Texas Mom Sues After Insurance Denies Claim and Daughter Dies of Appendicitis

The parents of Isabella Tolentino are suing their insurance provider of the death of their 6-yr. old daughter.

Prinsabella Mia FOundation/Facebook

A Texas nurse and mother has sued her insurance company after her 6-year-old daughter died of a brain injury when appendicitis surgery allegedly went wrong while the family was on vacation in the Dominican Republic in 2012.

Marissett Tolentino alleges in a lawsuit filed Dec. 17 in Galveston County Court that Blue Cross Blue Shield of Texas denied her sick daughter Isabella a medical jet that they were entitled to under their policy, which led to surgery "being performed in substandard conditions" at a local hospital.

Isabella had her appendix surgically removed at a BCBSTX-authorized facility, Hospiten Bavaro in Punta Cana, but she never came out of the anesthesia and suffered a fatal brain injury, the lawsuit alleges.

Ohio Transplant Victim Says Hospital 'Wasted' Brother's Trashed Kidney

Eventually, the insurance company approved the medical jet and airlifted the little girl to Miami, but it was too late to save her, according to the lawsuit.

"They gave her the dosage equivalent of a 6-foot, 200-pound man. And she was intubated with an infant-sized tube instead of a toddler one. Not only was she drugged up on so much anesthesia, she wasn't breathing the right amount of oxygen," explained the lawyer for the Tolentinos, Mason Herring of Houston.

The wrong-sized breathing tube was discovered when Isabella was airlifted to Miami and the medical team aboard the jet found mucus clogging the tube, according to Herring.

Tolentino and her husband Francisco allege in their lawsuit that the insurance company was too cheap to initially approve the flight.

"I just thought, I've been paying all these premiums all these years and then when I really needed them, they wouldn't pay for an $18,000 flight," Tolentino told the Houston Chronicle, which first reported the story. "I have to deal with the daily struggles of losing my child over something so stupid -- them flying her home."

Miami Hospital Circumcises Baby By Mistake

The lawsuit alleges "lack of ordinary care proximately caused injury, which resulted in plaintiff's death."

The Tolentino family has charged BCBSTX with "gross negligence" and violation of the state's Deceptive Trade Practices Act. They are seeking unspecified damages for Isabella's physical pain and their own mental anguish.

When contacted by ABCNews.com, Louis Adams, a spokesman for Blue Cross-Blue Shield of Texas, would not discuss the case because it was "a matter of pending litigation."

The company has not yet filed a response to the court.

Hospiten Bavaro was not named in the lawsuit, but Tolentino "absolutely has not absolved the hospital," said her lawyer Herring.

"She can't sue in the U.S.," he said. "The Dominican Republic's civil system is very antiquated and very harsh to foreigners."

When asked for comment, hospital spokeswoman Jacki Mendes told ABCNews.com, "Unfortunately we do not provide medical information about our patients without their authorization."

The lawsuit alleges that the insurance company and Hospiten Bavaro didn't share with the family the complications of surgery and didn't get her help in time.

"I feel very guilty, like I made the wrong decision," Tolentino told the Chronicle. "I should have fought the insurance company harder. They don't care about what happens afterward. It's not their child."

"Blue Cross Blue Shield was aware of the severity of Isabella's condition, yet they knowingly delayed the process and placed administrative prerequisites above the urgency required to save Isabella's life," according to the lawsuit.

According to court papers, Isabella complained of sharp stomach pains on July 5, 2012. When she developed chills and a fever, the family asked for help a medical clinic at Dreams Palm Beach Resort, where they were staying.

Doctors there diagnosed appendicitis and sent her to Hospiten Bavaro, where immediate surgery was recommended, according to the lawsuit.

"Plaintiffs were not comfortable with the idea of subjecting their daughter to a procedure in a foreign hospital that may not meet the standards of professionalism and care of an American hospital," alleges the lawsuit, and asked that she be transferred to the United States.

Local doctors and the girl's own pediatrician advised that putting Isabella on a commercial flight would be too dangerous and recommended she be flown to the U.S. on a medical jet, according to the lawsuit.

Their claim was denied by BCBSTX, according to the family.

"...[I]n their opinion, the medical condition was not severe enough," alleges the lawsuit, and the insurance company "trusted [the] expertise" of its local in-network hospital.

"The denial of this service forced plaintiffs to have Isabella's surgery performed at Hospiten Bavaro," the lawsuit alleges.

The family says that Isabella did not wake up after surgery and was told she was "very unstable," according to the lawsuit. Doctors told them their daughter had vomited while unconscious and blood had come through the intubation.

Hospital staff told them the girl's oxygen levels were low but "not to worry," according to the lawsuit. The next morning Isabella's condition was critical, but the family said BCBSTX, which was aware of her state, made no effort to contact them or approve a jet until the end of the day.

"They insisted on delaying the transfer until a Hospiten doctor sent a report to the doctors in Miami, where Isabella's transfer would be," alleges the lawsuit. "Hospiten staff unreasonably delayed in sending this report and claimed to have difficulties communicating with Miami."

"BCBS was fully aware of the severity of Isabella's condition but still had not authorized the medical jet," the lawsuit alleges. The family also says "precious time was wasted" with delayed paperwork to the Miami hospital where Isabella was to be transferred.

They also allege that both Hospiten Bavaro and BCBSTX refused to authorize the transfer of their daughter until payment was made. Then a medical jet scheduled for 10 a.m. did not arrive until 2 p.m., according to the lawsuit.

Doctors in Miami discovered "brain damage resulting from the oxygen deprivation," according to the lawsuit. Isabella later went into seizures and died.

Tolentino's lawyer said that medical records sent to Miami revealed hospital errors.

"But parts of the story don't add up and don't make sense," said Herring. "We are trying to get to the bottom of that. ... Now, insurance companies are making the decisions about what is a life-threatening sickness or injury -- they are making medical decisions for people."

The family has set up a web page, the Prinsabella Mia Foundation, in memory of their daughter to help other children with brain injuries.

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Virtual Insurance: How ObamaCare Saves 30 Million From Being Uninsured While Leaving 30 Million Without Coverage

Obama supporters cite the 30 million who stand eventually to gain health insurance coverage as the most compelling reason for not abandoning ObamaCare in its time of troubles. Despite a string of disappointments and broken promises, ObamaCare critics do not push back against this  claim. After all, the 30 million who will gain insurance is a calculation of the "non-partisan" CBO.

In actuality, the 30 million figure is the CBO's projected difference between the numbers of uninsured without and with ObamaCare in various years in the future. Given the current state of flux of our health insurance system, anyone who claims to know these figures is either a liar or a fool.

We do have at least two projections of the number of uninsured under the implementation of ObamaCare. They basically agree. The more widely publicized is the CBO's projection of 26 million uninsured in Obama's last year in office. A more recent independent study estimates 30 million uninsured at the end of Obama's second term, and finds, remarkably, that the uninsured  will have the same features (poor, Hispanic, young) as  before ObamaCare.  And I thought the primary goal of ObamaCare was to insure everyone, not to leave close to 30 million uninsured behind!

These two projections raise the question: How can ObamaCare raise the number of insured by 30 million as it leaves some 30 million uninsured?

Reconciling such inconsistencies is not a new challenge for the Obama team. If they could find millions of jobs "saved" by the stimulus as actual jobs were shrinking, they can find millions "saved" from not being insured in the absence of ObamaCare. It is as easy to save people from virtual uninsurance as to save virtual jobs.

To calculate virtual insurance, the CBO (Table 2) estimates the number of uninsured with and without ObamaCare through 2022. They conclude that the same number (56 million) would be uninsured in 2016 as before ObamaCare. (I wonder why  the CBO does not use Obama's 41 million uninsured figure — which includes "unauthorized aliens" — as its starting point?)

Per CBO we'd have 56 million uninsured without ObamaCare in the year the President leaves office.

