Hello Walgreens, Walmart, and CVS Health

Access to affordable and preventive health care is important. Retail clinics are surging and care is transitioning away from the hospital and doctors office to fill a void for many Americans who cannot afford to buy traditional health insurance. Some Americans can’t qualify for coverage under the Affordable Care Act, and others may have fallen between the cracks due to a lack of the Medicaid expansion in their state.

Although, biased about the care they’d prefer to receive and where they’d like to receive it, most consumers are on board with the concept of going to big box stores, grocery stores, and pharmacies for quality healthcare at an affordable price.

In a 2013 Oliver Wyman national consumer survey of more than 2,000 consumers, 77 percent were willing to receive at least one medical or wellness service from a retail establishment. For minor incidents, 36 percent of consumers were interested in receiving care at a drugstore and 20 percent at a grocery store.

Walgreens, Walmart, and CVS Health (formerly CVS Caremark) have each invested in a strategy, which incorporates a business model consisting of different mergers formed with hospitals, physician groups, and nurse practitioners to offer quality affordable healthcare directly to consumers. Health information technology (HIT) has helped to facilitate a smooth transition from traditional visits to the doctor’s office by providing a secure platform for partners to get access to, for the purpose of sharing patient data through electronic health records (EHR).

A new research study from Walgreens found the percentage of visits to Healthcare Clinic locations for preventive services, screening and chronic visit utilization (combined) increased from 4 percent in 2007 to 17 percent in 2013. The study also found the annual percentage of return patient visits to Healthcare Clinic climbed from 15 percent in 2007, to more than 50 percent in both 2012 and 2013. Walgreens has over 400 clinics that offer vaccines, physical exams, and screenings for blood pressure, cholesterol, diabetes, health risk assessment, and influenza.

Walmart has positioned itself to lead the healthcare retail price wars by partnering with hospitals and nurse practitioners from QuadMed to offer primary care services in their walk-in clinics seven days a week, inside Walmart stores. Services include preventive and routine exams such as cholesterol screenings, allergy care, and vaccinations. Employees enrolled in the company’s health insurance plan can pay four dollars for services.

CVS has more than 900 “MinuteClinic” locations, and it plans to expand over the next few years. CVS recorded $126.7 billion in sales during the last fiscal year, and is making headlines now because of the decision to stop selling tobacco products by October 1st. This was a brave proactive decision for preventive care.

Going forward, it will be interesting to see the primary care service line for each of the retail clinic chains. Perhaps, the next frontier could include possible alliances and partnerships with board certified sleep specialists and accredited sleep centers. Perhaps each company could consider offering sleep apnea screenings with portable home sleep study devices to consumers in rural and urban demographics where physician shortages exist, and where there are higher disparities for medical conditions such as diabetes, high blood pressure, heart disease, and cancer.

Has your sleep center team explored this prospect? I’d love to read your feedback, albeit positive or negative.



76% Say It’s Jobs But Millennials Are By No Means Provincial

August 26, 2012

By Melissa Bynes Brooks

Millennial voters are at a crossroads laden with a series of economic, social, and cultural issues to consider as they contemplate whether to vote for President Obama or Mitt Romney on Election Day.

More than three-quarters (76%) say jobs and unemployment represent critical issues facing the country according to a 2012 Millennial Values Survey conducted jointly by Public Religion Research Institute and Georgetown University’s Berkley Center for Religion, Peace, and World Affairs. Even though young people have been impacted the most during the recession, they remain the most optimistic about the recovery of the economy which has added jobs in a slower than desired pace.

From April to July 2012, the number of employed youth 16 to 24 years old rose 2.1 million to 19.5 million, the U.S. Bureau of Labor Statistics reported in August. This year, the share of young people employed in July was 50.2 percent. The number of unemployed youth in July 2012 was 4.0 million, a slight decrease from 4.1 million a year ago. The youth unemployment rate was 17.1 percent in July 2012. The unemployment rate for young men was 17.9 percent, in July 2012, and the rate for women was 16.2 percent. The jobless rate for whites was 14.9 percent, compared with 28.6 percent for blacks, 14.4 percent for Asians, and 18.5 percent for Hispanics.

The impact of past events on present circumstances has never been more apparent. Approximately 7.5 million jobs were lost in the eighteen months from the beginning of 2008 through the middle of 2009. This period was fully shaped by the Bush economic agenda. The takeaway, this is the same agenda Mitt Romney and Paul Ryan are campaigning on. Romney-Ryan would like to reinstate the same tax cuts and deregulation policies that resulted in the economic crisis. Romney-Ryan would also cut spending on roads, highways, and other physical infrastructure which would lower output in ways similar to the effects of cuts in private capital investment.

