into shops or restaurants older people will come talk to her even when she doesn’t know them. “It’s easy for me to talk to them,” she said. Klouse and her husband live on a farm near Rose Creek. They have three grown children who live in
the area, three grandchildren and a fourth on the way. Klouse’s brother also lives on the farm. But her immediate family aren’t the only people she considers family. She said the staff and residents at St. Marks feel like another branch of family. “You get to know the people, they feel like family to you,” Klouse said. “It’s just a good feeling.” There are about 24 people in her department. Although she loves her job, Klouse said she is looking to the next step. “I’m not too far from retirement age,” she said. She hopes to continue working and eventually retire with the job she has had all these years.
“I’ve taken care of people all my life so it’s just part of me.” Debra Klouse
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OCTOBER 24, 2014
Senior Living
AUSTIN DAILY HERALD
FedEx, UPS make plans for a better holiday season Associated Press
DALLAS — Facing an even bigger mountain of packages this holiday season, FedEx and UPS are hiring more workers to avoid the delays that frustrated shoppers and gift-recipients a year ago. Last December, the delivery giants were caught off-guard by bad weather and a surge in last-minute online shopping. An estimated 2 million packages were late at Christmas. On Wednesday, FedEx Corp. said it expects deliveries between Thanksgiving and Christmas Eve to rise 8.8 percent over last year, to 290 million shipments. Volume is expected to surge on each of the first three Mondays in December, with FedEx predicting a peak of 22.6 million shipments on Monday, Dec. 15. The delivery companies and Internet retailers are benefiting from a strengthening economy and optimism about consumer spending. At the same time, they’re dealing with consumers who increasingly enjoy the ease of shopping on computers and mobile devices but expect the goods to show up almost as quickly as if they had shopped at a store. That expectation is often fed by online retailers, who hold out the promise of free delivery until right before Christmas. About 1.3 million express packages handled by UPS and 618,000 carried by FedEx failed to get delivered on time last Christmas Eve, according to ShipMatrix Inc., which makes software for shipment tracking. The firm’s president, Satish Jindel, said UPS and FedEx were at fault only 30 percent of the time. In most cases, retailers promised guaranteed express delivery but tried to save money and didn’t pay the delivery companies for that speedier service, Jindel said. The merchants face tough competition for consumers who base purchases first on price, and second on free shipping, and the faster the better. “Every single year the percentage of retailers offering free shipping goes up,”
said Vicki Cantrell, senior vice president at the National Retail Federation. “The consumer expects it. The retailer may or may not be able to afford it.” Target Corp. has started offering free holiday shipping for any item on its website, a first for the retailer as it tries to compete better against online rivals such as Amazon.com Inc. The timing of the offer was stunning — weeks before the unofficial kickoff of holiday shopping. Cantrell said Target, Wal-Mart Stores Inc. and other retailers are getting better at the shipping game. They will ship items from stores instead of a central warehouse if that is faster, or tell online customers when the product they want can be picked up at a store near their home. Those strategies could relieve pressure on the delivery companies and satisfy the shopper more quickly. The retail federation’s online division, Shop.org, predicts that online sales in November and December will rise 8 to 11 percent over last year. To meet that demand, online retailers such as Amazon and the delivery companies are hiring more. FedEx plans to hire 50,000 seasonal workers, up from 40,000 last year. United Parcel Service Inc. says it will add up to 95,000 people, up from 85,000. Last year, both companies wound up scrambling to hire more seasonal employees than they had planned, which increased costs and cut into profits. FedEx also expects to invest $1.2 billion in its ground-shipping network in its current fiscal year, with most of that going to increase capacity and automation. The company said that the improvements have sped up ground delivery by a day or more in more than two-thirds of the U.S. UPS has also invested to boost shipping capacity during the holidays, said the company’s chief commercial officer, Alan Gershenhorn. He said that UPS had improved it forecasting and package tracking. UPS has not issued a holiday forecast. Shares of FedEx fell $1.41 to $158.47; UPS shares fell $1.69 to $99.06.
