AOL"s Tim Armstrong couldn"t be more wrong about "distressed babies" | Janet Sheaffer Pickel

Cade, son of Janet Pickel when he was born (left) and now (right). Photograph: The Guardian.

On the day my twins were born, they racked up health-related expenses of $ 29,000 apiece.

They were delivered by way of emergency caesarean segment at 24 weeks’ gestation, meaning I was approximately five months along. Our daughter, Jaina, weighed just below a pound her brother, Cade, weighed 1 pound, five ounces.

They could not breathe on their personal. Their skin was so thin, their bodies so little, we could watch their hearts beat. They hadn’t developed cartilage yet their ears and noses have been flaps of skin. We didn’t inquire how a lot it was going to expense to deal with them we just wanted our infants to live.

Our several physicians talked about day-to-day survival, not lengthy-term payment strategies.

My employer – a newspaper not far previous a round of buyouts and price-cuts – did not inquire me how significantly it was going to cost to deal with them. My co-workers pooled money and bought us present cards so we didn’t have to cook as we drove back and forth to the hospital for months.

When I study AOL chief Tim Armstrong’s remarks blaming his company’s improved well being-care expenses on two “distressed” infants with million-dollar healthcare expenses, I wondered if that’s what every person imagined about our twins. Did we invest as well considerably of an individual else’s money to consider to conserve them?

I know my unplanned initial pregnancy (at 41) value a total great deal of money, a lot of which did not come out of my pocket. Insurance coverage and Medicaid picked up all but a handful of thousand bucks of the $ 2m we “invested” at the Harrisburg Hospital neonatal intensive care unit in four months.

Our Jaina lived only 49 hrs. In that time, she had x-rays, blood transfusions, IVs, a ventilator, an incubator, a devoted nurse. I never even know what else. All I know is she was quite sick and she died, and I would’ve paid $ 10m – any amount – to save her if I could have.

Cade appeared healthier at 1st, but had his initial (of 10) surgeries when he was two weeks previous. When he was 3 weeks outdated, struggling through his umpteenth infection, a doctor asked us if we needed hold making an attempt to hold him alive.

We did, no matter the cost.

Thanks to talented doctors and nurses who found the supply of the infection and fixed it, Cade turned the corner following that day. He was not out of the woods, however. He could not breathe on his personal right up until he was two months previous. He had sight-conserving eye surgical procedure at 3 months.

At one stage, we have been advised he likely had cerebral palsy and would be disabled in some way, perhaps mentally, maybe physically, possibly the two. Was a disabled youngster also expensive to maintain? No 1 asked that query. My husband and I in no way deemed it.

Cade was launched from the NICU when he was four months outdated. His very first week home, he had 7 physician appointments. He did not have cerebral palsy soon after all, but received government-paid early intervention companies to help him find out to stroll and talk and catch up with his non-preemie peers.

Today, Cade is a content, wholesome two-yr-outdated. He has mild asthma, but has not been hospitalized unexpectedly for a lot more than 18 months, which is trigger for celebration. He still sees a good deal of medical professionals, but not really frequently. His final surgery was only a month in the past, but his scars on his back, his belly and his arm never seem to bother him. Largely, he giggles and skips and asks to watch “Hi Elmo” (Sesame Street) all the time.

I wonder if AOL’s Tim Armstrong, who has apologized for his statements, understands how dehumanizing they were. Some have even advised his remarks violated America’s healthcare privacy laws. Remember when Obamacare opponents were speaking about grandma being subjected to death panels as an alternative of expensive care? It is the very same thing. It’s as if he wished price-benefit analyses to be done just before our daughter’s IV was place in or our son’s cardiac surgeon referred to as.

Thankfully, in our situation, my husband and I were capable to determine what was very best for our child with no worrying about the price. We have usually paid our insurance coverage premiums and taxes without complaint, believing that the frequent very good is well worth sharing the ache. We have tried to give back what we’ve been provided by means of perform and volunteerism.

Must I really feel guilty for possessing medically fragile babies? Was it worth it? Was it fair for other people to aid pay out for them? Must my son truly feel pressured to have a much better-than-common existence due to the fact his start price a lot far more than every person else’s?

Unanswerable concerns. I cannot put a cost on a priceless existence, and neither can any individual else.

AOL"s Tim Armstrong couldn"t be more wrong about "distressed babies" | Janet Sheaffer Pickel

Did AOL CEO Tim Armstrong Violate HIPAA?

Tim Armstrong has presently acknowledged (and apologized) for his sizable gaffe final week, but is he also guilty of violating healthcare’s privacy law recognized as the Health Insurance Portability and Accountability Act (HIPAA)?

I’m not an attorney – or HIPAA topic matter specialist – but the incident does look like it warrants legal review.

Here’s a quick summary – trying to keep in thoughts that the sequence of events is relevant (irrespective of any apology both offered or accepted).