Over the most recent 18 months of the Obama administration, approximately 2.8 million jobs have been added. The average monthly job loss before President Obama’s policies took effect was 417,000. Over the last year-and-a-half, the average monthly job gain has been 155,000. When Congress failed to pass the American Jobs Act, President Obama announced a new initiative called Summer Jobs+ in January 2012. The Federal government and private sector came together to commit to creating nearly 180,000 employment opportunities for low-income youth in the summer of 2012, with a goal of reaching 250,000 employment opportunities by the start of summer. At least 100,000 were for placements in paid jobs and internships.

A majority of Milennials report that education (54%) is another critical issue facing the nation.  President Obama signed an overhaul of the student loan program into law, increased funding for Pell Grants and allowed for direct student loans while preventing student loan interest rates from doubling. The American Recovery and Reinvestment Act invested heavily in education both as a way to provide jobs and lay the foundation for long-term prosperity. The Act provides $5 billion in competitive funds to spur innovation and chart ambitious reform to close the achievement gap and includes over $30 billion addressing college affordability and improving access to higher education.

Mitt Romney proposes tightening eligibility requirements for federal student financial aid and decreased funding for Pell grants. This may present a problem for lower income families by limiting their access to affordable higher education. He also opposes gainful employment regulations which help to prevent students from increasing their student debt while working towards degrees issued by sub-par schools. According to the Congressional Budget Office (CBO), Paul Ryan’s budget plan to cut federal spending for education such as loans or grants may lower productivity by reducing people skills.

Only 1-in-5 Milennials think social issues like abortion (22%) or same-sex marriage (22%) are critical issues. 53% think abortion should be legal, 43% do not, while 35% don’t know. One point of consideration is that the next president of the United States may have an opportunity to nominate a Supreme Court justice. This will be of particular interest for voters with concerns regarding women’s reproductive rights and the future of Roe v Wade. In 1973 the United States Supreme Court ruled that a right of privacy was protected by the Fourteenth Amendment under the Constitution and guaranteed a woman’s right to have an abortion under certain circumstances. Voters will determine whether to elect Obama- Biden who supports a woman’s right to choose or to elect Romney- Ryan, a team at odds on the issue. Romney opposes abortion with an exception for cases of rape, incest and risk to the mother’s life while Ryan objects to abortion in all circumstances except when the mother’s life is at risk. Paul Ryan, if he’s vice president, will literally be a heartbeat away from being the president so this makes his perspective relevant.

Access to affordable and preventive healthcare is important. Millennials broadly favored proposals that all Americans have insurance, that the government provides help for those unable to afford it, and supported a government health insurance plan to compete with private plans. A Pew Research Center poll taken via landlines and cellphones on September 22 through October 4, 2011 reflected that 56% of Millennials do not feel the government is doing enough for elderly Americans. They also feel more should be done to reduce the gap between the rich and the poor.

Millenials have an innate sense for tolerance and treating others fairly irrespective of class, race, gender, or sexual orientation and are more racially and ethnically diverse. Only 59% are white non-Hispanic. They are more open-minded than previous generations, suggests an analysis of studies by the Center for Information and Research on Civic Learning and Engagement, part of the University of Maryland’s School of Public Policy. They are also more inclined to support President Obama’s position of prosecutorial discretion when confronting illegal immigration and agree that the Defense of Marriage Act (DOMA) is unconstitutional. This generation is by no means provincial and there will be consequences, whatever the presidential choice.

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks


“Obamacare: Win-Win for the Economy”

August 1, 2012

By Melissa Bynes Brooks

Theoretically, the cost of healthcare should decrease as the demand for products and services increase because the healthcare industry is the exception to the “basic economic” model of supply and demand. It is more complex. Health insurance costs are lower when larger groups of people are involved in the consumer pool thus increasing demand and lessening the costs of unhealthy or risky individuals with healthy or less risky individuals.

Despite looming promises of repeal by Republicans, the Affordable Care Act (ACA) is an essential component for cost containment and strengthening of the U.S. economy. This is especially true when 17 percent of the nation’s GDP is spent on health care with a GDP growth rate of only 1.5 percent.

Further analysis by the CBO, after the Supreme Court ruled that the ACA is constitutional, indicates that repealing the law would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, adding $109 billion to federal budget deficits over that period. Additionally, an estimated 60 million nonelderly people would be uninsured.

