Affordable Care Act, The Marketplace

In last week’s blog I gave you ACA (Affordable Care Act) in a nutshell.  This blog is designed to be part II to las week’s blog.  Our intent is to offer you a bit more insight as to how the Marketplaces, created by ACA,  are supposed to work.

First of, a Marketplace, or commonly referred to as an Exchange, is a place in the internet where everyone eligible for ACA may go and purchase their health insurance policy.

Before I go any further, let me refresh your memory as to whom is eligible for ACA.  Eligibility is very simple, you must be less than 65 years of age, a legal resident of the United States, and not be in prison.

Now there are some exemptions to the law and these are as follows: individuals who are covered under a company’s group policy, a veteran’s health plan, if you have a plan bought by you that meets the criteria of the bronze plan,  those who qualify for medicare or medicaid, children on the CHIP program, American Indians, yearly income below $10,000 for individuals, $20,000 for family, if you have to pay more than 8% of your income towards health insurance after employer contributions or tax credits, members of the Military, members of Congress, the President and if your dead.  I can assume that if you’re reading this blog, at least you’re not dead.

For the rest of us, to include the self employed, dependent family members, individuals whose employer have decided not to offer an insurance program, and everyone else not mentioned in any of the above categories, we have the Marketplace.  Side note, I did not mention the undocumented immigrants, only because they are not included in any of the health programs available to the rest of us.

So what is in the Marketplace?  Good question, glad you asked.  First let me tell you that there are two types of market places, actually four, there is the Federally run and the State run programs, and within those there is a Marketplace for individuals and their family and then there is the SHOP, which is a Marketplace for businesses with less than 50 employees.

Confused yet? Don’t be! Right now we are just going to speak about the Marketplace for the individual and their family.

I must add that not all states will have a Marketplace online, such as Florida.  So, if you are a resident of a State without a Marketplace, you can access the Federally run program.

So, back to the previous answer.  A Marketplace is an internet portal where, by putting your pertinent information, you will be able to seek, and maybe find, a premium discount.  You will be able to find out if you are eligible for a tax credit, and you will also be able to purchase your health insurance.  All Health Insurers who are licensed in your state will appear in the Marketplace.

I know your next question; so how does this work?  Well, each Marketplace, whether Federal or State, is connected to the IRS; yup! no more cheating on your taxes; once you put in the information requested you will be crossed referenced with the IRS servers and… Bingo!!! you are told if you are eligible for a premium discount, and if you are eligible for a tax credit.

Now you’re beginning to salivate; premium discounts and a tax credit to boot.  Well, not so fast, you may either get one of the two or none.  It all has to do with your yearly household income and the number of family members.  Again, the Marketplace figures all of that out for you.  If you are eligible for a premium discount you have the option of getting it right then and there or later on as tax write off.

So you have now entered all of the tedious information requested from you and you are told that you are eligible for a premium discount, you now go to the next phase, which is choosing which insurance policy best suits your family.  You will have a pick from four basic policies, Bronze, Silver, Gold and Platinum.

For the sake of numbers, let’s say that your family premium discount is $300 a month and you choose a program that will cost your family $500 a month; you will have to out-of-pocket the the balance of the monthly premium of $200.  Now lets reverse the scenario; let’s say that your premium discount is $300 a month and you choose the bare minimum program, and the premium on that program is $200 a month. Well, now you do not have to out-of-pocket one red cent.

Some families, depending on their income and family structure, may be eligible for a tax credit if they choose to pay for a policy whose premiums are above the allotted premium discount.  Once again, the Marketplace will figure it all out for you.

In a nutshell, this is the way that it will play out for most middle class families who do not enjoy the umbrella of a company group plan.

Before a I let you go so I can begin working on with my next blog, there are a couple of points which you should be aware of.  First, the only criteria to purchase health insurance after January 1st, 20114, is, age, if you are a smoker, state where you reside and family component.  So, if you are not in jail, an undocumented immigrant or dead, you are now able to obtain health insurance regardless of your health condition.  Second, don’t fret, it’s not as complicated as it seems, that’s why we’re here to help.

