MEDICAL and DENTAL EXPENSES Do Not Include Expenses Paid by Others Form

My father was not much of a worker either. We went without a lot and went hungry. During Winter it was sometimes so cold I could see my breathe inside. Some of my toes are messed up because there wasn't always money for shoes so I wore shoes that were too small. Milk was like gold.Sometimes you have to look at the positive because you are lucky that your uncle is willing to support you. Not everyone has someone who cares enough to step up and take that responsibility.The thing that you can take from it is that you need to break the cycle. Be a person with an awesome work ethic. You have an mentor in your uncle. Instead of getting depressed, pattern yourself after your uncle and be thankful to have his support. One day your uncle may need your help and you will be honored to have the opportunity to help him.Yes, it is embarrassing that your father will not work but you cannot change him. You cannot control what he does. You can only control what you do. You be the one to do your best whether at school or work and one day, you may be able to help someone else. Use your embarrassment to drive you and try not to lose all love and respect for your father. Good luck!

I was A2A.  I agree with others who've said that high deductibles discourage patients from going to their doctors.  But as currently worded the question asks, "how do you think Health care companies would deal with this change? "  So I'll try to deal with that.Some health insurance companies have historically offered such plans.  They appeal to young, healthy people who don't expect to use the doctor very often.  They expect to save money because the premiums are lower and their out of pocket costs are very low.  In case of a devastating accident or life threatening illness, they'll pay the high deductible and use their insurance to avoid bankruptcy.  When I worked for Xerox (1993-2012) the health insurance options changed from one year to the next, but there was generally a high deductible option and a low deduction option.  So, the health insurance companies are able to price the high deductible plans so that they make money.  I include some large corporations, like Xerox, in the "health insurance company" category.  Technically "self-insured" these companies collect premiums from their workers, pay health care providers (doctors, hospitals, labs, ...) for their services to employees, and just pay an "insurance company", like Blue Cross Blue Shield, to handle the paperwork.  So this saves money for the corporations that offer it.I've heard that the ACA now limits this kind of policy.  I don't know the details.  Whatever kind of health insurance I had, my doctors did exactly the same things.  Sometimes my specific policy had a lot of details that were different from other companies and my doctor didn't even know what my co-pay would be for an office visit.  My doctors billed my insurance companies.  Eventually they billed me for what they didn't collect.  Sometimes the insurance company negotiated a lower fee from the doctor, so the part I paid was lower.  Like sausage making, this was a process I didn't want to know about.The question also asks and speculates about administrative costs.  As far as I can tell, the fundamental choice is to spend less on employees who check the services and costs - and to accept higher levels of error and fraud.  Or to spend more on employees who check the services and costs - and hope to reduce costs due to error and fraud.  I don't know the optimum, or whether a single, long term optimum is even possible.

As per condition of foreign posting, the education of upto two children of an IFS , during the period of his posting abroad is paid by the Government, up to School level. They manage to pay for higher studies of their children from their savings supplemented by the children who are allowed to work for specified hours every week.

Social security benefits are funded both by payroll tax deductions and by the the Social Security Trust fund. When more money comes in through taxes than is paid out in benefits, the Fund grows. The Trust Fund (the combined OASDI Trust Funds total reserve is $2.89 trillion at the end of the year 2017) is invested in US Government securities that pay interest, a lot of interest. Social Security ran a surplus of $35 billion in 2017 and projects a surplus of $44 billion this year, 2018; however, long term projections based on the number of workers and the number of people signNowing retirement age, are that the surplus will turn to a deficit, relatively soon.If this drain went unchecked, eventually the Trust Fund would go to zero and there wouldn’t be enough money to pay social security benefits. SSA currently projects that depletion of the fund will occur in 2034.[1]Several small adjustments can be made now to fix the problem, such as raising the ceiling on income that is taxable, increasing the tax rate, lowering the social security cost of living adjustments, and raising the retirement age.The important thing in this discussion is that today the fix is easy because the Trust Fund is huge and earns lots of interest. If the Fund is starts to be depleted, that interest goes away and the amount of money to make up is vastly greater.Footnotes[1] Summary: Actuarial Status of the Social Security Trust Funds