To complete its virtual insurance calculation, the CBO estimates that, by 2016, an additional 31 million more will gain insurance (20 million from the new exchanges and 17 million from Medicaid expansion) than will lose coverage (4 million from employers and 2 million from individual markets). This is the source of the 30 million people that ObamaCare will save from being uninsured.

The CBO's calculation of virtual insurance is like measuring weight loss by subtracting your actual weight at the end of a diet from what it would have been without the diet. For example, a 200 pound man weighs 195 pounds after a month of dieting. He concludes he  lost 25 pounds because he figures he would have weighed 225 pounds without the diet.

Note the CBO "saves" us from being uninsured by assuming that 20 million Americans will be rushing to the exchanges in 2016 despite high premiums and even higher deductibles and that only 2.5 percent of employers stop offering employee coverage and only 7 percent lose their insurance in individual markets.

Although the exchange sign-up numbers have yet to be disclosed, our initial first-hand experience with the exchanges seems to be that they reduce the number of insured. The number of individual policies cancelled may turn out to be greater than the number turning to exchanges and Medicaid. The employer mandate has been delayed a year. How companies will respond is only a matter of speculation, but if only a quarter decides not to offer insurance,  ObamaCare will actually raise the number uninsured, according to the CBO formula.

The lesson: Never accept any projection of what will happen in the future without first reading the fine print.  I can apply equally plausible assumptions to the CBO calculations to conclude that ObamaCare will raise the number uninsured.

Politicians have learned to pick a number that makes their case, repeat it over and over until the public accepts it as true. The "repeated lie" tactic  works as long as it does not contradict what ordinary people see with their own eyes. Obama's "millions of jobs saved" became a national joke as jobs continued to disappear. ObamaCare's virtual insurance will suffer the same ignominy if people see the actual insurance rolls falling, while the administration claims otherwise due to virtual insurance gains. The public  could care less what the insurance rolls would have been if there were no ObamaCare.

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Deadline extended for health insurance sign-up

The deadline to sign up for insurance on the government's health care website arrived Tuesday, a day later than expected after the Obama administration granted those waiting until the last minute — or those tripped up by the site's glitches — an extra day to enroll.

The one-day grace period was the latest in a series of delays that have marked the rollout of the health care law. Officials said they decided to extend the deadline to Christmas Eve to ensure people in different time zones and those experiencing technical problems that might result from a last-minute rush of applicants can sign up successfully.

Among those not needing the extra day: President Barack Obama. The White House said Monday he had signed up for coverage through the new insurance exchange, even though he won't use it. And Obama aides didn't actually use the HealthCare.gov website to sign up their boss, a reminder of just how complex the process can be.

Had Obama tried to log on Monday afternoon, he would have been among the record 850,000 visitors to HealthCare.gov, five times the number logged by the same time last Monday. Julie Bataille, a spokeswoman for the federal agency in charge of the health care overhaul, said the system was handling the volume with error rates of less than 1 in 200 and response times of less than one second.

Still, critics of the law said the grace period is yet more evidence that the website still isn't working and that Obama keeps changing the rules. In Ohio, Lt. Gov. Mary Taylor called the deadline extension "a clear sign Healthcare.gov continues to struggle."

"Consumers are already confused and insurers are overwhelmed with the administration's last-minute changes, yet there seems to be no end in sight," said Taylor, a Republican who heads Ohio's insurance department.

Monday had been the deadline for Americans in the 36 states served by the federal site to sign up if they wanted coverage at the start of the new year. The remaining states operate their own online marketplaces, and some of them have also extended their deadlines.

The federal site had a disastrous, glitch-prone debut in October but has gone through extensive improvements to make it more reliable and increase its capacity. The Obama administration is hoping for a surge of year-end enrollments to show that the technical problems were merely a temporary setback. That would also go a long way toward easing concerns that insurance companies won't be able to sign up enough young, healthy people to keep prices low for everyone.

The administration was careful not to characterize Tuesday as a new deadline or an extension, likening the move instead to the Election Day practice in which people who are in line when the polls close are still allowed to vote. As the deadline drew near, more than 1 million people visited the website over the weekend, and a federal call center received more than 200,000 calls.

The government's original deadline already had been pushed back a week because of the website problems. The extra day will add to the already daunting administrative problems that insurance companies face, such as inaccuracies on applications, said industry consultant Robert Laszewski.

"Insurers would like to have two to three weeks to process applications. Now they're going to have a week, less one more day," he said. "When the day is done, it doesn't help."

Obama said Friday that more than 1 million Americans had enrolled for coverage since Oct. 1. The administration's estimates call for 3.3 million to sign up by Dec. 31, and the target is 7 million by the end of March. After that, people who fail to buy coverage can face tax penalties.

Minnesota, one of the states running their own insurance exchanges, extended its Monday deadline to Dec. 31 amid problems with its website and extra-long hold times to reach its help center. Maryland pushed back its cutoff date to Dec. 27. New York extended its deadline to midnight Tuesday.

Nevada stuck to its Monday deadline, and enrollment counselors there reported a surge of interest.

"We have people lined up out our door. We still have walk-ins, people are asking for help. Our phones are ringing nonstop," said Andres Ramirez in Las Vegas.

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CommVault and Hitachi Data Systems Bring Advanced Data Protection, Availability and Recovery to Enterprises and SIs

2013-12-22 14:53:54 - Enhanced Hitachi Data Protection Suite powered by CommVault Simpana® software automates data backup, management and access for unified storage, virtualized and cloud infrastructure

DUBAI , United Arab Emirates, 22nd December, 2013 - CommVault (NASDAQ: CVLT) today announced an expansion of its long-standing OEM partnership with Hitachi Data Systems to provide the industry's most advanced data protection and recovery solutions to enterprises and IT-as-a-service providers.

New, deeper integration of Hitachi Data Protection Suite, powered by CommVault, with Hitachi Virtual Storage Platform (VSP) and Unified Storage VM systems helps increase storage efficiency and automates data backup and recovery for application, file systems and hypervisor platforms. The high-speed recovery of data can lower operating and capital expenses, reduce complexity and risk for Hitachi Data Systems storage customers. They can also deploy Simpana-based h ardware snapshot and copy management as a standalone option or integrated with the complete

Hitachi Data Protection Suite, which also embeds backup, content-aware retention, deduplication, eDiscovery and search functionality into a single software platform.

"CommVault is committed to driving up efficiency and driving out costs for the enterprise through our vision for modern data management and single software platform architecture," said David West, senior vice president of worldwide marketing and business development, CommVault. "As our OEM partnership with Hitachi Data Systems enters its ninth year, CommVault is focused on offering innovation for our joint customers that help extend the value of their storage investments and data to transform their business."

"CommVault continues to deliver innovative data protection technology that our customers demand for emerging use cases and data-intensive environments, whether on premises or in the cloud," said Mike Walkey, senior VP of global partners and alliances at Hitachi Data Systems. "The enhanc ed Simpana software features and flexible deployment help Hitachi Data Systems storage customers increase the availability of their data while reducing risks and costs for their business."
Simplifying Backup and Recovery for Hitachi Virtual Storage Platform and Unified Storage VM
Simpana IntelliSnap technology normalizes and simplifies hardware snapshot management with industry-leading storage and application integrations, eliminating the need for custom scripts, multiple tools and manual processes. Working together, CommVault and Hitachi Data Systems have standardized management of snapshots across Hitachi Virtual Storage Platform or Unified Storage VM systems. With deepened IntelliSnap integration, Hitachi Data Protection Suite provides a single management console for easier administration, offering innovations and benefits such as:
Modern, efficient backup and recovery – integrated provisioning and management of Hitachi Thin Image snapshots and ShadowImage volume copies enable fast, space-efficient backup and recovery of application, file and object data at the speed of the hardware array.

Automation for simplified operations – automated management of Hitachi Open Remote Copy Manager (HORCM) tasks, such as file and pair discovery, speeds time to deployment, maximizes array recovery options and minimizes downtime. The increased productivity also frees up IT resources to focus on other priorities.

