Health Savings Accounts – An American Innovation in Health Insurance

INTRODUCTON – The term “health insurance” is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government. Synonyms for this usage include “health coverage,” “health care coverage” and “health benefits” and “medical insurance.” In a more technical sense, the term is used to describe any form of insurance that provides protection against injury or illness.

In America, the health insurance industry has changed rapidly during the last few decades. In the 1970’s most people who had health insurance had indemnity insurance. Indemnity insurance is often called fee-forservice. It is the traditional health insurance in which the medical provider (usually a doctor or hospital) is paid a fee for each service provided to the patient covered under the policy. An important category associated with the indemnity plans is that of consumer driven health care (CDHC). Consumer-directed health plans allow individuals and families to have greater control over their health care, including when and how they access care, what types of care they receive and how much they spend on health care services.

These plans are however associated with higher deductibles that the insured have to pay from their pocket before they can claim insurance money. Consumer driven health care plans include Health Reimbursement Plans (HRAs), Flexible Spending Accounts (FSAs), high deductible health plans (HDHps), Archer Medical Savings Accounts (MSAs) and Health Savings Accounts (HSAs). Of these, the Health Savings Accounts are the most recent and they have witnessed rapid growth during the last decade.

WHAT IS A HEALTH SAVINGS ACCOUNT?

A Health Savings Account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States. The funds contributed to the account are not subject to federal income tax at the time of deposit. These may be used to pay for qualified medical expenses at any time without federal tax liability.

Another feature is that the funds contributed to Health Savings Account roll over and accumulate year over year if not spent. These can be withdrawn by the employees at the time of retirement without any tax liabilities. Withdrawals for qualified expenses and interest earned are also not subject to federal income taxes. According to the U.S. Treasury Office, ‘A Health Savings Account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their health care.

HSA’s enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.’ Thus the Health Savings Account is an effort to increase the efficiency of the American health care system and to encourage people to be more responsible and prudent towards their health care needs. It falls in the category of consumer driven health care plans.

Origin of Health Savings Account

The Health Savings Account was established under the Medicare Prescription Drug, Improvement, and Modernization Act passed by the U.S. Congress in June 2003, by the Senate in July 2003 and signed by President Bush on December 8, 2003.

Eligibility –

The following individuals are eligible to open a Health Savings Account –

– Those who are covered by a High Deductible Health Plan (HDHP).
– Those not covered by other health insurance plans.
– Those not enrolled in Medicare4.

Also there are no income limits on who may contribute to an HAS and there is no requirement of having earned income to contribute to an HAS. However HAS’s can’t be set up by those who are dependent on someone else’s tax return. Also HSA’s cannot be set up independently by children.

What is a High Deductible Health plan (HDHP)?

Enrollment in a High Deductible Health Plan (HDHP) is a necessary qualification for anyone wishing to open a Health Savings Account. In fact the HDHPs got a boost by the Medicare Modernization Act which introduced the HSAs. A High Deductible Health Plan is a health insurance plan which has a certain deductible threshold. This limit must be crossed before the insured person can claim insurance money. It does not cover first dollar medical expenses. So an individual has to himself pay the initial expenses that are called out-of-pocket costs.

In a number of HDHPs costs of immunization and preventive health care are excluded from the deductible which means that the individual is reimbursed for them. HDHPs can be taken both by individuals (self employed as well as employed) and employers. In 2008, HDHPs are being offered by insurance companies in America with deductibles ranging from a minimum of $1,100 for Self and $2,200 for Self and Family coverage. The maximum amount out-of-pocket limits for HDHPs is $5,600 for self and $11,200 for Self and Family enrollment. These deductible limits are called IRS limits as they are set by the Internal Revenue Service (IRS). In HDHPs the relation between the deductibles and the premium paid by the insured is inversely propotional i.e. higher the deductible, lower the premium and vice versa. The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. The logic is that when the patients are fully covered (i.e. have health plans with low deductibles), they tend to be less health conscious and also less cost conscious when going for treatment.

Opening a Health Savings Account

An individual can sign up for HSAs with banks, credit unions, insurance companies and other approved companies. However not all insurance companies offer HSAqualified health insurance plans so it is important to use an insurance company that offers this type of qualified insurance plan. The employer may also set up a plan for the employees. However, the account is always owned by the individual. Direct online enrollment in HSA-qualified health insurance is available in all states except Hawaii, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Vermont and Washington.

Contributions to the Health Savings Account

Contributions to HSAs can be made by an individual who owns the account, by an employer or by any other person. When made by the employer, the contribution is not included in the income of the employee. When made by an employee, it is treated as exempted from federal tax. For 2008, the maximum amount that can be contributed (and deducted) to an HSA from all sources is:
$2,900 (self-only coverage)
$5,800 (family coverage)

These limits are set by the U.S. Congress through statutes and they are indexed annually for inflation. For individuals above 55 years of age, there is a special catch up provision that allows them to deposit additional $800 for 2008 and $900 for 2009. The actual maximum amount an individual can contribute also depends on the number of months he is covered by an HDHP (pro-rated basis) as of the first day of a month. For eg If you have family HDHP coverage from January 1,2008 until June 30, 2008, then cease having HDHP coverage, you are allowed an HSA contribution of 6/12 of $5,800, or $2,900 for 2008. If you have family HDHP coverage from January 1,2008 until June 30, 2008, and have self-only HDHP coverage from July 1, 2008 to December 31, 2008, you are allowed an HSA contribution of 6/12 x $5,800 plus 6/12 of $2,900, or $4,350 for 2008. If an individual opens an HDHP on the first day of a month, then he can contribute to HSA on the first day itself. However, if he/she opens an account on any other day than the first, then he can contribute to the HSA from the next month onwards. Contributions can be made as late as April 15 of the following year. Contributions to the HSA in excess of the contribution limits must be withdrawn by the individual or be subject to an excise tax. The individual must pay income tax on the excess withdrawn amount.