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A special supplement to the AUSTIN DAILY HERALD
Senior Living
FRIDAY, OCTOBER 24, 2014
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Wheel chairs dot the land in ‘Med City’ By Elizabeth Baier MPR.org/90.1 FM
ROCHESTER — Anyone who has spent much time in Minnesota’s “Med City” can’t help but notice that wheelchairs are everywhere, often in unusual surroundings. F r o m c i t y p a rk i n g ramps and downtown sidewalks to park trails and the local mall, the chairs have an inescapable presence. More than likely, that has do to with the fact that Rochester is home to Mayo Clinic, visited by thousands of patients every day. Many of them use wheelchairs to get around. So it’s not surprising that they exist in big numbers. The big curiosity is how they end up all over the city with their users nowhere in sight — a slice of life that some local residents can be oblivious to. Local residents Denny and Carol Scanlan say empty wheelchairs are just part of the Rochester landscape. “I never even thought of it until just now,” Denny Scanlan said over a drink at American Legion Post 92 where he is a member. “Well, I see them kind of everywhere we go, I guess — where you least expect them.” “Yes,” said his wife, with a laugh. “At the mall. In a restaurant.... We’re so used to it that I don’t even notice it.” But some people do notice the big blue chairs. At the Blue Water Salon, on the sky way level of the Doubletree Hotel, owner Shelly Joseph often sees
Mayo Clinic employee Merle Paxton collects a wheelchair he found in the Rochester downtown subway Sunday, Oct. 19, 2014, in Rochester. Paxton works for Mayo’s general services division, which collects the chairs from various locations around Rochester every weekend. Mayo Clinic has had wheelchairs end up in all sorts of places: walking trails, airports, and even in some in other states. Alex Kolyer/MPR News they’re in here, but randomly they’ re in this stairwell,” she said. “It’s a fire exit, basically … I don’t know if people are hiding them there.” At the Starbucks across the hall, manager Dawn L e e - B r i t t s e e s wh e e l chairs outside the employee entrance at the back of the coffee shop at least a couple of times a week. “Sometimes we can’t get out,” she said. “I’m getting used to it because them just outsider her largely used by hotel staff. we s e e t h e m s o o f t e n door, in a public stairwell “ I d o n ’ t k n o w w hy ... They’re just always
around. I don’t know why. It’s like they don’t need it anymore or it’s time to go. Mayo Clinic has 1,180 wheelchairs in its Rochester fleet, largely for patient transport. It loses up to 150 chairs each year, said General Services Manager Ralph Marquez, wh o ove r s e e s p a t i e n t equipment. At $550 each, that could be as much as $82,500 a year, but a small part of the clinic’s budget. “Yes, it’s a financial burden to us from that
standpoint, but it’s also a service we provide,” Marquez said. “And if the patient, you know, truly comes first, sometimes that’s the expense of the business.” Because the clinic does not want to restrict the wheelchairs from leaving the campus, the clinic’s courier service rounds them up weekly, mostly from hotels and any other places that alert them. But Marquez said the chairs can sometimes can travel great distances. “We’ve gotten calls from Orlando Airport. Goodwill up in Duluth had one of our chairs and luckily we were able to retrieve that one. We’ve had them in Denver, out east in a few airports,” he said. “They get back to us dirty and needing to be cleaned. People may take them home for a while. They wind up everywhere.” That includes the Roche s t e r P u b l i c L i b r a r y, where Communications Manager John Hunziker considers wheelchairs just another part of living in a medical community — just like oxygen tanks and IV stands. “I’m sure if you aren’t used to Rochester, seeing somebody going down the skyway, you know, pushing an IV on a rolling stand looks kind of weird,” he said. “But it’s just part of living in Rochester.” And on some days, part of Hunziker’s job is to let Mayo Clinic know there’s a blue chair to pick up in the lobby.