Granular intelligence to increase data availability and access – built-in Simpana awareness for application, hypervisor and file systems enables rapid recovery of individual files, objects and messages. Data is available to support business decisions, test and development and compliance requirements.

Support for heterogeneous physical and virtualized environments including:
File systems: Linux, UNIX, and Microsoft Windows File Systems
Applications: Microsoft Exchange, SharePoint and SQL Server, IBM DB2 an d Notes, MySQL, Oracle and SAP
Hypervisors: Microsoft Hyper-V and VMware

Availability
The full Hitachi Data Protection Suite powered by CommVault is available immediately from Hitachi Data Systems and a joint network of global reseller, systems integrator and solutions providers. The new capacity licensing options allow customers to quickly deploy modern snapshot management as a standalone option, integrated with HDS systems, and seamlessly upgrade later to the complete data and information management platform. The snapshot management-only option will be available in the coming weeks.

About CommVault
A singular vision – a belief in a better way to address current and future data management needs – guides CommVault in the development of Singular Information Management® solutions for high-performance data protection, universal availability and simplified management of data on complex storage networks. CommVault's exclusive single-platform architect ure gives companies unprecedented control over data growth, costs and risk. CommVault's Simpana® software suite of products was designed to work together seamlessly from the ground up, sharing a single code and common function set, to deliver superlative Data Protection, Archive, Replication, Search and Resource Management capabilities. More companies every day join those who have discovered the unparalleled efficiency, performance, reliability, and control only CommVault can offer. Information about CommVault is available at www.commvault.com. CommVault's corporate headquarters is located in Oceanport, New Jersey in the United States.

Media Contact
Colin Saldanha
Procre8
Mobile: +971506400762
Email: colin@procre8.biz

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Criminal Justice Degree Offers Detroiters Exciting Opportunities

For more news and information

about employment and education, visit

Let's Get To Work Detroit.

People in Detroit know how difficult it can be to land gainful employment in this tough Michigan economy; they also know how hard it can be to turn that position into a longtime, fruitful career. The Motor City may have its problems with crime, not unlike any other big city, but with the economy on the upswing, more Detroiters than ever are turning to the field of criminal justice to not only help combat tough issues in Motown, but to achieve some spectacular levels of success as well.

Daniel Draz, principal, Fraud Solutions (photo courtesy of Daniel Draz)

Daniel Draz is the principal of Fraud Solutions, an international fraud consulting firm. With 27 years of experience in the criminal justice field, Draz has a stellar record of fraud investigation, training, prevention, management and compliance experience — all within the private sector. He is often published in industry and trade publications and has been a Certified Fraud Examiner (CFE) since 1996. Draz has an master of science in economic crime management from Utica College and earned his bachelor of science in criminal justice from Arizona State University.

After graduation, how hard was it to transition to the working world?

"After graduating from college, I initially pursued a public sector career as a special agent with various federal law enforcement agencies. That was a long and tedious process. Although I passed the Treasury Enforcement Agent Exam, starting salaries in law enforcement at that time were less than my student loans, so I ultimately opted for an investigative position in the private sector where there were more readily available opportunities."

How important is a well-rounded, impressive education within your field?

"There are many different sectors in the criminal justice profession and the different sectors often have differing requirements concerning levels of education. For example, some agencies may require a college degree as the minimum entry requirement, while others might only require a high school education. So, an important consideration for applicants thinking about a position is what value does the agency place on an applicant's education?"Since most public sector positions in the criminal justice field are civil service jobs, the education equation is dictated by civil service rules, so having a degree may only provide minimal return versus an applicant with actual on-the-job experience. However, in the private sector, the education usually pays dividends as it is often a basic requirement of the job, while an advanced degree is often highly valued by management for promotional opportunities."

Do you have any advice for someone starting out in criminal justice?

"Given how the world is changing these days, I advise younger individuals to integrate other disciplines — language, business, finance, accounting, analytics, forensics, etc. — into their criminal justice studies to make themselves more well rounded. With the ever-present competitive nature of the economy, employers are looking for multifaceted individuals who possess multiple skill sets and that is often the differentiator between one candidate and another."

Michael Ferro is freelance writer and a graduate of Michigan State University where he majored in Creative Writing and received the Jim Cash Creative Writing Award. Born and bred in Detroit, he currently resides in Ypsilanti Township. Additional writing can be found at Examiner.com.

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Shifting Obamacare deadlines are giving insurance industry fits

The Obamacare enrollment deadline to have coverage by Jan. 1 was Dec. 15 ... then Dec. 23 ... then Dec. 24. Insurance industry workers charged with making it all work are not amused.

This Dec. 20 image shows part of the HealthCare.gov website. Anticipating heavy traffic on the government's health care website, the Obama administration effectively extended Monday's deadline for signing up for insurance by a day.
(Jon Elswick/AP)

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By Harry Bruinius, Staff writer / December 26, 2013 at 5:17 pm EST

As Americans scramble to meet all the sliding Obamacare deadlines and rule changes this week, the harried insurance industry is struggling to keep up.

A record two million people visited HealthCare.gov on Monday, while state exchanges, too, experienced record traffic and new applications ahead of the Dec. 23 deadline – which, at the last minute, became a Dec. 24 deadline – to apply for health insurance in order to have coverage in place by Jan. 1.

This was already an extended deadline from Dec. 15, which was supposed to give insurance underwriters and carriers just enough time to have their clients signed up and ready to go for the start of the new year. But now they're swamped with less than a week to go.

"If the launch had gone properly in October, we would not have been put between one rock and one gigantic hard place," says David Oscar, communications chair of the New Jersey Association of Health Underwriters. "All the rules that are coming out last-minute are unfair to both the consumer and the carrier."

Insurance workers know that the past weeks have been a matter of "grin and bear it." Like the Obamacare administration, the industry wants to enroll as many people as possible to avoid the specter of skyrocketing premiums next year. But for providers that have had to cope with the White House's shifting enrollment guidelines and goal posts, recent days have been an unwelcome reminder of how much depends on them, and how little time they have to get it right.

Nearly everyday, Mr. Oscar says, he's on the phone telling a client that what he told them earlier no longer applies. And it has gotten so frequent that his assistants and coworkers decided to make it a game. They printed a picture of a yellow school bus and taped in next to his desk. They also printed little miniature David Oscars.

Now, whenever they hear him apologizing to a client, or explaining new rule changes, they run over and tape a picture of him underneath. "Health-care reform is throwing me and my industry under a bus," Oscar says.

"We've been running for a deadline, and everybody wanted this coverage for Jan. 1, and then you sort of soft move it from Dec. 15 to Dec. 23," he says. "And then on the 23rd, you let it leak that day? You don't even give a heads-up announcement?"

Earlier this month, after appeals from the Obama administration, the major carriers said they would give people until Jan. 10 instead of Dec. 31 to pay their first month's premium – another problem waiting to happen, many believe, as thousands of people will be technically covered without having paid a dime.

"The goal posts keep moving,� � William Schiffbauer, an insurance attorney, told The New York Times Tuesday evening. "That raises questions about whether insurers can collect premiums in a timely manner to pay claims from doctors and hospitals."

The industry has tried to accommodate many of these late changes requested by the Obama administration, but it has refused some, including allowing out-of-network coverage and retroactive enrollment.

"Health plans will continue to do everything they can to help consumers through the enrollment process and mitigate potential confusion or disruption caused by all of these last-minute changes to the rules and deadlines," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, the industry's Washington lobby group, in a statement Tuesday.

Those who began their applications by the Christmas Eve extension, but were unable to complete it, could be given even more extra time on a case-by-case basis by calling the marketplac e call center. This means that New Year's Eve will probably be a busy day, too.   

"Our highest priority is making sure that everyone who wants to enroll to have health care coverage by January 1 is able to do so, particularly since consumers had a hard time accessing HealthCare.gov in October and November," said Julie Bataille, communications director at the Centers for Medicare and Medicaid Services, in a statement.

