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"What's
Bad/Good for GM Is Bad/Good for America!"
by Jin Zhou,
02/28/2005
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No. 1: Crisis |
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Health Care Costs for 2005:
[Black
Hole (Forbes.com)] |
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GM:
$5.6 Billion, $1,500 Per Car
(Big
3 $/Car?)
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USA:
$1.9 Trillion, 15.7% of GDP
GM posts $1.1 billion loss (Washington Post, DC)
GM Can't `Unilaterally' Cut Retiree Health, UAW Says (Update4)
(Bloomberg)
General Motors Says Second-Quarter Loss in
Part Attributable to Rising Employee Health Care Costs (Daily
Health Policy Report - Kaisernetwork.org)
GM chief warns of healthcare costs crisis
(Telegraph.co.uk, United Kingdom)
"The Chief
executive of General Motors admitted yesterday the company was
failing to deal with its healthcare crisis as the car maker said its
North American operations had lost almost $1.2billion (£700m) in the
past three months."
GM reports higher US sales but still posts loss
(International Herald
Tribune, France)
GM sees no government relief on health care
(Reuters)
"DETROIT, July 20 (Reuters) - General Motors
Corp. (GM.N:
Quote,
Profile,
Research) said on Wednesday that it sees no near-term relief
from the U.S. government on its massive health-care costs.
"I don't think there's any enthusiasm at the
political level to do anything on health care, period," said GM
Chief Financial Officer John Devine."
Production cutbacks, material and health care costs result in
$1.2 billion loss in North America (DetNews.com, MI)
"Wagoner
and Chief Financial Officer John Devine
promised to attack health
care costs, excess manufacturing capacity and purchasing
costs with new urgency,
but analysts were downbeat."
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No. 2: Diagnosis
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Dx from U.S. Supreme
Court?
(Copyright
© 2004-5
by
Jin Zhou, ERISAclaim.com) |
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Is
Health Care Issue Beyond GM Management's
Control
EVEN with "ERISA
Discretionary Clause"?
If
Yes = Chapter 11; If No, What to Do?
LAB Committee Hearing Transcript for 02/08/2005 - "ERISA
Discretionary
Clauses" |
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PEGRAM et al. v.
HERDRICH
Decided 06/12/2000
Healthcare Quality by State
Laws or ERISA? |
RUSH PRUDENTIAL v. MORAN Decided June 20,
2002
Medical Necessity by State Laws or ERISA? |
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Kentucky Assn. of
Health Plans, Inc. v. Miller
Decided: April 2, 2003
Managed Care Networks by State Laws or ERISA? |
AETNA HEALTH INC. v. DAVILA
Decided June 21,
2004
Health Care Quality & Cost Control by State Laws or ERISA?
|
Unanimous US Supreme Court Ruling In US Health Care Crisis
Aetna Health Inc. v. Davila
06/21/04
Opinion of the
Court
"Held:
Respondents’ state causes of action fall
within ERISA§502(a)(1)(B), and are therefore completely
pre-empted by ERISA §502 and removable to federal court.
Pp. 4–20."
"We hold that
respondents’ causes of action, brought to
remedy only the denial of benefits under
ERISA-regulated benefit
plans, fall within the scope of, and are completely pre-empted
by, ERISA §502(a)(1)(B), and thus removable to federal
district court. The judgment of the Court of Appeals is
reversed, and the cases are remanded for further proceedings
consistent with this opinion.7
It is so ordered."
ERISA For GM from the U.S. Court of Appeals
for the Sixth Circuit:
Hill, et al v. Blue Cross of MI,
05/13/2005
OPINION
_________________
"KAREN NELSON MOORE, Circuit Judge. Plaintiffs-Appellants John
L. Hill, Francine Barnes, Franchot Barnes, Francesca Barnes, and
Glory Celestine (“Plaintiffs”) filed the instant putative class
action against Defendant-Appellee Blue Cross and Blue Shield of
Michigan (“BCBSM”), the third-party administrator for
Plaintiffs’ employer-sponsored health insurance program (“the
Program”). Plaintiffs allege that BCBSM’s handling of their
claims for emergencymedical-treatment expenses resulted in the
wrongful denial of benefits and constituted a breach of BCBSM’s
fiduciary duties to Program members under the Employee
Retirement Income Security Act of 1974 (“ERISA”). The district
court granted BCBSM’s motion to dismiss Plaintiffs’ suit without
prejudice on the ground that Plaintiffs failed to exhaust
administrative remedies available under the Program prior to
filing suit. Plaintiffs now appeal, alleging, inter alia, that
exhaustion is not required for claims for breach of fiduciary
duty, that exhaustion of administrative-review
procedures would be futile, and that Plaintiff Hill has in fact
exhausted his administrative remedies. For the reasons set forth
below, we AFFIRM IN PART and REVERSE IN PART the
district court’s order granting BCBSM’s motion to dismiss
Plaintiffs’ complaint."