If you have any questions, are still confused, or just don’t want to think about it, send us an email to  We will try to answer your questions to the best of our ability, then send you on your way to the insurance program that best fits you and your family.

Long airport waits cost economy, travel group says


Lines for international passengers waiting to go through customs and immigration at Miami International Airport have been so lengthy that airport workers have handed out water to tired travelers. The airport has installed televisions to keep people entertained and is working to quicken the process.

Those waits — approaching a maximum of five hours in Miami earlier this year — are not just annoying to passengers, a travel-industry group said Wednesday. The delays could also cost the U.S. billions of dollars.

In a report released Wednesday, the U.S. Travel Association argued that long lines and delays to enter the country could cost the economy more than $12 billion a year and thousands of jobs. That’s both because of money not being spent during the wait in line — $416 million — as well as $11.8 billion in potential spending lost because travelers decided against coming to the U.S. because of the entry process.

The report called for several changes, including:

• Hiring 3,500 more U.S. Customs and Border Protection officers.

• Arranging schedules to make sure CBP officers are working at the busiest times.

• Adding technology to reduce the burden on officers.

• Reducing peak wait times by half and processing every traveler in 30 minutes or less.

Roger Dow, president and CEO of the nonprofit U.S. Travel Association, said during a conference call with reporters Wednesday that Customs and Border Protection officers work hard.

“They’re just under-resourced,” Dow said. “It’s like having one cashier at Costco during the holidays.”

While the U.S. has set a goal of 100 million international visitors annually by 2021, a lack of resources to adequately staff entry points could hurt that effort, the group said. Last year, 67 million international travelers visited the country; of those, 6.8 million came to Miami-Dade.

“The long process and the long wait times have travelers telling their friends that they’re going to avoid the U.S.,” Dow said.

The association examined data provided by CBP on wait times between June 2012 and May 2013 at five major international gateways: Miami, Chicago O’Hare, Washington Dulles, New York’s JFK, and Los Angeles. According to the report, more than 40,000 passengers at MIA waited longer than two hours to be processed during that stretch; at JFK, the number was 180,000.

Miami edged out JFK for the longest peak wait time: 4.68 hours in April 2013, just beating the 4.48 hours at JFK in December 2012.

Ken Pyatt, Miami-Dade Aviation Department deputy director of operations, said wait times have already improved by 5-25 percent since August 2012.

“I think we’ve taken some effective self-help measures that have improved the process,” he said.

Those include opening a dedicated security checkpoint for travelers with connecting flights who needed to be re-screened after going through customs and immigration; adding staffers to direct passengers to available CBP officers; and studying the most efficient ways to organize lines. CBP also helped by automating a form to streamline the arrival process, securing more overtime in the summer and scheduling shifts more efficiently, Pyatt said.

More relief is on the way. Miami International Airport has spent $3.5 million on 36 self-service kiosks that will allow U.S. citizens and Canadians traveling internationally to scan their passports rather than going to an inspector. The kiosks, which are expected to be installed by the Thanksgiving travel rush, will generate a receipt that an officer must read, but Pyatt said the actual interaction between passenger and officer will be reduced from an average of two minutes to about 15 seconds.

Miami also has the option to buy 36 more kiosks next year.

Pyatt said that after Chicago O’Hare installed similar machines, that airport saw more than 30 percent improvement in efficiency.

“Our operation is a little different, but we’re optimistic that we will be in that range,” he said.

Miami International Airport also was approved for a pilot program that would allow the airport to pay for overtime for CBP officers. The airport is still negotiating details with Customs and Border Protection. While MIA has identified up to $6 million for that program, Pyatt said he is confident the actual amount will be much lower thanks to self-service kiosks.

Pyatt said the airport is working hard — and dedicating money from the operating budget — to be proactive about addressing the long waits.

“We don’t want to give the impression that we’re immune to this and it’s not our problem,” he said. “We can’t physically hire and put customs inspectors in place. But we’re doing everything possible to work with them.”

Worship con Queso

How sensual delights prepare us for the eternal feast.
Carolyn Arends [ 8/29/2013 11:38:00 AM ]

here is a Tex-Mex restaurant in Houston I have visited on three occasions. Each meal has begun with chile con queso. The cheese at this particular restaurant is the most delicious food I have ever tasted.