Those missing the deadline can still apply for coverage in the open-enrollment period, but their coverage won't begin until Feb. 1.

"I was bombarded with phone calls between the 23rd and 24th," Oscar says. "My wife actually looked at me while we were at the Rockettes on Monday, because my leg kept on shaking with my phone buzzing so much."  

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Health-insurance sign-ups on U.S. exchange top 1.1 million in initial enrollment period

More than 1.1 million Americans signed up for an insurance plan through the federal health-care marketplace during its initial enrollment period, with more than 975,000 enrolling in December alone, the Obama administration announced Sunday.

The new figures, which came as the administration reworked its computer system to extend the deadline for an extra day, until midnight on Dec. 24, suggest that federal officials are making up some ground after glitches and processing errors made HealthCare.gov difficult to access and navigate during its first two months of operation.

So far, nearly 2 million Americans — who were either uninsured or had to change coverage after their existing plans were canceled — have signed up under the new health-care law on state and federal marketplaces. Roughly 850,000 people have enrolled through the state-run exchanges, according to Charles Gaba, a Web designer tracking enrollment numbers.

The administration is still far short of the enrollment targets it set just before the system was launched Oct. 1. The Department of Health and Human ­Services had anticipated that 3.3 million people would have signed up by now, according to a Sept. 5 agency memo.

Still, officials celebrated the end-of-year results.

"We are in the middle of a sustained, six-month open enrollment period that we expect to see enrollment ramp up over time, much like other historic implementation efforts we've seen in Massachusetts and Medicare Part D," Centers for Medicare and Medicaid administrator Marilyn Tavenner wrote on the HHS blog, referring to the ­nation's first health-insurance ­exchange under Massachusetts Gov. Mitt Romney (R), in 2006, and the prescription drug coverage expansion enacted during President George W. Bush's administration. "In part, this was because we met our marks on improving HealthCare.gov: the site supported 83,000 concurrent users on December 23rd alone."

The next critical deadline for enrollment is March 31, after which individuals face a tax penalty if they remain uninsured.

Some experts on health-care policy say the December surge increases the possibility that the law could meet federal projections of 7 million enrollments by March 31, 2014.

"It is starting to track with what people, particularly the Congressional Budget Office, projected originally," said Larry Levitt, senior vice president at the Kaiser Family Foundation. "December is the first month where federal sign-ups have kept up with state sign-ups, too."

Senior administration officials have said they expected enrollment to start slowly after the Web site's October launch and remain relatively low in November, before accelerating in December as many Americans sought out plans that would take effect Jan. 1.

That pattern materialized, although at a much lower level than officials initially expected. As of Dec. 22, 890,000 Americans had enrolled on the federal exchange, according to government figures that had not been made public, meaning that more than 200,000 people chose health plans on Dec. 23 or 24. By contrast, roughly 137,000 people signed up through the federal system in its first two months of operation.

Delayed by glitches

At least some of the late-
December shoppers didn't mean to procrastinate, but technical issues thwarted their earlier attempts to sign up for coverage.

Anita Pinser, 62, tried to buy coverage Oct. 1 but finally enrolled in a plan Dec. 22.

"I kept trying and trying," said Pinser, a former human resources professional who lives just outside Charlotte and who was laid off in 2008. "I called the 800 number and found out everyone was having problems."

When she saw a posting on Twitter Dec. 22 about the impending deadline, she decided it was time to give it a final try. "I had my account set up, so all I really had to do was click on the coverage that I wanted," she said. "It was really easy. The only bad experiences I had were the first month, when no one could sign up."

But others are still experiencing serious problems with the Web site. David and Karen Hart live in Santa Rosa Beach, Fla., and both are self-employed. Their existing Blue Cross Blue Shield policy was canceled in the fall and then reinstated, but they picked a new plan on HealthCare.gov and paid for it on Dec. 19.

When he noticed that their payment hadn't been deducted from their bank account, David Hart called Florida Blue on Dec. 27; he was told that the government's computer system had canceled their plan. His wife spent more than four hours on a federal hotline Saturday, at which point she was told the insurer had jettisoned their policy.

"I'm a 56-year-old, and I have had health insurance my entire life. It's just astounding that we've had to go through this," David Hart, an artist, said in an interview. He noted that he and his wife support the new law but have been dismayed by how federal officials are implementing it. "We think it's good policy, but what they're doing is atrocious."

By Sunday afternoon, CMS officials were investigating the Harts' complaint.

America's Health Insurance Plans spokesman Robert Zirkelbach, whose group represents insurers, said firms "are working around the clock to process the high volume of enrollments that they have received from the exchanges. While there are still some ongoing challenges with the back-end systems, including so-called 'orphan records' where the enrollment files are never received, health plans are working with CMS to resolve those issues as quickly as possible so that consumers' coverage can begin in January."

The CMS did not release any demographic information about who has enrolled, including the age breakdown. Those numbers are important, since insurers need a well-distributed risk pool in the exchanges to keep premium prices in check.

Outreach efforts

The administration is gearing up to preempt any health-care access problems that may crop up starting next month, publishing online guides on how to determine which doctor visits and prescription drugs are covered under the new system.

In a statement Sunday, the CVS pharmacy chain said that its employees "will provide information to help patients contact the appropriate health plan or insurance exchange," and work with insurers and government agencies to "help minimize disruptions to care whenever possible."

"In some circumstances and based on clinical considerations, we may also assist patients with a transitional supply of a prescription to a patient experiencing a temporary disruption in coverage to support their continuity of care," CVS said.

Officials also plan to intensify their outreach to young adults, Latinos, African Americans, women and other key groups after Jan. 1, they said, through intermediaries including celebrities, local activists, provider networks, nurses, doctors, churches, mosques and synagogues.

"We are eager to assist millions more Americans gain the health security offered by the Affordable Care Act in the weeks and months ahead," Tavenner wrote.

Former Vermont governor Howard Dean (D) said on "Fox News Sunday" that despite the problems of getting young people to sign up, he was confident that President Obama's health-care law would be "running a lot more smoothly" by March.

The former Democratic National Committee chairman, who is also a doctor, accused critics of overstating the problems. "I think the first year is going to be more successful than most people think," he said.

Emily Wax contributed to this report.

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Florida Car Accident Attorneys at The Berman Law Group Wish a Safe and Happy Holidays

BOCA RATON, Fla., Dec. 24, 2013 /PRNewswire-iReach/ -- The Berman Law Group, Florida personal injury and car acciden t lawyers, wish a happy and safe holidays to everyone this holiday season.  The holidays are notorious for the amount of accidents that happen, and the Berman Law Group wants to remind everyone to drive safely.  Not only can the weather have an impact on the driving conditions, but so can the amount of traffic on the roads.  Most people on the roads are in a holiday rush and the chances of accident or injury go up significantly during the holiday season.

(Photo:  http://photos.prnewswire.com/prnh/20131224/MN38007)

Below are some tips to help drivers this holiday season stay safe and avoid any accidents.  The Berman Law Group wants everyone to enjoy the holidays and enjoy time with family and friends, and not have to go through the ordeal of an auto accident, whether it be car, truck, or motorcycle.  No one wins when there is an auto accident.

• Drive slower than normal - Everyone is in a rush, so set yourself up for a safe ride by not b eing in a rush.  Take your time and allow plenty of time to get their on time.
• Focus entirely on the road - Too many people use the roads as a chance to get caught up on phone calls or texts (which is against the law), so give your full attention to the road and you will be much safer this 2013 holiday season.
• Make sure your car is well equipped - Do you have the right tires on your car? If you live in the colder parts of the country, you might even need chains on your tires.  Do you have enough gas to get to your destination? Make sure your tires and your car is properly serviced before you hit the road this holiday season.