Comment from Jin Zhou, ERISAclaim.com: This case ruling
indicates the entire GM health plan claim ERISA practice needs
to be re-visited or revamped, as ERISA failure is the root cause
of GM healthcare cost crisis and junk bond status,
yet
this GM ERISA bunker is least likely checked by GM for GM
healthcare crisis and possible chapter 11.
(Please
e-mail
Jin Zhou at
ERISAclaim.com for details of this Dx and more Rx)
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Jin Zhou's
Prophesiable
Dx from
ERISAclaim.com:
(Unofficial, 06/21/2008)
"We hold that Bush and GM courses of
action, brought to remedy "U.S.
Health Care Crisis", for health care
"quality and costs"
control by
shifting costs, such as HSA, AHP and CDH, for either small
businesses or GM, only
the reduction or denial of benefits under
ERISA-regulated benefit
plans, fall within the scope of, and are
completely pre-empted by, ERISA §502(a)(1)(B), and thus removable
to "ERISA Reality Channel".
The current BUSH or GM plan
is reversed, and the cases are
remanded for further
proceedings consistent with this opinion. It
is so ordered."
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No. 3: Rx &
Options for GM
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1.
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2.
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3.
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White House Rx |
GM
Plan & Rx? |
Jin Zhou ERISA Rx |
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White House Rx: |
$1,000 HSA
Personal Responsibility + AHP with
More "ERISA Advantage" for
"Widespread
Plan Insolvencies and Fraud" and
"A
Prescription For Disaster".
Association
Health Plans: No State Regulation Means Loss of Protections for
Consumers, Small Biz (PDF) (Blue Cross and Blue Shield
Association) |
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GM
Plan & Rx?: |
June 14, 2005: "Report:
GM sets deadline for UAW
"Auto firm gives union until June 30 to agree to health care
savings, or it will slash costs itself.
NEW YORK (CNN/Money) - General Motors Corp. is
set to take unilateral action to reduce its health care expenses if
it doesn't get concessions from the United Auto Workers union by the
end of the month, according to a published report."
Report: GM warns UAW on health benefits | wkyc.com
"The Wall Street Journal reports that GM has set a goal of
reducing the burden of its annual health-care costs by one billion
dollars this year and another billion in 2006."
I:
"GM looks to gain ground in Asia, control costs back home"
(Detroit
Free Press - www.freep.com)
"We invest it there, we get
a higher return and we can use that to pay off the obligations
here."
II.
GM to trim up to 2,000 workers
(The Detroit News, March 21, 2005)
White-collar staff to be cut by more than 10% in some areas, company
says.
"GM is
seeking to cut costs as it faces vastly reduced profits this year
and an expected first-quarter loss due to rising health care costs,
disappointing sales and shrinking market share in North America."
III.
GM considering asking for same health plan (businessweek.com)
"GM's salaried workers pay
27 percent of their total health care
costs, while the company's hourly workers, who are covered by the
United Auto Workers union, pay 7 percent,
according to GM data. The average U.S. corporate employee pays
32 percent of the cost of health
care, GM said.
"Our salaried employees
have one of the absolute best health care plans, probably in the
world, but definitely in the United States. The UAW hourly health
care is way, way richer than that,"
Lutz said. "We've
got to get to the point where all of our employees, hourly and
salaried and the UAW have the same health
care contract. ...
That would mean huge sums of money for
us."
IV.