Regulatory requirements have not eluded corporate leaders currently brainstorming and investing in new strategies and innovative technologies to position their companies for competition in a market place projected to expand health insurance coverage, to an estimated 14 million people by 2014, and 30 million people by the latter part of the coming decade.

Business mergers are forming between companies directly impacted by the ACA.

In early July, the first major health care sector merger occurred when health care giant WellPoint said it will buy Amerigroup, a managed health care company with 4.5 million customers of state sponsored health care programs, for $4.9 billion or $92 a share in cash.

“We believe that this combination will create an industry leader in the government sector serving Medicaid and Medicare enrollees,” said WellPoint CEO Angela Braly in a statement. Braly added that the merger, which focuses on Medicaid recipients like the poor and the elderly, is an opportunity to “position our companies for future growth as the health insurance industry changes and as we prepare for health insurance exchanges.”

Amerigroup shares increased 40 percent, to over $89.84 a share following news of the merger. WellPoint shares increased 3 percent, to $61.64 a share. Shares for both companies had decreased in value after the Supreme Court decision in June.

The ACA presents broad economies of scale for health information technology (HIT) companies specializing in the provision of secure platforms for accessing and sharing patient data through the installation of electronic health records (EHR), telemedicine, and mobile health applications. 88 percent of physicians said they would like their patients to track their health information and 40 percent of individuals said they would buy a personal health-monitoring device or pay for a monthly subscription to send health information to their providers.

Authentidate Holding Corp. provides secure web-based software applications and telehealth products and services that enable healthcare organizations to coordinate care for patients and enhance related administrative and clinical workflows.

Their alliance with hospitals, physicians, and consumers generated revenues for the quarter ending on March 31, 2012 of approximately $764,000, compared to $729,000 for the prior year period. Revenues were mostly from telehealth products and services. For the third quarter of fiscal year 2012, revenues increased approximately 16 percent compared to the second quarter of fiscal year 2012, due to higher telehealth revenues for the current period.

There are an estimated 5.9 billion mobile-cellular subscriptions. Mobile-broadband subscriptions have grown 45 percent annually over the last four years. PwC estimates the U.S. mHealth market opportunities will be $6.5 billion by 2017, for remote mobile-enabled services used to monitor symptoms and manage chronic conditions like high blood pressure and diabetes. Growth is expected to be driven in part by the ACA objectives of providing cost effective preventative care.

Administration of the U.S. health system alone accounts for 7 percent of total spending. ACA has established regulations to rein in costs. Health insurance providers are now required to decrease administrative costs. They must spend 80 to 85 percent of premium dollars on medical care and health care quality improvement or they will be required to provide rebates to their customers. This year an estimated nine million Americans may be eligible for rebates worth up to $1.4 billion.

There are reimbursement incentives for hospitals and healthcare providers busy implementing certified EHR technology to meet the Centers for Medicare & Medicaid Services’ (CMS) and Office of the National Coordinator’s (ONC) requirements for meaningful use by 2015. Health systems will see a decrease in their Medicare and Medicaid reimbursements if they are not able to demonstrate meaningful use relevant to e-prescribing, the electronic exchange of health information to improve quality care, and the submission of clinical quality and other measures.

Love it or hate it, the Affordable Care Act appears to be a win-win for the economy and healthcare industry stakeholders consisting of consumers, health systems, providers, and technology business enterprises.

“When you eliminate the impossible whatever remains however improbable must be the truth!”

-Sir Arthur Conan Doyle, Scottish author and creator of Sherlock Holmes.

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks

Bain Capital is Really that Relevant

June 9, 2012

By Melissa Bynes Brooks

There is frequent commentary and political ads about the record of former Governor of Massachusetts and presumptive Republican presidential nominee Mitt Romney, during his reign at Bain Capital.

Despite the criticism, many Americans do not know what Bain Capital is. Others on the street are asking themselves, “Why should I care?” and “How does this affect me?”

They are cynical about the relevancy of the firm’s operations to their livelihood and ability to survive on a daily basis in this staggering economy which includes higher food prices, fuel prices, and unemployment rates.

So what is Bain Capital?

Bain Capital , is one of the world’s leading private investment firms that sells shares to individuals and invests in securities issued by other companies. Bain Capital manages approximately $60 billion in assets. They began initially with venture capitalism, a strategy that requires investors to take an equity stake in a developing or struggling company that might otherwise not have easy access to capital. Their advisors make private equity, public equity, leveraged debt asset, and absolute return investments across multiple sectors, industries, and asset classes.