What a GOP-controlled Congress could mean for the Affordable Care Act By Anthony Wilson Kaiser News
In a matter of weeks, the midterm election will determine the balance of legislative power between Democrats and Republicans. With many observers expecting Republicans to win enough seats to gain control of Congress, could the party repeal the Affordable Care Act? First, let’s take a look at the math. Republicans are expected to maintain their majority in the House. In the Senate, there are currently 53 Democrats, 45 Republicans and two independents (both of whom caucus with the Democrats). Thirty-six seats are up for grabs in the midterm election, 21 of which are held by Democrats and 15 by Republicans. To control the Senate, the GOP needs to gain six seats. As of Oct. 16, FiveThirtyEight predicts there is a 60.8% chance of the party doing just that, while the Washington Postputs the GOP’s chances at 93%. Even if the GOP assumes control, a simple majority is no guarantee of progress on the party’s favored policies. Specifically, the GOP needs 60 votes to overcome a filibuster in the Senate. But perhaps the biggest roadblock is that a repeal comes down to one vote: President Obama. Add that up and there is a zero chance of repeal, at least until 2016. Assuming that Republicans nab control of Congress, a GOP majority in the Senate could still have a significant effect on the ACA. In an ironic twist, Republicans might be able to use the same technical procedure — reconciliation — that Democrats used in part to pass the ACA to slowly pick apart the law. GOP lawmakers could attach anti-ACA provisions to budget legislation that would need only 51 votes to pass. However, reconciliation is a lengthy and complex process, and it could end in an Obama veto.
The GOP’s best hope is to find unpopular provisions of the law and develop legislation that could attract support from Democrats. Obama might have a harder time vetoing “bipartisan” legislation, particularly coming from a Senate that has been gridlocked for years. Health policy experts who talked with California Healthline agree that Republicans will go after specific provisions of the law. They disagree on which provision marks the GOP’s best chance to chip away at the law. Here are two possibilities.
Risk corridors According to Dan Holler, communications director for Heritage Action, the provision will “be a big focus” for the GOP. Under the provision, health insurers who enroll a higher-than-expected number of sick people through the insurance exchanges can receive federal payments to offset their costs. GOP lawmakers have called for the provision to be revised, arguing that it is a taxpayer-funded “bailout” for insurers. Holler thinks the risk corridors issue is a winner for the GOP largely because it “has the ability to reposition the Republican Party in the mind of the voters.” He adds, “[Y]ou’re talking about a potential bailout for insurance companies. That is something that would be very popular politically, not just with the conservative base, but also with a lot of Americans who ... are distrustful of how things work in Washington, with well-connected special interests getting ahead while [they are] getting behind.”
Employer mandate Joseph Antos, a health policy expert at the American Enterprise Institute, thinks the more likely target is the ACA’s provision requiring most companies to offer health insurance to their employees. Antos notes that the
Obama administration already has delayed the employer mandate and argues that it could do so again, in part because he says the Treasury Department is unprepared to move forward with it anyway. He adds, “Let Congress take the initiative, rather than waiting for the Treasury to come up with some new reason why they won’t implement it.” Further, Antos adds that changing the reporting requirements for the employer mandate, which he says many mid-sized businesses would struggle with, could gain bipartisan support. Even if they aim just to incrementally change the ACA, Republicans still must walk a careful line: They can’t look like they’re attempting to improve the law. That’s a criticism many more moderate GOPers faced earlier this year, when lawmakers farther to the right pushed hard on an ACA repeal. Antos tells Califor nia Healthline that a big challenge for a GOP-controlled Senate would be the scope of whatever action the party takes. He says, “One of the biggest problems Republicans are going to have is the entry point. Are they willing to entertain a small change in the law, even if it is extremely popular with the voters? I think in the end, they will, because part of their challenge is to demonstrate to all the voters that they can actually run a government.” Antos adds that Republicans must take action, regardless of where it goes.