With every bite, I have been overcome with gratitude to God for creating taste buds, cows, and human ingenuity. And that gratitude has led to praise.

Some folks understand this. Some think I’m kidding. And others are skeptical that such a carnal thing as a Tex-Mex appetizer could provoke genuine worship.

We Christians have a long history of mixed and sometimes openly hostile attitudes toward sensual pleasure. Saint Augustine is the fourth-century poster boy for our dilemma, struggling in Book X of his Confessions to rein in each of his five senses. He attempts, for example, to “take food at mealtimes as though it were medicine” and to “fight against the pleasure in order not to be captivated by it.”

Augustine is ever-vigilant that pleasure in created things never replace our desire for the Creator. His caution is well taken. But lately I’ve been discovering an emphatically propleasure voice in the writings of another Christian guide.

C. S. Lewis is known, of course, as a literary scholar, novelist, and apologist. He is also, consistently, a curator of pleasure. Where there is beauty to be received, music to be heard, laughter to be welcomed, and (especially) food to be eaten, Lewis attends, celebrates, scrutinizes, describes, and partakes.

In Letters to Malcolm: Chiefly on Prayer, Lewis argues that the pleasures derived from forest moss and sunlight, bird song, morning air, and the comfort of soft slippers are “shafts of [God’s] glory as it strikes our sensibility.” Our task is not to guard against sensual enjoyment, but to allow our minds to run “back up the sunbeam to the sun”—to see every pleasure as a “channel of adoration.”

Lewis even argues that there is no such thing as a “bad” pleasure—only pleasures “snatched by unlawful acts.” But he is not blind to the “concupiscence” (lustfulness) that so haunts Augustine. When our response to pleasure is greed instead of adoration—when we seek to grasp and possess rather than receive—our healthy cry of “This also is Thou” distorts into “the fatal word: Encore.”

In his introduction to The Four Loves, Lewis distinguishes between “Need-pleasures” and “Pleasures of Appreciation.” The enjoyment we feel upon receiving a Need-pleasure—water to quench thirst, for example, or the scratching of an itch—is intense but short-lived. But with Appreciation-pleasures—nonessential things that awaken us to delight, like delicious smells and tastes and scenes of beauty—the sensation intensifies over time. Greed—the repeated cry of “Encore!” to, say, rich black coffee or extra-creamy queso—may transform a Pleasure of Appreciation into a Pleasure of Need, draining out of it all the lasting enjoyment.

The answer, Lewis contends, is not to avoid pleasure but to “have” and “read” it properly: to receive it, openhanded, as both a gift and a message. “We know we are being touched by a finger of that right hand at which there are pleasures for evermore. There need be no question of thanks or praise as a separate event, something done afterwards. To experience the tiny theophany”—the small sign of God’s presence—”is itself to adore.”

In many respects, Augustine and Lewis are arguing two sides of the same coin. But there is a major point of divergence at the heart of their opposite orientations to pleasure. Where Augustine sees our sensuality as a liability to be managed until God “consign[s] both food and belly to destruction,” Lewis views every earthly pleasure as an apprenticeship in adoration for the sort of thing that will go on forever in heaven.

Biblical writers seem irresistibly drawn to an image—part metaphor, part promise—of “the sacred meal with God.” From the table prepared for the psalmist (Ps. 23:5), to Jesus’ story of a great banquet (Luke 14:15–24), to the Revelation 19 vision of a wedding supper, the Scriptures are filled with the anticipation of feasting together—in the presence of God—forever. The prophet Isaiah (25:6–8) takes particular pleasure in this vision:

On this mountain the Lord Almighty will prepare
a feast of rich food for all peoples,
a banquet of aged wine—
the best of meats and the finest of wines.
On this mountain he will destroy
the shroud that enfolds all peoples,
the sheet that covers all nations; he will swallow up death forever.

For Lewis, earthly meals are chances to practice the gratitude and adoration that will accompany our everlasting feast with God. Just as trials train us in patience, pleasure trains us in worship. Every sensual enjoyment (properly received) is a “tiny theophany”—a chance to “taste and see” that God is good, and a reminder that there is a whole lot more where that came from.