Contributions by the Employer

The employer can make contributions to the employee’s HAS account under a salary reduction plan known as Section 125 plan. It is also called a cafeteria plan. The contributions made under the cafeteria plan are made on a pre-tax basis i.e. they are excluded from the employee’s income. The employer must make the contribution on a comparable basis. Comparable contributions are contributions to all HSAs of an employer which are 1) the same amount or 2) the same percentage of the annual deductible. However, part time employees who work for less than 30 hours a week can be treated separately. The employer can also categorize employees into those who opt for self coverage only and those who opt for a family coverage. The employer can automatically make contributions to the HSAs on the behalf of the employee unless the employee specifically chooses not to have such contributions by the employer.

Withdrawals from the HSAs

The HSA is owned by the employee and he/she can make qualified expenses from it whenever required. He/She also decides how much to contribute to it, how much to withdraw for qualified expenses, which company will hold the account and what type of investments will be made to grow the account. Another feature is that the funds remain in the account and role over from year to year. There are no use it or lose it rules. The HSA participants do not have to obtain advance approval from their HSA trustee or their medical insurer to withdraw funds, and the funds are not subject to income taxation if made for ‘qualified medical expenses’. Qualified medical expenses include costs for services and items covered by the health plan but subject to cost sharing such as a deductible and coinsurance, or co-payments, as well as many other expenses not covered under medical plans, such as dental, vision and chiropractic care; durable medical equipment such as eyeglasses and hearing aids; and transportation expenses related to medical care. Nonprescription, over-the-counter medications are also eligible. However, qualified medical expense must be incurred on or after the HSA was established.

Tax free distributions can be taken from the HSA for the qualified medical expenses of the person covered by the HDHP, the spouse (even if not covered) of the individual and any dependent (even if not covered) of the individual.12 The HSA account can also be used to pay previous year’s qualified expenses subject to the condition that those expenses were incurred after the HSA was set up. The individual must preserve the receipts for expenses met from the HSA as they may be needed to prove that the withdrawals from the HSA were made for qualified medical expenses and not otherwise used. Also the individual may have to produce the receipts before the insurance company to prove that the deductible limit was met. If a withdrawal is made for unqualified medical expenses, then the amount withdrawn is considered taxable (it is added to the individuals income) and is also subject to an additional 10 percent penalty. Normally the money also cannot be used for paying medical insurance premiums. However, in certain circumstances, exceptions are allowed.

These are –

1) to pay for any health plan coverage while receiving federal or state unemployment benefits.
2) COBRA continuation coverage after leaving employment with a company that offers health insurance coverage.
3) Qualified long-term care insurance.
4) Medicare premiums and out-of-pocket expenses, including deductibles, co-pays, and coinsurance for: Part A (hospital and inpatient services), Part B (physician and outpatient services), Part C (Medicare HMO and PPO plans) and Part D (prescription drugs).

However, if an individual dies, becomes disabled or reaches the age of 65, then withdrawals from the Health Savings Account are considered exempted from income tax and additional 10 percent penalty irrespective of the purpose for which those withdrawals are made. There are different methods through which funds can be withdrawn from the HSAs. Some HSAs provide account holders with debit cards, some with cheques and some have options for a reimbursement process similar to medical insurance.

Growth of HSAs

Ever since the Health Savings Accounts came into being in January 2004, there has been a phenomenal growth in their numbers. From around 1 million enrollees in March 2005, the number has grown to 6.1 million enrollees in January 2008.14 This represents an increase of 1.6 million since January 2007, 2.9 million since January 2006 and 5.1 million since March 2005. This growth has been visible across all segments. However, the growth in large groups and small groups has been much higher than in the individual category. According to the projections made by the U.S. Treasury Department, the number of HSA policy holders will increase to 14 million by 2010. These 14 million policies will provide cover to 25 to 30 million U.S. citizens.

In the Individual Market, 1.5 million people were covered by HSA/HDHPs purchased as on January 2008. Based on the number of covered lives, 27 percent of newly purchased individual policies (defined as those purchased during the most recent full month or quarter) were enrolled in HSA/HDHP coverage. In the small group market, enrollment stood at 1.8 million as of January 2008. In this group 31 percent of all new enrollments were in the HSA/HDHP category. The large group category had the largest enrollment with 2.8 million enrollees as of January 2008. In this category, six percent of all new enrollments were in the HSA/HDHP category.

Benefits of HSAs

The proponents of HSAs envisage a number of benefits from them. First and foremost it is believed that as they have a high deductible threshold, the insured will be more health conscious. Also they will be more cost conscious. The high deductibles will encourage people to be more careful about their health and health care expenses and will make them shop for bargains and be more vigilant against excesses in the health care industry. This, it is believed, will reduce the growing cost of health care and increase the efficiency of the health care system in the United States. HSA-eligible plans typically provide enrollee decision support tools that include, to some extent, information on the cost of health care services and the quality of health care providers. Experts suggest that reliable information about the cost of particular health care services and the quality of specific health care providers would help enrollees become more actively engaged in making health care purchasing decisions. These tools may be provided by health insurance carriers to all health insurance plan enrollees, but are likely to be more important to enrollees of HSA-eligible plans who have a greater financial incentive to make informed decisions about the quality and costs of health care providers and services.