Private equity firms will sometimes pool funds together to take very large public companies private. Many private equity firms conduct what are known as leveraged buyouts (LBOs), where large amounts of debt are issued to fund a large purchase.

In layman’s terms, a business will be purchased to increase its marketability in order to unload it later for a higher price. In most cases the business may be sold to another corporation, private equity firm, or be taken public.

The main objective of private equity is to reward investors.

Mitt Romney, who earned degrees from Harvard Law and Harvard Business School, was the founder of Bain Capital. He led the company from 1984 through 1998. During that time, Bain invested in 77 businesses. A Wall Street Journal analysis found that Bain made $2.5 billion in gains for investors from those businesses and did successfully turn around many of them.

In fact last month, to the dismay of many of President Obama’s supporters, former President Bill Clinton stated that Mitt Romney had a “sterling business career” as chief executive of Bain Capital.

“Why should you care?”

Because while the earnings for investors may look good on paper, one could venture (pardon the pun) to say that Mitt Romney was exceptionally good at helping the rich get richer and the poor get poorer.

And even when firms like Bain Capital often took substantial payments in the form of dividends and fees, some of the targeted companies would fail.

Of the 77 businesses, 22% either filed for bankruptcy reorganization or closed their doors by the end of the eighth year after Bain first invested, sometimes with substantial job losses. An additional 8% ran into so much trouble that all of the money Bain invested was lost.

Although Bain produced stellar returns for its investors, most of them were from a small number of its investments. More than 70% of the dollar gains were produced by 10 deals only.

Some of those companies, too, later ran into trouble. Four of the 10 businesses on which Bain investors scored their biggest gains, landed in bankruptcy court.

Some experts, while conceding that available studies don’t provide a direct comparison, said the rate at which the firms Bain invested in ran into trouble appears to be higher than experienced by some rival buyout firms during the era.

“How does this affect you?”

Once in control, private equity firms typically cut costs at the acquired company, a strategy that sometimes includes layoffs and restructuring.

One such example occurred in Miami, Florida.

It started in 1995, when Romney’s Bain Capital targeted the company that became Dade Behring, which made blood-testing machines and performed animal research at its Miami campus. Bain borrowed heavily to buy the company and closed a factory in Puerto Rico to improve the bottom line. About 400 lost jobs there. Then in 1997, Bain shuttered Dade Behring’s Miami operations, costing another 850 jobs and a $30 million payroll in the community. Before growing debt consumed the company, Bain executed its exit strategy and made $242 million.

This is all relevant to our staggering economy regarding future potential job gains or losses.

Mitt Romney has stated that he created more than 100,000 net jobs through his work in the private sector, and more jobs as governor than President Obama has created since taking office. Albeit, during a much more conducive economic environment than current times.

However, the first claim is unproven, and the second is misleading.

While it is true that the private equity firm Bain Capital, which Romney headed from 1984 to 1999, invested in many companies that went on to add jobs, there is no thorough count of the jobs gained and lost in all the companies in which Bain invested. And it’s highly debatable whether Bain, and Romney, deserve credit for all of the jobs created, particularly when there were other investors or executives who launched or ran the companies and then new owners in later years.

On the other hand, it is on the record that the economy was losing more than 700,000 jobs per month when President Obama took office. Since then and through May 2012, the economy has added 4.3 million private sector jobs over 27 consecutive months of job growth, an average of 158,000 jobs a month.

The pace of monthly job losses slowed dramatically soon after President Obama and Congress enacted the Recovery Act in February 2009.

Private employers added 82,000 jobs to their payrolls in May, while losses in federal, state, and local government employment held the total payroll employment gain to 69,000 jobs.

This means there has been “less government growth,” exactly what Mitt Romney and the Republicans are advocating for.

Hopefully, this data will highlight the significance of Mitt Romney’s business practices with Bain Capital. He prioritized earnings on a balance sheet over the job security of employees.

I think this is a no brainer regarding his intentions for the broader American economy.

Melissa Bynes Brooks is the editor of BrooksSleepReview.