I rest my queso.

Affordable Care Act In A Nutshell

You might as yourself; if Sora Global provides health insurance for the international community, why is he talking about the Affordable Care Act (or Obamacare, as most people call it)?  And no, this is not a political opinion blog.  I will not be offering my wisdom on whether it’s going to work or not, that’s for another time.  Anyway, regardless of my personal opinion on the subject, on January 1st of 2014 we will all be affected by this law in one way or the other.  Well, maybe not all; if you are the President or a member of congress you will be spared, but since most of us are neither we need to be aware so that we don’t get caught with our… whatever, down.

This blog will be very brief, I will only be offering the bare bones facts about the program, if you want to find out any more on the subject, you can call or email me and I will be glad to give you a more detailed account.

We can start by saying that we will all fit into one of three categories:

An employee of a company of 50 employees or more, where the employer will be required to offer you, not your family health insurance.  In this scenario, in order to qualify for your company’s health program you must be a full time employee (30 hours) or more.  The company may elect not to pay for your insurance in one of two ways: 1) Buy reducing your hours to less than 30 (a company is not obligated to pay for part time employees), or 2) By simply denying you, the employee coverage.  If the company opts for option 2, then the company is penalized by the government for a set amount per employee.  Your are now on your own to find affordable healthcare. Mind you, the company can opt to subsidize some of your healthcare cost by including a certain amount extra on your paycheck.  This possible subsidy, offered by the company, could create a positive tax advantage for the employer which could possibly offset the penalties set by the government.

A company employing  less than 50 employees, the employer is not required to offer you health insurance, and will not be penalized for doing so.  In the event that the employer does offer its employees health insurance, the employer can chose the company, how much of the premium is paid by you and if your dependents can be covered, or not.  If this employer decides to offer his employees coverage and said employees are earning within the poverty level, the employer may be eligible for a tax discount.   The drawback for you, the employee, is that if your health insurance is obtained through your employer you will not be eligible for possible premium discounts.  I’ll explain about these discounts when I talk about the individual or family policies.

So, let’s talk about what is going to be the bulk of us, those who are unemployed, self-employed, or whose employer has decided not to offer coverage; what’s going to happen to us?

We, and I mean we, I fit into one of those categories, are probably the most fortunate, we get to go online and chose to our heart’s desire.  The Federal Government and some States, Florida not being one of them, has set up what is called Marketplaces (In will speak in depth on this subject in my next blog).  A Marketplace has been referred to as Exchanges, and all that it is is a portal in the internet where you and I can go find our insurance coverage.  It’s that simple, huh! No, not quite that simple, that’s why you have and need me, but I’ll talk about that later on.

As of October 1st, 2013 the Federal Marketplace, for individuals as well as for small companies will go online.  At which time any of us can access it to find out our eligibility for discounts and costs.  Those are the discounts I spoke about in the last paragraph.  If you are within a certain income range and your family size is of a certain number, you may be eligible for an immediate discount on your monthly premiums.  How do you know if your eligible for the discount, simple, the Marketplace will take your data, cross-reference it with the IRS and “Bingo” you will be given a yes or no answer, and if the answer is yes, you will also be given a dollar amount.  Given you annual income and the size of your family you may also be eligible for a tax discount.

Who is eligible for the Affordable Care Act?  Well, anyone who is under 65 years of age, a legal US resident, is not in jail, and can afford to pay the premiums.

I know I made it sound simple, but I fear that it will not be as much.  That is why people such as myself, who are licensed insurance agents and have gone through the Marketplace and SHOP certifications are here to help you.

My next blog will speak to the Marketplace and Marketplace SHOP.  I will be offering more information as to eligibility, penalties and such.

In the meantime if you feel the need to ask questions, please feel free to do so at and we will be very glad to answer to the best of our ability.

As of October 1st, when the Marketplace goes online I will be able to offer more specific assistance and even get you started on your way to your new health insurance.