It is believed that lower premiums associated with HSAs/HDHPs will enable more people to enroll for medical insurance. This will mean that lower income groups who do not have access to medicare will be able to open HSAs. No doubt higher deductibles are associated with HSA eligible HDHPs, but it is estimated that tax savings under HSAs and lower premiums will make them less expensive than other insurance plans. The funds put in the HSA can be rolled over from year to year. There are no use it or lose it rules. This leads to a growth in savings of the account holder. The funds can be accumulated tax free for future medical expenses if the holder so desires. Also the savings in the HSA can be grown through investments.

The nature of such investments is decided by the insured. The earnings on savings in the HSA are also exempt from income tax. The holder can withdraw his savings in the HSA after turning 65 years old without paying any taxes or penalties. The account holder has complete control over his/her account. He/She is the owner of the account right from its inception. A person can withdraw money as and when required without any gatekeeper. Also the owner decides how much to put in his/her account, how much to spend and how much to save for the future. The HSAs are portable in nature. This means that if the holder changes his/her job, becomes unemployed or moves to another location, he/she can still retain the account.

Also if the account holder so desires he can transfer his Health Saving Account from one managing agency to another. Thus portability is an advantage of HSAs. Another advantage is that most HSA plans provide first-dollar coverage for preventive care. This is true of virtually all HSA plans offered by large employers and over 95% of the plans offered by small employers. It was also true of over half (59%) of the plans which were purchased by individuals.

All of the plans offering first-dollar preventive care benefits included annual physicals, immunizations, well-baby and wellchild care, mammograms and Pap tests; 90% included prostate cancer screenings and 80% included colon cancer screenings. Some analysts believe that HSAs are more beneficial for the young and healthy as they do not have to pay frequent out of pocket costs. On the other hand, they have to pay lower premiums for HDHPs which help them meet unforeseen contingencies.

Health Savings Accounts are also advantageous for the employers. The benefits of choosing a health Savings Account over a traditional health insurance plan can directly affect the bottom line of an employer’s benefit budget. For instance Health Savings Accounts are dependent on a high deductible insurance policy, which lowers the premiums of the employee’s plan. Also all contributions to the Health Savings Account are pre-tax, thus lowering the gross payroll and reducing the amount of taxes the employer must pay.

Criticism of HSAs

The opponents of Health Savings Accounts contend that they would do more harm than good to America’s health insurance system. Some consumer organizations, such as Consumers Union, and many medical organizations, such as the American Public Health Association, have rejected HSAs because, in their opinion, they benefit only healthy, younger people and make the health care system more expensive for everyone else. According to Stanford economist Victor Fuchs, “The main effect of putting more of it on the consumer is to reduce the social redistributive element of insurance.

Some others believe that HSAs remove healthy people from the insurance pool and it makes premiums rise for everyone left. HSAs encourage people to look out for themselves more and spread the risk around less. Another concern is that the money people save in HSAs will be inadequate. Some people believe that HSAs do not allow for enough savings to cover costs. Even the person who contributes the maximum and never takes any money out would not be able to cover health care costs in retirement if inflation continues in the health care industry.

Opponents of HSAs, also include distinguished figures like state Insurance Commissioner John Garamendi, who called them a “dangerous prescription” that will destabilize the health insurance marketplace and make things even worse for the uninsured. Another criticism is that they benefit the rich more than the poor. Those who earn more will be able to get bigger tax breaks than those who earn less. Critics point out that higher deductibles along with insurance premiums will take away a large share of the earnings of the low income groups. Also lower income groups will not benefit
substantially from tax breaks as they are already paying little or no taxes. On the other hand tax breaks on savings in HSAs and on further income from those HSA savings will cost billions of dollars of tax money to the exchequer.

The Treasury Department has estimated HSAs would cost the government $156 billion over a decade. Critics say that this could rise substantially. Several surveys have been conducted regarding the efficacy of the HSAs and some have found that the account holders are not particularly satisfied with the HSA scheme and many are even ignorant about the working of the HSAs. One such survey conducted in 2007 of American employees by the human resources consulting firm Towers Perrin showed satisfaction with account based health plans (ABHPs) was low. People were not happy with them in general compared with people with more traditional health care. Respondants said they were not comfortable with the risk and did not understand how it works.

According to the Commonwealth Fund, early experience with HAS eligible high-deductible health plans reveals low satisfaction, high out of- pocket costs, and cost-related access problems. Another survey conducted with the Employee Benefits Research Institute found that people enrolled in HSA-eligible high-deductible health plans were much less satisfied with many aspects of their health care than adults in more comprehensive plans People in these plans allocate substantial amounts of income to their health care, especially those who have poorer health or lower incomes. The survey also found that adults in high-deductible health plans are far more likely to delay or avoid getting needed care, or to skip medications, because of the cost. Problems are particularly pronounced among those with poorer health or lower incomes.

Political leaders have also been vocal about their criticism of the HSAs. Congressman John Conyers, Jr. issued the following statement criticizing the HSAs “The President’s health care plan is not about covering the uninsured, making health insurance affordable, or even driving down the cost of health care. Its real purpose is to make it easier for businesses to dump their health insurance burden onto workers, give tax breaks to the wealthy, and boost the profits of banks and financial brokers. The health care policies concocted at the behest of special interests do nothing to help the average American. In many cases, they can make health care even more inaccessible.” In fact a report of the U.S. governments Accountability office, published on April 1, 2008 says that the rate of enrollment in the HSAs is greater for higher income individuals than for lower income ones.