Contact information: melissabynesbrooks@comcast.net

Follow on Twitter @Mlbbrooks


Bain Capital (2012). About Bain Capital. Retrieved June 8, 2012, from http://www.baincapital.com/AboutBainCapital/Default.aspx

Caputo, M. and Leary, A. Times/Herald Staff Writers. (2012). In Miami, Story of Profits and Layoffs Highlights Debate over Mitt Romney’s Tenure at Bain. Retrieved June 9, 2012, from http://www.tampabay.com/news/business/in-miami-story-of-profits-and-layoffs-highlights-debate-over-mitt-romneys/1211253

Center on Budget and Policy Priorities (2012). Chart Book: The Legacy of the Great Recession. Retrieved June 9, 2012 from http://www.cbpp.org/cms/index.cfm?fa=view&id=3252

House Budget Committee Staff (2008). CBO Confirms Large Deficits and Weak Economy. Retrieved June 9, 2012, from http://democrats.budget.house.gov/sites/democrats.budget.house.gov/files/documents/09.09.2008_CBO_Summer_Baseline_2008.pdf

Investopedia (2012). Private Equity. Retrieved June 8, 2012, from http://www.investopedia.com/terms/p/privateequity.asp#axzz1xGViJ8QC

Liptak, K. (2012). Bill Clinton, Predicting Obama Win, Calls Romney’s Business Career ‘Sterling.’ Retrieved June 9, 2012, from http://politicalticker.blogs.cnn.com/2012/05/31/bill-clinton-predicting-obama-win-calls-romneys-business-career-sterling/

Maremont, M. (2012) Romney at Bain: Big Gains, Some Busts. Retrieved June 9, 2012, from http://online.wsj.com/article/SB10001424052970204331304577140850713493694.html

Robertson, L. (2012). Romney’s Shaky Job Claims. Retrieved June 9, 2012, from http://factcheck.org/2012/01/romneys-shaky-job-claims/

Is this Your Grandfather’s Republican Party?

May 28, 2012
By Melissa Bynes Brooks

In its latest 2012 report, the CBO provided estimates of the American Recovery and Reinvestment Act of 2009 (ARRA) regarding its impact on employment and economic output in the first quarter of calendar year 2012, and the entire period since February 2009.

In total, CBO estimates the legislation will increase budget deficits by about $831 billion over the 2009–2019 periods (the estimate before enactment was $787 billion for 2009-2019).

If you recall, lawmakers enacted the American Recovery and Reinvestment Act of 2009 (ARRA), in response to significant weaknesses in the economy. Its purposes were:
• Providing funds to states and localities
• Supporting people in need by extending and expanding unemployment benefits
• Purchasing goods and services by funding construction and investment activities that could take years to complete; and
• Providing temporary tax relief for individuals and businesses by raising exemption amounts for the alternative minimum tax, adding a new Making Work Pay tax credit, and creating enhanced deductions for depreciation of business equipment

The economy is recovering from the most severe recession since the 1930s, albeit slower than desired but positive growth is expected. The ARRA is estimated to raise real GDP by between 0.1 percent and 0.8 percent and increase FTE jobs by between 0.2 million and 1.3 million.

Compare this to 2001, when there was a projected surplus for 2008 of $651 billion. Instead, the economy moved in the wrong direction with a deficit of $407 billion, more than $1 trillion for 2008 alone. The economy lost 772,000 private sector jobs from Dec. 2007 to Sep. 2008 alone.

Another example of policy change occurred in March 2012. Officials at the Departments of Health and Human Services (HHS), Labor, and the Treasury took the next step in the Obama administration’s effort to ensure women will have access to recommended preventive services such as contraceptives, while respecting religious liberty.

Nevertheless, this has not preempted the nostalgia of extreme right wing conservatives longing to rewind the clock and take Americans back down memory lane. For this reason, actions of contemporary conservatives are reminiscent of times in history when barriers were officially implemented to perpetuate the status quo of inequitable institutions.

Is this your grandfather’s Republican Party? Sure, the approaches have evolved but the results are the same. The evidence is incontrovertible.

Mitch McConnell, Senate Republican leader of Kentucky, declared early on in President Obama’s administration, “The single most important thing we want to achieve is for President Obama to be a one-term president.”

This strategy was designed to win back all branches of government by any means necessary. The perk for conservatives has been the declining confidence in the American psyche regarding the state of the union. Without question, economic issues have presented abysmal challenges.

Yet, Republicans continue to engage in tactics aimed at derailing attempts by the Democrats to revitalize the economy. They endorse policies and pacts which benefit the upper class but are detrimental to middle and lower class groups.

To start with, House GOP Budget Chairman Paul Ryan of Wisconsin crafted a budget that would repeal the Affordable Care Act, reduce taxes, decrease spending for defense, and reform entitlements like Medicare and Medicaid for the poor.