When you may still need a travel agent

Four cases where professional expertise beats DIY travel planning

By Catey Hill

Job site CareerCast recently put them on its “most useless professions” list, many consumers have stopped calling or visiting them, and even some within the industry worry they may soon be out of work. After all, when it’s so easy for consumers to plan and book their own travel online, does anyone need a travel agent anymore?

While “travel agents used to be mostly mom-and-pop, brick-and-mortar shops selling trips to Disney World and cruises and things like that,” that’s all changing, says Elias Garcia, a marketing specialist at travel company Global Basecamps. Many agents still provide such services of course, but fewer and fewer are doing so, because those package deals, as well as one-off plane tickets and hotel rooms — once more difficult for regular people to find and compare on their own — are now at most everyone’s fingertips, he says. Despite that, one in four airline tickets is still sold by brick-and-mortar travel agents, according to industry estimates. (70% is for corporate travel and the rest leisure.)

While the professions prospects may be dimming, the ranks of a certain type of travel agent — one who puts together complicated and unique itineraries for wealthier consumers — are growing, experts say. These “travel consultants” distinguish themselves by being experts on the destinations they sell trips to. A sample trip, for instance, might include dinner with a local family, tickets to a VIP event, a boat rental, and a tour around town with a trustworthy guide. According projections from the Bureau of Labor Statistics, overall employment of travel agents is projected to increase by 10% from 2010 to 2020, but the agency notes that “job prospects should be best for travel agents who specialize in specific destinations or particular types of travelers, such as groups with a special interest or corporate travelers.”

“Generalists haven’t survived particularly well,” says Tony Gonchar, the vice president of American Express Travel; instead, more travel agents today are specialists, tending to focus on specific destinations or experiences, he says. “They’ll know that you should go to this restaurant at this time of day and sit in this seat for the best sunsets,” he says, adding they may even have an existing relationship with the restaurant’s manager.

The role of a travel agent has changed so much, in fact, that some don’t typically do the types of tasks that used to be standard: “When clients call me for a flight, I tell them ‘you don’t need to call me for that,’” says Denver-based travel consultant Joseph Sobin, noting that it’s often cheaper for clients to book flights directly online. “But if you want to know what to do and how to do it when you get there, call me for that.” And many travel agents now differentiate themselves in a whole new way: Rather than competing on price, “we focus on a service-oriented experience where we meet clients as soon as they step off the aircraft, are on call 24/7 and take responsibility if something goes wrong.” says Richard Bexon, the COO of Costa Rica-based Costa Rica Vacations.

For their part, consumers seem to be responding: Roughly one in five consumers with $100,000 or more in household income used an agent to book a trip in the past year, according to a study by research firm Harrison Group and American Express Publishing. That number is up from one in seven in 2009, and Jim Taylor, vice chairman of research firm Harrison Group, expects it to rise even more in the coming years.

Of course, you’ll pay for their services, though not necessarily out of your own pocket: Traditional agents are often compensated by the vendors they use, getting 7.5% to 15% of the total cost of the travel booked with that vendor, with the average being about 10%, says Sobin. The new breed of agents, Sobin says, often charge a one-time or hourly fee. And many may be paid both ways. Ask your agent how he or she is compensated to make sure you’re getting a fair deal; as with financial advisers, agents who are compensated by vendors may be biased toward a certain type of tour, even if it’s not the best one for you.
Beach near Nosara, Costa Rica.
Bottom line: Many people don’t need a travel agent. This is particularly true for those taking simple trips to well-known destinations — like flying to the Caribbean to stay at a resort — since it’s relatively easy and often cheaper to book the hotels, flights, cruises, cars and travel packages for trips like this online yourself. Internet-savvy individuals willing to do their research — to separate the good hotels, events and attractions from the bad — probably don’t need the help of an agent either.

When should you reach out to a travel agent?

• If you want someone to call when things go wrong: Nearly 70% of affluent consumers who use travel agents say what’s most important is that an agent protect them or help them when things go wrong with a trip, according to a study by Harrison Group and American Express Publishing. “Travel agents are a kind of insurance,” Taylor say. For many agents, this means being on call at all hours.