A study titled “Health Savings Accounts and High Deductible Health Plans: Are They an Option for Low-Income Families? By Catherine Hoffman and Jennifer Tolbert which was sponsored by the Kaiser Family Foundation reported the following key findings regarding the HSAs:

a) Premiums for HSA-qualified health plans may be lower than for traditional insurance, but these plans shift more of the financial risk to individuals and families through higher deductibles.
b) Premiums and out-of-pocket costs for HSA-qualified health plans would consume a substantial portion of a low-income family’s budget.
c) Most low-income individuals and families do not face high enough tax liability to benefit in a significant way from tax deductions associated with HSAs.
d) People with chronic conditions, disabilities, and others with high cost medical needs may face even greater out-of-pocket costs under HSA-qualified health plans.
e) Cost-sharing reduces the use of health care, especially primary and preventive services, and low-income individuals and those who are sicker are particularly sensitive to cost-sharing increases.
f) Health savings accounts and high deductible plans are unlikely to substantially increase health insurance coverage among the uninsured.

Choosing a Health Plan

Despite the advantages offered by the HSA, it may not be suitable for everyone. While choosing an insurance plan, an individual must consider the following factors:

1. The premiums to be paid.
2. Coverage/benefits available under the scheme.
3. Various exclusions and limitations.
4. Portability.
5. Out-of-pocket costs like coinsurance, co-pays, and deductibles.
6. Access to doctors, hospitals, and other providers.
7. How much and sometimes how one pays for care.
8. Any existing health issue or physical disability.
9. Type of tax savings available.

The plan you choose should according to your requirements and financial ability.

BIBLIOGRAPHY

1 Questions and Answers about Health Insurance- A Consumer Guide’ published jointly by the Agency for Healthcare Research and Quality (AHRQ)and America’s Health Insurance Plans (AHIP)
2 http://www.en.wikipedia.org/wiki/Health_savings_account
3 2002 AHIP Survey of Health Insurance Plans
4 “How High Is Too High? Implications of High-Deductible Health Plans” Davis, Karen; Michelle Doty and Alice Ho. The Commonwealth Fund, April 2005
5 http://www.fdhc.state.fl.us/schs/pdf/hsa_tri-fold_brochure.pdf
6 HSA/HDHP CENSUS 2008 by Hannah Yoo, Center for Policy and Research, America’s Health Insurance Plans
7″HEALTH SAVINGS ACCOUNTS Early Enrollee Experiences with Accounts and Eligible Health Plans” John E. Dicken Director, Health Care.
8 Thomas Wilder and Hannah Yoo, “A Survey of Preventive Benefits in Health Savings Account (HSA)Plans, July 2007,” America’s Health Insurance Plans, November 2007
9 Gladwell, Malcolm, “The Moral Hazard Myth”, The New Yorker (29-08-2005)
10 2008 Benchmark Survey HAS Bank
11. Employer Health Benefits 2007 Annual Survey, Kaiser Family Foundation
12. Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?Catherine Hoffman and Jennifer Tolbert for Kaiser Family Foundation, October 2006
13. Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Commercial Real Estate Marketing Plan – Key Points to Win the Client

In giving a client a marketing proposal and strategy to sell or lease a commercial property, a number of things need to be well detailed in the proposal itself. Here are some of the main ones that should never be overlooked in your property proposal.

  • Why Should I Use Your Agency? It is an important question and hopefully you have a very clear idea of the advantages you bring to the sale or leasing process. Generic statements like ‘we know the market’, ‘we are the best agent in town’, ‘we have been here for 50 years’, and ‘we will serve you well’, just do not cut it in competitive markets. Consider why your real estate agency can stand clear and separate to other competitive agencies in promoting the property. Make sure that the client knows without any doubt why they should choose you as the agent of choice. Do not base your marketing point of difference on low commissions or agency paid advertising; that just does not work in this market and will put you out of business fast. Your agency must have something that is special and not copied from other agencies; it should also be so unique that you are the first choice as the real estate agent to take on the listing. If you do not have this clear mindset, then welcome to the world of the ordinary real estate agent that has to fight for every listing. Be separate than everyone else, create your point of difference and then market it well.
  • Happy Existing Clients & Recent Sales: Evidence of market activity and positive results will always come in handy as you attempt to advise the client on the right strategy to adopt for their property. In this property market with an abundance of available property stock, you should never take on overpriced listings. On average it is better to walk away from them and work with listings that are closer to the market price or rent. Your time is a valuable resource and must be protected from unrealistic vendors. A realistic property owner that works within the property market is far better than a property owner that is trying to set their own property market.
  • Prospective Buyer Activity on a Property: Telling the seller or landlord of your current and prospective sources of enquiry is a worthwhile part of your marketing plan. This lets the owner of the property know that you are really on the right ‘wavelength’ when it comes to locating tenants and or buyers. Some agents also adopt the strategy of getting a series of inspections done quickly with potential buyers from their database even at the early listing stage. It is surprising how many listings are sold or rented even before they reach the market officially.
  • What is Value? What is a Property really worth? Whilst exact prices and rents are hard to pinpoint, you should have a reasonable idea to within 5% as to what price or rent you could achieve with any given property. If you have no idea of the rent or the price then it is better to put the property to the market on the basis of ‘expressions of interest’. In that way the market will tell you what they think. With some very unique properties this is necessary given the limited pool of buyers that can participate in the purchase.
  • Methods of Sale and Timing: The main possibilities when selling a property are usually sale by auction, sale by tender, sale at a price, sale by negotiation, expressions of interest, trade or exchange. Knowing the best one to choose is the key to success. Putting the property on the market at a price is the less successful way of property marketing. The reason for this is the market will judge the property and try to reduce the price; if the property is too highly priced it will ‘kill’ any genuine enquiry before you even hear about it. One other fact needs to be remembered and respected here; a property will become ‘stale’ on the market after about 90 days. If it does not sell by then, it is better to remove it from the listing books for some reasonable time, to freshen the property for the next stage of marketing that you need to go to.
  • GANTT Model: For those of you that may not be aware, this is a way of graphically displaying activity. It is a common graphing process. It just so happens that it is a very powerful tool when you put it in a commercial property proposal for sale or lease. The display shows the client exactly what you are going to do for them and when.
  • Question and Answer: As part of your property marketing proposal, it is wise to have one or two pages that handle the concerns and questions of the client. From the preliminary meeting with the client you will have ascertained what matters concern them; you can merge these concerns and your answers into a Q&A format within your proposal.
  • Executive Summary: Always use an Executive Summary at the front of your document. It should be no longer than 2 pages, and bring all the main points to the front of the proposal. Adults generally do not want to read a lengthy document, so all your great work may largely go unread unless you can get the key points to a place that interests the client to read further.
  • An Exclusive Selling Agency Agreement: Why should you do one? The obvious answer is that you can best serve the listing and the client; you can also control the competition agents that may be chasing the same property. Open listings are not desirable and are essentially a waste of time unless you specifically have a purchaser that is a strong contender to take the property immediately. Occasionally I come across an agency that has a business approach of listing everything they can regardless of agency type; whilst this method can work, it does require you to have a very large number of listings and plenty of signs on properties. In only that way will you get the enquiry and conversion numbers that you need for KPI’s on commissions.
  • What are the advantages to a Vendor in having only one Agent when selling a Property? Tell the client why one agent is the best way to go. Multiple agencies working on the one property do not allow focused communication of offers and marketing coordination. Tell the client how you will connect with them on marketing, negotiation, due diligence, and property settlement.
  • Advertising: Yes advertising is expensive and it is still necessary, although you can be selective. You need to get the property message out to the market in the most efficient and direct way. How you do that is really property specific, although the conventional processes of newspaper marketing (expensive) are becoming less necessary. The internet is taking over as the main advertising channel in commercial real estate sales and leasing, and offers your client far better and cheaper ways of putting the property to the market. A key strategy for property marketing is to create 3 different levels of marketing for the client to consider (gold, silver, and bronze), as it gives them the feeling of control when it comes to spending on vendor paid advertising.