Federal and state governments jointly finance the cost of Medicaid under current law. The federal government is projected to provide nearly 57 percent of the total cost for Medicaid services in 2012. Chairman Ryan’s proposal would shift some of the burden of Medicaid’s growing costs to the states.

Payment rates for providers under Medicaid are generally lower than they are under Medicare and private insurance. If states lowered payment rates even further, providers might be less willing to treat Medicaid enrollees. As a result, Medicaid enrollees could face limited access to care.

Next, the most renowned pact was garnered by Grover Norquist, head of Americans for Tax Reform since 1986. It has been a major obstacle to forging a negotiable agreement between the Democrats and Republicans on the debt crisis. More than 270 Republican members of Congress and nearly all 2012 Republican presidential primary candidates signed a pledge. They promised to never vote to raise taxes despite concessions by Democrats for spending cuts in their most coveted programs.

Then recently on May 24, the GOP-led House approved a 2013 budget that would cut taxes for the wealthy, revamp Medicare and slash federal spending (translation- neglect the poor). It was a 228-191 party-line vote. Presumptive GOP presidential nominee, Gov. Mitt Romney has embraced the proposal. No Democrats voted for the measure and 10 Republicans voted against it.

In their new book, titled “It’s Even Worse than It Looks: How the American Constitutional System Collided with the New Politics of Extremism,” Tom Mann of the Brookings Institution and Norm Ornstein of the American Enterprise Institute share their views about conservative extremism in the Republican Party.

“In our past writings, we have criticized both parties when we believed it was warranted,” Mann and Ornstein write. “Today, however, we have no choice but to acknowledge that the core of the problem lies with the Republican Party.”

Their book outlines documented incidents of ruthless challenges to President Obama’s initiatives.

They explain that essentially, the Affordable Care Act is the 1993 Republican health plan. It was backed by the late Republican Sen. John Chafee and former Republican Sen. Dave Durenberger along with current Senators Chuck Grassley and Orrin Hatch. It was the alternative to President Clinton’s plan merged with elements of Governor Mitt Romney’s plan.

Republicans suddenly labeled their very own plan, i.e., The Affordable Care Act, “socialism.”

Then there was the “appalling spectacle of hostage taking,” as Mann and Ornstein described last year’s budget crises, when Republicans threatened a government shutdown and public default in the name of fiscal responsibility. It did not matter that the country’s credit standing was threatened and U.S. treasuries were downgraded.

Suffice it to say, it has not mattered to most Republicans that Congress has failed to negotiate reasonable thoughtful solutions to the social and economic challenges of the day.

In the final analysis, the X- Factor is the only thing that matters, “Bring down President Obama.” But, does that bring about any sort of positive change?

Melissa Bynes Brooks is the editor of BrooksSleepReview.
Contact information: melissabynesbrooks@comcast.net
Follow on Twitter @Mlbbrooks


Civil Rights Act (1964). Retrieved May 27, 2012, from http://www.ourdocuments.gov/doc.php?flash=true&doc=97

Congressional Budget Office (2012). Estimated Impact of the American Recovery and Reinvestment Act on Employment and Economic Output from January 2012 Through March 2012. Retrieved, May 28, 2012, from http://www.cbo.gov/publication/43274

Congressional Budget Office (2011). Long-Term Analysis of a Budget Proposal by Chairman Ryan Retrieved May 28, 2012, from http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/121xx/doc12128/04-05-ryan_letter.pdf

Egan, T. (2012). Do Nothings and Know Nothings. Retrieved May 27, 2012, from http://opinionator.blogs.nytimes.com/2012/05/03/do-nothings-and-know-nothings/

Herszenhorn, D. (2010). Hold On to Your Seat: McConnell Wants Obama Out. Retrieved May 27, 2012, from http://thecaucus.blogs.nytimes.com/2010/10/26/hold-on-to-your-seat-mcconnell-wants-obama-out/

Kroft, S. Correspondent (2011). The Pledge: Grover Norquist’s hold on the GOP. Retrieved May 28, 2012, from http://www.cbsnews.com/8301-18560_162-57327816/the-pledge-grover-norquists-hold-on-the-gop/

Mann, T.E. and Ornstein, N.J. (2012). It’s Even Worse Than It Looks: How the American Constitutional System Collided With the New Politics of Extremism. New York, NY: Basic Books. A member of The Perseus Books Group.