• If you’re pressed for time or just want to avoid hassles: About one in three travelers feels overwhelmed by the amount of travel information online, according to the American Express Spending & Savings Tracker, a survey that looks at Americans’ spending and saving habits. If you’re in this group, or simply don’t have time to deal with trip planning, travel agents can do it all for you. Tell them where you want to go and the types of things you like to do, and they can put together a list of options for you and book them, saving you time. Agents are particularly useful to travelers who plan to take complicated trips, or go to multiple destinations or with multiple generations, says Gonchar.

• If you want more of a local experience: Good travel consultants have relationships with locals in your destination, experts say, so they can do things like arrange for you to have dinner with a local family, recommend restaurants and pubs that residents like but tourists don’t tend to know about, or find a tiny B&B for you to stay at where you can get to know the owner.

• If you want a highly customized experience: More and more travelers are asking for one-of-a-kind trips specifically tailored to their likes, says Gonchar. A foodie might want something like a private cooking class in Italy, a meet-and-greet with a chef she’s been reading about and a table in the private wine room of a restaurant. While she might not have the connections to get this done herself, a travel agent with deep local knowledge might be able to make this happen for her, Gonchar says.

Sobin says that the best way to find a travel agent is to get referrals from people you know. If you don’t know anyone, call a handful of agents and ask them questions about the destination you want to go to and the kinds of things he or she recommends there, to see if the agent has the insider knowledge and connections to make your trip unique. Experts also recommend that you ask for referrals and then call previous clients to ask about their experiences.

Security Message for U.S. Citizens No. 76: Bomb Blast in Nasr City

September 5, 2013

The U.S. Embassy has received reports of a bomb blast in Nasr City, Cairo, that targeted Egypt’s Minister of Interior. Security Forces are at the scene and the investigation is ongoing. This incident serves as an indicator of the tension and volatility that continues to exist throughout the country. Though the size and ferocity of demonstrations has subsided over the past few weeks, there have been several instances throughout the county of the targeting of police stations. The U.S. Embassy urges U.S. citizens to avoid areas where incidents or unrest have recently occurred. Additionally, U.S. citizens should recognize that police stations and security forces may be targeted, and should avoid unsecured areas where police or security forces are congregated.

As a matter of general practice, U.S. citizens should avoid areas where large gatherings may occur. Even demonstrations or events intended to be peaceful can turn confrontational and possibly escalate into violence. U.S. citizens in Egypt are urged to monitor local news reports and to plan their activities accordingly.

The Embassy reminds U.S. citizens to review their personal security plans and remain alert to their surroundings at all times in Egypt. For the latest security information, U.S. citizens traveling abroad should regularly monitor the Department of State’s Internet website where the Worldwide Caution, Country Specific Information for Egypt, Travel Warnings, and Travel Alerts, can be found. Follow us on Twitter and the Bureau of Consular Affairs page on Facebook, and download our free Smart Traveler App, available through iTunes or Google Play to have travel information at your fingertips.

Up-to-date information on security can also be obtained by calling 1-888-407-4747 toll-free in the United States and Canada, or, for callers outside of the United States and Canada, on a regular toll-line at 1-202-501-4444. These numbers are available from 8:00 a.m. to 8:00 p.m. Eastern Time, Monday through Friday (except U.S. federal holidays).

U.S. citizens are advised to maintain valid travel documents and enroll with the Department of State or the U.S. Embassy Cairo through the State Department’s Smart Traveler Enrollment Program website. If you enroll we can keep you up to date with important safety and security announcements and can also help your family and friends get in touch with you in an emergency. U.S. citizens without Internet access may enroll directly with the nearest U.S. Embassy or Consulate.

For further information, U.S. citizens may call the Embassy’s American Citizens Services Unit at 2797-2301 during business hours, Sunday to Thursday from 8:00 a.m. until 4:30 p.m. Please refer to the American Citizens Services Facebook page at: For emergencies after business hours and on weekends and holidays, U.S. citizens can contact the Embassy Duty Officer via the Embassy switchboard at 2797-3300. The Embassy is located at 5 Tawfik Diab Street (formerly known as Latin America Street), Garden City, Cairo.