The holidays are a time to be enjoyed with friends and family.  Make sure you get there safely and enjoy the holidays.  If you have any trouble and aren't sure what your legal options are, call the Berman Law Group at 1-888-211-2304 or visit their website at http://lawyerinjuryaccident.com

The Berman Law Group is com mitted to delivering professional legal services for those who have been injured.  They are Florida personal injury lawyers and are able to help with wrongful death, car accidents, truck wrecks, motorcycle injuries, and all other types of personal injury law.  They offer free consultations and offer a no win, no fee guarantee, which means their clients do not pay anything for their legal services unless they win their case.

Media Contact: Russell Berman, The Berman Law Group, 1-888-211-2304, info@lawyerinjuryaccident.com

News distributed by PR Newswire iReach: https://ireach.prnewswire.com

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It's Not Just Poor People Getting Hosed When Congress Lets Unemployment Insurance Expire

NEW YORK -- David Torian is an Ivy League-educated lawyer and a onetime chief of staff to then-Rep. Michael McNulty (D-N.Y.). He has 23 years of experience in congressional and government relations, witnessed and practiced politics at the highest level, and has been well compensated along the way.

On Dec. 28, he will also be among the 1.3 million Americans who will lose their long-term federal unemployment insurance benefits.

Unemployment is not just a blue collar problem. As Torian's experience shows, it can affect even Beltway power players. And it comes without much, if any, warning. When the consulting firm that Torian worked for after his time on the Hill folded, there were few options available. He took time off to help his sister tend to their ailing mother, who died at the end of 2012. The Washington resident then went looking for work. While he found that his government affairs experience was a draw, his age, 49, was not.

"I get interviews but lose out in the end because prospective employers tell me my experience makes me 'over-qualified' and they do not feel I would stay long in the position if it was offered," Torian told The Huffington Post.

For over a year now, he has been receiving unemployment benefits as he tries to find a job. The benefits, roughly $430 a week, were set to last another few months. But he has been informed that his last check came this past Wednesday.

"The whole experience of not working and looking for work has been extremely stressful on me. It's a pride issue. It is an embarrassment issue, too. A lot of my casual friends don't know I'm not working. I'm too embarrassed to tell them that I'm out of work and on unemployment insurance," he said. He had hesitated to talk on the record because of that.

When lawmakers skipped town for Christmas break this year, they left unresolved what to do about federal unemployment insurance. The benefits, available to jobless workers who had used up six months of state-funded compensation, had been running since the Great Recession hit in 2008. Early in 2012, Congress began scaling back the duration of federal benefits as the economy improved. There was uncertainty as to what would happen at the end of this year with even better economic conditions. Now, with the program set to lapse, recipients such as Torian are left gaming out a petrifying next few months.

Already, he said, he's moved to a cheaper home, maxed out credit cards, and gone through his savings and 401(k) accounts. He's found some work on the side through a friend. But the income isn't enough. He figures that he can pay rent for three more months without the unemployment insurance. He's thought about looking for more blue collar work. But he has no background or skill set in those fields.

"I'm in and out of depression mode," he said. "I will stay in my apartment for days without leaving. It's emotionally draining."

Unlike food stamps -- another safety net program that Congress likes to kick around -- Americans don't qualify for unemployment insurance by being poor. In fact, you can only qualify for unemployment benefits if you had a solid work history prior to being laid off. And you can only remain eligible by continuing to search for work.

Roughly 40 percent of Americans who've received long-term unemployment benefits since 2008 had previously earned between $30,000 and $75,000, according to an analysis of Census data by the White House Council of Economic Advisers. Earlier research by the Congressional Budget Office has shown that more than two-thirds of recipients had annual incomes more than twice the poverty level and that such households received 70 percent of all unemployment payments. In other words, unemployment insurance for the most part serves the middle class.

Yet up until recently, there was little apparent appetite to tackle the issue in Washington. Since early December, Democrats have waged an aggressive publicity campaign in favor of preserving the benefits, with daily statements from the White House and Democratic members of Congress. But even though he routinely threatens to spoil senators' weekends and holidays with urgent votes, Senate Majority Leader Harry Reid (D-Nev.) has said the Senate won't vote on restoring the benefits until Jan. 6 at the earliest.

Advocates for the program aren't particularly bullish on the likelihood of Congress' restoring the benefits retroactively either. But Democrats have been buoyed by local press coverage of the issue. In an effort to amplify that coverage, several lawmakers have begun meeting directly with unemployment insurance recipients in addition to putting them on conference calls with national reporters. Bruce Hirshfield of Bethany, Conn., was one of those examples, highlighted by Rep. Rosa DeLauro (D-Conn.) as representative of the wide universe of individuals set to take a hit.

Hirshfield has lived a largely ideal life. After leaving the insurance industry (where he had worked for 20 years), he joined a Connecticut bank as a vice president, earned a six-figure salary and lived comfortably with his wife and children, one of whom he had sent to college. The job was relatively stable and professionally stimulating. At 54 years old, he was happy.

Then it fell apart. The bank went through one, two, three restructurings. The last one cost Hirshfield his job.

He began training for a new career, taking a 30-week course in project management at the University of New Haven in hopes of widening his allure to prospective employers. But the search for work has been impossibly tough. He has been unemployed now for 14 months. For just over a year, he has been receiving unemployment benefits.

"It's tough," Hirshfield said in an interview. "I'm one of four children. I'm the youngest. My dad died when I was 18 and a half. My mom turned to me and said, 'You are now the man of the house.' That burned inside me. That really shaped me for who I am as a person. And now, here I am as the classic provider guy and I'm not that anymore in a sense."

Repeatedly during the interview, Hirshfield stressed that he doesn't think of himself as a "sob story." His wife is working and he receives roughly $600 a week in benefits. He recognizes that others are in much worse straits. Yet when the long-term unemployment benefits expire on Dec. 28, he will face difficult choices. He has a daughter who is a junior in college and another who is in her senior year of high school. He has thought about selling his house, but isn't sure he would qualify for a mortgage or if it would be financially smart.

Hirshfield says he's more open now to blue collar work. But like Torian, he isn't sure if his skill set would be appealing to such an employer and he stubbornly (he admits) wants to hold on to the life he built.

"You grow into a certain station in life, and you want to maintain that," he said. He bristled at the notion that unemployment benefits had dulled his desire to find full-time work -- a criticism of the program made most recently by Sen. Rand Paul (R-Ky.).

"My motivation is not about getting unemployment benefits. My motivation is to get back to where I was," Hirshfield said. "Rand Paul to me, I appreciate his perspective, he is a smart man, but I don't necessarily agree with his viewpoints. I understand what he is saying, but he is dead wrong."

With no immediate employment opportunities, Hirshfield has stretched his dollars as far as he can. He stopped going out to dinner, began doing some of his own auto repairs, drained his savings, dipped into his pension and whittled down his stock portfolio. With the remaining $20,000 or so, he is taking risky bets in hopes of high returns.

The day before the Dec. 28 deadline for unemployment benefits to lapse, he decided to cash in three $25 bonds that he had received as a bar mitzvah gift. They stopped accruing interest in 2000. He estimates he can get $400 out of them.

"I had held on to them largely for nostalgic value," he said. "I never even thought about cashing them in. Never once gave it a second thought. Now I think, 'Wow, I could get some groceries out of this.'"

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The Quiet Death Of Long-Term Unemployment Insurance In 2013

WASHINGTON -- The looming expiration of federal unemployment benefits raises the question of whether Democratic lawmakers bungled the debate.

Though Congress can still act retroactively, Democrats' goal had been to pass an extension of the benefits before Dec. 28, when they are set to expire. The administration and allies on the Hill tried to attach a provision to the budget deal passed in mid-December. But by the time they began engaging the fight, few Democrats seemed particularly attentive and Republicans were more than comfortable running out the clock.

Now, with Congress in recess, long-term unemployment insurance will come to an end for 1.3 million Americans, potentially costing 240,000 jobs, according to the White House's Council of Economic Advisers. Was it inevitable? Or was it a case of political mismanagement?