Mascaro, L. (2012). House Passes GOP Budget on Party-line Vote. Retrieved May 28, 2012, from http://articles.latimes.com/2012/mar/29/news/la-pn-house-set-to-approve-rep-paul-ryans-controversial-2013-budget-20120329

U.S. Department of Health and Human Services (2012).Administration releases Advance Notice of Proposed Rulemaking on Preventive Services Policy. Retrieved May 28, 2012, from http://fulltextreports.com/category/documents-in-the-news/

President Obama’s Export Economy

By Melissa Bynes Brooks
April 14, 2012

The accurate forecasting of export trends and developments in the foreign market place by the Obama Administration, demonstrates this administration’s competence for reviewing and analyzing financial data that affects the economy. The outcome epitomizes their proficiency for implementing strategies that influences growth in a positive direction.

The President launched the National Export Initiative (NEI) during his State of the Union address on January 27, 2010 and established a national goal of doubling U.S. exports by the end of 2014. This was to done so that U.S. Government agencies are focused and working together to ensure that U. S. companies have access to these markets, and that all companies, large and small, get the assistance they need to compete on a fair and level basis with foreign competitors.
Here is some insight regarding the steady improvement of the economy under the Obama Administration with respect to exports.

Specifically, U.S. export sales grew by more than 11 percent in 2010 in real terms, the fastest growth since 1997. In terms of job creation, the number of U.S. total export-supported jobs increased by almost 6 percent in 2010, even as the overall economy was still losing jobs.

IHS Global Insight expects trade to soften in 2012, with export values increasing only 4.8% while import values rise 5.8%, due to the Eurozone’s sovereign debt crisis. However, the driver for exports continues as fast-growing countries with increasing middle class sizes and infrastructure needs creates a demand for U.S. goods such as machinery, transportation, and chemicals industries. It’s estimated that U.S. export growth will average 8% annually over the next 10 years, outpacing imports which will advance by 4.8%. As a result, the U.S. trade deficit should continue to decrease as opportunities to sell goods globally increase.

Data released on April 12, 2012, by the U.S. Bureau of Economic Analysis and U.S. Census Bureau, showed the U.S. monthly international trade deficit decreased in February 2012. The deficit decreased from $52.5 billion (revised) in January to $46.0 billion in February, as imports decreased and exports increased. The previously published January deficit was $52.6 billion. The goods deficit decreased $6.0 billion from January to $61.4 billion in February, and the services surplus increased $0.5 billion to $15.4 billion.

Exports of goods and services increased $0.2 billion in February to $181.2 billion, reflecting an increase in exports of services. The increase in exports of services was mostly accounted for by increases in travel, other private services (which includes items such as business, professional, and technical services, insurance services, and financial services), and royalties and license fees.

Exports of goods decreased. The decrease in exports of goods was more than accounted for by decreases in automotive vehicles, parts, and engines and foods, feeds, and beverages. Increases in other goods and consumer goods were partly offsetting.

In data released by the Bureau of Economic Analysis on March 29, 2012, real gross domestic product (GDP) after changes of inflation are taken into account, increased at an annual rate of 3.0 percent in the fourth quarter of 2011 (from the third quarter to the fourth quarter), according to the “third” estimate released by the Bureau of Economic Analysis. In the third quarter, real GDP increased 1.8 percent. What’s notable here is that exports contributed to the increase in real GDP in the fourth quarter although imports, a subtraction in the calculation of GDP, increased.

Many Americans continue to grapple with higher levels of unemployment and poverty as the labor market recovery continues. However, the economy has added jobs continuously since October 2010 and had 2.2 million more jobs in February 2012 than in June 2009, when the economic recovery started. The private sector has added 2.8 million jobs during this period.

In keeping his commitment to improve the economy, President Obama continues to be engaged in economic activities and is currently attending the Sixth Summit of the Americas held in Cartagena, Colombia from April 14-15, 2012, where he will be promoting U.S.-Latin America trade ties to help accelerate private sector job growth.


IHS Global Insight (2012). U.S. Metro Economies: Exports in the Next Decade. Retrieved April 14, 2012, from http://usmayors.org/exportsandports/media/metro-exports-report.pdf

Istrate, E. Associate Fellow and Senior Research Analyst, and Marchio, N. Research Assistant, Metropolitan Policy Program, the Brookings Institution (2012). Export Nation 2012: How U.S. Metropolitan Areas Are Driving National Growth. Exports, Competitiveness, U.S. Economic Growth, Cities, Regions And States. Retrieved April 14, 2012, from http://www.brookings.edu/reports/2012/0308_exports.aspx#3

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By Melissa Bynes Brooks
April 9, 2012

“Despite the current period of regulatory ambiguity swirling around the Supreme Court’s final decision on whether to uphold or repeal the Patient Protection and Affordable Care Act (Obama Care), the creation and establishment of health insurance exchanges continues to be implemented at the state level and is one of the major components shaping the health care market place.”