MSMS Sues Blues (msms.org)
(ERISA
SEARCH)
"DOCTORS SUE BLUE CROSS OVER AUTO/UAW
HEALTH CARE PLANS
EAST LANSING – The Michigan
State Medical Society and the Michigan Osteopathic Association today
jointly filed a lawsuit against Blue Cross Blue Shield of
Michigan alleging that BCBSM is
wrongly fixing the fees
physicians charge for office visit services provided to enrollees
in the
new “preferred provider organization” health care plans for United
Auto Workers under the most recent UAW/automaker contracts......
MSMS is the professional association of 14,500
medical doctors. MOA is the professional association of
4,500 osteopathic physicians."
V.
Big Three, UAW say they must solve crisis before 2007 contract
(DetNews.com)
UAW to GM: Hands off our contract (MLive.com,
April 15, 2005)
"DEARBORN -- United Auto Workers President Ron Gettelfinger says the
union is willing to help ailing General Motors Corp. trim its
out-of-control health care costs. But forget about reopening the 2003
labor contract."
""But Anderson said the federal government needs to trim paperwork and
bureaucracy in the Medicare- and private insurance-driven system.
Some health care experts say
administrative costs and insurance company profits represent as much
as 50 percent of all health-care spending in the United States."
VI. "Hill, et al v. Blue Cross of MI,
05/13/2005"
AND
Doctors fight Blues over fees - 09/10/04 (The Detroit News)
State medical society suit threatens reduced amount UAW workers pay
for office visits.
"The lawsuit was filed after discussions between Blue Cross and the
medical societies failed to resolve the issue.
"We disagree and
are obligated to administer
health care benefits in accordance with the health plan design
requirements of our automotive customers,"
Blue Cross said in a
statement.
Automakers and the
UAW are taking a hands-off
approach to the dispute.
"The UAW is not a party in the Michigan State
Medical Society's suit against Blue Cross-Blue Shield of Michigan, and
we have no comment on the suit at this time," the UAW said in a
statement.
Ford, GM and Chrysler declined to comment directly
on the lawsuit.
GM spokesman Kerry Christopher said
the matter "is between Blue
Cross/Blue Shield and the Michigan State Medical Society."
VII: GM
plans to close more US factories (Detroit
Free Press, MI)
"Some of
Wagoner's comments also seemed to be aimed at the UAW -- and telling
the union a plan to reduce GM's health care costs must be worked out,
with the union or without it."
VIII:
UAW Members OK GM Health Care Proposal
(ABC News)
"DETROIT Nov 11, 2005 — General Motors Corp. got some
relief from its spiraling health care costs as auto workers agreed to
pay more of their health costs, but analysts said the ailing automaker
must do more to turn around its North American operations."
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Jin Zhou ERISA Rx
U.S. Healthcare
Crisis Turnaround?
Jin Zhou ERISA Rx
Is the Only Power that Can Stop Medical Inflation and Waste |
Zhou's Prudent Healthcare Model
($700/Car) to get GM out of GM "Black
Hole", to spare
"the death
of GM
'Michelle'",
to
avoid
GM
"John Q. ERISA
Enforcement",
to spare Bush & Congress from stopping
"the bondholders to
pull the feeding tube" from
"the corporate
version of poor Terri Schiavo, with all options for survival
exhausted":
"50% savings on
health care costs without simply shifting the uncontrollable burden
that would actually inflame the medical inflation!"
Union OKs GM health care cuts (Oakland
Press, MI - Nov 12, 2005)
Will increased co-pays and deductibles really
save GM as much as it anticipated?
The past history of managed care reality is
clear: high co-pay with high deductible always caused higher
inflation of medical claims in the past 20 years.
Can GM healthcare crisis be
fixed without having to change UAW contract and to shift
burden/crisis to UAW members?
Yes, but only through a
fundamental solution to fix medical inflation/healthcare costs, and
someone else would have to lose significantly from GM $5.6 billion
"fortune opportunity pie", that may never happen.....
Why Can't GM Learn From HMO's
for $5.8 Billion?
($1.9 Trillion - $5.7 Billion (%±GM/HMO)
= $300/Car?)
Weiss Ratings: HMO & Health Insurance News Releases
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White House to GM:
HSA & AHP Only.
Get ready for
"ERISA Advantage"!!!