The record indicates that Democrats were late to show up, distracted in part by other concerns. A month and a half before the deadline, few members of Congress or administration officials were even talking about unemployment insurance. The first major mention from the White House came in mid-November, in a little-noticed remark from top economic adviser Gene Sperling during an interview at The Atlantic's Washington Ideas Forum.

"With an unemployment rate of 7.3 percent, we need to raise the emergency unemployment insurance and push for extensions to 2014," Sperling said.

The statement received such scant attention that administration officials had to flag it for news outlets to ensure that the message actually got out. One day later, White House Press Secretary Jay Carney amplified Sperling's remarks by declaring the president "believes we should extend this provision through the end of 2014, and we are confident that Congress will join us in this effort."

But there was no reason for the White House to be confident. The shutdown of the federal government in October, followed by the disastrous launch of the president's health care law, had commanded the spotlight. On the Hill, lawmakers were only casually paying attention to unemployment insurance, outside of the House Ways and Means Committee, which oversees the benefits.

"It is true there were other major, major issues, and at times they seemed to be overshadowing this, but it's not too late to act," Rep. Sander Levin (D-Mich.), the ranking member of that committee, said on a conference call Thursday. Levin noted that Democrats on the committee began raising concerns about the expiration of the benefits in early November.

But even then, most other members assumed that the issue would resolve itself as it has the past two times an extension was needed, when Republicans were more or less politically shamed into supporting it.

"Last year, there was no real debate over this. And the year before, Republicans got so hammered on it, they essentially had to do this by unanimous consent with their tail between their legs," said one Democratic congressional aide. "I think Democrats could be generally forgiven for having assumed a little bit that this was something that Republicans would not put up a fight over, because it's a losing issue for them."

Republicans certainly learned a lesson from years past. But it wasn't to acquiesce on unemployment insurance -- rather, it was to keep their mouths shut. As a result, only a few members came out forcefully against extending benefits.

Sen. Rand Paul (R-Ky.) caused a stir when he argued that the benefits turned job-seekers into welfare dependents. And Rep. Dave Camp (R-Mich.), chairman of the House Ways and Means Committee, was probably the only high-ranking Republican to make a serious argument for dropping the benefits altogether. In an interview with the Detroit Free Press, he pointed to North Carolina, where the Republican-controlled state legislature deliberately made the state ineligible for federal jobless aid.

"There, the program ended in July and the state has seen rapid job creation," Camp said.

Camp's argument was debunked by both liberal and conservative think tanks, which pointed out that North Carolina's unemployment rate declined since July largely because benefit cuts pushed people out of the workforce.

A small group of House Republicans did send a letter urging for the benefits to be extended. But the effort gained little momentum and its organizer, Rep. Chris Gibson (R-N.Y.), has stayed relatively quiet about the issue.

House Speaker John Boehner (R-Ohio), meanwhile, stayed as ambiguous as possible. He would innocuously and repeatedly declare that he was open to looking at a proposal from the president to extend benefits and that he would judge that proposal on its merits. There is no evidence that President Barack Obama directly engaged Boehner's office, aside from a discussion between the two men in early December.

"The President and senior members of his team have been pushing, and will continue to push to get unemployment insurance extended so families are able to make ends meet while fighting to find a job," said White House spokeswoman Amy Brundage.

Privately, the Republicans were stern in opposition, Democratic aides said. Levin and Rep. Chris Van Hollen (D-Md.), the top Democrat on the House Budget Committee, urged for unemployment insurance to be a chief demand for Democrats during the crafting of a budget deal. But Budget Committee Chair Paul Ryan (R-Wis.) demanded that the cost of the benefits -- an estimated $25 billion for one year -- be offset in a way that was acceptable to Republicans.

Publicly, the fight over renewing the benefits escalated as the deadline neared. Obama mentioned it in a much-touted speech on economic mobility. He then made it a focus of his weekly White House radio address, while the Council of Economic Advisers put out a state-by-state report on the impact a lapse would bring. When the budget deal ultimately came out without unemployment insurance in it, the administration called for it to be considered outside of that package.

Levin and Van Hollen proposed a three-month extension that is unpaid for, though aides said they could decide to slash agriculture subsidies as a way to cover the cost. Valerie Jarrett, the president's closest adviser, endorsed the Levin-Van Hollen proposal. But Boehner felt no concrete pressure to bring it to a vote after Senate Majority Leader Harry Reid (D-Nev.) publicly stated that the issue would have to be tackled in the next calendar year -- a pronouncement that caught some Democratic aides by surprise.

Reid's office did not return a request for comment.

The party is now putting its hopes for extending the benefits on local political pressure. Democrats are betting that over the holiday break, enough Republican members of the House of Representatives will hear from angry constituents that they'll push Boehner into finding a piece of legislation he can support. It's a long-shot strategy. But aides say they've been buoyed by the press coverage the issue has received outside the Beltway.

Reid, meanwhile, has set up a procedural vote on the three-month extension for Jan. 6.

"Leader Reid has said that he will bring up the bipartisan legislative proposal in the Senate as soon as they return and we are hopeful it will pass," said Brundage. "We urge the House leadership to allow a vote and stop obstructing a common sense proposal that would help Americans across the country and our economy."

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Motorcycle Accident Lawyers

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As with many areas of law, choosing from the vast array of motorcycle accident lawyers is not an easy task, but for those facing accidents or injury, choosing the right attorney is often the difference between success and failure in the courtroom. 

There are some key considerations that anyone needing an attorney for motorcycle accidents can and should consider and the purpose here is to provide a starting point from which you can choose a lawyer who will best be able to resolve your legal problems following a bike accident.

Let's get some background here. There are around 3000 people killed in motorcycle accidents each year in the United States alone – and many more in other jurisdictions like Canada, the UK, Australia and elsewhere where there is a common law system to handle prosecution and civil law remedies.

But death by accident is one thing – serious injury is quite another and there are major disabilities and injuries that occur multiple times across the country as a result of motorcycle accidents in all manner of circumstances.

Very often the cause of the accident is not the motorcyclist but a motorist driving a truck, van or car. As motorcycles are fast and often difficult to see there will frequently be visibility issues involved in the accident.

Get an experienced lawyer

There are many lawyers who will proclaim their expertise in motorcycle accidents, but you need to focus on those who have experience in the field. There are multiple legal issues involved here, ranging from injury and hospital costs to distress, emotional harm, lost wages and all manner of other damages and costs.

Get your statements and reports

Following an accident, and depending upon how serious it is, you need to ensure that when you are looking for a motorcycle accident lawyer you can go armed with witness statements, or at least then names of witnesses to the accident.

You should also obtain police and other reports relating to the accident, together with as much relevant information from the other motorist (if a motorist is involved) as you possibly can. You will often be required to obtain compensation and the use and availability of reports and witness statements is extremely important in making a successful compensation claim.

Get someone with local knowledge

Whether you are seeking motorcycle accident lawyers in Los Angeles, or in Houston, Las Vegas, New York or anywhere else, you need an attorney who knows the local courts, the local rules relating to compensation claims and who also has experience that he or she can tell you about.

Ask your potential lawyer what they have done, how successful they have been in their motorcycle court cases or claims and what sort of track record they have.

Make Sure You Check on Insurance Issues

Insurance questions come into play with any major or minor accident, but there are some special considerations applicable in respect of motorcycle accidents that require you to carefully check your policy and see what you can recover.

Mostly you cannot recover medical expenses, but these may be covered under other policies.  The same goes for lost wages.   You need to check with a motorcycle accident lawyer who knows the rules, the policies and what you can do so make sure you ask the right questions.

Negotiate the Best Fees Deal

You should also ensure that you get the best fees deal by working something out with your lawyer in terms of what they will be taking on any settlement that you will (hopefully) be obtaining for your motorbike accident.

A good lawyer in any personal injury lawsuit situation like this will explain what he will charge and how the fees and disbursements will be worked out.