“Congress has essentially done nothing since 2010, not just on health care, but on anything, and so Republicans really have to step up,” he says, adding, “I think their strategy is to send things that everybody likes and the president will sign, or send things that everybody likes that the president won’t sign. Either way they win.” Meanwhile, Holler thinks that the strategy of taking on individual pieces of the ACA falls into “two buckets,” only one of which is “fixing Obamacare.” In the first bucket, Holler says the more you help “people that are being harmed by Obamacare,” the “less of a coalition you have supporting getting rid of the entire thing and starting over.” The other bucket includes strategies that are not “making the law more stable and less controversial.” He places the risk corridors provision in the second container because “you could make the argument that if you take the risk corridors piece out, insurers are then being negatively impacted by the law.” The bottom line is that with a presidential election coming down the pike, a Republican win in 2016, plus the GOP controlling Congress, could spell end for the ACA. All of the experts California Healthline spoke with insisted that full repeal of the law is not off the table. Still, repealing the ACA would be difficult, for two reasons: Repealing major legislation, especially a law as
large and complex as the ACA, is politically risky. By the time there’s a new president, the ACA will have been through three enrollment cycles, and potentially tens of millions of U.S. residents will have gained coverage. Making any changes to that coverage would be a major optics issue, particularly for a party that made such a fuss about plans being canceled because they did not meet the ACA’s minimum coverage standards. It could also mean eliminating a number of popular provisions, such as the ban on discriminating against people with pre-existing conditions or allowing children to stay on parents’ insurance plans up to age 26. Republicans might not maintain control of the Senate for long. As Ezra Klein notes in Vox, the 2016 Senate elections are “even more favorable” to Democrats than the 2014 election is to the GOP. There are 34 seats up for grabs in 2016, and 24 of those are held by Republicans. Any GOP president’s challenge would be to assure the public that the rug won’t be pulled out from under them. Says Antos: “Abolishing [the ACA] without allowing people to keep what they have is a politically unwise thing to do.” He adds, “It’s language versus reality. ... I think a Republican president would absolutely have to say they would repeal [the ACA], but it wouldn’t stop just with that phrase. They would, ideally, go on to say what they would replace it with, and it would have to be serious and
there would have to be some real details.” But the notion that Republicans “want to take everything away and go back to the status quo” is misleading, Holler says. He notes that both candidates in the 2008 election campaigned on the idea that the U.S. health care system was “broken,” and neither party “wants to go back to that.” Rather, Holler says, “What Republicans and conservatives are saying is the way the Democrats went about fixing it was totally wrong and we’re going to try something different.”
Around the nation Here’s what else is making news on the road to reform. The delicate dance of the GOP governor. The Atlanticchronicles the difficulties Republican governors face in dealing with the ACA. On the one hand, GOP governors must find a way to work with the law to best serve their residents. On the other hand, they must hew the party line, which is that the law must be repealed. Case in point: Ohio’s John Kasich, who this week said an ACA repeal is “not gonna happen” and then later backtracked. Uninsured and unaware. The Kaiser Family Foundation’s most recent tracking poll finds that nearly nine in 10 uninsured U.S. residents are unaware that the ACA’s second open enrollment period is set to launch in November. Meanwhile, two-thirds of uninsured respondents knew little or nothing about the law’s exchanges.
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Senior Living
FRIDAY, OCTOBER 24, 2014
A special supplement to the AUSTIN DAILY HERALD
Social Security benefits get another tiny increase Associated Press
WASHINGTON — Come January, nearly 60 million Social Security recipients will get benefit increases averaging $20 a month, the third straight year of historically small pay hikes. The 1.7 percent cost-ofliving adjustment, or COLA, will also boost government benefits for millions of disabled veterans, federal retirees and people drawing disability payments for the poor. Year after year of tiny increases are weighing on many older Americans. “What is it going to cover? Not even the cost of one medicine,” said Louis Grosso, a 66-year-old retired doctor who lives in Philadelphia. “Do you know how much my cholesterol medicine is?” The gover nment announced the benefit increase Wednesday when it released the latest measure of consumer prices. By law, the increase is based on in-
flation, which has been below historical averages so far this year. For example, gasoline prices have dropped over the past year while the cost of clothing is up by less than 1 percent, according to the September inflation report. Even medical costs, which disproportionately affect older Americans, are up just 1.9 percent over the past year. Meanwhile, the amount of Americans’ wages subject to Social Security taxes is also going up. Social Security is financed by a 12.4 percent payroll tax on the first $117,000 of a worker’s wages — half is paid by the worker and half is paid by the employer. Next year, the wage cap will increase to $118,500, the Social Security Administration said. As for payments to beneficiaries, Congress enacted automatic increases in 1975, when inflation was high and there was a lot of
pressure to regularly raise benefits. For the first 35 years, the COLA was less than 2 percent only three times. Next year, the COLA will be less than 2 percent for the third straight year, and the fifth time in six years. This year’s increase was 1.5 percent, the year before it was 1.7 percent. “While any increase is better than no increase, the fact of the matter is that for millions of seniors, retirees and federal employees, these annual increases will be gone before most even receive them,” said J. David Cox, national president of the American Federation of Government Employees. In all, the COLA affects payments to more than 70 million Americans — more than a fifth of the country. About 59 million retirees, disabled workers, spouses and children get Social Security benefits. The average monthly payment is $1,192.