A letter emailed to GM from
ERISAclaim.com
2/28/2005 11:45:58 A.M.
Central Standard Time |
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It is time for automakers to wake up from
political hallucination: White House solutions to automakers
nightmare and Rx the doorsteps of Chapter 11.
It is absolutely clear to any reasonable mind of
commonsense leadership that:
1. White House and the President
does not have any solutions as you anticipated, if he did have a
solution, he would have given to you without you asking;
2. The president is absolutely
determined, as determined as on his war strategy and no one can
change him, that HSA and AHP are the solution to US health care
crisis, which is exactly the cause of GM health-care crisis: "ERISA
Advantage" with PPO medical inflation, as I explained to GM and the
USA for three years;
3. Does President Bush make a
complete mistake? Did GM proposal fall on deaf ears?
HSA & AHP are as bad as Wagoner/GM's proposal:
They Both failed to identify and fix the fundamental failure of the
employer-sponsored health-care delivery and administration system =
ERISA Failure and Medical Inflation!
4. "Mr. Rick, Car man" has as
many deaf ears as the President Bush, "Failure of Imagination" Again
in Health Care. If a GM automobile engine is not running or running
poorly, we all need to get down to the engine to identify the
problems and fix the problems where originated, as a commonsense,
but this commonsense has not been followed by GM and the President
in health care crisis management.
"But Bush, acknowledging that health care costs are hurting
businesses - "whether it be the automaker or the family restaurant
in Michigan" - said the first priority should be making health
insurance more affordable for small businesses. "
"More
than half of the uninsured are small business employees," said Bush,
who was flanked by GM Chairman Rick Wagoner, Ford Motor Co. Chairman
Bill Ford Jr. and Chrysler Group President Dieter Zetsche on the
dais. "To me, that makes sense to start there."
Apparently and completely determined by President
Bush, HSA and AHP for small businesses and uninsured are the
priorities for the next four years, if no one can change President
Bush on his war strategy, no one in his lifetime can change
President Bush's HSA and AHP strategies.
"Bush
said businesses should be allowed to band together to buy health
insurance at cheaper rates.
But
many business groups are opposed to the idea. They say the
president's proposal, known as association health plans, wouldn't
be subject to state regulations and would allow the plans to deny
coverage to older, more expensive workers.
"
"ERISA Advantage"= "More
"ERISA Advantage" for
"Widespread
Plan Insolvencies and Fraud".
(With hyperlinks to references
)
GM relied upon ERISA advantage for 30 years
and end up with $5.6 billion in yearly health-care costs and
$1500 per car
President Bush firmly believed that small
business should be allowed to bind together to do exactly what GM
has done in the past 30 years: "ERISA Advantage" and PPO Saving ("Medical
Inflation, WMD")
Click the following hyperlinks To learn What Blue
Cross Blue Shield Actually says About ERISA advantage for Small
businesses And AHP
$1,000 HSA Personal Responsibility +AHP
with
More "ERISA Advantage"
for "Widespread
Plan Insolvencies and Fraud".
"unlimited and frequent premium increases, and
the potential for rampant fraud with little, if any, regulatory
recourse"
When President Bush has decided to share ERISA
advantage with small businesses, someone is finally telling the
truth: ERISA Advantage Will Be as bad as WMD.
7. "Bush
offers no silver bullet for automakers' health care costs"
(boothnewspapers.com)
"Last
summer, Wagoner urged the winner of the presidential election to
appoint a high-powered panel of business, labor and political
leaders to propose ways of at least slowing health care costs,
which have been rising more than 10 percent a year recently.
Wagoner
said last month his proposal had fallen on deaf ears."
"Mr. Rick, Car man", President Bush, Congress and USA all have Deaf
EARS:
8. SOS For GM bottom line: HSA & AHP can never
help GM but speed up Chapter 11 for our national icon.
Respectfully, but no Deaf ears.
Jin Zhou
President
ERISAclaim.com
630-736-2974
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Subject: |
Rx!!!: "Facing losses of up
to $2 billion":
GM Wagoner Shuffle Lutz &
Cowger
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Date: |
4/10
1:31 PM |
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Dear Mr. Wagoner:
The conventional strategies have been proven to be
failing for GM & Big Three. Cost shifting and tighter managed
care will cause more bleeding, medical inflation, and more
possible headaches, nationwide union strikes, similar to
that recently triggered by
"GE show-down"
"yesterday".