Life of a US Army Doctor ‍⚕️:—U.S Army sleep medicine specialist discusses his path in medicine and how his clinical research may have helped detect a new sleep disorder, allowing soldiers and civilians to sleep better at night.Col. Vincent Mysliwiec, MD, is at the forefront of U.S. Army sleep research. He is currently assigned to the 121st Combat Support Hospital in Seoul Korea as a Sleep Medicine Specialist. He has dedicated his medical career to learning more about risk factors and treatments for sleep disorders in soldiers. He was accepted to medical school at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and went on to do his residency in internal medicine at Tripler Army Medical Center in Honolulu. During his Pulmonary, Critical Care and Sleep Medicine Fellowship at Brooke Army Medical Center in San Antonio from 1999 to 2002, Dr. Mysliwiec discovered opportunities to dive into the relatively new and under-recognized field of Sleep Medicine. As Operation Iraqi Freedom began, he and his colleagues discovered soldiers were being affected by sleeping disorders such as insomnia, coupled with symptoms of associated conditions like Post Traumatic Stress Disorder (PTSD). They began to examine how the war affected soldiers' sleep habits and behaviors. Recently, Col. Mysliwiec and his colleagues at Madigan Army Medical Center published an article on a newly proposed sleep disorder, Trauma Associated Sleep Disorder, which primarily affects combat veterans. Col. Mysliwiec is one of the U.S. Army's 26 sleep medicine specialists who evaluate tens of thousands of patients each year for sleep disorders.Often times when one chooses the career of a doctor, there’s a clear road to follow. For my journey, that path looked a bit different, as I’ve always had the desire to serve my country as well. For as long as I can remember, I’ve wanted to join the military, just like the soldiers, sailors, airmen and marines whom I would see at parades. I aspired to be an individual who was proud of what I was doing by both serving my country and helping others.When I entered the U.S. Military Academy at West Point in the summer of 1988, I was driven to excel. The career opportunities for a U.S. Army physician are plentiful — surgery, family practice, internal medicine, pediatrics, psychiatry — to name a few. However, it was a particular issue I had during my time at West Point that turned me to sleep medicine. During my time at West Point, the academics, sports, and extracurricular activities were numerous, as were the required military duties. To get the most out of the experience, the aspect I thought I could sacrifice was sleep. Frequently, I would sleep for only four hours or less per night. Needless to say, this short sleep duration resulted in difficulties trying to stay awake long enough to get through the day. It got to the point where I fell asleep while standing during one of the lectures by world-renowned Brig. Gen. Charles Brower, who had served as the U.S. Army Aide to President Reagan. The importance of sleep and its implications on my military medical career have persisted.After West Point, I attended the Uniformed Services University of the Health Sciences (USUHS) in Bethesda, Maryland, with my wife, who is also a military doctor. We’ve been fortunate enough to have always worked in the same military hospital since we were married 21 years ago. Following medical school, we moved to Tripler Army Medical Center in Honolulu, Hawaii, for internship and internal medicine residency.I choose internal medicine as my focus because I appreciated the variety of illnesses and breadth of this medical specialty. In the U.S. Army, you’re not only encouraged to pursue your interests, but you’re supported. Internal medicine afforded me the opportunity to learn about aspects of many disease states and how they affected patients. This knowledge continues to help me daily as nearly all medical and psychiatric illnesses affect sleep in some way.As my first duty assignment, Tripler was a wonderful demonstration of how U.S. Army Medicine was a team effort. When you are in the military, your fellow soldiers are your extended family. At Tripler, the house staff formed this extended family; we frequently gathered on weekends to spend time together and many of my fellow residents continue to remain life-long friends. The beaches of Hawaii were also a welcome bonus that made our time away from medical training relaxing.After residency, my wife and I went to Brooke Army Medical Center where I was a pulmonary, critical care, and sleep medicine fellow. While I had initially pursued this fellowship track to care for critically ill patients, it was the relatively new specialty of Sleep Medicine that piqued my interest.My initial interest in sleep medicine came from my knowledge — and living example — of the signNow effect you could have on patients by treating their sleep disorders. Obstructive sleep apnea (OSA) was finally gaining awareness as a medical disorder and with continuous positive airway pressure treatment you could improve not only patients’ sleep, but their daytime performance. The implications of this on military personnel are critical, especially because they typically received six hours of sleep per night, fewer than the recommended eight hours that can help ward off fatigue and other issues.During Operation Iraqi Freedom and Operating Enduring Freedom, the spectrum of sleep disorders and the importance of sleep were magnified. During times of war, U.S. Army physicians are placed throughout the globe to help oversee the health and safety of soldiers, which often leads to new discoveries in medicine and therapy.Prior