So these key points should be well handled in your property proposal. When you get the points clearly set out, the client knows what you can do and why they should choose you as the property agent of choice.

Women's Style: How to Look Good in Military Boots

Looking good is a huge concern for women the world over, unfortunately, for many of us, having a good understanding of what looks hot, and what looks rot escapes us completely. Happily we live in age known as the information age; literally, anything we want to find out is now available, and with a little bit of research, we can all find out the latest ‘do’s and don’ts’ of fashion, as well as all the latest trends available.

Here, we will look at shoes for women, in particular, the military boot, and consider the ways in which we can wear them to ensure that we not only look great, but feel great too. After all, feeling good comes, in part, from looking good, and feeling good gives us the feelings of confidence that are essential as we move through our fast paced, appearance orientated, crazy, world.

Military boots, surprisingly, can look good when teamed with certain styles of dress. Firstly, when choosing which boots to opt for, you need to understand the sorts of clothing that suits you – pay little heed to fashion magazines, because a look that is great on one person, will not necessarily look so on another, choose clothes that suit your colouring and body shape. Once you understand the types of clothing that suits you, then you can move on to choosing suitable shoes for women.

If you feel as if you are slightly overweight, or are heavy set, then be careful to purchase boots that are not too bulky. The wider the shoes, the bulkier your calves may appear to onlookers, so if you are trying to look slim, avoid a wide boot. You will also want to avoid wearing wider styles of footwear if you are of a short stature, as they make legs appear shorter. The converse is true of people who wish to appear taller, or wider, than they actually are, for these people, a bulky shoe is the correct choice. Remember also, that a bulkier shoe carries with it masculine overtones, so for those girly girls amongst us, a narrow shoe is always best.

Military boots are incredibly versatile in terms of the style of clothing that they suit. Long skirts are a great item to wear with this style of footwear, but our suggestion is that you keep to a narrower style if you wish to retain a sense of femininity. A long length skirt and a pair of boots is perfect for women who like to adopt a grunge look, but bear in mind, that to carry-off the style correctly, you must not show any flesh. Short skirts can also be worn with military boots, but shorter women need to be careful here, as the combination of skirt, flesh, then boot, can make you appear short if the boots have high uppers. If you are a short woman and wish to adopt this look, then make sure that you select a pair of boots that are very low.

Stress – How it Affects You and How You Can Treat It

Your life is full of stress! Any arguments? Didn’t think so. Your life is full of pressure, frustration, and stress. Worrying about job security, being overworked, driving in rush hour traffic, arguing with your spouse, even dealing with medical bills – all of these create stress in your life.

According to the American Psychology Association, more than half of all Americans report being concerned about the level of stress in their lives. Most people are feeling over scheduled, overextended, and overworked. By far, the most commonly reported source of stress is the workplace.

Studies suggest that stress is a contributing factor in the development of chronic and degenerative conditions such as heart disease and diabetes. High stress levels at work can lead to job burnout, reduction in productivity, ill health, job dissatisfaction, and absenteeism. As these problems add up over time, you worry more about keeping your job while your boss becomes more dissatisfied, leading to more stress and an ever-growing vicious cycle.

When you experience stress, glands within your body respond by releasing a hormone called adrenocorticotropic hormone – we’ll call it ACTH for short. When your glands send out a burst of ACTH it is like an alarm system going off within your body. ACTH tells other glands to flood your body with the hormones cortisol and adrenaline. These two hormones cause your heart rate and blood pressure to increase. They shut down your digestive system and even alter your immune system. When you remove yourself from the stressful situation, the levels of cortisol and adrenaline decrease. As cortisol and adrenaline decrease in your system, your heart rate, blood pressure, digestive system and immune system return to normal.