The insurance exchanges allow individuals and small businesses to use a Web-based system to compare private health plans, get information about coverage options, determine eligibility for tax credits, and enroll in a health plan that meets their needs at lower costs. Essentially, consumers have an opportunity to make informed and educated decisions about purchasing health insurance. They can keep the insurance they have, upgrade, or switch to another provider altogether.

In an effort to lower costs and improve quality care, all states are required to implement affordable insurance exchanges by the year 2014 under Obama Care. States have the option to establish one or more state or regional exchanges, partner with the federal government to run the exchange, or to merge with other state exchanges. If a state chooses not to create an exchange, the federal government will set up the exchange(s) in the state. As of March 2012, 13 states and the District of Columbia have enacted state-based health insurance exchanges. Massachusetts and Utah passed laws prior to the enactment of Obama Care in March 2010.

Last month, the U.S. Department of Health and Human Services (HHS) published a final rule on Affordable Health Insurance Exchanges offering a framework to assist states in setting up Affordable Insurance Exchanges. The framework preserves and, in some cases, expands the significant flexibility in the proposed rules that enables states to build an Exchange that works for their residents.

For example, the final rule allows states to decide whether their Exchange should be operated by a non-profit organization or a public agency, how to select plans to participate, and whether to partner with HHS for some key functions. The final rule offers additional flexibility regarding the eligibility determination process. It also makes it easier for small businesses to get coverage through the Small Business Health Options Program (SHOP), strengthens consumer protections, and keeps it simple for health plans interested in participating in Exchanges.

“Perhaps, even in this uncertain economic and political environment, many of the state based insurance exchanges are being created because there is a perfect fit in the exchange of goods and services with the ideological concepts of a free market place and competition.” For example, Florida which is one of the 26 plaintiff states against Obama Care and the individual mandate, is working on an insurance exchange that would open in 2012 to small businesses only, with 50 or fewer employees. The exchange will not provide subsidies or tax credits, or have an essential benefits requirement but will provide an online tool allowing businesses to easily shop for health plans offered in their respective county. Florida’s exchange would be implemented to attract employers who are less likely to offer insurance coverage to their employees.

A PwC Health Research Institute Consumer Survey conducted in 2011, regarding consumer expectations about exchanges, showed that 34% of the consumers reported they would have a less than favorable impression of a health insurance company that decided not to participate in their state’s exchange. 37% of consumers surveyed think health insurance exchanges will make it easier for them to find and purchase a competitive health insurance plan. 29% of the consumers felt they do not know enough about health insurance exchanges to form an opinion.

As a result, marketing strategies for many insurance providers now consist of targeting specific businesses and population segments, as well as providing information and expanding direct-to-consumer sales while new channels for reaching consumers directly are being explored. These are all signs of the health care market place steadily transforming and providing opportunities to offer health insurance exchanges to different market niches.


Galewitz, P. Kaiser Health News (2011). Florida Readies its Own Health Insurance Exchange. Retrieved April 8, 2012, from http://www.kaiserhealthnews.org/Stories/2011/October/09/florida-health-exchange.aspx

HealthCare.gov (2012). Affordable Insurance Exchanges: Choices, Competition and Clout for States. Retrieved April 8, 2012, from http://www.healthcare.gov/news/factsheets/2011/07/exchanges07112011a.html

HealthCare.gov (2012). Affordable Insurance Exchanges. Retrieved April 8, 2012, from http://www.healthcare.gov/law/features/choices/exchanges/index.html HealthCare.gov (2012).

Kaiser Health Reform Source (2012). State Action toward Creating Health Insurance Exchanges, as of March 1, 2012. Retrieved April 8, 2012, from http://www.statehealthfacts.org/comparemaptable.jsp?ind=962&cat=17

National Conference of State Legislatures (2012). State Actions to Implement the Health Benefit Exchange. Retrieved April 8, 2012, from http://www.ncsl.org/issues-research/health/state-actions-to-implement-the-health-benefit-exch.aspx

PricewaterhouseCoopers LLP, (2011).Top health industry issues of 2012: Connecting In
Uncertainty. Retrieved April 8, 2012, from http://www.pwc.com/us/en/health-industries/publications/top-health-industry-issues-of-2012.jhtml