Collett Joins Willis to Expand Financial Solutions Division in Hong Kong

As per Insurance Journal

Willis Group Holdings announced the appointment of Les Collett to establish a Financial Solutions office in Hong Kong, effective from October 1, 2013. He joins Willis from Standard Bank in Hong Kong where he is currently Head of Loan Syndications – Global Markets Asia.

Collett is an experienced banker and has held senior positions in London prior to moving to Hong Kong in January 2007. Paul Davidson, CEO of Willis Financial Solutions, explained that he would “continue the successful development of our political and trade credit risk practice in Asia.

Davidson added that Willis already has a strong “position in the region from our existing operations in Singapore. The continued expansion and development of international trade in Asia presents significant opportunities for our clients, as well as regulatory capital management challenges.”

Surgeons Defend ‘Smile Surgery’

By Jeyup S Kwaak

The need to smile all day at work is turning young South Koreans towards a surgical procedure that lifts the corners of their mouths.

Cosmetic surgeons in Seoul say they are seeing a sudden rise in demand for the so-called smile surgery this year among men and women in their 20s and 30s, most of whom are concerned about facing criticism at work because of their expressionless miens.

“Even when you are looking like your normal self, people keep asking you: ‘Why are you frowning?’” said Kwon Taek-keun, a plastic surgeon in practice for 20 years and known in professional circles as the first in the country to popularize the procedure. “That’s a lot of stress.”

The pictures and video clips that Dr. Kwon’s clinic, Aone Plastic & Aesthetic Surgery, posted online have caused a controversy in recent days, attracting derision from some media reports and the blogosphere, and comparisons to the Joker character from the Batman series.

But the cosmetic surgeons who carry out the procedure argue people, young and old, come psychologically scarred by hurtful remarks about their naturally downturned lips, especially if they have customer-facing roles. Services-industry workers such as flight attendants and consultants frequent the clinics, according to the surgeons.

The need to smile all day at work is turning young South Koreans towards a surgical procedure that lifts the corners of their mouths.

Cosmetic surgeons in Seoul say they are seeing a sudden rise in demand for the so-called smile surgery this year among men and women in their 20s and 30s, most of whom are concerned about facing criticism at work because of their expressionless miens.

“Even when you are looking like your normal self, people keep asking you: ‘Why are you frowning?’” said Kwon Taek-keun, a plastic surgeon in practice for 20 years and known in professional circles as the first in the country to popularize the procedure. “That’s a lot of stress.”

Goldenview plastic & aesthetic surgery clinic Before and after “Smile Surgery”
The pictures and video clips that Dr. Kwon’s clinic, Aone Plastic & Aesthetic Surgery, posted online have caused a controversy in recent days, attracting derision from some media reports and the blogosphere, and comparisons to the Joker character from the Batman series.

But the cosmetic surgeons who carry out the procedure argue people, young and old, come psychologically scarred by hurtful remarks about their naturally downturned lips, especially if they have customer-facing roles. Services-industry workers such as flight attendants and consultants frequent the clinics, according to the surgeons.

Goldenview plastic & aesthetic surgery clinic Before and after “Smile Surgery”
Known in the West as “Valentine anguloplasty” after the heart shape of the removed muscle tissues at the lip’s edge, the smile surgery was first developed as a part of an overall anti-aging face lift, Dr. Kwon and other surgeons say. Tightening the drooping face parts didn’t restore the lips to the original upturned position, making an extra procedure necessary, they said.
“It is going against gravity,” said Dr. David Song of Golden View Plastic Surgery. He added that he observes the patient in different poses, such as in a seated position or while lying down, to get the most natural angle for the lips. “We’re restoring the original lip line.”
Though South Koreans are some of the most avid users of plastic surgery in the world – the country has the world’s highest number of cosmetic surgery procedures per capita, according to the International Society of Aesthetic Plastic Surgeons – the area around the mouth was relatively unexplored, the surgeons say.

The age demographic of clients asking about the smile surgery became substantially younger, the surgeons say, after some celebrities’ smiles began attracting public scrutiny earlier this year. Few have admitted to going under the knife for a perkier expressions.
But some clinics now publicize more than 15 different procedures for the lip and the mouth, including enlargement, reduction and gum exposure reduction. The most common procedure? The smile surgery, according to Dr. Cha Seung-youn at ZIEN Plastic Surgery.
“Your eyes and mouth make up the most of your facial expression,” said Dr. Cha.