As you pile one stressful situation on top of another, your body has no time to recover. If you are in a constant state of stress, or experience many stressful situations, your body’s stress response system can disrupt nearly all of your body’s processes. Some of the effects can lead to chronic illness and disease.

Stress affects the digestive system so much that stomachaches and diarrhea become common. The hormones related to stress slow down the release of stomach acid and the process of emptying the stomach. The same hormones stimulate your colon which speeds the passage of its contents – a.k.a diarrhea.

Chronic stress dampens your immune system making you more susceptible to colds and other infections.

Stress affects your nervous system and has been linked to depression, anxiety, panic attacks, and dementia. Over time, chronic release of cortisol can even cause damage to several structures in the brain.

Stress affects your cardiovascular system by causing an increase in heart rate and blood pressure and increasing the risk of heart attacks and stroke.

Unlike most other diseases that affect Americans, there really isn’t any routine medical treatment for stress. Some doctors prescribe antidepressants. But drugs have a limited ability to alleviate stress.

The most effective way to reduce or relieve stress is through lifestyle habits.

Lifestyle habits such as spinal alignment, exercise, breathing exercises and coping strategies are the most effective ways to reduce stress.

Exercise is a good way to deal with stress because it is a healthy way to relieve your pent-up energy and tension. By getting physically active, you can decrease your levels of anxiety and stress, and elevate your moods. Numerous studies show that people who exercise exhibit a marked improvement in their ability to concentrate, sleep better, suffer fewer illnesses, suffer from pain less, and report a higher quality of life.

One of the consequences of stress is a tendency to unconsciously tense up your muscles, especially in your upper back and shoulder regions. This chronic tension, coupled with poor posture, causes the vertebrae of your spine to become misaligned. Misalignment causes irritation. Irritation causes more tension. More tension causes greater misalignment. And the cycle continues and you continue to get worse. Most people experience a notable improvement in their own stress levels almost immediately after a spinal adjustment. You can reduce your level of stress by visiting your local chiropractor to have a spinal adjustment.

There are two types of nutritional supplements. There are nutritional supplements that help reduce stress and there are nutritional supplements that help the body better cope with the effects of stress. Supplements that help reduce stress belong to a class of herbs that helps the body relax. Herbs such as chamomile, skullcap, valerian, and lavender help to clear your mind and calm intense emotions. Many of these herbs are taken in the form of a hot or warm tea.

Supplements that help the body cope with the physical effects of stress are the B-vitamins and zinc. When you experience stress, your body needs more zinc and more of the Vitamin-B complex. Your health suffers and you are more prone to illness when you don’t have enough of each in your body. Taking a B-complex with zinc in the form of a liquid nutritional supplement will help protect your body from the negative effects of stress.

The final key to treating stress is healthy thinking. Most stress is caused by two factors – dealing with change and feeling out of control. While you can’t predict the changes that will occur in your life, you can – control how you plan each day, – you can positively respond to change, and – you can act with purpose.

The combination of these three positive thinking habits can help remove stress from your life and diminish the effects of stress. These three simple ‘attitude adjustments’ will help you feel more in control and once adopted as a habit, can be quite relaxing.

Don’t let prolonged or repeated episodes of stress lead you to chronic or degenerative disease like diabetes or heart disease. Lifestyle habits such as spinal alignment, exercise, breathing exercises and coping strategies are the most effective ways you can reduce stress and the effects of stress on your body.

Essential Bathroom and Kitchen Remodeling Tips

The real sign of a remodeled home is how well the bathroom and kitchen have been renovated. These days’ buyers will judge your home by the look of your kitchen as well as the bathroom. Some homeowners prefer an open concept where their kitchen is on the display for all visitors and guest to see. In this article we will discuss various important kitchen and bathroom renovation tips to help you with your project.

There used to be a time when homeowners did not pay much attention to these rooms. These areas were simply utilized for their function. Today the kitchen is the central gathering where all family members join one another after a hard day at work to share a meal and socialize. In the same way the bathroom is seen as a place to relax and be comfortable. Below are some tips to consider before venturing out on your home improvement project.

Clarity and Budget

You need to measure the size of your bathroom and your kitchen so that you can determine how much room you have. Knowing this information is critical as you can determine what can be added and what does not fit. You then need to determine what you are trying to gain from your kitchen renovation project or from your bathroom makeover. Are you looking to add more cabinets, perform a simple make over, or are you looking at knocking down walls and do a full renovation. How much are you willing to spend and how much can you accomplish with your budget. Being clear helps you to get to where you want to go.

Where to Find Ideas

Start looking online as there are various sites that provide you with kitchen renovation ideas and bathroom remodeling ideas. You should also flip through the pages of home improvement magazines to see what style and ideas you would like to deploy. These designs will provide you with the theme that you can use in your renovation project.

Be Honest and Be Willing to Learn

This is not a time to let your ego get the better of you. You need to be frank with yourself and asses your skills. Ask yourself what you can do on your own and when to call in a hired hand. There is certainly some work that you can take on, such as painting the walls. You can also learn other simple tasks by taking advantage of various online training videos or free training classes provided by some suppliers such as Home Depot.

These trainings can assist you on doing some of the work that is not so difficult. For instance, if you are only replacing your existing counter top or bathroom sink, you could take advantage of these DIY training to reduce the cost of your renovation project by doing some of these work yourself.