GM and Big Three are at the most critical time in
the history to make some critical and correct decisions to stop
medical inflation caused by GM and Big Three.
Sincerely,
Jin Zhou
President
ERISAclaim.com
630-736-2974
Executive Suite Shuffle
Sunday,
April 10, 2005; Page F02
Executive Suite Shuffle
"Facing losses of up to $2 billion in its North American auto
business this year, General Motors chief executive G. Richard
Wagoner Jr. said he would run the division himself, pushing
aside two trusted deputies, Robert A. Lutz and Gary L. Cowger.
GM's market share in the first quarter declined, to 25.7 percent
from 27 percent a year earlier.
Wagoner's challenges will be
to lower health costs, close unneeded
plants, develop a line of cars that excite consumers, and wean
the company off its dependence on rebate-induced sales.
"
"What's Bad/Good
for GM Is Bad/Good for America!"
by Jin Zhou, 02/28/2005
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Health-Care 9/11 Report of 2005
Health-care WMD
by Jin Zhou,
02/05/2005
© 2005,
Jin Zhou,
ERISAclaim.com |
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Unanimous US Supreme Court: |
Employer-Sponsored Health-Care Is
Completely Governed by ERISA laws and rules;
Aetna Health Inc. v. Davila, 06/21/04 |
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Congressional Leaders: |
One
Administration = One Voice = ERISA Self Enforcement only, or
No Enforcement? |
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Health-care Terrorists? |
"ERISA Advantage" bogus
plans,
"unlimited and frequent premium increases, and the potential for
rampant fraud with little, if any, regulatory recourse" in 30
years of ERISA self enforcement. |
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Health-care WMD (Weapons of Mass Destruction) |
"Medical
Inflation, WMD" for
"ERISA Advantage" from
ERISA Failure -
"Failure of Imagination" Again
for US Healthcare:
USA:
$1.9 Trillion, 15.7% of GDP
GM:
$5.6 Billion, $1,500 Per Car
Economists: Federal deficit a bigger risk than terrorism (USA
Today) "The survey, taken
between Feb. 28 and March 8, found U.S. businesses had three nearly
equal concerns about longer-term risks: health care, the aging
population and the federal deficit." |
| USA
2005: |
-
Personal Bankruptcy
-
GM Chapter 11,
-
National healthcare expenditure $$1,9 trillion
-
One nation under debt
-
GAO Report: Tax
Expenditures Represent a Substantial Federal Commitment and Need to
Be Reexamined (PDF) (U.S. Government Accountability Office)
Abstract Highlights-PDF PDF
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| White
House Rx: |
$1,000
HSA personal responsibility + AHP with
More "ERISA Advantage" for
"widespread
plan insolvencies and fraud" and
"A
Prescription For Disaster". |
| 2005 for
Michael Moore? |
"John Q. ERISA
Enforcement"??? |
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Congressional conclusion 2008:
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"Failure of Imagination" Again,
with No One's Responsibility and Accountability. |
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Tort Reform, Fraud
& Healthcare Crisis? |
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New From Center for Justice &
Democracy:
***New Study*** Falling Claims and
Rising Premiums in the Medical Malpractice Insurance Industry
(July 7, 2005)
Appendix
News Release: New Study Leads
Attorneys General to Proclaim “No Excuse” and “A Matter of
Life and Death” (July 7, 2005)
PDF
"Joanne
Doroshow, Executive Director of the Center for Justice &
Democracy, which commissioned the report, stated, “To put it
bluntly, if you look at what the insurance companies say
about why they raise premiums, and then look at the data in
this report, thenumbers just don’t add up. The facts are
very simple: medical malpractice payouts are down yet
insurance companies have significantly increased premiums.
This shows that the
entire campaign to limit liability for doctors over the last
several years by capping compensation to injured patients
has been a fraud, and that based on these data, insurers
must know that it has been a fraud.”
Study Backgrounder (July 7, 2005)
PDF
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ERISAclaim.com - A $1.0 Trillion Nuclear
Solution to U.S. Health-care Crisis & $44 Trillion Budget
Deficits |
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