You want a 'no surprises' deal that ensures you not only have a good lawyer working for you out of the wide selection of motorcyel accident lawyers out there,  but also have one who will not be charging you so much that you are further 'injured' following your initial accident.

Read More About Motorcycle Accident Law Here

What questions should you be asking your motorcycle accident lawyer?

Many motorcyclists involved in accidents fail to ask the right questions.

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LA Motorcycle Accident Attorney – Michael Ehline -

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What questions s hould you be asking your motorcycle accident lawyer?  The reality is that many motorcyclists involved in accidents fail to ask the right questions. – See more at: http://www.lawfuel.com/motorcycle-accident-faq/#sthash.nihSTQiK.dpuf

What questions s hould you be asking your motorcycle accident lawyer?  The reality is that many motorcyclists involved in accidents fail to ask the right questions. – See more at: http://www.lawfuel.com/motorcycle-accident-faq/#sthash.nihSTQiK.dpuf

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Obama to Health Insurance Companies: Merry Christmas. Now, Drop Dead.

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Insurance is a complicated product. Even President Obama figured that out. Hundreds of highly trained actuaries spend thousands of hours assembling risk pools to determine premium levels, underwriting standards, and product offerings. Investment managers spend thousands more trying to match financial assets acquired from those premium payments with long term liabilities to guarantee coverage promises can be kept. Get it right and you are rewarded with a stable company with stock suitable for widows and orphans. Get it wrong and your business dies.

When it comes to health insurance, however, this finely tuned balance has now been completely destroyed, culminating years of political meddling. And for its final Christmas present of a year that will go down as the worst in insurance history, the Obama Administration unilaterally waived yet another key provision of the Affordable Care Act.

Four days before the deadline to sign up, the Department of Health and Human Services told people with cancelled plans facing Obamacare Exchange sticker shock they can now buy cheaper "catastrophic" plans after all—at least until the 2014 midterm elections. This, along with a dozen other changes voted on by exactly zero legislators, may well be the last nail in the coffin of commercial health insurance. The insurers themselves may not admit it, but they are the walking dead.

Richard Cloward and Frances Fox Piven could not have designed a better strategy to catalyze the collapse of the private insurance market, paving the way for single-payer nationalized health insurance—which remains the stated goal of both the president and many members of Congress. Despite Politifact's award of "Lie of the Year" to President Obama's claim that you could keep your existing insurance, there is no reason not to take these people at their word when it comes to their long sought objective. What champions of progressivism couldn't get through legislation they appear determined to achieve through faulty execution.

The "bungled" ObamaCare rollout will not be fixed when the website is finally debugged. Premiums, products, underwriting standards, and financial assets and liabilities cannot possibly be matched under a command-and-control regime that makes ad hoc changes driven solely by political considerations. A system better designed to collapse upon itself could hardly be conceived.

Insurance company executives have no one to blame but themselves. Rather than fight the passage of the Affordable Care Act, as they did with Hillarycare during the Clinton administration, they made the proverbial deal with the devil, lured by a law that promised to command every citizen to buy their products. But they forgot one thing.

While politicians love making backroom deals with crony capitalists, they cannot be forced to honor their side of the bargain. Government bureaucracies are often partners in a scheme to loot the public one day, just to turn on their erstwhile cronies the next. Ask Jamie Dimon how that works.

If we stay on our present course, bankruptcy, bailouts, and nationalizations lie ahead—except for insurers smart enough to quietly withdraw from the market, as many are already doing. Insurance companies that remain will end up little more than public utilities providing contract entitlement administration.

In the end, a two-tier system is inevitable. One will be a national health service, free to all, staffed by civil servants. VA Hospitals are probably the closest model. Health care will be rationed, choices will be limited, waiting lists will be long, quality will be marginal, and innovation will grind to a halt. Yet progressives will tout this as nirvana, much like they do Cuba's healthcare system, framing the narrative around the rubric of "equality."

Yes, a national health service will deliver equality—just as effectively as the Post Office or your local DMV. The biggest difference is that it will lose a lot more money. And the need to "reform" it every few years will guarantee our politicians a steady flow of campaign donations.

A private alternative will eventually emerge from the wreckage of the insurance industry, when a new administration finally decides to clean up the mess now being made by the current one. Concierge doctors, elective surgeries, high-impact procedures, heavily rationed services, alternative medicine, and advanced therapies not yet included in the public plan will be purchased out-of-pocket, supplemented by high deductible catastrophic insurance.

The latter, when it emerges through some future act of deregulation, will be real insurance and not a cover story to engage in massive income redistribution. Employers will have nothing to do with it, just as they have nothing to do with car insurance despite the fact that most of their employees drive to work. Pity we can't just jump straight to the answer rather than drag our moribund economy through additional years of uncertainty and chaos.

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Five Reasons Not to Cut Disaster Recovery from Your Budget

When was the last time you experienced unplanned downtime? How much did it affect your organization?

Ninety-one percent of respondents in a 2013 Ponemon Institute study reported experiencing unplanned downtime in the last two years. Although that's not a shocking statistic to those in the cloud arena, what is alarming is the fact that an estimated 30 percent of organizations that experience a severe outage never actually recover.

Business leaders often think a disaster is something that happens to someone else. When most people think of disasters, they immediately think about hurricanes or earthquakes. But a disaster doesn't have to be a naturally occurring one. It could be human error or a cyber attack. Therefore, it's important to have a plan B to protect your mission-critical applications and data. It's also important to know that it's more than a loss in revenue or five minutes of downtime—an IT disaster can wreak havoc on your overall brand and customer loyalty.

Here are six reasons why not to cut disaster recovery (DR) from your budget.

1. Disaster Recovery Is Cost Effective

On average it takes organizations two days to recover from an IT disaster, according to a 2012 Ponemon Institute study on disaster recovery. The same study found that this duration equates to $366,363 in costs a year. There are some hidden costs to experiencing downtime, however, such as lost revenue and damage to the brand. For example, when a major airline's reservation system goes down for eight hours straight, it leaves customers stranded, scrambling to make other arrangements and thinking twice the next time they book a flight.

Organizations that use disaster-recovery-as-a-service (DRaaS) providers reported cost savings as the leading benefit of using the public cloud for disaster recovery, according to a study by the Aberdeen Group—a research firm helping businesses understand the implications and results of technology deployments. You don't have to worry about a large capital investment; you can trade that in by contracting DRaaS.

Costs to work with a DRaaS provider vary depending on how many virtual machines an organization needs to replicate and the size of the data. Costs can range from $60 to $120 per month per virtual machine and can vary depending on factors such as recovery-point objective (RPO), recovery-time objective (RTO), storage and so on.

2. DR Is Easy to Implement

Disaster recovery in the cloud is now more attainable for businesses of all sizes than it was five years ago. Before virtualization, disaster recovery would cost at least three times as much because an organization needed to have multiple data centers, specialized software and large network connections. To do this in the physical world is extremely costly. That's why only the largest of enterprises were able to do it. Now, virtualization makes disaster recovery easier by encapsulating virtual machines (VMs) into a few files, making the data portable and in turn reducing costs.

DR solutions also give users the flexibility to take a look at their applications and define how they want them to be recovered. Do they want to protect the entire infrastructure? Do they want to protect just Tier 1 applications? Do they need a variable recovery time and variable recovery point from Tier 1 down to Tier 3 applications? Gone are the days of having to build a secondary site identical to a primary site and incur all the additional management costs and operational challenges.

3. DR Reduces Data Loss

The risk of business interruption, loss of business-critical data and the length of time to recover that data are three leading pressures driving organizations' use of the public cloud for disaster recovery, according to a study by the Aberdeen Group. DRaaS users are able to recover three times faster and drive up the percentage of data they're able to recover twofold.

Consider this example: Having your company in Delray Beach, Fla. is great…until a hurricane hits. That's what happened to Fleet Lease Disposal when Hurricane Wilma struck in October 2005 and took down the company's main office and primary data center. Although it successfully recovered and operated for four months from its backup office in New Jersey, four years later, Fleet Lease discovered that it lacked adequate hardware and bandwidth to support data recovery at its secondary site.