Get Your Family Involved

Bathroom renovation or kitchen updating should not be a grim task. You can turn this to a family event by giving your family members a to-do list and making it fun. Working alongside one another to improve the overall quality of your life can be a fun and fulfilling activity.

Commercial Real Estate – Listing Tools and Tactics

Attracting new property listings is an ongoing task that requires constant focus for the commercial real estate agent. Whether they are new or old to the industry, prospecting for new listings is (or should be) ongoing. Clear tactics are required if you want to dominate your market and the other real estate agents around you.

Without new listings you cannot generate the commissions and quality of enquiry you require. What I will give you here is a well proven base plan and set of tactics for generating listing opportunity.

Understand this, the more enquiries you generate from the people you know, the better your real estate business. You have to know a lot of people to be successful in the real estate business.

With the advances in technology today you would think that this is prospecting process is easier than ever before, although some people still struggle with it.

So where can you generate the property enquiry that you need? Here is a list that will help you on the way:

  • Old real estate sales and leasing activity over the last few years will give you the names and dates of transactions that will soon potentially come back in the market. That means you should use the old property sales and leasing records from your region as a base of fresh prospecting and cold calling. Most investment property will change hands every 5 to 7 years. It is a cycle that allows you to target properties that have been held for some time by the same owners. They are likely to need your help soon.
  • Business owners may lease or own their premises. Make the call to these people or drop in at their offices to find out what they need and want in the way of property.
  • Walk the streets that contain the good properties and the good businesses. Leave your business card and pick up the business card of all the managers or proprietors.
  • Ask the people you meet in the local businesses about the local properties around them and any changes that they know about. This is a great source of market intelligence. They know the market around them better than you do.
  • Vacant land should always be researched as to the owner and what they are doing about the property. You can put your sign on vacant land if the owner lists their property with you. The more signs you get up the better for your market image and market share.
  • Old property listings that other agents have failed to sell or lease should be monitored in case the listing can be reactivated. As part of this keep a tally on the time on market for the listings. This will tell you when the market is changing with certain listing types.
  • Make cold calls on developers, solicitors, accountants, and architects. They all have an interest in commercial property and will have clients that need help from time to time.
  • Rent rolls and other property managements held by other agents are prime targets for new business. By their very nature, the owners of these properties are investors, and many investors own more than one property.

You and your daily activities are at the center of this prospecting process. Prospecting is hard for some people given that the level of self-discipline required is high. Many salespeople will find something else to do that is easier. Any excuse will do to avoid prospecting. Many salespeople will take the easy prospecting process of dropping flyers and sending generic mail to hundreds of local businesses where they do not follow up. Does this really work? Yes but only to a minor degree and the road to success is slow.

You have to talk to people if you want to fast track your listings and opportunity.

If you take on this challenge and practice your prospecting processes until they are second nature, then you will create better results. As you improve, the more meetings and presentations you can do, and this leads to listings.

It pays to keep a running tally of your calls, meetings, and conversions to listings. This helps you understand when you are getting better at the prospecting process. So who are you going to call? This is the research part of the prospecting model and every day you do a bit more research into the properties and the areas that you are interested in. This also helps you understand what is going on in your area.

New property listings help you build your database. It is the database that will bring you so much market share and qualified enquiry. The bigger and more accurate your database, the more people you can call when some enquiry or opportunity arises. Your database is a very personal thing and should be maintained by you personally. This helps you take ownership of the process.

Economic Recession Blues – Hospitals Aren't an Exception

In its most recent update, the International Monetary Fund (IMF) announced that world growth is forecast to fall to its lowest level since World War II. And with the US being one of the worst hit, the hospital business, an integral part of the medical marketplace, and often regarded as recession proof is beginning to feel the heat.

Despite the fact that hospitals aren’t hit the way the way the automotive sector or the retail has been, and that people will continue to fall sick irrespective of the economy, it seems that the number of people seeking medical care and the profitability of hospitals don’t walk hand-in-hand.

Growth stunted & patients decreasing

A recent report by the American Hospital Association (AHA) finds that the sputtering economy has already led to 45% of hospitals to postpone forthcoming capital projects, with about 13% being forced to completely stall any expansion projects already underway. The AHA report included 639 hospitals in the study.

Further, experts believe that even though people continue to fall sick they’re postponing, most treatments if not all, which can be classified as elective. The credit for the prevailing scenario goes to all the layoffs and the slowing economy. As per the Bureau of Labor Statistics the month of December saw some of the worst layoff figures, as there were 2,275 mass layoff actions, involving 226,117 workers.

What seems worse is that aside from foregoing elective treatments, patients seem to be avoiding essential drugs, with many actually abusing prescription drugs, such as narcotic painkillers , sedatives and tranquilizers and stimulants.

As a consequence, hospitals are reeling under delayed hospital equipment and supply purchases, declining patient visits, reduced staff with no fresh hiring, unpaid medical bills, in addition to ceasing any construction projects. The AHA survey, released in November last year found that patient visits were static or had decreased during the third quarter of 2008, and the cases of unpaid medical bills for hospitals registered a hike of 8%.

The government’s role in uplifting the spirit of hospitals is being thought to be instrumental as Medicare and Medicaid account for about half of the hospital business industry.

Heavy Equipment Operator Jobs For the Future

Back in the days before the industrial revolution, everything was done by hand. Although the invention of machines dated all the way back to the wheel, it was only during the industrial revolution that machines became automated. Today, our world revolves around machines and nowhere is our mechanical advances seen more clearly than with heavy equipment. Whether its in mining or construction, it seems like we can move the world with our modern machines.

Operating these machines has become a very specialized skill and something that evolved from flipping a few leavers to becoming a full operator. Modern machines like cranes, bulldozers and dumb trucks are sophisticated pieces of equipment that requires skilled people to operate them.