The COLA also affects benefits for about 4 million disabled veterans, 2.5 million federal retirees and their survivors, and more than 8 million people who get Supplemental Security Income, the disability program for the poor. Many people who get SSI also receive Social Security. By law, the cost-of-living adjustment is based on the Consumer Price Index for Urban Wage Earners and Clerical Workers, or CPI-W, a broad measure of consumer prices generated by the Bureau of Labor Statistics. It measures price changes for food, housing, clothing, transportation, energy, medical care, recreation and education. The COLA is calculated by comparing consumer prices in July, August and September each year with prices in the same three months from the previous year. “In the last several years we have had extremely low inflation,” said economist
Polina Vlasenko, a research fellow at the American Institute for Economic Research. “Basically because inflation is low, the cost-ofliving adjustment is going to be low, too. It’s supposed to just compensate you for inflation.” President Barack Obama and some Republicans in Congress have expressed support for a more conservative measure of inflation that would, on average, result in smaller COLAs. Obama included the new “chained CPI” in his 2014 budget proposal, but he left it out of his proposal for 2015. For next year, the chained CPI would have resulted in a benefit increase of 1.6 percent. Many Democrats in Congress and advocates for older Americans have panned the chained CPI. They want a more generous COLA that, they say, would better reflect price increases faced by older Americans who tend to spend more
of their income on health care. The rise in medical costs has slowed in recent years, but people hit with serious illnesses can still see their individual costs soar. “Seniors across this nation understand how important having an accurate measure of their real costs is to their dayto-day survival,” said Max Richtman, who heads the National Committee to Protect Social Security and Medicare. “While there has been a lot of talk in Washington about the need to find a more accurate COLA formula, unfortunately that attention has largely focused on ways to cut the COLA even further.” The White House has said Obama would accept the new inflation measure only as part of a larger deficit reduction package that also included tax increases. Such a “grand bargain” has been elusive in Obama’s first six years in office.
Forget Ebola and get a free flu shot By Michelle Andrews Kaiser Health News
Take a break from worrying about Ebola and get a flu shot this fall. While the Ebola virus has so far affected just four people in the United States, tens of millions are expected to get influenza this season. More than 200,000 of them will be hospitalized and up to 49,000 will likely die from it, according to figures from the Centers for Disease Control and Prevention. A new HuffPost/YouGov poll of 1,000 adults found that the flu is perceived as only slightly more threatening than the Ebola virus, however. Forty-five percent of people polled said that the flu posed a bigger threat to Americans than Ebola, but a substantial 40 percent said it was the other way around. Fifteen percent said they weren’t sure. “Ebola is new, mysterious, exotic, highly fatal and strange, and people don’t have a sense of control over it,” says William Schaffner, a professor of preventive medicine and infectious disease at Vanderbilt University. Influenza, on the other hand, is a familiar illness that people often think they can easily control, Schaf fner says. “T hey think, ‘I could get vaccinated, I could wash my hands’ and prevent it.” Ye t t h at f a m i l i a r i t y may lead to complacen-
cy. Flu shots are recommended for just about everyone over six months of age, but less than half of people get vaccinated each year. Now there’s even more reason to get a shot. The health law requires most health plans to cover a range ofpreventive benefits at no cost to consume r s, i n cl u d i n g re c o m mended vaccines. The flu shot is one of them. (The only exception is for plans
that have been grandfathered under the law.) The provision making t h e va c c i n e ava i l abl e w i t h n o o u t - o f - p o cke t expense is limited to services delivered by a health care provider that is part of the insurer’s network. Depending on the plan, that could include doctors’ offices, pharmacies or other outlets. Medicare also covers flu shots without patient
cost sharing. Please contact Kaiser Health News to send comments or ideas for future topics for the Insuring Your Health column. Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of theHenry J. Kaiser Family Foundation. —Distributed by the Associated Press