• AOL AOL is a publicly traded organization with about 5,600 workers


• Yearly income of about $ two.5 billion


• Yearly revenue of about $ 140 million


• Present Industry Capitalization of $ 3.64 billion


• Mr. Armstrong’s compensation is about $ twelve million (right here)

Appearing on CNBC last Thursday – and in an try to clarify latest alterations to AOL’s 401(k) worker matching contributions – Mr. Armstrong stated the following:

“We have to look at our rewards packages really critically. As a CEO and as a management staff we had to make a decision, do we pass the $ seven.1 million of Obamacare charges to our staff? Or do we attempt to eat as significantly of that as attainable and lower other rewards?” CNBC Video (right here)

Honest adequate. That just qualifies as portion of the developing stampede of insensitive, substantial-priced CEO’s eager to blame Obamacare for growing healthcare expenses – but that’s not the place it ended.

Throughout a town-hall type meeting with employees to clarify the planned changes to individuals 401(k) contributions Mr. Armstrong added these statements (daring emphasis mine):

“Two items that happened in 2012. We had two AOL-ers that had distressed babies that have been born that we paid a million dollars each and every to make certain people babies have been Okay in general. And people are the factors that add up into our benefits value. So when we had the final choice about what rewards to minimize since of the improved healthcare fees, we created the choice, and I manufactured the selection, to fundamentally modify the 401(k) program.”  AOL’s Armstrong Responds to 401(K) Controversy in Inner Memo to Personnel – CNBC (here)

A single of the mothers (and wife of an AOL employee), Deanna Fei elected to inform her side of the story yesterday – My Little one And AOL’s Bottom Line (here).

Ms. Fei’s public disclosure could resolve at least 1 aspect of any feasible HIPAA violation (since she publicly shared her personal health care story), but it does not resolve the timeline – or the achievable inspiration for her public disclosure. In truth, it’s very unlikely that Ms. Fei would have felt compelled to defend her deeply private healthcare story (independent of charges) absent the insensitive statement by Mr. Armstrong for the duration of the company town-hall meeting.

Late yesterday Ms. Fei acknowledged a private contact with Mr. Armstrong in which he apologized – and she completely accepted his apology (here).

The 2nd mom remains unknown – except (perhaps) to numerous AOL co-employees. In a company of in excess of 5,000, it could be comparatively easy for a honest quantity of co-staff to deduce the identity of the 2nd mom of a “distressed baby” now that one particular mom has now been plainly identified.

As a big employer – it is highly probably that AOL is self-insured. Practically all firms with above one,000 staff are. Beneath HIPAA, firms that are “self-insured” are regarded as “health care providers” and as a result, immediately liable for any HIPAA infractions.

What stays debatable then is if a “distressed baby” qualifies as “personal overall health information” (PHI) in the situation of two AOL beneficiaries. It possibly isn’t a violation, but at least some of that legal nuance may possibly rely on whether or not Mr. Armstrong knew the identities of both beneficiaries (prior to Ms. Fei’s public disclosure). It is undoubtedly conceivable he did – and we’ll have to see if the Workplace of Civil Rights (beneath Overall health and Human Services) initiates any legal inquiry or action.

The bigger concern stays. The insensitivity of properly-heeled corporate CEO’s who make employees like Ms. Fei really feel “like greedy customers of well being care benefits” (as quoted to NBC right here).

By virtue of supplying the advantage (itself a massive corporate tax benefit), organizations are increasingly creating personnel really feel directly accountable for all healthcare hazards and increasing charges. It is a really slippery slope – that usually starts innocuously enough with the notion of “corporate wellness.” Organizations that institute these plans often contain a “health threat assessment” questionnaire in the course of open enrollment.

Final results of those questionnaires can then be utilized to recognize personal well being dangers and then assign individual penalties/rewards primarily based on those health hazards.

Penn State waded into this precise hot water last 12 months when it started out requiring “health risk assessments” as a way to determine advantage pricing. If wellness connected concerns close to psychological overall health, pregnancy and other risk variables weren’t answered, staff were subject to a increased premium fee. In the case of Penn State, that amounted to about $ one,200 per yr per worker (or $ 2,400 with spousal coverage).

All of which begs a straightforward question. How is this various than “pre-existing” problems that had been utilised by overall health insurance coverage companies (to calculate premium rates) – and then not too long ago outlawed by Obamacare?

These colliding interests – and liabilities– were greatest summarized by Matthew Bodie (a Labor and Employment Law Professor at the St. Louis University School of Law) in the Penn Story story which was covered in detail by the New York Occasions. The post consist of this quote by Mr. Bodie.

These tensions among getting employers control wellness care coverage and workers wanting to have some private room are crashing into each other. It’s possibly going to get worse.” Matthew Bodie – On Campus, a Faculty Uprising Over Personal Data – New York Instances (Sept, 2013 right here)

Did AOL CEO Tim Armstrong Violate HIPAA?