to Operation Iraqi Freedom and Operation Enduring Freedom, sleep was viewed as something you could sacrifice. Military personnel did not have sleep education or sleep training; sleep just happened. Two years after the start of Operation Iraqi Freedom, we witnessed a marked increase in the number of soldiers with sleep disorders, and we saw the cases get more complex in our clinical practice. Diagnoses of obstructive sleep apnea increased six fold and insomnia greater than 20 times during Operation Iraqi Freedom and Operation Enduring Freedom. Along with this, there were soldiers who had complex sleep complaints of disruptive nocturnal behaviors (tossing, turning, thrashing, yelling, and striking out) in the context of traumatic dream enactment. As a sleep medicine physician in the military these issues resulted in major medical challenges — managing the growing number of active duty personnel with sleep disorders; studying the change in the presentation and prevalence of sleep disorders and working within the military to enact the required changes for sound sleep.As a Lt. Col. at Madigan Army Medical Center, after completing my fellowship training I was able to institute clinical changes, perform world-class research, and work on one of the largest preventive health care reforms ever implemented to address the sleep medicine challenges we faced. Still relatively early on in my career, I was helping implement health care reform and performing research that’s never been done before. Opportunities for unexplored research, excellence in training, and being on the cutting edge of medical innovation and advances remains one of the best benefits of working for the U.S. Army. It was during this time that I was also able to fill a medical leadership role.As the Chief of Sleep Medicine at Madigan Army Medical Center, I was fortunate to have institutional support to lead the development of a soldier-centered sleep home. When I arrived at Madigan, there were two sleep physicians. Over the course of eight years, we grew to a multi-disciplinary team consisting of five board-certified sleep medicine physicians, in addition to nurse practitioners and physician assistants, respiratory therapists, and sleep psychologists. In this clinical model, we provided world-class clinical care to address the sleep disorders of soldiers, and improve both their sleep and their responses to other treatments for post-traumatic stress disorder and traumatic brain injury. Witnessing the clinical changes, it required research to explain the nature and etiology of the sleep disorders that we conducted.Prior to this, there was little scientific data regarding sleep and sleep disorders in military personnel. During this time, I had access to scientific colleagues and innovative researchers who assisted me in defining the prevalence of sleep disorders in military personnel. We found that comorbid insomnia and obstructive sleep apnea, two sleep disorders co-existing at the same time, were in fact the most frequent sleep diagnosis in military personnel. To explain the frequently reported complex, disruptive nocturnal behaviors of soldiers, we published a study on a proposed new sleep disorder, Trauma Associated Sleep Disorder. Ideally, by recognizing these disorders, we would look to prevent them in the future.U.S. Army Surgeon General, Lt. Gen. Patricia Horoho, proposed the Performance Triad with the tenets of sleep, activity and nutrition. As one of only 26 sleep medicine specialists in the U.S. Army, and a recognized expert in Sleep Medicine, I have worked with the Sleep Working Group, a panel of recognized sleep medicine experts, to develop recommendations to improve the sleep education and training of U.S. Army soldiers. As part of the system for health, my input into developing scientifically valid, operationally sound sleep will help ensure soldiers sleep better in the future, which can improve their safety and optimize their performance.My military medical career is unique and rewarding. Its generous financial benefits have allowed both my wife and I to be practicing physicians debt-free. It has also provided opportunities to advance clinical practice, make scientific discoveries, and work on a global preventive health measure that helps make a real difference in our soldiers’ lives, and eventually, civilians as well. Throughout this time, I have also been fortunate to eat lunch with my wife on most days — even as a busy, military physician.Credits :—A Good Night’s Sleep for Soldiers: One U.S. Army Doctor’s Career | NEJM CareerCenter

Marketing is about trade-offs. You want to know where you want to focus your efforts and dollars for the highest reward. So, first thing I’d do is look into whether the extra price would likely pay for itself and even lead to profit for my business.More foot traffic is great exposure, but is your store designed to attract and convert that foot traffic? I live in Philadelphia, and in the high-traffic areas, I see a higher percentage of retail and restaurants with pretty amazing displays and branding. My first concern would be, can your storefront compete for attention in that competitive environment, or will it lose most of that traffic to impulse buys?Where you want to put most of your Marketing dollars will likely be near the decision point for your customers. When do your customers choose to come in and see you? Is it an impulse buy, or does this happen as the result of a triggering event or process? Will people conduct an online search, or will they ask their friends for a referral?Generally, wherever most of your ideal customers recognize that need is where you want to be.Hope that helps!