Heavy equipment operator jobs are currently in high demand and in short supply. With billions of dollars of construction work on the horizon in the USA, we are set for some major shortages of operators.

The fact that there are more and more machines required to speed up building work and improve productivity, now is the time to get into this occupation.

Becoming an operator can not just give you a stable job, but it can potentially be a very lucrative career. With the demand being so high, salaries are set to rise and if you advance yourself and become more skilled in operating different heavy machines you can secure yourself a bright future – and always be certain of a job.

What is particularly good about being qualified as a heavy equipment operator is the fact that you can work across several different industries. Although the majority of job opportunities is in the construction industry, there is a lot of work in mining, shipyards and disaster relief.

Regardless of your preference and your skill level, you can find a job in this exciting industry.

Getting qualified usually involves a full year of training. Many trade schools and technical colleges offer 1 year programs and upon completion you will receive a certificate as well as a heavy vehicle drivers license. Not all qualifications are equal though and its important that you look into the school or college very closely. Prospective employers value certain qualifications more than others.

Its always a good idea to find someone who is already in the profession and ask around. Some construction companies eve have training programs where they will train you while you are in employment with them. This will allow you to earn while you learn and graduate with experience.

Visit my blogto read more on finding heavy equipment operator jobs.

The Need For Spyware Removal on Your Computer

Should something infect the software like a pathogen or spyware, the person will shortly lose sensitive info or at worse have to spend plenty of money to have it fixed.

This may be done by ensuring that there are backup files stored in a secure place and setting up certain defense mechanisms from viruses and other threats. One such system is known as an adware spyware remover and people who only need the best should get it from Symantec. Symantec is an example of the number 1 service suppliers of products of business answers to tiny, medium and massive ventures. The purchaser can select a program to deal with a precise or multiple threats such as viruses, Trojan, spyware and worms. This individual can then use the card to make unapproved purchases or nick money from the account. Symantec’s adware spyware remover system is engineered to look for existing bugs in the system and then destroy it.

The package it offers can be employed by those at home or when working in the office.

Since new spyware and adware pop up common-or-garden, patrons who opt to purchase the system can be be assured that the PC is always secure as the company always launches product updates that may be done either manually or instantly. Those that are uncertain whether to purchase it can try it for thirty days free but pay before the expiration to keep on the services. Symantec unlike other programs does not need to be turned on to do a systems check on the PC. When the spyware or adware has been removed, the easiest way to guarantee it doesn’t return is by making a firewall. It has received good reviews from critics and Computer mags for the standard of excellence it has given in all of its products. As software corporations attempt to make the computers folk use safe common-or-garden, so too are the hackers and programmers who need to do the same for private gain. The individual can have chosen to be with the best or get something else but it is always better to be safe than sorry when it comes to safeguarding the data stored in the PC.

Cheap Car Insurance and Car Safety – Vehicle Inspections

The issue of statutory vehicle inspections and whether your vehicle needs one or not is something that matters both at a legal level and at a practical level. When buying a car, it is Uncategorized to assume that the vehicle falls into one of two categories. Either the vehicle is brand-new or relatively new and as such probably does not require a statutory vehicle inspection.

It will normally have some type of manufacturers guarantee that will cover parts and labour for a specified period of time. There may well be a dealership deal in addition to the manufacturer’s help that may extend the guarantee over a period of time, or may extend it in different ways such as to include breakdown insurance or optional windscreen cover etc.

The second category of vehicle is simply that which does not fall into the category as described above. What defines a vehicle as being new or nearly new is a matter of some debate, but in a general sense it is likely to be a car that is two or three years old up to a car can be 20 or 30 years old. The newer the car the less likely it is to need a vehicle inspection as required by statute. Having said that the distinction as to whether a vehicle needs a vehicle inspection by law or not does varies hugely so it is well worth checking what the legal requirement is where you live or where the vehicle is going to be used.

Even cars that are not new will quite often have some type of warranty, either that offered by a dealership or by an insurance company. The option of being able to buy a warranty by an insurance company is becoming increasingly common nowadays, and is sometimes offered as an extension of a person’s car insurance.

Obviously the terms and the cost of such warranty do vary hugely and you will need to have your car inspected prior to the insurance company granting you such cover. Such cover in terms of extending warranties is normally fairly pricey, but like most types of insurance its real benefit is in supposedly giving you freedom from worry. Such peace of mind exists when you don’t have to make a claim, but is quite often tested if you do have to.

If your vehicle does require a vehicle inspection by law, then be aware of how long the inspection is valid for, what testing stations are available to carry out such inspection, and limitations of what it might mean not have one. Whilst it is unlikely that you would deliberately not have a vehicle inspection, it is quite likely that some people will simply forget or not realise that there the vehicle is due to have inspection on a particular date.

The implications of this, aside from being a breaking of the law, can also relate to the persons car insurance. It may well be that the car insurance is dependent upon the vehicle inspection being carried out and the vehicle passing such vehicle inspection.

Most vehicle inspections as required by law are pretty basic inspections and normally have one aim in mind, which is to verify that the vehicle is effectively in a roadworthy condition. To this end the inspection will check things like tyres, oil levels and various mechanical and structural elements of the vehicle. These types of vehicle inspections are not the same as an inspection that needs to be carried out or should be carried out of vehicle prior to buying it.

That type of inspection is one that is designed to give you some relief that there is nothing inherently wrong with the vehicle and that it is okay to buy it without fear of its going dramatically wrong immediately after you bought it. A legal vehicle inspection is normally pretty basic and is designed to assess certain core safety elements of a vehicle and make sure it is safe to drive on the road.