With a typical price tag of up to $2,000, the “natural” killer smile doesn’t come cheap, and Dr. Song warns that consistent care will be needed over a three-to-six months of the recovery period.

SWEDEN: How Sweden will deal with EU cross border healthcare

Sweden is decentralizing the operation of cross-border healthcare to the regions.

It often tops the world rankings for the best healthcare. The Swedish healthcare system is universal and free for all. It is government funded and decentralised. The problems are few, but for some operations in some regions there are queues for treatment and the relatively high cost of private Swedish healthcare means that patients can choose many EU countries where they could get quicker treatment at prices that would be lower than the local costs; although they would still have to pay for accommodation and healthcare so numbers taking advantage are not expected to be high.

While Swedish counties normally pick up the tab for health care, the central state has administered and paid for health care purchased in other EU countries. But that system is set to change on October 1st, although the state has promised to earmark funds in the autumn budget for the counties to dip into to ease the transition.

Sweden is divided into 290 municipalities and 20 county councils, which include the regions of Gotland, Halland, Västra Götaland and Skåne.There is no hierarchical relation between municipalities, county councils and regions, since all have their own self-governing local authorities with responsibility for different activities. The only exception is Gotland, an island in the Baltic Sea, where the municipality also has the responsibilities and tasks normally associated with a county council.

In theory, patients will get more choice on what treatment to seek abroad, but nobody is sure what the result of transferring the decision-making process to the regional level will be. The regions could be very strict, or if there are local queues, could pay for treatment and other costs too. The decision of who gets what from whom will transfer over to the counties, which will confer in reviewing patient applications with the National Insurance Agency.

Hasse Knutsson of the Swedish Association of Local Authorities and Regions (SALAR) says that while patients can apply retroactively to have their treatment or operation paid for by Swedish authorities, there is never a guarantee that the full cost will be reimbursed, “If replacing a hip costs 55,000 kronor in Sweden, but you get it done in Germany where the price is 70,000, you would only get back 55000.”

In 2012, 3,000 Swedes got money back for health care obtained abroad, but 400 people who applied for coverage were rejected. Swedish patients most commonly seek help with skin conditions and eye problems, but there are signs that ailments that Swedish health care has little capacity to treat are pushing patients over the borders.

Hasse Knutsson of SALAR admits, “It is difficult to speculate about what effects this reform will have, both in terms of the number of people leaving for treatment and people coming here.

There may be more patients coming here.” – See more at:

Euro-zone factory rebound spreads to Spain, Italy Recovery seen in countries hit by fiscal crisis

By Alex Brittain

A recovery in the euro-zone manufacturing sector broadened in August, as factory activity picked up in countries such as Spain and Italy that have suffered long downturns sparked by the region’s fiscal crisis.

The latest signs of growth in these countries, as well as bail-out recipient Ireland, helped euro-zone manufacturers overall grow at the fastest rate in over two years, said data provider Markit in its monthly report Monday.

Growth accelerated in Germany, the euro zone’s biggest and strongest economy, and resumed in Spain after more than two years of decline. Factory activity in crisis-hit Greece shrank, but at the slowest rate in more than three years. The French factory sector ebbed, as it did in July.

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The release adds to a growing pile of evidence that the euro-zone economy, which emerged from a shallow, 18-month downturn in April, will continue to grow in the third quarter. Growth prospects remain poor, though, as governments continue with austerity policies and consumers and businesses refrain from spending freely. Unemployment is near record highs.

Markit said the euro-zone purchasing managers’ index for manufacturing rose to 51.4 in August from 50.3 in July. The figure is a slight upward revision from the 51.3 previously announced, and pushes the sector further above the 50 index threshold that indicates month-to-month growth.

“Manufacturing in the euro area continued to show signs of recovery in August,” said Chris Williamson, chief economist at Markit. “What’s especially encouraging is that the upturn is broad-based,” he added.