In working with a DRaaS provider, Fleet Lease Disposal was able to restore its IT infrastructure and data in less than one hour, save thousands of dollars and man-hours a year, and achieve an 18-month return on investment. With replication and highly available cloud-computing resources, the company now knows it can count on quick access to its applications and data—especially during hurricane season.

4. DR Restores Applications and Operations Quickly and Effectively

According to a survey conducted by the Aberdeen Group, businesses that use DRaaS reported faster recovery time from downtime incidents as the second leading benefit of relying on the public cloud.

Many believe backing up data on tapes is the equivalent of DR. Protecting data is important, but the ability to recover applications efficiently and quickly is essential in restoring operations. Having data on tapes or using data storage without virtual resources and the ability to easily test isn't disaster recovery; it's just off-site back up and not true business continuity.

For example, one major global biotechnology firm dramatically simplified its recovery process by closing one of its data centers and moving from an environment that employed multiple technologies to support the replication of systems and data to a single solution that automates the recovery of all applications.

5. Testing 1, 2, 3…

Businesses can put their DR plan to the test anytime throughout the year without bringing down production. It's extremely important to ensure applications and data or IT environments come up on another site and no data is lost. Businesses can conduct planned or unplanned outages in the first few months of replication to ensure their DR plan works.

In a 2012 study, Forrester reported that only about half of companies conduct full tests once a year. Although organizations cite limited employee resources as the biggest stumbling block, cloud DR tests are now more automated and require less manual intervention.

When Verdande Technology needed a way to extend its infrastructure without making a significant investment, it turned to a DRaaS provider to provide a flexible, cost-effective means to extend its testing environment and eliminate the hardware and operational headaches at the same time.

"We have the flexibility and control we need," said Peter Varlien, IT systems engineer at Verdande Technology. "We can remotely configure a test bed according to testing requirements, and our DRaaS provider bills us only for what we've used. We don't have to worry about when, where or how we need to test anymore!"

The value of DR testing is to ensure all systems you want to replicate are recovered and that you have access to them. Once you are in the middle of an actual DR event, it's too late.

Leading article image courtesy of IntelFreePress

About the Author

Jack Bailey is a solutions engineering manager for iland cloud infrastructure, a pure-play IaaS provider delivering global cloud services since 2007.

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Last-minute insurance shoppers get 1-day extension

CHICAGO (AP) — Anticipating heavy traffic on the government's health care website, the Obama administration extended Monday's deadline for signing up for insurance by a day, giving Americans in 36 states more time to select a plan.

It was the latest in a series of pushed-back deadlines and delays that have marked the rollout of the health care law.

But federal officials urged buyers not to procrastinate.

"You should not wait until tomorrow. If you are aiming to get coverage Jan. 1, you should try to sign up today," said Julie Bataille, a spokeswoman for the federal agency in charge of the overhaul.

Bataille said the grace period — which runs through Tuesday — was being offered to accommodate people from different time zones and to allow for any technical problems that might result from a last-minute rush of applicants.

The HealthCare.gov site had a disastrous, glitch-prone debut in October but has gone through extensive improvements to make it more reliable and increase its capacity, and the administration said the system was running well Monday.

By the afternoon, the site had received a record 850,000 visits, five times the number logged by the same time last Monday, the ad ministration said. Bataille said the system was handling the volume with error rates of less than 1 in 200 and response times of less than one second.

The Obama administration is hoping for a surge of year-end enrollments to show that the technical problems were merely a temporary setback. That would also go a long way toward easing concerns that insurance companies won't be able to sign up enough young, healthy people to keep prices low for everyone.

But the grace period may have been a tacit acknowledgement that the website remains vulnerable to heavy traffic. What's more, the delay offered critics of "Obamacare" another opportunity to argue that the law still isn't working and that President Barack Obama keeps changing the rules.

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In this Friday, Dec 20, 2013 photo, in Johanna Diaz, left, points out information to Senior Certifie …

In Ohio, Lt. Gov. Mary Taylor called the deadline extension "a clear sign Healthcare.gov continues to struggle."

"Consumers are already confused and insurers are overwhelmed with the administration's last-minute changes, yet there seems to be no end in sight," Taylor, a Republican who heads Ohio's insurance department, said.

The administration was careful not to characterize Tuesday as a new deadline or an extension, likening the move instead to the Election Day practice in which people who are in line when the polls close are still allowed to vote.

Monday had been the deadline for Americans in the 36 states served by the federal site to sign up if they wanted coverage at the start of the new year. The remaining states operate their own online marketplaces, and some of them have also extended their deadlines.

As the deadline drew near, more than 1 million people visited the website over the weekend, and a federal call center received more than 200,000 calls.

Roger Colyn, 60, of Des Moines, Iowa, was happy when he left his Monday morning appointment with a state enrollment navigator. She helped him sign up for a "silver" plan that will cost him $10.79 in monthly premiums after government aid is factored in.

"I feel relieved," Colyn said.

Others said they will let the date pass without making a decision.

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In this Friday, Dec 20, 2013 photo, certified enrollment specialist Richelle Baker, right, talks to  …

"I'm in no hurry, though it'd be nice to be able to visit a doctor without stress," said Kyle Eichenberger, an uninsured 34-year-old from Oak Park, Ill., who said he hit a wall on the website when he first tried to enroll early on.

"I'm an Obamacare supporter, though I think it is full of problems," Eichenberger said. "I'd like to see the whole system streamlined to be more user-friendly. Keep the basic idea, but don't make me feel like I'm navigating a maze to get a simple checkup."

The government's original deadline already had been pushed back a week because of the website problems. The extra day will add to the already daunting administrative problems that insurance companies face, such as inaccuracies on applications, said industry consultant Robert Laszewski.

"Insurers would like to have two to three weeks to process applications. Now they're going to have a week, less one more day," he said. "When the day is done, it doesn't help."

The president himself signed up for coverage through the government site over the weekend — a purely symbolic move since he will continue to get health care through the military as commander in chief. He chose a less-expensive "bronze" plan.

Obama said on Friday that more than 1 million Americans had enrolled for coverage since Oct. 1. The administration's estimates call for 3.3 million to sign up by Dec. 31, and the target is 7 million by the end of March. After that, people who fail to buy coverage can face tax penalties.

Minnesota, one of the states running their own insurance exchanges, extended its Monday deadline to Dec. 31 amid problems with its website and extra-long hold times to reach its help center. Maryland pushed back its cutoff date to Dec. 27. New York extended its deadline to midnight Tuesday.

Nevada stuck to its Monday deadline, and enrollment counselors there reported a surge of interest.

"We have people lined up out our door. We stil l have walk-ins, people are asking for help. Our phones are ringing nonstop," said Andres Ramirez in Las Vegas.

In Connecticut, which also kept to a Monday deadline, Ronshelle McIntyre, a 41-year-old mother from New Britain, arrived at a state-run insurance store around 9:30 a.m., and by noontime, she was among about 40 people waiting to speak with a specialist. Some were told the wait could be two hours or more.

"I don't mind," said the mother of three. "For health insurance, I think all it's going to cost me is a little bit of time and patience to get it plugged up, you know?"

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Associated Press writers Josh Lederman in Honolulu; Sandra Chereb in Carson City, Nev.; Susan Haigh in Hartford, Conn.; Catherine Lucey in Des Moines, Iowa; Kelli Kennedy in Fort Lauderdale, Fla.; Patrick Condon in St. Paul, Minn.; Brian Witte in Annapolis, Md.; Michael Virtanen in Albany, N.Y.; Ann Sanner in Columbus, Ohio; and Donna Blankinship in Seattle contributed to this report.

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Associated Press Medical Writer Carla K. Johnson can be reached at http://www.twitter.com/CarlaKJohnson.

• Politics & Government
• Health Care Policy

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